Australian Skeptics take aim at the Pharmacists of Australia

An Open Letter from the Australian Skeptics to The Pharmacists of Australia:

Australians trust Pharmacies and Chemists’ shops. As pharmacists, you play an important role in the health of the Australian public by functioning as a conduit between doctors and prescription or pharmacy drugs. You also have a respected role as a first resource for medical advice for many people in our community. We are all familiar with the slogan “Ask your Pharmacist”.

When we ask our Pharmacist, what kinds of answers do we want? Not quack products like ear candles that do nothing except pose a hazard. We now ask our Australian pharmacists: What standards do you set for yourselves? You sell a growing number of products for which there is little or no scientific evidence of efficacy. Calling them “alternative” does not make them work. Examples include homeopathic preparations, magnetic pain relief devices, detox programmes, dodgy weight loss products and ear candles. Such products commonly appear in a “Natural Medicine” section of pharmacies but are sometimes displayed alongside real medicines whose benefits are scientifically proven.

Ear candles are of particular concern. There are reports of serious injuries from them including temporary hearing loss, burns, ear canals blocked by dripping wax and punctured ear drums (see Seely, Quigly, Langman (1994). Health Canada has banned them in Canada. Even the first professor of alternative and complementary medicine at Exeter University, Edzard Ernst, called for them to be banned. Despite this, many Australian pharmacies are selling them.

“Ear candling is one of those CAM modalities that clearly does more harm than good… its mechanism of action is first implausible and second, demonstrably wrong… in my view, therefore, it should be banned” said Ernst.

What next, will you start selling cigarettes? Like the supermarkets, who you do not want to be allowed to sell pharmaceuticals because they do not have qualified staff? What standards do you set for yourselves for staff?

We see a growing trend of so-​​called “practitioners” with little or no scientific training being brought in as “consultants” including iridologists, homeopaths and naturopaths. Iridology is a discredited way of diagnosing the dysfunction of internal organs via the markings on the iris. There is no evidence that it works but some pharmacies promote the fact that customers can get “readings” in their stores.

Your customers rely on you and anyone in a professional capacity within your store to provide sound medical advice and products. We fear that in some cases they are receiving what amounts to little more than magical sugar pills and spurious health advice.

Pharmacies need to make a profit, but this should not be done through quack products and bad advice. To regain the status a pharmacy should have – a place to get sound advice and effective medicine, supported by scientific and clinical evidence – we implore our pharmacists to stick to worthy products sold by knowledgeable staff.

Australian Skeptics Inc.

Ernst, E. Ear candles: a triumph of ignorance over science. The Journal of Laryngology and Otology. 2004; 118: 1 – 2.
Seely DR, Quigley SM, Langman AW. Ear candles – efficacy and safety. Laryngoscope. 1996; 106(10): 1226 – 9.

Thanks to the investigative reporting of Information 2 Pharmacists E-​​Magazine below is an official response from Gerard McInerny, president of the Pharmacy Board of NSW. He has collated the following extracts from their regular bulletins.

The community holds pharmacists in especially high regard and places its trust in pharmacists’ professional judgment, and relies on pharmacists’ professional advice. Because a recommendation by any pharmacist for any medicine gives that medicine special credibility, it is essential that the recommendation is soundly and scientifically based. The trust in pharmacists and pharmacies is such that simply because a medicine is available in a pharmacy, consumers will infer that the medicine carries the pharmacist’s endorsement and recommendation. Therefore, pharmacists must be personally and properly persuaded of the safety and effectiveness of the medicines available in their pharmacies.

Consumers have a right to make their own choices but pharmacists must protect the consumers by not inadvertently making a recommendation by implication. Pharmacists who recommend alternative medicines to consumers must be appropriately and properly trained. Additionally, recommendations may be made only according to the principles of evidence based medicine. So as to assist pharmacists in the evaluation of published papers, it recommends completion of a course of critical appraisal of scientific literature as part of proper training. One such course approved by the Board, is Critical Literature Review, a module of the Graduate Diploma in Clinical Pharmacy offered by the Australian College of Pharmacy Practice.

The Board recognises that some pharmacists are likely to have a passion and appropriate training for alternative, complementary and natural therapies. Nevertheless, pharmacists must limit their provision of advice about such therapies only to those who voluntarily seek it, and only about therapies for which there is documented evidence of effectiveness.

Pharmacists must especially refrain from intervening inappropriately with prescribed medicine. If an intervention is appropriate, it should be made only through the prescriber.

The story has even been picked up media attention in India.

It seems the NSW Pharmacy Board can certainly talk the talk, but I can’t see any mention of how or when they will walk the walk. Why not follow suit from Canada, and ban Ear Candles outright from sale in NSW Pharmacies? Perhaps I am too impatient. The fact they are acknowledging the Australian Skeptics’ concern is a positive step forward. Having these complimentary and alternative medicines available in Australian Pharmacies lends them an air of credibility that they do not deserve.

Next time you’re in your local Pharmacy, if you spot that they are selling Ear Candles or Homeopathic remedies, why not politely ask your Pharmacist why they sell these products? I don’t know about you, but I would be very interested to hear what they have to say…