ALIVE - Canadian Journal of Health and Nutrition, December, 1999
Rainforest Remedies
by Daniel T. Wagner, RPh, MBA, Herbalist
There is a burgeoning revolution in the American medical profession that is
clearly the color of green. Some call it green medicine, some alternative medicine
and some complementary, but whatever your fancy, the fact is the nation's 65,000
MDs are taking a growing interest in herbal and dietary supplements. If one
reads the headlines of a myriad of articles in leading newspapers, health and
consumer magazines and even JAMA, it becomes apparent that the American public
and most likely your patients want professional intervention and not biased
scrutiny about these supplements.
The headlines are everywhere. "Forty to fifty percent of Americans Using Alternative
Medicines and Therapies." "More Americans Now Visiting Alternative Practitioners
than Medical Doctors." "Over 10,000 Deaths from Adverse Reactions in Hospitals."
"Pharmaceutical Firms Playing in Expanding Herb Market." "Fifty-three Percent
of Herb Consumers Choose Them Over Drugs for Safety Reasons."
As we collide with the year 2000, holding back the tide of escalating healthcare
costs has become a priority. As the "baby boomers" approach retirement there
will be greater burdens on our healthcare system. Our aging population is accompanied
by a rise in chronic disease that threatens to drain our healthcare resources
even more. There is a growing disdain for the proliferation of "managed care"
from both sides of the fence. Patients feel that it is impersonal, too expensive
and less effective. Physicians feel that it is compromising patient care, increasing
their paperwork and deflating their salaries and job security.
To preserve our healthcare system, there arguably exists three possible outcomes:
Either we continue to ration medical care and services, have it go bankrupt
or develop a new paradigm.
Some suggest we start re-examining our definition of health and disease. Perhaps
it will take more of us getting in the "health" business and not in the "sickness"
and "disease" business. Nearly 99 percent of all the drugs that are part of
the pharmaceutical revolution are for treating disease states once you are afflicted.
Few physicians are teaching patients how to prevent disease. Since 1960, the
FDA has approved very, very few products that actually are used as preventatives.
Some include fluoride for toothpaste to prevent cavities, calcium for preventing
osteoporosis and PABA in sunscreen to prevent sunburn. That's about it.
Herbs, natural products and alternative therapies, although sometimes used as
drugs to mitigate a disease state, are mainly used in Europe as preventatives.
Common preventatives are vitamin C, A, E and selenium to boost your immune system
as anti-oxidants, Gingko for mental acuity, Saw Palmetto to prevent prostate
hypertrophy and Echinacea to prevent colds and flu. The fact is people are relating
to these products, whether their physician agrees with them or not regarding
their effectiveness or lack of scientific proof. Frequently, patients hide the
fact that they are using dietary supplements because they are afraid they may
get belittled or ridiculed by the doctor. I frequently remind physicians at
my lectures that your patient are taking these things, so it may be critical
to learn more about these products so that adverse events don't occur.
According to a USA Today article, patients respond that if their doctor can't
answer important questions about herbs, they "will keep looking around until
they find someone who knows." This is the problem. Who are the qualified health
professionals in this area? Unfortunately doctors, pharmacists and nurses don't
get this training in their professional courses. Alternative practitioners,
like chiropractors, naturopaths and acupuncturists may have some background
in herbals, but get no courses in conventional medicine. So the patient ends
up getting critical information about possible drug/herb/diet/nutritional use
and misuse and effects and side effects from magazines, health food stores,
or a vitamin distributorship sales representative. It is easy to see that more
professional intervention is needed and it is incumbent on physicians to learn
more.
The new paradigm may be a simple one: be tenets of good medicine. Don't judge
the efficacy of a plant medicine, an herb, or an alternative therapy just because
it wasn't taught in medical school. Learn more about the functions of preventative
and not just predictive medicine. Surely, there is a certain lack of scientific
evidence supporting the efficacy of alternative medicine. But unfortunately
there also appears to be an excess of narrow-minded medical philosophy. Let's
face it, nearly 70 percent of the people on the planet are still treated primarily
with plant medicines.
All people deserve choices. Just about every patient can make better choices
for improving his or her own health when they have better information and education.
Be the harvesters of this education and information. Encourage choice that is
prudently pursued. For in almost every instance, the patient will respect and
follow the opinion of a qualified health professional who better knows what
he or she is talking about.
Daniel T. Wagner, R.Ph., is president-elect of the Allegheny County Pharmacist
Association.