Could some pharmacists be the victims of their own misplaced expectations?
Dennis MillerIn Part 1, I wrote about the disillusionment some pharmacists feel about their jobs - the ones who feel starved of creative opportunities and professional satisfaction, and feel devalued by the mechanistic point of view that defines them as pill-processing machines. Now I want to look at another source of disillusionment: the faulty premises of modern medicine, with its focus on quick fixes rather than on basic disease prevention.
See also: Is job satisfaction too much to ask?
If you are the type of person who carries on a continuing conversation in your brain about whether people need so many pills and whether they wouldn’t be better off with major changes in lifestyles, you might not be too happy as a chain-store pharmacist. On the other hand, if you like being slammed for your entire shift so that you day goes by more quickly, you just might be able to tolerate working for a chain.
A district supervisor once told me that I think too much about what I’m doing. He implied that I should just function on autopilot from the time my shift began until the time it ended. I guess my frustration showed.
In my opinion, there is a wide variation in the rationality and usefulness of the prescriptions we fill, and it spans the entire spectrum from the best and most useful drugs in the pharmacy to those that seem to be no more than pure marketing hype.
To my way of thinking, modern medicine at its best is exemplified by the use of insulin to treat type 1 diabetes and by the proper use of antibiotics to treat serious infections (not the common cold). Insulin is a life-saving drug. People with type 1 diabetes would die without access to this drug. Antibiotics, when properly used, can be truly miraculous drugs. Insulin and antibiotics are the drugs that initially gave modern medicine its exalted status.
In contrast to dispensing insulin and antibiotics, how do you feel about filling a raging river of prescriptions for anxiety, depression, psychosis, insomnia, constipation, excess acid, obesity, menopausal symptoms, and erectile dysfunction?
See also: Are pharmacists pill-happy?
Have you noticed that a lot of new medical “disorders” appear to be springing up lately?
Its critics believe that the pharmaceutical/medical establishment is engaged in a massive effort to label common life experiences as “disorders” in order to sell more pills.Could some interested parties be uneasy about the legitimacy of these diagnoses? Is that why the term “disorder” is used so freely - to justify attempts to win public acceptance for certain products?
This is medicalization and pathologization of normal human experience.
What’s your opinion of the onslaught of prescriptions you fill every day for drugs that treat elevated blood pressure, elevated blood sugar (in type 2 diabetes), and elevated cholesterol?
Have you ever thought that the focus on these conditions should be on prevention through lifestyle changes, such as changes in diet, increased physical activity, etc.?
When you fill prescriptions for the treatment of cancer, do you ever wonder whether cancer might be largely a preventable disease resulting from the ubiquity of synthetic chemicals in our food, air, and water, and in factory workplaces?
The ultimate fulfillment for healthcare professionals should come from teaching people how to prevent disease. The treatment of existing disease may be much more financially lucrative, but it delivers far less professional satisfaction than you get from preventing disease in the first place or successfully transforming root causes.
Do you think pharmacists find fulfillment in the staggering number of prescriptions they fill each day? Or would pharmacists find it more satisfying to teach customers about lifestyle changes that could lessen or eliminate their need for drugs that treat diseases of modern civilization?
Of course, a drugstore is not the ideal setting for educating the public about the importance of lifestyle changes. This should be done in schools, starting with very young children. In my opinion, intensive education about prevention would, in a huge number of cases, trump pills.
Even so, healthcare professionals and public schools are handicapped by the Standard American Diet (SAD), with its preponderance of processed foods.
How many times have you heard this advice: “Shop the perimeter of your grocery store”? It is around the perimeter that fresh foods and whole foods are available (fresh fruits and vegetables, fresh meats, etc.). The inside aisles of the typical supermarket consist of processed foods in boxes, jars, and cans.
In my opinion, modern medicine is very often unsatisfying and unfulfilling because it is:
1. Mechanistic. Modern medicine views the human body as a machine apart from the natural world.
2. Reductionistic. Modern medicine focuses on illness at the molecular and cellular levels, rather than viewing human illness as a discordance between our genetic makeup and life in modern societies.
3. Paternalistic. For centuries physicians have taken a doctor-knows-best approach to their patients, and patients have all too often responded with passive subservience.
4. Militaristic. Human healthcare is seen as a constant war on disease, deploying potent weapons known as pharmaceuticals.
You can see where I’m headed with all this. If you’re feeling frustrated, disillusioned, dissatisfied, and unfulfilled, you might want think about another approach to the practice of pharmacy – one that enables you to collaborate with your patient in the creation of health, rather than merely in the management of disease.
Dennis Milleris a retired chain-store pharmacist living in Delray Beach, Fla. He welcomes feedback at email@example.com. His books "Chain Drug Stores are Dangerous" and"Pharmacy Exposed" are available at Amazon.com.