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Letters

More on the Business of Clinical Pharmacy

I have just finished reading the commentary in the March 1998 issue with its comments from Michael P. Laddin of the American College of Clinical Pharmacists (Consult Pharm 1998;3:227-8). Although I agree that "learning to walk the walk and talk the talk" of financial administrators is very helpful in facilitating the communication process, I am struck by the author's omission of a very important point. Communication is a two-way street! I remember learning this in the early grades in school. Financial decision makers, it seems to me, would do well to learn to "walk the walk and talk the talk" of consultant pharmacists, as well as all other clinicians.

The notion that the list of future managed care paradigms will not include structures allowing clinicians to do what clinicians do (the business of health care is making people healthy) reflects the absolute arrogance mankind has paid dearly for time after time.

Indeed, it is only a matter of time before the pendulum swings.

As I speak (Michael Laddin, I suspect would agree), that pendulum continues to swing toward more centralized decision-making and control. To suggest that the pendulum will never swing back, allowing Adam Smith's "invisible hand" to take charge, is absolute folly! I will gladly learn any financial decision maker's language, matching step for step his or her efforts to learn my own.

Paul J. Schmidt Jr., MS, RPh
Pharmacy Consultant Resources/Quest Pharmacies
Longview, Texas

The Triumph of the Herbals

The recent article on herbal remedies (Consult Pharm 1997; 6:631-6) was very interesting. It was once the opinion of many, including R.W. St. Clair and myself, both formerly of the Massachusetts College of Pharmacy faculty, that botany and pharmacology were doomed and that pharmaceutical chemistry would dominate the coming century. Not so! It now appears certain that botany and pharmacology will do the dominating.

In 1992, Congress established the Office of Alternative Medicine, to be based at the National Institutes of Health, to study, among other things, herbal therapy. The United States Pharmacopoeia (USP) is also heading in that direction; it is currently enlarging its testing laboratory department for the purpose of studying the constituents of crude drugs, as it did in the USP IX era (circa 1930s).

George F. Archambault
Bethesda, Maryland

Editor's note: For guidance on evaluating herbal product information and a list of pertinent Internet resources see page 336 of the April 1998 issue of The Consultant Pharmacist.
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