Some practice related questions....from a fence-sitter (aka mongrel)

[muthu kumar]

That is a nice way of putting it Joy-
Out of curiosity - let me ask you
(Of course 'classical' or 'non classical' - homeopaths of all colors
and flavors can reply)

1) How many patients are generally NOT helped by homeopathy? In my
practice I would have thought the success rate ( sometimes cured,
sometimes controlled, definitely helped so that they do not take other
medicines for their complaints) to be about 60-70%? May be 2/3s of my
patients- Give or take - In your practice say about 70? 80? Definitely
none of us can say 100% I think including Hahnemann/ Kent

2)What do we do for the rest of them? If the patient still comes to us
for treatment how long do we persist if they do not respond? If they
do not respond do you put it down to your failure ( lack of knowledge
etc)or the systems? Whatever it is, what is the next step?
Send them to another homeopath?

Send them to another system?

If so which system would that be so that it is not considered sitting
on a fence? Which system would that be so that we can be confident
that it will help where homeopathy had failed?
Or would you just say that you have not been able to help and let the
patient decide? Would that be fair?

3)Would you consider referring to allopathy at any point at all? If so
why and when? Leave alone legal and mandated instances... assuming
that there is no legal compulsion, just based on case diagnosis and
the merits of the case, when would you think of sending a patient to
allopathic care?

4) If a patient comes to you for severe depression, for example , with
suicidal ideation, and you have not been able to help, how long will
you persist? Let us say this is a bipolar disorder and still there are
manic episodes now and then...

5) what about emergencies? Status asthmaticus? Severe anaphylaxis?
severe renal colic? Acute condition with a known rabid dog bite on the
face?

Would you consider yourself competent to handle these? Are there
homeopaths around who handle these? If not, is it fair to send them to
allopathy? What point do you think it is best for them to return to
you since they are in allopathy care or is it better for them to
continue in allopathy at that point since they have been tainted -
the toxic load etc...

6)What if a patient comes to you first for a complaint? Let us assume
that you have the legal rights to come to a diagnosis and order tests
( let us say you are practising in India or you are advising some one
practising in India)

Let us say cough with blood in sputum- would you run sputum tests -
culture? Or would you rather not? Or for urinary tract infection- do
you do culture at all? Would you want to find what type of infection
at all? What would you call urinary tract infection since infection
itself is a doubtful concept for those not on the fence- just urinary
tract inflammation? arsenic poisoning? Only symptoms would guide -
right? To what stage would you investigate and when would you stop?

Stool test for worms? Is it really needed where you suspect worms?
Can worm symptoms be caused by excess thiocyanates or something else
in nutrition?
For thyroid problems - would you think hormone assays important? Does
homeopathy have any problem recognizing endocrine disorders? Are
biochemic tests helpful at all or are these just a waste of money and
effort? Would you consider them important for case management?
Will be interesting to see how a 'classical' approach to these
situations would be....
-- In minutus@yahoogroups.com, Joy Lucas wrote:
"works",

[dr. leela]

Hello HAhnemannian,
I"m jumping in and have no idea where this discussion originated. But
there is a very simply answer to your so many questions.
I wouldn't know which flavour or colour of classical homeopath I am - but:

The CHOICE lies with the patient FIRST and the practitioner SECOND.

I find that pateints who have complete confidence in me or in
homeopathy alleviating through problems (acute or chronic) will stick
by my treatment though storm or sunshine. If I'm not available they
weigh their odds - trust another homeopath or take allopathy or whatever.

I will work to my utmost to help patients (who have already been with
me on consitutional treatment) through acute emmergencies as well as
acute exacerbations of chronic problems.
Sometimes I give them a time frame based on pathological parameters,
that I have to find the similimum within that limited time frame even
if there are a couple of misses - I clearly tell them that if the
remedy is correct they should be comletely well within a certain
period of time and they learn to recognize that and get back to me
with better characteristics when they are not better.

IF things don't work out for a multitude of reasons:
- i'm unavailable
- they cannot get back to me as they are in TImbuctoo
- someone has frightened them about the consequences of waiting
- they cannot get hold of the similimum remedy, etc
they (THE PATIENTs) decide whether they will take some other
assistance (allopahtic, ayurvedic, whatever).

I have found that the more accurate I have been in finding a similimum
(consitutional, acutes, etc), the more my confidence in handling
difficult situations has grown. The pateints are more willing to
depend on homeopathy, and we hardly have to worry about refering out.
HOmeoapthy is a complete system of medicine.
OF course I make use of any necessary laboratory parameter to confirm
clincal improvememnt where necessary, especially in serious cases.
BUT I don't usually ask for unnecesary investigations when I'm sure
of the diagnosis and sure of the remedy response except for proving a
point/diagnosis to a patient who needs it.
dr. leela
--- In minutus@yahoogroups.com, "hahnemannian2002"
wrote:
would
sits
only
individuality

[muthu kumar]

Thanks Dr.Leela-
This is pretty much what I do and most homeopaths do anyway...
-- In minutus@yahoogroups.com, "dr. leela" wrote:
- but:
whatever.
never
studied
their

[dr. leela]

You're welcome HAhnemanian.

But I dont agree with you: I don't notice most homeopaths doing that -
unfortunately. I"m sure most AIM to do so though, at least I hope they
do (aim so) which is the reason why I posted.

The reason I say so is because of the confidence level to handle
acutes and emmergencies as well as lack of proper guidance to
appraoch such situaitons in a simple, logical manner.
There is a lack of confidence in prescribing the similimum in acutes
(with frightening names like PAncreatitis, cardiac angina, coma, etc)
and a lack of guidance on how to handle/manage the acute vis a vis
constitutional treatment in a particluar case at a particular point of
time.

HOpefully this will change slowly in the future. Acute management does
not reuqire one to know exotic remedies. But it does require vigilance
for a change of precription while watching the direction of cure.

MAybe I did not undertand the reason for your questions - but I
understood through them that somehow we can't seem to shake off our
fear of these situations. OFten instead we look to mixopathy and Quick
fix protocols with the excuse that there are not "good" classical
homeoapths" or that we dont'know if we'll find the remedy in these
situations - what a comedown!!!
Instead of working on ones confidence level KNOWING that classical
homeoapthy is capable of this, and BECOME GOOD CLASSICAL PRESCRIBERS
that ANYONE with simple interest and pasison for homeopathy could
achieve, with a ilttle guidance in the right direction. (I"m not sure
if you follwed the thread of PROTOCOLS on the Lyteforce list. But
certainly many seemd to be ready to jump on the quick fix protocol
badwagon rather than follow classical rules which you claim is what
most homeoapths do.)

In complicated cases I"m always happy to have an allopathic MD
watching the pathology but its not a necessaity - and its important
that they are sympathetic to homeopathic treatment and do not
interfere with the progress. I have been forutnate to always have this
partnership/collaboration with sincere symptomatic alloapthic MD's.
--- In minutus@yahoogroups.com, "hahnemannian2002"
wrote:
other
of my
Definitely
to us
knowledge
sitting
let the
If so
, with
there are
on the
them to
assume
tests
some one
urinary
Does
money and
homeopathy"?

[muthu kumar]

This is the only list I visit... so am not sure of the lightforce
discussions on protocols. Though I have not used protocols,I am not
against protocols by principle. If that is how someone wants to
practice and if they and their patients are satisfied, why should one
care? We do not have hard and fast rules for this- so cannot complain.
If I can stand meditative provings I can stand anything....

I have known some lay practitioners who used to give combinations etc.
in homeopathy slowly learning the system more and more to become good
and confident single medicine practitioners. Some people still give
combinations... in my opinion though single medicine is preferable I
do not see any thing sinful in giving combinations as well..if the
combination does not work they are going to lose their practice - if
it works then there is no complaint- they may not be "classical"- so
what the h---? As long as they are helping someone in the way they know.

I have been associated with a lot of homeopaths who are excellent
prescribers - I am not sure if classical or non-classical as I am
ignorant of what that means- who had excellent acute prescribing skills.

Acute prescribing is not too difficult in a way - since the symptoms
are more clear-cut and more defined- so with a couple of modalities
and an aetilogy prescribing is usually easy.

Problem is with having adequate support, hospital services available -
for fluid replacement ( in vomiting for example)etc. I have seen the
best acute care from small town homeo prescribers in India- who are
stuck with managing all cases because they do not have the luxury to
refer to allopathy doctors and patients also have nowhere else to turn to.

Since big-town and city doctors are exposed to standards of practice
and patient care and patients are also more educated and aware of
options and consequences there is much more accountability. Instead of
taking a risk and losing their practice they feel it is better to
refer. I have seen a symbiotic relationship in many places - where the
allopathy and homeopathy doctors refer cases to each other.

Personally I think if one feels one cannot handle a case using
homeopathy there is no harm in referring without fear of ridicule and
being called names.

Patient care is much more important than our pet theories. May be that
person's knowledge in homeopathy is inadequate - so what? That happens
for anyone... Can the patient and condition wait till he/she shores up
their knowledge and / or confidence in homeopathy and come back to
treat? This is neither a slight on homeopathy nor on the homeopath.
Each one should know when to stop meddling. Homeopathy is capable of
100% care in ideal circumstances. But conditions are not always ideal...
--- In minutus@yahoogroups.com, "dr. leela" wrote:
originated. But
stick
with
even
similimum
out.
confirm
proving a
colors
If they
diagnosis and
patient to
long will
return to
tainted -
tests -
infection- do
infection
infection
stop?
worms?
something else
If one
hopefully not
fundamentals of
one

[dr. leela]

Hi HAhnemanian,
You have a point about an EVOLVING homeopath.
But this statement :
I have known some lay practitioners who used to give combinations etc.
in homeopathy slowly learning the system more and more to become good
and confident single medicine practitioners. Some people still give
combinations... in my opinion though single medicine is preferable I
do not see any thing sinful in giving combinations as well..if the
combination does not work they are going to lose their practice - if
it works then there is no complaint- they may not be "classical"- so
what the h---? As long as they are helping someone in the way they know.

--- makes for shoddy homeopathy in the long run for teh homeoapth, the
homeoapthsy evolution, the homeopaths confidence, the patient, the
pateints health in the long run and for teh system of homeopathy in
general. ITs no wonder we're laughed at as spinelss people with
placebo treatment.

What do we wish to achieve with homeoapthic treatment?
Cure?
Symptomatic relief?
Earn a living?
All of the above?

Finally we have to live with our consciences. I expect GOOD QUALITY
homeoapthic treatment for MYSELF AND FOR MY FAMILY> I will not settle
for combinations or protocols becasue I do not trust their effect on
my system in the long term.
HEck I will not settle for ALlopathy either today, I've evolved to
that point! - Why would I knowingly subject my pateints to anything
less (mixopathy/protocols/even allopathy when CLASSICAL HOMEOPATHY CAN
DO THE BEST JOB (unless they made the choice)???? BEcasue I"m afraid I
may lose the patients or I want to make a few more bucks? OR I have
such a big Ego, I wont ask for help from another homeopath or I can't
work with another homeoapth becasue of the same BIG EGO?
Or I wont take the trouble to work on MYSELF?
OR I just have a fascination for Quick Fixes and NO thinking and NO
HARD WORK?

NO, if we let our standards down, we're letting down the system of
homeoapthy. EVERYONE needs to know that a good standard of homeopathic
precribing is possible for EVERYONE and should make an EFFORT to learn
the same and evoelve over time.
A standard that seeks the BEST HEALTH of the pateint in the long term
and not use the crutch of some silly quick fix that ALLOPATHY IS
BETTER AT.

BAsed on teh oirginal discussion, I still think using allopathy as a
crutch is not the best thing - and every homeoapth CAN AIM to move
beyond that point, even those who feel they are mediocre. Work in a
team, work with like minded colleagues, learn from one another and
EVolve.
ONe can move from mediocrity to being very good classical homeoapths
who care about their pateints long term health. The difference is in
the CONFIDENCE and the HUMILITY.

Sigh - I wanted to say this on the lyteforce list - but I got so
horribly busy I could not continue the discussion. I"m still busy,
but I've probably been ithcing to say all this
thanks for the opporunity!
dr. leela
I think I ahve more patients today becasue I"m honest about
--- In minutus@yahoogroups.com, "hahnemannian2002"
wrote:
turn to.
I am
SECOND.
they
well as
parameters,
I'm sure
In my
cured,
confident
assuming
anaphylaxis?
guide -
disorders? Are
type that
spread
nothing else

[Shannon Nelson]

Hi Leela,

What do you feel a patient ought to do when "the best" is not available?
What do you feel a practitioner ought to do when they know they are not
"the best"--as they continue to learn?
Given that "using allopathy as a crutch is not the best thing"--I think
we are all agreed on that--what do you feel one should do under the
situations described, where for whatever reason it had not been
possible to find "the remedy" needed?
Shannon
[Non-text portions of this message have been removed]

[cbwillis9]

I hear CONFIDENCE batted around here quite often, ability to
prescribe with confidence. I consider "confidence" to be
a red herring in homeopathic practice.

Partly there is a problem of ambiguity of the term "confidence",
whether the word means 1) statistical probability, or 2) a
feeling of certainty (that may foster an "attitude"),
or 3) some combination of both.

If it's anything that patients have come to despise in
health care practitioners, it's *attitude*, superior and dismissive
attitudes, particularly when results are unsatisfactory.

Certainty implies truth. It makes no sense to say we
are certain of something if it's not true. (However some people
may have a *feeling* of certainty, and alas have it turn out
what they felt "certain" about is not true.)
I submit that feeling without truth to back it up
(truth being equal to good results in the present case,
hopefully for good reasons) has no place in homeopathy.
There is statistical probability from the past, but there is also
the truth of results, of what will yet happen in the
particular case that we don't know yet.

What matters is GOOD RESULT(s), for GOOD REASON(s).
Attitude is optional. And no-attitude is even better.

There can be CONFIDENCE with NO GOOD RESULT. (undesirable, arrogance)
We can have a feeling of certainty without something being true.
I would think this is to be avoided at all costs, and this is
perhaps what Dr. Leela was referring to.

There can be GOOD RESULT with NO CONFIDENCE (lack of certainty).
(To me, this is quite acceptable, since I think in terms of
"well-indicated" and likely, but also am open to surprises
and learning something new about a remedy in a particular
case situation. I don't assume everything about a remedy is
documented in the literature, have heard Shankaran say and have
experienced myself a remedy that cured was not documented for
the rubrics in question. Even though we may suspect
strongly a particular result, "it's not over til it's over".
It's not over til the results are in and examined short term
and longer term in the larger context of the case, bringing
up the vital force, non-suppression, and harmlessness.)

There can be GOOD RESULT with CONFIDENCE. (Most would consider
this an ideal, but I still don't think
we can reasonably have 100% certainty, rather we may have strong
suspicions based on degrees of high probability. And we may
be correct nearly all of the time, that's great. *Feeling*
of confidence, however, I would consider unnecessary.
This is not to say we need to be anxious with massive doubt - no,
just that the feeling element is unnecessary and a frequent
stumbling block in good prescribing, and in the homeopathic
PROCESS. Humility demands that we step back and
observe the process with care and interest but without ego
attachment that an attitude of "confidence" could foster.)

There can be apparent GOOD RESULT for BAD REASONS. (combination
remedies, suppression, partial results, short-term results ->
dangerous as it's so misleading.)

There can be NO GOOD RESULT (even harm) with GOOD REASONS.
(well-indicated remedy, too high potency, etc -> Undesirable).

"Confidence" is a red herring, unless you mean by confidence
in prescribing "a very high statistical probability [of correct
single remedy in whatever potency]". If that is what is meant,
then I'd prefer someone SAY "a very high statistical probability".
But let's not confuse high statistical probability based on
a study of the past with results yet to be observed
in the particular case at hand. "It's not over til it's over."
Carol Willis
June 3, 2006
cbwillis9@yahoo.com
http://groups.yahoo.com/group/willis_protocols
Article archive in Files, blog, Links, not a discussion group.
See "Anti-Abuse Education" folder in Links, abuse being suppressive.

[muthu kumar]

Thanks for the input-
Glad that you got the opportunity to get something out to the
practising world

Keep up the good work
-- In minutus@yahoogroups.com, "dr. leela" wrote:
etc.
good
I
if
so
know.
the
settle
on
CAN
afraid I
have
can't
homeopathic
learn
term
a
homeoapths
in
not
should one
complain.
combinations etc.
good
give
preferable I
the
if
so
they know.
skills.
symptoms
modalities
available -
the
are
luxury to
practice
Instead of
where the
ridicule and
be that
happens
shores up
to
homeopath.
capable of
ideal...
doing that -
hope they
handle
acutes
coma, etc)
vis
point of
management does
vigilance
cure.
off our
and Quick
classical
these
classical
PRESCRIBERS
could
not sure
But
protocol
what
important
have this
MD's.
anyway...
wrote:
homeopath
in
will
available
allopathy or
already been
as
frame
if the
certain
back to me
waiting
other
a
handling
willing to
refering
to
serious cases.
of all
homeopathy?
sometimes
not take
be 2/3s
80?
still comes
respond?
of
step?
considered
help and
at all?
example
how
still
dog bite
Are there
to send
to
them to
Let us
and order
advising
sputum
of
just
would
would you
suspect
important?
of
management?
these
wrote:
word.
other but
who has
and
to
means that