Seth Godin has this magical way of finding the exact words for some of the myriad of thoughts that pass through my mind when I attempt to write something relevant for my profession.
And then it just happens.
My “in-box” lights up with Seth’s latest blog and ignites and organises my thoughts into a straight line.
A sort of ESP.
We’ll pick him up a short way along this article.
For some time now I have been troubled by organisations that have sought to virtually hijack the profession of pharmacy, along with a range of other health modalities, through a relentless and long-range campaign aimed at limiting the freedoms and health deliveries that have been built by generations of dedicated pharmacists, and others.
These organisations seem to be almost cult-like in their approach to science – a cultist sort of “scientism”, (dictionary definition – excessive belief in the power of scientific knowledge and techniques), that vilifies any modality that may have a different approach to their view of science, and which seems to follow the views of Big Pharma which is a warped version of science manufactured to fit into a marketing strategy rather than for the well-being of a patient.
Its adherents seem to be akin to “serial stalkers”, their methods manipulative and they operate in the manner of a spy agency
For example, take the issue of homeopathy, a low key and relatively inoffensive health modality that has been around for a long period of time that appears to help a range of patients who feel comfortable with that philosophy.
With Australian literacy levels at a point where the average patient is quite capable of deciding what care they need and who will provide it, it is a bit presumptuous for those addicted to Scientism to be able to dictate to those patients as to what they will do and when they will do it.
Homeopathy has been subjected to some very aggressive attacks that were designed to destroy its very existence, on the basis that it had no evidence to support its version of patient engagement.
The NHMRC has pronounced homeopathy as having no science foundation through one of its committees having a range of scientism members with the majority vote.
The committee refused to accept evidence from non-English speaking countries (despite the fact that the hard-nosed Swiss government found that it worked well enough to reduce their health budget expenditure, while a country like Cuba relied totally on homeopathy and produced some dramatic cures for some very serious conditions.
It is well-accepted in most European countries.
This NHMRC committee also refused to accept a body of evidence from an expert homeopath, an executive member of their governing body.
The result was always going to be rigged and homeopaths would feel well justified in disregarding the findings of that committee.
One extra disappointment (to me) was that my peak policy body (The Australian Pharmacy Liaison Forum) created an anti-homeopathy policy (APLFCommunique_September2015_Position-Statement) within 24 hours of the NHMRC pronouncement, which I believe was a completely unethical move.
No registered health profession has the right to stand in judgement of another modality unless it is causing damage to patient health.
The speed at which this normally somnolent body moved to make this pharmacy policy was outstanding, and they then moved to change their name to the Australian Pharmacy “Leaders” Forum – what a joke!
Scientism has arrived in pharmacy!
However I do find some aspects of homeopathy a little strange from my training and perspective as a pharmacist, but I would deem it extremely unethical to pursue a homeopathic patient and embarrass them into accepting my philosophical version of science or to even criticise the way in which homeopathic practitioners organise their own patient practices.
There would only be one exception to this, and that would be if there was a demonstrated life-threatening practice that was continually being replicated.
Yet there is no evidence of an alarming death rate at any stage of homeopathic existence.
Further, there is a startling comparison with mainstream medical practice in that this modality is now in the top three in all causes of death, even exceeding motor vehicle accidents, in all western economies.
Remember, this is the “First do no harm” modality that does not even acknowledge that something has gone seriously wrong with their own processes or to seriously look for a solution.
Pharmacy is appended to the above because it has, at its core, the process of dispensing of Big Pharma drugs commoditised by government through the PBS, which in itself has reached the end of its product life-cycle, after having been a target in a Big Pharma marketing exercise.
The combination of the above two forces has seen community pharmacy lose direction and control over its own destiny because pharmacy leaders have not been astute enough to avoid being compromised by those forces.
The adoption of an anti-homeopathy policy is an example of the quality of pharmacy leaders, and it is not a good look.
New disruptive innovations will now take over pharmacy direction in the form of Artificial Intelligence (AI) systems targeting all of health, the rapid deployment of 3D printing (a solution for ever increasing drug shortages) that may find a home with a generic manufacturer rather than a compounding pharmacy, and the lack of activism to secure the medical cannabis market for pharmacy as a Schedule 3 drug and a useful replacement for codeine potentially lost to pharmacy pain management programs.
To this we might also add that the ongoing fight with “Scientism” groups is destroying a traditional market for well-being through pharmacist prescribing of clinical nutrition items and useful forms of complementary medicine (CM) – all markets initially encouraged by government as being best managed by pharmacists (through the virtue of their formal training).
The CM success in the marketplace has alarmed drug manufacturers because they are better accepted by consumers than patented drugs, and consumers obviously find benefit because they continue to consume these items safely and beneficially.
And therefore are willing to pay for the benefits without government subsidy.
Scientism groups aided by mainstream media (that have a significant pharma financial investment) trumpet their version of pharma science and criticise the supposedly large profits earned by pharmacies, as reasons for pharmacy to abandon these markets.
Patient benefit and obvious patient satisfaction does not appear to count within Scientism philosophies.
Nor is there any criticism of Big Pharma evidence by Scientism groups, so it is reasonable to assume they have been compromised by Big Pharma funding, usually through indirect methods.
So now I will enlist the thinking of Seth Godin to expand the “Scientism” concept.
To countless teenagers who had the wrong teacher in high school, it means, “a boring collection of right answers, categorized by topic.”
Once we discover that some things we were taught aren’t black and white any more (Pluto, DDT, infant formula), it’s not surprising that people begin to go from bored to skeptical. About all of it.
Except that’s not what science is.
Science is a process. It’s not pretending it has the right answer, it merely has the best process to get closer to that right answer. Science is an ongoing argument, one where you show your work and make a prediction about what’s going to happen next.
And you’re not allowed to have magical faeries. Not allowed to change the explanation based on what just happened. You must begin again, from first principles, and make a new argument, and show new work, and make a better prediction.
Science isn’t only done in the lab. Every one of us does it at work, daily.
Science isn’t something to believe or not believe. It’s something to do.
Seth’s opening sentences state the obvious.
Science is a progressive story collating a series of known facts that when organised into a suitable format, give us an insight to the solution of a specific problem.
When new facts emerge the story can change abruptly and new insights emerge that potentially support totally different concepts and solutions.
Therefore all evidence can never be absolute at a given time.
It can only support a philosophy that may also reflect an interpretation bias by its author and therefore open to challenge at any time.
Clinicians are taught never to rely on a single reference and in practice, a final decision on behalf of a patient is simply a reflection of a clinician’s practical experience.
It is noticeable that the quite vocal spokespersons for Scientism groups often lack a broad clinical experience often never having had patients of their own to treat.
Seth’s second point is that science is a process that does not pretend it has the right answer but merely is the best process to get closer to that right answer.
Again, Seth clarifies more economically my elaboration of his first point.
The dark agenda of Scientism is that it lays claim that it “owns” the only valid form of evidence absolutely, and only its interpretation is the right version.
Therefore Scientism is a cult that seeks to control health disciplines through destruction of each modalities’ evidence base in favour of the “one true religion” of its invalid and biased evidence base.
That court cases levying fines running into $’s billion around the world, awarded against Big Pharma evidence manipulation or interpretation, is validated through a simple Google search.
You hear little about these fines because mainstream media simply avoids the issue, does not do its job, undermines the concept of democracy and makes a mockery of freedom of the press.
Seth also reinforces the point that evidence is simply a prediction.
As a prediction it remains open to interpretation.
Seth’s third point is that if new data arrives that can change the original conclusion the the process must begin again, at the beginning.
No short cuts to a new conclusion – only the new rational scientific process to reach a better prediction.
Seth’s final point has a particular interest for pharmacists.
He states that science is not only performed in the lab, we all do it at work daily – science is not simply a belief – it’s something to do!
When I first started my career as a pharmacist dispensing was primarily compounding of doctor prescriptions or to your own private formula.
Private formulas were jealously guarded and stored in a notebook that you always kept in your shirt pocket.
But they were derived from practicing pharmacists sharing information within the pharmacy as to what they found “worked” for their patients.
I realised how important these information sharing sessions were as my own private formula record began to expand.
And it was information that you continued to add and share with each pharmacy you worked in.
What was happening was that you were continually collecting and validating data that were observations from your peer group.
It was a form of ongoing clinical trial that might be regarded as primitive by Scientism groups today, but it was a highly effective system.
In fact, a similar exercise could be established if community pharmacy was able to manage medical cannabis at an S3 level.
Community pharmacy has the ability to organise ongoing studies into the properties and benefits of the various cannabinoids and prepare private formulas for cannabinoid combinations that are effective for various patient conditions, particularly chronic conditions that are going to hit our elderly population in avalanche proportions, because our health system is even now unable to cope.
In this edition you will find an article by Gerald Quigley who talks about treating dementia.
He introduces the concept of “Informed Medicine” as the pharmaceutical version of “evidence based medicine” as the most suitable version to underpin pharmacy practice.
He has coincidentally arrived at a similar conclusion as to the best form of evidence base that would suit pharmacy practice and be owned by it, always recognising that other valid forms of evidence can exist outside of pharmacy.
It would be far superior to the Big Pharma version as promoted by the Scientism groups and would make way for genuine contributions to patient health by the pharmacy profession.
The purpose of this article is simply to highlight that pharmacy had a very efficient evidence base that was owned by pharmacists in the same way that other health modalities develop their own evidence to underpin their practice specialties, that while slightly different and acquired “on the job”, is just as efficient as the academic version and can also provide new streams of data for academia to include in new studies.
The original private formula only disappeared when the PBS only wanted to only pay for manufacturer products because pharmacist compounding was deemed “too expensive”.
In retrospect, the prices being paid by our PBS system today are alarming to say the least.