|THE HOMEOPATHIC APPROACH TO THE PATIENT|
THE HOMEOPATHIC APPROACH TO THE PATIENT
The homeopathic approach to the patient is derived from the goal of the homeopathic consultation, to understand the state of the patient well enough to select the appropriate homeopathic treatment. Understanding a patient begins with the medical diagnosis and expands to include the particular aspects of the patient’s illness, history, and personality.
The homeopath is interested in understanding the uniqueness of the illness and the person who has the illness. What makes this person’s illness peculiar to him or her? What makes this person sick? What are the patient’s unique habits and attitudes? The homeopath will rely on observation and examination, oral communication, and written records to make a comprehensive homeopathic evaluation.
Initial Contact Observation begins with the first contact between homeopathic doctor and patient. In small practices, some homeopathic doctors schedule appointments personally, whereas in larger practices the task is delegated. Unusual patient attitudes, varying from extreme shyness to urgent demands for prompt appointments, are noted. It is not unusual for a homeopath with a full practice to have a waiting time of several months. 7 Homeopathic Principles in Patient Cared for scheduling new patients, and this is quite disconcerting to some patients.
Although homeopathic doctors vary in their routines for scheduling patients and obtaining medical histories, it is a common convention of practice that the doctor goes to the waiting room to greet the patient and lead the way to the consultation room. While approaching the waiting patiently, the homeopathic doctor seeks useful observations that express something of the nature of the patient, including posture, level and choice of activity, interaction with other waiting patients, general appearance, and whether the patient has come to the consultation alone or with others.
Although no conclusions can be drawn at this time, it may prove useful in the final understanding to remember whether the patient was humming and staring out the window, arguing with the front desk, or quietly reading. Most homeopaths request that the patient complete history form before the appointment.
Forms vary from single pages that contain typical medical information (e.g., previous illnesses, surgeries, family history, and allergies) two lengthy forms that introduce the patient to the homeopathic line of questioning(e.g., the content of dreams, sleep patterns, details of the emotional aspects of the patient’s history). Medical records from other practitioners, conventional and complementary, are important parts of the full evaluation of the patient.
The Homeopathic Consultation, ideally occurs in a quiet room, comfortably furnished with chairs for all, a writing desk for the homeopath, and reference books or a computer. Homeopaths who see children usually provide toys or drawing materials so the children may have some freedom of movement or play. An examination table and equipment may be in a corner of the room may be located elsewhere.
The interview may be videotaped for purposes of the case analysis and teaching. Informed consent is required for videotaping. Style of Interview Throughout the interview, each line of questioning is initiated with an open-ended approach, which allows the patient to express fully everything that he or she has intended to tell the homeopath, in his or her own words and manner.
The patient may begin speaking without any prompting from the homeopath or may sit quietly and wait for a question. Some homeopaths spend a minute or two looking through the patient’s forms to allow the patient time to adapt to the room and inspect diplomas or photographs if he or she subsists homeopath will begin the interview with a simple question, “What may I do for you?” or “What brings you here today?” The question may be joined to a brief statement about the purpose of the interview: “I am interested in learning as much as possible about your medical problems and about you personally. Please start wherever you like and tell me about yourself.”
The homeopathic doctor listens to everything the patient says without interruption unless the patient is drifting seriously off course. To minimize any possible influence on what the patient is saying, the practitioners’ nonverbal responses are neutral or gently supportive and encouraging.
The content of the Examination A homeopathic interview covers three types of information:
1. Chief and secondary complaints
2. Review of systems
3. The nature of the person
CHIEF AND SECONDARY COMPLAINTS
The order in which information is gathered varies among practitioners and according to the way in which the patient reveals the information. Observations regarding the patient’s nature are made throughout the interaction. The chief complaint is usually the patient’s starting point.
The homeopathic doctor asks patients to tell the story of the problem in their own words. The homeopathic first is interested in the patient’s perceptions—how the illness is experienced and how it affects the life of the patient. The patient’s answer is always helpful, even if it is not what the homeopath has asked for.
REVIEW OF SYSTEMS
If the patient chooses to describe his or her illness by listing the doctors consulted and what those doctors tested, diagnosed, and treated, the homeopathic doctor regards that orientation as valuable information; For some reason, as yet unknown, the patient has chosen to talk about what medical specialists have said rather than about his or her own experience. That observation is filed away and will be considered in the analysis, but important information is still needed regarding the complaint.
THE NATURE OF THE PERSON
The homeopathic doctor must understand the nature of the complaint with great clarity to make an accurate homeopathic analysis. Beginning with open-ended questions and eventually becoming as specific as necessary, the homeopath wants to learn about the onset of the condition, the nature of the patient’s symptoms, and the management of the problem.
The homeopathic doctor’s consideration of possible causation expands on the conventional view. A homeopathic doctor will want to know about risk factors and specific events in the patient’s history that may, from a homeopathic perspective, be associated with the problem.