Our work in oncology also has an international scope. We’ve had great results participating in European projects such as the European Partnership Action Against Cancer (EPAAC). Just today we were given the green light to support a workshop at the European Congress of Integrative Medicine, which will include U.S. contributors for the first time among its expected 1,000+ participants. This workshop is on integrative oncology for refugees, especially from the Middle East because there’s a network for integrative oncology in that region that brings together Israelis, Palestinians, Turks, Lebanese, Moroccans and others. The Region of Tuscany is supporting this financially because there’s strong agreement about the importance of this topic.
This is one of the characteristics of Tuscany as a region: we are a center of innovation. Interestingly, in Tuscany, 37.9% of oncology patients use CM and 66.3% tell their doctors that they are also using complementary medicines. Certainly there are people who say CM is placebo, but the great majority of people here accept it as a normal and useful thing.
You seem to represent a new kind of figure in homeopathy – that of homeopath as activist, lobbyist, and educator all rolled into one. Does this description resonate with you?
At some point, I went from being a classical homeopath interested in matching a person’s symptoms with the best remedy to being a classical homeopath interested in social homeopathy. This is the term I started to use years ago to refer to the question of what are the effects of homeopathy on society, on healthcare, on public institutions. My experience in Cuba helped me begin this reflection and we have come a long way since then.
Experience has confirmed for me that either you’re within the system or in some sense you don’t count – you stay in a sort of parallel world, perhaps doing what you want, but you’re insignificant from the broader social perspective. So we embarked on this path regarding complementary medicines, including homeopathy, as a whole. As you can imagine, it’s not easy to “hold” homeopathy together with other complementary medicines because our institutions tend to separate it out as non-scientific and non-plausible in terms of its mechanisms of action. Acupuncture and herbal medicine, on the other hand, have taken hold at all levels. For us, it has taken 20 years of experience and clinical work in which we documented everything we did. Even if we don’t have full evidence for the scientific basis and the mechanisms behind homeopathy, we have a case load of over 6,000 consecutive cases from our hospital clinic in Lucca. Sharing these results has made a big difference.
Other regions of Italy seem to be making progress, but none so much as Tuscany. In addition to your hard work, it seems perhaps there was a fortuitous alignment of players and situations. What really is the secret to your success in Tuscany? And what advice can you share with others wanting to replicate that success?
It is a great question that many people ask me. As you said, there are many situations that aligned. An example is the ongoing support of government officials. The chair of the health board who first supported us became the president of the region. The chair who replaced him, Enrico Rossi, followed his footsteps, so there has been a clear political continuity. Not least of all, we’ve had great support on the part of the public, which has influenced politicians. And finally, the practitioners who participated in this movement all aligned. We all worked together, even though we’re from different disciplines. We knew that there would be no future in the fight for the integration of homeopathy only, or acupuncture only or anything else, independently of the other disciplines.
One of the interesting alignments in the beginning was an initiative by the medical board of Tuscany, which sent a survey on complementary medicines to all its registered general practitioners and pediatricians. There was a very high response rate, especially if we consider that these were pre-Internet days and recipients had to mail the survey back at their own expense. Among 3,000 doctors surveyed, 80% responded, the vast majority of them in support of complementary medicine and training in that area. We also discovered that doctors were using CM for their health more than their patients: 23% vs. 20%.
Having this kind of support was invaluable. So, for our progress, we have to credit the readiness of medical practitioners and the general public, as well as the preparation of those who worked on these initiatives, the experience we gained in the social arena, and most importantly the tenacity and seriousness with which we pursued our objectives over the years.
I have to reiterate, though, that this was a 20-year process. It took that long to build an embryo of a system. Certainly, our situation in Tuscany is quite a jewel. We’re not the only ones in Italy doing this work anymore, but we’re the only ones doing it at this level. We’ve tried to export our model to other regions with varied results. One important win was a national law, an agreement between national and regional governments defining training criteria for complementary medicine, passed in 2013, which most regions have supported and are working to implement . The difficulty is that many regions are currently faced with an economic deficit.
Free healthcare for all is a positive ideal but it is difficult to achieve and maintain, as we see with the United States. Costs are very high and growing. The latest anti-cancer therapies or immunotherapies cost 30,000 to 40,000 euros per patient. It’s not possible to sustain costs like that. This is partly why complementary medicines are important in the public sector – because they help to cut costs and educate patients about maintaining health though diet, lifestyle, and so on.
There are great benefits to having homeopathy in the public healthcare system. Are there any costs? For example, are there changes you’ve had to make in the way you practice, possibly in response to pressures extrinsic to homeopathy?
We have never had external pressures. Our internal pressures are mostly related to hospital turnaround times. It’s simply not possible to do 3-hour visits. We give each of our patients a half hour for the first and second visits, which very occasionally will extend to an hour. This means that if the patient has a very complicated case, we’re not able to see them as long as we’d like.
I don’t think this is unique to the public sector, though. When I started in homeopathy, Schmidt and other masters were doing half-hour visits, some of them having to see 60-70 patients a day. Kent practiced like this too. Naturally, if you have 40 years of experience, half an hour can be enough, but not always.
My personal challenge is that we spend a lot of time documenting our results. Among my patients, I can tell you how many are doing well, how many are not, and which pathologies are showing more or less positive results. For example, we’ve had greater challenges with people who come to us with predominantly psychosomatic problems. Our time constraints simply don’t allow us to enter that deeply into a patient’s issues. Still, we would have to compare our results with those of homeopaths elsewhere to understand if the differences in results are significant.
This reminds me of a conversation between Pierre Schmidt and Jacques Imberechts in Geneva. It went something like this:
Schmidt: How many years have you been practicing homeopathy?
Imberechts: It’s been 20 years already.
Schmidt: What are your results after 20 years? How many patients are cured?
Imberechts: Well, I’d say that 70% of my patients have good results.
Schmidt: Ah, good, very good. Do you know what my results are, after 60 years practicing homeopathy? Forty percent.
“What? Forty percent? How is that possible?”, replied Imberechts with great surprise. The answer was that, the more you’re known, the harder and more complicated are the cases that come before you. Cases with complicated life stories and a preponderance of mental pathology have to be analyzed carefully. Our hospital setting doesn’t allow us to delve into people’s life stories in that way.
That said, in most cases, we don’t find this is a problem. In many ways, we have great advantages. It’s easier to work in a hospital. You’re more supported and you can count on specialized advice or help interpreting labs from your colleagues whenever you need it. Homeopathy patients often come for treatment because they want to replace their pharmaceuticals – antibiotic, psychotropic or anti-epileptic drugs, for example – with homeopathic treatment that has the same properties but without side effects or toxicity. The transition away from conventional pharmaceuticals is very delicate and it can create greater problems if not managed well. Within a hospital setting, this transition can be made more safely because you can consult more easily with your specialist colleagues to understand the best way to proceed.