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    Pharmacists and cognitive dissonance

    When diametrically opposed views are the framework of daily reality


    Mechanistic vs. holistic

    Why does our healthcare system place a mechanistic and reductionistic focus on molecules and cells, rather than a holistic focus on nutrition and lifestyles?

    Why is modern medicine fixated on alpha blockers, beta blockers, calcium channel blockers, H2 antagonists, proton pump inhibitors, HMGCoA reductase inhibitors, etc.? Has modern medicine miraculously discovered errors in tens of thousands of years’ worth of human evolution?

    Why is modern medicine obsessed with attacking and overwhelming delicate biological processes with synthetic chemicals foreign to human evolution?

    Why is our healthcare system fixated on chemistry rather than on nutrition and lifestyles?

    Why do pharmacy schools focus so heavily on chemistry, when retail pharmacists have no need for chemistry?

    Why are we in the business of pushing pills rather than changing lifestyles, in light of the fact that major dietary and lifestyle changes can, in general, do more to improve the health of our customers?

    When worlds collide

    The pharmacy establishment (boards of pharmacy, schools of pharmacy, APhA, AACP, Big Pharma, chain drugstores, FDA) promotes one reality. Pharmacists in the trenches experience an entirely different reality.

    In order to lessen the inner turmoil caused by the attempt to hold diametrically opposed views simultaneously, pharmacists have to adapt to big contradictions. How do they reconcile the establishment’s rosy view with their daily reality? How do they do it?

    Dennis Miller is a retired chain-store pharmacist living in Delray Beach, Fla. He welcomes feedback at [email protected]. His books Chain Drug Stores are Dangerous and Pharmacy Exposed are available at Amazon.com.

    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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    • Anonymous
      You continue to amaze me, Dennis. I can't believe you can read my mind so perfectly! The cognitive dissonance you speak of is as familiar to me as getting out of bed in the morning, and much less palatable. How DO you reconcile what you know to be true with what you must tolerate to survive. For many years, I have felt "two-faced" or phony in my practice of pharmacy. What I really want to do is tell my customers to flush the medication and start taking care of their bodies. What I have to tell them is how the medication will "help" them, and how they should take it faithfully. I've played the part as long as I can - I'm getting out. I can't in good conscience keep shoveling this stuff out. Keep up the good work! Tired Pharmacist.
    • MarkBurger
      Dennis, You're right on the money again! Good job. Another way to ask the question: When did pharmacology and epidemiology trump Physiology and Biochemistry? I saw a cartoon last week: It was of a Scientist looking through a microscope (presumably an immunologist). God, from above, sarcastically said, "What a blunder! I forgot to complete the Immune System! I count on you to address this." We forget, I think, that enzymatic reactions defy the Laws of Thermodynamics and occur in a quantum physics manner. And, finally, there's this from the New England Journal of Medicine :: "Lifestyle intervention reduced incidence of diabetes by 58% and metormin by 31% as compared with placebo; •“The lifestyle intervention was more effective than metformin." ~ REFERENCE Diabetes Prevention Program Research Group, New Engl J Med 2002;346(6): 393-403