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| Hpathy Ezine - July, 2004 | ||||
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Prescribing Online - A Perspective -- Dr. Leela D'Souza |
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Prescribing online over the last 3 years has been a very exciting experience for me. I’m a mother of 3 children (5.5, 3.5 and 1 yrs) which makes having a regular practice near impossible. And with my husband constantly being transferred in his Job, I restarted and discontinued my private practice 3 times over the last 12 years!! I had to send my patients away to my homeopathic colleagues for continued treatment which was demoralizing for them as well as for me. Then, I had the opportunity to keep in touch with my subject (homeopathy) online through two bulletin boards. That is how David Johnson and I met and worked on a few cases, which resulted in us starting the internet practice together, working as a team. It was a learning experience the first year, where we were seeking to obtain a precise and complete history from our patients in order to make accurate prescriptions right from the first prescription onwards. Then, began the careful monitoring of each case as we were keen to avoid keeping people on un-indicated remedies for a long period of time as well as provide them early relief. We realized how much empathy as well as intuition played a part, not only in remedy choice but in case management as well, particularly in difficult cases that required both an understanding of the pathological process, and a miasmatic interpretation of what was happening. Below are a few pointers I’d like to share with young homeopaths interested in practicing online.I think any responsible homeopath would strive to work at these as they form the basis of an Internet practice, without which it could be a serious mistake to take on people online for chronic treatment. 1. The Organon of Medicine by Dr. Samuel Hahnemann details in Para 3 - 6 the qualities that are expected of any homeopathic practitioner re: knowledge of what is disease, knowledge of the remedies, knowing what is to be cured, obtaining a good history to form a “portrait of disease” and practicing with an unprejudiced mind. For practicing online, this strong knowledge base has to be supported by adequate experience in clinical practice of following patients for at least 5 years. It allows for patient confidence in homeopathy as well as in the homeopath, when the patient realises that we understand what we are doing. It helps us to deal with difficult clinical situations where decisions of posology and management have to be made. 2. Always strive to take a complete and detailed history before
making a prescription. It concerns me that I am putting my patient
on a remedy that could affect his health for the long term. So,
adequate maturity and responsibility has to be attached to a remedy
suggestion. A detailed questionnaire suited to ones approach and
understanding of homeopathic practice is hence the first step to
obtaining this history. Due to wide differences in styles and methods
of analysis, someone else’s questionnaire is not the answer – its
best to frame your own! 3. Strive to keep complete records of the patients’ history as
well as follow ups. My experience is that follow-ups need to be
regular one a week or once a fortnight.This allows for a deeper
understanding of the case, accurate analysisof the sequence of events
– of symptoms as well as of remedy’s prescribed - in order to clearly
perceivewhether the patient is moving towards cure, based on Hering’s
‘Nature’s Law of cure’ and Miasmatic interpretations. Suppressionsand
temporary palliations then can be clearly observedby the trained
eye both in acute cases as well as chronic conditions. At no point
can one be complacent about ones choice of remedy, however confident
one is of that choice. 4. In all serious, deep cases (not life threatening) it is very helpful that the patient has a regular family physician giving a diagnosis of the condition, an unprejudiced objective assessment of clinical signs, and do relevant laboratory investigations that help us to make ‘clinical’ judgments of the progress of the case. Remember, subjective expressions of the patient are not always dependable and something superficial may look terrible to a lay person but in reality may be a harmless progression with deep internal improvement. |
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