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    In My View

    Are pharmacy schools teaching about health?


    Modern medicine is often maligned by critics who say things like “If you want to learn about health, physicians are the last people you should consult. Physicians trained in western medicine are educated about disease, not health.”
    Can the same criticism be leveled at pharmacists? Are we the last people the public should consult about health? Has our education focused too heavily on molecules, cells, chemistry, and pharmacology rather than health?
    Should the primary focus of pharmacy school be health or be pills? Some would say that pharmacy schools exist to teach about drugs. But when was the last time you used your knowledge of inorganic chemistry, organic chemistry, medicinal chemistry, and biochemistry in the drug store?

    One of the most shocking things for me about pharmacy school was that it seemed to have so little do with health. Students are taught a mechanistic and reductionist view that seems to completely remove Homo sapiens from the natural world.

    It is as if human health were completely dependent on the manipulation of molecular and cellular processes with synthetic chemicals. Mother Nature had these biological processes well in hand for thousands of years. Yet the message of pharmacy school seems to be that human health is directly proportional to the per capita consumption of pharmaceuticals.

    In pharmacy schools the focus of the curriculum is a chemical attack on human biology. Pharmacy students learn about health and illness based on attacking and overwhelming biological processes with synthetic chemicals. This militaristic model employs an endless number of inhibitors, antagonists, and blockers to conquer or subdue intricate biological processes that have been fine-tuned during the long course of human evolution.

    At these pharmacy “war” colleges, students are force-fed a curriculum based on a pharmacological assault on molecules and cells rather than being taught about health in its widest context. There are an infinite number of social, cultural, economic, political, psychological, environmental, dietary, and lifestyle factors in the causation of human illness that pharmacy schools seem to ignore.

    Pharmacy students have been led to believe that technology holds the solution to all health problems and that health is a commodity to be purchased in the marketplace as easily as one purchases a refrigerator or washing machine at Sears.

    As a consequence, many pharmacists are unfortunately narrowly competent but broadly deficient. A pharmacist who understands pharmacy—but nothing else—doesn’t really understand pharmacy.

    I encourage all pharmacists to read Western Diseases by Temple and Burkitt (Humana Press, 1994), which discusses how so many diseases prevalent in modern societies were rare or nonexistent centuries ago and remain rare today in many non-advanced societies.

    My experience in pharmacy school was profoundly at odds with what I saw in the real world. When students graduate, they soon discover that the real world is a brutal exercise in market efficiency where the only thing that matters is how fast we fill prescriptions, a case study in the massive overmedication of the population.

    In pharmacy school we were evaluated by how well we retained minutiae about drugs. In the real world we are evaluated by how well we satisfy industrial production metrics.  Health is not the primary focus in any of this.
    The militaristic approach to health has dominated pharmacy schools since synthetic chemicals replaced plant-based drugs.

    I am not recommending a return to botanical remedies. I am recommending a major shift to dietary/nutritional and lifestyle changes. If your primary interest is in preventing disease, pharmacy school and medical school are not your best career path.

    Dennis Miller, RPh
    Dennis Miller is a retired chain-store pharmacist living in Delray Beach, Fla. He welcomes feedback at [email protected] His books ...

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    • UBM User
      My comment would be that 1. It's been my personal observation that modern pharmacy education focuses on a much more diverse study of drugs, chemicals, and health/physiology at this time than 1988 when I obtained my first BS in pharmacy. Over the years, with continual pharmacy school education in the non-traditional PharmD program, I found my second pharmacy degree in 2004 afforded a much greater range and depth of patient-oriented experience, updated health research, and increased pharmaceutical knowledge --and that was just in the space of 15 plus years. Now, that I contact pharmacy students routinely in clinical practice, I realize new grads will have experiences quite different in focus than when I started pharmacy school in the late 70s. When I chose pharmacy, I wanted to have first-hand knowledge of human physiology and drug therapy, but had no experience with people taking medications routinely, nor even for specific problems other than the recommended benzoyl peroxide for acne, amoxicillin, aspirin for a headache, and Pepto-Bismol for an upset tummy. I find that while the sentiment expressed in the article may be nostalgic for a time that I didn't experience in my years in college, I think the current students are more savvy with directing their clients to available services. At some time, their pay incentives will be more aligned with a national fervor in promoting health and commonly accepted preventative disease practices.