MD, PhD, FMedSci, FRSB, FRCP, FRCPEd
What is a competent homeopath? This intriguing question was addressed in a recent article by researchers from the Department of Public Health, School of Health and Related Research, University of Sheffield, UK, and the Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway. Non-homeopaths would probably argue that either a clinician is competent or he/she is a homeopath; being a competent homeopath seems like a contradiction in terms. So, is is interesting to see what these authors had to say on the subject.

They started by pointing out that homeopathy is unregulated in most European countries, it is therefore not clear, in their view, what it means to be a “competent homeopath”. To clarify this issue, they decided to conduct a small survey investigating homeopathy-educators’ views on what a “competent homeopath” might be and what homeopaths might require in their education. They did a qualitative study based on grounded theory methodology involving telephone interviews with 17 homeopathy-educators from different schools in 10 European countries. The main questions asked were “What do you think is necessary in order to educate and train a competent homeopath?” and “How would you define a competent homeopath?

The results indicate that the homeopathy-educators defined a “competent homeopath” as a professional who, through his/her knowledge and skills together with an awareness of his/her bounds of competence, is able to help his/her patients in the best way possible. This is achieved through the processes of study and self-development, and is supported by a set of basic resources. Becoming and being a “competent homeopath” is underpinned by a set of basic attitudes. These attitudes include course providers and teachers being student-centred, and students and homeopaths being patient-centred. Openness on the part of students is important to learn and develop themselves, on the part of homeopaths when treating patients, and for teachers when working with students. Practitioners have a responsibility towards their patients and themselves, course providers and teachers have responsibility for providing students with effective and appropriate teaching and learning opportunities, and students have responsibility for their own learning and development (in order to avoid confusion or misinterpretation, I have copied this section almost verbatim from the abstract).

The authors consider that, according to homeopathy-educators’ understanding, basic resources and processes contribute to the development of a competent homeopath, who possesses certain knowledge and skills, all underpinned by a set of basic attitudes. And they conclude that this study proposes a substantive theory to answer what homeopathy educators believe a competent homeopath is and what it takes to be educated and trained to become one. The model suggests that certain basic resources and educational and self-developmental processes contribute to developing knowledge and skills necessary to be competent homeopaths. It also pinpoints underlying attitudes needed in the education as well as the clinical practice of competent homeopaths.

I find two things particularly striking in this text which I have copied almost unchanged from the abstract of the original paper (the full text is hardly more illuminating).

Firstly, these statements tell me virtually nothing that is specific to homeopathy. In my view, they are merely a bonanza of platitudes without much real meaning. We could substitute almost any other health care profession for “homeopath”, and the text would still be applicable in a very general and politically correct sort of way. I see nothing here that is specific to homeopathy.

Secondly, according to the findings of this survey, a “competent homeopath” does not seem to have much need for evidence. With virtually every other health care profession I know, one would expect a very strong emphasis on the need for the competent clinician to abide by the rules of evidence-based medicine. Not so in homeopathy!

Why? The answer seems obvious: if a clinician practices evidence-based medicine, he/she cannot possibly practice homeopathy – the evidence shows that homeopathy is a placebo-therapy. So, here we have it: a competent homeopath has to be a contradiction in terms because either someone practices homeopathy or he/she practices evidence-based medicine. Doing both at the same time is simply not possible.

10 Responses to The “competent homeopath”, a contradiction in terms?

  • This is a repeated theme in debates with homeopaths: any null result experienced by a skeptic is because we didn’t try “proper” homeopathy with a “competent homeopath”.

    Homeopaths cannot, by definition, be competent in the sense used in the standard four quadrant competence model. Medicine is about conscious competence, medical science is about the path from conscious incompetence to conscious competence, homeopathy depends on unconscious incompetence because it has no mechanism for self-examination or self-correction.

  • I have read the abstract but have no access to the full article. Based on the abstract I agree with you totally on the vagueness of their survey results.

    However I woulld say that your remarks should be directed more to the survey and it’s authors then draw a conclusion of that the survey says in any way something more substantial about a competent homeopath. In my view a competent homeopath should be defined withing the boundaries of it’s field of expertise. The author’s of the study would have been more succesfull and with more substance to their survey results if they had asked for complete curriculum documentation of the education centres for homeopathy. Also to request the set of guidelines from the various branche organisations that exist that homeopaths should belong to, including organisations that deal with auditing homeopathy practices.

    Then and only then you could say something about what is considered to be a competent homeopath. And again within the boundaries of his or her profession.

    If you define a competent homeopath as someone that should be measured against the rules and regulations of the medicial profession then you are correct in that there are no competent homeopaths as there are no competent physiotherapists, massage therapists or any other person that has no MD.

    And no, I am not a homeopath or an MD but I am someone that is very interested in the ongoing discussion on western and eastern medicine.

    • what is professional competence? it is the capability to perform the duties of one’s profession generally, or to perform a particular professional task, with skill of an acceptable quality. so the question about the “competent homeopath” is perhaps a question of whether his/her task is simply to prescribe homeopathic remedies, or whether he/she should effectively cure disease and alleviate symptoms. as clinicians, I think they must do the latter. if that is so, there cannot be a “competent homeopath” because homeopathy is not effective beyond placebo.
      if homeopaths, however, declare WE ARE NO CLINICIANS, WE ARE GURUS, PRIESTS…AND HOMEOPATHY IS A RELIGION, SECT, CULT…,that would change things quite a bit, I think.

      • I have suggested exactly this several times, since it is clear that homeopathy is indeed a religion rather than a system of medicine, but believers seem to think that claiming to be a system of medicine is a core doctrine so are unwilling to change despite the obvious potential impact this would have on the level of criticism they receive.

        How much would it change things, though? If they continue to make claims to cure – positioning themselves as faith healers, essentially – would anything be materially different?

    • @Nico:

      I am someone that is very interested in the ongoing discussion on western and eastern medicine.

      Which of those categories do you put homoeopathy in?

    • There is no such thing as “western” or “eastern” medicine. Only MEDICINE which developed in the West, but is now used worldwide–east and west, north and south. So called “eastern” medicine is nothing more than an aspect of religion. People in every part of the world may cling to “traditional healing”, but when they are actually ill (and if they have any sense) will all turn to “western” medicine–if they want to have a real chance at recovery.

      To attempt to study homeopathy the way you describe is known as Tooth Fairy Science. That is, you are falsely looking at something that isn’t plausible to begin with, but pretending that it is!

  • That sounds reasonable, although I’m not sure what you’re aiming at, Nico. The problem is, homeopathy pretends to be a medical profession, it is defined as such by homeopaths themselves. It’s a discipline that has the same scope of practice as mainstream medicine, but different methods — methods that are, essentially, pseudo-philosophical deliberations that are not only not confirmed experimentally, but fly in the face of virtually everything we have learned from biology, chemistry and physics over the last few centuries.

    Strictly within the field, in the universe that functions as described by homeopathy (as defined by its practitioners), one might well excel at following the rules and applying the methods of homeopathy. The problem is, of course, that the universe described by homeopathy is not the same with the one we are actually living, for all we know. Describing someone as a “competent homeopath” is not unlike describing Nostradamus as a “competent astrologer”, and only one step removed from saying that Harry Potter is a “competent wizard”.

    Talking about “competent homeopaths” is equivalent to talking about “competent astrologers” or “competent wizards”.

  • Here’s a classic comment about the competence of homoeopaths that I spotted a few years back:

    I do not know what the situation is, but if she saw a competent homeopath then the only reason homeopathy did not work is because the remedy chosen was not the correct remedy for her.

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