The Use of Intuition in Homeopathic Clinical Decision Making: An Interpretative Phenomenological Study

Sarah Brien,Bridget Dibb,Alex Burch

doi:10.1093/ecam/nep153

Abstract

While intuition plays a role in clinical decision making within conventional medicine, little is understood about its use in complementary and alternative medicine (CAM). The aim of this qualitative study was to investigate intuition from the perspective of homeopathic practitioners; its' manifestation, how it was recognized, its origins and when it was used within daily clinical practice. Semi-structured interviews were carried out with clinically experienced non-National Health Service (NHS) UK homeopathic practitioners. Interpretative phenomenological analysis was used to analyze the data. Homeopaths reported many similarities with conventional medical practitioner regarding the nature, perceived origin and manifestation of their intuitions in clinical practice. Intuition was used in two key aspects of the consultation: (i) to enhance the practitioner-patient relationship, these were generally trusted; and (ii) intuitions relating to the prescribing decision. Homeopaths were cautious about these latter intuitions, testing any intuitive thoughts through deductive reasoning before accepting them. Their reluctance is not surprising given the consequences for patient care, but we propose this also reflects homeopaths' sensitivity to the academic and medical mistrust of both homeopathy and intuition. This study is the first to explore the use of intuition in decision making in any form of complementary medicine. The similarities with conventional practitioners may provide confidence in validating intuition as a legitimate part of the decision making process for these specific practitioners. Further work is needed to elucidate if these findings reflect intuitive use in clinical practice of other CAM practitioners in both private and NHS (i.e., time limited) settings.

Highlights

The use of evidence-based knowledge in clinical decision making has been widely explored but the role of intuition has emerged as important [1,2,3,4,5,6,7]
Using intuition as a “clinical tool” [8] in decision making has to date, been explored mainly in nursing populations [1, 4], and in occupational medicine and general practitioner consultations [8, 9]
There are some salient features common to many definitions, including, a characterization of its speed [1, 16, 17] and the difficulty individuals have in explaining how they came to an intuitive decision [18]

Summary

Introduction

The use of evidence-based knowledge in clinical decision making has been widely explored but the role of intuition has emerged as important [1,2,3,4,5,6,7]. There are some salient features common to many definitions, including, a characterization of its speed [1, 16, 17] and the difficulty individuals have in explaining how they came to an intuitive decision [18]. It has been described as a multidimensional concept synonymous with insight and instinct, an understanding based on background knowledge, a skill developed through previous experiential knowledge, as well as a connection between patients and practitioners [3, 12]

Methods

Results

Conclusion