Doctor's Review: Medicine on the Move

September 26, 2021

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In France, the pharmacist rules

Omnipotent and self-important come to mind

Years ago, when I was a student in France, I had a breakout of acne, a rarity for lucky teen me. As it was unusual, I made an appointment with a dermatologist and came out of my consultation with a prescription as thick as any senior thesis. I took it to the closest pharmacist who didn’t blink an eye.

Any time you sniffle in France your friends and neighbours (all amateur diagnosticians), will quickly recommend all number of pills and sirops, any one of which is guaranteed to knock you out for a week. They know what to take for whatever kind of headache ails you. Toddlers in France can tell you if their mal de tête is stress-related or whether your angine is a petite angine or a grande angine. Or whether you have one of the ailments that I’ve only ever heard of in France. My favourite is the ever rampant “crise de foie.”

Far be it from me to suggest that France is a nation of hypochondriacs, but let’s just say their comprehensive healthcare system — which hovers at the top of the WHO’s best healthcare lists — makes it rather easy to be one.

The French visit the doctor more than in any other country. And there is a cultural consensus that the doctor isn’t treating you well unless you come away with a prescription. Or two. Or three.

Next stop: la pharmacy.

I can’t honestly remember ever walking into a pharmacy in any French city or town, and not seeing it full of people: elderly ladies, sniffling young students, well-suited men and chic women with equally chic kids in tow, all lining up to present their ailments and receive the benefit of the pharmacists wisdom.

There are all kinds of theories, on a sliding conspiracy scale, about the tight and mutually beneficial relationships between pharmacies and doctors in France, but it is generally accepted that France is one of the most highly “prescribed” countries. When everything from prescriptions to seawater spa therapies is covered it’s easy to understand why. Indeed the pharmacy and the pharmacist’s importance in French society cannot be exaggerated. And it goes beyond the nature of the healthcare system.

Presentation counts

The French fixation with all that is scientifically au courant has ensured that le pharmacien is embedded in the Gallic esprit as omnipotent. Since the days of Molière, Voltaire and Flaubert, the self-important pharmacist has been celebrated and lampooned (as have their patients) as they dispense pseudo-scientific potions to a nation of hypochondriacs. Remember Monsieur Homais in Flaubert’s Madame Bovary who represented scientific progress and modernity, but whose overzealous prescribing is fraught with error.

Since my first visit to une pharmacie, my fascination has grown. They are always one of my first stops on trips to the country. One is never hard to find. The sheer ubiquity of them means that you will see the flashing green cross indicating “Pharmacie” on nearly every street in every town, village or city.

Pharmacies throughout France look as important as they are. Many are elegant old shops with polished wood counters and glass shelves lined with antique vessels holding arcane formulas. Some have chandeliers. The Pharmacie de la Bourdonnais, near the Eiffel Tower, for example, is a 19th-century establishment that has been deemed an historic monument.

French pharmacies are different from North American drugstores. Cartesian to the core, French pharmacies are single minded places, so you won’t find cigarettes, greeting cards, water wings, magazines, groceries or other things associated with the one-stop, convenient drugstore. Conversely, pharmacies, with their monopoly on selling prescriptions, make it impossible to buy so much as aspirin at a supermarket. The key relationship between the customer and pharmacist, who is usually also the owner, is trust, as opposed to convenience or price along the lines of our pharmacies. The pharmacist is heavily involved in advising customers and patients on the appropriate over-the-counter medicine and/or the most appropriate toothpaste.

Medication and more

The reverence with which the pharmacist’s advice is held carries over to skincare products. Perhaps unsurprisingly, in France proper skincare is treated seriously. Children are taught by their mothers about moisturizing procedures from very young ages.

I like to observe conversations between client and pharmacist with the latter’s weighted opinions on, say, the correct dandruff shampoo. I rarely see anyone question the authority of the pharmacist or even their lieutenants: no-nonsense, lab-coated salesladies. They’ll analyze skin problems and lead you to anything from mink oil face cream to Homéoplasmine, a waxy balm traditionally used to soothe nursing mothers’ chafed nipples, now the Parisians’ preferred remedy for chapped lips, to Embryolisse Lait Creme Concentré, the well-priced and truly wonderful face cream with the disconcerting name. While I heard that, at one time, the product contained sheep embryo extract, the company assured me that that is not the case.

A number of these products have achieved cult status in the skincare industry and are now available in Canada at drugstores like Shoppers Drug Mart, Rexall, London Drugs or Jean Coutu. But most other tried-and-true staples like green clay, which is used to cure everything from acid reflux to the PH balance in hair, remain out-of-reach products in this country and continue to carry old-world mystery and allure. Elaborate window displays change according to the seasons. At exam time, the pharmacy window will be full of ads for, and boxes of, things that truly I’ve only seen in France: memory pills, anti-snoring tablets and, of course, pills and supplemental regimes for le fatigue.

After exams come summer holidays so remedies for slimming are given the spotlight. Slimming creams have traditionally been standard practice in the fight to reduce — anti-cellulite pills, pre-bronzing capsules, gel for “heavy legs” — as opposed to the rather vulgar American alternative: a visit to the gym.

By the fall, pharmacist windows are filled with fascinating fungi charts. Autumn is wild mushroom season bringing in cèpes, girolles, chanterelles and the sinister sounding trompettes de la mort (trumpets of death), which are in fact edible (the reason I know this is because the pharmacist told me).

One of the most important functions of the French pharmacist is mushroom indicator. All French pharmacists are required to study mushroom taxonomy as part of their training and provide the service of examining your basket of foraged fungi. Lines of men and women bringing filled-plastic bags or straw baskets into the pharmacy to have their bounty inspected by the pharmacist is one of the enduring images of fall in France.

Alas, as with many other icons of French culture such as cafés and bistros, the pharmacy as it exists is facing threats. The current government has floated the idea of deregulating pharmacies, which pharmacists worry will allow supermarkets to begin selling over-the-counter drugs and which will also potentially allow corporations to buy up the typically owner-run pharmacies. The highly personalized service would be just one casualty of that model, they say. To protest, they upheld another French tradition: they went on strike.

This article was accurate when it was published. Please confirm rates and details directly with the companies in question.


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