GP HOMEOPATHIC
PRESCRIBING
Dr Tim’s Magic Box
Objective
To introduce and encourage
homeopathic dispensing
in Primary Care setting
Current situation in NHS
homeopathy nationally
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9 NHS Hospital Consultants
34 NHS Hospital Clinical Assistants /
Specialist Doctors
692 GP with homeopathic training
Homeopathy in NHS Primary Care
Delivery options:
 Homeopathic advice only
 Homeopathic FP10 prescription issued
 Homeopathic medicine dispensed
Homeopathic dispensing
Benefits to:
 Patients
 Practitioners
 NHS hospitals
 Faculty of Homeopathy
Benefits to Patients
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Immediate treatment – no delay in first aid and
acute situations
Effective alternative to conventional medicine
– no treatment / failed treatment /
contraindicated / side-effects
Patient education – scope of homeopathy
Holistic approach
Pharmacy not involved
Pharmacy associated problems
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Most pharmacists don’t have homeopathic
knowledge
Unreliable information / advice on
homeopathic usage
Don’t stock full range of medicines / potencies
Have to make special order for medicine –
takes time and effort for patient
Pharmacy problems
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Incorrect advice given to patient
Fobbed off with an incorrect potency / another
OTC remedy / herbal alternative / conventional
alternative
Pt looses heart / gives up / reaches for OTC
conventional medicine
Net effect: Missed homeopathic opportunity
Benefits to practitioner
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Personal satisfaction – ease suffering
particularly with failed conventional treatment
More effective practitioner – more to offer
patients – homeopathy complements
conventional treatment
Knowledge utilisation
Learning opportunity
Reinforcing homeopathic knowledge
Benefits to NHS hospitals
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Increased referral rates from primary care for
more complex problems that require more than
10 minutes
Support of NHS homeopathic hospitals
indirectly supports teaching centres that are
linked to the hospitals
Benefits to the Faculty of
Homeopathy
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Retention – increased use of homeopathy leads
to reduced disuse / disinterest / disengagement
Recruitment – increased patient demand for
homeopathy encourages training of our
colleagues. Personal success stories shared
with colleagues may also lead to pursuit of
training
Why don’t more practitioners
dispense homoeopathic medicine?
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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.
Homeopathic medicine dispensed in
10 minutes - LIVE!
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GP / Patient / history / diagnosis
Key notes / specific condition / modalities
Homeopathic medicine decided
Offer homeopathic or conventional treatment –
‘nothing to loose’ / ‘conventional fall back’ etc
Record notes – HRX / RHRX
Write / print prescription
Print label
Print instruction sheet
Make-up homeopathic medicine
Make up homeopathic medicine
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Pill bottle – 7 gram – pre-filled with pillules
Magic Box – index - medicating potencies
Add potency – 2 drops / shake / chat –
instructions / frequency / stop advice
Give instruction sheet to patient
Give bottle of pillules to patient
Label – from dispensary or apply directly
Review – make appointment for 4 weeks
How are you going to set-up your
dispensary?
To be considered:
 Medicines
 Box
 Pillules
 Bottles
 Labels
 Instruction sheet
Medicines
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Many or few?
Suggested ‘start-up’ box of 30 medicines –
based on:
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Cost – to make it affordable
Basic ‘must have’ medicines
Gives scope to add further medicines according to
personal perceived need
Medicine choice justified
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Common medicines and conditions as
demonstrated by my 12 months audit
National 15 GP study of Primary Care
homeopathy
Gut instinct with review of my 252 potencies –
medicines and potencies that I wouldn’t be
without!
Dr Tim’s Magic Box medicines
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Aconite 30c
Allium Cepa 30c
Arg Nit 30c
Arnica 30c
Ars Alb 30c
Belladonna 6c
Belladonna 30c
Carcinosin 30c
Cocculus 30c
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Colocynth 30c
Cup Met 30c
Gelsemium 30c
Hayfever 30c
Hep Sulph 30c
Ignatia 30c
Lachesis 6c
Lachesis 30c
Lycopodium 30c
Dr Tim’s Magic Box medicines
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Mag Phos 30c
Mix Grass Pollen 30c
Nat Mur 30c
Nux Vom 30c
Phosphorus 30c
Pulsatilla 30c
Total 30 medicines
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Rhus Tox 6c
Rhus Tox 30c
Silica 30c
Staphysagria 30c
Sulphur 6c
Thuja 6c
Comments on choice of medicines
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Polycrests – all there!
Potencies – more than one potency in some
e.g. Belladonna 6c / 30c
All familiar medicines – no high brow (Lac
Meerkcat) or small medicines (Teucrium)
Most covered in first year of homeopathic
training to PHCC level
Medicating potency
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Dropper bottle – containing potency with 95%
alcohol
Quantity – 5ml = 100 droplets = 50 bottles of
each medicine dispensed (2 drops each bottle)
Cost: £4.65 - £7.00
Dispensing box
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Box – better than loose. Quicker to select and
pick-out
Move between surgeries / practices / home
Choice 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.
Pillules
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Pillules 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.
Bottles
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7 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.
Bottles - preparation
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Pre-fill bottles – at home or surgery
receptionist
Fill 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
Labels
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Dispensary 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.
Instruction sheet
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Instruction sheet - 2 sections:
- basic instructions for taking medicine
- general information about homeopathy
Write your own or use mine
Download it from the Faculty website
Save it as a shortcut icon on your desktop - 2 clicks
and it’s printed
Another version with instructions on how to make up
LM potencies available
Instruction sheet – reasons for use
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Too 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.
Instruction sheet – basic instructions
for taking medicine
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Aggravation 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.
Instruction sheet – general
information about homeopathy
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Evidence 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.
The bottom line – what does it cost?!
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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.
Summary – benefit to patients
Benefits 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.
Summary – benefits to practitioners
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Increased use = increased learning
Increased use = knowledge maintenance – no
disuse atrophy
Increased use = increased experience =
increased effectiveness as a homeopath
Increased use = increased job satisfaction and
personal rewards
Summary – benefits to NHS
Homeopathic hospitals
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Increased use = increased referrals – supports
business case for hospitals.
Increased use = generates need for
postgraduate education – supports training
centres.
Summary – benefits to Faculty of
Homeopathy
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Member 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.
What now?!
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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.
I give you……
Dr Tim’s
Magic Box
…….Thank you