When it comes to her doctor, my mother is like most near 70-year-old Black women in America. Like her minister, when the doctor speaks, she takes his word as gospel — the gospel concerning her health, that is. When he writes this prescription or that for that ailment or this, she makes her way to the local pharmacy to collect her pills, cream, or medicinal fluids in rhythm.

I’ve become more of a naturalist as an adult, so I was increasingly concerned with this routine as I grew up. I became more alarmed years ago when I learned that prescription drug complications send more people to the morgue and the emergency room than all illegal drugs combined.

Of course I love my mother, so when I open her medicine cabinet, a part of me wants to clear it out like Jesus cleared out the temple. “Not in my mother’s house!” you might say. But I haven’t done that because I know how she feels about her medicine.

In this society, we’ve been taught that illegal drugs are bad, but prescription drugs — they’re good, and we have the TV commercials to prove it. We’re so comfortable with prescription drugs that we follow up print and TV ads with visits to the doctor where we request drugs by name. We take that same faith to the pharmacy where we expect to collect the medication our doctors prescribe. But a 2008 report from the National Consumer’s League (NCL) says otherwise.

According to the NCL report, pharmacists regularly engage in a process politely called “therapeutic substitution.” This is defined as “the practice of dispensing an alternative drug that is not chemically or generically equivalent to an originally prescribed drug,” sometimes without the patient or prescribing doctor being aware.

The report cites a survey where 15 percent of respondents indicated that they or a family member had recently received a medication different from what was prescribed. One-third of those people mentioned that the switch occurred without input from the prescribing physician, and the balance stated that the patient was not informed in advance. Sixty-six percent of the respondents were completely unaware that pharmacists have the authority to change medications in this way. But this practice is legal in many states.

The NCL report expresses an obvious, critical concern “that both consumers and physicians should be involved in the decision to switch (prescription medication).” References are also made to opposing positions held by prescribing doctors and pharmacists in the related debate “with physician groups often opposed to the practice, or at least expressing reservations,” while “pharmacist groups (are) more supportive of it as a way to control costs.”

Of course, when the medical industry mentions “control costs,” they really mean “increase profits.”

In addition to the concerns just mentioned, medical associations referenced in the report suspect that insurance companies are pressuring pharmacists to switch drugs to save costs — I mean, increase profits. Since cash moves everything around us in America, especially with the insurance industry, their suspicions are probably true. The pursuit of profit causes the medical and insurance industries to treat a trusting public like mere drug and insurance product consumers when we should be respected as full human beings in need of quality health care.

A new documentary film titled “Money Driven Medicine” presents this reality in explicit detail. In a compelling scene from the film, Harvard pediatrician and leading authority on health care quality, Dr. Donald M. Berwick, explains that market competition has “set up [a] war” over profits within the medical industrial complex that “the patient doesn’t need.”

The film’s writer, health care activist, former Yale professor and financial journalist  Maggie Mahar, adds that in the current medical environment, patient’s are not “the center of a collaboration” to improve their health as it should be. Instead, they are “victim(s) of a competition” for profits within the health care industry. She punctuates her remark with an elegantly simple African proverb that says, “When elephants fight, the grass is trampled.”

In other words, with medical care in general and “therapeutic substitution” in particular, needy and trusting patients are being trampled by greedy insurance and medical service providers who love money more than they love serving people. The ongoing dance between those same insurance companies and congress over universal health care reform is further proof of that fact. But even as that struggle continues out loud, the National Consumer’s League warns us that insurers are quietly imposing a different and potentially dangerous brand of prescription health care reform on the American public.

So I give thanks to the NCL for shedding light on this troubling practice. My only regret is that their report didn’t specify how often African-American people have their medications switched in this way. Since being exploited for profit is part of our history in this country, I would bet that many of us are receiving different drugs than our doctors prescribe on a daily basis. If it happens with us as often as I suspect, then it’s probably affecting people like my mother the most. After all, statistics indicate that women take more prescription drugs than men and children do, and history reveals that African-American mothers, sisters, daughters, and wives get more than their fair share of attention in this regard.

This should remind us all that the capitalist creed — caveat emptor (let the buyer beware) — applies to prescription drug purchases and all other commerce in America. And while we rightfully criticize the spirit, character, and practices of insurance crooks and their medical counterparts who victimize our society and the people in it for profit, we must trust no one more than ourselves to direct and protect our health interests.

Generally speaking, no medicine is better than exercise and a healthy diet on the front side of illness. If we add an increased measure of balance and propriety in our life practice, we’ll further improve our health condition. But when we do find ourselves having to visit a doctor, we must be prepared to ask a lot of questions, insist on real answers and read the fine print — especially concerning prescriptions. If and when problems arise, we must also not hesitate to file medical board complaints and reach out to community organizations for assistance and collective resistance to health care abuses.

After all, it seems painfully clear that the only real health care reform we’re going to see anytime soon is the kind that we create for ourselves. Otherwise, we’re sure to be left with policies favored by insurance companies that continuously reform our bank accounts to a minimum balance, while rolling pills like dice in a greedy gamble with our health.

Mshujaa Komoyo is a freelance writer and engineer based in Long Beach.