Minutus

This is a question, and a challenge, for the practitioners amongst us who, having made known their practice as homoeopathic, send a consulting patient away with a prescription for a combination medicine that the patient could have obtained (or could obtain an equivalent substitute for) from a pharmacy without paying for any consultation.
Please redistribute this message widely amongst your polypharmaceutical-prescribing friends, and ask them to reply on this forum.
The question is this:
Do you, or would you be willing to, as a matter of principle, refuse to accept payment for the consultation resulting in a "combination" prescription?
Kind regards,
John Harvey
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"Because we're supposed to have an open government—a democracy—everything the Government does is presumptively public, and can be legitimately concealed only with compelling justifications. That's not just some lofty, abstract theory; it's central to having anything resembling 'consent of the governed'."
—Glenn Greenwald, "The moral standards of WikiLeaks critics", Salon.com 1 Dec 2010, .

--- In minutus@yahoogroups.com, John Harvey wrote:
could

Not much different than an MD suggesting aspirin.

Not saying either is right or wrong.

Leilanae

Not a relevant question IMO.
The patient pays a consultation fee, not a medication/therapeutic fee.
 
Dr. J. Rozencwajg, NMD.
"The greatest enemy of any science is a closed mind"
Visit my new website www.naturamedica.webs.com

Leilanae, I see your point: that an allopathic physician too may prescribe something for which no consultation would have been required in order to buy it. And it might seem that the apparently unsophisticated prescription in common with a "homoeopathic" physician who doesn't take a full case or doesn't use it as the basis of prescription (i.e. doesn't practise homoeopathy in that particular case) places the two in the same ethical position.

Actually, though, there's a world of difference.

The allopathic physician is consulted for usually around three to five minutes; exceptionally, for half an hour.

He is expected to have no professional interest in the peculiarities of one patient's symptom that distinguish it from another's of identical type and cause, and in fact to be unable to use that information to the patient's benefit.

He is almost universally understood to be trained by a university whose funding depends on good relations with drug sellers, and to have received, in lieu of further on-the-job education, a continuing bundle of free samples; pep talks; free dinner presentations and conferences in lush venues; branded merchandise; and wholly sales-directed propaganda.

He is expected to operate in this atmosphere of corruption by doing his best to prescribe responsibly from amongst an armamentarium about much of which the best one can reasonably say is that some of the evidence in its favour may not have been invented by its subject's manufacturers, may not have been falsified or substantially misinterpreted, may not have been ghostwritten and placed in a journal under the name of a willing paid accomplice, may not have been inserted into a journal whose budget depends almost entirely on the advertising inclinations of that manufacturer and his oligarchy partners or indeed whose entire identity is a fraud perpetrated by the manufacturer in order to hoax doctors into believing they're reading conclusions published in a real journal.

Finally, he is expected to prescribe with no knowledge of the primary effects of the drug and to have great limitations upon his ability to assess strange results of the prescription.

In such circumstances, the most responsible course that any physician could take who is unwilling to give up the practice altogether is to prescribe wherever possible the simplest available drug that will, in his understanding, do minimal harm. Very often, aspirin or paracetamol or even an antibiotic appears to fill the role and fulfils professional allopathic standards of best practice. Therefore, the physician who prescribes an aspirin in preference to the plethora of more expensive and less-well understood drugs to prescribe which he is being offered many inducements is probably deserving of praise rather than of reproof.
By contrast, what are the universal understandings and expectations and best practices of the homoeopathic physician?

Far from being expected to jump on a discussion list and ask what a good remedy is for warts or a cough, he is universally understood to be attempting to treat and to remove the patient's entire illness.

He is generally understood to do so through an extensive case-taking consultation lasting, in acute cases, perhaps for an hour, and, in chronic ones, perhaps for three to four hours and an unpredictable amount of research.

He is expected to have no arbitrary preferences in medicines but to be seeking, in the course of his researches, the single medicinal substance whose effects mimic to a unique degree the patient's entire particular symptomatology.

He is expected to do so on a basis of scientifically reasonable certainty deriving from his exquisite familiarity with and careful consultations of the pathogenesis of that substance and other, competing, candidates for his prescription; on a basis, in other words, of exquisite and intimate knowledge of the prescribed drug's relationship of similarity with the symptoms of the patient's illness.

He is expected, in conducting this course of research, to use the patient's most individual symptoms and signs to carefully distinguish the medicine most homoeopathic to the patient's condition.

And he is expected to understand the patient's responses to the prescription and to be able to gauge from them whether to allow the patient to continue reacting to it if he is, whether to change course in some way, and whether to seek some maintaining cause of illness.

All of these are possible and expected of homoeopathic practitioners of all schools, and best practice demands more still, including attention to fitting the potency to the individual's sensitivity, illness chronicity and severity, and other considerations. And all of these expectations are inconceivable in the prescription of a polypharmaceutical prescription designed to remove a single, uncharacteristic symptoms such as a cough.

The educational, fiscal, and purposeful attributes and underpinnings of the homoeopathic physician have implications for the ethicality of failing all of these expectations in favour of prescribing even one medicine without a known strong relationship to the patient's symptoms -- let us say, the equivalent of aspirin.

But they have stronger implications still for the ethicality of prescribing simultaneously two or more such medicines unrelated to the patient's individual symptoms. One poor single prescription offers at least the slight advantages of (a) a very weak possibility of sufficient similarity to help the patient and (b) the possibility of shedding subsequent light (through new symptoms) on the patient's state. A multiple prescription, no matter how well or how vacuously argued the case for it may be, offers no such slight potential benefit.

Therefore, the physician who, in the name of homoeopathy, prescribes in such a manner has, aside from unnecessarily conducting his practice in ignorance at expense of the possibility of any improvement in the patient's overall health, disappointed all legitimate expectation of him and misrepresented his profession.

There's a world ofethical difference, then, isn't there, between a homoeopath who prescribes two or more medicines simultaneously to relieve a symptom and an allopath who prescribes aspirin to relieve a symptom.

Kind regards,

John

Uh-huh. Thank you for stating your position.

Cheers --

John
Not a relevant question IMO.
The patient pays a consultation fee, not a medication/therapeutic fee.
 
Dr. J. Rozencwajg, NMD.
"The greatest enemy of any science is a closed mind"
Visit my new website www.naturamedica.webs.com

Most classically trained homeopaths wouldn't "prescribe" a combo--would they?

--- In minutus@yahoogroups.com, John Harvey wrote:

It was in answer to your original question.

Not interested in going down the 20+ paragraph rabbit hole.

Leilanae
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And it might seem that the apparently unsophisticated prescription in

Now, that's what I'd call irrelevant to the question. The point really concerned not classical training or otherwise but the promotion of self as "homoeopath" and the contrast between the expectations that raises and the actions of the combination prescriber, as detailed in the message Leilanae attempted to answer before she'd read it.

Cheers --

John

Do you think so? Answering the original question required a "Yes" or a "No", not an analogy.
That's fine, Leilanae. I teased that analogy apart for your chief benefit; if you lack the time and inclination to read it, that doesn't make your original analogy more relevant, and is no loss to the rest of us. Feel free to keep up the sniper fire, though, even if you don't pay attention to what you're answering; it makes you look intelligent.

Kind regards,

John

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"Because we're supposed to have an open government—a democracy—everything the Government does is presumptively public, and can be legitimately concealed only with compelling justifications. That's not just some lofty, abstract theory; it's central to having anything resembling 'consent of the governed'."
—Glenn Greenwald, "The moral standards of WikiLeaks critics", Salon.com 1 Dec 2010, .

Leilanae, upon further reflection: if the aspirin analogy was your answer to the question, then you're saying you were one of those I was addressing -- which helps explain why you took the word "cretin" to apply to you. Actually, the reason I made no effort to use the female form of the word is that I didn't mean it to apply to anybody in particular. But feel free to call yourself whatever you like.
I understand, then, that your answer, mentioning as it does the doctor who prescribes aspirin, is your way of saying that you are as entitled as a doctor is to your fee; and that therefore it's a way of giving "No" as your answer. Please correct me if I'm wrong, and allow me to congratulate you on being the first to answer the question. Dr J.'s answer I interpret also to be a "No", but he came a close second to you.
Kind regards,
John
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"Because we're supposed to have an open government—a democracy—everything the Government does is presumptively public, and can be legitimately concealed only with compelling justifications. That's not just some lofty, abstract theory; it's central to having anything resembling 'consent of the governed'."
—Glenn Greenwald, "The moral standards of WikiLeaks critics", Salon.com 1 Dec 2010, .