Case Management in Layers
Dilemma in Case Management
We have this strange dilemma in the homoeopathic world. It is about this expectation that if someone is changing prescriptions very often they are not doing a good job. In fact if someone asked a practitioner to pick their successful cases they would invariably pick those that did well on one remedy. All those cases that got an equally good outcome but needed a series of remedies are just not good enough.
I went through the same dilemma as a student and intern. There was this huge gap between the everyday cases we took under supervision while training at the college hospital to the ones I saw in seminars. The cases we took went through ups and downs, many prescription changes,using intercurrents, acutes, and newer repertorizations as layers unfolded through the weeks and months. It was the classical peeling an onion approach. But the seminars seemed to be full of cases where one remedy did the trick or where a rare remedy produced a miracle cure.
What you will never learn at Seminars
It was not until I sat with these same wonderful teachers in their own clinic that I really understood the missing pieces - the difference between their seminar cases and everyday cases. I saw cases in every form. Those cases that did very well on one remedy or cases where unknown remedies did the job much efficiently than any known remedy. But the majority of the clinical cases went through the same process of basic principles that I learnt in those OPDs. These cases needed frequent remedy changes as and when new layers emerged. Eventually the cases did well although through a longer zig zag process. So overall the success rate of these practitioners was still high.
But interestingly these everyday cases rarely found their way for the seminars. Somehow the focus of most seminars is to teach advanced concepts to advanced practitioners. You expect to learn about newer remedies or newer ways of case taking that will fine tune skills or better the current success rate. You expect to learn things that are not taught in school. Hence to be fair the seminars needed to have cases that are focussed on these aspects rather than everyday homoeopathy.
Unfortunately most of the seminars are full of students and very new graduates.
Hence I am a big fan of training and mentoring new practitioners through a well formed course that go through weeks or months. My everyday knowledge comes to the forefront much better when I mentor my students on a day to day basis. I can then help them unfold layers at every followup. Similarly it is easier to share failures and successes when I connect with my online course students every week.
I remember almost every case that came through the student clnic at the start of this year was solved using a step by step layered approach. They learn using intercurrents or acutes or miasmatic nosodes every time there is a followup.
But if I was speaking for a weekend seminar I will simply not have the time to cover these vital steps in those few hours. It is a trailer where you have to fast track the journey as you present the cases due to time barriers.
So this time I thought I should share a case where I work using a layered approach. And I will talk about a journey of the patient in 3 months that happened during a single term in the student clinic where I supervised. It is not about a miracle cure or a rare unknown remedy but it is an immensely valuable learning about every day homoeopathy.
Do you use this approach in your practice? I would love to hear your feedback and frank comments.