Building an integrative pharmacy practice: Learn as you go


Interested in finding out what integrative/functional pharmacy is all about? Here's a list of resources to get you started - and a thought to take away.

Mark BurgerI hope you have become at least mildly interested in the concept of The New Pharmacy. I've tried to share some resources for obtaining knowledge, focusing on the most common aspects of the functional pharmacy approach to health; how to set up your practice; how and when to follow up with patients; and what to expect from patients, doctors, and the community.

See also: The New Pharmacy, Part 5: What we're up against

In this installment I'd like to suggest some health-and-wellness resources to help you stay in front of the rapidly expanding body of knowledge and research connected with functional medicine/integrative pharmacy.

Bear in mind that you're not likely to see the positive studies in the allopathic medical literature. You're likely to read or be shown negative papers from the medical literature and from lay publications such as The New York Times, The New Yorker, The Atlantic, not to mention comments posted at countless blog sites and in social media.

Nonetheless, you must know how to evaluate clinical trial results. You should review the terms NNT (number needed to treat), NNH (number needed to harm), RR (relative risk), AR (absolute risk), CI (confidence intervals), risk vs. benefit, risk/benefit/cost, etc. Only when you have a working knowledge of these terms will you be able to evaluate the claims made for drug therapies or the value of studies examining nutritional interventions.

Lastly, remember: Natural/nutritional/herbal/vitamin/mineral studies are difficult to find; there is no financial reward for funding a study of these products, since they are not patentable and are therefore nonproprietary.

See also: Case study from an integrative pharmacy

The following are a few links to more information about these concepts.

Number needed to treat, etc.

• Austin Frakt and Aaron E. Carroll, "Can This Treatment Help Me? There's a Statistic For That," The New York Times, January 26, 2015.

• Austin Frakt and Aaron E. Carroll, "How to Measure a Medical Treatment's Potential for Harm," The New York Times, Feb. 2, 2015.; The NNT, developed by a group of physicians to produce “quick summaries of evidence-based medicine”; Centre For Evidence-Based Medicine (CEBM), UK; “Number Needed to Harm,” Bandolier, evidence-based healthcare information site, UK

Other information websites

There are plenty of websites to help us keep abreast of studies and news reported in print and online through magazines, newspapers, and blogs, as well as mentions in Facebook posts, Tweets, and other minimalist media. Here are some sites that interest our practice the most:
(formerly Natural Standard and Natural Medicines Comprehensive Database) [New England Journal of MedicineJournal Watch] 



Here are some titles that might help you start thinking about reasons for establishing a New Pharmacy practice.

1. Angell, Marcia, MD. The Truth About the Drug Companies: How They Deceive Us and What to Do About It (Angell is former Editor-in-Chief of the New England Journal of Medicine)

2. Balch, Phyllis A., CNC. Prescription For Natural Healing: 5th Edition

3. Buhner, Stephen Harrod. Vital Man: Natural Health Care for Men at Midlife

4. Buhner, Stephen Harrod. Herbal Antibiotics, 2nd Edition: Natural Alternatives for Treating Drug-resistant Bacteria

5. Critser, Greg. Generation Rx: How Prescription Drugs Are Altering American Lives, Minds, and Bodies (Critser also is author of FatLand: How Americans Became the Fattest People in the World)

6. LaValle, James B., RPh, MS, CCN, DHM, DHPh. Cracking The Metabolic Code: 9 Keys to Optimal Health

7. LaValle, James B., RPh, MS, CCN, CMD, DHM, DHPh, and Pelton, Ross, RPh, CCN, IAACN. The Nutritional Cost of Drugs: A Guide to Maintaining Good Nutrition While Using Prescription and Over-The-Counter Drugs

8. LaValle, James B., RPh, MS, CCN, CMD, DHM, DHPh. YourBlood Never Lies

9. Ross, Julia, M.A. The Mood Cure: The 4-Step Program to Take Charge of Your Emotions – Today

10. Watson, Brenda, CNC. The Road to Perfect Health: How Probiotics Balance Your Gut and Heal Your Body

11. Yance, Donald R., CN, MH, RH (AHG). Adaptogens In Medical Herbalism: Elite Herbs and Natural Compounds for Mastering Stress, Aging, and Chronic Disease 

12. Zand, Janet, OMD, Lac, and LaValle, James B., RPh, MS, CCN, DHM, DHPh. Smart Medicine for Healthier Living

So there's our list. It barely scratches the surface of the resources out there, but it's a start.

Here's one more suggestion: Sign up for all the e-mail newsletters available from all the manufacturers. You can unsubscribe from the ones that you don't find helpful. Subscribe to some functional medicine magazines, and share what you learn with your patients, your doctors, and your peers. Don't be afraid to challenge the status quo, even if the medical status quo is powerful.

The takeaway

The contemporary approach to medicine and pharmacy is changing more quickly than you realize. More and more doctors and pharmacists are going to seminars sponsored by the American Academy of Anti-Aging and the Institute for Functional Medicine, taking the courses, and discovering what true healing is all about. Once they see how powerful is this approach, they never go back to the old ways. 

Mark Burgerowns Health First! Pharmacy and Compounding Center in Windsor, California. He welcomes your questions and comments at

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