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Healthy Skepticism Library item: 401

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Kamat VR, Nichter M.
Pharmacies, self-medication and pharmaceutical marketing in Bombay, India.
Soc Sci Med 1998 Sep; 47:(6):779-94
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VBF-3T3SS6V-1H&_coverDate=09%2F16%2F1998&_alid=305663279&_rdoc=1&_fmt=&_orig=search&_qd=1&_cdi=5925&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=77260eaace668b4e4f2bdc8361b37ee6


Abstract:

Studies of pharmaceutical practice have called attention to the role played by pharmacists and pharmacy attendants in fostering self-medication and medicine experimentation among the public. Left undocumented is the extent to which clients passively follow the advice of pharmacy personnel or question their motive or expertise. While research has focused on pharmacists and pharmacy attendants as agents encouraging self-medication and medicine experimentation, adequate attention has not been paid to pharmacist-client interactions that are sensitive to the social, cultural, and economic context in which medicine sales and advice occur. This paper highlights the context in which pharmacy attendants engage in “prescribing medicines” to the public in Bombay, India. An ethnographic description of pharmacies and pharmaceutical-related behavior in Bombay is provided to demonstrate how reciprocal relationships between pharmacy owners, medicine wholesalers and pharmaceutical sales representatives (medreps) influence the actions of pharmacy staff. Attention is focused on the role of the medicine marketing and distribution system in fostering prescription practice, pharmacy “counter-pushing” and self-medication. In documenting the profit motives of different players located on the drug sales continuum, it is argued that the economic rationale and the symbiotic relations that exist between doctors, medreps, medicine wholesalers and retailers, need to be more closely scrutinized by those advocating “rational drug use”.

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909