jeggels.com

The Future of Homeopathic Practice in South Africa
My Nomination to the Position of HSA President

To whom it may concern:

The purpose of this communication is to acquaint you with requests and complaints received from my homeopathic colleagues prior to, as well as following my election during 2012 to the Professional Board Homeopathy Naturopathy Phytotherapy (PBHNP), as well as my subsequent election as Chairperson thereof. I am currently obtaining legal advice regarding my vacating the position of member, and Chairperson, of the PBHNP. In the circumstances, I elected to remove from my website the documents on this matter, which were online temporarily to inform my constituents and colleagues on the matter. Nevertheless, the requests from my homeopathic colleagues suggested that there are serious shortfalls in their training which resulted in:

  1. Their perceived incompetence or inadequacy with regard to basic and advanced medical diagnostic skills
  2. Their perceived inadequate training in homeopathic pharmacology and practices leading to inadequate and/or unprofitable practice performance
  3. The inability to perform other than in a strictly homeopathic private practice environment serving mostly the well-worried non-critical, and non life-threatening patients, versus their ambition to act in a wider medical environment, such as in public health facilities, e.g., clinics or public hospitals. Last-mentioned is the aim, and official position, of the Homeopathic Association of South Africa (HSA)

These complaints and observations were made to me by a number of homeopathic colleagues with a view of enlisting my intervention due to the assistance which I am able to provide based on my profile which can be read below, as well as my previous position as Chairperson of the PBHNP. However the above assistance can still be provided as I have recently been nominated (and have accepted the nomination) to avail myself to the position of President of the HSA. The nomination process ends 14 July 2013, following which in all likelihood an election will be conducted.

Nevertheless, these requests and observations were supported by the personal experiences and observations of those colleagues which I have no reason to doubt in the slightest, since they are further underpinned in the observations obtained in 2 M. Tech theses authored by Dr. Fotini Babaletakis and Dr. Melanie Sweidan. Each of these 2 theses encompassed interviews with dozens of homeopathic colleagues, in toto numbering close to 100. Each being public documents which served as my authority for observations. Apart from these and other sources, I personally observed on many occasions that bright graduates were totally at a loss with regard to effective and profitable homeopathic practice when they sat in with me. Most importantly they lacked indispensable diagnostic skills which would enable them to diagnose routine medical conditions as well as potentially life-threatening conditions for immediate referral, or to treat those conditions of which they had a clear clinical and diagnostic perspective; the latter were often referred to general practitioners for attention when they could and should have been dealt with by the homeopathic practitioners.

Furthermore, these observations were shared by more than 20 homeopathic graduates who are either studying towards the MB ChB medical qualifications, or have already qualified. Some of the observations relayed to me were that they believed that they were not fit to practice homeopathic medicine unless they had the knowledge and skills imparted to them in MB ChB training. This is fully supported by the fact that M. Tech graduates, not withstanding their ambitions, have unfortunately not had the opportunity to acquire via their studies many of the most basic activities and procedures required to function in a conventional hospital or clinical environment. Until these skills are learnt, examined and passed, those who wish to be employed in a broader context remain less employable - this is borne from the fact that the DoH is not clamoring for the services of our M. Tech graduates?

My personal profile can be accessed here, nevertheless, my profile includes the fact that:

  1. I hold a medical degree from The Netherlands
  2. I qualified in postgraduate internal medicine in the United Kingdom and was accepted as a Member of the Royal Colleges of Physicians of the United Kingdom [MRCP (UK)]. This incorporates a qualifying examination and is the highest available qualification in the UK in clinical internal medicine - a coveted qualification to attain, which consequently draws MDs from all parts of the Commonwealth to the UK
  3. I practiced successfully as Consultant Physician at Livingstone Hospital, Port Elizabeth
  4. I have practiced homeopathic medicine successfully for more than 20 years, first in hospital, then in private practice. I have assisted in my own rooms without charge many colleagues in attaining a higher standard of practice
  5. I participated in the upgrading program for B-registered homeopathic colleagues as a pre-requisite for their A-registration during 1997-1998
  6. I was accredited during 6 successive years as a Provider of Continued Professional Development (CPD) by the South African Medical Association (SAMA) acting as accrediting agent for the HPCSA, for general medicine and homeopathic medicine. I discontinued this official programme to complete my research which led to the publication of my article
  7. I was awarded honoris causa the Post Graduate Diploma in Homeopathic Medicine [DHM (Hon)] and was admitted as an Honorary Fellow of the British Institute of Homeopathy [FBIH (Hon)]

Quite possibly as a result of the above which gives me a unique perspective of conventional medicine and homeopathic therapeutics (HTS), I am regarded me as the best person to bring skills, expectation and employment prospects forward by the many who approached me. It goes without saying that I am perhaps the individual who can on an equal footing engage our medical colleagues from the Department of Health (DoH), the HPCSA, and SAMA to enlist their support in upgrading and preparing colleagues for public service, as well as to enlighten my medical colleagues on the unique role which HTS can play in public health facilities by employing the outcomes achieved through HTS. This as the profession of medicine is quietly moving away from the erroneous reliance on experimental results (RCT results which society distrusts - see the bmj, and theatlantic) to real-life outcomes as benchmark for therapeutic success (please see this page which provides only a drop in the ocean of homeopathic clinical successes). Furthermore, please recall that I have been granted upgrading authority officially by the HPCSA via SAMA for homeopathic colleagues. That’s sympathy to the homeopathic profession, but which will only be granted to someone with higher qualifications and experience in medicine, and homeopathy. Anyone less qualified and experienced will remain in no-man’s land. Simply stated, the HPCSA and SAMA membership must trust the individual performing the upgrading to trust that the upgraded colleagues are safe to practice in clinics and hospitals. But beyond that, what can HTS bring to public health - that I alluded to earlier. It therefore goes without saying that homeopathic colleagues require a great deal of additional training and upgrading to function successfully in public health facilities. They therefore require training in the entire spectrum of medical disciplines which train MB ChB graduates - though indispensible, the mentioned has it shortcomings, concerning which I shall elucidate on below.

Therefore, besides the roles outlined above, I remain committed to provide my colleagues with those tricks of the trade, from within the practice of medicine, as well as those tricks of the trade for the most exemplary competent and professional employment of HTS within the practice of medicine. For example, how to professionally and competently assess patients, especially the seriously ill who require emergency interventions generally, but primarily homeopathically, the assessment of which allows one to treat the patient within 5 minutes of the start of the consultation, and evaluate the successful outcomes of the treatment within 15-30 minutes of the commencement thereof. To function in clinics or hospitals demands that we must be able to consult and treat patients professionally and effectively within 5 minutes in order to consult up to 100 patients every single day. This is what our Indian colleagues achieve in their clinics and hospitals, and this is what we must achieve. If this is not possible, we really should stay out of public health facilities. Nevertheless, this is the training which I have been engaged in in my practice since 1997 for many homeopathic colleagues and medical practitioners employing HTS. The importance of this type of training is reflected in the wise perception of a recent graduate, a mature student, who stated: "However valuable this was, I found it difficult to translate what I learned from a day with a dermatologist or a surgeon into the practice of homoeopathy." Last-mentioned statement reflects what Prof David Wootton says in his book, Bad Medicine, Doctors Doing Harm Since Hippocrates. Oxford University Press, © D Wootton 2006. He said that the history of medicine till 1865 was of an increase in knowledge, but not of therapeutics. Therefore, what’s the use of a diagnosis if there’s no therapy for the patient? There was “a progress in science and not technology.” “We tend to think that where there is progress in knowledge there is progress in therapy: for over the last one hundred years the two have gone hand in hand.” Thus, sitting in with medical specialists is tantamount to a diagnosis without the availability of therapeutics. However, medical specialist must yet train colleagues in general, but especially in the recognition of those emergency conditions which every graduate must not miss, even though graduates may not be able to treat some of those patients, since they may in fact require urgent surgical interventions. Those patients must be referred professionally to save their lives.

Furthermore, we must recall that HTS was perfected by Dr. Samuel Hahnemann MD. A master clinician, chemist, pharmacist, linguist, and one of the greatest systematists and theorists. HTS arose out of therapeutic uncertainty – how to match, akin to a pass word, a therapy with a disease of a particular patient, which that patient is suffering from at that particular moment in time. He was followed by qualified and competent MDs who applied the therapeutics to the whole ambit of the practice of medicine. The therapeutics spread due to its ‘distinct superiority’ in treating many life-threatening epidemics across Europe and America during the 1800s. By the year 1900 there were about 20 homeopathic medical schools in the USA. By 1920 their curricula were politically forced-changed to the dominant version of medicine. The most professional employment of HTS today can be found in India, where it’s employed, amongst others, in about 190 homeopathic hospitals. The therapeutics has been booted out of the realm of Hahnemann and his successors in many countries around the world for many years, except perhaps India. It has landed up, in many instances, in the realm of the well-worried, non-urgent, and non-emergency spheres of healthcare run by non-MDs – a valid realm of health care, but not its only, or exclusive realm, as the therapeutics has been, is being, and aught to be, employed in all realms of healthcare. This is the aim of the HSA which requires the interventions which I discussed above.

I am and remain thoroughly committed to our wonderful profession and to furthering your skills in any way and in any capacity, as I have always been and done. Finally, the above comments reflect my person views on the subject.

Yours sincerely,

Dr. Herman Jeggels

© Dr. HJD Jeggels, June 2013.