The Pharmaceutical Journal
Vol 268 No 7187 p288
2 March 2002

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If we endorse quack cures we really deserve to be dubbed "Baddy Chemists"

By Simon Whitaker

It is one of the unwritten rules of the British education system that each school must have its eccentric teacher, one whose quirky ways and means brighten the day of his or her pupils. In our school that teacher was Mr Robey, a former Royal Air Force officer who marched us through "O"-level chemistry with an exuberant passion for his subject, all the while entertaining his troops with a myriad of idiosyncratic sayings and catchphrases. While some of these had clear, educational merit ("CAT-ions are PUSS-ative - Miaow!"), others were more philosophical or reflective. Of them all, the one that always stuck in my mind, because it struck so close to home, was "Baddy Chemists".

Mr Robey was nothing if not committed to his discipline, and it pained him greatly to hear its appellation being misappropriated by high-street retailers. Woe betide the boy who mentioned within earshot that he had purchased something from "the chemists". "They're not real chemists," Mr Robey would shout, his face reddening at the mere thought of it. "They're Baddy Chemists." There would then follow a well-rehearsed rant on the failings of the Baddy Chemist. Mr Robey would accuse the Baddy Chemist of a litany of sins, most notably his willingness to shun the principles of science, often while blinded by the lure of the filthy lucre.

Later, as an undergraduate pharmacy student, I began to take great umbrage at Mr Robey's assertion that my chosen profession could possibly have lost its grounding in science, an assertion which I had previously seen as merely a few minutes' worth of quality entertainment, without reflecting too deeply on its content. I, like many of my colleagues, arrived at university armed with "A"-levels in chemistry, biology and physics, and felt justified in wondering just how much more scientific Mr Robey wished me to be. I eventually decided that his view of pharmacy must have been based on outmoded stereotypes and that his prejudices had probably prevented him from stepping foot inside a modern pharmacy. Armed with a good, scientific education, my fellow bachelors of science and I were about to fall out, head for the front line and fight for our profession's good name. We'd show him a thing or two about Baddy Chemists!

Fast-forward 10 years to the present day. Since I last saw my old chemistry master, pharmacists have been the focus of an advertising campaign that heralds us as "the scientist in the high street". Our new recruits now spend even longer at university and graduate as nothing less than masters of science. Out in the real world, the evidence base is king. While Mr Robey must be squirming in his boots at the mere thought of it all, we pharmacists surely have every right to congratulate ourselves on this not inconsiderable repositioning. Haven't we?

Sadly, I fear we have not. Despite the advertising campaign rhetoric and the important-sounding degree, we seem not to have moved one iota closer to genuinely becoming "the scientist in the high street". Mr Robey might well suggest that pharmacists have no more right to claim the word "scientist" than they do to claim the word "chemist", and he would be forgiven for this bold claim because the evidence supporting such an assertion can be found in almost every high-street pharmacy in Britain. Nestling up next to the paracetamol is a dizzying array of quack cures and spurious remedies that would give Mr Robey just cause to shout "Charlatan!" as he ran from the shop aghast, his worst fears confirmed.

Homoeopathic remedies have colonised pharmacy shelves, despite the complete absence of any scientific evidence to suggest that they are efficacious. These highly priced placebos compete for much-coveted shelf space with bogus weight-loss
pills, pick-me-up tonics
and whichever previously unheard-of herbal preparation is this week's miracle cure for arthritis and, just like the homoeopathic pills, these "remedies" also lack any credible evidence base. Yet despite the lack of evidence, pharmacists continue to stock these quack cures, and in doing so offer their implicit endorsement. Worse still, in some cases pharmacists actively promote use of these bogus remedies in preference to conventional medicines. What message does this send out to the people who matter: our patients, our fellow professionals and our paymasters? Never have Mr Robey's words echoed so loudly in my ears.

Those arguing in favour of alternative therapies often use the defence that "if the patient wants to use them, who are we to argue?". The answer is, quite clearly: "We are scientists!" Attempting to adopt the position of the scientist in the high street while promoting such quackery is indefensible. Promoting these spurious treatments strips us of our credibility in the eyes of patients and fellow professionals alike. We cannot hope to be treated as equals by other health professionals so long as we assert on the one hand that evidence is paramount, while using the other hand to stuff our tills with the proceeds of therapies that have no basis in scientific fact.

This is a difficult time for health professionals and for public health. In the wake of BSE, and with the hysteria surrounding the MMR vaccine currently reaching fever pitch, the public's faith in conventional medicine has never been lower. Given the circumstances it is not difficult to understand the allure of alternative therapies to lay people. However, pharmacists, along with their fellow health professionals, have a duty of care towards their patients, and this includes a responsibility for giving correct and appropriate advice based on sound scientific principles. In this context, quack cures like homoeopathy, fat busters and spiritual healing simply have no place.

If it is the case that pharmacies cannot survive on ethically sound sales alone, then this is an issue that the profession's representative bodies should take to task without a moment's delay. If , however, the promotion of quack remedies within pharmacies is an unnecessary evil, as I believe it is, then it is for each and every pharmacist to ask him or herself whether a few more pounds in the till is an acceptable price to pay for a loss of credibility and the denigration of our profession to the point where we can no longer claim that pharmacy is a scientific discipline.

There is almost certainly a role for the Royal Pharmaceutical Society's Council to play in resolving this issue. It could, for example, be more resolute in its advice to members regarding the sale of alternative remedies. The Code of Ethics currently only goes as far as demanding that pharmacists should not recommend remedies such as homoeopathy "where they have any reason to doubt its safety or quality" — something of a non-issue where placebos are concerned. However, there is also an onus on each and every practising pharmacist to examine the scientific basis of the remedies they advocate and sell, and to act accordingly.

If we do nothing to correct the malign influence of quack remedies on our collective reputation, then we should hand back the mantle of science to those who deserve it, and instead accept that we really are no more than "Baddy Chemists".

Simon Whitaker is a locum pharmacist working in Oxfordshire