I alluded to some badness in a previous comment. Specifically concerning FP10s for Homeopathic medications. The pharmacist concerned must remain unnamed, but it is not me, honest!
One of our fairly local surgeries is an an outlying village. The sort of outlying village that has a church, a statue, a vague history and a pub. Fairly middle-class and a large number of GROLIES. (Guardian readers of limited intelligence in ethnic skirts). One of the GPs likes to dabble in Homeopathy. Strangely she dabbles in Homeopathy for people with minor, self-limiting problems and not for patients with cancer, hypertension or those needing palliative care. There is a certain irony there, is there not? "Yes, I will prescribe this bogus medication for you, but only for minor problems that will go away in three days"
My colleague is renowned for being somewhat of a cowboy. There are a lot of Homeopathic preparations, all packed in nearly identical little plastic pots. Being, like myself, somewhat sceptical and cynical, he decided that he would only keep one pot of Homeopathic medication and dispense those tablets for every Homeopathic prescription that he had.
His logic was flawless-If any professional colleague reported him he could simply say they were mistaken and there was no way that he could have been caught. What would they do, assay the tablets which would contain not one molecule of active ingredient either way.
This started in 1992 and continued until recently. Hundreds, maybe even thousands, of prescriptions presented to him and every single one dispensed with Nelsons Rhus Tox. (That's the most diluted one and therefore the strongest, right?!)
How many complaints did he have in all these years? Not one. Not one patient noticed he was taking a harmless placebo and the doctor never realised that her patients remained unmedicated.
So, either Rhus Tox in minuscule quantities is a miracle cure for everything, or all homeopathic medications are interchangeable. Hmm, that's a tough one.
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============================================ Submitted on: July 18, 2008
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10 comments:
Despite your obvious hero-worship and dribbling excitement over how clever your 'friend' is, it's a bit pathetic really that a professional could behave in this way, even if it is homeopathic sugar pills (which I am wholeheartedly against and hate with a passion by the way)
Nope, no hero-worship.I just found it intriguing that in all these years nobody had noticed that the hand-picked, professionally chosen,"used for centuries", treatment was not noticeably better than the Rhus tox.
Sorry, but I find it hard to get irate about a colleague swapping one inert lactose tablets for another one.
I'm more irate about the "homeopathy can cure ME" drivel, that was on Radio 4 at lunchtime today.
and dribbling? Please...I wish
I dispensed my first homeopathic thingummy today. I suppose you're asking for it really if you work in Glastonbury...
More power to the elbow of Mr Hunnybun's "friend", I say.
Here's a thought - if you gave ibuprofen for every script for an NSAID would you also think that was OK?
I mean the patients with acute inflammation would all get better so who cares if it's Ibuprofen, Aspirin, Diclofenac, or anything else...? Ask your "friend" if he would do that for a few weeks and see what happens....or maybe he could try it with cetirizine and loratidine next time he gets antihistamine scripts...
Disagreeing with homeopathy is one thing (and I am not a fan either) but deceiving patients and professional colleagues is another altogether....oh and illegal, but hey who cares...it's only homeopathy so at least he can't kill anyone or get found out...
What an idiot
Hi Muggy-I see the analogy that you are trying to make. but it doesn't work. He's not replacing one active ingredient with another, is he?
What he's doing, is replacing a tablet with possibly not one molecule of active ingredient with another tablet with the same probability of no active ingredient. The two tablets are, to all intents and purposes identical (and I'm sure a bit of spectroscopy would prove similar)
Presumably that's why no one has queried him over the years.
You are right, it's illegal and possibly unethical too.
I thought it was an interesting experiment, which is why I posted it up. I suspected it'd provoke the reaction it did.
Personally I don't think homeopathics preps should be availble at NHS expense. Then again if eveything was blacklisted that had no evidence base we'd be very quiet boys and girls.
OK then what about replacing one cough bottle with another - we know neither work...indeed the BNF tells us they don't but lo and behold coughs get better.
Also, how on earth does your friend know that no-one has ever noticed his deception? You make no mention of how he labels or dispenses the medicine. If he labels it with the name of the drug on the script and yet uses an entirely different drug for dispensing, this is beyond stupid. If he labels the same as what he gives but just gives a different medicine, then it's only a matter of time before the doctor catches on...
Regardless of whether it is homeopathy or not, this is illegal, unethical and fraudulent. No doubt your knowledge of the crime and yet inaction to stop it or report it - indeed giving it a wider audience it on your blog, will also be of interest to the Stat. Comm when they come to call ;)
It is entirely possible that the patient returns to the doctor no better and a new prescription is issued which is dispensed at another pharmacy - possibly even one where the professional upstanding pillar of the community is actually abiding by the law (there must be a few...)?
Or the patient *does* improve but no thanks to the homeopathy - just like cough medicines and proven 'ineffective' treatments available on the NHS such as rubefacients, etc - what's the problem? Patient gets better, job done. In this case the only issue that remains is the disgusting unprofessionalism (is that a word?) of your friend.
Listen, I'm not a fan of homeopathy and I don't even much enjoy being a pharmacist these days, so I am not sure why this is getting me so excited...it just seems so....wrong!
Off for a lie down...
Hi Muggy,
Yes, it is dodgy beyond belief. There were dodgy goings on such that I would not even locum there for a day.....my pre-reg tutor warned me off. He also pointed out that it was not acceptable to pretend endorse all Gaviscon Rx as 5x100ml, which was one of their scams.
I see you point about cough medicines. But they do have an active ingredient, Okay, it may not work, but it is still detectable by assay.
I am not sure the GP ever caught on. How could they? Dilution to such an extent means that no molecule of drug would be detectable in either sample.
I assume he labelled as Rx was written, then switched meds to another container? Not sure anyone would be wiser unless they pulled all his wholesaler invoices and compared them with what was dispensed.
I am happy to say that I have not seen a Rx for a hompepathic product for many years. If I got one? Well, that's a tricky one....I guess it'd be easier to opt out and send the patinet to somewhere that stocked it-I see on their website that Boots are big fans of such medications.
Further up you said
"Sorry, but I find it hard to get irate about a colleague swapping one inert lactose tablets for another one."
I find it interesting how you now admit it is "dodgy beyond belief....illegal and possibly unethical too"...sounds like you changed your tune...
Perhaps it was the realisation that by giving this idiot's actions a public forum and admitting that you have known about this and his other little 'tricks' for a while without taking any professional responsibility to report it, you have implicated yourself as an accessory...? Or maybe you still think it's an "interesting experiment" to commit fraud? Do you think anyone from Lambeth reads your blog?
You picked on homeopathy as an easy target and ended up tying yourself in ethical knots...gave me a good laugh though and there's not many of those in UK pharmacy these days so thanks :)
Oh, but I/we did Matt.
We mentioned it to the local health service (whatever they were called before PCT/PGDs)and to the various RPSGB inspectors. This we did many times over a ten-year period. Nothing ever seemed to happen.
I think it is possible to admit it's "dodgy" without being overly concerned. I didn't change my tune, more clarified my position :)
I don't really want to go into any more details on my colleague here (but feel free to email). Suffice to say that the homeopathic prescription incidents were pretty low in the "dodgy goings on" league table.
Sorry but who's Matt? I think you may be confusing me with someone else...
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