In a recent interview, I drew attention to aspects in the ongoing debate about homeopathy, that I feel have been somewhat under-discussed.
The first is that our critics never seem to mention the patient and empathic way homeopaths listen to the story of their patients’ illnesses in the context of their whole lives, before even thinking of which ‘controversial’ white pill to prescribe. Critics and sceptics may believe that homeopathic benefits (‘if any’) derive solely from this. If this is what they believe, they should say so openly. If they are genuinely interested in patients’ well being, the next logical step would be a major medical investigation into trying to understand why patients who are listened to in homeopathic, way start dramatically improving!
The second aspect I believe does not get enough attention is Outcome and Patient Satisfaction. An outcome study is a study in which patients are simply questioned comprehensively on the outcome of any medical intervention. In this regard, homeopathy has scored very highly as in the Spence Outcome Study in Bristol. That study was attacked by critics – mainly due to their distaste for outcome studies in general.
But why? For patients outcome is everything. Patients care about getting better; how they got better is of secondary importance. What critics of homeopathy have done is to some extent deride the obvious beneficiaries of homeopathic treatment.
Just as homeopaths listen to suffering patients carefully and empathically, so critics of homeopathy should listen to what satisfied homeopathic patients have to say about their experiences. Outcome studies are no more than a collation of the voices of patients – the very people whose welfare this debate has apparently been all about.
Hi Dr Kaplan
It’s been a while, but I was interested in this point:
“The first is that our critics never seem to mention the patient and empathic way homeopaths listen to the story of their patients’ illnesses […]. If this is what they believe, they should say so openly. If they are genuinely interested in patients’ well being, the next logical step would be a major medical investigation into trying to understand why patients who are listened to in homeopathic, way start dramatically improving!”
Well my understanding is that they do mention the empathic nature of the homeopathic consultation, and do so repeatedly and openly. In example, you might want to want this watch this Youtube clip of Prof. Richard Dawkins and Prof. Michael Baum (at approx 6mins and 11:30mins). What you’ll find is a deep respect for the homeopathic consultation, and the belief that mainstream medicine could benefit from some of this:
https://www.youtube.com/watch?v=E0-NalmRSl8
Ben Goldacre too cites evidence that doctors who adopt a warm, friendly and reassuring manner are more effective than those who keep consultations short and formal. He also rues the limitations of the 6 minute GP consultation to maximise the therapeutic relationship (Bad Science, p75-76).
Prof. Edzard Ernst also says this in support of the homeopathic consultation:
“If observational data show improvements while clinical trials tell us that homeopathic remedies are placebos, the conclusion that fits all of these facts comfortably is straightforward: patients get better, not because of the homeopathic remedy but because of a placebo-effect and the lengthy consultation with a compassionate clinician.” (Guardian 2012)
He also cited Brien et al. (2011) to back this up, that concluded:
“Homeopathic consultations but not homeopathic remedies are associated with clinically relevant benefits for patients with active but relatively stable [rheumatoid arthritis].”
You’ve perhaps also read Kliems & Witt (2011) who conclude:
“The findings confirm other studies of patient satisfaction and physician characteristics. The availability of time, a holistic approach, and high physician empathy lead to high patient satisfaction. Homeopathic physicians probably are more likely to exhibit these characteristics.”
Makes me wonder why you’d say that, as I’m assuming you are more knowledgeable about the views of your critics than me?
Sorry for going on a bit, and thanks for your time.
Thank you Dr. K for such a clear and helpful explanation. Your reassuring voice reminds me of the old-fashioned doctors when you felt they really cared…