GP Homeopathic GP Homeopathic PrescribingPrescribing

Dr Tim’s Magic BoxDr Tim’s Magic Box

ObjectiveObjective

To introduce and encourageTo introduce and encourage

homeopathic dispensinghomeopathic dispensing

in Primary Care settingin Primary Care setting

Current situation in NHS Current situation in NHS homeopathy nationallyhomeopathy nationally

9 NHS Hospital Consultants9 NHS Hospital Consultants 34 NHS Hospital Clinical Assistants / 34 NHS Hospital Clinical Assistants /

Specialist DoctorsSpecialist Doctors 692 GP with homeopathic training692 GP with homeopathic training

Homeopathy in NHS Primary CareHomeopathy in NHS Primary Care

Delivery options:Delivery options: Homeopathic advice onlyHomeopathic advice only Homeopathic FP10 prescription issuedHomeopathic FP10 prescription issued Homeopathic medicine dispensedHomeopathic medicine dispensed

Homeopathic dispensingHomeopathic dispensing

Benefits to:Benefits to: PatientsPatients PractitionersPractitioners NHS hospitalsNHS hospitals Faculty of HomeopathyFaculty of Homeopathy

Benefits to PatientsBenefits to Patients

Immediate treatment – no delay in first aid and Immediate treatment – no delay in first aid and acute situationsacute situations

Effective alternative to conventional medicine Effective alternative to conventional medicine – no treatment / failed treatment / – no treatment / failed treatment / contraindicated / side-effectscontraindicated / side-effects

Patient education – scope of homeopathyPatient education – scope of homeopathy Holistic approachHolistic approach Pharmacy not involvedPharmacy not involved

Pharmacy associated problemsPharmacy associated problems

Most pharmacists don’t have homeopathic Most pharmacists don’t have homeopathic knowledgeknowledge

Unreliable information / advice on Unreliable information / advice on homeopathic usagehomeopathic usage

Don’t stock full range of medicines / potenciesDon’t stock full range of medicines / potencies Have to make special order for medicine – Have to make special order for medicine –

takes time and effort for patienttakes time and effort for patient

Pharmacy problemsPharmacy problems

Incorrect advice given to patientIncorrect advice given to patient Fobbed off with an incorrect potency / another Fobbed off with an incorrect potency / another

OTC remedy / herbal alternative / OTC remedy / herbal alternative / conventional alternativeconventional alternative

Pt looses heart / gives up / reaches for OTC Pt looses heart / gives up / reaches for OTC conventional medicineconventional medicine

Net effect: Missed homeopathic opportunityNet effect: Missed homeopathic opportunity

Benefits to practitionerBenefits to practitioner

Personal satisfaction – ease suffering Personal satisfaction – ease suffering particularly with failed conventional treatmentparticularly with failed conventional treatment

More effective practitioner – more to offer More effective practitioner – more to offer patients – homeopathy complements patients – homeopathy complements conventional treatmentconventional treatment

Knowledge utilisationKnowledge utilisation Learning opportunityLearning opportunity Reinforcing homeopathic knowledgeReinforcing homeopathic knowledge

Benefits to NHS hospitalsBenefits to NHS hospitals

Increased referral rates from primary care for Increased referral rates from primary care for more complex problems that require more than more complex problems that require more than 10 minutes10 minutes

Support of NHS homeopathic hospitals Support of NHS homeopathic hospitals indirectly supports teaching centres that are indirectly supports teaching centres that are linked to the hospitalslinked to the hospitals

Benefits to the Faculty of Benefits to the Faculty of HomeopathyHomeopathy

Retention – increased use of homeopathy leads Retention – increased use of homeopathy leads to reduced disuse / disinterest / disengagementto reduced disuse / disinterest / disengagement

Recruitment – increased patient demand for Recruitment – increased patient demand for homeopathy encourages training of our homeopathy encourages training of our colleagues. Personal success stories shared colleagues. Personal success stories shared with colleagues may also lead to pursuit of with colleagues may also lead to pursuit of trainingtraining

Why don’t more practitioners Why don’t more practitioners dispense homoeopathic medicine?dispense homoeopathic medicine?

Fear of the unknown.Fear of the unknown. Never had time to research it / think it through.Never had time to research it / think it through. Setting it up – what medicines / bottles / labels.Setting it up – what medicines / bottles / labels. Where from? What cost? Who pays?Where from? What cost? Who pays? Time constraints – 10 minutes. Time constraints – 10 minutes. Prefer FP10 – issue and out!Prefer FP10 – issue and out! Too much to explain in too little time.Too much to explain in too little time. Just not possible in 10 minutes.Just not possible in 10 minutes.

Homeopathic medicine dispensed in Homeopathic medicine dispensed in 10 minutes - LIVE!10 minutes - LIVE!

GP / Patient / history / diagnosisGP / Patient / history / diagnosis Key notes / specific condition / modalitiesKey notes / specific condition / modalities Homeopathic medicine decidedHomeopathic medicine decided Offer homeopathic or conventional treatment – Offer homeopathic or conventional treatment –

‘nothing to loose’ / ‘conventional fall back’ etc‘nothing to loose’ / ‘conventional fall back’ etc Record notes – HRX / RHRXRecord notes – HRX / RHRX Write / print prescriptionWrite / print prescription Print labelPrint label Print instruction sheetPrint instruction sheet Make-up homeopathic medicineMake-up homeopathic medicine

Make up homeopathic medicineMake up homeopathic medicine

Pill bottle – 7 gram – pre-filled with pillulesPill bottle – 7 gram – pre-filled with pillules Magic Box – index - medicating potenciesMagic Box – index - medicating potencies Add potency – 2 drops / shake / chat – Add potency – 2 drops / shake / chat –

instructions / frequency / stop adviceinstructions / frequency / stop advice Give instruction sheet to patientGive instruction sheet to patient Give bottle of pillules to patientGive bottle of pillules to patient Label – from dispensary or apply directlyLabel – from dispensary or apply directly Review – make appointment for 4 weeksReview – make appointment for 4 weeks

How are you going to set-up your How are you going to set-up your dispensary?dispensary?

To be considered:To be considered: MedicinesMedicines BoxBox PillulesPillules BottlesBottles LabelsLabels Instruction sheetInstruction sheet

MedicinesMedicines

Many or few?Many or few? Suggested ‘start-up’ box of 30 medicines – Suggested ‘start-up’ box of 30 medicines –

based on:based on: Cost – to make it affordableCost – to make it affordable Basic ‘must have’ medicinesBasic ‘must have’ medicines Gives scope to add further medicines according to Gives scope to add further medicines according to

personal perceived needpersonal perceived need

Medicine choice justifiedMedicine choice justified

Common medicines and conditions as Common medicines and conditions as demonstrated by my 12 months audit demonstrated by my 12 months audit

National 15 GP study of Primary Care National 15 GP study of Primary Care homeopathyhomeopathy

Gut instinct with review of my 252 potencies – Gut instinct with review of my 252 potencies – medicines and potencies that I wouldn’t be medicines and potencies that I wouldn’t be without! without!

Dr Tim’s Magic Box medicinesDr Tim’s Magic Box medicines

Aconite 30cAconite 30c Allium Cepa 30cAllium Cepa 30c Arg Nit 30cArg Nit 30c Arnica 30cArnica 30c Ars Alb 30cArs Alb 30c Belladonna 6c Belladonna 6c Belladonna 30cBelladonna 30c Carcinosin 30cCarcinosin 30c Cocculus 30cCocculus 30c

Colocynth 30cColocynth 30c Cup Met 30cCup Met 30c Gelsemium 30cGelsemium 30c Hayfever 30cHayfever 30c Hep Sulph 30cHep Sulph 30c Ignatia 30cIgnatia 30c Lachesis 6cLachesis 6c Lachesis 30cLachesis 30c Lycopodium 30cLycopodium 30c

Dr Tim’s Magic Box medicinesDr Tim’s Magic Box medicines

Mag Phos 30cMag Phos 30c Mix Grass Pollen 30cMix Grass Pollen 30c Nat Mur 30cNat Mur 30c Nux Vom 30cNux Vom 30c Phosphorus 30cPhosphorus 30c Pulsatilla 30c Pulsatilla 30c

Total 30 medicinesTotal 30 medicines

Rhus Tox 6c Rhus Tox 6c Rhus Tox 30cRhus Tox 30c Silica 30cSilica 30c Staphysagria 30cStaphysagria 30c Sulphur 6cSulphur 6c Thuja 6cThuja 6c

Comments on choice of Comments on choice of medicinesmedicines

Polycrests – all there!Polycrests – all there! Potencies – more than one potency in some Potencies – more than one potency in some

e.g. Belladonna 6c / 30ce.g. Belladonna 6c / 30c All familiar medicines – no high brow (Lac All familiar medicines – no high brow (Lac

Meerkcat) or small medicines (Teucrium)Meerkcat) or small medicines (Teucrium) Most covered in first year of homeopathic Most covered in first year of homeopathic

training to PHCC leveltraining to PHCC level

Medicating potencyMedicating potency

Dropper bottle – containing potency with 95% Dropper bottle – containing potency with 95% alcoholalcohol

Quantity – 5ml = 100 droplets = 50 bottles of Quantity – 5ml = 100 droplets = 50 bottles of each medicine dispensed (2 drops each bottle)each medicine dispensed (2 drops each bottle)

Cost: £4.65 - £7.00Cost: £4.65 - £7.00

Dispensing boxDispensing box

Box – better than loose. Quicker to select and Box – better than loose. Quicker to select and pick-outpick-out

Move between surgeries / practices / homeMove between surgeries / practices / home Choice of materials: Choice of materials:

- Cardboard box with holed insert - £4.84 for - Cardboard box with holed insert - £4.84 for box of 28. box of 28. - Plastic box with handle – £34.50 for box of - Plastic box with handle – £34.50 for box of 58. 58. - Wooden box - £40 for box of 70.- Wooden box - £40 for box of 70.

PillulesPillules

Pillules 3mm or 4 mm diameter.Pillules 3mm or 4 mm diameter. Suggest 4mm as patients find this size easier to Suggest 4mm as patients find this size easier to

tip a single pillule into the cap of the bottle. tip a single pillule into the cap of the bottle. 3mm are too small and fiddly. Less wasted. 3mm are too small and fiddly. Less wasted.

Less chance of patient taking more than one Less chance of patient taking more than one which adds to confusion on dosage.which adds to confusion on dosage.

Tablets don’t medicate so easily when shaken Tablets don’t medicate so easily when shaken compared with pillules.compared with pillules.

Cost: £12 for bag of 1kg.Cost: £12 for bag of 1kg.

BottlesBottles

7 gram size. Brown glass for sun protection. 7 gram size. Brown glass for sun protection. White cap.White cap.

Contain 50 pillules (4mm diameter). Contain 50 pillules (4mm diameter). Easy to handle for the patient to tip one single Easy to handle for the patient to tip one single

pillule out into the cap.pillule out into the cap. Easy for me to handle to medicate while in Easy for me to handle to medicate while in

conversation with the patient.conversation with the patient. Cost: £70 for tray of 405 bottles.Cost: £70 for tray of 405 bottles.

Bottles - preparationBottles - preparation

Pre-fill bottles – at home or surgery Pre-fill bottles – at home or surgery receptionistreceptionist

Fill with care – no contamination of the Fill with care – no contamination of the unmedicated pillules.unmedicated pillules.

Use funnel to channel pillules into bottles.Use funnel to channel pillules into bottles. Judge with eye – neck of bottle = 7 grams = 50 Judge with eye – neck of bottle = 7 grams = 50

pillulespillules

LabelsLabels

Dispensary practice – print label in dispensary.Dispensary practice – print label in dispensary. Label printer – stand alone label printer on Label printer – stand alone label printer on

desk in consulting room.desk in consulting room. Sheet of pre-printed labels with spaces for Sheet of pre-printed labels with spaces for

‘name’, ‘medicine / potency’, dosage ‘name’, ‘medicine / potency’, dosage frequency / surgery address & phone numberfrequency / surgery address & phone number

Avery labels size 63.5mm x 38.1mm wraps Avery labels size 63.5mm x 38.1mm wraps around 7 gram bottle neatly. Longer labels can around 7 gram bottle neatly. Longer labels can be folded to leave a flap.be folded to leave a flap.

Instruction sheetInstruction sheet

Instruction sheet - 2 sections: Instruction sheet - 2 sections:

- basic instructions for taking medicine - basic instructions for taking medicine

- general information about homeopathy- general information about homeopathy Write your own or use mineWrite your own or use mine Download it from the Faculty websiteDownload it from the Faculty website Save it as a shortcut icon on your desktop - 2 clicks Save it as a shortcut icon on your desktop - 2 clicks

and it’s printedand it’s printed Another version with instructions on how to make up Another version with instructions on how to make up

LM potencies availableLM potencies available

Instruction sheet – reasons for useInstruction sheet – reasons for use

Too much information for me to give in the Too much information for me to give in the limited 10 minute consultation.limited 10 minute consultation.

Too much information for patient to take in Too much information for patient to take in within a 10 minute consultation. within a 10 minute consultation.

Patient can read and re-read instructions at Patient can read and re-read instructions at their own leisure. their own leisure.

Instructions in clear plain English – no Instructions in clear plain English – no confusion. Pitched at basic level.confusion. Pitched at basic level.

Instruction sheet – basic instructions Instruction sheet – basic instructions for taking medicinefor taking medicine

Aggravation reactions and how to manage it.Aggravation reactions and how to manage it. Practical aspect of not touching pills.Practical aspect of not touching pills. Clear advice about antidoting medicine with coffee Clear advice about antidoting medicine with coffee

and toothpaste.and toothpaste. Contact details for any queries or adverse reactions.Contact details for any queries or adverse reactions. Clear advice on timing of taking medicine with Clear advice on timing of taking medicine with

respect to meal times.respect to meal times. Practical advice on how to give to a baby and child.Practical advice on how to give to a baby and child.

Instruction sheet – general Instruction sheet – general information about homeopathyinformation about homeopathy

Evidence base awareness.Evidence base awareness. Facts about safety profile of homeopathy.Facts about safety profile of homeopathy. Conditions treated by homeopathy.Conditions treated by homeopathy. Subtle advert about homeopathy. Increases Subtle advert about homeopathy. Increases

exposure and stimulus for patient to learn exposure and stimulus for patient to learn more about homeopathy. more about homeopathy.

Patient able to share handout with other family Patient able to share handout with other family members and friends.members and friends.

The bottom line – what does it cost?!The bottom line – what does it cost?!

Without a box £292. Without a box £292. With a cardboard box £302.With a cardboard box £302. With a wooden box £332. With a wooden box £332. Tax deductible.Tax deductible. Who pays? You (= £332) or Practice (4 partners = Who pays? You (= £332) or Practice (4 partners =

£83 each or 6 partners = £55.33). £83 each or 6 partners = £55.33). Sell your case to your partners – saving on Sell your case to your partners – saving on

conventional medicine spend / good for patient’s conventional medicine spend / good for patient’s perception of the practice / off-loading heart sink perception of the practice / off-loading heart sink patients to you.patients to you.

Summary – benefit to patientsSummary – benefit to patients

Benefits to patients:Benefits to patients: Immediate – ideal for first aid / acute Immediate – ideal for first aid / acute

situations.situations. Pharmacy not involved.Pharmacy not involved. Effective alternative to conventional Effective alternative to conventional

treatments.treatments. Increased exposure to homeopathy – more Increased exposure to homeopathy – more

aware of its capabilities.aware of its capabilities. Holistic approach to medical care.Holistic approach to medical care.

Summary – benefits to practitionersSummary – benefits to practitioners

Increased use = increased learningIncreased use = increased learning Increased use = knowledge maintenance – no Increased use = knowledge maintenance – no

disuse atrophydisuse atrophy Increased use = increased experience = Increased use = increased experience =

increased effectiveness as a homeopathincreased effectiveness as a homeopath Increased use = increased job satisfaction and Increased use = increased job satisfaction and

personal rewardspersonal rewards

Summary – benefits to NHS Summary – benefits to NHS Homeopathic hospitalsHomeopathic hospitals

Increased use = increased referrals – supports Increased use = increased referrals – supports business case for hospitals.business case for hospitals.

Increased use = generates need for Increased use = generates need for postgraduate education – supports training postgraduate education – supports training centres.centres.

Summary – benefits to Faculty of Summary – benefits to Faculty of HomeopathyHomeopathy

Member retention – increased usage prevents disuse Member retention – increased usage prevents disuse atrophy / builds personal experience / benefits atrophy / builds personal experience / benefits patients and GP – net effect is continued use of patients and GP – net effect is continued use of homeopathy and hence member retention.homeopathy and hence member retention.

Member recruitment – increased patient awareness of Member recruitment – increased patient awareness of homeopathy leads to increased patient demand for homeopathy leads to increased patient demand for homeopathy - may encourage GP to undertake homeopathy - may encourage GP to undertake homeopathic training.homeopathic training.

Member recruitment – homeopathic case successes Member recruitment – homeopathic case successes shared with GP colleagues – may encourage GP to shared with GP colleagues – may encourage GP to undertake homeopathic training.undertake homeopathic training.

What now?!What now?!

Buy your own Magic Box / pillules / bottles. Buy your own Magic Box / pillules / bottles. Use my list of potencies or use it as a Use my list of potencies or use it as a suggestion list and adapt it to your instinctive suggestion list and adapt it to your instinctive needs.needs.

Download the patient instruction sheet.Download the patient instruction sheet. Go forward, go ahead – go dispensing.Go forward, go ahead – go dispensing. Think benefits. Think benefits. Think recruitment. Think recruitment. Think retention.Think retention.

I give you……I give you……

Dr Tim’s Dr Tim’s Magic BoxMagic Box

…… …….Thank you.Thank you