Saturday 12 December 2009

GP Dr Tim Robinson - why Homeopathy works in my practice

I've been meaning to post the letter below from GP Dr Tim Robinson for some time. It was published on www.pulsetoday.co.uk a few months back and has of course brought the usual cabal of homeopathy's critics out of the woodwork to criticise him for doing something which works for his patients.

Good for him. He follows in the line of many doctors through the last 200 years who have incorporated whatever elements of natural medicine work for them into their practices.

Homeopathy doesn't poison people and its remedies have gently cured millions of people of their ailments for over 200 years. Conventional Medicine, so-called, sadly too often harms those it seeks to treat and its proponents have too large a share of information control in health matters. We are unlikely to change their minds. In the words of Ogden Nash "I cannot help mentioning that the door of a bigoted mind opens outwards so that the only result of pressure of facts upon it is to close it more snugly." However, we should continue to try and ensure that our fellow humans have the right in return for the taxes they pay to full, undistorted information on health matters, freedom from coercion, and the right to choose the treatments they believe will help them best where these are economically possible.


Dr Tim Robinson's letter:

"I have been incorporating homeopathy into my general practice for almost 15 years.

I have found homeopathy effective as an alternative to conventional medicine for problems in all the systems: respiratory, digestive, skeletal, hormonal, skin and mental/emotional health. It is also extremely useful in situations in which conventional medicine is ineffective or non-existent such as bruising, recurrent cold sores, chilblains, leg cramps, glandular fever, growing pains, teething, infantile colic and children with bedwetting and sleep problems.

Incorporating homeopathy into my general practice has also reduced my referral rate to secondary care, as well as saved my drug budget. Along with these advantages I believe that I have benefited through dealing with my heart-sink patients more effectively. Homeopathy has enhanced my communication skills and resulted in a greater ability to connect with my patients.

The provision of a homeopathic service in routine general practice is very straightforward. As with all consultations the patient presents their particular problem or set of symptoms from which I make a diagnosis and decide upon a management plan for the case. If I consider homeopathic treatment is an appropriate, safe and valid alternative I offer my patient the choice at that point.

I usually point out that although we homeopaths don’t yet know how it works, years of homeopathic experience support its effectiveness. When I am offering the homeopathic choice I back it up with the fact that it won’t do any harm and if it doesn’t work we still have conventional medicine to fall back upon. Patients are usually receptive to this and grateful for the choice.

Homeopathic prescribing is perfectly possible within the standard 10 minute GP consultation time. The prescription is usually based upon one of a number of possible prescribing strategies. For example some specific conditions respond to specific medicines, such as Arnica for bruising or Cocculus for car sickness. I may also prescribe on ‘local’ features of a condition i.e. those features that are individual to the case, for example joint pains that are better for heat and movement (Rhus Tox rather than Bryonia).

Homeopathy has received a lot of slating over the last few years. Our critics discredit homeopathy by saying that patients improve (yes, they admit they do improve) because of long and repeated consultations. As I have described, my homeopathic consultations are mostly seen within standard 10 minute GP appointments. The additional psychotherapeutic effect that can be gained from long consultations does not apply in this situation.

I audited my homeopathic prescribing over a year and demonstrated the wide range of conditions that homeopathy can be prescribed for (1). I assessed the outcomes from the homeopathic treatments by scoring the degree of improvement. I was pleased to find that 78% of those patients treated noted an improvement. These results support the use of homeopathy within my NHS general practice. It was also pleasing to find that this improvement was of the same magnitude as other outcomes studies performed in homeopathic hospital outpatient clinics. (2, 3, 4, 5)

Despite the consistency between these independent outcomes studies, the sceptics are still unconvinced. It is often said in the media that there are no clinical trials in homeopathy that show a positive effect. This is simply untrue. A total of 138 randomised controlled clinical trials have been done, in 71 different medical conditions – 60 had a positive outcome, 68 weren’t statistically conclusive and only 10 were negative. We openly admit that the medicines are often so dilute there are none of the original molecules left in it but how do you explain that these same medicines have a measurable effect in laboratory experiments with allergy response blood components? (6,7)

The sceptics also claim that patients improve (yes, they still state that they improve!) because we only treat conditions that get better on their own with no treatment. Those of us who have been treating patients with homeopathy for long enough will know that we successfully treat many long-term conditions that have previously shown no sign of improvement over long periods of time.

We are also accused of deliberately misleading our patients; as I described earlier, I deliberately tell my patients that we don’t understand how homeopathy works and leave it to them to decide between conventional and homeopathic treatment.

My final annoyance with the sceptics is that they accuse us of being dangerous and treating inappropriately by discouraging childhood immunisation and recommending homeopathic vaccination. Members of the Faculty of Homeopathy are all statutorily registered healthcare professionals who operate within very clear policy guidelines which unequivocally advocate conventional medical immunisation.

The Faculty of Homeopathy offers training at various levels, the first of which is a short course leading to the Primary Health Care Examination. Passing this exam enables you to join the Faculty as a Licensed Associate and to use basic homeopathy in your general practice.

In an ideal world there would be even greater provision of homeopathic treatment in the GP setting. I know that it would bring great benefits to our patients, ease the NHS drug bill and pressure on hospital services. It would also increase the enjoyment and effectiveness of practising as a GP; the quality of life of all parties involved would be enriched.

For more information about training in homeopathy, go to www.facultyofhomeopathy.org"

References:
1. Robinson TW. Responses to homeopathic treatment in National Health Service general practice. Homeopathy 2006; 95: 9–14.
2. Spence D, Thompson E, Barron S. Homeopathic treatment for chronic disease: a 6-year university hospital based outpatient observational study. J Altern Complement Med 2005; 5: 793–8.
3. Clover A. Patient benefit survey: Tunbridge Wells Homoeopathic Hospital. British Homeopathic Journal, 2000; 89: 68–7.
4. Richardson WR. Patient benefit survey: Liverpool Regional Department of Homoeopathic Medicine. British Homeopathic Journal, 2001; 90: 158–162.
5. Sharples F, van Haselen R, Fisher P. NHS patients’ perspective on complementary medicine. Complementary Therapies in Medicine, 2003; 11: 243–248.
6. Belon P, Cumps J, Ennis M, et al. Histamine dilutions modulate basophil activation. Inflammation Research, 2004; 53: 181–188.
7. Chirumbolo S, Brizzi M, Ortolani R, Vella A, Bellavite P. Inhibition of CD203c membrane up-regulation in human basophils by high dilutions of histamine: a controlled replication study. Inflammation Research, 2009: e-published, 6 May.

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