“Is There a Crisis in the Drug Business”
By JOHN I. KELLY
A Paper Read Before the Baltimore Retail Druggists Association
Monday, March 10, 1913
Mr. President and Gentlemen:
The subject, “Is There a Crisis in the Drug Business,” which your president has unfortunately selected me to discuss, is so vitally interesting and important to each of you that I suppose there may be a great many here who have given much more thought, and are so far more versed on the subject than I, that any feeble effort of mine would suggest no new thought, supply no new theories or give subject-matter with which you are not already familiar. However, as I have been requested to give a personal opinion, I ask your indulgence, particularly if my efforts do supply nothing new and are only in the nature of a review.
The “Crisis in the Drug Business,” referred to and discussed by many, pro and con, seems to pertain particularly to the prescription end of it, and as such will be most considered. “Crisis,” meaning a “vitally important or decisive state of things, the point at which a change must come, either for the better or worse,” somewhat describes the situation, though it has been a gradual evolution, approaching slowly, almost stealthily, until now, aroused, the condition seems acute, apparently a sudden and startling metamorphosis. It may be more properly described, however, as a gradual but decided revolution in conduct and method of business, partly due to natural conditions over which the druggist has no control, and partly to changes which he has been slow to realize and slower to adapt himself.
These changes we shall divide into scientific and commercial. Through laboratory research work, modern medical science has progressed to such an extent that in some diseases the form of medication has changed entirely, while in others medication is reduced to a minimum. Chemical combinations, synthetics, biological products, vaccines, etc., have all in a natural sequence deprived the pharmacist of many prescriptions.
The various salts of mercury and potash have been to some extent replaced by salvarsin and copavia, nitre, menthelene blue seem about to be effected by gonococcous vaccine and anti-gonococcic serum. Your gargles, douches, sprays, external and internal medication have to a considerable extent been supplanted some time ago by anti-toxin, and so on, but the unfortunate side of it is that in cities such as ours much more of these products are supplied through the health department and the hospitals than through the legitimate channel of trade, the druggist, and oftentimes to many undeserving people. Some family physicians, who are nothing more than diagnosing agents for the specialists, and who, when called in to see the sick, immediately consult a specialist, with the result that in about 50 per cent. of the cases the subject generally finds his or her way into the hospital. The great number of dispensaries in our community, with their indiscriminate service and consequent unbridled abuse, is another cause for the falling off in the prescription business.
The surgeon, the X-ray, radium, etc., all play their individual part in the decline of prescriptions. These are a few of the reasons for a more or less elimination of prescription writing, for which we may say that science is either directly or indirectly the contributing cause.