medical coding training at home.
"The physician's highest calling, his only calling is to make sick people healthy"
- Hahnemann, Organon. 6th Edition.
1. Introduction: Pre-1850
2. Homeopathy Medical Philosophy
3. The Flexner Report
4. Allopathy-Critique
5. Homeopathy Today
6. Conclusion
1. Introduction: Pre-1850
In the early 19th century, most hospitals were for the poor and physicians were not a crucial part of most American patients' experience. Sick people relied on the advice and help of neighbors and midwives. When patients did seek out a medical practitioner they had a plethora of options, perhaps the widest choice in American history. At the time, there was no single medical profession in the US. There were no national boards, specialty boards, government or private research institutes, or certification committees. Because there was no national examining or regulatory agencies, the doctors' practices were even more individualize than it is today.
Medical practice was not unified. American medicine was diverse and competitive; perhaps the most open medical marketplace of any Western nations. Doctors often disagree about the proper therapy and about diagnosis. Their practice had to be responsive to the context in which it occurred. They frequently complained that as they entered a patient's home, it was not the doctor but the patient and family who made the final choice of treatment. Until the 1850s most medical education did not take place in medical schools. An American practitioner did not need to have a medical degree or any formal certification from the state to be regarded as a legitimate physician. Medical training was done by apprenticeship. Doctors obtained medical skills and knowledge from older skilled healers in their communities (Rogers).
2. Homeopathy Medical Philosophy
Amid these diverse medical practices, homeopathy was easily one of the best choices for most patients. Homeopathy was developed and constructed in 1790 by a German Physician Samuel Hahnemann (1755-1843). Hahnemann was known at the time for his papers on medicine and chemistry and his work in pharmacology, hygiene, public health, industrial toxicology, and psychiatry (Freeman et al.). He became dissatisfied with the medical practices of his day, especially with the impurity of drugs and the imprecise way in which they were produced. This led to his rejection of the accepted medical practices of his day such as bloodletting, cathartics, leeches, and many other highly toxic chemicals. This type of treatment is more deadly than the disease, but it was believed that it was the only potent way to kill diseases.
Hahnemann felt that these types of therapies were useless if not down right harmful and was prescribed without any coherent theoretical justification. He wrote in his diary: "Soon after my marriage, I renounced the practice of medicine, that I might no longer incur the risk of doing injury" (Freeman). Later on, Hahnemann studied eighteenth century medical writings and discovered the medical philosophy of homeopathy. He derived the word 'homeopathy'from the Greek word 'homios pathos' or 'like-suffering', which is more fully explained in his major work, Organon der rationellen Heilkunde (1810) (Rogers). In other texts, homeopathy comes from two Greek words 'omio' meaning 'same' and 'pathos' meaning 'suffering' (Lockie).
Basically, homeopathy teaches the stimulation of the natural healing elements in the body to prevent illnesses. This is accomplished by introducing into the body a substance that, in a healthy person, induces symptoms identical to the symptoms of the disease (Freeman et al.). Hahnemann initially experimented on himself to prove his discovery. Twice a day, he ingested cinchona, a Peruvian bark that contains quinine chemical and is well known as a cure for malaria. Each time he ingested the bark, he developed periodic fevers, symptoms common to patients with malaria. When he stopped taking the medication, the symptoms disappeared. Hahnemann theorized that if taking a large dose of cinchona created malaria-like symptoms in a healthy person, a smaller dose would stimulate bodily healing elements in a person sick with malaria. He then conducted many experimental tests on other substances and meticulously and systematically recorded the results. He observed and recorded symptoms that were not only physical, but also of an emotional and mental states. It was believed that the symptoms of the disease and illness always manifest on all three levels and treating the physical level only, as occurs in allopathic medicine, represented an incomplete treatment. In other words, all physical, emotional, and mental qualities must be considered when choosing the remedy. Then, multiple remedies, but not all at the same time, may be used to treat the person (Freeman et al.).
Hahnemann developed three essential principles of homeopathy: 1) The Principle of Similars, is based on the principle of "Like cure Like." This law states that if a substance, given in large doses, induces specific disease symptoms in a healthy person, that same substance, given in small doses, will cure the disease in those who are ill. 2) The Principle of Infinitesimal Dose, through experimentation, Hahnemann discovered that the more times he diluted the substance, the more effective it became. This also avoided the toxic side effects of the stronger remedies of the time (Freeman et al.). Because of the infinitesimal dose, American practitioners of homeopathy constantly faced the charge that their drugs were so mild that they were in fact inactive, that nature, rather than homeopathy, was the healer. This argument was part of an attack by orthodox reformers who were themselves critical of heroic therapies (Rogers). 3) The Principle of Specificity of the Individual: homeopathic practitioners believe that the treatment for a physical condition must be matches to the unique symptoms of the individual. The influenza or headache is not treated; rather, the person with flu-like or headache-like symptoms is treated (Freeman et al.).
The idea that remedies and symptoms sharing certain key features might interact in such a way as to banish illness, and the implied outcome that two similar states of discomfort cannot exist in the same body, was not new even two century ago. It was well known to the Greek and the Chinese many millennia before. Hippocrates, whom over 2400 years ago, also taught the Law of Similars or "like cures like." The great achievement of Samuel Hahnemann was that he systematically studies, for himself, all the orthodox medical remedies of his day, noted their effects on healthy people, and then used this knowledge to find very specific and safe treatments for sick people. This was revolutionary in an age when medicines were indiscriminately prescribed often in poisonous quantities (Lockie).
Hahnemann disliked the tendency of physicians to explain and classify diseases, and he argued that these disease classifications were erroneously constructed. In other ways, Hahnemann's system reflected the mainstream medicine of his day. He believed that disease was the result of the disturbance of the body's vital force, a term he used to refer sometimes to a physiological principle, sometimes to a spiritual one. Homeopaths' mild therapies, he argued allowed the body's vital force time to heal. His concept of the vital force attracted intellectuals already intrigued by other philosophies that sought connections between the materials and the spiritual (Rogers).
3. The Flexner Report
In 1847, the American Medical Association (AMA) was established as a professional organization for physicians from the medical belief system known as allopathy or biomedical paradigm, the opposite approach of homeopathy, which is defined as a system of therapeutics in which disease, is treated producing a condition incompatible with or antagonistic to the condition to be cured (Lockie). Allopathic physicians called themselves 'regular' or 'orthodox' physicians. They regard all other medical practitioners as 'irregular' or 'unorthodox.' Their practices were characterized by Heroic and invasive treatments such as bloodletting, purging, blistering, vomiting, and medicating with powerful drugs, such as opium, and poisons, like mercury and arsenic. The initial program of the AMA was to create internal professional cohesion and standardization by controlling the requirements for medical degrees and by enacting a code of ethics that would exclude 'irregular' practitioners from this opportunity. These efforts were aimed mostly at reducing the influence of their chief competitors-homeopathic physicians, who had organized the American Institute for Homeopathy in 1844 (Freund et al). However, the public at the time as expected, was more attracted to the less dangerous forms of medicine practiced by homeopathy, naturopathy, and hydropathy.
Those were the time when American had choices regarding health care because it was not yet strongly regulated and industrial capitalism was still a baby. But the event that changes the American medical landscape was the Flexner Report. Abraham Flexner, not a physician but a professional educator, was hired by the Carnegie Foundation to improve the standards of medical schools by exposing their faults to the public. Backed by the Carnegie Foundation funding, the Flexner Report contributed to the homogenization of the medical profession and the public notion of the ideal American medical school; or rather, the powerful upper, upper class's notion of American medical school. The disappearance of the alternative medical schools was another major consequence of this homogenization of the medical profession because it simply did not conforms to the belief system delineated by Flexner and his upper class financier. Flexner examined thirty-two unorthodox schools: fifteen homeopathic, eight osteopathic, eight eclectic, and one physio-medical (Rogers). He judged only 20 percent of the schools as adequate, recommending stricter standards and certification procedures.
The Flexner Report of 1910 was a major catalyst for the change from medical diversity to a rigidly homogeneous medical system in the US. His report prompted crucial changes in medical education, with both good and bad outcome for the practice of medicine. On the good side, shoddy schools were closed and the public could now have more confidence in the professional abilities of their physicians. But on the bad side, the report effectively made all healing practices that did not conform to his narrowly defined scientific view illegal, restricting acceptable medical practices to a narrowly defined system (Milburn).
The Flexner Report gives legitimate birth to allopathy or biomedical paradigm of medical philosophy and practices because it conforms to the belief delineated by Flexner and his upper class supporters. In fact, his financier commissioned him to do just that: to define allopathy as normal and legitimate and to label all other competing practices as deviant and illegal. The allopathy/biomedical paradigm are based on the Galenic or Heroic medical theory. For a number of reasons after the Flexner Report, this scientific medical practice grew to eventually monopolize health care and spread itself around the world as a universal system of healing.
4. Allopathy-Critique
Despite the astounding success of the allopathic system of the past, according to Le Fanu, today doctors are increasingly discontented and the public is increasingly neurotic about its health. Medicine's moral and intellectual integrity has gradually been eroding over the last decades. First, doctors themselves are dispirited due to increasing lack of autonomy. The proportion of doctors regretting their decision to enter medical practice rise from 15% in 1966 to 50% in 1988. Second, the public's attitude toward health shows precisely the same patterns. Despite the impressive medical advances of the postwar years, the proportion claiming to be 'worried' about their health has also risen from 15 percent to almost 50 percent between 1966 to 1988. Third, comes the paradox that despite the fact that modern medicine clearly works, a startling number of adults are sufficiently dissatisfied with its style or what it has to offer, and seek out alternative practitioners. Finally there is the paradox of the explosion in costs with very little to show for it. The paradox of the rise of medicine costs lies in the magnitude of the increased funds allocated to health, which in the US have almost doubled in the last ten years from $391 billion to $668 billion without there being any measurable improvements on a scale to justify such an increase (La Fanu).
Allopathic medicine is sadly, no longer as satisfying as in the past. This lack of satisfaction has been compounded by the rise of specialization in medical practice. In short, medicine is duller, as can readily be ascertained by contrasting the sparkle and interest of medical journal from two or three decades ago with those of today. It is paradoxical to think that as medicine has become more successful, the proportion of the public who are 'worried' about their health has also increased. This growing discontent/distrust with biomedical paradigm lies primary in its belief system that it can explain everything about health and illness, yet it recognizes only one source of knowledge-that which has 'been proven' by statistics, or the paradigm of empiricism and this is a potent source of error (Le Fanu).
There are many ways of knowing and among the most powerful is the tacit knowledge that comes from experience. The effectiveness of the modern drugs that came out of the drug companies in the 1960s and 1970s led to the neglect of simpler, more traditional remedies and the dismissal of anything that did not fit the scientific ideas of the nature of disease. Consequently, this growing failure of the allopathic system gives rise to the growing interest of alternatives medicine that once was an important part of people's lives. Homeopathy, naturopathy, acupuncture are now becoming increasingly more popular, being used by one-third of adults in any one years (Le Fanu).
One of American homeopathy's most lasting critiques of orthodox medicine came from the term 'allopathy' from alloison pathos, or 'unlike suffering', which was drawn from Hahnemann's description of medicine that he characterized as based on the Galenic theory of Contraria Contraril, the opposite of 'like cures like.' Homeopaths argued that this theory was not only wrong but also unacknowledged by its practitioners. Orthodox practitioners scorned the term allopathy as a description of their practice. Their efforts were useless; the term was widely adopted by all anti-orthodox groups and is still widely used today as an epithet by those critical of biomedicine (Rogers).
5. Homeopathy Today
At the turn of the 20th century, one out of every five American doctors practiced homeopathy. After a lengthy period of declines due mainly to the Flexner Report, there are again increasing numbers of physicians in the US using homeopathic treatment. Today, homeopathy is practiced worldwide. It is estimated that more than 500 million people receives homeopathic treatments. The World Health Organization (WHO) recommended that homeopathy be integrated with conventional medicine to provide adequate global health care. Homeopathy has been scientifically verified in the consulting room and at the bedside countless numbers of times, in most countries in the world, especially in Europe, South America, Mexico, and India. In Europe, the birthplace of homeopathy, there are more than 6000 German and 5000 French practitioners. All French pharmacies are required to carry homeopathic remedies, as well as conventional drugs. In Great Britain, homeopathic hospitals and outpatient clinics are part of the national health care system (Freeman et al.). Homeopathic physicians in England are licensed to practice and are reimbursed under the National Health Service.
The homeopathic movement also encourages laypersons to self-treat certain illnesses and to learn to use some of the homeopathic medicines. The various natural health movements were generally suppressed in the United States, but in some European countries, such as Germany, these practices have long been more acceptable as a complement to biomedicine. But contemporary versions of homeopathy appear to be used increasingly in the United States and Britain, perhaps as a result of dissatisfaction with the dominant, allopathic medical system (Freund et al).
Today homeopathy offers a safe, effective, and low cost in health care. It is use to stimulate the body natural defenses rather than inhabit or suppress the body's attempt to become well. It is a form of preventive treatment that helps to stop the problem of human vulnerability that allowed the problem to develop in the first place. Homeopathy is used to restore a state of health, rather than to simply fight disease (Lockie). Positive research studies on homeopathy have been published in prestigious medical journal such as The Lancet and the British Journal of Clinical Pharmacology. Homeopathic physicians are licensed independently in Connecticut, Arizona, and Nevada. Homeopathic medicines are legal drugs, being specifically mentioned in the Pure Food and Drug Act, the Medicare and Medicaid Statutes, and the Drug Enforcement Administration Statutes. Almost all homeopathic medicines are classified as over-the-counter products by the Food and drug Administration (Milburn).
As people become healthier through homeopathy, they become sick less often, get well more quickly, miss less time from work - (this may not be so good if your job only make the boss richer and you only grow wearier.) In any rate, it is better to be healthy than to be sick. Successive generations of homeopathic patients become even healthier as the vulnerability to disease is reduced. The demand for homeopathic treatment is growing very rapidly as people become more aware of its safety, effectiveness, and low cost. It is equally concerned with maintaining good health and aiding recovery from ill health, and like all forms of medicine-even those that use powerful drugs and high-technological surgery-relies on the body's own powers of self-regulation and self-healing. Since its development nearly two hundred years ago, homeopathy has benefited millions of people, young and old, from all walks of life, in countries all over the world.
In modern Western societies, where biomedicine is the dominant medical paradigm, people mostly use several healing systems simultaneously with biomedicine. For example, someone with back pain, for example, might consults a pharmacist, massage therapist, orthopedist, physiatrist, or chiropractor, depending on how the person interpreted the pain, its seriousness, and its possible causes. For many people, seeking help for health or illness includes several options in addition to orthodox medical care. Even though allopathy has attained a virtual monopoly of medical education, licensing, and practice in the United States and Canada, and also in most of Europe, their system is quite clearly failing to meet the medical needs of the population.
The single most important reason for this is the deliberate move away from looking at people as a whole. This has led to an increasingly mechanistic view of disease and consequent reliance on physical methods of treatments such as drugs, surgery, radiation, and other high-tech methods. While there have been successes for some disorders, they are not appropriate for the majority of diseases. People have lost confidence as a result. In fact some 50 percent of drugs prescribed are never taken. It has also been shown that the very foundations of scientific medicine in practices are twenty years out of date. The last twenty years have seen dramatic rise in interest in alternative or complementary medicine among doctors and other health care professionals. Homeopathy is a safe form of medicine that treats the whole individual. The importance of treating disease gently by nurturing and stimulating the bodies' own immune system and other healing mechanisms are being increasingly acknowledged (Lockie).
There are few sociological studies of the extent of use of these nonallopathic therapeutic systems, but evidence suggests that they are used in conjunction with biomedicine, although without the knowledge of the patients' medical doctors. Surveys indicate that in Europe roughly one of every five persons has used alternative healing approaches. Using a much broader definition of 'alternative,' a large US survey indicated as many as one in three persons may have used some kind of alternative therapeutic approach (Freund et al.).
Homeopathic medicine never perceived the mind and body as separate, so it never went down the tracks of conventional medicine and many of the dead ends of conventional medicine in that regard (Freeman et al.). However, like allopathic medicine, these alternatives approaches are organized as professional practices, with their own body of knowledge, training and certification standards, code of ethics, and organizations. They also rely largely on learned diagnostic and therapeutic techniques, which do not require the patient to understand or agree with the underlying paradigm in order to be treated effectively. Despite their more holistic ideals, like biomedicine, many nonallopathic therapeutic approaches tend to locate illness in the individual, separate from social context, and to treat patients' bodies as material objects, and not a social objects (Freund et al.).
6. Conclusion
It is now recognized by most health care professionals that no one system of medicine has all the answers for all the ills that afflict humankind, any more than any one doctors can hope to cure every problem in every patient every time. All alternatives are needed to work together. The main problem is knowing which is the most appropriate treatment for any particular patient. Obviously, the less life-threatening and more chronic the conditions, the more sense it makes to use nontoxic and immune system boosting therapies first, and only to progress to potentially harmful methods if these fails or the situation becomes more critical. In case of acute, serious illness we still have to rely heavily on proven orthodox methods. At least until we have had more experience of using alternative or complementary therapies in these situations.
Today, most illness is socially constructed or causes by the way society is disorganized. This form of social illnesses manifesting itself on the human bodies is increasing rapidly due to unhealthy living. To fix a lot of these illnesses is to fix the society and its infrastructural arrangement as a whole. Until we can fix these issues to facilitate better health for all human being, homeopathy is the next best solution to a good health care.
Bibliography:
1. Freeman, et al. Mosby's Complimentary & Alternative Medicine: A Research-Based Approach. 2001. Mosby, Inc.
2. Freund, McGuire. Health, Illness, and the Social Body: A Critical Sociology. 1999. Prentice-Hall, Inc.
3. Le Fanu, James. The Rise and Fall of Modern Medicine. 1999. Carroll & Graf Publishers, Inc
4. Lockie, Andrew. The Family Guide to Homeopathy. Fireside. 1993
5. Milburn, Micheal. The Future of Healing: Exploring the Parallels of Eastern and Western Medicine. 2001. The Crossing Press.
6. Rogers, Naomi. An Alternative Path: The Making and Remaking of Hahnemann Medical College and Hospital of Philaddelphia. 1998 by Alleghenny University of the Health Sciences. Rutgers University Press.
medical coding training at home.