READER RESPONSE:Health stores take the concerns over mixing herbs with prescription drugs seriously
Dear sir,
Muiris Houston’s concerns (in Medical Matters, March 10th) about possible interactions between drugs and herbs are well recognised by members of the Irish Association of Health Stores (IAHS).
While we have not been able to sell St John’s Wort, since it was put on prescription in 1999, we are extremely cautious about selling any remedies to people already on medication.
Indeed customer safety is our priority. The IAHS operates a strict protocol which makes it mandatory for us to advise any potential customer, who we know to be on prescribed medication, to check with their pharmacist or health practitioner on the advisability of using any herbal remedy or food supplement.
On the other hand, it’s not uncommon for customers to come to health stores with queries relating to nutritional aspects of their medical problems, such as the one Dr Houston quotes about garlic and Warfarin.
With people increasingly on multiple medication, we frequently find that we cannot sell any remedies as such, but that we can give the nutritional advice which often goes hand in hand with a medical diagnosis.
Yours,
Jill Bell
President, Irish Association of Health Stores,
Midleton, Co Cork
Dear sir,
In an article by Lorna Siggins called “Prescribing practices called into question” on February 24th, a quote from a study by a Kealan Flynn states, “The elephant in the room is the State-funded drug reimbursement regime, which pays a fee to both the doctor and the pharmacist for every prescription validly written and validly dispensed etc.”
I have been in practice for a number of years and I can assure you that there is no such payment to doctors.
In the case of Medical Card patients, GPs get an annual fee for total patient care and no additional fee is paid for prescriptions.
In the case of private patients, there is a consultation fee and not a fee for a prescription.
The other issue ignored in the report is that fact that many prescriptions for tranquilisers originate from the general hospitals and the psychiatric services and GPs are obliged, and often patients demand, that the medications are prescribed by their GPs, even in cases where we may question the use of such medications.
There is still a hospital-based culture of prescribing sleeping medication and once a patient becomes dependant on this treatment, it is almost impossible to stop it, despite one’s best efforts.
Rather than point the finger at GPs, the authors of this study should enquire more deeply into the basis for such prescribing, why general and psychiatric services continue to prescribe such treatments and why many patients continue to demand these medications.
Dr Garrett Hayes
Lucan Court Medical Centre,
Lucan,
Co Dublin
Dear sir,
Surprisingly, your correspondent, Maurice Neligan, appears to be unaware that his medical colleague, Prof Brendan Drumm, sits on the HSE Board.
In his article “A rudderless health system without leadership” (on March 10th) he describes (erroneously) the HSE board as being “a medic-free zone”.
He goes on to describe the “medical system” as “rudderless and without leadership”. It may well be, but is he not being a little hard on his colleague, the chief executive, Prof Drumm?
After all, Drumm has no previous experience of macro-administration and his training is that of a medical clinician only.
Can one think of a less appropriate training for this level of management?
Donal Atkins,
Greystones,
Co Wicklow