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| Hpathy Ezine - October, 2006 | |||||
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Dr. Navin Pavaskar
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| Dr. Leela: Yes we will be including the announcement of this Workshop in this issue of the ezine. Tell us more about this MD training and the hospital work you have. Dr. Navin: At the time of induction itself, when a trainee is introduced to the institute, he gets glimpses of its objectives, origin, culture, training methods, training modules, ethics and norms. Apart from the basic training in specified subjects in homeopathy we focus on sensitivity training as a person, training of the observer within the physician, and clinical training for balancing his sensitivity and sensibilities. Then there is bed side training for them to learn to prescribe in acute and emergency cases and make accurate observations of management. We have developed a standard case record specifically for IPD management. Our aim is to develop an MD homeopath’s ability to devise strategies for handling patients at multiple levels in a hospital set up We train the student in human care, economic care, legal care, social care, ethical values, system care and team work. The success of this training is demonstrated in the bed side manner and action. We focus on the trainee learning to be part of the established system in the hospital for which requires an understanding and respect of the system. Dr. leela: What are these systems you are referring to? Dr. Navin: The Systems is a complex whole, set of connected things organized in such a way so as to work together. It demands methodical work as per plan.
Hospital Systems is a module where each MD student has to learn to be a clinical administrator. Dr. leela: So in short, an MD has to first learn to be a ward boy, a clerk, a nurse, a social worker, a pharmacist before donning the mantle of an accomplised MD. He must work his way up the ladder as it were – a good exercise in humility and respect for others, right? Dr. Navin: (Laugh) Something of the sort. Our Organization believes it is important for a hospital working homeopath to understand how all these systems connect to each other for efficient functioning, how each role is important in the TEAM EFFORT of serving the suffering patient. Then once he’s got that grasp, he must earnestly learn the medical aspects. These include: Ward procedures (suctioning, wound dressings, putting in IV lines, etc) ; Minor procedures (Wound Suturing, Pleural Tapping, Ascitic Taps, Lumbar Punctures, Blood collection for blood gases, and other lab work, etc) ; Life saving procedures (Inserting an Endo-tracheal tube, Putting in a CVP line, Emergency training, etc) ; Medico-legal procedures. He must understand the indications and utility of all these procedures with the contraindications, risk, and surgical preparation required for all of them. He must know how to interpret various investigations and reports as well. All this is additional training that is not necessarily part of the usual homeopathic training. For MD’s it is important today, to be technologically in touch and accessible. Each doctor has to be computer savvy and carries a Pen Drive. Each postgraduate is expected to use homeopathic software. Presently we use CARA, Hompath, RADAR and Organon 96, which is the indigenous software of the ICR group. All this is in addition to serious clinical homeopathic training.
This makes the job tough for the MD Trainee. They need physical
strength and mental stamina to sustain this, coupled with a high
degree of motivation. Dr. leela: Dr. Navin,
you’re making me feel that I was born a decade too early Dr. Navin: Yes one of our objectives is to develop a successful protocol for the functioning of Homeopathic Hospitals that can be easily replicated. We have found over the last 6 years that we seem to have got the combination right. This begins with the correct mindset and focus, onwards towards clinical training including how to work with scientific advancement in Modern Medicine without compromising on homeopathic principles. Of course this requires collaboration with MD’s from the Allopathic side who are open to our system of medicine and also trust that our remedies really do work. That is not difficult when they are able to clearly observe the clinical improvement. Dr. leela: We saw this at our own Mumbadevi hospital. But what I like about the Dhawle Group is that you have concentrated on maintaining homeopathy as the main and first choice therapeutic modality for every clinical case. Dr. Navin: Yes, we have been very careful in our choice of MD's from Modern Medicine who are part of our hospital infrastructure. As I mentioned earlier, they have to be open to another system of therapeutics working within their management responsibility. If they see results, they too are ready to allow the patient under their care the confidence that a homeopathic remedy will work. They wait for our therapeutics to be applied for a healing response within a stipulated period of time. Each case has a planned therapeutic programme and an expected outcome . The team sets goal to achieve them. Occassionally due to our own short-coming to find an appropriate simillimum, the outcome does not fulfill expectations. The team then decides whether the situation is in the interest of the patient and whether he is benefitting with the plan of treatment. When sufficent time has elapsed, if the patient does not improve then we on our part need to be open enough to accept our limitations as physicians and allow the patient to choose the next alternative. This attitude becomes more important when one is working in a team, more so in acute critical illnesses. Openness , acceptance of a result/limitation and the best interest of the patient should be our focus. Then desicion making becomes easier when following this rationale. But, we train our homeopaths so that they can meet the high clinical demands required of a competent homeopath. Our MD course is geared towards this.
Dr. Navin: Quite right! One good hospital case was actually a surgical case. A 25 year old man came to the ER with:
We had to call in an Orthopaedic surgeon for an opinion. He suggested
that it should be drained as it was very large, loculated and painful.
He agreed that we could manage the case with homeopathy. He took
the patient into the Operation Theatre and midway through the draining
he called us in to have a look. The tissue was very friable (easily
bleeding on touch) and there was a lot of pus but it was loculated
in pockets and the surgeon had to literally lacerate the wound and
remove the septae to allow all the pus to drain out and not leave
small loculations of pus. The therapeutic objective now was to prevent
a recurrence of the pyemeia. Based on our observation of the wound
in the operation theatre, the choice of remedy needed to cover this
stage of the healing process - the post surgical wound. The remedy choice was Calendula. We continued Calendula for over a month with no other medication along side - not even a local application of it. Also, the dressings were done with sterile gause and sterile water, nothing else. The progressive healing can be seen in the attached slides. He recovered completely on only Calendula - to complete funtion and complete recovery of the range of movement in the limb. Of course, we took his chronic case as well and these were the
characteristic picture of symptoms for brevity: All this pointed to Silica as the constitional remedy. But we did not need to prescribe it till the wound had completely healed. It was then he was prescribed Silica 200C, one dose. Dr. leela: It's wonderful
to see all this in colour :)I think what you have shown us is how
both systems of medicine can work together provided we have our
homeopathic principles clearly in place as well as understand the
scope and the limitation of homeopathy in these scenarios. Last
month, Dr. Barvalia expounded his vision in this direction very
clearly where he identified 3 different groups of patients that
require hospital level management:
Dr. leela: Yes thank you this is all tremendously inspiring. We will print these cases in this issue as well as future issues. I believe it could be replicated globally for the establishment of homeopathic hospitals. As I told Dr. Barvalia last month, talking about hospital work is very close to my heart. Please tell us about the Protocol you have that you have envisioned for homeopathic hospitals. Dr. Navin: The basic philosophy for homeopathic hospitals includes keeping a focus on serving people with compassion. Money at an early stage will always be a problem, but it will be forthcoming once clinical results are obvious. Basing one's therapeutic approach on economic gains will not succeed because then one begins to compromise on basic homeopathic principles. A homeopath with a hospital mindset has to understand that: 1. The law of Similars remains effective even in critical situations. 2. Emergency in homeopathy is clinically, conceptually and from the philosophical standpoint extremely demanding. This is because:
3. The practice of homeopathy in Emergencies demands a holistic approach with the team work of other professionals. 4. Homeopathy is minimally invasive on patients and hence iatrogenically safe. 5. Homeopathy is cost effective to the patient as well as to the service provider. If money is an issue for a homeopath, I think they should not venture into this because it involves a lot of hard work and commitment that one can hardly be paid for. Again the focus has to remain on service and healing with compassion. Though all of us in the ICR are financially blessed, the satisfaction comes from seeing people truly healed and on the track to health with minimally invasive treatment. Homeopathy can in such circumstances, be applied to various aspects of medical practice and all that is required is further developing one’s clinical skills and ability based on homeopathic principles. Dr. leela: Thank you
Dr. Navin for your time today and your patience with showing me
around the hospital. Thanks for the lunch as well I would encourage homeopaths from all over the world to visit and see for themselves here, that homeopathy has a serious future, a truly gentle and curative alternative to Modern Medicine. Details for the WORKSHOP
and contact for the Palghar hospital is available here.
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This is what I’ve always wanted to do. Luckily I have now
have admission into an MD course, but restricted to Homeopathic
subjects. I would have been thrilled to work in a residential course,
but family constraints do not allow me. Still, I see all this, a
tremendous hope for the development of hospital homeopathy worldwide.
