THE COMMERCIAL SIDE.
Several times agents for tablet houses have called on me and said: “Dr. So and So has just given me a little order, or intends to increase his line of our goods; of course, we don’t sell doctors direct, so if you will let me send these goods through you I will bill them straight, subject to a 10 per cent. discount to you; this means business for me and 10 per cent. on the doctor’s purchase for you. In other words, I was to guarantee their bill, wait for my money until the doctor was ready to pay, and act as their collecting agent, for all of which the above traveling man most magnanimously offered the above highly remunerative 10 per cent. and this for the worst enemy the druggist has—the dispensing doctor. That gentleman who pays no taxes on his stock and fixtures, needs no traders’ license, is subject to no drug inspection, who is insincere with his patients, and needs but the occasion to discredit druggists, as a whole, in furthering his schemes of diverting from the proper channels that which rightfully does not belong to him.”
Another reason is the mistake made at times by the druggists, as a body, of often plunging headlong, and with the purest motives possible, into any vortex created by a few overzealous men, both physicians and pharmacists, who are more often theorists than practical druggists, and to illustrate my point I recall an incident of more or less recent occurrence that tended to inspire little confidence of thoughtful physicians in them as a whole.
Various medical associations, pharmaceutical associations, and nearly every journal allied to medicine and the drug trade decried the use of hand-me-downs. The committee on revision of the N. F. immediately offered us a number of preparations of varying merit, that were not even good substitutes for the above, and these I have understood at the suggestion of some physicians.
Glycerinated Elix. Gentian, if made according to formula, with its excessive amount of solution of saccharine and its repulsively excessive amount of acetic ether, would never supplant the preparation it was intended to take the place of.
Pulv. Acetanilid Comp. is as dangerous a heart depressent as the nostrum it was supposed to displace.
We were told that Lactopeptine was too expensive to use as a vehicle, and was worth not a continental medicinally; that Pancreatin and diastase were destroyed by Pepsin in the presence of an acid; besides, after the chemists of the A. M. A. were through their analysis, they found there was so little Pepsin that it was scarcely worth mentioning, but if the doctor wanted a good pharmaceutical we could supply Pulv. Pepsin Comp. or Elix. Digestive Comp., either just as good, not quite so expensive, and certainly would do no more harm. Associations printed proprietaries and substitutes side by side and launched this matter as a propaganda of education for the physicians; material that filled no void, supplied no deficiency and appealed to many only as a means to increased profit.
That some physicians did prescribe was only because they had more confidence in the druggists as compounders of the above preparations than they had in the manufacturers of the nostrum; because they were friendly enough with the individual druggist to open an opportunity for a little better profit; because they thought their patients would be more economically handled; but had the revisionists advanced a few scientific combinations, elegant pharmaceuticals or easily prepared chemicals, they would have given the druggist better material for propaganda work and appealing agents to most physicians. It was, however, to a certain extent a wasted effort, lacking in conception, devoid of originality and decidedly wanting in producing lasting results. So much for some of the contributing causes.
Now for the effect. Business conditions have undoubtedly changed. This applies not only to the drug business, but to every line of trades or professions.
Our good old friend, the family doctor, has felt the effects of the surgeon, the specialist, the hospital, the dispensary.
Lawyers, the effect of the title guarantee companies and syndicated law.
The dry goods and notion business has been revolutionized into department stores.
The horse dealers, horseshoers and carriage builders must feel the introduction of the motor vehicle.
Laborers have felt the innovation of the steam shovel, etc.
I could go on almost indefinitely, but these changed conditions are the outcome of science or commercialism, and are inevitable. Now, what is the remedy? I had intended to say nothing on this subject, as it would make quite an interesting paper or be food for animated discussion, but a short consideration of this text is so intimately associated with the subject under discussion that it seems particularly well timed. We are on the eve of still another “crisis”—a “crisis” that partly answers the question, “What is the remedy?” and a close investigation will discover that a pronounced reaction is setting in against many of the products of the laboratory physicians and the faddists who have led their more gullible fellow-practitioners to adopt their experimental novelties and reluctantly have found that practicing medicine without the materia medica is like playing Hamlet without the Melancholy Dane.
The reckless use of biological products, vaccines, etc., is even now being severely handled by both medical and lay journals, and as interesting reading I would call your attention to two articles, one a serious editorial in the Journal of the American Medical Association under date of February 22, 1913, page 602, entitled “Phylacogens,” and the other in a lighter vein, entitled “Medicine,” by Cobb, in the Saturday Evening Post of November 30, 1912.
The man who seeks the little things generally gets the little sought; the man who hunts big game, and is persistent, most often makes a good bag, but the old adage, “Everything comes to him who waits,” may have applied years ago, but many theories and much fact disprove it now. There are still going to be sick people to prescribe for and doctors to do the prescribing. Someone must fill the prescriptions. Who is it to be? It is going to be the man who can shape and mold himself to conditions as they arise. Most doctors are your friends. Even now the ties are becoming more firmly cemented. He is dependent on you to a certain extent. Be fair with him, and he will in most cases reciprocate. And last, but not least, just for a suggestion, lend your aid to some concerted action to control the dispensary evil by having all applicants for treatment first obtain pauper cards from the Police Department or Federal Charities, then see that the dispensing doctor is placed on an equal business footing with you, have him pay his legitimate taxes on his stock, take out a traders’ license, let the drug inspector examine his stock for purity and potency, and finally, see if there is not some way of reaching the gentlemen, for to my mind a physician has no greater right to practice pharmacy without registration than a druggist has to prescribe.
Pharmacy is a profession of the highest order, a sort of composite type, requiring the manipulative skill of the mechanic with the technical knowledge of the professional man, and demanding above all other professions at all times a clear head and an immediate and scrupulous knowledge of your subject. There is no profession where demands are so exacting and mistakes more consequential.
Still you have seen your profession tossed and buffeted about like a ship on a stormy sea. You have had your honesty questioned by a certain class of physicians when it suited their purpose; you have been called substitutors in patent medicine literature and advertisements; you have stood endless vilification from one source or another and retained a calm, dispassionate silence, an indifference so intense as to become startling in its apparent acquiescence.
Can you blame the public for believing some of the things said about you when not so much as a word of defense or a syllable of protest is offered in rebuttal?
As individuals you can protect yourself but feebly and accomplish but little; united you must be a power. Every one of you wields an influence, great or small, that in the aggregate will well be worth catering to, if you work as a unit. You have it within your power to do much of mutual benefit if, as a body, you work toward a common goal. Decide in meetings on that which is best; start with a thorough plan; play politics, if necessary, but that politics that knows no party but the one that is willing to prove your friend and help you realize your needs. All the resolutions passed, all the enthusiasm demonstrated in your meetings will amount to nothing and you will revert into a mutual admiration society unless followed up by every ounce of alertness, activity and aggressiveness that your various committees and your massed membership can summon to their aid. Yours is a worthy cause; one that demands justice and equity, and in all fairness to yourselves, you want to enter it with that energy that brings success. You can remain passive no longer; you must be up and doing and your rights cannot be denied you if your demands are honorable, just and consistent, and I am sure they will be.
Every letter, magazine article and trade journal containing short essays from druggists scattered the length and breadth of this great land of ours sound the same note, strike the same chord, and are united in one grand chorus of perfect harmony the summary of whose song is “Corrective Laws and Unity.”
Our great trouble seems to be that we lack union and concerted action on important matters. Laws are enacted and enforced by every line of tradesmen, mechanics, professional men, and even laborers, protecting their individual interests, and which we all must live up to, whether we consider them fair or unfair.
Your plumbing must be done by none, however skilled, but a registered plumber, and the law is positive. Arguments before your law courts can be conducted by no one, no matter how able, unless he be a registered lawyer, and the law is definite. No one dares to practice medicine who is unregistered, and the law is explicit, but where do the rights of the pharmacist begin and where do they end? The unrestrained and indiscriminate sale of medicines by department stores, the corner grocery, patent medicine shops and what not, whose proprietors are not only unregistered, but whose only knowledge is to handle it like the rest of the merchandise they sell, without any restriction, makes us feel like we wasted time in becoming registered at all.
Is antikamnia more potent when dispensed as a prescription than antikamnia sold in 25-cent boxes by department stores?
Does paregoric sold on a doctor’s prescription require greater technical skill in handling than that sold in 5-cent and 10-cent bottles at the corner grocery?
Does the strength, purity or therapeutic value of tablets of asperin, calomel or pills of quinine dispensed by the druggist on prescription vary from those peddled by the dry goods stores in 100 lots?
Does the registration of pharmacists mean simply a guarantee of competency to fill prescriptions?
Should drugs of a questionable degree of potency be given indiscriminately to the public, without someone who understands them to either recommend or advise against their use?
Is not the competition waged in the traffic of medicines to an irresponsible public by houses without registered proprietors in fact considered in an entirely different line of business, as much a hardship to the big druggist as to the little man, simply a question of proportion, and if continued must mean but one thing, “the survival of the fittest?”
Suppose we turn from drugs and chemicals to other forms of medication. What protection have any of you? Only very recently one of the large general merchants advertised vaccine virus, and actually vaccinated his customers.
But the druggist lies supinely by, with scarcely a murmur of protest, while National, State and Municipal laws are made for him. Laws that are definite, made to prosecute, to handle him criminally and contemptuously; that afford no protection, allow not the slightest leeway, are as fragile as glass apparently for others, but for him as unyielding and inflexible as steel, and as positive as the Decalogue; made by men who have no practical knowledge of the business, know little, and inform themselves less on the matter they are legislating. Why does the druggist submit? Has he become callous through long exposure to this condition? Does he hope to win his immortal crown through his great humility and patience, or does he accept as a fact that he is following a well-defined precedent, for as far back as Shakespeare’s time we find Romeo saying to the apothecary:
“Upon thy back hangs ragged misery.
The world is not thy friend, nor the world’s law.
The world affords no law to make thee rich;
Then be not poor, but break it, and take this, etc.”
But, unlike Romeo, I advise obedience and respect for the laws you have. Make the best of them until such time may arrive when we can demand equitable treatment; when you will live under laws formulated by yourselves; when your laws protect, and do not discriminate or oppress; when the dignity of pharmacy is akin, at least, to other professions. It may be at a distance, but the longest road oft-times has many short cuts, so it is with you now to take the initiatory step, for, as the saying goes, “Something attempted, something done,” any movement toward a realization of our ideals should be eagerly sought and accepted.
You have the blood and sinews of the drug trade of the town among you. As an association, don’t follow the paths of your predecessors. Establish an individuality by doing things differently from others. Let every man pledge his moral, and, if necessary, his financial support, and stick to it. Let us prepare a new path and tempt Opportunity, and when that great, but elusive and fickle dame, should appear, make her welcome so sincere and royal that the good lady would not deign to leave.
Unite in your efforts; combine in your legislative matters, combine on educational features; combine on social relations; combine on grievances; combine with your ways and means committee. We have a common cause to work for. Every man is as vitally interested as the other, and has as much at stake, HIS ALL. And I am sure by unity of action on matters well discussed in meetings, much of material advantage can be accomplished, and before the sun sets on many another year many trade defect will be on a fair way to be remedied, and what now appear to be breakers ahead will subside, calmed by the oil of Prosperity, to make easy sailing for the Good Old Ship Contentment.
A MODERN FOUNTAIN—SIMPLE AND INVITING. IN THE STORE OF DAVIS DRUG COMPANY, FORT SMITH, ARK.