The new pharmacy: these 21st-century health centers combine the full range of pharmaceuticals with alternative treatments, natural products and advice from nurses, nutritionists and naturopaths

Natural Health, April, 2004 by Nora Isaacs

Instead of a harried lunch hour spent rushing from the drugstore to the health-food store to the bookstore, imagine this scenario: You walk into your local pharmacy to drop off a prescription for antibiotics. While you wait, you have a cup of tea and research Chinese medicine at a computer kiosk. Next, you take a seat at a blood-pressure machine for a quick reading. You ask the on-call naturopath about the best remedy for your husband's insomnia. When your prescription is ready, the pharmacist advises you on what herbs interact with your medication. It sounds like a fantasy, but "natural" or "integrative" pharmacies--providing everything from aestheticians to Zoloft--are popping up across the country. They often serve as community centers, offering workshops, lectures, libraries and a rotating staff of expert consultants for the health-conscious consumer.

This is the store of the future," says Paul W. Lofholm, Pharm.D., clinical professor of pharmacy at the University of California at San Francisco. "Patients will seek out those who have expertise on their staff to find out what they have to offer--whether it's nutrition, medication, or education--all under the rubric of wellness."

spanning the spectrum

Driving the demand for this new model of pharmacy are the Baby Boomers, who came of age during the open-minded 1960s and must now struggle with the "less is more" policies of HMOs, which provide little if any preventive care. So it's no surprise that this generation has turned to complementary treatments. According to the AARP Public Policy Institute, 83 million Americans have used some form of complementary and alternative medicine, and the largest segment of CAM users is the 50-to-64 age group.

It makes sense that these consumers, highly educated and proactive about their health, are spurring on a new model of care. "Boomers are approaching health in a new way from the previous generation," says AARP spokesman Mark Beach. "They are willing to look at alternative medicines and explore other health-care options.

blurring the lines

According to the business model of the Boulder, Colo.-based Pharmaca Integrative Pharmacy, the answer is to transform small, traditional pharmacies into places where customers can get the best of conventional and natural medicines. After just four years, the company runs eight stores in Colorado, California, Washington and Oregon, and their top-selling products are evenly distributed between supplements and prescription medicine. "The lines between mainstream and counterculture are pretty blurred," says Russell Precious, Pharmaca's vice president of design and branding.

Pharmaca's stores are staffed with naturopathic doctors, nurses, nutritionists, herbalists, homeopaths and aestheticians. Pharmacists are highly knowledgeable about supplement use and drug/herb interactions. To maintain a neighborhood feel, the pharmacies include spaces for people to relax, sit, drink tea or study. Four of Pharmaca's locations are "heritage sites" that have been restored or enhanced, and three have compounding pharmacies. "In the '50s and '60s, everything used to be compounded," says Precious. "It's kind of a lost art that is being revived."

compound phases

A surge of interest in compounding pharmacies--where medication is customized to meet individual patient needs--can be seen in venues like Hickey Chemists in New York and ApotheCure in Dallas. This blend of science and art appeals to those who require traditional drugs but also want to maintain as natural a lifestyle as possible. Consumers can get custom compounds free of unnecessary ingredients, such as dyes, alcohol, preservatives, wheat and sugar.

"As one of the largest compounding pharmacies in the country, we have dealt with doctors of all disciplines, including M.D.s, D.O.s and N.D.s," says Bob Bishop, a compounding pharmacist at ApotheCure. "Most of the physicians we deal with use a more functional complementary approach to medicine. However, we formulate and compound any medication a doctor may prescribe for his or her patients. Because of the nature of what people demand, we have settled in the middle."

When a study released by the National Institutes of Health revealed that the combination of estrogen and progestin in Hormone Replacement Therapy could increase the risk of heart disease, many women asked for an alternative that carried fewer risks. In response, pharmacists at ApotheCure compounded natural HRT formulas.

the big box

While many shops, such as Willner Chemists in New York, prefer a smaller scale of operations, Elephant Pharmacy in Berkeley, Calif., has plans to become the first chain of large-scale integrative drugstores. "What Whole Foods is to Safeway, Elephant is to Walgreens," says Stuart Skorman, Elephant's chief executive officer. The success of Whole Foods, which Skorman helped create, made him realize there was a void in "big box" pharmacies that offered both Eastern and Western methods of healing.

Elephant's flagship store includes almost everything you would find in a conventional pharmacy, along with herbal and dietary supplements, and natural cosmetics and body-care products. But the store's biggest selling point is its focus on education, which has been incorporated into every facet of the shopping experience. This includes fact sheets that give a rundown of an item's pros and cons, and books placed adjacent to products. A staff of experts such as ayurvedic doctors, herbalists, acupuncturists and massage therapists are at the store to give advice every day, and a classroom accommodates as many as 60 people for lectures and workshops on topics like "Qi Gong for the Heart" and "Reducing Your Cholesterol Naturally."