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Interview with Brian Ellinoy, Pharm.D. |
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by Barbara Howard
A New Breed of Pharmacist is Emerging –
The Integrative Pharmacist
The conventional medical profession is beginning to understand the need for knowledge and education about complementary therapies, nutrition and natural health. Since most doctors depend on pharmacists for information and advice about medications, can integrative pharmacists provide an even broader, valuable service to health care providers and patients?
I recently attended a seminar at our local community hospital where I met Dr. Brian Ellinoy, an integrative pharmacist consultant and educator. To my surprise, he presented information about supplements and foods to help cancer patients augment conventional treatment and deal with side effects, and offered natural tips on cancer prevention as well.
With the dawning of the new integrative medicine model, there may also be a need to add education and training of complementary therapies on the pharmacist level. The editors of totalhealth magazine agree it is important to explore this topic further. The following is my interview with Dr. Brian Ellinoy.
Barbara Howard: Thank you for meeting with me. Please tell me about your background.
Dr. Brian Ellinoy: I obtained a Doctor of Pharmacy (Pharm.D.) degree from the University of Southern California School of Pharmacy in Los Angeles followed by a residency in hospital pharmacy and a tour of duty in the Indian Health Service. Subsequently, at the University of Vermont College of Medicine I was affiliated with the PROMIS Laboratory, a group led?by Lawrence Weed, M.D., developer of the Problem-Oriented Medical Record, which was involved in the pioneering computerization of the patient medical record and in the development of online guidance used in medical decision making. Returning to California, I became a staff clinical pharmacist at Community Hospital of the Monterey Peninsula, a position I held for more than twenty years.
By choice, I’m no longer a practicing pharmacist. I’m now an integrative pharmacist consultant with a practice in Monterey, California. I felt it really was time for a change. I sensed a need by the public for much more information about the universe of modalities available beyond drugs, surgery, chemo, and radiation for dealing with health challenges. I felt confident that I finally knew enough at last to begin providing a unique service with a foot in both worlds, and was greatly encouraged by medical colleagues who had integrative practices or understood the integrative approach.
Ms. Howard: Why did you decide to learn more about complementary therapies and how did you expand your knowledge base?
Dr. Ellinoy: My original interest in complementary therapies arose from illness of a family member and the inability of conventional medicine to provide adequate assistance. This led to an investigation into alternative therapies. I took classes and received certificates in acupressure, Healing Touch, Neuro-Emotional Technique (NET), and Total Body Modification (TBM) both in my local area and elsewhere in California, completed a correspondence course in practical herbal therapy from the Australian College of Phytotherapy and an Internet course on homeopathy and homotoxicology from Westbrook University. In addition, I attended national seminars and conventions on complementary modalities, participated in online or by mail pharmacy continuing education programs on herbs and supplements, and engaged in sessions of Qi Gong, Tai Chi and yoga for my own personal health.
Ms. Howard: How did you weave this into your practice as a pharmacist?
Dr. Ellinoy: It was very difficult to weave this into my conventional hospital practice as the hospital environment was much too conservative to allow for the inclusion of complementary modalities into everyday practice. On occasion I was able to make a suggestion to a patient or a nursing colleague who I knew was interested in different approaches, but I was imbedded in an environment which focused primarily on drugs, surgery, chemotherapy, and radiation. I developed a monthly class open to the public on herbs, supplements, and other complementary therapies. Guest speakers were invited to present their specialties and it was well received by the public. I got to be known as the pharmacy’s “fruit and nut man!”
Ms. Howard: What is an integrative pharmacist?
Dr. Ellinoy: My definition may differ from that of others. I feel it’s important to try to keep it consistent with the term “integrative medicine” in order to align myself with true integrative physicians and other integrative practitioners. An integrative pharmacist is a licensed health care professional who has been educated in the basic sciences of pharmacy and medicine, has graduated from an accredited college of pharmacy, has obtained additional training in and experience with specific integrative/complementary therapies such as herbs, nutritional supplements, acupressure, Healing Touch, homeopathy, and imagery, and is familiar with many other integrative healing modalities and practitioners.
Ms. Howard: What does an integrative pharmacist do?
Dr. Ellinoy: An integrative pharmacist, using this unique educational background, training, and experience, is able to assist patients, physicians, and other health care providers both with conventional drug therapy and with the selection and use of integrative/complementary therapies to enhance care. In this advisory role, an integrative pharmacist’s primary concerns are patient safety, efficacy of all therapies, appropriate use of evidence-based information, and the fostering of patient responsibility for individual health care choices. It is very important to note that while pharmacists are not usually licensed to diagnose or treat except under physician-supervised protocols, their licenses do allow them to offer information and advice that can be used by patients in concert with their primary medical care providers.
Ms. Howard: It seems that pharmacists are being woven into the pharmaceutical advertising/sales world. I’ve recently seen new advertising campaigns by some pharmaceutical companies which recommend that you ask your local pharmacist. This is a switch from previous ads which recommend that you ask your doctor. However, I rarely see pharmacists talking to customers. How do conventional pharmacists typically deal with customers?
Dr. Ellinoy: The pharmacist is supposed to consult with the customer about each new prescription. What usually happens in busy community pharmacy practices is that the clerk or cashier will ask the customers whether they would like to discuss their prescription with the pharmacist and leave the decision up to the patient. Filling prescriptions is so labor intensive, even with the help of technicians, that the pharmacist has very limited time for consultations.
If the patient obtains prescriptions from just one pharmacy or pharmacy chain (which is recommended), the pharmacist will have a full record of all medications being taken and will address the new prescription in the context of the total picture. If the patient shops at different pharmacies, the pharmacist will not necessarily have a full record with which to work.
The prescription is usually entered into the pharmacy’s computer, at which time an automatic check for contraindications, allergies, duplications, correct dosage, and drug-drug interactions is conducted by a computer program. If a potential problem is detected, the pharmacist will evaluate and contact the physician if necessary, as well as talk with the patient to get more information. The pharmacist has no way of knowing what over-the-counter medicines or supplements the customer is taking unless there is an initial consultation.
Ms. Howard: In addition to the need to know about prescription drug side effects, and interactions with over-the-counter medicines and supplements, what are some of the biggest challenges your clients face?
Dr. Ellinoy: Not only do my clients have challenges with their own health issues, which are enough by themselves, they also have to deal with a health care system that in my view is basically unresponsive to their needs. They are often given a dire diagnosis but with seemingly little support at the beginning when they need it most about the true universe of options at their disposal and the ways they can empower themselves to deal successfully with their individual situations. They frequently are coerced to make decisions based on fear rather than be able to utilize their own personal intelligence and innate wisdom. They don’t get questions answered to their satisfaction and they often have difficulty even getting their phone calls returned. Many physicians are not keen about their patients using nutritional supplements or other complementary modalities, and patients feel like they either have to battle for their right to choose (which is not pleasant) or say nothing at all. When clients come to see me, part of what I try to do is help them navigate more easily through the system, replace fear as much as possible with a more positive approach in which they feel self-empowered, and support them on their healing journey no matter which path they choose, while focusing on keeping them safe above all.
Ms. Howard: Do you think the need for complementary therapy education should be addressed when people enter schools of pharmacy?
Dr. Ellinoy: I do believe that schools of pharmacy should include the study of complementary therapies in the education of pharmacists. A combined training program in pharmacy and naturopathy might be one approach to consider.
Ms. Howard: Where do you see the practice of integrative pharmacy going?
Dr. Ellinoy: My view is that the health care system in this country needs revamping, including a major focus on health and the prevention of disease. It means utilizing the best in both conventional and non-conventional approaches for health challenges. The pharmacist, with expanded training and experience, would be in a favorable strategic position to provide advice to both the health care provider and client to help individuals navigate their health journeys. In my daily work I am working toward this end.
Ms. Howard: Thank you.
Brian Ellinoy, Pharm.D., has an integrative pharmacist consultant practice at both the Center for Integrative Therapies and Lemuria Health Institute in Monterey, California. He is a featured speaker and presenter at professional group meetings, health fairs, and organizations. His Web site is http://www.integrativepharmacist.com and he can be reached at
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Barbara Howard is a writer and frequent contributor to
totalhealth magazine. She resides in Monterey, California. She can be reached at
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