Wonderful story, reckoned we could combine some unrelated data, nonetheless truly worth taking a look, whoa did one understand about Mid East has got more problerms at the same time…

Nybgrus:“Gasp!!!!! I have on these very pages and very recently violently opposed naturopaths being recognized as primary care practitioners (PCPs), with similar privileges to doctors.”

Gasp!! And on these very pages you have maligned the role of legislative regulation as a means of doing anything useful in regards to CAM. Yet how do you propose we not recognize NDs as PCPs if we don’t refuse to license them as medical practitioners?

??? (that last sentence) Anyhow, I simply see legislation as having limited reach. As we try to control something like CAM with tighter and tighter legislation, resistance will increase asymptotically. We, meaning doctors and scientists, do not have sufficient public trust to be given absolute discretion over what treatments they may have access to or what medical claims are allowed. We will be afforded patchy control.

“everybody already knows that naturopathy is unscientific, or is considered so by doctors and most scientists.”

[citation needed]

Yes, that is an unwise over-generalization from me. I was thinking of the politicians, wherein even those promoting naturopathy will be aware of the scientific opposition to it.

Still, there are enough clues around that everyone else ought to know this. An Internet search on “naturopathy” and “scientific” yields this at the very top “— scientific evidence does not support claims that naturopathic medicine can cure cancer or any other disease –” Where would you go to avoid encountering such opinions?

Gasp!! And on these very pages you have maligned the role of legislative regulation as a means of doing anything useful in regards to CAM. Yet how do you propose we not recognize NDs as PCPs if we don’t refuse to license them as medical practitioners?

??? (that last sentence) Anyhow, I simply see legislation as having limited reach. As we try to control something like CAM with tighter and tighter legislation, resistance will increase asymptotically. We, meaning doctors and scientists, do not have sufficient public trust to be given absolute discretion over what treatments they may have access to or what medical claims are allowed. We will be afforded patchy control.

everybody already knows that naturopathy is unscientific, or is considered so by doctors and most scientists.

[citation needed]

Still, there are enough clues around that everyone else ought to know this. An Internet search on “naturopathy” and “scientific” yields this near the very top “— scientific evidence does not support claims that naturopathic medicine can cure cancer or any other disease –” Where would you go to avoid encountering such opinions?

SBM has them. Perhaps not REALLY bad ones, but cobblings together of half-truths, exaggerations, over-generalizations, over-simplifications, and small misunderstandings concerning CAM that we then base our rhetoric and other reactions upon. Some are very subtle. They certainly strain my vocabulary .

They derive from the approximations and declamations of normal human discourse, which can develop a life of their own when constantly echoed and never challenged within an intensely tribal environment such as this. Everyone knows that the least departure from the party line will provoke hostile reactions, insult and being called names.

So I have to say again, that a more accurate understanding of CAM, why people do it, and what they might get out of it, is not the same thing as wholesale approval. It may lead to less hostility to those engaged in it, but it is arguable whether trench warfare is the ideal strategy when dealing with CAM, anyway.

I would have to say that the fact that there is licensure for naturopathy along with all the other trappings – including cancer institutes, working side-by-side with actual oncologists, and their own oncology board – certainly do indicate that a significant portion of the public and their government representatives believe naturopathy to be a scientific discipline that can and should operate alongside actual medicine.

I don’t think pmoran actually wants this to be the case, but I do agree that his accomodationist/apologist (insert whatever term you feel most comfortable with since he is pretty nebulous on these topics) is what allows it to happen.

Gasp!!!!! I have on these very pages and very recently violently opposed naturopaths being recognized as primary care practitioners (PCPs), with similar privileges to doctors.

Gasp!! And on these very pages you have maligned the role of legislative regulation as a means of doing anything useful in regards to CAM. Yet how do you propose we not recognize NDs as PCPs if we don’t refuse to license them as medical practitioners?

everybody already knows that naturopathy is unscientific, or is considered so by doctors and most scientists.

[citation needed]

Even worse, this claim

And this despite the fact that everybody already knows that naturopathy is unscientific, or is considered so by doctors and most scientists.

is patently false, and shows that you’re either (a) completely clueless, (b) grossly dishonest, or (c) so blinded by your ideological commitment to quackery that you simply assume whatever is necessary to support that. NO, THE GENERAL PUBLIC DOES NOT KNOW THAT NATUROPATHY IS UNSCIENTIFIC – OR THAT IT DOESN’T WORK. They believe it IS in all ways comparable to real medicine, because doctors and politicians accommodate and tolerate it just as you advocate.

Gasp!!!!! I have on these very pages and very recently violently opposed naturopaths being recognized as primary care practitioners (PCPs), with similar privileges to doctors. I am less sure about attempts at regulation that would control what they can claim to do or what kind of education they must have.

At least twice I have pointed out here that the best argument against naturopaths as PCPs is that proper doctors harm a number of patients as it is, through mistakes in diagnosis and prescribing. It therefore makes utterly no sense to allow any reduction in the educational and experience standards for primary care.

In another scenario the public might be pushing for subsidy of their naturopathic care. In that instance the best argument is that only a small section of the community wants it. It is an optional add-on to normal medical care. Non-users should therefore definitely NOT have to subsidize it.

May I point out that before I started to think critically about my own understandings of CAM I probably would have missed these points? I would have sputtered on indignantly and at length about how scientifically ridiculous naturopathy was, and if the above points were mentioned they would be buried at the end of a lengthy discourse, to be possibly overlooked given the attention span likely in the average politician. And this despite the fact that everybody already knows that naturopathy is unscientific, or is considered so by doctors and most scientists.

If I remember there is some evidence we are pretty bad at estimating our well-being under various counterfactuals (I’m sure somebody way smarter than me-NYB I’m looking to you-knows what it is…but Dan Gilbert has done some work in the area). So while I agree the person who does not think life was brutal in the 19th century is very wrong…it is probably also true we would not be as terribly off in the 19th century as we estimate in 2012 (or rather, the bias works both ways).

Also I suspect some of the disgust toward previous conditions comes from our exposure to current conditions (some, not all). For instance it does sound bad to have a life-expectancy of 30 or 40 (better start making my will!). But I wonder if it would sound as bad to someone in the 19th century who thinks such a life-expectancy is normal, and cannot easily observe a greater life expectancy. For instance I feel very little (or nothing) about not living to 200 years old, or not having a time machine, or whatever other conveniences the future does or may hold.

Just my 2cc on that tangential issue. Great post and discussion everyone.

Your naturopath anecdote reminds me of another. I was talking with someone who moved to Massachusetts from Oregon, who was very much in favor of naturopaths being given the same prescribing privileges here that they have there. The reason? NDs in Oregon don’t quibble when you want antibiotics, and just prescribe them without question.

None of that pesky investigation to find out whether there’s actually a bacterial infection the antibiotics might help. No consideration of how effectively that promotes antibiotic resistance. Attractive only if you don’t understand the larger picture of WHY MDs don’t hand out antibiotics like candy.

This is precisely what pmoran wants to legitimize. And it illustrates the dangers of that legitimacy. The scientific standard of care exists for a reason. Letting quacks get away with ignoring it is actively harmful, but if they are treated as legitimate providers of medical care, it will be assumed that their standard of care is appropriate!

Why should I talk to you Nybgrus, when you just keep restating the same opinions, some of which I don’t disagree with?

I know I’m going to regret this, but it’s funny you should say that. I concluded the same thing about you a long time ago, which is why I rarely bother with you anymore, the only difference is that these days I disagree with many of your opinions and you seem immune to even considering that you might be way off base.

I agree and also read his message the same way. Though I think the bit of nuance he would add is that our “fight” would only serve to entrench CAM more and drive people towards more dangerous complimentary medicines and eschew modern medicine for the “alternative.” It is on these points that I disagree since the evidence I see and experience I have is one of a lack of information and knowledge driving the majority of CAM use, not a deeply entrenched CAM friendly philosophy or a distrust of modern medical science. Yes, those do exist, but I see no evidence that they are the major contributor, especially since – as we can all plainly see – sCAMsters try so hard to sound sciencey and ape the same things we do rather than reject it all outright. Even my woo-iest of friends have told me about truly alternative practitioners so far removed from the trappings of modern medical science that they ran after a single consultation.

I even had one acquaintance say she went to a naturopath because they are licensed to practice medicine in her state and figured that meant they had some legitimate “alternative” or “complimentary” medical advice to offer her to treat her condition. She had developed idiopathic glomerulonephritis and was under the care of an actual nephrologist. The condition scared her – reasonably so – and so she wanted to explore more options. She found that naturopaths went to school for post-graduate education, were licensed by her state to practice medicine, read about their “integration” into “mainstream” medicine, and decided it was worth a consultation. After one visit she said it was so kooky she never wanted to go back.

In her case all she lost was some time and money (and gained a laugh about how the ND told her to keep a warm poultice of magical herbs on her flanks to help cure her kidney problem) but this person was not locked into an ideology of woo and had already experienced the tangible benefits (though no cure) of actual medicine and made the rational and easy decision to stick with that. But many could be snookered as we have seen, and fighting legislative alchemy, educating people about why NDs and their ilk are not qualified medical practitioner, etc is thus necessary. But boy is it hard for me to convince someone that an ND is a quack when they point to the fact that similar quackery is taught in legit universities, actual medical doctors practice these quackeries, and there is even a naturopathic oncology group and hospital associated with the Cancer Treatment Centers of America (and that Memorial Sloan-Kettering Cancer Center offers quackery as part of their integrative cancer center).

That is why it is incumbent for us to fight quackademic medicine and these ridiculous integrative medical centers – the conversation is too long and nuanced for the average person and much easier to simply point out that supposedly legit institutions are embracing this quackery as justification for its validity.

Oh yeah, and I wrote a brief comment to pmoran but it is in moderation – likely because I used h-e- double-hockey-sticks once in it.

No. That is not a position which could ever be accepted by any ethical person. Actively fighting to limit the damage they cause isn’t just reasonable, it is an affirmative obligation of the entire medical field.

But to claim that because you were alive in the 60′s and practicing medicine means you are first hand aware of the entirety of the evolution of CAM is ludicrous. But hey, I’m just telling you what I was actually taught in my medical anthropology classes. It isn’t my narrative – it is what I was taught by the very same people who are the CAM promoters and believers in my university courses. And it is rather well documented both here and at Respectful Insolence.

But fine, I am also bored with this conversation as well. Do you ever wonder why I (and others here) keep saying the same thing over and over to you? Because you are also a broken record. And a tiring one at that because you consistently dodge and feint, seamlessly transition between meanings of words without delineation, ignore what you don’t want to address, and keep hammering in your points at will… despite the fact that none of us here – not even Dr. Hall – can actually figure out what the hell it is you are actually trying to say.

And I am sorry you felt insulted by my saying you can’t see past your nose. But if you think education isn’t the single best (not the only) long term solution, then you really can’t see past your nose. I genuinely hope you don’t take it personally, just as I did not take personally your vastly more vicious diatribe (more vicious than anything I have ever laid out to you) about me some time ago.

You’re walking home when a car mounts the pavement you’re walking on. You suffer numerous injuries such as fractures, TBI, soft tissue damage.

The driver of the car offers one of the following statements as justification:

“The sun was really low in the sky. As I turned onto that street the glare from the sun temporarily blinded me. I am devastated about this”

or

“As I turned onto the street I saw my neighbour, Peter. I don’t like him, I’d had a really awful day at work, and my dog died last week. I just snapped, and decided to run him over. He was in the wrong place at the wrong time”

If the person that mowed you down is #1, do your bones spontaneously knit back together upon hearing her explanation? Does the extensive bruising resolve, and the catastrophically high ICP return to a safe level when you hear that it was an accident?

Of course not. Intent is not magical. A chiropractor kills a young woman by causing a massive stroke during neck manipulation. Does the difference between the “honest” chiropractor believing what he was taught, and the guy who trained knowing that chiropracty is bunk alter the outcome?

Is the dead child of “true believer” homeopaths any less dead because that belief was borne of good intent?

CAM is, at best, pointless and at worst, actively harmful. That isn’t altered by the sincerity of the practitioner.

Nybhrus – WRT legislation, an American version of the UK ‘Cancer Act’ would be a good start. It would, at the very least, put a stop to things like Gerson “therapy”, laetrile, Rife, and Burzynski’s bull-dust, being advertised as “cures” for cancer.

http://en.wikipedia.org/wiki/Cancer_Act_1939

You lost my interest when you presented a completely untrue account of the evolution of CAM, and then stuck to it without offering the least further support when challenged (yes, I was there, practicing medicine since the 60s — ask Wally Sampson if what I had to say about the initial flowering of CAM was true or not and how well documented that period is).

You also insulted me as not being able to see beyond the end of my nose. You now accuse me of pushing a double standard when I am simply trying to explain to a higher level of sophistication than is usually considered here the conventions under which CAM operates. That does not mean I support them. It simply helps me understand my fellow humans better and more sympathetically.

In this last piece you are talking around about a very peripheral and uninteresting matter to me of what constitutes fraud, when all I am saying is that is is wrong and unfair for SBM propaganda to imply that anyone who supports CAM is a fraud. You have agreed that this is not so elsewhere but still want to regard them as such and to legislate as such.

So unless you have something new to contribute, I will not respond further.

If medical science has no good answer, then there is no good answer known —

Oh, I wholeheartedly agree but I am trying to show how that is not relevant to the matters that sustain CAM. (I have restored the full context of the remark you go on to describe as as BS, so that its logic is apparent.)..

Having been there myself, I also understand how difficult it is to countenance the idea of two vastly different medical systems, having such antithetical standards operating within a modern society. The only way to accommodate it is to accept that it is an established fact, that CAM will wax and wane under influences that we cannot wholly control, just as we more or less have to do with religious beliefs despite their equally irrational aspects and very similar potential for harm.

We accept “the fact” of CAM within the privacy of our consulting rooms, while roundly condemning the least tolerance of CAM in any other circle. Is that hypocrisy or what? What is the defence of that? We had better have one. But I am not even asking for tolerance of CAM in the any way that goes beyond the extant science.