May

We read the article “Prescribing second-generation antipsychotic medications: Practice guidelines for general prac­titioners” [BCMJ 2012;54:75-82] with great interest and applaud the efforts of Ms Horn and colleagues on their practical and useful guide for prac­titioners concerning a class of medications that are increasingly being prescribed for a wide variety of psych­iatric and behavioral conditions.[1] 

Dr Wong’s comments about homeopathy [Homeopathic medicine (arsenic and aconite) and Health Canada, BCMJ 2012;54:66] in which he quotes himself as a source, contain a number of inaccuracies and misconceptions. The quoted Cardiology 1999 article by Guha and colleagues reports the toxic effects of aconite tincture (italics added), which is not a homeopathic ultradilution.

I am pleased that Dr Malthouse took interest in my letter on homeopathic medicine. The safety of homeopathic medicines should be expected because of their extreme dilutions. In regard to aconite tincture, hom­eopathic tincture is the undiluted form of homeopathic medicine, and is not an ultradilution. 

One of the principles of the practice of homeopathy is that the more diluted the homeopathic pre­paration, the more potent it is. Dr Malthouse may consider the undiluted aconite tincture (which is still a hom­eopathic medicine) being too weak in potency. 

In the summer of 2010 my relative almost died from pseudomembranous colitis when treated with antibiotics for a postoperative pneumonia at a Fraser Health facility. I rationalized that the spread of Clostridium difficile was an accepted antibiotic complication and didn’t really think more about it.

Simulation activities as a form of CME have become an in­creasingly common method for physicians to learn new skills, re­fresh forgotten ones and make the learning experience more lifelike. The old fashioned way of sitting quietly in a semidarkened room, listening to an expert lecturer, can be quite soothing and even soporific, although it may not be that effective in changing phy­sician behavior.  For physicians who have already been to a few of their own medical school reunions, learning experiences and CME using simulation techniques may be unfamiliar.