Most homeopathic practitioners regularly attend homeopathy conferences and study groups. (The Homeopathy Association of Arizona has organized three study groups in the Phoenix area alone!) These usually include presentations of cases, or descriptions of how specific individuals have been helped by homeopathy. Case reports are typically thought to be simply narrative stories that chronicle a case from beginning to end. But how you choose, prepare and present that case can make a significant difference to what others are able to learn from it. Case reports should always be geared to specific audiences, which can vary widely from members of the general public who want to learn more about the process of homeopathic care to students of homeopathy who want to learn more about how to take, analyze and manage a typical case. Although in the end we are all students of homeopathy, this discussion focuses on case presentations aimed for a conference or study group audience comprised mainly of professional homeopaths.
Case studies are actually a type of research method. Of course, homeopaths do not take cases for research purposes; they take them so they can help heal individuals. But similar to case study researchers, homeopaths collect data from a number of different sources, including interview notes or transcripts, direct observation and other objective data such as laboratory test results. Using different information sources to help understand a case in this way is referred to as “triangulation”. Homeopaths also use techniques similar to those employed by researchers to analyze their cases, such as pattern-matching (seeing if an individual’s symptoms fit a remedy pattern), repeated observations (looking for repetitions of this pattern within the case), explanation-building (using timelines to investigate symptom etiology) and testing rival explanations (looking for evidence in the case that might contradict the suspected pattern)[i]. As a result of these and other similarities, there are lessons that can be learned from case study research that can be applied to case reports shared at homeopathic conferences and study groups. So in order to improve the learning from your case, you may want to consider asking yourself the following questions:
- Is my case generalizable?
This question is central since it partly determines which case you choose to share. Generalizability is the key to maximizing what others can learn from your case since it helps them transfer the lessons you learned to their own cases. In order to figure out if your case is generalizable, you are looking for what might be typical in your case, so you might ask yourself: How common is the main health condition in my case? If uncommon, is there a need among homeopaths to learn more about it? How small or large is the population my case falls within? How likely is it that other homeopaths will encounter clients in this group? Did I use resources available to most other homeopaths in working through the case? The answers to these questions provide the context for your case and help others determine how and whether the lessons learned might apply to their cases. Even if your case deals with a rare condition and/or a small sub-population or employs a tool that is unavailable to most homeopaths, it would be helpful to communicate this clearly so that audience members can assess whether your case is generalizable to their practice.
- Does my case add to the body of knowledge about homeopathy?
This question also relates to the case you choose to share. An audience of professional homeopaths is mostly interested in adding to their understanding of the healing process (theory) or improving how we facilitate healing (methods). Here, what you are looking for is what makes the case unique, which on the surface might seem to be the opposite of what might make a case generalizable. The Journal of Medical Case Reports advises that case reports should include a “new association or event” or what is “previously unreported”, “unusual” or “unexpected”. Of course, homeopathic care is clearly different from conventional medical treatment because it is individualized, however, the process of teaching and learning about a case is actually similar. What makes the case unique is not what is unusual or unexpected about the individual who is the center of the case (i.e. their childhood, symptom etiology, etc.), but rather, what is unusual about the case (what it illustrates generally about healing or how to bring about healing).
In order to help figure out how to identify what is unusual or unexpected about your case, here are some questions you could ask yourself: Did I use an approach to case-taking, case analysis or case management that is not yet well established? Did I prescribe a well-known remedy for a symptom or condition not normally associated with it? Or a lesser known remedy within a well-known remedy family? Did my client’s healing follow an unusual path? If the answer to all of these and similar questions about theory (the healing process) and methods (how to bring about healing) is “no”, then your case may still be engaging, but might have limited learning value for your audience. That said, simply thinking about these kinds of questions may help you identify new lessons from your case that you didn’t previously consider and can share with others.
- Has my presentation clearly communicated the main lesson(s) my case illustrates?
You have now chosen your case based on the balance between what is typical about it (generalizability) and what is unusual or unexpected about it (adds to knowledge). It’s now time to plan the presentation. It is at this point that it’s important to distinguish between a story and a case report. Details in homeopathic cases are always critical in the process of providing homeopathic care, so it is tempting to want to share as many of them as possible in case presentations. While the basic story of the case is almost always necessary, story details tend to direct the attention toward the storyteller and his or her personal abilities as a practitioner rather than the lessons others can learn from the case. So rather than fill all the available time elaborating on the particulars of the case, it may be constructive to take some of that time to spell out the reasons for how and why your case is generalizable and how it adds to knowledge. This requires a higher level of analysis over and above telling the story.
- Did I communicate what I did not do in my case and why?
This may seem like a strange question, but describing what you did not do and why you didn’t do it also further helps others learn what is unusual or unexpected about your case. So you could ask yourself the following questions: Did I explain how the outcome of my case might have been different if I had chosen a more typical approach to case-taking (or case analysis, or case management)? Or why my attempt to employ the usual approach did not or would not work? Answering these questions might help sharpen the focus on why your case is significant.
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The ultimate purpose of sharing case reports at conferences and study groups where the audience consists primarily of practicing homeopaths is to communicate what you have learned from a case that has enhanced your practice and helped make you a better homeopath. So perhaps the most important question to ask yourself is: How and why did this case transform my practice? This is what others want to learn from you!
[i] Robert K Yin (1994) Case Study Research: Design and Methods 2nd edition. Thousand Oaks: Sage. This book is actually in its 5th edition (2014).