After 25 years of practice, I find myself increasingly interested in how to follow a patient over time. Is it enough to see a patient once or a few times? How do we fair as a profession in terms of long term follow up? What about treating children into adulthood? With regard to homeopathy in particular, are there any guideposts that let us know our patient is moving in the right direction? Certain philosophical and practical tools can be helpful. This article, through a pediatric case presentation, describes one such tool, the Map of Hierarchy.

One of the things I have most loved about practice is the long arc of treating a baby or small child and watching them develop over time. In many ways this has mirrored my own evolution as a mother, first of little ones and now of three college-aged kids. It should be that with good naturopathic care and homeopathic prescribing, a person reaches their optimal level of health, that somehow their genetic potential has more of a chance of being realized. We all like the overnight miracles, the patient who makes great strides in a few short months either from a brilliant prescription or more commonly from a joint effort of doctor and patient and the healing power of nature. But with children, things can be both easier and more difficult. Lifestyle changes may or may not be relevant, compliance may or may not be forthcoming and in the case of autistic patients, some of the challenges seem insurmountable. In this patient narrative, I focus on the use of the Map of Hierarchy, as opposed to case analysis or the elucidation of  materia medica, as it has wide application for pediatric cases but also is relevant for all patients.