The reality is that my job constantly challenges my sanity. Sometimes, I just want to scream.

Patient:  “Doc, I don’t want to put any poisons in my body!  Isn’t there a ‘natural’ remedy I can take?”

Doc: “No, I want you to take my poison!  I haven’t poisoned my quota of patients this month and need to reach my goal.”

Poisoning patients really isn’t good for business.  Why would a patient believe that FDA approved medications are poison?

Just watch any TV advertisement.  The FDA requires that all promotional pieces be balanced (the term is “fair balance”).  Balance means, if you say something good, you must say something bad.  So product “Y” protects you against stroke but can cause fatal bleeding.  The fact that bleeds occur in only 0.001% of patients is irrelevant; the only thing the audience hears is “fatal bleeding.”  So, having been scared out of taking a life saving “poison,” the patient has a massive stroke.

While your doc and pharmacist are handcuffed and gagged by fair balance, your local herbalist and vitamin purveyor (VitaHerb Central ) isn’t.  I’m jealous.  I recently walked into one of the VitaHerb Central stores (any national chain vitamin/herb store) and scoped out what they carried.   Instead of a trained and licensed pharmacist, a young man offers advice and sells you “natural” pills in a bottle.  He does not know the source of the material in the bottle.  He does not know how the “natural” medicine (yes, it’s a medicine) in the bottle is absorbed and processed.  He does not know if it is safe for your liver or kidneys.  He does not know if it will interact with anything else you are taking.

He tells you it is good for fatigue.  He tells you it will boost your immunity.  He does not know your medical history.  He has no idea that you have kidney disease and asthma.  You don’t know you have kidney disease and asthma either.  You don’t see a doctor because doctors use poison.  He can tell you anything because he is not gagged and handcuffed by the FDA nor by science and a code of ethics.  He’s just doing his job, hoping to finish college one day.

You start having problems breathing.  Finally, you see a doctor.  After a multitude of tests and introducing FDA approved “poisons” into your body, you finally admit that you are taking supplements.  The doc asks you to bring them in.  In the bottle is Echinacea (for your immune system) and a “respiratory rescue” herbal mix containing 15 “natural” cures, including licorice.  During your initial visit, you stated that you had ragweed allergies, problems with gluten, and licorice.  Case solved.  You’ve been poisoning yourself with “all natural” medications, dispensed by a clerk at a vitamin/herb store.  Echinacea is ragweed.

You trust the clerk while shunning my science.  If you are taking a pill, any pill, it is a medication.  It has potential side effects, interactions, and risks.  It is processed either by your liver or your kidneys and can be toxic if you have problems with renal or hepatic metabolism.  It is manufactured without government supervision.

Every bottle has the “Medical Miranda Rights” printed on it.  “These statements have not been approved by the FDA.  This product is not intended to diagnose, treat, cure or prevent any disease.”  My wife and I just spent five minutes looking for our magnifying glass so I could read the inscription on a bottle of cold prep a guest left at my house. The “Miranda” statement was positioned below the easily readable, miraculous claims section.

Despite the obvious fact that vitamin/herbals are manufactured pills unofficially claimed to treat a multitude of diseases and the fact that they are expensive, they outsell my “poisonous” medications.

Despite the fact that I have years of education and 28 years serving my community, the clerk at the vitamin/herbal store trumps my science.  The clerk at “VitaHerb Central” trumps the pharmacist.  He even trumps the FDA.

Yes, I must be crazy to come to the office every day.  If I was sane, I would go to work for VitaHerb Central, sell snake oil, and be revered.

Stewart Segal is a family physician who blogs at Livewellthy.org.

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