Homeopathy 2013; 102(03): 199-206
DOI: 10.1016/j.homp.2013.03.002
Original Paper
Copyright © The Faculty of Homeopathy 2013

Homeopathy in rural Australian primary health care: a survey of general practitioner referral and practice in rural and regional New South Wales, Australia

J. Wardle
1   Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, 235-253 Jones Street, Ultimo, NSW 2007, Australia
2   Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), Australia
J. Adams
1   Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, 235-253 Jones Street, Ultimo, NSW 2007, Australia
2   Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), Australia
D. Sibbritt
1   Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, 235-253 Jones Street, Ultimo, NSW 2007, Australia
2   Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), Australia
› Author Affiliations

Subject Editor:
Further Information

Publication History

Received23 October 2012
revised02 March 2013

accepted13 March 2013

Publication Date:
18 December 2017 (online)

Introduction: Homeopathy has attracted considerable recent attention from the Australian conventional medical community. However, despite such increased attention there has been little exploration of the interface between homeopathy and Australian conventional medical practice. This article addresses this research gap by exploring homeopathic practice and referral by rural and regional Australian general practitioners (GPs).

Materials and methods: A 27-item questionnaire was sent to all 1486 GPs currently practising in rural and regional New South Wales, Australia (response rate 40.7%).

Results: Few GPs in this study utilised homeopathy in their personal practice, with only 0.5% of GPs prescribing homeopathy in the past 12 months, and 8.5% referring patients for homeopathic treatment at least a few times over the past 12 months. Nearly two-thirds of GPs (63.9%) reported that they would not refer for homeopathy under any circumstances. Being in a remote location, receiving patient requests for homeopathy, observing positive responses from homeopathy previously, using complementary and alternative medicine (CAM) practitioners as information sources, higher levels of knowledge of homeopathy, and being interested in increasing CAM knowledge were all independently predictive of increased referral to homeopathy amongst GPs in this study. GPs in this study were less likely to refer to homeopathy if they used peer-reviewed literature as the major source of their information on CAM.

Conclusions: Homeopathy is not integrated significantly in rural general practice either via GP utilisation or referral. There is significant opposition to homeopathy referral amongst rural and regional GPs, though some level of interaction with homeopathic providers exists.

  • References

  • 1 Xue C., Zhang A., Lin V., Da Costa C., Story D.F. Complementary and alternative medicine use in Australia: a national population-based survey. J Altern Complement Med 2007; 13: 643-650.
  • 2 MacLennan A., Wilson D., Taylor A. The escalating cost and prevalence of alternative medicine. Prev Med 2002; 35: 166-173.
  • 3 MacLennan A., Myers S., Taylor A. The continuing use of complementary and alternative medicine in South Australia: costs and beliefs in 2004. Med J Aust 2006; 184: 27-31.
  • 4 Wardle J., Adams J., Soares-Magalhães R., Sibbritt D. The distribution of complementary and alternative medicine (CAM) providers in rural New South Wales, Australia: a step towards explaining high CAM use in rural health?. Aust J Rural Health 2011; 19: 197-204.
  • 5 Australian Bureau of Statistics. Australian social trends, 2008: complementary therapies. Catalogue no. 4102.0 Canberra: Australian Bureau of Statistics; 2008.
  • 6 Directory of AROH Registrants. http://www.aroh.com.au/Default.aspx?pageId=992076.
  • 7 Bensoussan A., Myers S., Wu S., O'Connor K. Naturopathic and Western herbal medicine practice in Australia – a workforce survey. Complement Ther Med 2004; 12: 17-27.
  • 8 Hall H., McKenna L., Griffiths D. Midwives' support for Complementary and Alternative Medicine: a literature review. Women Birth 2012; 25: 4-12.
  • 9 Makich L., Hussain R., Humphries J. Management of depression by homeopathic practitioners in Sydney, Australia. Complement Ther Med 2007; 15: 199-206.
  • 10 Cohen M., Penman S., Pirotta M., Da Costa C. The integration of complementary therapies in Australian general practice: results of a national survey. J Altern Complement Med 2005; 11: 995-1004.
  • 11 Pirotta M., Cohen M., Kotsirilos V., Farish S. Complementary therapies: have they become accepted in general practice?. Med J Aust 2000; 172: 105-109.
  • 12 Easthope G., Tranter B., Gill G. Normal medical practice of referring patients for complementary therapies among Australian general practitioners. Complement Ther Med 2000; 8: 226-233.
  • 13 Steinsbekk A., Adams J., Sibbritt D., Jacobsen G., Johnsen R. The profiles of adults who consult alternative health practitioners and/or general practitioners. Scand J Prim Health Care 2007; 25: 86-92.
  • 14 Poynton L., Dowell A., Dew K., Egan T. General practitioners' attitudes towards (and use of) complementary and alternative medicine: a New Zealand nationwide survey. N Z Med J 2006; 119: U2361.
  • 15 Evans A., Duncan B., McHugh P., Shaw J., Wilson C. Inpatients' use, understanding, and attitudes towards traditional, complementary and alternative therapies at a provincial New Zealand hospital. N Z Med J 2008; 121: 21-34.
  • 16 Holt S., Gilbey A. Beliefs about homeopathy among patients presenting at GP surgeries. N Z Med J 2009; 122: 94-95.
  • 17 Ross S., Simpson C., McLay J. Homoeopathic and herbal prescribing in general practice in Scotland. Br J Clin Pharmacol 2006; 62: 647-652.
  • 18 Thomas K., Coleman P., Nicholl J. Trends in access to complementary or alternative medicines via primary care in England: 1995–2001 results from a follow-up national survey. Fam Pract 2003; 20: 575-577.
  • 19 Cohen D. BMA meeting: BMA representatives vote to ban homoeopathy from the NHS. [News] BMJ 2010; 340: c3513.
  • 20 Holt S., Gilbey A., Colquhoun D., Baum M., Ernst E. Call for doctors not to practice homeopathy or refer to homeopaths. N Z Med J 2011; 124: 4621.
  • 21 Fisher P. Homeopathy and the Lancet. Evid Based Complement Alternat Med 2006; 3: 145-147.
  • 22 Anonymous. The end of homeopathy. Lancet 2005; 366: 690.
  • 23 May C., Sirur D. Art, science and placebo: incorporating homeopathy in general practice. Sociol Health Illn 2001; 20: 168-190.
  • 24 Brien S., Lachance L., Prescott P., McDermott C., Lewith G. Homeopathy has clinical benefits in rheumatoid arthritis patients that are attributable to the consultation process but not the homeopathic remedy: a randomized controlled clinical trial. Rheumatology (Oxford) 2011; 50: 1070-1082.
  • 25 Spence D., Thompson E., Barron S. Homeopathic treatment for chronic disease: a 6-year, university-hospital outpatient observational study. J Altern Complement Med 2005; 11: 793-798.
  • 26 Rossi E., Endrizzi C., Panozzo M., Bianchi A., Da Frè M. Homeopathy in the public health system: a seven-year observational study at Lucca Hospital (Italy). Homeopathy 2009; 98: 142-148.
  • 27 Witt C., Lüdtke R., Mengler N., Willich S. How healthy are chronically ill patients after eight years of homeopathic treatment? – Results from a long term observational study. BMC Public Health 2008; 8: 413.
  • 28 Spence D. Good medicine: homeopathy. BMJ 2012; 345: e6184.
  • 29 Ernst E. Homeopathy, a “helpful placebo” or an unethical intervention?. Trends Pharmacol Sci 2010; 31: 1.
  • 30 Freckelton I. Death by homeopathy: issues for civil, criminal and coronial law and for health service policy. J Law Med 2012; 19: 454-478.
  • 31 Complementary medicines – homeopathy update. http://www.nhmrc.gov.au/your-health/complementary-medicines.
  • 32 NHMRC Research Tracker – 21 April 2011 edition. http://www.nhmrc.gov.au/media/newsletters/research-tracker/2011/nhmrc-research-tracker-21-april-2011-edition.
  • 33 House of Commons Science and Technology Committee. Evidence check 2: homeopathy. Fourth report of session 2009–10. London: The Stationery Office; 2012.
  • 34 National Health and Medical Research Council. DRAFT NHMRC public statement on homeopathy. Canberra: National Health and Medical Research Council; 2011.
  • 35 MacLennan A., Morrison R. Tertiary education institutions should not offer pseudoscientific medical courses: standing up for science. Med J Aust 2012; 196: 225-226.
  • 36 Dwyer J. Is it ethical for medical practitioners to prescribe alternative and complementary treatments that may lack an evidence base? – No. Med J Aust 2011; 195: 79.
  • 37 Lewis M. Risk and efficacy in biomedical media representations of herbal medicine and complementary and alternative medicine (CAM). J Evid Based Complementary Altern Med 2011; 16: 210-217.
  • 38 Ernst E. Homeopathy: what does the “best” evidence tell us?. Med J Aust 2010; 192: 458-460.
  • 39 Zetler I. Homoeopathy. Zetler J., Bonello R. Essentials of Law, Ethics and Professional Issues for CAM. 2012. Sydney: Churchill Livingstone; 231-239 Chap 14.
  • 40 Australian Medical Workforce Advisory Committee. The general practice workforce in Australia: supply and requirements to 2013, AMWAC report 2005.2. Sydney: Australian Medical Workforce Advisory Committee; 2005.
  • 41 Sulfaro F., Fasher B., Burgess M. Homoeopathic vaccination. What does it mean? Immunisation Interest Group of the Royal Alexandra Hospital for Children. Med J Aust 1994; 161: 305-307.
  • 42 Wardle J., Lui C., Adams J. Complementary and alternative medicine in rural communities: current research and future directions. J Rural Health 2012; 28: 101-112.
  • 43 Adams J. Exploring the interface between complementary and alternative medicine (CAM) and rural general practice: a call for research. Health Place 2004; 10: 285-287.
  • 44 Williams A., Kitchen P., Eby J. Alternative health care consultations in Ontario, Canada: a geographic and socio-demographic analysis. BMC Complement Altern Med 2011; 11: 47.
  • 45 Australian Institute of Health and Welfare. Rural health: the RRMA classification. http://www.aihw.gov.au/ruralhealth/remotenessclassifications/rrma.cfm.
  • 46 Wardle J., Adams J., Sibbritt D. Acupuncture in Australian general practice: trends in reimbursed acupuncture services from 1995 to 2011. Acupunct Med 2013; 31: 45-50.
  • 47 Smeaton J. Homeopathy. J Complement Med 2002; 1: 38-41.
  • 48 Andrews G.J., Adams J., Segrott J. Complementary and alternative medicine (CAM): production, consumption, research. Brown T., McLafferty S., Moon G. A Companion to Health and Medical Geography. 2010. Oxford: Wiley-Blackwell; 587-603 Chap 30.
  • 49 Adams J., Sibbritt D., Broom A. et al. A comparison of complementary and alternative medicine users and use across geographical areas: a national survey of 1,427 women. BMC Complement Altern Med 2011; 11: 85.
  • 50 Adams J., Sibbritt D., Lui C. The urban–rural divide in complementary and alternative medicine use: a longitudinal study of 10,638 women. BMC Complement Altern Med 2011; 11: 2.
  • 51 Robinson A., Chesters J. Rural diversity in CAM usage: the relationship between rural diversity and the use of complementary and alternative medicine modalities. Rural Soc 2008; 18: 64-75.