Elephant Pharmacy Integrates Traditional and Alternative Therapies

Linda Timm Wagner, PharmD; Charlotte A. Kenreigh, PharmD


May 22, 2006

More and more patients are looking for ways to incorporate complementary and alternative medicine (CAM) into their healthcare regimens. CAM represents a wide range of medical practices and therapies, many of which stem from naturopathic and Eastern medicine traditions. Complementary medicine is defined as therapies that are used together with conventional medicine, while alternative therapies are used as substitutes.

Although many patients, especially those with chronic medical conditions, have sought alternatives to conventional Western medicine for some time, the American healthcare system has been slow to incorporate Eastern and naturopathic therapies. However, an emerging strategy called "integrative medicine" combines mainstream medical care with CAM therapies that are supported by high-quality scientific evidence.[1] Against this backdrop, integrative pharmacies have cropped up to deliver the wide array of products and services that many consumers demand, from herbal teas to yoga classes to traditional prescription medicines.[2]

This business model has been adopted by both independent pharmacies and pharmacy chains that see it as a way to embrace the growing number of patients who want more ownership of their health-related decisions, from aging Baby Boomers to the young "alternative" crowd. Perhaps the most well-known example of this new-age model is Elephant Pharmacy, which first opened in Berkeley, California, in 2002. Introduced as an alternative to conventional retail pharmacy settings, the store was designed with the health-conscious consumer in mind, offering all the traditional retail pharmacy items (prescription and over-the-counter products) along with alternative remedies. The pharmacy employs both traditional pharmacists and alternative medicine practitioners, including Ayurvedic doctors, herbalists, and homeopaths. In addition, the store provides an herbal, homeopathic, and naturopathic apothecary, and practitioners advise clients about natural therapies.

Elephant Pharmacy now has 2 stores in California, with a third scheduled to open in 2006. Each store offers access to a wide range of practitioners, including pharmacists, homeopaths, nurses, herbalists, nutripuncturers, nutritionists, and aestheticians. Elephant also features the types of products that many health-conscious consumers appreciate: earth-friendly, fair trade, locally produced, and organic.[3]

In the Elephant Pharmacy stores, collaboration is promoted among the traditional and nontraditional providers, and clients are encouraged to use all of the various types of services. For some practitioners, this "crossing of the line" might be disconcerting.

But Anne Wardell, RPh, a pharmacist at Elephant Pharmacy, says she finds the work environment very rewarding. "I was a hospital pharmacist before I joined the staff at Elephant Pharmacy and had spent nearly 30 years in that environment," she says. "The interaction with patients and the opportunity to be more involved in their lives brings me a great deal of satisfaction."

Anne Wardell, RPh

Pharmacists considering a transition to this type of setting must be able to work in a team-oriented environment and be willing to learn about nontraditional medicine practices, Ms. Wardell says. Although she notes that "a basic understanding of herbs is definitely helpful," a willingness to learn is also very important. The environment there "encourages customer-practitioner interaction and the development of ongoing relationships."

The ability to meet special needs also presents opportunities for greater interaction, says Cecilia Hart, ND, a naturopathic physician with Elephant. Naturopathic medicine is a 4-year postgraduate program with a curriculum that mimics traditional MD programs.

Cecilia Hart, ND

"Elephant Pharmacy provides high-quality products that are often difficult for people to obtain," she explains, such as homeopathic drops for ear infections that are being recommended more and more by pediatricians; nettles (a bulk herb) for seasonal allergy support; and pharmaceutical-grade fish oils that provide essential fatty acids with myriad health benefits. In addition, Elephant Pharmacy's free consultations with alternative practice professionals reach some people who otherwise might not have access to such information.

"The environment is energized because practitioners and staff are passionate about their work and are eager to share their knowledge," she says.

The blending of traditional and alternative medicine has become increasingly popular, Dr. Hart says, and integrated pharmacies such as Elephant Pharmacy allow patients to incorporate multiple health perspectives into their lives without having to travel between different stores or clinics.

The success of the Elephant Pharmacy model stems partly from the store layout, the ease of access to practitioners, and the educational outreach provided.

The interior of an Elephant Pharmacy store.

The natural apothecary and the conventional pharmacy are separated by an education center, which offers health-related resources and a classroom. Practitioners often find themselves meeting "in the middle" at the education center, the Elephant providers explained. Customers are encouraged to talk with different practitioners to gain different perspectives about the various therapeutic options available. All patients are offered free consultations daily with a rotating staff of local health practitioners, including registered nurses, naturopathic physicians, Ayurvedic doctors, herbalists, and homeopaths. Pharmacists may fill prescriptions written by naturopathic physicians for certain non-prescription products, but most of those orders are filled in the natural apothecary.

Elephant Pharmacy strongly encourages customers to research their healthcare choices and be informed consumers, the providers said. Health and wellness books are made available that relate to the products stocked in the store, with guides to herbs above herbal remedies and exercise books above the protein powders. Information cards placed throughout the store cover everything from vitamin C to how to choose children's cough medicine. The free cards explain both the traditional medical and the naturopathic perspectives on each health topic, offering customers access to balanced information.

The onsite classroom is used throughout the week for the free classes taught by local health and wellness professionals, and a schedule is posted on the company Web site. A wide range of classes includes yoga, Pilates, relaxation techniques, Feldenkrais, skin care, massage, life coaching, therapeutic uses of herbs, homeopathy, and nutriceuticals, as well as the benefits of Feng Shui.

Some market observers believe that integrative pharmacies such as Elephant will continue to grow in popularity. According to Paul W. Lofholm, PharmD, clinical professor of pharmacy at the University of California at San Francisco, this new model is the "store of the future," and patients will continue to seek advice and help from the various practitioners who staff these pharmacies.[2]

Others believe this trend simply represents a niche market in the pharmacy business. What do you think? Readers are invited to share their views and ask each other questions on the Medscape Pharmacists discussion board.


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