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Here we go again: A bill licensing naturopaths rears its ugly head in Michigan

If I’ve pointed it out once, I’ve pointed it out a thousand times. Naturopathy is a cornucopia of almost every quackery you can think of. Be it homeopathy, traditional Chinese medicine, Ayurvedic medicine, applied kinesiology, anthroposophical medicine, reflexology, craniosacral therapy, Bowen Technique, and pretty much any other form of unscientific or prescientific medicine that you can imagine, it’s hard to think of a single form of pseudoscientific medicine and quackery that naturopathy doesn’t embrace or at least tolerate. Indeed, as I’ve retorted before to apologists for naturopathy who claim that it is scientific, naturopathy can never be scientific as long as you can’t have naturopathy without homeopathy and naturopaths embrace homeopathy. Unfortunately, naturopaths have over the years been having some success in persuading state legislatures to license naturopaths, in some cases even giving them the privilege of being considered primary care practitioners. It’s part of an organized effort, too, and I don’t expect that effort to let up. True, the governor of Massachusetts did veto a naturopathic licensing bill that came across his desk recently, but no one following this issue expects the naturopaths to let up. As Jann Bellamy put it, the naturopaths will be back. They always are.

Indeed, in the wake of the failure to pass a naturopathic licensing bill in Massachusetts, Michael Cronin, the president of the American Association of Naturopathic Physicians (AANP) lamented:

This brings up many thoughts and emotions for me. I feel disappointment over a legislative process that seems slow and unfair. And there is anger at a process that placates the desires of the Massachusetts Medical Society over serving the health needs of the public and the desire of the Commonwealth.

But he also brags:

There are currently licensing laws in 16 states (up from 5 in 1978), the District of Columbia, the United States territories of Puerto Rico and the U.S. Virgin Islands, and 5 Canadian provinces. We have 7 healthy, accredited North American colleges and there are now 43 state associations.

And urges his fellow naturopaths:

I send the highest kudos to our ND brothers and sisters in Massachusetts. May you heal your wounds and come out fighting.

In the meantime, unfortunately, they seem to be coming out fighting in my home state of Michigan. I just learned from Jann Bellamy over the weekend that a naturopathic licensing bill has been introduced for consideration by the Michigan legislature. I’m referring to Michigan House Bill 4152 (2013), which is now in the House Committee on Health Policy. Apparently it was introduced on January 31 by Representative Lisa Posthumus Lyons, who is the Assistant Floor Majority Leader and represents District 86, which encompasses a rural area the Lower Peninsula east of Grand Rapids. I couldn’t find anything about her bill on her House website, but I did find a Facebook post by her congratulating Kelly Hassberger for opening her new Naturopathic Health Clinic in Grand Rapids. One notes that this particular news story notes that Hassberger focuses on “homeopathic medicine,” which shows just how far Lyon’s acceptance and even promotion of quackery goes.

There is, however, a rather interesting bit of information in this story:

While naturopathic doctors are licensed practitioners in the state of Arizona, they are not in Michigan.

Hassberger is working with The Michigan Association of Naturopathic Physicians and state legislators to get practitioners who graduated from accredited doctorate programs in naturopathic medicine to practice as primary care physicians in the state.

State Reps. Lisa Posthumus, Ellen Lipton and Joseph Haveman introduced House Bill 5594 to the House in May 2012.

The proposed bill outlines what would be required to be a licensed naturopathic physician in Michigan, including defining what an accredited naturopathic medical program entails, creating a naturopathic medical medical board, as well as defining the scope of practice for naturopathic physicians in Michigan.

“It would give us back the ability to use the skills we are trained in, including IV therapy among others, as well as give us the right to accept insurance, run lab testing, diagnose and prescribe prescription drugs when needed,” Hassberger said. “I want to give the public an understanding of the differences between my training and other programs in Michigan. My goal is to be here and develop awareness and help to get that bill through.”

So this is not the first bite at the apple that Lyons has taken. Notice how Hassberger refers to “IV therapy.” Naturopaths shouldn’t be let anywhere near an intravenous line, much less IV therapy, because in the hands of naturopaths IV therapy usually means quackery like high dose intravenous vitamin C or chelation therapy.

Sadly, this is a bipartisan effort, with Lyons being the Republican half of the not-so-dynamic duo of legislators, and Ellen Cogen Lipton being the Democratic half, representing the Michigan 27th House district, which represents Detroit suburbs such as Ferndale, Royal Oak Township, Oak Park, Huntington Woods, and Hazel Park. I know some of these towns. For instance, Ferndale is known as one of the “hipper” cities in the Detroit metropolitan area; it’s not surprising to me that a Representative whose district encompasses Ferndale would be sympathetic to naturopathy to the point of being willing to make repeated attempts to pass a bill that would license naturopaths.

Let’s take a look at MI HB 4152.

The bill defines “naturopathy” and “naturopathic physicians” thusly:

(3) “NATUROPATHIC MEDICINE” MEANS A SYSTEM OF PRACTICE THAT IS BASED ON THE NATURAL HEALING CAPACITY OF INDIVIDUALS FOR THE DIAGNOSIS, TREATMENT, AND PREVENTION OF DISEASES

(4) “NATUROPATHIC PHYSICIAN” MEANS AN INDIVIDUAL WHO ENGAGES IN THE PRACTICE OF NATUROPATHIC MEDICINE AND WHO IS REQUIRED TO BE LICENSED OR OTHERWISE AUTHORIZED UNDER THIS PART TO ENGAGE IN THAT PRACTICE.

The wag in me can’t help but point out how stupid this definition is. Let me just put it this way. Science-based medicine relies on the natural healing capacity of individuals for the diagnosis, treatment, and prevention of diseases. Think about it. Setting broken bones would be useless if the body weren’t able to heal itself naturally. Surgery itself relies on the ability of the body to heal itself; otherwise cutting into the body to rearrange its anatomy for therapeutic intent would be the gravest of folly. The very definition of naturopathy is a false dichotomy between conventional medicine and “natural healing.”

So what does this law authorize “naturopathic physicians” to do? The list is disturbing:

(A) ORDER AND PERFORM PHYSICAL AND LABORATORY EXAMINATIONS FOR DIAGNOSTIC
PURPOSES, INCLUDING, BUT NOT LIMITED TO, PHLEBOTOMY, CLINICAL LABORATORY TESTS,
ORIFICIAL EXAMINATIONS, OR PHYSIOLOGICAL FUNCTION TESTS.
(B) ORDER DIAGNOSTIC IMAGING STUDIES.
(C) DISPENSE, ADMINISTER, ORDER, OR PRESCRIBE OR PERFORM ANY OF THE FOLLOWING:

(I) FOOD, EXTRACTS OF FOOD, NUTRACEUTICALS, VITAMINS, AMINO ACIDS, MINERALS,
ENZYMES, BOTANICALS AND THEIR EXTRACTS, BOTANICAL MEDICINES, HOMEOPATHIC
MEDICINES, ALL DIETARY SUPPLEMENTS, OR NONPRESCRIPTION DRUGS AS DEFINED BY THE
FEDERAL FOOD, DRUG, AND COSMETIC ACT, 21 USC 301 TO 399D.
(II) PRESCRIPTION OR NONPRESCRIPTION MEDICINES AS DESIGNATED BY THE
NATUROPATHIC FORMULARY COUNCIL.
(III) HOT OR COLD HYDROTHERAPY; NATUROPATHIC PHYSICAL MEDICINE;
ELECTROMAGNETIC ENERGY; OR THERAPEUTIC EXERCISE.
(IV) DEVICES, INCLUDING, BUT NOT LIMITED TO, THERAPEUTIC DEVICES, BARRIER
CONTRACEPTION, OR DURABLE MEDICAL EQUIPMENT.
(V) HEALTH EDUCATION OR HEALTH COUNSELING.
(VI) REPAIR AND CARE INCIDENTAL TO SUPERFICIAL LACERATIONS OR ABRASIONS.
(VII) MUSCULOSKELETAL MANIPULATION.
(D) UTILIZE ROUTES OF ADMINISTRATION THAT INCLUDE, BUT ARE NOT LIMITED TO, ORAL,
NASAL, AURICULAR, OCULAR, RECTAL, VAGINAL, TRANSDERMAL, INTRADERMAL,
SUBCUTANEOUS, INTRAVENOUS, OR INTRAMUSCULAR CONSISTENT WITH HIS OR HER
NATUROPATHIC EDUCATION AND TRAINING.
(E) OTHER NATUROPATHIC THERAPIES AS APPROVED BY THE BOARD.

I suppose I should be relieved that the law would not allow naturopaths (I refuse to use the term “naturopathic physician”) to prescribe controlled substances. administer ionizing radioactive substances, perform chiropractic adjustments, do acupuncture, or perform very minor surgical procedures, or to do anything encompassed in the scope of practice of physicians.

Not surprisingly, the Michigan Association of Naturopathic Physicians is very much behind this effort. Hilariously, the MANP frames their effort as being driven by a concern protecting patients, arguing that “Without licensure, it is difficult for health consumers to discern between natural health consultants and naturopathic doctors. State licensure is the only way to protect the public by providing regulation to verify the credentials of their naturopathic physicians.” Never mind that those credentials are fairy dust, what Harriet Hall so aptly described as “tooth fairy science.” Seriously, on its blog, the MANP is referencing articles on Mike Adams’ NaturalNews.com, which is about as good a sign that it is not science-based as I can think of. Be that as it may, the MANP also argues that if the Michigan legislature doesn’t pass a naturopathic licensing law, then Michigan residents seeking “natural healing” will go across state lines to get it.

Funny, they say that as if it were a bad thing.

It would appear that there’s a situation here that is in desperate need of monitoring and action in my state, and I plan on doing just that. Here’s hoping that in 2013 the fate of this bill is the same as it was in 2012: Oblivion.

Posted in: Naturopathy, Politics and Regulation

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57 thoughts on “Here we go again: A bill licensing naturopaths rears its ugly head in Michigan

  1. Janet says:

    Moan. Groan. Sigh.

    I applaud your refusal to use the term “naturopathic physician”. Limiting the use of “doctor” and “physician” would be a good first step for medical doctors to take to put the brakes on this scurrilous practice of sCAM. Is there any professional group that might be interested?

    It has always bothered me when PhD’s use “doctor” to imply that they are (or should have the same status as) physicians. I have a friend (biologist) who does this to try to get more attention from service personnel. I told him off about it and he says he stopped doing it. If only quacks were so easily reprimanded!

    I don’t even like psychologists using the term “Dr.” because it confuses them with psychiatrists–who DID go to medical school, after all. It should be J. Q. Doe, PhD–not, Dr. Doe. There’s just a huge difference between having a doctorate in philosophy and medical school–both require years of study, but they do not equal the same training. There are enough quacks who have MD after their names already without adding the PhD’s to the mess.

  2. cervantes says:

    Excuse me Janet, but I think you have that backwards. PhD stands for “Doctor of Philosophy.” Ergo, we are doctors. What is wrong is conflating the term “doctor” with “physician.” I don’t personally care what people call me, as long as it’s nice, but there is no reason why medical doctors should somehow be thought of as superior to people with other kinds of doctorates. That seems quite offensive. In fact I know far more about certain important subjects in medicine than most doctors, who do not, for example, understand Bayes’ theorem and think that 90% specificity means that if you test positive, you have a 90% chance of having the condition.

    That said, the N.D. degree is not a legitimate doctoral degree. An academic degree should require training in the rules of evidence, critical thinking, and content appropriate to a field of study. N.D.s don’t know anything, and don’t know how to do anything useful.

  3. WilliamLawrenceUtridge says:

    a naturopathic medical medical board, as well as defining the scope of practice for naturopathic physicians in Michigan

    I almost want these bodies to come into existence. Could you imagine the internecine battles between naturopaths?

    Naturopath 1: “Your patient died because of your failure to use of eye of newt!”

    Naturopath 2: “Nuh-uh, their patient clearly died by their failing to needle the 6th ah-shi point when Mars was in ascension!”

    Naturopath 3: “How can you be so blind to the effects of CIA N-Rays on this case? A double-layer of aluminum foil is the standard of care when Big Pharma is projecting bad thoughts on the populace in an effort to sicken and dis-ease them so their ineffective allopathic poisons can be applied?!?!?!”

    Sadly this requires a coda:

    Patient: [dead of metastatic cancer]

    I suppose I should be relieved that the law would not allow naturopaths (I refuse to use the term “naturopathic physician”) to prescribe controlled substances. administer ionizing radioactive substances, perform chiropractic adjustments, do acupuncture, or perform very minor surgical procedures, or to do anything encompassed in the scope of practice of physicians.

    Am I missing something? Because it seems like at least some of these are included in their scope of practice:

    - prescribe controlled substances: PRESCRIPTION OR NONPRESCRIPTION MEDICINES AS DESIGNATED BY THE NATUROPATHIC FORMULARY COUNCIL

    - administer ionizing radioactive substances: (B) ORDER DIAGNOSTIC IMAGING STUDIES [and] (C) DISPENSE, ADMINISTER, ORDER, OR PRESCRIBE…(III) ELECTROMAGNETIC ENERGY

    - perform chiropractic adjustments: (VII) MUSCULOSKELETAL MANIPULATION

    - do acupuncture: (D) UTILIZE ROUTES OF ADMINISTRATION THAT INCLUDE, BUT ARE NOT LIMITED TO…TRANSDERMAL, INTRADERMAL, SUBCUTANEOUS, INTRAVENOUS, OR INTRAMUSCULAR

    - perform very minor surgical procedures: (C) PERFORM…(VI) REPAIR AND CARE INCIDENTAL TO SUPERFICIAL LACERATIONS OR ABRASIONS

    It looks like they can do a host of rather terrifying things, made worse by:

    (E) OTHER NATUROPATHIC THERAPIES AS APPROVED BY THE BOARD

    …which is basically “anything we damned well please”.

  4. Quill says:

    That said, the N.D. degree is not a legitimate doctoral degree. An academic degree should require training in the rules of evidence, critical thinking, and content appropriate to a field of study. N.D.s don’t know anything, and don’t know how to do anything useful.

    Aye, there’s the rub, which I think this article clearly demonstrates is a looming problem in Michigan. Doctoral programs are supposed to be rigorous and exactly as cervantes outlines. One of the basic problems with the N.D. degree is that it really doesn’t rise above the level of an associate’s degree, and that may be insulting to anyone with an actual associate’s degree! Offhand I can’t think of any credential more useless than an N.D., except perhaps for those places you can send in $15 and become a licensed minister.

  5. Neil J says:

    @Janet @cervantes

    cervantes:

    Excuse me Janet, but I think you have that backwards. PhD stands for “Doctor of Philosophy.” Ergo, we are doctors. What is wrong is conflating the term “doctor” with “physician.”

    Agreed. I working on getting a PhD and I’ll be damned if anyone tries to take the title of “Doctor” away from me. I’ve already claimed the email alias “dr.j” for my institutional email account, and I’d rather not be made a liar.

    Although, since I’m getting a PhD in Physics, maybe I can legitimately call myself a Physician?

  6. WilliamLawrenceUtridge says:

    Offhand I can’t think of any credential more useless than an N.D., except perhaps for those places you can send in $15 and become a licensed minister.

    Licensed ministers can marry people, which is a valuable contribution to soceity – making it far more useful than an N.D.

  7. Quill says:

    ^ Good point. So the N.D. is in fact the most useless credential. :-)

  8. WilliamLawrenceUtridge says:

    Particularly since it subsumes within itself so many other useless credentials :)

  9. David Gorski says:

    But what about L.Ac.? Now there’s a useless credential! Or even worse: D.Hom.?

  10. tanha says:

    Why do you think the US Department of Education accredited some ND Doctorate programs?

    Neil J, “I working on getting a PhD and I’ll be damned if anyone tries to take the title of “Doctor” away from me.” Why will graduating from your PhD program make you feel entitled to be a “Doctor”? Who says you are worthy of that title?

  11. Narad says:

    Excuse me Janet, but I think you have that backwards. PhD stands for “Doctor of Philosophy.” Ergo, we are doctors.

    This is a matter of etiquette. At my previous gig, references to others in print allowed “Dr.” only for M.D.’s. Ph.D’s were “Professor” or nothing.

  12. NYUDDS says:

    Re: Massachusetts:

    “This brings up many thoughts and emotions for me. I feel disappointment over a legislative process that seems slow and unfair. And there is anger at a process that placates the desires of the Massachusetts Medical Society over serving the health needs of the public and the desire of the Commonwealth.”

    This actually was a much closer call, as I posted in more detail previously. The bill to register, license and regulate naturopaths PASSED the House and Senate and went to the Governor’s desk for signing. It was only the pocket veto of Governor Deval Patrick, who has invested heavily in Massachusetts’ involvement with Life Sciences and Biotechnology, that stopped the process in its tracks. IMHO, the constant and consistent reasonable, scientific opposition of the Massachusetts Medical Society, committed to paper as a submitted unified opinion, affected the Governor’s opinion to let the bill die on his desk.

  13. daijiyobu says:

    [I'd posted a version of this comment at Respectful Insolence, too].

    Re: the post’s “naturopathy can never be scientific as long as you can’t have naturopathy without homeopathy and homeopaths embrace homeopathy”. I think Orac you meant “and naturopaths embrace homeopathy.” I like to say that homeopathy is fused with naturopathy [any who...].

    Here’s deep proof of that fusion from a rare book:

    I recently bought and scanned Wendell’s 1951 “Standardized Naturopathy” [so old there's no ISBN; no preview available at books.google.com] and page 17 states regarding naturopathy’s ORIGINS:

    “in 1900, Benedict Lust [pronounced Loost] purchased the name naturopathy, first coined by Dr. John H. Scheel in 1895, a German homeopath [!!!...in] 1901 a Kneipp convention was called for the purpose of enlarging the Kneipp treatment [...] it decided to appoint a committee with Benedict Lust as chairman [...] the committee decided that all methods of drugless healing should be practiced [...including the] metaphysical [...] mesmeric [...] homeopathy [...] spiritual: occult therapy, divine healing [...] naturo-therapy [...including] naturopathy [...] at the meeting it was decided to change the name from the Kneipp Water Treatment to a new name [hmmmm, how about this one I just bought that I have lying around? Be a shame to waste it!].”

    And therefore “naturopathy”, the cornucopia. Except, of course, these days they want script rights, too. Just like ‘allopathy’ the term ‘naturopathy’ originated with a homeopath. Hahnemann, Schee — respectively.

    Absurdly, in the foreword, Wendell, who has the credentials M.D. D.O. D.C. N.D. [the quadruple threat!] tells us “naturopathy is defined as a scientific system.”

    Re: “it would appear that there’s a situation here that is in desperate need of monitoring and action.”

    It’s a shame there isn’t someone / an entity nationally doing for science based medicine something similar to what Eugenie Scott and the NCSE are doing to defend standards as boots on the ground at these hearings and such.

    Physical presences are, not to pun, vital.

    Hell, if I could get funding, even I’d try to do it [currently between jobs ;)].

    -r.c.

  14. HDCase says:

    @Narad

    “Doctor” as a term for the highly-educated academic far predates its use as a synonym for physician. To claim that referring to a Ph.D or Sc.D. as “Doctor” is just “a matter of etiquette” is rather off-the-mark, historically speaking.

    @tanha

    Because that’s what a “Doctor” *is*. Obtaining a legitimate doctorate degree entitles the recipient to the title “Doctor”.

  15. Quill says:

    L.Ac. is definitely useless but perhaps not as offensively useless as N.D. as it is only claiming some kind of licensure and not doctoral study.

    However, the D.Hom -could- be considered as useless but its pure comic potential is greater than the N.D. Therefore it may be of great use to skeptics and stand-up comedians. :-) N.D.’s can at least claim a range of silly knowledge while the Dee-hommies pile it all up in one kind of silliness.

  16. egstra says:

    “Agreed. I working on getting a PhD and I’ll be damned if anyone tries to take the title of “Doctor” away from me. I’ve already claimed the email alias “dr.j” for my institutional email account, and I’d rather not be made a liar.”

    My PhD is in clinical psychology… I introduce myself as “Dr.” only in professional contexts, and only when my actual degree/title is important. Otherwise, it’s first and last name. As for socially… Ms. works fine.

  17. Jann Bellamy says:

    @tanha:

    “Why do you think the US Department of Education accredited some ND Doctorate programs?”

    The Department of Education looks only at administrative issues like financial soundness and record keeping. It does not care about course content. I discussed this process in “Dept. of Education to Council on Chiropractic Education: Straighten Up!” http://www.sciencebasedmedicine.org/index.php/dept-of-education-to-council-on-chiropractic-education-straighten-up/

  18. Linda Rosa says:

    Please consider emailing Michigan legislators, urging them to kill HB-4152. The bill has been assigned to the House Health Policy Committee (with no date set yet for the hearing).

    The committee members:

    GailHaines@house.mi.gov, MikeCallton@house.mi.gov, HughCrawford@house.mi.gov, BobGenetski@house.mi.gov, MikeShirkey@house.mi.gov, FrankFoster@house.mi.gov, ThomasHooker@house.mi.gov, KenYonker@house.mi.gov, dalewzorn@house.mi.gov, JosephGraves@house.mi.gov, KlintKesto@house.mi.gov, georgetdarany@house.mi.gov, davidknezek@house.mi.gov, jimananich@house.mi.gov, katesegal@house.mi.gov, thomasstallworth@house.mi.gov, winniebrinks@house.mi.gov

    Alas, there are seven other such bills in other states.

  19. Linda Rosa says:

    “Why do you think the US Department of Education accredited some ND Doctorate programs?”

    As an emphasis to what Jann Bellamy has written about the DOE having no interest in content, it is said that the DOE accredits an astrology school.

  20. HDCase says:

    @egstra

    Ah, but it would appear that at least a few of the other comment authors here would seek to deny you even that – to them, you are obviously not “entitled” to call yourself “Doctor” in *any* context because you are not an MD.

  21. Chris says:

    The legislators should just make it a requirement that anyone who whats to be a primary care provider that they pass the medical licensing exam. Though I doubt they will do that, just as I doubt any naturopath could pass it.

  22. Narad says:

    Ah, but it would appear that at least a few of the other comment authors here would seek to deny you even that – to them, you are obviously not “entitled” to call yourself “Doctor” in *any* context because you are not an MD.

    If you’re including me in that, you’ve misconstrued the observation.

  23. WilliamLawrenceUtridge says:

    But what about L.Ac.? Now there’s a useless credential! Or even worse: D.Hom.?

    I still say N. D. wins, since they are generally simultaneously-practicing acupuncturists, homeopaths and herbalists. In fact, I have heard of N.D.s who inject homeopathically-prepared herbs into acupuncture points.

    Naturopaths – winning at losing.

  24. nobeardpete says:

    Janet, I’m afraid you told your friend off erroneously. If you are as much of a pedant as you sound, you really ought to go, apologize to him, and explain where you went wrong.

    “Doctor” means the holder of an advanced academic degree, and has meant this since University as we know it first arose in Europe over a thousand years ago. It’s etymological roots are in the Latin word for “to teach”, indicating that the word truly originates in an educational, academic context, and not a practicing, professional one. Medical practitioners, on the other hand, have, and have long had, words to describe themselves, such as “physician” and “surgeon”. Until quite recently, the majority of physicians and surgeons were hacks who did far more harm than good, and therefor suffered from a deservedly low worth in the court of public opinion. They have thus endeavored, over the centuries, to appropriate the titles and accoutrements of other professions, such as academics and scientists. Thus their taking on the title of “doctor”, even before such time as it was common for physicians to actually hold a post-graduate degree. Thus the white lab coat, long in use among chemists, being coopted by physicians.

    Physicians have done a tremendous amount to right their own ship, have abandoned many of their formerly harmful practices such as bloodletting, and have greatly improved the value of their services to their patients. They have consequently enjoyed a great improvement in their reputational stock, and are now highly esteemed by much larger fractions of the general public. Historically ignorant physicians will thus sometime bristle at the thought that academics who study other arts, sciences, or engineering fields use the title “doctor”, or that scientists wear white laboratory coats, and will advocate that only physicians should be allowed to do so. This is an indefensible idea, rooted in hubris, willful blindness to the facts, and solipsistic lack of perspective. This is a scenario analogous to that of a group of unwelcome, uninvited houseguests, who have brought discomfort and annoyance to their long-suffering hosts, declaring that, now that they have become potty-trained and have a stable job, they would like for the homeowners to depart. Were physicians to somehow succeed in such a motion, it would be a tremendous injustice.

    English has a word for a phycian. That word is “physician”. English has a word for the holder of an advanced academic degree. That word is “doctor”. I don’t see how you can possibly advocate that both of these words should belong to physicians, and nothing left for the doctors.

  25. HDCase says:

    @Narad
    No, not you. Just Janet and tanha, who seem to believe that PhD’s should not be allowed to use the word “Doctor” in any context. I was specifically quoting tanha with the word “entitled”, after all.

    It is funny to hear someone think that a PhD has some kind of illegitimate sense of “entitlement” to the term “Doctor”, since one of the meanings of “entitled” is, in fact, “bestowed with a title”. A PhD is bestowed with the title “Doctor”; hence, by definition, they are entitled.

  26. Narad says:

    A PhD is bestowed with the title “Doctor”; hence, by definition, they are entitled.

    So are lawyers, although the introduction of the J.D. has a history rooted in the fact that at one point not too long ago, an undergraduate degree wasn’t needed for law school.

  27. Narad says:

    It’s etymological roots are in the Latin word for “to teach”, indicating that the word truly originates in an educational, academic context, and not a practicing, professional one.

    Are you familiar with the etymological fallacy?

  28. nobeardpete says:

    @Narad, what’s your point?

    The word “doctor” now means, and has meant for something like a thousand years, one holding a doctoral degree. The etymology helps to demonstrate the antiquity of this usage. That the word “doctor” is still widely used in this sense is also clear – walk into any department office of any university in the US, and ask where Dr. Smith’s office is, and I can guarantee they won’t bat an eyelash at your use of that title.

    The etymology of the word is a supporting point of half of my argument, not my whole argument.

    There are a great many doctoral degrees one can earn at this point, some serious, some frivolous. People have doctoral degrees in stuff like Spider Man comic books. One might argue it’s a field of literature to study not unlike any other. Likewise, I don’t doubt that the study of Naturopathy could constitute a reasonable basis for a doctoral degree. NDs, however, are in a position not unlike that of a man with a PhD in the literature of Spider Man, but who does not realize that Spider Man is a fictional character. The problem with them isn’t that they call themselves doctors, but that they can’t distinguish between fantasy and reality.

    When they use the term “physican”, I’d consider that to be a problem, as it implies their ability to render services to people which they can not, in fact, render. To call themselves “physicians” is rather fraudulent.

  29. Davdoodles says:

    The merits of the argument aside, there is a common confusion between what academia terms a “doctor” and what lay people consider a “doctor” (an MD).

    And certainly, I’ve not come across anyone who mis-uses the title to claim that they are something they are not.

    But, it’s hard to avoid the conclusion that the use by non-MDs of the term “Doctor” does sow some level of confusion with regular folk, and opens the door a little wider for any naturopath scumbag with every intention of deliberately exploiting that confusion.
    .

  30. Narad says:

    @Narad, what’s your point?

    The word “doctor” now means, and has meant for something like a thousand years, one holding a doctoral degree.

    I have three points. One, which does not directly relate to your comment but may as well be set out, is that the appearance of the word “doctor” in a degree is a nonsensical approach to deciding whether to use the title. The second, which is direct, is that if one strips out the etymological fallacy from your previous comment, what is left is the naked assertion that “‘Doctor’ means the holder of an advanced academic degree” and some seeming suggestion that M.D.’s should be addressed as “Physician So-and-So.” This is worse pedantry than what you complained about.

    The third is just what I said at the outset, which is that the use is a matter of etiquette and, as such, is a purely social construction that varies based upon context. You can call yourself anything you like, but I will contend that the only people who can realistically insist upon being addressed as “doctor” are physicians in the context of patients and staff. On the other hand, in the gig I referred to, in correspondence nearly everybody was “doctor,” even in return correspondence to the editors if half-competent. Nobody much thought it a matter to be concerned about, and figuring out whether an author was really “Mr.” or “Ms.” came off as frankly obnoxious. I daresay the same likely goes in reverse for a non-tenure-track type wandering the halls and getting huffy when not addressed by the preferred title. However, on the tenure track, one at least gets to be “professor.”

  31. mousethatroared says:

    Oh – That can’t be true. The Michigan Legislature has been so sensible lately.

  32. Narad says:

    (As a postcript, I will note that it took me about a decade between the time that my vet suggested that I call him by his first name and when I started to feel comfortable with it, mainly because being reciprocally addressed as “mister” makes me squirm.)

  33. tanha says:

    So the nurses that are now getting PhDs should also be called “Doctor”? I don’t understand why someone who has spent X many years getting a PhD in Math should be called “Doctor” but someone who studied the same number of years getting a Doctorate in [naturopathy] should not be called “Doctor”. Who gets to decide which non-physician doctors should be called doctors?

    nobearpete: the Washington State Department of Health defines them as naturopathic PHYSICIANS, so they can call themselves that without committing FRAUD. I’m sorry that you want it to be fraud but you don’t get to decide that unless you are the DOH.

  34. Neil J says:

    Uh oh. I think my previous comment was taken more seriously than I had intended.

    Oh well. Here’s my take on this. When I get my PhD in Physics, will I be a doctor? Well, yes and no.

    When asked if I’m a doctor, the answer will almost always be “no”. In the general sense, “doctor” is the casual, popular vocational title for a physician.

    The rare instances where I’d be allowed to say “yes” are when I’m asked the same question by people who are familiar enough with my academic background to know I’m not a physician, and in those cases they’re much more likely to ask if I have a PhD anyways.

    Traditionally, along with the PhD comes the privilege to toss “Dr.” in front of your name on academic papers, business cards, presentations, etc., as well as the privilege of being called “Dr. _____” by colleagues and students. In cases where my non-medical background isn’t obvious, I’d be more than happy to supplement that with a PhD at the end, but apparently someone a long time ago decided that was tacky and unbecoming.

    But I think that we could agree to share the “Dr.” prefix. You can be Dr. ______, MD and we’ll be Dr. ______, PhD. The NDs can take Fr. or Rev., since what they do is closer to religion anyways.

  35. tanha says:

    So NDs should be called Rev because what they do is closer to religion but you should be called doctor because what you do is closer to…doctoring? medicine? physics sounds like physician?

  36. FulfilledDeer says:

    @Neil J – You make the sensible point. Yes, PhD is Dr. but there’s the colloquial use referring specifically to a physician. If anybody doesn’t agree, just as the next kid who says they want to be a doctor what field they want to be in. PhD’s get a single count for using “Dr” but MD’s get 2 counts – technical and common – for “Dr”. So it’s context specific.

    On that point, and to perhaps elaborate some deeper currents that flow here, MD’s can be bit more sensitive about the topic than you may expect because of the increasing frequency of midlevel providers – nurses usually – who are encroaching on the “Dr.” title the same way some people here are arguing. They now have a doctorate degree, which according to some allows them to introduce themselves as “Dr.”. Which is at the very least confusing, and potentially harmful. But more than that, it’s another symptom of midlevels attempting to take on the role of MD’s – something that isn’t always welcome.

    Actually, I’m curious if that’s ever been addressed here, but there are certainly analogies to the CAM/ND licensing topic. A lot of the studies pushed out by the nursing programs to support that initiative are just bad science. Not that I’m in any way equating nurses with quacks. There are just resonances.

  37. Neil J says:

    Oh boy, do you ever have a wonderful sense of humour.

    FYI, both medical professionals and high-level University graduates have been using the title for about the same amount of time. We aren’t trying to co-opt the term, it was shared to begin with. Before that, Doctor was actually a religious title. Maybe we should both give it back to the clergy? (source: http://www.etymonline.com/index.php?term=doctor)

    What I do is Physics. When I graduate, if someone asks me what I do, I will say “Physics” or “I’m a physicist”. If someone asks me what degree I have, I will say “a PhD”. If someone asks me what my title is, I will say “Neil J, PhD” or “Dr. Neil J”. If I teach at a University and a student calls me “Dr. J” I will respond. If they call me “Mr. J” or “Prof. J”, I will respond. If someone starts choking at a restaurant and their spouse shouts for a doctor, I’ll think about physics stuff and enjoy my steak while my girlfriend saves their life.

    It’s not clear from your response. Do you have an issue with anyone outside of a medical doctoral program taking the title “Doctor” (which is very different from the same people calling themselves a doctor in the general sense, mind you), or are you defending NDs who call themselves doctors?

  38. tanha says:

    Should it matter? Let’s say that I don’t believe NDs are physicians. If you (as a PhD) should be called Dr., then the nurse with a PhD should be called Dr., and the naturopath with a doctorate should also be called Dr.
    Like I said before, who gets to decide what non-physician doctors should be called doctors?

  39. Neil J says:

    @FulfilledDeer

    That’s why I’d argue for the double title, Dr. _____, MD/PhD/whatever have you. Nurses and physicists alike could identify themselves as “Dr.” in a formal setting, while still making their true credentials clear.

  40. Narad says:

    But I think that we could agree to share the “Dr.” prefix. You can be Dr. ______, MD and we’ll be Dr. ______, PhD.

    That’s hopelessly redundant.

  41. Neil J says:

    @tanha

    They should all be called Dr. ______, formally. Though I actually prefer Dr. ______, MD/ND/PhD for better specificity. However, only the MDs should be called doctor in the informal sense (“Why yes, I’m a doctor”, “I went to my doctor” or “Doctor, doctor! I have a nickel stuck in my nose”).

    The difference is entirely context-driven.

  42. tanha says:

    Neil J, ok. I understand that.

  43. Neil J says:

    @Narad

    The way I see it, the first title pronounces a postgraduate degree, and the second communicates the specifics of that degree. I prefer a little redundancy to a lot of confusion, like a nurse whose hospital ID says “Dr. _____”.

  44. niftyblogger says:

    “It has always bothered me when PhD’s use “doctor” to imply that they are (or should have the same status as) physicians. I have a friend (biologist) who does this to try to get more attention from service personnel. I told him off about it and he says he stopped doing it. If only quacks were so easily reprimanded!
    I don’t even like psychologists using the term “Dr.” because it confuses them with psychiatrists–who DID go to medical school, after all. It should be J. Q. Doe, PhD–not, Dr. Doe. There’s just a huge difference between having a doctorate in philosophy and medical school–both require years of study, but they do not equal the same training. There are enough quacks who have MD after their names already without adding the PhD’s to the mess.”

    What what what?????

    Did you really just say all of that?

    You don’t think PhDs should have the same “status” as physicians? And what “status” would that be, exactly? The status of “Best Smartest Person Ever” ? Please! Are you that insecure that you don’t want to share your title with another educated colleague for fear that people will not kiss your feet enough? Did you really tell off your biologist friend and he graciously conceded? I highly doubt that. He probably thinks you’re a pompous ass and laughed at you to his biologist friends afterwards. Researchers may have different training than doctors but it is not of lesser value. And what is this status nonsense anyway? Who are we trying to prove ourselves to? Just shut up and do your work!

    I’m ALL for naturopaths and chiropractors not confusing patients and consumers by calling themselves physicians. But this imaginary status distinction between PhDs and MDs and the competition of who has the better education that is thusly more deserving of respect and prestige is just absolute nonsense. Grow up!

  45. Narad says:

    But this imaginary status distinction between PhDs and MDs and the competition of who has the better education that is thusly more deserving of respect and prestige is just absolute nonsense. Grow up!

    The problem here is that the non-professorial Ph.D.’s are the ones with the problem. I completely agree with Neil J that “the difference is entirely context-driven,” although I do not agree with the redundancy solution, which is of limited applicability at best. It’s not about “status.”

  46. FulfilledDeer says:

    @Niel J

    I think you’re right in a major sense. But clinically I think Dr. should only be used for MD’s (or dentists or other areas given appropriate context). The argument I agree with is the Dr. Niel, Nurse Practitioner while actually very specific, is actually too confusing. Especially, and this is the real big issue, when those same people are trying to take over MD responsibilities. If it acts like a doctor and calls itself a doctor, how are you supposed to know that it isn’t a doctor? It’s….a different debate. Not one that has to be attempted here.

    To confuse matters more, I believe (and someone can correct me) that in the UK you’re a “Dr.” for a long time as a physician, but then when (if) you manage to attain the highest level of your profession (a consultant) you actually go back to “Mr./Mrs.”.

  47. Neil J says:

    I was on board with the first part of @Janet’s post, which made it sound like the friend was telling people “I’m a doctor”, a disingenuous thing for a PhD to say. However, things kind of go off the rails in the latter half of the post, when @Janet argues for stripping PhDs of their “Dr.” title. This does not sit well with me, a prospective “Dr.” in the making. It’s an honorific title that originally applied to both medical professionals and academics, and I think we can share it peacefully.

    The only problems come about when PhDs use the similar title to draw on the perks of being an MD, or vice versa, where MDs use the similar title to… uh… make a lot less money and work in a room with no windows? I got nothing.

  48. FulfilledDeer says:

    ….how about when MDs use the similar title to suggest authority on basic scientific matters (Dr. Oz anyone)?

    Boom! Boom! Burn on physicians!!!!

    Wait….that’s soon to be me….

  49. Chris says:

    The important thing to remember is that ND actually means “Not a Doctor.”

    They do not have a Phd, nor do they have any kind of real education that includes an residency where they learn “on the job.”

    Just try to keep it in perspective. Just remember to clarify what kind of post-graduate degree of your primary care health practitioner. In the USA you are okay-dokay with an MD or a DO (Doctor of osteopathy, which have changed to actually practice real 21st scientific medicine). Both of these types have gone through an “apprenticeship” as an intern and/or resident dealing with real life medical issues under supervision. The last time my son was in an emergency room before spending a few days in the hospital the family doctor overseeing his care was a DO (there was also a neurologist doing her residency who saw him because one of his possible diagnoses was stroke).

    What is not okay is if the PhD is something completely outside of biology. Some examples:

    Viera Scheibner, geology (micropaleontologist, very small fossils)
    Andrew Cutler, chemical engineering
    Amy Lasley, computer engineering

    … and on and on… and I am not counting the pretend degrees from diploma mills like that for Gary Goldman’s “PhD in computer science.”

    Unfortunately, there have been too many folks who have an education that is Piled High and Deeper who think they know something outside their area of work. And it pains me that many of them are engineers (I used to be an aerospace engineer, but I at least know when I am out of my depth).

    Now folks, stop arguing trivialities. Insist that anyone who wants to be a primary medical care practitioner actually understands the basics by passing the medical licensing exam.

  50. Marc Stephens Is Insane says:

    It seems every quack website I visit has “doctors” behind it, but when you look closer you see PhDs in things like art hisory or economics. Yes, of course, as Phd holders they’re doctors, but the intention on these quack sites is to deliberately mislead with false credibility. Using the title “doctor” in a medical context leads most people to believe doctor means MD.

    This is most frequent on the most extreme quackery sites like German Non-Medicine. Several doctors but not an MD in sight.

    It also really bugs me when chiropractors insist on being called “doctor” to confer themselves the same medical status as real MDs. There was a running gag on Two And A Half Men concerning Alan Harper (Charlie Sheen’s brother) who insisted everyone call him doctor (he plays a chiro on the show). There was a great scene in an emergency room where an MD puts him in his place.

    I am friends with my GP (I knew him before he graduated from med school) and call him by his first name socially, but in the office it’s always “Doctor Smith” or sometimes “Doc” to show him the respect he has earned and worked so hard for.

  51. Harriet Hall says:

    I get my care in the military medical system. When I am given an appointment, I am told it is with Provider Jones. Sometimes that Provider turns out to be an MD, sometimes a DO, sometimes a PA, sometimes a nurse practitioner. Sometimes I’m seen by a resident and the doctor only comes in for a few minutes at the end. I’ve never been dissatisfied with the care I got from any of them. So far it has never been a naturopath or a DC. If that day comes, you will hear me screaming from miles away. :-)

  52. pmoran says:

    To confuse matters more, I believe (and someone can correct me) that in the UK you’re a “Dr.” for a long time as a physician, but then when (if) you manage to attain the highest level of your profession (a consultant) you actually go back to “Mr./Mrs.”.

    No. Surgeons are routinely referred to as “Mr” in the UK and the nether parts of Australia, — physicians and all other specialties as “Dr”.

  53. Scott says:

    The standard etiquette as I learned it is that, in a medical setting, only MDs or DOs are “Doctor.” In academic settings, a holder of any doctoral degree is “Doctor.” In social settings, it varies depending on formality. Informal, titles aren’t used anyway. Very formal, a holder of any doctoral degree. In the middle, typically MDs or DOs will use the title.

    But of course, there’s only one The Doctor.

  54. HDCase says:

    @Narad

    It is only an etymological fallacy if the etymology is being used to imply a meaning that is no longer considered accurate or used in common parlance. The attribution of “Doctor” to those holding advanced degrees predates (even if only slightly) the term for physicians and – let me be very clear here – has NEVER FALLEN OUT OF USE. The additional later connotation of “physician” does not invalidate that fact.

    You have, however, by making a distinction between professorial and non-professorial PhD’s, engaged in your own etymological fallacy – “doctor” has not been restricted to “one who teaches” in quite some time.

  55. marylight says:

    Actually, just about every single one of you is dead wrong, including the author of the article. I rarely have any reason at all to go onto this site, but in today’s case, a link passed by my feed that concerns me and many others around me.

    Traditional Naturopaths do not practice ” allopathic medicine”- they practice health care. For a growing many, the care they provide IS chosen as primary care.

    It is only what we call the “medical’ naturopaths- a small handful of schools on the US west coast- who want to push for this hybridization of allopathy blended with some, but certainly not all, aspects of classical traditional naturopathy. It is they who are pushing these bills, and the purpose of the bill is to legislate the word “naturopath” and it’s scope of practice , more than anything else.

    Traditional Naturopathy- which does NOT endeavor to “diagnose or cure” , and does NOT wish for rights to prescribe drugs- is alive and well and will continue to grow and gain acceptance. We, by and large, are NOT the ones proposing these bills. The “naturopathic physician” camp would have you think they and they alone are the “naturopaths”- but they are not. Additionally, we are not at all interested in being mistaken for medical doctors- most all of our clients are trying to escape the medical industry and find true health care, which medical doctors, with their narrow allopathic scope of practice and training, fail to provide.

    For all your bantering about accreditation, who is or is not a doctor, or a physician – rather sophomoric of all of you to have to digress on that tangent – every single one of you appear to not understand that there are other paradigms of health care, and these paradigms are not sub par to allopathy…. and that many consumers/clients much prefer them. That doesn’t make those of us within such paradigms “quacks’- because we don’t practice “medicine”- we practice health care , healing, and health building. A “quack” is someone who bumbles in practicing allopathic medicine- and hey- I ‘ll say it again, we’re not about allopathy at all.

    We also study a great deal of physical medicine, physical assessment methods, physical healing, physiology of function; are often experts in herbology and nutrition (as medical doctors decidedly ARE NOT)- that defines a physician. Doctor derived from the Latin “do-cere”- to teach- and we teach our clients , too. We do that because it helps them heal and maintain health care- not because we are ignorant , or following something “outdated’. Baby, we’re bringing it back! We can dance circles around “medical doctors” because we have studied this , practice this, and live it.

    We Naturopaths don’t : ” prescribe controlled substances. administer ionizing radioactive substances, perform chiropractic adjustments, do acupuncture, or perform very minor surgical procedures, or to do anything encompassed in the scope of practice of physicians. ” – to borrow from the article- nor do we endeavor to or want to, because there are many other much better ways to heal. Do you GET THIS? We would not do this if you paid us, and have no desire to inflict more useless allopathy on those looking for better alternatives.

    In closing, I find it interesting that some of you defend your arguments because “something has been done for a long time ” and some of you defend your arguments because “something has not been done a certain way for a long time”, and some of you are the same person saying both.

    Regardless of what anyone on this site “thinks” of the other health care professions and paradigms out there, they are here to stay, and have actually been in place prior to modern allopathy, or what you like to smugly call “science ” based medicine. Sorry folks, but the world has changed around you. It would even be wonderful of the “medical “naturopaths proposing these bills would figure this out- but one thing you may be correct about , at least for now – “they’ll be back”.

  56. Chris says:

    marylight:

    It is only what we call the “medical’ naturopaths- a small handful of schools on the US west coast- who want to push for this hybridization of allopathy blended with some, but certainly not all, aspects of classical traditional naturopathy.

    Did you read the article? Michigan is not on the US west coast.

    marylight:

    Do you GET THIS? We would not do this if you paid us, and have no desire to inflict more useless allopathy on those looking for better alternatives.

    How is treating someone with something that is ineffective a “better alternative”?

    There is no reason to take naturopathy seriously when they use pretend medicine, claiming it gets better the more you dilute it (homeopathy).

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