BHA

GP practice

GP homeopathy study

Tim Robinson outlines his audit of responses to homeopathic treatment in general practice

The provision of homeopathy in the general practice setting has many benefits. Fellow GP homeopaths who combine conventional medical care with homeopathic treatment see these on a daily basis. Homeopathy offers an alternative treatment for most conditions that present in everyday routine general practice and we also see that homeopathy is extremely helpful in conditions in which conventional medicine is less effective or has no treatment, such as recurrent sinusitis, car sickness, chilblains and growing pains. Homeopathy is also of great help in situations where conventional medication is contraindicated; for example, in pregnancy or when there is a past history of indigestion which would preclude the use of an anti-inflammatory drug.

For all these reasons those of us who provide homeopathy in general practice are rewarded with the satisfaction of relieving the suffering of our patients more effectively. As a consequence of this experience it’s only natural that we should wish that more patients had the opportunity of homeopathy in the general practice setting. With this in mind I tried to think of ways to interest more of our non-homeopathic GP colleagues to consider homeopathy as a valid therapeutic tool. I am frequently asked by them “What can you use it for?” and “How effective is it?” There is also the mistaken belief that any success with homeopathy is due to the lengthy consultation in which the patient can off-load all their troubles to a sympathetic listener.

In order to address these questions and the time issue, I wanted to demonstrate the applications and effectiveness of homeopathy in the standard ten-minute GP consultation setting. This formed the basis of a study in which I recorded each patient consultation where homeopathic treatment was given over a 12-month period. Age, gender, clinical condition, prescribing strategy and the medicine prescribed were recorded on a computer spreadsheet that I designed. The response since the previous homeopathic consultation was measured by using a modified scoring system that has been used successfully in previous “observational” studies. At the start of each review consultation I asked my patient the following standard sequence of questions: “Are you better, worse or exactly the same?” Then: “Has there been a mild /moderate /major improvement or deterioration?” The patients who described an improvement that was mild, moderate or major were scored +1, +2 or +3 respectively. If there was deterioration they were given minus scores. Thus I had a subjective response score according to my patients.

Throughout the year I recorded all this data within routine surgeries in my three-partner rural practice in West Dorset. Patients are seen in standard ten-minute consultations that are made by appointment. I offer homeopathic treatment when appropriate, as an alternative to conventional treatment or in situations when conventional treatment has nothing to offer. If my patient chooses homeopathic treatment I issue a prescription to take to the chemist. I also give my patient an information sheet explaining the principles of homeopathy as well as instructions on how to take the medicine. At the end of each consultation in which I had prescribed homeopathy I asked the patient to re-attend for case review if appropriate.

At the end of the 12 months I sat back and relaxed with my weighty spreadsheet! It contained a lot of interesting data. Firstly I discovered that I had conducted 489 homeopathic consultations. Over theyear, the total number of consultations in my general practice was 5331. Thus nine percent of these were homeopathic which I consider to be a significant proportion. This illustrates how frequently homeopathy can be used in routine general practice. Analysis of the age and sex of the patients was also interesting. This demonstrated that 21 per cent of my patients were in the birth to nine age band which reinforces the experience of GP homeopaths who find that homeopathy is extremely useful and effective in children. The data also demonstrated that 72 per cent of my patients who took homeopathy were women perhaps because they are exposed to homeopathy when they attend with their sick children, who are then offered homeopathy by me. Or perhaps it’s because women are naturally more wise and receptive to complementary medicine than their sceptical, blinkered male counterparts!

One of the main objectives at the outset of my study was to be able to give an idea to my non-homeopathic GP colleagues of the variety of conditions that homeopathy can be used for. I classified the conditions according to their medical speciality. Many conditions could not be classified in this way and so I grouped them as “miscellaneous”. These included conditions such as bruising, motion sickness, leg cramp, chilblains, “tired all the time”. The study revealed that I treated conditions in all the medical specialties but the top three were ear, nose and throat (ENT) followed by mental/psychological and dermatological. The majority of ENT cases were viral respiratory tract conditions. Antibiotics are not indicated in these conditions and I find homeopathy particularly helpful. The second commonest group of cases was the mental/psychological one. In this group I treated anxiety most frequently. Homeopathy also offers treatment for conditions such as grief, shock, fear and panic, for which conventional practitioners will often not prescribe treatment or can only suppress these problems with beta-blockers or benzodiazepines. Before I provided homeopathy to my patients I used to find these conditions very difficult to treat; I found that I could offer support and little else. Discovering homeopathy gave me a new and more effective tool.

The study showed that I had prescribed 79 different medicines. It was no surprise that the most frequently prescribed were our old friends Pulsatilla, Arnica, Lycopodium and Belladonna. The majority were issued as “specific” prescriptions. This is when a particular medicine is used for a specific condition, for example Arnica for bruising.

An analysis of the responses to the homeopathic medicines revealed that 78 per cent of my patients noted an improvement following my treatment. I suspected that I had chosen the wrong medicine or strength for the 19 per cent who had not noticed any response. I was sorry for the three per cent of my patients who had found that their condition had worsened following treatment. Occasionally patients can experience an aggravation of their symptoms at a stage of their treatment. Thus this result was not unexpected but at the same time I always feel disappointed for my patient when this happens.

I now had a list of conditions and a gauge of the effectiveness of homeopathy. The study clearly demonstrated the wide variety of conditions that are treatable with homeopathy in a standard ten-minute GP consultation. The treatment responses demonstrate the beneficial effects of homeopathy as judged by patients.

Having analysed all the data I presented my study as a paper in Homeopathy, the Faculty of Homeopathy’s journal. Following publication, the paper was reported in the GP press. This was precisely what I was hoping for as it brought to the attention of my fellow GPs the application and effectiveness of homeopathy in the general practice setting. I was pleased to read in the GP press a few weeks later that my study was referred to in a subsequent article on homeopathy.

An unexpected and exciting development as a result of my study has been a subsequent larger scale data collection study that Robert Mathie reported on in the summer 2005 issue of Health & Homeopathy. This is awaiting publication but suffice it to say there has been further fascinating data collected which supports my study. As a consequence of this it is hoped that an even greater data collection study will be undertaken in the next year or so. Imagine how the press will enjoy reporting the paper that will come out of such a study! This could not fail to be noted by our non-homeopathic GP colleagues and hopefully encourage even more of them to take homeopathy seriously and even undergo training in this amazing treatment. This would fulfill my highest aspiration which is to bring more homeopathy to a larger number of our patients.

Case studies
Sarah has suffered with irritable bowel syndrome, IBS, for over ten years. She had been referred to the local surgeons twice over that time to be investigated. Barium enema and ultrasound studies were negative. The antispasmodic medicine Colofac and a wheat-free diet were ineffective. Sarah was given the homeopathic remedy Lycopodium and began to feel the difference after four days. “I would say it took about two weeks for me to feel better. I was very impressed with how fast the remedy worked. Given that I did not seek out treatment and therefore had no preconceived ideas as to its effectiveness, having had no previous experience or knowledge of homeopathy, I can’t see that it is a placebo effect.”

David had been troubled by travel sickness for approximately 45 years. Journeys by car, coach, plane and ferries all resulted in being sick, both at home and abroad. Stugeron, Quells, root ginger, travel wrist bands had all been unsuccessful. He was prescribed the well known homeopathic remedy Cocculus 30c, to be taken before and if needed, during each journey. “The results were outstanding. I am able to travel anywhere, in anything!” After all the years of travel sickness, his life has been transformed. “The results are everything needed in the way of proof that it (homeopathy) works,” he said.

Tim Robinson MB BS MRCGP DRCOG MFHom has been practising homeopathy since 1995. A full-time GP since 1989, he is now convener of the Faculty of Homeopathy Members’ Committee and teaches on the Bristol homeopathic course. He has recently joined the GP Associates steering group for the Prince of Wales’s Foundation for Integrated Health.