Homeopathy

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Amat34

Amat34

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I understand that there hasnt been enough evidence or should I say, there has been evidence that shows that homeopathy doesnt work.

So should doctors scoff(i.e., criticise and dismiss) at the idea of homeopathy because it lacks evidence?
 
Amat34 said:
I understand that there hasnt been enough evidence or should I say, there has been evidence that shows that homeopathy doesnt work.

So should doctors scoff(i.e., criticise and dismiss) at the idea of homeopathy because it lacks evidence?
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No they should scoff at it because the entire idea is utterly ridiculous. Water has memory... ha.
 
Amat34 said:
I understand that there hasnt been enough evidence or should I say, there has been evidence that shows that homeopathy doesnt work.

So should doctors scoff(i.e., criticise and dismiss) at the idea of homeopathy because it lacks evidence?
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This is a rhetorical question, right? What in the hell else are we supposed to do if not scoff at something that has been proven not to work yet continue to promote itself as otherwise?
 
Amat34 said:
I understand that there hasnt been enough evidence or should I say, there has been evidence that shows that homeopathy doesnt work.

So should doctors scoff(i.e., criticise and dismiss) at the idea of homeopathy because it lacks evidence?
Click to expand...
Doctors should scoff at, criticize, and dismiss the ideas of homeopathy because homeopathic principles defy basic laws of physics and chemistry. The reason why homeopathic remedies don't work isn't because there isn't any evidence for them. They don't work because it's physically impossible for them to work, unless you want to argue that the last 500+ years' worth of advances in the physical sciences are all wrong.

Doctors should also scoff at, criticize, and dismiss homeopathy because letting patients pay money for worthless treatments, and having patients delay seeking real medical care to use homeopathy, causes them harm. On the bright side, taking homeopathic remedies won't physically hurt people, either, unless they accidentally aspirate the contents of the bottle rather than swallowing them. :d
 
No no I was just curious if anyone actually stood up for homeopathy.
 
Amat34 said:
No no I was just curious if anyone actually stood up for homeopathy.
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Inasmuch as anyone stands up for crystal healing, exorcisms, and calling on the essence of the land to invigorate your spirit animal.
 
Amat34 said:
I understand that there hasnt been enough evidence or should I say, there has been evidence that shows that homeopathy doesnt work.

So should doctors scoff(i.e., criticise and dismiss) at the idea of homeopathy because it lacks evidence?
Click to expand...

I'm not sure what you're asking exactly, but there's a pragmatic element here. If you have a patient in front of you who is a fan of her homeopathic treatments, you need to be careful not to alienate her and drive a wedge into the patient-doctor relationship. I'd say you should be straightforward, and explain that there's no plausible way for homeopathic remedies to work, and that attempts to test them all show that there's no effect beyond the placebo effect. I would recommend against scoffing, or seeming dismissive, or like you think the patient is a fool for believing in this.
 
phltz said:
I'm not sure what you're asking exactly, but there's a pragmatic element here. If you have a patient in front of you who is a fan of her homeopathic treatments, you need to be careful not to alienate her and drive a wedge into the patient-doctor relationship. I'd say you should be straightforward, and explain that there's no plausible way for homeopathic remedies to work, and that attempts to test them all show that there's no effect beyond the placebo effect. I would recommend against scoffing, or seeming dismissive, or like you think the patient is a fool for believing in this.
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👍

Sometimes you have to be a little diplomatic. A patient taking both effective medicine and homeopathy is better off than a patient only taking homeopathy because they were offended and alienated by their physician.

You can be honest with them, but effective persuasion contains an element of empathy for the other person's position. Stating your opinion and that people are stupid for disagreeing with it rarely works.
 
Amat34 said:
I understand that there hasnt been enough evidence or should I say, there has been evidence that shows that homeopathy doesnt work.

So should doctors scoff(i.e., criticise and dismiss) at the idea of homeopathy because it lacks evidence?
Click to expand...

When something is clearly ridiculous you don't need to rely on empiricism, assuming you aren't a total *******!
 
But, it is helpful to understand how to address the concerns of patients who DO believe in homeopathy. You should probably also know what to do if a patient suddenly tells you they're taking 200C Oscillococcinum (after Wikipediaing it).
 
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QuizzicalApe said:
Inasmuch as anyone stands up for crystal healing, exorcisms, and calling on the essence of the land to invigorate your spirit animal.
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****, ill stand up for that part
 
I rotated with a FMG who was a firm believer that homeopathic remedies worked. She was from Russia, so I guess maybe she had some experience with it over there or whatever.

Everyone scoffed at her, but not overtly. I mean, we had to work with her. She never tried to prescribe anything homeopathic or even recommend it, but it still shaded my opinion of her clinical judgement.
 
My view on this entire alternative homeopathic medicine is by all means they can go ahead and try it, but only after they are done with conventional methods. Water with memory and what have you is not supposed to be a first line treatment.
 
DrCoffeeBean said:
My view on this entire alternative homeopathic medicine is by all means they can go ahead and try it, but only after they are done with conventional methods. Water with memory and what have you is not supposed to be a first line treatment.
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The problem is that they often are using homeopathic treatments concurrently with accepted medical management hence blurring their cause and effect interpretation.
 
DrBowtie said:
The problem is that they often are using homeopathic treatments concurrently with accepted medical management hence blurring their cause and effect interpretation.
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Yeah, one of those things one has to deal with I suppose. If I am ever in that situation I hope I will have a strong enough patient-doctor relationship to convince them to try all their herbal stuff after the proper meds.

Some of that homeopathy herbs can actually interact with conventional pharm not in a good way, so it just creates more problems if they take it at the same time.
 
Homeopathy eh? Never was a beat poem kind of guy, but this is just really well done.

[youtube]y1yxDWxUIM0[/youtube]
 
Tired said:
I thought the whole point of homeopathy is that substances are diluted to very low concentrations? Seems unlikely that diluting anything way out will have a particularly large impact on a medication you're taking.

It's like saying that you shouldn't put garlic in your food if you're taking aspirin, because it can increase bleeding risk. Sounds good in theory, but probably not clinically relevant.
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people have different reactions to medications. A dose that does not affect one person is an overdose to another. If the patient is willing to take that risk then fine. But also note, that not all herbs have to be at full strength to have an adverse affect. Valerian, which is an herb used in teas to help promote sleep has been shown to be a risk factor in the development of delirium.

Your advise is just that, advice. If the patient would choose not to follow that advise, they have that right. If you advise the patient to avoid certainly homeopathic remedies because of an interaction with medication and they still choose to take it, then that is the risk they take. On the other hand, if the patient taking the homeopathic treatment makes them more comfortable taking conventional medications and there is little or no side effects or potentiation then all the better.
 
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Tired said:
I'm on record on this board for nearly 5 years saying that CAM is one of the biggest frauds ever perpetrated on the American public.

I do believe that we should always be honest with our advice. I don't care for the "Well, if it's not hurting them or interfering with your care, you should be supportive" argument that gets thrown out here all the time.

But I am also suspicious of the "herbal medicines interfere with allopathic medications." I've been hearing this one since med school, but from reading the literature it seems that there are very few cases where this is true. Ginseng and warfarin is one, along with a few other herbs + warfarin. But for the most part, there seems to be very few actual interactions, and most of them seem to involve lab abnormalities rather than clinically relevant effects.

Homeopathy is just another name for water. The doses of actual substances in their "treatments" are so low as to be basically undetectable. It does absolutely nothing, so I don't play up that angle with patients.

What I do tell them any time the subject comes up is that CAM doesn't do anything that matters. The treatments are worthless and will do nothing beyond the placebo effect. And despite the accusations I sometimes hear on this board, I have yet to have a patient refuse to come back to me because I express this opinion.
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Certain Naturopathic practitioners combine the homeopathy dilutions with actual, Chinese/Mexican/etc herbs and potions (among other interventions, such as acupuncture). In this case "homeopathy" may include herbs, spices, potions, massages, oils, nutrition changes, crystal healing, and whatnot.

I don't think it's the physician's responsibility to analyze every possible drug/CAM interaction the patient might resort to. In fact, it would be expeditious to not consider it at all... who has time in their day for that (unless you come to warfarin)? The patients are still wasting their money on CAM remedies, though, and it might be a kind notion to mention to them to stop it. Finally, if anybody really cares about the drug/CAM interactions, they can hire an ND to tell them exactly what might be in the potions and herbs and then refer it to a pharmacologist.
 
All the ND's I know prescribe both forms of treatment... and more.
 
I'm not familiar with the whole "philosophy" behind homeopathy (water has memory?!... wth?), but there are medical benefits (perhaps a better term would be "medical effects") to a few select OTC herbal supplements.
 
Tired said:
Not to split hairs, but in that case it would be "Naturopathy" not "Homeopathy."
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yeah, not that I really care, but homeopathy is just the whole "super-diluted solutions of something similar/related to the ailment will cure it" deal. Herbal treatments, acupuncture, crystals and the like are all other forms of alternative medicine.

On a side note, someone did the calculations based on the number of water molecules in 100 drops, and the overwhelmingly most likely situation is that, given that homeopathic treatments are 30 dilutions, there isn't even a single molecule of the original "treatment substance" in the water being given.
 
Slaol said:
I'm not familiar with the whole "philosophy" behind homeopathy (water has memory?!... wth?), but there are medical benefits (perhaps a better term would be "medical effects") to a few select OTC herbal supplements.
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Well, it was a spinoff of the whole vaccination theory (back when they actually infected you with the disease or a spinoff/attenuation of it before they realized that some killed vaccines worked as well), and to the extent of their understanding it seemed plausible back in the day I'm sure.
 
I'm uncomfortable with the word "scoff".

depends on the setting I suppose. In some circles Im comfortable saying that the foundations of homeopathy require the eating of paint chips, sucking of gas fumes, or someone with posters of aspiration and ambition featuring Forrest Gump and Radio in order to be accepted.

However in front of a patient who believes in such things I will likely take a different approach. I would still offer correction/advise and I will simply not tell a patient to go for it just because I dont see the harm. the harm is the propagation of such ideas that leads towards a delay in proper healthcare while people fiddle around with nonsense
 
started googling around to get some interesting reading material on the subject to post and just got irritated after landing on an ND page with online advice.

Listen, ALL healthcare professionals believe that the body has an innate ability to heal itself. This is not unique to naturopaths, homeopaths, chiropractors, or whatever. these "informative sites" tout an approach as being focused on the body's ability to heal as if this is a novel concept. The difference between actual medicine and various forms of voodoo is that we hold the believe that every once in awhile something comes along that your body cannot handle on its own. But by emphasizing the similarity and spinning it as a difference, these other practitioners start to believe they can have an effect when they simply cannot.

when im practicing I really hope all my patients are active, eat plenty of vegetables, stay hydrated, and you know... all of those other COMPLETELY COMMON SENSE things that naturopaths and homeopaths treat like eureka moment criteria. These alternative schools of thought personify the human body which does nothing other than demonstrate an understanding similar to that of a child.

/rant *deep breaths*

ok what were we talking about?

oh, i will say this: I think a big reason these sorts of ideas are still around is because you are much more likely to hear "it isn't your fault and this is easy to fix" with these alternative practitioners than you are with a physician. again, that is due to a skewed perception of reality.
 
I've always wondered: if homeopathy states that water holds memory of things previously dissolved in it, then doesn't that mean any homeopathic tonic we take in is incredibly toxic, too? All the waste that has been filtered out from our drinking supply must still have the same (if not more potent) effect on us. For that matter, all the substances that have ever touched that water molecule for millions of years should still be around if we take their premise on face value.

The homeopathy thing irks me, but I'm willing to be diplomatic with patients on the subject. What really gets me going though are the anti-vaccine people. People like Jenny McCarthy and Oprah Winfrey have done so much damage toward the public's perception of vaccinations. Misguided or not, the blood really is on their hands.
 
clifftacopter said:
I've always wondered: if homeopathy states that water holds memory of things previously dissolved in it, then doesn't that mean any homeopathic tonic we take in is incredibly toxic, too? All the waste that has been filtered out from our drinking supply must still have the same (if not more potent) effect on us. For that matter, all the substances that have ever touched that water molecule for millions of years should still be around if we take their premise on face value.

The homeopathy thing irks me, but I'm willing to be diplomatic with patients on the subject. What really gets me going though are the anti-vaccine people. People like Jenny McCarthy and Oprah Winfrey have done so much damage toward the public's perception of vaccinations. Misguided or not, the blood really is on their hands.
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😱👍 :highfive:
 
clifftacopter said:
I've always wondered: if homeopathy states that water holds memory of things previously dissolved in it, then doesn't that mean any homeopathic tonic we take in is incredibly toxic, too? All the waste that has been filtered out from our drinking supply must still have the same (if not more potent) effect on us. For that matter, all the substances that have ever touched that water molecule for millions of years should still be around if we take their premise on face value.

The homeopathy thing irks me, but I'm willing to be diplomatic with patients on the subject. What really gets me going though are the anti-vaccine people. People like Jenny McCarthy and Oprah Winfrey have done so much damage toward the public's perception of vaccinations. Misguided or not, the blood really is on their hands.
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Fantastic points. 👍
 
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Anyone hear of the guy who had knee surgery with no anesthesia and only an acupuncturist in the room with him? Is this true lol? What do you think about that?
 
I'll stand up for it. What about the placebo effect of homeopathy? Or patients educating themselves by looking up the symptoms of their disease?

Homeopathy may be a crock of !@#$ and utterly wrong but if a patient wants to try something that isn't contraindicated, might make them feel better via placebo, and requires researching what they have, I'm all for it.
 
Kevin Baker said:
I'll stand up for it. What about the placebo effect of homeopathy? Or patients educating themselves by looking up the symptoms of their disease?

Homeopathy may be a crock of !@#$ and utterly wrong but if a patient wants to try something that isn't contraindicated, might make them feel better via placebo, and requires researching what they have, I'm all for it.
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so when a patient who could have come to you with a fresh burn to be cleaned and treated instead does his own thing for 3 days before abandoning homeopathy and comes in with an old burn that is now infected - you are ok with this because placebo can offer relief? touting the effects of placebo is never appropriate. it exists to offset the perceptions of those involved in the study.

if someone experiences a placebo effect and feels "better" their problem was unlikely serious in the first place. if this same person now fully ascribes to this technique and decides to use it again when the problem is now life threatening.... well now we have a problem. a problem which wouldnt have existed if people were educated on what placebo really meant
 
SpecterGT260 said:
so when a patient who could have come to you with a fresh burn to be cleaned and treated instead does his own thing for 3 days before abandoning homeopathy and comes in with an old burn that is now infected - you are ok with this because placebo can offer relief? touting the effects of placebo is never appropriate. it exists to offset the perceptions of those involved in the study.

if someone experiences a placebo effect and feels "better" their problem was unlikely serious in the first place. if this same person now fully ascribes to this technique and decides to use it again when the problem is now life threatening.... well now we have a problem. a problem which wouldnt have existed if people were educated on what placebo really meant
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Don't turn this into a scenario that isn't. I never advocated homeopathy + waiting 3 days to see the doc.

And about 42% of American docs disagree with you on never prescribing a placebo. This isn't an easy issue to address and while your scenario is plausible, there are a plethora of other hypotheticals or real cases I could describe showing the opposite.
 
i am not turning into anything it isnt. it is a possible playout of what you suggested. the underlying reasoning is that it is not a good idea to instill faith in a treatment that doesnt work because the only real consequence is that you will later have to fight against that faith when you want to attempt the appropriate treatment.

where do you get that 42% of docs are in favor of prescribing placebo? I'd like to see that source
 
And another possible playout is the person gets 100% better or doesn't wait 3 days to see a doc. I really don't want to engage in hypotheticals.

The source is here

http://www.medscape.com/viewarticle/731485

question 7 under patient-treatment issues
 
so you think there is no basis for the fear that placebo alternative techniques will keep patients from receiving the care they need in any capacity?
 
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SpecterGT260 said:
so you think there is no basis for the fear that placebo alternative techniques will keep patients from receiving the care they need in any capacity?
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There is a definite basis for fear. There is also a definite basis for better outcomes. It comes down to weighing the pros and cons of that specific scenario.
 
Kevin Baker said:
And another possible playout is the person gets 100% better or doesn't wait 3 days to see a doc. I really don't want to engage in hypotheticals.

The source is here

http://www.medscape.com/viewarticle/731485

question 7 under patient-treatment issues
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your argument is basically: "It is OK because the patient could live" vs "its not ok because the patient could die" hypotheticals aside, the issue is whether or not it is ok to direct patients towards PRACTICES that use placebo. not just placebo itself.

if you want to prescribe a placebo to someone just to shut them up that is your business. When things get serious you still have the option to pull treatment and go with something else. you do not have this luxury if you tell your patients it is OK to go see the homeo therapist. therefore with a life-threatening situation and an instilled faith in homeopathy via a doctor who thinks its ok to prescribe placebo, my scenario is much more likely than yours.
 
SpecterGT260 said:
your argument is basically: "It is OK because the patient could live" vs "its not ok because the patient could die" hypotheticals aside, the issue is whether or not it is ok to direct patients towards PRACTICES that use placebo. not just placebo itself.

if you want to prescribe a placebo to someone just to shut them up that is your business. When things get serious you still have the option to pull treatment and go with something else. you do not have this luxury if you tell your patients it is OK to go see the homeo therapist. therefore with a life-threatening situation and an instilled faith in homeopathy via a doctor who thinks its ok to prescribe placebo, my scenario is much more likely than yours.
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Hold up.

1. I want to clarify my argument. I originally stated, if a patient wants to try homeopathy, then I'd be all for it. I don't feel it is ethical to direct a patient towards placebo unless they want to explore that option and bring it up first.

2. Your scenario could happen, as could a placebo cure. This is why I don't like dealing with hypotheticals, or generalizing. Even if you can show your scenario is more likely to happen, which I am not conceding, what about the specific scenarios where life threatening illness is not likely? Should we generalize and say all uses of placebo are always wrong? I also think your attitude towards patient knowledge and this instilled faith in homeopathy is a bit disheartening. I don't see why a patient given a placebo for something minor, or who is directed to a practice dispensing placebos, must put their trust in placebo for something major.

I had a friend recently go to a naturopath for help with weight loss. (not a homeopath but lets assume they're the same for this scenario). The naturopath spiels some crap about a gall bladder issue and carb digestion, and prescribes a special organic, expensive, magical bread (because we all know the gallbladder is integral in the digestion of carbs /sarcasm). My friend goes on the special expensive magical bread diet and a few months later she is down 15 lbs, looks stunning, and is a lot more engaged and happy with life. So what if the diagnosis was wrong? The patient got the outcome she wanted, placebo or not. Maybe she was inspired. Maybe the naturopath successfully addressed the biopsychosocial aspect of medicine. Who cares. Her faith in naturopathy isn't instilled to a point she'd go there for cancer treatment, though maybe she'd go for a quick diet again. But at least in these types of low risk scenarios, ignoring this readily available tool of CAM seems to be doing us and the patients a disservice.
 
QuizzicalApe said:
Inasmuch as anyone stands up for crystal healing, exorcisms, and calling on the essence of the land to invigorate your spirit animal.
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Come on now, the things you listed actually have a chance of working.

I have a nitrogen metabolism exam in the morning, let my inner spirit animal be invigorated now.
 
Kevin Baker said:
Hold up.

1. I want to clarify my argument. I originally stated, if a patient wants to try homeopathy, then I'd be all for it. I don't feel it is ethical to direct a patient towards placebo unless they want to explore that option and bring it up first.

2. Your scenario could happen, as could a placebo cure. This is why I don't like dealing with hypotheticals, or generalizing. Even if you can show your scenario is more likely to happen, which I am not conceding, what about the specific scenarios where life threatening illness is not likely? Should we generalize and say all uses of placebo are always wrong? I also think your attitude towards patient knowledge and this instilled faith in homeopathy is a bit disheartening. I don't see why a patient given a placebo for something minor, or who is directed to a practice dispensing placebos, must put their trust in placebo for something major.

I had a friend recently go to a naturopath for help with weight loss. (not a homeopath but lets assume they're the same for this scenario). The naturopath spiels some crap about a gall bladder issue and carb digestion, and prescribes a special organic, expensive, magical bread (because we all know the gallbladder is integral in the digestion of carbs /sarcasm). My friend goes on the special expensive magical bread diet and a few months later she is down 15 lbs, looks stunning, and is a lot more engaged and happy with life. So what if the diagnosis was wrong? The patient got the outcome she wanted, placebo or not. Maybe she was inspired. Maybe the naturopath successfully addressed the biopsychosocial aspect of medicine. Who cares. Her faith in naturopathy isn't instilled to a point she'd go there for cancer treatment, though maybe she'd go for a quick diet again. But at least in these types of low risk scenarios, ignoring this readily available tool of CAM seems to be doing us and the patients a disservice.
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We will have to agree to disagree then. I've heard the "who cares if we get results" argument plenty of times in plenty of scenarios. I believe from a pretty deep seated place that any adopted misunderstanding carries with it a possibility of mistake and a certainty of delayed progress. The placebo effect is what fostered blood letting for so long (my go-to example), and even that DOES have clinical use...

Bottom line is: I view homeopathy as something that impedes patient education and offers nothing more than a potential obstacle for me and the treatment of my patients.

As far as progress goes: it's the same argument I used in the chiropractor thread. If there IS some real use to a therapy that is currently held by pseudo scientists and the lot, we have a harder time incorporating valuable treatments while we allow the fallacies that underlie them which and facilitate inappropriate treatments. It's idealistic and philosophical, I know, but it's why refuse to condone letting a patient lie to him or herself just because I think their problem is in their head.
 
I am suspicious of people with unsubstantiated claims, who keep criticising evidence-based medicine. Come on! Dilluting a poison into oblivion to treat a condition?

How do they actually squeeze the oil out of snakes?
 
As long as its not something that could be harmful I usually just tell people that I dont understand it nor do I use it but that if it works for them (usually in reference to headaches, curing a virus like the flu/cold) then thats great. I leave it at that unless they are genuinely wanting my opinion on the scientific evidence which is rare. Usually they are already convinced and want you to try it too, in that case I figure i will let what ever small placebo effect that there is remain.
 
I think you are doing a terrible disservice to your patients by not educating them on the science behind homeopathy (or should I say, the lack of) and how the idea of it is not even plausible. It's definitely important to not alienate them, but its critical to educate them.

Sure, its not going to harm anyone since it's just water, but what about harming their wallets? It's obviously a complete waste of money.

Also the harm of perpetuating the belief that homeopathy works leading to people delaying treatment for serious illness. Saying "if it works for you, then that's okay" is in a way promoting the idea that anecdotes are a good method to test efficacy of a product.

Its hard to believe but there are people using homeopathy and natural supplements/herbs to treat cancer. They think they can try out some "natural" treatments for their stage I cancer. Then their cancer progressives to stage IV and they seek real medical attention, and by this time it might be too late. Or their cancer does not happen to metastasize and they think their natural supplements/herbs cured their cancer and they promote this "cure." That's the harm.
 
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