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You can find the current article at its original source at http://www.theguardian.com/commentisfree/2014/apr/11/of-course-homeopathy-doesnt-work-but-some-dont-want-to-hear-it
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| Version 1 | Version 2 |
|---|---|
| Of course homeopathy doesn't work – but patients don't want to hear it | Of course homeopathy doesn't work – but patients don't want to hear it |
| (about 2 hours later) | |
| All my children were resolutely bald for the first two years of their life. I | All my children were resolutely bald for the first two years of their life. I |
| didn’t mind, but the concern of a woman at playgroup made up for my lack of it. | didn’t mind, but the concern of a woman at playgroup made up for my lack of it. |
| Convinced that baldness signified a "bodily | Convinced that baldness signified a "bodily |
| imbalance", she exhorted me to seek homeopathic treatment. I was recommended a practitioner | imbalance", she exhorted me to seek homeopathic treatment. I was recommended a practitioner |
| who had successfully treated the woman’s own children for asthma, colic and | who had successfully treated the woman’s own children for asthma, colic and |
| school-related stress. All her treatments were natural, safe, guaranteed to | school-related stress. All her treatments were natural, safe, guaranteed to |
| work, and relatively cheap at $40 apiece. My poor daughter, routinely mistaken | work, and relatively cheap at $40 apiece. My poor daughter, routinely mistaken |
| for a boy, would soon flaunt Rapunzel-like hair. And what more, my private | for a boy, would soon flaunt Rapunzel-like hair. And what more, my private |
| health insurance would cover her transformation. | health insurance would cover her transformation. |
| When I politely demurred, the | When I politely demurred, the |
| woman’s irritation was obvious. "You western doctor types", she shook her head | woman’s irritation was obvious. "You western doctor types", she shook her head |
| disapprovingly, "you just can’t bear to think that you don’t have all the | disapprovingly, "you just can’t bear to think that you don’t have all the |
| answers." | answers." |
| Comprehensive research by the well-regarded | Comprehensive research by the well-regarded |
| Australian NHMRC concluded this week that homeopathy is ineffective. Prominent | Australian NHMRC concluded this week that homeopathy is ineffective. Prominent |
| doctors declared it unethical to prescribe, and health funds told to stop | doctors declared it unethical to prescribe, and health funds told to stop |
| subsidising it. | subsidising it. |
| To the medical community fed up with quackery, the results simply confirm an established fact. But as the ensuing | |
| furious exchange shows, to those who would cure an infant’s baldness with | furious exchange shows, to those who would cure an infant’s baldness with |
| homeopathy, the conclusion is just another example of the bias of conventional | homeopathy, the conclusion is just another example of the bias of conventional |
| doctors against something they don’t want to learn about. The | doctors against something they don’t want to learn about. The |
| establishment dismisses homeopathy, but a million Australians are willing to | establishment dismisses homeopathy, but a million Australians are willing to |
| embrace it, defend it, and ridicule the evidence against it. | embrace it, defend it, and ridicule the evidence against it. |
| As an oncologist, I am no stranger to | As an oncologist, I am no stranger to |
| patients who would happily spend the consultation trying to convince me of the | patients who would happily spend the consultation trying to convince me of the |
| salutary benefits of apricot kernel or lavender extract. Discussions of | salutary benefits of apricot kernel or lavender extract. Discussions of |
| homeopathy as a viable alternative to chemotherapy cause their own share of | homeopathy as a viable alternative to chemotherapy cause their own share of |
| disagreement. But how does one handle these testy conversations? Time-honoured | disagreement. But how does one handle these testy conversations? Time-honoured |
| tools include rolling one’s eyes, declaring that a patient is mistaken, and | tools include rolling one’s eyes, declaring that a patient is mistaken, and |
| gradually disengaging, all practiced with varying degrees of subtlety. They | gradually disengaging, all practiced with varying degrees of subtlety. They |
| only serve to alienate patients who still need our help and partnership. | only serve to alienate patients who still need our help and partnership. |
| Users of alternative health take any number | Users of alternative health take any number |
| of unknowable and even dangerous products, but they all tend to describe one | of unknowable and even dangerous products, but they all tend to describe one |
| common element – they feel heard. They sense sympathy for their condition, they | common element – they feel heard. They sense sympathy for their condition, they |
| feel respected, and they are drawn to the appeal of a simple explanation even | feel respected, and they are drawn to the appeal of a simple explanation even |
| if it’s wrong. | if it’s wrong. |
| "I | "I |
| don’t care if homeopathy is crap, but it’s the only place someone really listens | don’t care if homeopathy is crap, but it’s the only place someone really listens |
| to me", said a patient. In other words, what people hanker for is human communion, | to me", said a patient. In other words, what people hanker for is human communion, |
| a rare commodity in modern medicine whose absence is noted by opportunists. | a rare commodity in modern medicine whose absence is noted by opportunists. |
| The research findings make me reflect that | The research findings make me reflect that |
| doctors can either spend their time wondering why people can’t see what’s good | doctors can either spend their time wondering why people can’t see what’s good |
| for them, or we can seek to improve our communication with patients to at least | for them, or we can seek to improve our communication with patients to at least |
| partly address the reasons people turn to alternative health practitioners. And | partly address the reasons people turn to alternative health practitioners. And |
| here, medical training is widely thought to do an inadequate job. | here, medical training is widely thought to do an inadequate job. |
| The more medicine advances, the more nuanced | The more medicine advances, the more nuanced |
| it becomes. On a ward round, absolute answers to thorny issue are missing. | it becomes. On a ward round, absolute answers to thorny issue are missing. |
| Should a deeply unconscious stroke patient be artificially fed and for how long? | Should a deeply unconscious stroke patient be artificially fed and for how long? |
| Should a competent woman be allowed to return to a dozen cats, rancid food and | Should a competent woman be allowed to return to a dozen cats, rancid food and |
| an unsafe home? How does one broach a not for resuscitation directive with | an unsafe home? How does one broach a not for resuscitation directive with |
| somebody who doesn’t realise the gravity of his disease? Is the patient | somebody who doesn’t realise the gravity of his disease? Is the patient |
| refusing treatment in denial or is she reasonably declining the poor offerings? | refusing treatment in denial or is she reasonably declining the poor offerings? |
| The answers have less to do with following a strict medical protocol than with | The answers have less to do with following a strict medical protocol than with |
| skilfully navigating difficult and deeply sensitive conversations with | skilfully navigating difficult and deeply sensitive conversations with |
| vulnerable patients and anxious relatives. These conversations require a range of skills | vulnerable patients and anxious relatives. These conversations require a range of skills |
| including medical expertise, but also a greater measure of compassion, empathy and patience. Time and again it is not the smartest doctor | |
| who helps the patient, but the one who takes the time to listen, who is at ease | who helps the patient, but the one who takes the time to listen, who is at ease |
| with uncertainty and who can articulate a viewpoint without seeming arrogant or | with uncertainty and who can articulate a viewpoint without seeming arrogant or |
| defensive. Patients say that even when the news is bad, the way it is delivered | defensive. Patients say that even when the news is bad, the way it is delivered |
| can sustain hope or shatter it. | can sustain hope or shatter it. |
| As a trainee oncologist, I participated in a memorable workshop with a simulated patient who tactfully told me that I needed to lift my act. I found the experience transformative, more so than memorising all the chemotherapy protocols. | As a trainee oncologist, I participated in a memorable workshop with a simulated patient who tactfully told me that I needed to lift my act. I found the experience transformative, more so than memorising all the chemotherapy protocols. |
| Anyone who has encountered a doctor appreciates | Anyone who has encountered a doctor appreciates |
| that there is an art to medicine. But by and large, we allow doctors to | that there is an art to medicine. But by and large, we allow doctors to |
| practice medicine with minimal training in how to hone this art and how to communicate | practice medicine with minimal training in how to hone this art and how to communicate |
| effectively with patients. There is an entrenched belief that either the skill | effectively with patients. There is an entrenched belief that either the skill |
| is inherent, or that one will eventually master it. On the contrary, it | is inherent, or that one will eventually master it. On the contrary, it |
| requires regular practice, good role models and robust mentoring. | requires regular practice, good role models and robust mentoring. |
| With or without research to expose homeopathy | With or without research to expose homeopathy |
| as bogus, the believers will prevail in their view. Dismissing them outright | as bogus, the believers will prevail in their view. Dismissing them outright |
| doesn’t really advance the issue, but we could use the opportunity to examine | doesn’t really advance the issue, but we could use the opportunity to examine |
| the role of doctor-patient communication in driving people to seek the false | the role of doctor-patient communication in driving people to seek the false |
| reassurance of alternative remedies. | reassurance of alternative remedies. |