Sub-headings: -- At what point should a clinician consider using only homeopathic medicines?

-- At what point should a clinician not consider homeopathic medicines and use only conventional therapeutics?

-- And at what point should a clinician consider using both homeopathic and conventional medicines?

-- Conclusions

• These are all critical questions that will be increasingly asked as growing numbers of health professionals incorporate homeopathic medicines into their practice. The answers to these questions will not be hard and fast, for each sick person brings his or her own unique illness to the clinic, and each sick person has his or her own desires for how relief or cure should be obtained.
• In addition to what the sick person brings to the therapeutic encounter, each practitioner brings his or her own values, knowledge, competence in homeopathy, and competence in conventional therapeutics to the situation.
• And both patient and practitioner bring the various fears, anxieties, and emotional baggage to the relationship. If the patient or someone close to him or her recently had a bad experience with a conventional physician or with a homeopath, then this experience will affect their feelings about the type of treatment that is preferred. Similarly, if the practitioner recently experienced a malpractice suit, he or she may be more cautious in recommending alternatives or conventional therapeutics, whichever seemed to initiate the lawsuit.
• In other words, this article will not provide easy or quick answers to the above questions.

At what point should a clinician consider using only homeopathic medicines?

--Practical and philosophical issues

• Hippocrates insisted that physicians "First, do no harm." One can easily make a compelling case for why safer therapeutics should be considered first, thus leading modern clinicians to use homeopathic and other natural therapies before resorting to conventional medical treatments.
• Such a protocol would instantly make homeopathy and natural therapies into leading primary care treatments. Sadly, however, the biases against these therapeutic strategies have led to their disdain, rather than incorporation within our medical care system. These biases are finally diminishing, though there is still a long way for contemporary clinicians to go to attain a healthy attitude towards natural therapeutics.
• Using homeopathic medicines as a first mode of treatment in non-emergency primary care would lead to its application in a wide, even a very wide, assortment of acute care. At the most extreme extent, one could say that homeopathic medicines can and should be considered whenever some type of heroic medical treatment is not necessary. At the other end, one could say that homeopathic medicines can and should be considered only when there is no evidence that the benefits of a conventional medical treatment outweigh its potential side effects.
• One might think that a middle position is the best way to go. However, finding that middle position is not always easy. For instance, one might ask the seemingly important question: what evidence is there that either homeopathic or conventional medicine is more effective? There are very few studies that provide such a comparison, and even when it has been done, it is an unsound comparison. For instance, while it may be true that a painkiller will decrease the pain in patients more effectively than a homeopathic medicine, it does so with various side effects. And while a person taking a homeopathic medicine may initially have more pain than a person taking a painkiller, the long-term health of the person may be a more appropriate measure of a treatment's successes.
• The problem with figuring out the costs and benefits of each treatment is that conventional physicians and homeopaths will have different analyses of the costs and benefits to each treatment. For instance, conventional physicians will acknowledge that cortisone has serious side effects, but they generally minimize them when used over a short period of time. Homeopaths, on the other hand, are considerably more cautious due to the fact that their detailed casetaking over the years has led to the frequent observation that cortisone and many other conventional drugs suppress a person's minor illness into a considerably more serious ailment.
• Conventional physicians insist that a person's new complaint is not related with the previous one, while homeopathic practitioners assert that nothing comes from nowhere and that disease is often built from previous illnesses.
• This debate will inevitably become more heated as increasing numbers of health professionals use homeopathic medicine in their practice and as these individuals begin to come to grips with the implications of homeopathic principles. This debate will benefit both patients and practitioners because there are important philosophical and therapeutic issues that homeopathy brings out which are not presently being address.
• Specifically, conventional clinicians presently do not even consider that their treatments may suppress a person's disease and lead to a more serious complaint. While psychiatrists are intimately aware of the fact that people can suppress their feelings, which then leads to more serious problems, conventional physicians do not presently consider the possibility that certain drugs can suppress specific physiological responses of the body to infection or stress, thereby providing temporary relief of a problem but sometimes creating a deeper and more troubling condition.
• Most conventional physicians consider side effects to be the worst possible problem of conventional drugs. While the various short-term side effects can indeed be a problem, homeopaths assert that there are also long-term consequences to some pharmacological interventions. These long-term consequences are the result of a drug's ability to inhibit the normal physiological responses of the body, thereby allowing the disease processes to be pushed deeper into the organism.
• Homeopaths consider the term "side effect" to be inaccurate and propagandistic term that mollifies its real actions. From a purely pharmacological perspective, drugs do not have "side effects" but only have "effects," and that physicians arbitrarily differentiate those effects that they like from those they don't like (calling these symptoms "side effects").
• Ultimately, it will be difficult for clinicians to rely upon homeopathic medicines as the sole treatment modality until they have been adequately trained in its application. While most training programs in homeopathy are three or four years, these programs, as any homeopathic student or practitioner will tell you, are only the beginning of a homeopath's experience.
• When practitioners have this training and 10 years of experience under their belt, I have little doubt that most practitioners will feel confident enough in homeopathic medicines to be the sole or primary treatment in the vast majority of primary care cases.
• Practitioners who have less training and experience will probably not be as confident in their use of homeopathic medicines as a primary treatment, except in those cases where there is no adequate conventional treatment, as is common in many viral infections, common infant complaints (i.e., teething and colic), premenstrual syndrome, and allergies.