The spotlight has recently been shone on Homeopathy with GP commentators saying that if pharmacist collaboration is to occur with GP’s then homeopathy should be banned within pharmacies.
Then we have had some pharmacy commentators echoing the call mainly from the HMR accredited sector- the pharmacists actually seeking collaboration with GP’s.
Given that the collaborative pharmacists are independent and not directly selling homeopathic remedies, there is no real issue.
If a collaborative pharmacist wishes to recommend homeopathic remedies in conjunction with a GP, then surely this is a matter of consensus.
Personally, I am wondering what all the noise is about because from whatever perspective you have about homeopathy it has an unrivalled safety profile when compared to mainstream medicine.
“First do no harm” is certainly a met condition with homeopathy.
However, there is a mischievous group called the Friends of Science in Medicine (FSM) who seem to have made it their objective to eliminate all forms of medicine other than mainstream medicine.
If that is their lobby, then it remains valid provided they do so openly.
That they operate more like a military intelligence agency protecting Big Pharma means that they are operating outside of normal parameters for lobbying.
One suggestion is that FSM comprises mainly medical academics who receive money in the form of grants, often to develop new drugs or support wider use of old drugs.
And that is reason enough for “turf protection”, but as we are all aware, a lot of this sort of research has been proven to be fraudulent.
And for this reason, diversions are required to change public focus and perception.
So, chiropractors, homeopaths, complementary medicine practitioners and even pharmacists are attacked because they are “soft” targets.
FSM are well organised, have great influence but do not conform to their own vision of being a “friend” of medical science, otherwise they would be attacking mainstream medicine at all levels – and this has not occurred.
Again, from a personal basis, I never had need to recommend homeopathic products, but I remain open to anything that “works”. I see nothing wrong with pharmacists methodically collecting data on products that have efficacy and systematically recording and sharing that data to develop organised evidence for those products.
It was an informal system that I grew up with in pharmacy, but it is a system that needs expansion and an upgrade (including a formal home) to make it more relevant in today’s climate.
The PSA has commented on homeopathy following a recent report from the NHMRC:
“Mr Kardachi said PSA’s Code of Ethics, endorsed by the Pharmacy Board of Australia, applied to every pharmacist irrespective of the role, scope, level or location of practice.
“Our Code of Ethics states that a pharmacist recognises the health and wellbeing of the consumer as their first priority,” Mr Kardachi said.
“It stresses that when recommending a therapeutic product, any new evidence or lack of rigorous information must be carefully balanced with the consumer’s choice and health status.
“It goes on to highlight that professional judgement must be exercised to prevent the supply of products whose use may result in an adverse health outcome.
“Clearly under the PSA Code of Ethics pharmacists must caution against the use of homeopathic products.”
The report is available at http://www.nhmrc.gov.au/guidelines-publications/cam02 “
What I have stated above does not conflict with the PSA code of conduct.
So if you have a strong belief in the efficacy of a homeopathic product to recommend it to a patient, then you must be able to defend the decision to recommend it to a patient.
But this really applies as well, to all products sold in a pharmacy.
The Australian Homeopathic Association responded to the NRHMC report and has identified areas of bias, unfairness and conflict of interest and identifies FSM interference.
All pharmacists are urged to read Open_response_letter_by_AHA_to_NHMRC that provides details and allegations of bias etc.
The entire campaign against homeopaths is unnecessary and a pharmacist’s position with any patient should be to caution the patient in respect of evidence strength, but also to provide their requested product if they cannot be otherwise swayed.
Patients must be allowed to take control of their own health, not have a restricted version foisted upon them.
Patient beliefs have always been a component of healing and the time spent with a patient by a health practitioner is another component (recognised as “care”).
I have also read a clinical trial that proved homeopathic remedies were 2.5 times more efficacious than placebo.
That evidence alone would have been sufficient to launch a new mainstream drug if it had achieved similar results for efficacy.
Historically, homeopathy has a proud story and has been adopted by orthodox medical practitioners, other health practitioners or by clergy serving in remote regions.
Homœopathy has been practised by individual practitioners throughout Australia since the 1840s.
The history of medicine during the formative years of the Australian colonies revolves around the fact that, apart from in the main cities, there were very few people who had formal qualifications as medical practitioners.
People were very reliant on whatever assistance they could find, including self-help via domestic medicine chests.
These people might be termed ‘lay prescribers’ rather than ‘lay practitioners’, in that they provided assistance for their family and friends in their community, but they did not establish themselves as practitioners.
There were also opportunities for people who did not have formal medical qualifications to establish practices. Some had medical expertise and successes in treatment, regardless of their lack of formal qualifications, while others were obviously charlatans taking advantage of the total lack of regulations in the newly-formed colonies.
The first homœopath to come to Australia was Englishman Dr Stephen Simpson, who wrote one of the earliest books on homœopathy in English. He arrived in Sydney, New South Wales, in 1840, but after six months there he moved to Queensland, to become a government administrator. Dr William Sherwin, a practitioner who was born in Australia and gained his qualifications in England, was the first ‘home-grown’ doctor to use homœopathy, and it is likely that he was Australia’s second homœopath.
A later publication by Dr Sherwin indicated that he commenced examining and using homœopathy around 1842 or perhaps earlier.
Some missionaries deliberately learned homœopathy so that they could help with the physical as well as the spiritual needs of their people, although they did not set up official medical practices.
Dom Salvado established a Benedictine monastery at New Norcia in Western Australia, where local aborigines and settlers were treated using homœopathy.
Baptist clergyman, Rev Benjamin Wilson, studied homœopathic medicine in England, with the aim of becoming a medical missionary.
On the voyage to Brisbane he treated many conditions using homœopathic medicines, and apparently his treatments were more successful than those of the ship’s doctor.
Rev Marcus Brownrigg, Church of England minister, used homœopathy to treat his own family in Tasmania and the aboriginal people whom he met on his many journeys to the Furneaux group of islands in Bass Strait. Rev Holden was a Church of England clergyman who studied medicine and homœopathy privately for over seven years in England, and provided medical treatment for the poor when working in parishes in Victoria, South Australia and country New South Wales, where he found that there was no doctor in the town.
Henry Backhaus, a Roman Catholic priest, used homœopathy to treat people in Victoria’s goldfields.
Supporters and users of homœopathy included many of Australia’s notable people – Archbishops, Members of Parliament, Premiers, rich pastoralists and businessmen, and their wives.
Soon free homœopathic dispensaries for the poor were established in Victoria (Geelong, Melbourne and Ballarat), Adelaide in South Australia, and Sydney in New South Wales.
The Melbourne Homœopathic Hospital, established in 1876, was the first homœopathic hospital in Australia. (It was eventually renamed as Prince Henry’s Hospital.)
There followed the Hobart Homœopathic Hospital (1899), the Launceston Homœopathic Hospital (1900), eventually renamed St Luke’s, and the Sydney Homœopathic Hospital (1902).
The leading figure in the establishment of the Adelaide Children’s Hospital was a homœopath, Dr Allan Campbell. At that time, three of its six medical officers were homœopaths.
These hospitals operated successfully for over 60 years until the late 1920s when they began to experience increasing difficulties in continuing to operate. Contributing factors for their demise included the advent of anti-biotics, increasing opposition from the orthodox medical establishment and the difficulty of obtaining qualified homœopathic staff.
The subsequent revival of homœopathy in Australia over the past 50 years is part of a story of world-wide changes in spiritual values and public perceptions regarding health. The past decade has seen an accelerating interest in complementary healthcare, including homœopathy.
Current Regulatory Context (from AHA Website)
Australian Federal Government reports have recommended that there should be effective and accountable structures to ensure that complementary medicine practitioners are appropriately qualified and work within appropriate standards of ethical and professional behaviour to safeguard consumers.
In this regard, the homœopathic profession in Australia has achieved some major milestones in the past decade. As a result, the profession has already achieved the type of organisation and self-regulation suggested by the Government.
The homœopathic profession, in conjunction with the Federal Government, established National Competency Standards in Homœopathy in 1999. These standards are incorporated in the Government’s Health Training Package, and define what should be taught in accredited courses in homœopathy as conducted by registered training organisations. These were first established in 2002, and are reviewed biennially by the profession in conjunction with the Government. The Australian Homœopathic Association (AHA) supports this process, and has provided significant input by participating in the industry reference group representing the profession.
Perhaps the most significant advance took place when an independent national registration board was established, also in 1999, for homœopaths who meet the government-endorsed standards. This board, the Australian Register of Homœopaths (AROH), is the national register and self-regulation body for homœopaths, replacing the registration role which had previously been fulfilled by the various homœopathic associations throughout Australia. The AHA was instrumental in supporting the establishment of this registration board and has significant on-going representation on the board. The criteria for registration with AROH are based on the National Competency Standards in Homœopathy mentioned above, including underpinning knowledge, clinical competencies, medical sciences, etc. In addition, practitioners must maintain their professional registration annually which includes meeting continuing professional development (CPD) requirements, and maintaining indemnity insurance. Registered practitioners are recognised by all the major health insurance funds for the purpose of rebates on consultation fees.
Thus, as of 2010, the profession is operating under a system of ‘self regulation’ with government-endorsed competency standards in homœopathy, and a national registration system established by the profession. However, there are no statutory regulations controlling the practice of homœopathy by individuals, or protection of the title of “homœopath”. Unfortunately this means that currently anyone can legally call themselves a homœopath, although health insurers will only acknowledge the services of registered practitioners for the purposes of rebates on homœopathic consultations.
Sadly, to-date, this matter has not become a matter of priority for our State Health Ministers despite ongoing submissions by the AHA. Government priority is determined by the ‘risk’ involved for the general public in any therapy, and since homœopathy is considered to be a low-risk therapy there is no sense of urgency to implement the relevant legislation.
I2P has no agenda in providing reportage for homeopaths other than a sense of fairness, because their voice is drowned out through FSM influence and the political agendas of mainstream and medical media.
That homeopathy touches pharmacy involves the interface of homeopathic products appearing on pharmacy shelves which may give the public an impression of pharmacy endorsement.
Because they represent a small market segment generated mainly by patient requests and take up a small section of shelving, I see no problem in this if actual display is not in a prime position and that these products do not appear in pharmacy catalogues.
Sometimes there is confusion between homeopathic products, nutritional products and complementary medicines. Critics only see all of the above as homeopathic.
As stated before, I see no problem with a pharmacist recommending any product if that pharmacist believes the product is best suited for that patient and that full education is given to the patient.
The media argument is not one that pharmacy needs to buy into.