Sunday 13th January, the Sunday Times in Scotland published an attack on homeopathy by one of their journalists, Joan McAlpine. (Sorry I can’t put a link in cos the Sunday Times doesn’t bother to put their Scotland-only articles on their website) The “stimulus” for the article was a written answer to a question in the Scottish Parliament which showed the cost of GP prescriptions for homeopathic medicines in Scotland. There was nothing really new in the attack – same old arguments really – but what bothered me most about it was the headline describing homeopathy as a “sick fantasy”, the claim that homeopathy was “dangerous” and the dismissal of patients’ reports as being just about feeling better (the implication being they were not really better).
The paper published an edited version of my letter on Sunday 20th but I thought I’d just put the full letter here for you to read.
Dear Madam
£250,000 spent last year by the Scottish NHS for “alternative” drugs? What an outrageously small amount! In the same year the Scottish NHS drugs footed a £1 billion pound bill to the drug companies for prescribed medicines. Yet, 90% of all drugs only work in 30 – 50% of the people who take them. Deaths from homeopathic medicines in the whole of the UK in 2006? Nil. Deaths from prescribed drugs? 1013 reported (over 10,000 estimated). Cost of Adverse Drug Reactions to homeopathic medicines? Nil. And to prescribed drugs? About £500 million a year.
Let’s be clear. Human beings are not machines. What works for one person may not work for the next. Health care needs to be diverse. We need more research into non-drug, non-surgical treatment options and we need to make more available on the NHS inexpensive, safer treatments, such as homeopathy which two out of three patients report is of benefit to them. And while we are at it, Joan McAlpine, let’s stop the arrogance of dismissing the relief of human suffering as “sick fantasy”. If someone says their pain has gone, it has. Prove it hasn’t! If someone says their depression has lifted, it has. It’s time to start putting patients first. At Glasgow Homeopathic Hospital we are, like all good doctors everywhere, successful because we listen to patients and believe what they tell us. We could do with more of that on the NHS.yours faithfully
Dr R W Leckridge
Heroes Not Zombies 
Homeopathy may have no physiological side effects but the awkward fact that its advocates ignore is that evidence for efficacy is severely lacking. Anecdotes are not acceptable as scientific evidence as <a href=”http://www.sciencebasedmedicine.org/?p=33″ this excellent article shows.
Thank you again for being a leader, and a compassionate one at that.
“If someone says their pain has gone, it has. Prove it hasn’t! If someone says their depression has lifted, it has.”
THIS is a HUGE point. I can tell you, from personal experience, that most of my unsatisfying experiences with doctors have been because I wasn’t treated as part of the equation. My BODY and all its mechanics were important, but *I* wasn’t included in any of it.
I truly believe that we are the sum total of our being and that my attitude and my energy and my beliefs have as much to do with my health as my diet or my exercise habits or my genetics. Finding physicians who are open to honoring that – and who aren’t at the end of drug companies’ leashes – is important, but also difficult. My suspicion is that none of you is taught that there are any other gods but that of Modern Western Medicine (caps intentional) and that dabbling in more intuitive practices is somehow a sign of weakness or a lack of intelligence. I couldn’t disagree more.
Hi gimpy, thanks for the link to that article.
I do understand the value of RCTs and of the insights which scientific experiments can bring. But on a day to day basis I’m a clinician. My daily priority is each and every patient who comes to see me seeking help. Yes, it’s helpful to be able to consult an experimental evidence base to know of the potential of a treatment (if such an evidence base exists….which for a lot of interventions it doesn’t) but I also need to use my clinical judgement to assess if the treatment under consideration may or may not be of value to this particular patient (and that can include their past experience of this treatment, or other treatments).
As a clinician, I need to know how to understand stories. Diagnosis is based, firstly, on a good history; secondly on an examination of any objective changes; and thirdly on the results of investigations. But it all starts with the patient’s story.
As Mary Midgley, the English philosopher wrote in ‘Wisdom, Information and Wonder’ –
“One cannot claim to know somebody merely because one has collected a pile of printed information about them.”
Human beings cannot be reduced to a set of data.
We use narrative to make sense of our lives and we use it to communicate our subjective experience to others.
My point in my letter about listening to patients is that without trusting their stories, we can make no sense of their illnesses and we cannot interpret the responses they have to their treatments.
The world is not so black and white. It doesn’t split nicely into “proven” and “unproven” treatments. Either may work for one patient and not for the next one. We need to use both data and narrative to practice effective medicine.
Dismissing a patient’s experience as anecdote doesn’t make for good medical practice. It’s central to every single instance of therapy.
Thank you GaleG. I appreciate your encouragement. Compassion is a big thing for me. There’s not enough of it in the world I’m afraid. Without trying to put yourself into the shoes of someone who is ill, you just can’t understand them. And THAT’S my key value – understanding.
I think that’s my job – to understand people.
If by leadership you mean standing up for those kinds of values, then you’re right. I do. Of course, it’s up to others to decide what values they want to live THEIR lives by.
Ah, mrschilli, do you remember these lines from T S Eliot’s ‘The Cocktail Party’?
In a consultation with the doctor or surgeon
In going to bed in the nursing home
In talking to the matron, you are still the subject.
The centre of reality. But, stretched on the table,
You are a piece of the furniture in a repair shop
For those who surround you, the masked actors
All there is of you is your body
And the “you” is withdrawn.
No, Doc, I did not call those lines to memory. Now I’m going to go off and think on them for a while, while I try to form words to express my appreciation for your most recent post….
[…] See more of Beb Leckridge’s wonderful blog site…. […]
[…] of stories here, and he has been ruminating on the connection between the body and the person here – both topics have really helped me clarify my own thinking about not only my health, but also my […]
Bob
The arguments you present above are basically consistent with what a lot of us sceptics would say, namely that homeopathic treatment is a kind of “stealth counselling therapy”. I note that even some eminent (ex) homeopathic physicians agree
I would agree that mainstream doctors need both evidence-based interventions AND “human insight”. And the good ones do.
But… most Alternative practitioners have, at best, only the human insight, because there is little or no objective data or evidence base to what they do, and most of what there is is resoundingly negative.
I’ve nothing against counselling – my wife’s work as a conventional doctor involves bags of listening, talking, and counselling-type strategies. But as far as I can see Alt Therapists should “fess up” and admit what it is they really do, stripped of all the cultural baggage, mysticism and ritual trappings. The NHS needs good counsellors, so there would still be work. There just wouldn’t be so much deception and sleight-of-hand.
Listing the deaths from homeopathy versus conventional medicine is rather funny when you think about the fact that homeopathy has no effects at all (no side effects and no medicinal effects). Spending £250,000 on “alternative drugs” is £250,000 too much because it has zero efficacy. (Gee, what a racket – I’d love to get paid £250,000 for selling people water.) I suggest that homeopathy is based purely on placebo effect, and your standard of evidence is set far too low. Listening to your patients is great. Believing that the placebo effect is anything but placebo is sloppy.
Tinyfrog, I see from your blog that you call yourself a skeptic. Can I ask you something about skepticism? Does being a skeptic make you more certain of things? You seem to be certain about the efficacy of ALL “alternative” drugs, certain about what the placebo effect is, and certain that homeopathy is “based purely on placebo”. What makes the belief system of “skeptics” so sure of things?
draust, I’m sure you won’t be surprised to know I don’t accept that GPs who use homeopathy are being deceptive, or using “sleight of hand”. Yeah, counselling can be a useful intervention, but it isn’t always, and it’s only a part of a doctor’s skills (as I’m sure your wife will agree). Good listening skills (which isn’t the same as counselling) and keen observation are also part of the job and learning the homeopathic method seems to improve both of those (so the doctors who take our training courses tell us).
I know of no evidence that a GP who uses homeopathy is any less honest than one who does not.
About “alt therapists” I can’t comment – it’s way too broad a label – maybe some are simply good counsellors as you say, maybe some have other skills and talents. I’m wary of generalisations.
Thank you for your lovely comments on my blog in your “Passing love around” post on theinnerdoor.wordpress.com mrschilli
I a friend of Mrs. Chili’s and am very much an advocate of homeopathy. I’m married to a Naturopathic doctor and have used homeopathy with varying degrees of success (the right remedy vs the wrong one) for the last 15 years.
I have to laugh when I hear people dismiss homeopathy as merely employing the placebo effect because I have seen, firsthand, homeopathy work on children and animals!
My husband’s training, his 4-years of medical school, his residency at another Naturopathic medical school and his current practice have shown me that both acute and constitutional remedies work; from Crohn’s disease going into remission, to depression lifting, to innumerable others, I trust it. Am I foolish to dismiss the plethora of research that attempts to refute its efficacy? I believe those who will only be satisfied with a definitive works/doesn’t fail to see that just because they don’t understand something – in this case energetic treatment – does not render it irrelevant.
I don’t have the statistics, but am I wrong that a HUGE study in the last few years determined that despite rigorous attempts, studies could NOT show homeopathy *didn’t* work?
Hi Organic Mama, and welcome!
You know I really am a believer in diversity and choice in health care. My experience, and I’m sure that of every doctor, is that every patient is different and no single treatment of any condition works for every single person who presents with that condition. I also believe that health is an experience and as such always has a strong subjective aspect. That means that only YOU can tell when you don’t have pain. Only YOU can say when you don’t feel itchy. Only YOU can say if you can clearly read an eye chart! Those who dismiss your reports of your own life, dismiss you.
I don’t think I understand your last sentence though – there never will be a single piece of research to show whether homeopathy “works” or “doesn’t work”. The critics dismiss the studies which show a difference between homeopathic treatments and placebo and only accept studies which don’t show a significant difference. But even that isn’t enough. The homeopathic method is more than the remedies used. Pretty much all the research focuses on the remedies, not the process of care.
Research is never finished. The more we study any phenomenon, any treatment, the more we learn about it. At any point, you can only say, at best “so far, as best I understand it…..blah blah blah (insert your hypothesis in question here!)” Anyone who says at any point we don’t need to learn any more about this or that is likely to be proved wrong in time.
Thanks again for stopping by, and thanks for commenting so thoughtfully
Bob
Thank You for this lovely discourse on homeopathy!
My last sentence was based on a vague memory of a Lancet meta-analysis, but I misremembered the biased, poorly quantified results of that and instead recalled earlier WHO studies that did not claim homeopathy was less effective than placebo, but just the opposite.
Yes, treatment and its results ARE subjective, regardless of the medical paradigm. What I love about homeopathy – classic homeopathy with its exhaustive interviews – is just the process you refer to. In fact, I am going to see a practitioner in Maine very soon for a badly-needed constitutional remedy; the doctor (an ND who specializes in homeopathy) comes highly recommended and I am looking forward to the unique care I have come to expect from homeopaths.
Organic Mama, I hope your trip to Maine goes well and you find what you hope for and expect
Bob