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GPs who dole out sugar water give our critics a free pass

Dr Pete Deveson

Dr Pete Deveson BLOG duo_3x2

There’s a new study out this week in which some ivory tower public health types have used a baffling statistical analysis to slam the prescribing practices of frontline GPs, and regular readers will be unsurprised to learn that I have strong opinions about it.

However, in something of a pivot from my previous blogs like the acclaimed ‘Shut the hell up, dweebs’ and ‘If I hear one more non-GP tell me how to do my job I won’t be held responsible for my actions so help me’, on this occasion I find myself lined up alongside the nerdy REMFs who created the study in question, hurling brickbats at my GP colleagues.

And that’s because they’ve found that one in 12 GP practices prescribe homeopathic remedies.

For the uninitiated, homeopathy is based on the premise that you can cure a condition by giving a substance that induces similar symptoms (well, that seems kinda ludicrous after even a few seconds of consideration but go on), and furthermore that you render the cure increasingly more powerful by diluting it over and over until no molecules of the original substance remain (OK that seems fair enou…wait what?); but don’t worry, the active ingredient will still have an effect on the water it’s mixed in because…(this had better be good because frankly if you want to get me back on board, whatever you say next has a LOT of lifting to do) every time you dilute it, you tap the bottle in a special magical way so the water remembers (All right GET OUT! SHRED YOUR MEDICAL DEGREE AND GET OUT! WHAT EVEN IS THIS?).

Startlingly, practices that dole out this stuff score badly on other prescribing quality measures

I’m serious; homeopaths believe that you can turn water into wonder drugs by banging it repeatedly on a desk; if that was the case, the water in my head could cure cancer right now.

In a startling turn of events, the study shows that practices that dole out this stuff score badly on other prescribing quality measures.

I’m sure the GPs prescribing homeopathy believe they’re doing the right thing, and it’s far from the only irrational act in the NHS. There may be GPs reading this whose practices regularly pray together for their patients, or perhaps their CQC results; and I myself continue to hand over the best part of a bag of sand to the RCGP and BMA each year in the blind faith that, despite mounting evidence to the contrary, this might one day confer on me some individual or collective benefit.

But come on guys. This is 2018. There’s so many people queueing up to tell GPs how crap we are, let’s not give them a free hit by handing out sugar water.

Dr Pete Deveson is a GP in Surrey

 

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Readers' comments (17)

  • Nail. Head. Hit.
    Cue inevitable non evidenced wailing from astrology lovers and ouija board enthusiasts.

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  • If NHSE refuse to blacklist homeopathic drugs then GPs will always be tempted to use these useless but harmless placebos for vague but benign symptoms in the worried well. Is it really any worse than prescribing Vit D to a TATT patient? (whose blood level is almost guaranteed to be below 75). Or quinine for night cramps? (what else is there?). It takes steely determination to send patients away empty handed, and a 10 minutes consultation could be open-ended without the closure of a prescription, placebo or not.
    Blame the authorities who lack the bottle to ban this rubbish rather than the hapless GP facing the bottomless pit of demanding patients..

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  • Macaque

    Pete I love your train of thoughts!!!

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  • I have not prescribed homeopathic medication. However trials have suggested that there is a placebo effect. The appropriate homoeopathic remedy involves a lengthy very precise history taking and because of this the placebo effect is increased. Patients enjoy talking about their symptoms whether physical or mental and appreciate the time and intensity of the history taking. Immune symptoms improve when patients receive things that they believe in, whether homeopathic medication, praying, massive doses of vitamin C, seeing a Doctor they like, etc. However we should not ignore allopathic medicine.

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  • I agree with David Banner. It works well as a placebo and allows time to work it's magic of self healing, while protecting the patient from anything more noxious.

    It is a customized placebo. I see nothing wrong in that, although I have never prescribed it.

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  • Patients can pay for their own placebo!

    The concept that a homeopathic lump of sugar does no harm is ludicrous. Reinforce the belief that this does something other than make the patient and the Dr feel warm and snuggly about having "done something". So, wonderful the placebo effect works for the non-medical thing that just needed a chat and a bit of reassurance. But what about the harm from "well my Dr thinks homeopathy is great so it must be ok to treat my heart attack, cancer, HIV etc with homeopathy.

    Condoning rubbish does harm. Do the placebo bit by listening to patients. Refer them to counselling if talking is what they need. Be honest. But don't prescribe for the sake of it and comfort yourself with the nice warm feeling that you did good because the patient was happy. I'm sure many of my patients would be happy if I gave them a month's sick note and a bucket of whatever is their favourite prescription tipple. Doesn't mean it right, or profession, or ethical.

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  • Placebo does not mean homeopathy works.
    And you can getting water out of your taps.

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  • Have you ever heard yourself explaining to the TATT patient about these "little chemical imbalances in your brain" and if you take these little pills they will get all smoothed out. But the imbalances are pesky blighters and you won't notice any effects for about three weeks at all. "And what's the best length of time I need to take these pills doc?" And you hear yourself saying that the best evidence points to anywhere within the tight limits of 6 weeks to 6 years. Now go shred YOUR medical degree!

    The author is on a slippery slope. Homeopathic prescribing is on a par to antidepressant prescribing as far as ridiculous nostrums that GPs have bought into over the decades. Until you look at numbers needed to harm...

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  • Hang on Peter, there is MUCH better evidence for prayer-healing than there is for Homoeopathy!

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  • Have you got a brain tumour, Peter? No? Well thats because the water in your brain has anti-cancer effects which have been brought about by the precise way in which you shake your head in despair when thinking about homeopathy.(/s).

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