Soy for heart health. Probiotics to counter antibiotics? effect on the gut. A nice piece of salmon to boost brain function, black cohosh and vitamin E to cool hot flashes, glucosamine for painful joints, green tea to fight against cancer.
More and more medical doctors are making suggestions about a range of products from foods to supplements to personal care items commonly sold at naturals stores. Among a growing number of these mainstream physicians, you?re as likely to get a recommendation for calcium supplements and whole-grain bread as a prescription for Fosamax or a cholesterol-fighting statin drug.
But ask a typical doctor what brand of vitamin E to buy for those hot flashes and a patient is likely to get an offhand comment like, ?It doesn?t matter. They?re all the same.?
Supplements buyers who have worked hard to build a quality product assortment know that?s not true. But how to communicate that information to doctors? How can stores provide useful information to physicians and their patients?
?[Doctors] have many patients who are asking them about alternative medicines, and they don?t necessarily have an answer,? says Don Summerfield, vice president of integrative medicine at Pharmaca, based in Boulder, Colo. ?We provide them with scientific research on the use of natural medicines. We get a lot of phone calls from physicians on those issues. ? They?re calling for advice, we help them, and hopefully that kind of ripples out to other practitioners.?
It?s information that could save lives. Researchers from the Stanford University School of Medicine studied more than 20,000 office visits by patients deemed at risk for heart disease, the No. 1 killer in the United States. Despite ample evidence that diet and exercise can reduce the risk of cardiovascular disease, these patients received diet counseling less than 45 percent of the time and exercise counseling less than 30 percent of the time.
Senior author Randall Stafford, M.D., assistant professor of medicine at the Stanford Prevention Research Center in Palo Alto, Calif., says he believes physicians ?feel they lack the tools and training? to talk about diet and exercise. While becoming somewhat more common, programs in integrative medicine at conventional medical schools are still few and far between.
The good news, Summerfield says, is that conventional medical practitioners are becoming more open-minded about the benefits of supplements. Doctors don?t have time to research individual brands, which leads to the frustrating occurrence of ?doctors from Columbia, Harvard and Yale, serious M.D.s who know the research? telling patients to go on the Internet and buy ?the cheapest Sam-E they can get,? he says.
?There?s a great opportunity for the natural products industry to work more closely with the medical profession,? he says. ?They are really looking for a place where they can send people to get this kind of service.?
How to get doctors to see your store as a health partner? You have to put yourself in their shoes and provide something that they need, advises Kare Anderson, a Sausalito, Calif., consultant and author of Smart Partnering (Say It Better Center, 2004).
Don?t bother with coupons, brochures or giveaways, she says. ?It?s all been done by pharmaceutical companies with tons more money than you,? Anderson advises. ?Don?t say, ?Here?s what you can do for me.? Think of what you can do better together.?
For example, if you sell books, ask practitioners to recommend their favorites and put up shelf talkers that highlight their expertise. Anderson advises ?selling by situation? rather than by health condition, such as distributing a snack giveaway at the soccer field that can bounce back to a new family practice in your neighborhood for sports and school physicals, as well as to your store?s promotion of ?meal ideas for your young athlete.?
Some stores have partnered with practitioners by hiring them to interact with customers. Pharmaca hires herbalists, homeopaths and naturopathic doctors to staff its stores, Summerfield says. He encourages natural products manufacturers to attend medical symposia and reach out to physicians, even as he encourages doctors to explore alternative medicine.
?There?s fear on both sides,? he says. ?That?s what I hear a lot—the fear.?
What do doctors want? In a word, science.
?I?d like to see modest claims about specific issues. The standard way to be credible is to develop a research base,? says David Spiegel, M.D., medical director of the Center for Integrative Medicine at Stanford. ?The other thing that they could do is not exaggerate claims.?
Because doctors can?t legally prescribe foodstuffs, they can only recommend dietary changes or supplements, and the gray areas in botanics and nutritional products make a lot of physicians uncomfortable, Spiegel says. ?Doctors by and large are not grand experts on nutrition. We know a lot about other things.?
Oncologist Anthony Elias, M.D., of the University of Colorado Health Sciences Center in Aurora, Colo., hesitates to recommend supplements, whose toxicity he doesn?t know, on top of chemotherapy agents that put a substantial burden on a patient?s liver. The research on toxicity, even among well-studied drugs, is always changing, he says.
But he advises his patients at the University of Colorado?s Breast Center that exercise is the single most important thing one can do to prolong life after cancer treatment. He tells women to take a multivitamin and eat their broccoli. And he recommends well-researched nutrition supplements, such as glucosamine for joint pain and calcium to counteract some cancer meds? bone-damaging side effects.
?Moderation is a very boring philosophy,? Elias notes. ?But in the end it seems the safest way to go.?
The 11-store Pharmaca chain reaches out to physicians through its compounding pharmacy program, says Christopher Turf, a pharmacist who runs the compounding program and is also director of medical outreach. Compounding offers a way to customize a pharmaceutical, by changing the dose, combining agents or making a topical preparation. Sometimes an herbal or homeopathic remedy can be combined with a prescription drug. ?It is an art, so it makes us a destination,? Turf says.
And it gives Pharmaca a platform upon which its stores can build relationships with physicians, starting with the familiar realm of prescription meds. ?I?m on the phone with 40 or 50 physicians a day, taking prescriptions over the phone,? Turf says. ?It only takes a few seconds to say, ?Hey, I?m a compounding pharmacist.??
For stores without a pharmacy, Turf advises contacting doctors? offices to put patient literature in their waiting rooms and offer to serve as a resource, a ?trusted editor? of information about alternative health. Get to know the other professionals in their practices, such as nurse practitioners and physicians? assistants. Give them refereed journal articles. Speaking to medical societies is an excellent way to open doors, he adds.
It works the other way too, by providing brochures, product information and interactive kiosks such as Healthnotes to customers and suggesting they pass them along to their doctors.
Turf says he gets 30 to 40 women a week in Pharmaca?s downtown Boulder store asking for help with menopause symptoms. He compounds a bio-identical estrogen preparation that provides relief without the risks of hormone replacement therapy. Doctors can be motivated to call the store for further info ?if they come to him and say, ?This is what I want,? ? Turf says. ?A menopausal woman can be very persuasive.?
Natural Foods Merchandiser volume XXV/number 12/p. 20, 24, 26