After working a grueling 12-hour shift, I’ve often heard pharmacists admit things they would not otherwise admit. It’s at times like these that pharmacists sometimes let their hair down and make comments like, “If people would just take better care of their health, they wouldn’t need nearly as many pills.”
I suspect that every pharmacist has heard one or more of his/her technicians comment on the huge number of pills that our customers take. Techs often say something like this: “I wonder how Mrs. Smith has any room left for food.”
But we pharmacists typically shrug our shoulders and laugh nervously because we realize the system has a powerful preference for pills rather than prevention. This attitude is like that old saying: You can’t fight city hall. In the world of pharmacy, a similar dictum is: We can’t fight the powerful corporations that long ago concluded the treatment of disease is infinitely more lucrative than the prevention of disease.
Many pharmacists say that our healthcare has very little to do with health. Our system is about pills, not health.
The Cult of Pharmacy
In my experience, it is usually bad practice to say, in a group of pharmacists, that our customers would likely need far fewer pills if they learned to take care of their health. That view challenges pharmacy orthodoxy. It is pills that pay our salaries, not dietary and lifestyle advice about preventing disease.
There is a strong bias in drug stores toward treatment of diseases with pills, rather than toward the prevention of disease via lifestyle and dietary changes. Employers usually expect retail pharmacists to maintain a completely positive attitude toward the pills we dispense, rather than question whether the current system is the best way to make people healthy. Pharmacists who worry about potential adverse effects of drugs or who prefer prevention over pills are often seen as heretics who should be excommunicated from the profession.
Should we shun or ostracize our colleagues who are more enthusiastic about prevention than pills? Are these pharmacists “disloyal” to our profession?
Are we harming our customers by being complicit in the mystification of health? The pharmacist’s mechanistic, reductionist, and product-centered view of health convinces people that health is dependent on the technical expertise of people in white coats rather than on fundamental changes in diets and lifestyles.
I have seen pharmacists give positive and reassuring answers in response to customers’ questions about some drugs even though I often suspect those pharmacists would never take those drugs or recommend them to a family member or close friend. Pharmacists should critique the pills we dispense as aggressively as some pharmacists critique the football and basketball teams at their alma mater.
Up next: The true science of pharmacy