Following Poor Locums

[imaginegenerous]

There seems to be a lot of homeopathic scripts around the Gloucestershire area. Handwritten and very hard to read! My first day as a pharmacist was in one of these pharmacies. Dispensary filled with lots of potions and powders. Luckily, I had 2 very knowledgeable assistants to help out!

There's a local surgery in the area that prescribe an awful lot of homeopathic stuff. The branch I work in now is the first one where we ger really regular scripts so it's all a bit of a novelty for me I'm trying to work therough the CPPE pack on complimentary/alternative meds/therapies to see if that gives me a bit of background.

[DavidS]

I'm trying to work therough the CPPE pack on complimentary/alternative meds/therapies to see if that gives me a bit of background.

This is quite good...
Homeopathy - Wikipedia, the free encyclopedia

[dizzyb23]

Getting back to some of the earlier comments about poor managers, if you are new to managing and not sure about your performance, ask one of your members of support staff for some feedback (constructive). It's impossible to just be good at everything straight away. Things take time. Our previous manager thought she was doing all the right things (she wasn't) and when we tried to explain things and help, she took it badly. Actively seeking feedback may help get you settled in. Just a thought......

And I totally sympathise with locums. We have had so many over the past two years. Some great, some ok and some that should NEVER be allowed out in public EVER but they do have a difficult job trying to run a strange dispensary, usually with no help.....If you come to our dispensary, you'll get a cup of tea, a biscuit and a wonderful guided tour and you'll be looked after all day, should you need it......

[SolomonQ]

Quote:
Originally Posted by Tony Schofield
How do you reconcile dispensing placebos with your CPD and ethical obligations?

Galen: "First, do no harm."

Its well known that most diseases are self-limiting, so stimulating the patient's own power of recovery by using motivational techniques like placebo-giving (if that is all homeopathy is, which I doubt, whatever Ernzt says) is a viable first step.

Galen went on to say that the treatment should be through dietary control in the first instance, followed by vancomycin (I made that last bit up)

Zoggite wrote:

Amongst my Clientele in Belgium, I used to have a proud owner of an award-winning herd of pedigree Belgian Blue beef cattle: they used to suffer quite a bit with joint aches due to their excessive muscular build, as a lot of pedigree animals do; The farmer treated them with homeopathy, as there was no "waiting time" for using the milk of the meat of the animals. He used to swear by it, and he was as tight as anything, so it must have worked or he wouldn't have kept on spending his dear money on the stuff...?

Coin Toss experiment:

A normal coin (fair and unbiased) is thrown five (5) times to see the sequence of which side its lands on, only two possible outcomes of a throw are possible, heads (H) or tails (T).

Key: H=Heads T=Tails

Scenario 1: H, T, T, H,T

Scenario 2: H, T, H, T, H

Scenario 3: H, H, H, H, H

Now the million dollar question, which scenario is most likely in such a situation? which sequence is more random? Which scenario is the least random?


Surprisingly (or Maybe not), all three sequences are equally likely, if anyone disagrees or doubts this than they can work out the mathematics of its but that is beyond the scope of what I am trying to illustrate here.

Homeopathy to put it bluntly is a trade in placebos and nothing else, whoever believes homeopathic medicins to have any actualy therapeutic effects, should also start believing in Santa Claus, easter bunny and the Tooth fairy because they all belong in the same category.

So why do they (appear to) work? well simply because of the placebo effect. Why did the tight belgium farmer believe in them? because if he didnt believe in them he's got nothing else to believe in, and sometimes people want to believe in something. Therefore the use of such therapies for conditions difficult to treat with "conventional" medicine e.g. arthritis, ever heard anyone using homeopathy for headache? or MRSA? I doubt it, why? because the proof is in the pudding.

Without going into the ins and outs of it all, I locum for many pharmacies that stock these therapies, but if ever asked about them I always say they are for self-selection and I dont give advice regarding them but we stock them because of demand.

However, on the other hand, as pointed out they do act as very good placebos, and if the doctor is prescribing them as solely placebo pills I would agree with that but to say "x" CC of belladona will treat "z" condition, than that is wrong in my opinion. . I know certain members of this forum disagree totally with precribing or using such pills but I would rather a doctor prescribe a Placebo to a child with a viral infection rather than normal antibiotics as this action goes better with "first, do no harm".

'nough said...peace out

[DavidS]

Surprisingly (or Maybe not), all three sequences are equally likely

OK, its true, but the chances of five heads in a row are much less than any other random result, and isn't that what we are talking about?

Why did the tight belgium farmer believe in them?

Good question. A more interesting question is, can my beliefs affect people and animals that are around me and dependent on me? If you are right, then this must be true.

Without going into the ins and outs of it all, I locum for many pharmacies that stock these therapies, but if ever asked about them I always say they are for self-selection and I dont give advice regarding them but we stock them because of demand.

me too

[bobbin]

There seems to be a lot of homeopathic scripts around the Gloucestershire area. Handwritten and very hard to read!

Oh well, even if you dispensed the wrong one it probably wouldn't make any difference!

Bobbin

[PinkGlitter]

Oh well, even if you dispensed the wrong one it probably wouldn't make any difference!

Bobbin

Exactly! There is never the fear of killing anyone with these "meds"!

[SolomonQ]

Exactly! There is never the fear of killing anyone with these "meds"!

hmm, but say if you were supplying random homeopathic meds to patients and a patient didnt get cured and they'd try to sue their doctor for this, then it would come down to looking at what the patient was taking, now if the wrong homeopathic med had been dispensed I think by law the pharmacist would be liable. Also patients using these types of meds are alot more fussy, so sorry to scare you guys but the risk of harm might be minimal but risk of being struck off, sued etc.. are alot higher

also regarding the coin toss scenario, what I was trying to demonstrate was that for some reason people assume the most likely random sequence is scenario 1 and the last sequence (5 Hs) is the least random, this is an illustration of a basic fallacy which inhabits most human thinking, for some reason people want to see reason and order in things which dont possess it and end up inventing the desired order. An example where this reasoning and order is useful (understatement) is seeing (i.e. when you see somehthing), all thats happening is electromagnetic waves are bouncing off things, hiting the retina and certain frequencies of these EM waves (i.e. light) are interpreted as what you see, therefore order from random information, but looking for this same order in the scenario demonstrated resulting in the wrong answer.

Now, the probability of say a cure with a homeopathic med is alot lower, but study of various clinical studies shows that even placebos can cause considerable positive outcomes. These outcomes happening to the same person more than a few time might be very unlikely but it is not impossible, just like winning the lottery might have a chance of say 1 in 60 million, but there are weeks where we see 4 or 5 people winning with the same numbers, so here the reality is seen as 5 in 60 million i.e. the odds appear to have reduced to 1 in 12 million, so people seem to think they have a higher chance of winning the lottery than they actually do. Thus the relative high opinion held of homeopathy. But the actuall affect of these pills explains the low circulation (Use) of these types of medications, i.e. the belgian farmer, if the results are so good why arent other belgian farmers using these same techniques? Easy, because one reason could be somehow this belgian farmer always gets cows who "heal" easily with time, chance of one in many millions, but call it his good luck, or maybe his herd(?) is from the same genetic makeup where the cows inherit this "healing" ability from their parents, AN EXCELLENT EXPLANATION. Whereas other belgian farmers dont share his luck, so the homeopathic meds dont appear to work so well on their animals.

To put another argument forward, in this country Medicine or healthcare isnt really something that can be bought or sold or seen as such, but the vast majority of the world people pay directly for healthcare, so say you were an up and coming pharmacist/doctor, would you not tap into this resource, you could diagnose people like you normally would, but "prescribe" only homeopathic meds, these would be alot cheaper than conventional meds (guess why), and if they worked, you would end up treating alot of people, make healthcare available to BILLIONS make a name for yourself AND wait for it.....make loadsa money....millions...multi millions....billions...loadsa money!!!! these pharmaceutical companies are hungry for new products, they fight each other like dogs to try and get the next big drug out. These companies are especially desperate because of all their blockbuster meds coming off patents, they would have jumped on this like starved wild hyenas if there was any flesh on the skeleton that is homeopathy. A skeleton some people are trying to pass off as a living breathing human being. "look it's got two hands and two legs...."

just a final thought, ever played a game based on chance? I have. Some time back now, I was playing monopoly with my cousin, this one game he bought and put a hotel on Mayfair, he had a few other measley streets with at most two houses, he'd played risky and put all his money into developing mayfair, I had many streets and was going well on my way to developing them. For the next three turns after he put the hotel on mayfair, I landed on it every single time, I could have sworn it was black magic, it was unbelievable (the board and dice were mine so werent fiddled with), he was also landing on my streets which was kinda paying for the misfortune at mayfair but it finally left my finances crippled and I lost.
Now another million dollar question, did he win because he was better than me at monopoly or because chance was on his side?
Hint: Clearly he thought the former but my defeat was only due to me landing on the same spot three times and he only put a hotel on mayfair because he had no where better to invest the money.

[johnep]

Oh dear, if you dispense the wrong dilution and the pt dies of some quite unrelated condition, could you still be faced with a crinimal prosecution?
johnep

[lamzee]

Oh dear, if you dispense the wrong dilution and the pt dies of some quite unrelated condition, could you still be faced with a crinimal prosecution?
johnep

No-one could prove it. Nothing to analyse...