Homeopathy in Russia is still looked upon as a stepdaughter of academic medicine. This can be partly due to the fact that homeopathic methods are not easily standardised and rely on an individual approach to patients and the practitioner's relative freedom in terms of prescribing treatment. This approach apparently defies conventional medicine with its standard protocols and causes conventional medics to discount homeopathy as a 'pseudoscience'.
In turn, homeopaths respond by trying, by one way or another, to fit into the mainstream, and some practice their methods as a supplement to conventional medicine. In an executive summary to his Ph.D. thesis entitled 'Social and Professional Status of Alternative Medicine Practitioners: the Case of Homeopaths', Radik Sadykov examines the situation of practicing homeopaths who would like to offer effective treatment to patients, but do not appear to be fully confident of their methods. As a result, the homeopathic community in Russia remains weak and lacks visibility and representation.
Sadykov's research is based on official statistics, on findings from a survey of conventional medical doctors conducted by the Public Opinion Foundation in 2002, on interviews with 149 homoeopaths during a conference in Moscow in January 2013, and on a survey of 605 medical specialists conducted as part of the RAS Institute of Sociology's project 'Russian Doctors: Attitudes and Adaptation Strategies'.
The early 1990s saw a boom in alternative therapies, including traditional and eastern healing practices, leech therapy, and many others, as the country's newly liberated market offered a wide range of private medical services. Patients' disillusionment with conventional medicine contributed to this boom in alternative therapies; in fact, some doctors shared this disillusionment. According to Sadykov, it was mainly general practitioners, pediatricians, and psychiatrists who switched to alternative medicine. Many chose homeopathy because they felt that their potential was not being fulfilled by conventional medicine.
According to Sadykov, certain alternative practices can coexist peacefully with conventional medicine today. Thus, manual therapy and reflexology have been recognised as legitimate medical specialities covered by public health insurance for certain categories of patients. In contrast, homeopaths, according to Sadykov, "are mainly in private practice and cannot access public funding for research in their field."
Meanwhile, Sadykov notes, there is a growing demand for their services, at least judging by pharmaceutical market data. Market research (IMS) suggests that homeopathic remedies accounted for 3.1% (in monetary terms) of the total retail sales of pharmaceuticals in Russia in 2009. According to the Homeopathic League's estimates, the market for homeopathic drugs increased by 60% between 1995 and 2005.
Despite these apparently optimistic sales trends, it is too early to say that homeopathy has strengthened its position. Back in the 1990s, the Russian government assisted in the development of alternative medicine; homeopathic societies were restored and new associations established, and official documents were adopted to support and regulate homeopathic methods. In the 2000s, however, the government's approach became much more cautious, Sadykov says. He further notes that the government repealed certain regulations, but stopped short of imposing tougher control over homeopathy.
Homeopaths are not a serious force in the medical community, according to Sadykov. He attempted to assess the social resources available to homeopaths by looking at how much they perceive being trusted by patients and respected by various medical specialists. Most respondents (73%) perceived a growing public trust in their methods, but only 35% reported a growing respect from the medical community.
Sadykov also found that the homeopathic community has become fragmented, and their self-regulation is weak.
Never granted the official status of a medical specialisation, homeopathy is not taught in medical schools. Moreover, homeopaths complain that their methods are often perceived as similar to those of healers or occult practitioners.
Sadykov found three major types of attitudes towards homeopathy in the medical community – antagonism, neutral skepticism, and positive acceptance. But even in the latter case, homeopathy is still perceived as secondary. "Whether or not an alternative treatment method can get successfully integrated into the public heath system depends on the extent to which such a method meets the criteria of the dominant biomedical model, i.e. to what extent it can be standardised," Sadykov explains.
He further argues that homeopathy cannot be fully standardised because of its individual approach to each patient. As are result, homeopaths remain outside the mainstream and have to look for other solutions for promoting their social and professional status. One such solution is combining homeopathy with mainstream medical treatments.
According to Sadykov, medical doctors find it fairly easy to practice homeopathy in the workplace: some 70% of the respondents said that nothing prevented them from using homeopathy at the health facility where they were employed or from deciding how many patients they could see in a day.
Most doctors practicing homeopathy (71%) are employed in the private health care sector and benefit from higher than average income (exceeding 40,000 rubles per month), but also run a greater risk of low earnings, while homeopaths employed in public healthcare earn a lower average salary (20,000 to 40,000 rubles), but their risk of earning less is lower. Understandably, some homoeopaths have part-time jobs with two or three health care facilities. Sadykov notes, however, that respondents' average salaries were lower than those earned by medical doctors in general.
Using the findings from the survey 'Russian Doctors: Attitudes and Adaptation Strategies', Sadykov compared homeopaths with other alternative medicine practitioners in how often they take professional development courses and found that 55.6% of homeopaths – as opposed to 23.5% of all alternative medicine practitioners – had attended more than three training courses within the last year.
Professional training in homeopathy is provided as a postgraduate course; therefore, only trained medical doctors can practice homeopathy in Russia. Nearly half (46%) of all doctors practicing alternative medicine are GPs by their basic medical specialization.
Sadykov also examined homeopaths' political influence and found that homeopathic associations provide training and information, but have little political weight and are unlikely to become autonomous leaders of Russia's homeopathic community.
Although 72% of Sadykov's respondents expected professional associations to promote alternative medicine in Russia, just a little more than a third were members of any such association, and even then their membership was often a mere formality, Sadykov concludes.