The pharmacist: The bridge between doctor and patient for dietary supplements

Drug Store News, July 20, 1998 by James B. Lavalle

The explosion of natural medicine has created a need for the consumer to have a reliable resource for information concerning the use of dietary supplements. As a pharmacist, I feel strongly that if a product comes in a pill, capsule, cream, spray, suppository, drop or any other dosage form, we pharmacists should know about it. Many of us shy away from the topic of natural medicine because we hold to the belief that unless it is a traditional pharmaceutical, it holds little value. The issue is not whether or not we believe that a particular dietary supplement or homeopathic medicine has value for us. The real issue is that people are using these agents without any guidance.

The roots of our profession are founded on hundreds of years of plant-based substances. Modern herbal medicine is quickly being well-defined and studied. Other natural therapeutics, such as nutritional support, aromatherapy and homeopathy, are also being validated, even though in some instances we may not fully understand the mechanism of action. Pharmacists must be aware of various types of natural therapies regardless of personal beliefs because, quite frankly, millions of people are using them. When we give our opinion based on the "head in the sand" principle, we lose the opportunity for good communication and counseling with our customers. It is our responsibility to meet the needs of our customers. People who want natural products should be able to turn to their pharmacists for advice.

Pharmacists can play a key role in various levels of counseling with their customers, including:

* Guiding the wise selection of traditional OTC and natural care products for self-limiting conditions;

* Guiding the wise selection of dietary supplements for prevention and performance enhancement;

* Assisting the physician in the selection of natural therapeutics as an adjunctive therapy or as a rational first line of treatment for a disease state;

* Educating the customers of potentially beneficial natural therapies they may not be aware of (This could include knowing and recommending other health care professionals in the community who are providing other forms of natural therapy, such as massage, acupuncture or stress reduction.);

* Guiding the public in lifestyle and food selection changes that may enhance their health outcome (This is a traditional role that is now being reemphasized with the advent of diabetes and asthma education.); and

* Heightening public awareness on such issues as osteoporosis, prostate conditions and cardiovascular disease. (This could include screening for early warning signs, as well as recommending supplements that may be appropriate.)

A patient will typically see his or her pharmacist seven to eight times more often than a doctor. The pharmacist, being the most trusted healthcare professional, is in the ideal position to gather information and make recommendations on natural products based on specific customer needs. Logically, we need to counsel customers when natural products are contraindicated or if a potential drug nutrient depletion may occur from prescription or OTC drugs. Drug nutrient depletion becomes even more important when you consider that the typical American is not receiving adequate nutrient status from his or her diet.

The pharmacist has historically been the bridge between physicians and their patients, assisting people in their self-care complaints and wellness needs. This bridge now needs to be widened so the pharmacy profession can take a leading role in the category of natural therapeutics. Education is essential to making natural products part of the counseling process. Our goal should be "Primum Non Nocere" (first do no harm). Expand your repertoire of recommendations in the OTC category for people who are at risk because of current medications or existing conditions or for those who want to try a natural alternative first. They should have the full value of the expertise of pharmacists. Also, remember that many customers want to use natural agents to reduce cost, enhance performance, reduce health risks and, most importantly, improve quality of life.