GP Homeopathic Prescribing
اسلاید 1: www.tabaye.ir
اسلاید 2: GP Homeopathic PrescribingDr Tim’s Magic Box
اسلاید 3: ObjectiveTo introduce and encouragehomeopathic dispensingin Primary Care setting
اسلاید 4: Current situation in NHS homeopathy nationally9 NHS Hospital Consultants34 NHS Hospital Clinical Assistants / Specialist Doctors692 GP with homeopathic training
اسلاید 5: Homeopathy in NHS Primary CareDelivery options:Homeopathic advice onlyHomeopathic FP10 prescription issuedHomeopathic medicine dispensed
اسلاید 6: Homeopathic dispensingBenefits to:PatientsPractitionersNHS hospitalsFaculty of Homeopathy
اسلاید 7: Benefits to PatientsImmediate treatment – no delay in first aid and acute situationsEffective alternative to conventional medicine – no treatment / failed treatment / contraindicated / side-effectsPatient education – scope of homeopathyHolistic approachPharmacy not involved
اسلاید 8: Pharmacy associated problemsMost pharmacists don’t have homeopathic knowledgeUnreliable information / advice on homeopathic usageDon’t stock full range of medicines / potenciesHave to make special order for medicine – takes time and effort for patient
اسلاید 9: Pharmacy problemsIncorrect advice given to patientFobbed off with an incorrect potency / another OTC remedy / herbal alternative / conventional alternativePt looses heart / gives up / reaches for OTC conventional medicineNet effect: Missed homeopathic opportunity
اسلاید 10: Benefits to practitionerPersonal satisfaction – ease suffering particularly with failed conventional treatmentMore effective practitioner – more to offer patients – homeopathy complements conventional treatmentKnowledge utilisationLearning opportunityReinforcing homeopathic knowledge
اسلاید 11: Benefits to NHS hospitalsIncreased referral rates from primary care for more complex problems that require more than 10 minutesSupport of NHS homeopathic hospitals indirectly supports teaching centres that are linked to the hospitals
اسلاید 12: Benefits to the Faculty of HomeopathyRetention – increased use of homeopathy leads to reduced disuse / disinterest / disengagementRecruitment – increased patient demand for homeopathy encourages training of our colleagues. Personal success stories shared with colleagues may also lead to pursuit of training
اسلاید 13: Why don’t more practitioners dispense homoeopathic medicine?Fear of the unknown.Never had time to research it / think it through.Setting it up – what medicines / bottles / labels.Where from? What cost? Who pays?Time constraints – 10 minutes. Prefer FP10 – issue and out!Too much to explain in too little time.Just not possible in 10 minutes.
اسلاید 14: Homeopathic medicine dispensed in 10 minutes - LIVE!GP / Patient / history / diagnosisKey notes / specific condition / modalitiesHomeopathic medicine decidedOffer homeopathic or conventional treatment – ‘nothing to loose’ / ‘conventional fall back’ etcRecord notes – HRX / RHRXWrite / print prescriptionPrint labelPrint instruction sheetMake-up homeopathic medicine
اسلاید 15: Make up homeopathic medicinePill bottle – 7 gram – pre-filled with pillulesMagic Box – index - medicating potenciesAdd potency – 2 drops / shake / chat – instructions / frequency / stop adviceGive instruction sheet to patientGive bottle of pillules to patientLabel – from dispensary or apply directlyReview – make appointment for 4 weeks
اسلاید 16: How are you going to set-up your dispensary?To be considered:MedicinesBoxPillulesBottlesLabelsInstruction sheet
اسلاید 17: MedicinesMany or few?Suggested ‘start-up’ box of 30 medicines – based on:Cost – to make it affordableBasic ‘must have’ medicinesGives scope to add further medicines according to personal perceived need
اسلاید 18: Medicine choice justifiedCommon medicines and conditions as demonstrated by my 12 months audit National 15 GP study of Primary Care homeopathyGut instinct with review of my 252 potencies – medicines and potencies that I wouldn’t be without!
اسلاید 19: Dr Tim’s Magic Box medicinesAconite 30cAllium Cepa 30cArg Nit 30cArnica 30cArs Alb 30cBelladonna 6c Belladonna 30cCarcinosin 30cCocculus 30cColocynth 30cCup Met 30cGelsemium 30cHayfever 30cHep Sulph 30cIgnatia 30cLachesis 6cLachesis 30cLycopodium 30c
اسلاید 20: Dr Tim’s Magic Box medicinesMag Phos 30cMix Grass Pollen 30cNat Mur 30cNux Vom 30cPhosphorus 30cPulsatilla 30c Total 30 medicinesRhus Tox 6c Rhus Tox 30cSilica 30cStaphysagria 30cSulphur 6cThuja 6c
اسلاید 21: Comments on choice of medicinesPolycrests – all there!Potencies – more than one potency in some e.g. Belladonna 6c / 30cAll familiar medicines – no high brow (Lac Meerkcat) or small medicines (Teucrium)Most covered in first year of homeopathic training to PHCC level
اسلاید 22: Medicating potencyDropper bottle – containing potency with 95% alcoholQuantity – 5ml = 100 droplets = 50 bottles of each medicine dispensed (2 drops each bottle)Cost: £4.65 - £7.00
اسلاید 23: Dispensing boxBox – better than loose. Quicker to select and pick-outMove between surgeries / practices / homeChoice of materials: - Cardboard box with holed insert - £4.84 for box of 28. - Plastic box with handle – £34.50 for box of 58. - Wooden box - £40 for box of 70.
اسلاید 24: PillulesPillules 3mm or 4 mm diameter.Suggest 4mm as patients find this size easier to tip a single pillule into the cap of the bottle. 3mm are too small and fiddly. Less wasted. Less chance of patient taking more than one which adds to confusion on dosage.Tablets don’t medicate so easily when shaken compared with pillules.Cost: £12 for bag of 1kg.
اسلاید 25: Bottles7 gram size. Brown glass for sun protection. White cap.Contain 50 pillules (4mm diameter). Easy to handle for the patient to tip one single pillule out into the cap.Easy for me to handle to medicate while in conversation with the patient.Cost: £70 for tray of 405 bottles.
اسلاید 26: Bottles - preparationPre-fill bottles – at home or surgery receptionistFill with care – no contamination of the unmedicated pillules.Use funnel to channel pillules into bottles.Judge with eye – neck of bottle = 7 grams = 50 pillules
اسلاید 27: LabelsDispensary practice – print label in dispensary.Label printer – stand alone label printer on desk in consulting room.Sheet of pre-printed labels with spaces for ‘name’, ‘medicine / potency’, dosage frequency / surgery address & phone number Avery labels size 63.5mm x 38.1mm wraps around 7 gram bottle neatly. Longer labels can be folded to leave a flap.
اسلاید 28: Instruction sheetInstruction sheet - 2 sections: - basic instructions for taking medicine - general information about homeopathyWrite your own or use mineDownload it from the Faculty websiteSave it as a shortcut icon on your desktop - 2 clicks and it’s printedAnother version with instructions on how to make up LM potencies available
اسلاید 29: Instruction sheet – reasons for useToo much information for me to give in the limited 10 minute consultation.Too much information for patient to take in within a 10 minute consultation. Patient can read and re-read instructions at their own leisure. Instructions in clear plain English – no confusion. Pitched at basic level.
اسلاید 30: Instruction sheet – basic instructions for taking medicineAggravation reactions and how to manage it.Practical aspect of not touching pills.Clear advice about antidoting medicine with coffee and toothpaste.Contact details for any queries or adverse reactions.Clear advice on timing of taking medicine with respect to meal times.Practical advice on how to give to a baby and child.
اسلاید 31: Instruction sheet – general information about homeopathyEvidence base awareness.Facts about safety profile of homeopathy.Conditions treated by homeopathy.Subtle advert about homeopathy. Increases exposure and stimulus for patient to learn more about homeopathy. Patient able to share handout with other family members and friends.
اسلاید 32: The bottom line – what does it cost?!Without a box £292. With a cardboard box £302.With a wooden box £332. Tax deductible.Who pays? You (= £332) or Practice (4 partners = £83 each or 6 partners = £55.33). Sell your case to your partners – saving on conventional medicine spend / good for patient’s perception of the practice / off-loading heart sink patients to you.
اسلاید 33: Summary – benefit to patientsBenefits to patients:Immediate – ideal for first aid / acute situations.Pharmacy not involved.Effective alternative to conventional treatments.Increased exposure to homeopathy – more aware of its capabilities.Holistic approach to medical care.
اسلاید 34: Summary – benefits to practitionersIncreased use = increased learningIncreased use = knowledge maintenance – no disuse atrophyIncreased use = increased experience = increased effectiveness as a homeopathIncreased use = increased job satisfaction and personal rewards
اسلاید 35: Summary – benefits to NHS Homeopathic hospitalsIncreased use = increased referrals – supports business case for hospitals.Increased use = generates need for postgraduate education – supports training centres.
اسلاید 36: Summary – benefits to Faculty of HomeopathyMember retention – increased usage prevents disuse atrophy / builds personal experience / benefits patients and GP – net effect is continued use of homeopathy and hence member retention.Member recruitment – increased patient awareness of homeopathy leads to increased patient demand for homeopathy - may encourage GP to undertake homeopathic training.Member recruitment – homeopathic case successes shared with GP colleagues – may encourage GP to undertake homeopathic training.
اسلاید 37: What now?!Buy your own Magic Box / pillules / bottles. Use my list of potencies or use it as a suggestion list and adapt it to your instinctive needs.Download the patient instruction sheet.Go forward, go ahead – go dispensing.Think benefits. Think recruitment. Think retention.
اسلاید 38: I give you……Dr Tim’s Magic Box …….Thank you
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