Pharmacists vote no on naturopathy


spoonful of vitamins

The AJP’s latest poll clearly shows that our readers have their suspicions about the validity of naturopathic medicines, with a whopping 544 voters choosing the option, “No, there’s no evidence they work” at the time of writing.

This constitutes 65% of readers who took part in the poll.

A significant minority – 193 readers, with 23% of the vote – said that pharmacies should stock these medicines as they are legitimate products.

Five per cent said that while they questioned their efficacy, pharmacy should stock them; and 3% said they were unsure, but the public wanted them.

Three per cent voted, “Other,” including Jarrod McMaugh, who commented, “I voted ‘other’—No: there’s evidence that they don’t work.

“The first thing I did when I purchased my new pharmacy was to remove all homeopathic products from the shelf,” he said. “There’s no place for them.”

The Tim Minchin joke: “Do you know what they call alternative medicine that’s been proven to work? Medicine,” was again invoked.

Some readers questioned the way the poll was structured, highlighting that there is a difference between some CMs which have evidence to support their use, and other naturopathic “medicine” such as homeopathy.

“Homeopathic medicines should not be stocked,” said reader Tim Bangsund.

“Natural medicines with supporting evidence should be stocked and sold only if the pharmacists selling them are comfortable with their knowledge in order to provide proper counselling and patient care.”

Taree pharmacist and member of Friends in Science and Medicine Ian Carr, who has spoken to the AJP several times in the last couple of weeks as debate has continued about the subject of naturopathy in pharmacy, said he was surprised and pleased at the strength of the No vote.

“I looked at [the poll] on the first day, and there was definitely a majority saying these things have no evidence, but there was still above 30% saying yes, they were legitimate products,” Carr told the AJP.

“That’s been dwarfed by a lot of people who’ve looked in, and it’s interesting to have that many people vote.

“I’m glad that it seems to be becoming recognised that there’s a need for the evidence base in these things, and the difference between having a naturopathic product or supplement on the shelf, and having somebody there charging for their time, as a naturopath, dispensing advice without knowing the patient’s background and without an intervention by a registered pharmacist.”

He encouraged pharmacists concerned about the validity of naturopathy to consider what products and services they offer.

Where naturopaths are used, they should at least be expected to keep a record of products and advice dispensed, he says, similar to protocols around blood pressure and blood glucose monitoring.

“If there’s going to be an insistence that naturopaths remain, that’s the way I’d like to see it: that the pharmacy has good records and oversight of what they’re doing.

“I think, given our connection to the PBS and the fact that we as pharmacists are looking for a more serious role as part of the health care team generally, and having a more active and integrative role, we would be silly to fritter it away on peripheries like naturopathy.

“I personally see the opportunities in evidence-based medicine and what flows from that, rather than trying to make up dollars. We’re more likely to lose control of pharmacy if we don’t guard it jealousy.”

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12 Comments

  1. William
    31/05/2016

    It seems that the 23% who feel they should stock this rubbish are more interested in profit than being professional.
    And we are arguing about allowing supermarkets into pharmacy for “professional” reasons?? Amazing, they are just a bunch of shop keepers in mentality!

  2. craig wainwright
    31/05/2016

    Why is the debate about complementary medicine always about homeopathy? The majority of complementary medicine uses herbal extracts and nutritionals, vitamins and mineral. I hope pharmacists are vigilant about counselling against prescribed antibiotics for sinusitis and bronchitis (as endless meta-analyses have shown they don’t work!). Do we advise clients that anti-depressants don’t work if you have low Folate or ZInc levels (again as research has repeatedly shown). Too many pharmacists have no formal training in nutritional or herbal medicine or never look at research outside of pharmaceuticals, and like many other medical professionals speak on a topic they know little about, but happy to parrot similarly misinformed medical opinions. Health is about restoring physiology, which pharmaceuticals do not do

    • Ian J Carr
      31/05/2016

      Are you suggesting that pharmaceuticals do not restore a normal blood pressure in hypertension?

  3. Karl Landers
    31/05/2016

    This is an excellent result and I am encouraged that pharmacists are understanding the importance of naturopathy. 28% of pharmacists agree naturopathy products (like iron tablets for anaemia, vitamin D for osteoporosis, B9 or folate for pregnancy just to mention a fraction of what is available should be in pharmacy is more than I expected! In time this figure I believe will only increase as pharmacist become more aware of the integral role naturopathy play in our healthcare system. Naturopathy is a 4 year bachelor degree course. I agree with Jarrod McMaugh that he did the right thing to remove homeopathy from his pharmacy – because he is not trained in homeopathy and knows very little about it. We are in the information age now and patients are much more educated in their healthcare requirements. People spend billions of dollars on naturopathy every year and it’s certainly not because it doesn’t work! Pharmacists are in a unique position to be able to embrace ALL facets of healthcare and the more we educate ourselves in the role these industries’ play in healthcare the better patient outcomes we will all achieve.

  4. Not suprised
    31/05/2016

    As a bachelor qualified naturopath who underwent a rigorous 5 year Bachelor of Naturopathy at SCU under Professor Stephen Myers (former head of CMEC; the formerly funded complementary medicines arm of TGA) I believe it is an advertisement of ignorance for trained medical professionals to state there is no evidence base for use of natural and complementary medicines, let alone the thousands of years of empirical use and clinical case studies. You have at your disposal well researched information sources like NPS, Victorian Better Health Channel and Natural and Complementary medicines Database (subscription) beside the wealth of information from the authentic Australian practitioner range companies who are investing into research and evidence into their products as well as novel compounds and ground-breaking understanding of the pathological process of disease.
    It is however not unusual for the public to be mis-informed or mislead by popular media and as custodians for evidenced based health solutions and professional disease management protocols you should see it as your duty to de-mystify this mis-information and steer your patient to qualified practitioners or trained staff within the pharmacy.
    Unfortunately the same non-believers or protectors of their own realm bring up these sensational, non effective non evidenced, “witchery” arguments about natural therapies on a cyclical basis, perhaps just before an election, for whatever means, but you should be aware that the patient that seeks natural therapies, preventative and dietary measures and health solutions, rather than mainstream palliative symptom relief or partial disease suppression, is an informed, educated and willing participant in their own health care and sees through the transparency of smear campaigns because they know natural therapies work. As for the poor mis-informed public they should be seen by health professionals as an opportunity to educate and assist in better health outcomes through accurate information rather than popular media.
    (Naturopath 15 years)
    (Pharmacist 10 years)

    • Ian J Carr
      31/05/2016

      In 2014, Friends of Science documented 50 Australian pharmacies advertising Naturopathic services which included the following. PLEASE let me know which of the following you feel are “modalities” deserving of research funding, or useful for the betterment of my pharmacy’s clients — and why.
      1. Tongue Analysis 2. Tooth Meridian Diagnostics 3. Detox 4. Electrodermal screening 5. Hair Analysis 6. Iridology 7. Live Blood Analysis 8. Zinc taste test 9. Reflexology 10. Kinesiology

      And please stop with the straw man argument that any questioning of your modalities is motivated by us bad guys protecting our lucrative turf! My own philosophy of health is entirely “holistic” and has been achieved without any of the above.

    • Daniele
      31/05/2016

      As a pharmacist who is also a herbalist, I thoroughly agree with you! Nutrition and herbal medicine is not witchcraft with no evidence base…. And in real life, it works. The life changing effects that these modalities have for chronic health conditions, balancing hormones, addressing eczema, asthma, inflammation, childhood behavioural disorders, GIT issues and so much more, can be profound. It’s time the THEM and US bickering stopped. It’s based on fear and ignorance. Both sides can often work together for the best outcome for our patients.
      There is a time and place for pharmaceuticals, especially in acute conditions, whereas the chronic ones are often best managed with incorporating a more naturopathic approach. We have forgotten that food is our first medicine to prevent illness in the first place. With good nutrition so many diseases can be prevented and even reversed. We don’t need a double blind, placebo trial to prove that- doctors even agree that cardiovascular disease is largely a lifestyle disease.
      Let’s get back to basics. The pharmacists that embrace this model and educate themselves in this arena will be the future of a far more successful health model.

  5. Simon O'Halloran
    31/05/2016

    Among the overwhelming respondents that voted “No, there’s no evidence that natural medicines work” how many understand the number of medicines in the scheduled medicines range which by virtue of clever marketing outdated or poorly conducted clinical trials are probably no better than (or marginally better than) placebo. The placebo effect is an effect, simply take a look at any controlled trial involving antidepressants. We should probably take a closer look at our own practice before we criticise CAMs or risk being labelled hypocritical oafs.

    • Ian Carr
      31/05/2016

      No one has ever suggested that Evidence Based Medicine is flawless. The thing about science is, it is an ongoing review process which allows for the jettisoning of poor science or incorrect hypotheses. You have used the “tu quoque” fallacy, failing to address the problems with naturopathy by making accusations about its opponents. And if we start down the path of CAM’s Conspiracy Theory of Real Medicine, then all rational argument is of no use…

      • Simon O'Halloran
        01/06/2016

        Agreed it appears I did go down that path with my comment however that was not my intention. As a pharmacist with a deep skepticism towards an array of naturopathy “modalities” I would merely suggest that it would be a shame for all CAMs to be thrown away because of the questions surrounding the usual dubious go-to’s like iridology and homeopathy. If such modalities are promoted in store or offered purely as a commercial interest with no consideration to their evidence or even the soundness of their theory then they have absolutely no place in pharmacy. However there are some complementary medicines with valid roles in patient management and these should not be seen as an opposing form of treatment, but as supportive; certainly not as an “alternative” or replacement for conventional or evidence based medicines. If you can’t decipher and stack the evidence or lack the skill and confidence to make sound recommendations concerning CAMs then by all means you are safest to throw out the baby with the bathwater and operate under the sweeping comment that “the evidence says all natural medicines don’t work”.

  6. Simon O'Halloran
    31/05/2016

    Among the overwhelming respondents that voted “No, there’s no evidence that natural medicines work” how many understand the number of medicines in the scheduled medicines range which by virtue of clever marketing outdated or poorly conducted clinical trials are probably no better than (or marginally better than) placebo. The placebo effect is an effect, simply take a look at any controlled trial involving antidepressants. We should probably take a closer look at our own practice before we criticise CAMs or risk being labelled hypocritical oafs.

  7. United we stand
    08/06/2016

    Personal anecdote: Male, 64, diagnosed with BPH
    Patient suffered from severe constipation after taking Flomaxtra. Doctor switched to Avodart. His libido and sexual drive was non-existent. Starting experiencing erectile dysfunction and decided to stop it.

    We recommended switching to saw palmetto as there are well documented studies that it does lower plasma DHT. He’s been on it for 5 months now. Urine flow has improved significantly and is getting much better sleep at night. All sexualising side effects are worn off now as well

    There is a place for Complementary medicine in Pharmacy. You just need to do your research before recommending any product

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