Objective: To determine whether health shop staff give specific therapeutic recommendations to someone who describes symptoms associated with serious pathology and to determine whether they refer this person to conventional medical care.
Design: Quantitative survey using participant observation.
Setting: Health food shops selling herbal, homeopathic or nutritional remedies in inner London.
Method: A researcher visited 29 health food shops and claimed to be suffering from severe, daily headaches of recent onset. The researcher recorded on tape whether the health shop staff took diagnostic information; recommended any therapeutic intervention; asked about or recommended seeing a general practitioner (GP); asked about use of conventional drugs. Coding of the interactions was carried out independently by two researchers.
Results: Whereas all but two shops recommended a specific therapeutic intervention, less than one in four advised a GP consultation. Forty-two different interventions were recommended. There was little consistency in the advice given.
Conclusion: Health food shops need to review the circumstances in which they should venture to provide advice and the basis on which they make any therapeutic recommendations. Shops selling over-the-counter herbal, homeopathic and health food products are a common feature of UK high streets. Such shops could be a useful source of health information and advice to their customers, but could also lead to harm, for example by delaying treatment of known benefit, if their recommendations were to be inaccurate or inappropriate.