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Legislative Alchemy: Naturopathy 2013

A fresh season of state legislative sessions is upon us and with it comes the ubiquitous attempts by purveyors of so called “complementary and alternative medicine” (or “CAM”) to join the health care provider fraternity. Via the magic of legislative alchemy, state legislatures transform pseudoscientific diagnoses (e.g., “chronic yeast overgrowth”) and treatments (e.g., homeopathy) into faux, but legal, health care. Once the imprimatur of legitimacy is bestowed by the state in the form of a health care practice act tailored to their special brand of quackery, these newly licensed health care providers are free to foist their practices onto an unsuspecting public and charge them for the privilege. All of this is done under the false assumption that such legislation is necessary to protect the public health, safety and welfare.

We might well want to consider how far this whole thing is going. Will practitioners of CAM split into an ever-expanding number of CAM provider guilds, all with their own practice acts? First, chiropractors were the only CAM practitioners who managed to get themselves licensed in all 50 states. Then along came acupuncturists, who are now licensed to practice in over 40 states. A few states license homeopaths. Some states licensed naturopaths early on. Now the naturopaths, licensed in 16 states, are in a full court press to catch up and legitimize themselves with licenses to practice “naturopathic medicine.”

Why? Because, according to Lorilee Schoenback, ND, a Vermont practitioner and American Association of Naturopathic Physicians (AANP) Board member:

If the law [the Affordable Care Act, or ACA] is implemented as intended NDs in 16 states will immediately be covered by insurance.

“Implemented as intended” refers to Section 2706 of the ACA, which prohibits “discrimination” in insurance coverage of services provided by any state licensed health care provider. According to the AANP (per Schoenback) this

suggest[s] that if insurers cover a health condition, they must pay any providers are licensed to treat that condition. If the insurer covers a service provided by medical doctors . . ., for example, it must also cover that service when provided by another legal provider, such as NDs, acupuncturists or chiropractors.

Schoenback continues,

it’s a change our nation needs. Our health care system needs prevention-oriented, low-cost primary care that’s effective for chronic illness. There’s no profession that does that better than us.

It is just this sort of evidence-free delusion about their competency that makes further licensure of naturopaths such a disturbing prospect.

One true and many false assumptions

So let’s turn to their current efforts to become licensed primary care providers. The AANP announced licensure in 11 more states as its goal for 2013, and licensing legislation has been introduced to date in six: Arkansas, Colorado (for the umpteenth time), Illinois, Maryland, Massachusetts (also for the umpteenth time) and Michigan. David Gorski discussed the Michigan bill in his Monday post, but we’ll analyze it further here.

[I have copies of the bills introduced in all states except Maryland. The office of its sponsor promised to fax me a copy, but I never got it. My discussion will exclude Maryland except for what little information I can get from a summary of the bill, provided courtesy of the National Health Statistics Report No. 12) Even in Washington State, where health insurance coverage of naturopathic services is mandated per state law, a study revealed that only one percent of a large sampling of insured pediatric patients (age birth-17 years) made a claim for naturopathic care in 2002, while 97.5 percent made a claim for a visit to a conventional medical provider. Of 600,000 insured persons (all ages) in Washington, another study found that only 1.6 percent made an insurance claim for naturopathic services in 2002. If giving NDs licenses to practice as primary care physicians and having insurance pay for their services doesn’t bring them in, what will?

Because there is a fictional market for naturopaths, the state must license them as health care providers. Among other presumed reasons, which are not stated, the public has “freedom of choice in health care.” Illinois and Arkansas specifically mention this “freedom” as a mandate for licensing.

Assuming, for the purposes of argument, that citizens desire licensing of naturopaths, let’s address the proposition that state licensing must necessarily follow. This means that licensing of health care providers is basically a popularity contest and equally available to all comers who profess they are such and can chum up enough legislators to agree with them. Whether these self-appointed health care providers actually provide safe and effective health care apparently is not open to question. If they say they do, then, ipso facto, they do. Otherwise, states obviously would not have licensed chiropractors, acupuncturists, homeopaths and naturopaths.

Having dispensed with the notion that safety and effectiveness are relevant to the issue, let’s move on to “freedom of choice.” Outside the inventive minds of naturopaths and other CAM providers, I know of no state or federal constitutional provision specifically guaranteeing a “freedom of choice” in healthcare which would translate into a state mandate that naturopaths be licensed. Apparently this is like those terms that CAM devotees use to sound “science-y.” “Freedom of choice” in health care sounds “legal-y” so they use it without defining what it means or citing the source of this allegedly guaranteed “freedom.”

Regulation of naturopathic practice is necessary to the health, welfare and safety of the state’s citizens.

This is necessarily an assumption behind all health care licensing because it is the constitutional basis of the state’s authority to regulate health care. But as we’ve demonstrated at SBM over and over, licensing naturopaths is anathema to the very notion of health, safety or welfare. One need only read Kimball Atwood’s informative series on naturopathy to thoroughly debunk that notion. Or Mark Crislip’s deconstruction of a naturopathic white paper, which discusses many of their pseudoscientific diagnostic methods and treatments as well as their opposition to vaccination.

And as David Gorski said just this past Monday:

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.

Obtaining a “naturopathic doctor” degree from a school accredited by the Council on Naturopathic Medical Education, which is recognized by the U.S. Department of Education as the accrediting agency for naturopathic medicine, and passing an exam administered by the North American Board of Naturopathic Examiners qualifies one to practice primary care medicine. (As we’ll see below, this is essentially the scope of practice allowed by the pending bills.)

First, as we know, the Department of Education does not care one whit about course content in general or its scientific validity in particular, and it has said as much.  The Department looks only at administrative issues, like record keeping, conflicts of interest and financial stability. Department recognition of an accrediting agency says virtually nothing about the quality of education received at an accredited institution. This leaves a private agency created by and for naturopaths at the controls of naturopathic education.

And it shows. While naturopathic schools have misappropriated the term “medical” and pasted it onto their names, what they teach is nothing like a real medical school. Outside of naturopathy, little is known about the actual content of these courses – the only information available to the outside world are course names and brief descriptions. However, the Textbook of Natural Medicine (2013), the foundational text of naturopathy, provides some insight.

As we’ve previously seen, this text includes a chapter on humoral medicine, the ancient Greek system based on the presumed control over bodily function by the “four humors,” and not just as a matter of historical interest. The Textbook also includes chapters on Ayurveda (ancient Hindu medicine), fasting, glandular therapy, virtually universal food “sensitivities,” chronic candidiasis, functional toxicology and vaginal depletion packs. No responsible physician would use of these therapies or employ these diagnoses in the manner suggested by the Textbook. In addition, the Textbook suggests the use of dietary supplements for illnesses in cases which there is insufficient, or no, evidence of safety or effectiveness.

To add insult to injury, none of the licensing statutes has any residency requirement. Once they’ve graduated from medical or osteopathy school, real primary care physicians must go through residency training, an additional three years of hospital based training caring for the most vulnerable and sick patients.

After ND school, ND graduates head, sans residency, straight for the NPLEX exam, which, again, is created by naturopaths, for naturopaths. No one outside the naturopathic fraternity appears to know what is on this exam or whether it has any relevancy whatsoever to the actual practice of primary care. If anyone knows anything about this mysterious document, please advise. We are all anxious for information.

Apparently, none of this makes the slightest difference to the credulous legislators who introduce and vote for naturopathic licensure.

The bills

Now let’s look at what these legislators — based on the false assumptions they’ve made about naturopathic licensing — are going to let NDs do.

Scope of practice:

In all six states an ND can “diagnose” or “evaluate” any human condition, illness or disease in any patient, including children. In other words, they are licensed as primary care physicians, which, as noted earlier, is what they want. In other words, they are limited only by the methods they can use to diagnose and treat, but there is no limitation on what they can diagnose and treat. Here is what they should be able to do, according to one definition of primary care provided by the American Association of Family Physicians (emphasis added):

Primary care is that care provided by physicians specifically trained for and skilled in comprehensive first contact and continuing care for persons with any undiagnosed sign, symptom, or health concern (the “undifferentiated” patient) not limited by problem origin (biological, behavioral, or social), organ system, or diagnosis.

Primary care includes health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis and treatment of acute and chronic illnesses in a variety of health care settings (e.g., office, inpatient, critical care, long-term care, home care, day care, etc.). Primary care is performed and managed by a personal physician often collaborating with other health professionals, and utilizing consultation or referral as appropriate.

Primary care provides patient advocacy in the health care system to accomplish cost-effective care by coordination of health care services. Primary care promotes effective communication with patients and encourages the role of the patient as a partner in health care.

Other than providing some routine, non-controversial advice about exercise and diet (widely available from other sources, often at no cost) NDs are not properly educated and trained to practice the necessary elements of primary care, nor should they be allowed to until they can provide adequate evidence – not self-serving conclusory statements – that they have the appropriate skills and training.

The only limitation on their treatment of any condition or disease is in the Colorado bill. When a patient seeks treatment for cancer from an ND, the ND must

“recommend . . . that the patient consult with a licensed physician specializing in oncology.”

Note the disturbing implication here: that an ND is qualified to treat cancer.

“Natural” Treatments and OTC drugs:

All states allow use of some form of “natural substances,” including dietary supplements and homeopathy, which, as David Gorski correctly surmised:

Homeopathy is the perfect quackery. The reason that homeopathy is so perfect as a form of quackery is because it is quite literally nothing.

Most bills specifically include OTC drugs. Some bills also allow amino acids, enzymes, “natural” antibiotics, bioidentical or “natural” hormones and barrier contraceptives and NDs can sell at least some of these products to their patients in all states. By the way, according to the highly regarded publication, The Medical Letter, bioidentical hormones can have the same adverse effects as conventional hormone prescriptions. It concludes:

There is no acceptable evidence that ‘bioidentical’ hormones are safe or effective. Patients should be discouraged from taking them.

Prescription drugs:

These are permitted, including controlled substances, if on the naturopathic formulary, in Michigan (with additional training) and Colorado. “Some pharmaceutical drugs” are permitted in Maryland if on their formulary. As Mark Crislip said:

I will pause here to point out that if a provider believes that homeopathy is a reasonable therapeutic intervention, they cannot be trusted to understand modern pharmacology. . . If I were Pfizer I would be turning my sales force loose on the 800 plus ND’s in Oregon [who can prescribe drugs]: they have no background to understand the truth of what they are told, they have no critical thinking skills, they are used to accepting authority over evidence, they have no issues with being subsidized by industry, and crave respectability. Perfect fodder for the drug rep. They don’t have a chance. And neither do their patients.

Other treatments:

This generally includes some combination of manual therapy, electrotherapy, diathermy, ultraviolet light, ultrasound and hydrotherapy. All of these have legitimate uses, but some have the potential to become quackery in the hands of naturopaths. For example, “hydrotherapy” includes colonic irrigation to remove “toxins,” alternating hot and cold footbaths, and wrapping patients in wet towels. “Electrotherapy” includes “electroacupuncture” and “manual medicine” includes craniosacral therapy.

 Surgery:

NDs can perform “minor office procedures” in all states but only with additional training in Arkansas and Michigan. (Maryland unknown.) Surgery is not specifically included or excluded in Illinois (best I can tell).

Diagnostic methods:

NDs can employ lab testing, physical exam and radiological studies in Massachusetts, Michigan and Colorado, and in Arkansas if permitted by rule. Michigan allows use of “minor office procedures” to diagnose, so presumably can do tissue biopsies. (Not specifically mentioned in Illinois; Maryland unknown.)

As I pointed out in the previous post on last year’s ND licensing bill in Massachusetts:

 I will leave it to others to evaluate naturopaths’ level of understanding of conventional lab tests and x-rays. But it is worth noting that the Textbook of Natural Medicine (2013), the foundational text of naturopathic education and practice, has an entire section (Section 2) titled “Supplementary Diagnostic Procedures.” I take “supplementary” to mean “not used in conventional medicine, at least not in this way.” The twenty-two chapters include several tests for detection of the ubiquitous “toxins” naturopaths believe are causing ill health in us all. Other tests address “functional nutritional analysis,” a standard of “functional medicine,” and “immune function assessment,” because, as we know, naturopathy is all about “boosting the immune system,” another fuzzy and essentially meaningless term they use. In addition to being unnecessary themselves, the results of these tests can lead to all sorts of unnecessary treatments, such as vitamins, minerals and “detoxification.”

Governance and Oversight:

Board of Naturopathy (i.e., self-governance) in Colorado and Massachusetts; Board of Medicine or a state licensing department, with advice from naturopathy advisory board, in Michigan, Arkansas and Maryland (which puts one ND on medical board); Board of Medicine, to which an ND will be appointed, in Illinois.

Specialty practice:

Yes, if allowed by rule enacted by governing board, in Massachusetts and Arkansas.

Licensure by endorsement:

In other words, NDs can practice in the state if licensed in another state and if they meet certain minimum requirements. Licensure by endorsement is permitted in Illinois, Michigan, Arkansas and Colorado. (Maryland unknown.) This is important because underemployed and unemployed NDs will likely want to move to other states where there is more work. The four ND schools in the U.S. graduate more students than is currently necessary to meet demand, which is negligible.

Other bills

In states where NDs are already licensed, the following legislation is proposed:

Hawaii:

Bills filed in the Senate and House makes the legislative finding that “naturopathic physicians [who apparently don’t subscribe to The Medical Letter] are known for their expertise in bio-identical hormones.” Thus, if passed, Hawaii would allow NDs to prescribe bio-identical testosterone, a controlled substance in that state.

Oregon:

I previously posted about NDs not getting included in coordinated care organizations (CCOs), which are designed to reduce Medicaid costs, because they don’t practice evidence-based medicine, a statutory requirement for CCO care. As noted in that post, they went crying to their friends in state government to make the mean old CCOs let them participate. This effort has come to fruition in the form of House Bill 2522, which forces CCOs to provide members with access to chiropractic and naturopathic services as primary care and access to acupuncturists and massage therapists for specialty care. The CCOs must pay these providers for their services at the same reimbursement rate they pay to all providers without regard to the license or certification of the provider. So even though the law requires the practice of evidence-based medicine it will also require the inclusion of practitioners who don’t practice evidence-based medicine. Go figure.

Senate Bill 108 attempts to tighten up the regulation of NDs by the Naturopathic Medicine board. According to an article in the Portland Business Journal dated January 30, 2013 (which is no longer available online), the most common complaints “involve personal boundary issues between the caregiver and the patient, as well as the writing of prescriptions for chronic pain management.” Complaints are directed at 4 per cent of licensed NDs (n = about 1,000) but that doesn’t indicate how many are actually practicing, which is likely a lower number.

On the other hand, Senate Bill 302 abolishes the Oregon Board of Naturopathic Medicine (and the State Board of Chiropractic Examiners, along with other regulatory boards) and transfers all of their duties, including discipline and rulemaking, to a single entity, the Oregon Health Licensing Agency. Whether this will provide some reasonable regulation and oversight remains to be seen.

Help is on the way

Other than the glimmer of hope offered by the possibility of abolishing the Oregon ND Board, these bills continue to demonstrate a remarkable lack of critical thinking on the part of state legislators. So, as you will see in Fighting Back, above,  I decided to help them out.

UPDATE

I just learned that a naturopathic licensing bill was introduced in Pennsylvania on February 6.  The text of House Bill 612 is not available yet, but a summary provided by its sponsor, Rep. Mark Mustio, contains many of the evidence-free assumptions discussed above:

Licensure of Naturopathic Doctors will help to fill the medical void in many communities lacking general practice doctors. Naturopathic Doctors complete a four-year, graduate level medical school program and pass medical boards. These Doctors are highly trained specialists in the areas of nutrition, herbal medicine, homeopathy, and are the only group of medical providers trained in herb-drug and herb-nutraceutical interactions. . . . Licensure of Naturopathic Doctors will help patients who are seeking naturopathic medical care select qualified and accredited practitioners. . . .Licensure of Naturopathic Doctors would give Pennsylvania residents a choice in their health care and provide for an integrative model of healthcare. The patients of Pennsylvania Naturopathic Doctors deserve access to the care their doctors can provide and the State of Pennsylvania needs quality care providers who will reduce the burden of chronic disease.

 

 

Posted in: Herbs & Supplements, Homeopathy, Legal, Naturopathy, Pharmaceuticals, Politics and Regulation, Public Health

Leave a Comment (93) ↓

93 thoughts on “Legislative Alchemy: Naturopathy 2013

  1. kathy says:

    Jann quoted: “A significant number of the citizens of this state are turning to naturopathic practitioners for their healthcare needs.”

    That word “significant” is a good example of scienceyness (if such a word doesn’t exist, then it should!). Politicians/the public use it with a different meaning from statisticians and, when they both use it in company with each other, there is mutual incomprehension.

    Anecdote coming down the line: I shan’t ever forget a boss, a non-scientist, that could NOT understand why I couldn’t get EXACTLY the same results every time I tested a batch of carrot seed for germination. I tried and tried to explain to him that when you have 3 tons of seed, and test the germination of just 400 seeds, the results will vary. But according to the tables I had, the difference between two tests was not significant.

    He thought I was being cheeky and saying his problem was insignificant, that it didn’t matter, and I couldn’t fathom why he didn’t “get” the very simple stats involved. We ended the discussion very cross with each other. I wish now that I’d realised that the problem was linguistic, not that (as I thought) he was stupid or (as he thought) that I was being evasive.

  2. nobeardpete says:

    Minor quibble – my understanding is that, while the vast majority of MDs and DOs will complete an entire residency program, completion of an intern year followed by a passing score of Step III is all that is required to obtain a license to legally practice medicine. So only one year of post-medical school training is legally mandated.

  3. Janet says:

    Even scarier to me is the increase in MD’s offering all sorts of sCAM. I am increasingly finding that when I try to talk with people about the lack of validity of whatever woo they are using, they counter that they are seeing an MD who is providing the woo. It seems insufficient to respond that the MD is a quack–true but not likely to convince the user.

    I think this is a bigger threat to public health than the ND’s wanting licensure, even though I would not minimize the stupidity of that endeavor. The overall numbers of people seeing ND’s seems small (thankfully), but if MD’s offer similar services, not only do they lend credence to these “treatments”, the treatments will be much more widely available–confounding the problem.

  4. David Gorski says:

    Minor quibble – my understanding is that, while the vast majority of MDs and DOs will complete an entire residency program, completion of an intern year followed by a passing score of Step III is all that is required to obtain a license to legally practice medicine. So only one year of post-medical school training is legally mandated.

    While this is true, such a doctor will find it very difficult to obtain hospital privileges, be registered as a provider by insurance companies and Medicare, etc. Such a doctor will have a hard time doing anything other than working for a salary under the supervision of board-certified doctors. In other words, such a doctor will have a very hard time functioning as an independent practitioner. Naturopaths, on the other hand, after their minimal medical education, expect to function as practitioners on par in the eyes of the law (i.e., independently) with internists, pediatricians, family practitioners, and other generalists.

  5. WilliamLawrenceUtridge says:

    By the way, according to the highly regarded publication, The Medical Letter, bioidentical hormones can have the same adverse effects as conventional hormone prescriptions.

    If you dig a bit at BHRT and compare it to “non-bioidentical” HRT, you find that Big Pharma actually produces many of the substrates used by BHRT. If you dig a bit more, you find that Big Pharma actually produces and sells bioidentical hormones. You don’t need to go to a quack, ND or compounding pharmacist to get them, you just have to know what to ask for. And these hormones, indeed, have adverse effects, because they’re hormones. In fact, some of the “non-bioidentical” hormones (specifically premarin) come from horses and upon passing through the digestive tract, are cleaved into molecules that are identical to human hormones. BHRT is nonsense, and if you’re not getting them in Big Pharma-produced versions, expensive nonsense that may contain anywhere from 60-270% of the dose you’re expecting to get.

    NDs can employ lab testing, physical exam and radiological studies

    As in x-rays? Terrifying.

    so presumably can do tissue biopsies

    And some day some arrogant ND is going to biopsy someone’s artery, leading to a massive bleed-out on their office floor. The pendulum swings, it’s a shame people have to die for this to happen.

    The CCOs must pay these providers for their services at the same reimbursement rate they pay to all providers without regard to the license or certification of the provider.

    This may erode the amount of time NDs may be able to spend with their patients, which in turn may erode one of the primary advantages NDs have compared to real doctors. Hooray?

    the most common complaints “involve personal boundary issues between the caregiver and the patient, as well as the writing of prescriptions for chronic pain management.”

    So…sexual contact with patients and over-prescriptions of addictive opiates? Terrific. NDs are almost certainly going to be victims of their own success, sadly at the cost of patient morbidity and mortality.

  6. ” So only one year of post-medical school training is legally mandated.”

    As David said, good luck practicing medicine in this day and age without being board certified in any specialty (which unless I’m mistaken , generally requires completing a residency) unless you’re grandfathered in from a previous era.

  7. Quill says:

    All I needed to know about naturopathy and naturopaths was provided in Jann’s post on the 2013 edition of their “Textbook of Natural Medicine.” If that is the stuff being taught then these people should not be licensed in any kind of medical setting.

    I wish that where I live (California) was not one of the states that licenses N.D.’s and that we did not have the California Bureau of Naturopathic Medicine even though it entertainingly sounds like something you’d find in an X-Files script. I particularly loathe the part of California law that says “‘Naturopathic medicine’ means a distinct and comprehensive system of primary health care practiced by a naturopathic doctor for the diagnosis, treatment, and prevention of human health conditions, injuries, and disease.” If that is the definition then it is maddening they do not have anything like the education and training required to fulfill it. (Source: http://www.naturopathic.ca.gov/laws/index.shtml)

    Almost as bad, perhaps even worse, are new things that went into effect on the first of this year. These specifically include “the administration of intravenous (IV) therapies” and “physical and laboratory examinations for diagnostic purposes, including, but not limited to, phlebotomy, clinical laboratory tests, speculum examinations, orificial examinations, and physiological function tests.” Oh, and of course, the had to specifically include “colon hydrotherapy” as well, although they don’t mention whether or not coffee is appropriate.

    How much training will they undergo to administer IV’s? The law is specific in its requirement of damn little: “The qualifying course shall consist of a minimum of 25 classroom hours on IV administration through injection of applicable naturopathic formulary substances, of which at least 14 classroom hours shall be identified as practicum.” Wow, two weekends.

    (Source: http://www.naturopathic.ca.gov/laws/newlaws_2013.pdf)

  8. FulfilledDeer says:

    I have to say, I agree with @Janet. That more than any other thing is what frustrates me about “CAM”. If there was a united front, but doctors were just disinclined to band together (which is not uncommon), then things would be different. But it’s sooo much harder to convince anybody that, say, acupuncture is ridiculous when student health of the medical center offers it.

  9. Eugenie Mielczarek says:

    Jann , Thank you for this excellent post and your new website . It’s not surprising that naturopaths are moving ahead at state levels. In addition to expected coverage of their services under the Federal Health Care Bill from 2000-to present awards from NIH covering naturopathic curriculum and research projects totals about $30 million.
    Eugenie Mielczarek

  10. yodeladyhoo says:

    I have also tried to find out the curriculum at the naturopathic schools with no success. Today I did find a student’s class notes from a class at Bastyr. The notes are labeled “Naturopathic Clinic Theory: Jared Zeff, Louise Edwards N.D. 2/6/05″

    The link is here: http://jacobleone.home.comcast.net/~jacobleone/clintheory2/Naturopathic_Clinic_Theory.doc

    What I found curious was the number of religious comments during the lecture:

    ” intuition – knowing w/o knowing how you know. Remote perception- being able to see what is going on at a distance (phone rings and you have a sense of who it is). Own this as individuals personally and as dr’s. this is one of the gifts of being divine spirits. You will have information that comes up that you will not know how you know it, but you should trust that this intuition is valid (even scientifically). We have the ability to create by what we think and to extract information w/o knowing the source.”

    This helps me understand why a particular “naturopathic oncologist” asserts that all ovarian cancer patients are hypothyroid. It’s not true; there is real data showing it’s not true. But her belief in that statement makes it true. If this is representative of their didactic teaching, it sounds like some heavy-duty brainwashing to me.

    And the notes say, “Physician was like the priest in older times
     We should function similarly as well as with our own spirituality”

    It explains a lot. Then there’s a case history of an elderly woman who wouldn’t stop eating fruit because she was scratching a “spiritual itch,” and it eventually led to a really bad hip. Their scienc-y way of putting that is, “Hahnemann says the original miasm is psora, which is a spiritual itch- a desire occurs in us to do something that can potentially hurt us.” I was going to look up miasm and psora, but I’ve had enough for one night. ;)

  11. weing says:

    @yodeladyhoo,

    What I see here is rampant reductionism. Not to the molecular level, but to fantasy.

  12. mdcatdad says:

    At least one institution in Maryland thinks there will be a demand for naturopathy and the like:
    http://www.baltimoresun.com/health/bs-md-tai-sophia-accredited-20130211,0,4224280.story

  13. naturecurepath says:

    My goodness Jann I would really like to know the impetus for you to put so much time into this article.

    I myself am a third year medical student at SCNM – Southwest College of Naturopathic Medicine in Tempe, AZ.
    First off, here is our curriculum – http://www.scnm.edu/images/stories/ND%20Program_of_Study.pdf

    As you can see, the program is not only completely ‘science-based’, but also heavily rigorous. We have a tremendous amount of hours seeing patients during our third and fourth years, as well as continuous studies to develop our education.

    Also, this ‘Textbook of Natural Medicine’ which you say is the basis of our education? Funny, I’ve never even heard of that particular book and I am in the middle of my third year…

    Your entire article is heavily biased towards your opinions of what our education entails, and I’d really like to know why your opinions are so strong? All of my classmates with myself included simply want to help people with chronic disease who would like to tackle their problems using natural and alternative therapies.. what is so bad about this? We are giving people options, and it is completely their choice to come to us…what is the problem here?

  14. Marc Stephens Is Insane says:

    What’s “science-based” about homeopathy? Or “mind-body” medicine?

  15. naturecurepath says:

    Classic Marc. Go straight for the homeopathy. All I need to ask is who is getting hurt by receiving a homeopathic remedy? Please let me know I’d like the information.

    And really? Going after mind-body medicine? Are you trying to infer that the health of the mind has no connection with the body? Or maybe we should just consider the mind and body completely disconnected and give anti-depressants to everybody who has any mental issues instead of taking some time and finding out the cause of a patient’s distress… just go on pub med and search for mind-body medicine you will see how greatly beneficial it is for so many people with issues of the mind.

    I can not seem to understand why there is such anger towards naturopathic medicine??? Almost everyone I talk to about maintaining their health through nature’s wisdom seems to think it is wonderful. Please I’d like to hear why the people here on this website seem to think otherwise??

  16. Marc Stephens Is Insane says:

    Homeopathy is a cornerstone of naturopathy. As such, the entire field of naturopathy is not science-based. It’s nothing but magic water and sugar pills. Mind body medicine is wishful thinking. You’ll find neither of those practices is held in high regard here by real doctors, researchers and scientists.

    What would a naturopath do for a patient with cancer or AIDS?

  17. naturecurepath says:

    First of all, researchers and scientists are not clinicians. And wishful thinking?… I’m guessing you didn’t look on pubmed…

    Second of all, what would any PCP do for a patient with cancer or AIDS?

  18. naturecurepath says:

    support their body as best you can and refer to a specialist…

  19. JJ Borgman says:

    naturecurepath,

    Sincere question: Is there such a thing as cancer or AIDS naturopathic specialists? Or do you have to depend on allopaths for the very serious indications?

  20. naturecurepath says:

    JJ.

    Since response: We are trained as primary care physicians, so anything which requires a specialist would be pertinent for us to refer. On the subject of AIDS – these patients need to be monitored closely with their HAART medications, but AIDS patients also fare better with the right nutritional/botanical support. With cancer – we are not accepted into hospitals to be trained in chemotherapeutics/radiation, so if a patient requires this it would be beyond our scope. We do have ‘naturopathic oncologists’ who do residencies to become specialized in naturopathic cancer care, but still they would need to work with oncologists who are trained in chemotherapeutics/radiation if the patient needs it.
    We can work with the specialists to support the patient through their pathological process, but we are trained as primary care physicians – anything beyond what a PCP would take care of requires a specialist.

  21. naturecurepath says:

    sincere response*

  22. doctorbull says:

    naturecurepath…save your energy and keep doing what you are doing. These people are the Westboro Baptists of medicine.

    This woman has made it her life’s mission to combat “alternative” medicine. And as an attorney, Jann will forever be right and she will always find a way for anyone that opposes her to be wrong. There is no use in trying to properly educate her or anyone else on here on what naturopathic medicine is today; they have no interest in considering counterarguments.

    Best of luck in the career ahead of you.

  23. pharmavixen says:

    From the “Mostly Science” blog, linked above:

    The Textbook of Natural Medicine, 4th Edition (2013) teaches naturopathy students about the four humours- blood, phlegm, black bile and yellow bile. The idea developed by the ancient Greeks was that an imbalance of any of these humours causes disease. Of course with the advent of modern medicine we now know this is just plain wrong, however this seems to not get through to the naturopaths who are taught according to the old principles.

    1. Is this quote incorrect? Are naturopaths not taught the four humours?

    2. If naturopathy is so “science-based,” why have it at all as an alternative to mainstream medicine? If it is “science based,” is it not then duplicating science-based medicine?

    3. What’s your stance on vaccines?

  24. WilliamLawrenceUtridge says:

    My goodness Jann I would really like to know the impetus for you to put so much time into this article.

    Easy. Naturopaths, through their ignorance, unfounded beliefs and primary definition as a profession in opposition to real science and medicine, puts their patients’ health at risk. If naturopaths rebranded themselves as “medicine-focused counselors”, I’d have little objection to them. You could talk to your patients, spend a lot of time with them, and then not give them any homeopathic preparations.

    What do you study in “oriental medicine” class? Do you focus on the unique gene loci divergences from Africans that render people of Asian descent more or less vulnerable to specific diseases? Or is it more like “Jewish medicine” or “Greek medicine” where you give undue credibility to now-disproven unscientific beliefs about the human body and how it works?

    Also, this ‘Textbook of Natural Medicine’ which you say is the basis of our education? Funny, I’ve never even heard of that particular book and I am in the middle of my third year…

    What books do you use instead?

    Classic Marc. Go straight for the homeopathy. All I need to ask is who is getting hurt by receiving a homeopathic remedy? Please let me know I’d like the information.

    Nobody, because it’s worthless. Unless of course, your patients use homeopathy to try to treat real medical conditions and die because of it.

    Question – if you apparently don’t believe in homeopathy (good for you), what do you think of having to take four full courses on it? Shouldn’t it be a single-page handout with “It doesn’t work” written on bold letters, then you move on?

    Are you trying to infer that the health of the mind has no connection with the body? Or maybe we should just consider the mind and body completely disconnected and give anti-depressants to everybody who has any mental issues instead of taking some time and finding out the cause of a patient’s distress… just go on pub med and search for mind-body medicine you will see how greatly beneficial it is for so many people with issues of the mind.

    There may be some relatively trivial connections, but that doesn’t mean thinking happy thoughts can cure most diseases. Linking antidepressants to any medical condition except depression would be pretty much wrong too. A bit of a straw man there.

    I can not seem to understand why there is such anger towards naturopathic medicine???

    Here is a starting point.

    Almost everyone I talk to about maintaining their health through nature’s wisdom seems to think it is wonderful. Please I’d like to hear why the people here on this website seem to think otherwise??

    Sure, it sounds wonderful. It’s just meaningless. “Nature’s wisdom” saw fit to put our trachea and esophagus so close together we are at much higher risk of drowning than most other animals. “Nature’s wisdom” renders us more likely to die of cancer as we grow older. Not to mention “nature” has no “wisdom”. “Nature” is the earth, in conjunction with the sun, which has produced an environment that includes self-replicating units. “Nature” has no personality, no emotions, and does not care if we live or die. Or is a total bitch, for creating smallpox, polio, and that worm that burrows into the eye of small children.

    We are trained as primary care physicians, so anything which requires a specialist would be pertinent for us to refer.

    Sounds like you are completely redundant to real doctors.

    On the subject of AIDS – these patients need to be monitored closely with their HAART medications, but AIDS patients also fare better with the right nutritional/botanical support.

    Question – do you know who Matthias Rath is? Find out, then come back and tell me about nutrition. Second question – what botanical support?

    specialized in naturopathic cancer care

    Also known as “watching the natural course of cancer from detection to ugly, ugly death”. Or, possibly, taking the patients money while they get conventional care and drink some tea, then taking the credit.

  25. WilliamLawrenceUtridge says:

    doctorbull

    naturecurepath…save your energy and keep doing what you are doing. These people are the Westboro Baptists of medicine.

    I prefer to think of myself as a realist who acknowledges that nature is pretty indifferent to my survival – both as an individual, and as a species. Anyone who thinks otherwise, who thinks that somehow humans are the pinnacle of evolution, ignores the 15 billion years that lacked humans after the Big Bang, and the 4.5 billion years when the Earth was present but lacked human presence.

  26. daijiyobu says:

    I’ve been collecting naturopathic material before, of course during, and after I left ND school in CT.

    Regarding SCNM, the school of commenter ‘naturecurepath’, I can illustrate their absurdity with two SCNM claims that are completely at-odds:

    you have the claim of naturopathy as one of the “branches of medical science” and I show there that starting as early as 1993 they advertised in print media like Vegetarian Times the claim “scientific naturopathic solutions” (collected here, http://sothisisscience0050.blogspot.com/ ),

    and you have their claims of being based on the science-ejected simultaneously (collected here, http://animatisticnapantheism051.blogspot.com/ ).

    I call the mode of thought ‘the naturopathillogical’ — wherein, something is what it is not, a ‘science subset nonscience’ condition falsely labeled science — and therein, naturopathic junk thought truly is as bad as 2 +2 = 5.

    -r.c.

  27. doctorbull says:

    Sir WilliamLawrenceUtridge

    Nature is indifferent to your survival? Nature may not need US to survive, but we certainly need it. Modern medicine is a mere 100 years old – how did our species survive without it for the thousands of years it has been in existence? Do all the animals that have evolved with us rely on a modern medicine for their survival and presence here today? And you are aware, I’m sure, that the majority of pharmaceuticals on the market today are derived from plant chemistry – from NATURE?

    No properly educated naturopathic doctor is against modern medicine (that is, an ND that has gone through the four-year program at one of the 7 accredited institutions. Do not confuse a licensed Naturopathic Doctor with someone calling themselves a “naturopath”. There are severe differences in education, or lack thereof in the latter). Modern medicine and the science it uses is truly fascinating and a major tribute to the intelligence of our species. It treats acute conditions very well and has saved millions of lives. But just because something is “science-based” does not mean it is the best course of treatment. Modern medicine has killed hundreds of thousands of people due to adverse reactions, surgical complications, overdoses, etc., while few have been harmed or have died from complications resulting from the care received through naturopathic medicine. Naturopathic doctors offer modalities of treatment that allopathic doctors cannot, which is extremely useful when patients have not found answers in modern medicine, or when they do not wish to undergo treatments that may have adverse reactions.

    There is an incredible amount of misconception on this website about naturopathic medicine, and everyone is so fueled by this misinformation that they are not able to objectively and critically think about any component of opposition to it. Again, the majority of ND’s are not against science-based or EVB medicine, but I cannot respect anyone that cannot recognize the shortfalls of it.

  28. WilliamLawrenceUtridge says:

    I’m not a sir.

    Nature is indifferent to your survival? Nature may not need US to survive, but we certainly need it. Modern medicine is a mere 100 years old – how did our species survive without it for the thousands of years it has been in existence?

    By giving birth many, many more times than necessary to maintain a stable population. Mostly to account for the massive number of infant deaths. In large, settled societies if you wanted two kids to survive to adulthood, you needed to have a lot more than just two. Where do you get the idea that before modern medicine the world was a healthful utopia? Infant death was the norm, not the exception that it is today. Modern marriages often break down after the death of a child, because now it is a highly unusual and unexpected event. In hunter-gatherer societies there were fewer deaths from infectious diseases passed person to person, but lots more deaths due to horn-through-the-belly/hoof through the chest and starvation.

    We don’t need “nature” to survive, we need food, water, oxygen and some place to dump excess heat and wastes. “Nature” doesn’t exist as a coherent, stable entity. What is “natural” on earth has changed considerably. It was once “natural” to have no water, merely constant rain and evaporation. It was once “natural” to have no oxygen. It was once “natural” to have much higher levels of oxygen, the type that would kill us now. “Nature” is ever changing, and life changes with it, irrespective the change being a hotter sun, a colder earth, a meteor strike or a million years of volcanic eruptions (as we call it now, “India”).

    Modern medicine gives us lower infant mortality rates, relief from many infectious diseases (both human transmitted and due to injuries), better mobility as we age, surgical correction of congenital defects, antivenom and the like. I’m always curious how rising life expectancies concurrent with the rise of modern medicine are waved away.

    Do all the animals that have evolved with us rely on a modern medicine for their survival and presence here today? And you are aware, I’m sure, that the majority of pharmaceuticals on the market today are derived from plant chemistry – from NATURE?

    Nope, but animals living in zoos, with veterenary care, live longer than their wild counterparts and have more surviving offspring. And that’s with a medical system covering many thousands of species that doesn’t spend a lot of time, money or research trying to prolong survivial. So no, animals in “nature” (which nature?) don’t rely on modern medicine to survive, they just live a lot longer (and more comfortably, with more and healthier offspring).

    Yes, some of the medicines use today are originally from nature – and have been heavily modified, standardized and purified to be safer, offer a consistent dose, and have fewer side effects. Willow bark, for instance, is far, far harder on the stomach than aspirin, because it is modified. Nature also puts massive amounts of energy into compounds that are useless to us (medically and otherwise) or outright harmful, even in tiny doses. You are identifying compounds that plants create for purposes other than helping human health, but happened to have a molecular structure we could co-opt into relieving symptoms or eliminating diseases. And as science marches forward, I’m guessing the number of nature-derived compounds will drop and pre-designed compounds will increase as we better understand our molecular and genetic makeup.

    No properly educated naturopathic doctor is against modern medicine (that is, an ND that has gone through the four-year program at one of the 7 accredited institutions. Do not confuse a licensed Naturopathic Doctor with someone calling themselves a “naturopath”. There are severe differences in education, or lack thereof in the latter).

    Just like no true Scotsman would ever be a serial killer. I think at best you could say your school doesn’t necessarily make it explicit. I’m guessing I could identify exceptions to your rule if I cared to look hard enough.

    Modern medicine and the science it uses is truly fascinating and a major tribute to the intelligence of our species.

    Nope, it’s a tribute to our willingness to fool ourselves. Science exists because humans are vulnerable to logical fallacies and must erect a massive, artificial structure to try to overcome them.

    It treats acute conditions very well and has saved millions of lives. But just because something is “science-based” does not mean it is the best course of treatment.

    Absolutely not, “science-based” is meaningless. Each intervention on its own course. What does naturopathy have to offer type-I diabetics by the way, besides an early death? Medicine is pretty good at treating a lot of chronic conditions as well, and offering advice about chronic lifestyle conditions that can be improved by diet and exercise. Unfortunately, patients often don’t follow that advice and that naturopaths are parasitic on it as well.

    Modern medicine has killed hundreds of thousands of people due to adverse reactions, surgical complications, overdoses, etc.,

    And thus we have our first talking point. How many of those people would have died without intervention? What is the risk:benefit ratio? Who researches and publishes the numbers on complications, adverse reactions and overdoses? Naturopaths, or doctors?

    while few have been harmed or have died from complications resulting from the care received through naturopathic medicine.

    I’ve never seen a reference to support this, could you provide one? Because otherwise that’s simply empty rhetoric. I can say that naturopaths have a lobotomy before graduation, that doesn’t mean it happens.

    Naturopathic doctors offer modalities of treatment that allopathic doctors cannot, which is extremely useful when patients have not found answers in modern medicine, or when they do not wish to undergo treatments that may have adverse reactions.

    Like what? Name one modality of treatment naturopaths can offer that doctors can’t. Then please provide me good-quality studies supporting that modality as a form of treatment. Naturopaths are parasitic on science, since they rarely do any actual science themselves. Well-validated treatments are adopted into real medicine, naturopaths either pilfer from these interventions, or are making assertions about safety and efficacy that are not backed by quality research.

    There is an incredible amount of misconception on this website about naturopathic medicine,

    Great, find a specific one and provide some citations.

    and everyone is so fueled by this misinformation that they are not able to objectively and critically think about any component of opposition to it. Again, the majority of ND’s are not against science-based or EVB medicine, but I cannot respect anyone that cannot recognize the shortfalls of it.

    Can you provide publications where naturopaths are recognizing the shortfalls of medicine? Generally medicine is quite self-critical, and pursues an ongoing program of self-improvement to drop recommendations that don’t work and adopt those that do. With that in mind, why do naturopathic schools teach about homeopathy? Do you use homeopathy in your practice? Why? How do you justify it, ethically, financially and scientifically? The latter is of particular interest, since your practice is apparently so strongly based on science.

  29. doctorbull says:

    I never said naturopathic medicine is strongly based on science (if we were able to match the funding the pharmaceutical world receives it would be helpful for alternative medicine research), but it is in no way dangerous in the way you and this site claims – and certainly no more “dangerous” than the trial and error method we exercise in the name of science.

    Here are my responses to your points in response to naturecurepath:

    “Naturopaths, through their ignorance, unfounded beliefs and primary definition as a profession in opposition to real science and medicine” – misconception. What you may hear one sham of a “naturopath” say does not define the profession.

    “What do you study in “oriental medicine” class? ” – There are thousands of medicinal herbs that have been used over hundreds of years to treat various illnesses (herbs that successfully treated people before modern medicine was born). So it might take a few years to become an expert on each of these so a patient can be recommended a proper treatment. The potency of herbs is well known and includes both positive and adverse reactions – I’d think you’d want anyone prescribing them to know what they’re talking about.

    “What [text]books do you use instead?” – Perhaps whatever books are used in traditional medical school? Do you think naturopathic doctors think the anatomy, biochemistry, physiology etc. of our bodies are any different from what allopathic doctors learn and what science has taught us? Such ignorance.

    Homeopathy – What length of study have you done on homeopathy? Perhaps you should take four full courses on it and then objectively and critically form your opinions from there – then you can denounce it all you want; I’ll respectively listen to and consider your thoughts then. Whether you think homeopathy is worthless or not, the fact is that sometimes it work. There might not be a scientific explanation at this time (and perhaps there never will be), but no harm was done. That same patient could have also been successfully treated with a drug, but perhaps they would have experienced side effects. Or perhaps not. Regardless, the same outcome was received, so what is the harm? No doctor is just going to let a patient worsen if they aren’t responding to treatment – a PCP trained in naturopathic medicine is no different. Jesus, naturopathic doctors aren’t Satan.

    Mindbody connection “There may be some relatively trivial connections, but that doesn’t mean thinking happy thoughts can cure most diseases” – where did you learn that naturopathic doctors think they are miracle workers and can cure disease with the mind. Do you have statistical evidence to back this claim – a survey done by all licensed NDs?

    HERE is a list of sites that outline deaths caused by pharmaceuticals deemed “ok” by science.

    http://www.drugwarfacts.org/cms/Causes_of_Death#sthash.ZnyQtLR7.L8RMmSqb.dpbs

    Here’s one just for the state of Georgia alone:
    http://gbi.georgia.gov/press-releases/2012-08-14/deaths-related-prescription-drug-overdoses-decline-2011

    Here’s an article on the number of malpractice deaths here are each year (by “real doctors”):
    http://www.justice.org/cps/rde/justice/hs.xsl/8677.htm

    These are yearly numbers, and for the US alone – pretty stark difference to the 200 names listed on the site you provided, which spans 10 years, and the globe. I also wonder how many of those harmed by alternative medicine were receiving treatment from some sham of a person, one without an education from an accredited school. I would guess all of them.

    There are a lot of bogus “naturopath doctors” out there (without proper training), just are there are a lot of bogus MD’s out there – I don’t judge the entire allopathic medical community on those people.

    Your vendetta against nature – We are just another organism that has evolved among the thousands of others we share this planet with. Therefore, it is common sense that our bodies are able to process natural compounds much more efficiently and much more gently than it can process man-made compounds. No science needed to understand that.

    “Sounds like you are completely redundant to real doctors.” – Are you aware that there is a severe shortage of PCPs in this country? Having more people capable of treating mild to moderate health concerns would only be beneficial.

    Matthias Rath – had to Google him. Trained in allopathic medical school, by the way, not in naturopathic medical school. Clearly he has extreme views on the treatment of HIV/Aids and cancer. I assure you that the ways of “Dr. Rath” are not what is taught in any medical institution – allopathic or naturopathic. This is another example of your ignorance. As naturecurepath stated previously, a properly trained ND would clearly work with a specialist when severe health concerns are present, just as any PCP would. I do not understand why you have trouble accepting this fact.

    I think I will take my own advice to naturecurepath – it is mpossible to argue with ignorance and people that are so set on their ways of thinking that they are not open to discussion.

    Agree to disagree.

  30. Chris says:

    doctorbull:

    Homeopathy – What length of study have you done on homeopathy? Perhaps you should take four full courses on it and then objectively and critically form your opinions from there – then you can denounce it all you want; I’ll respectively listen to and consider your thoughts then.

    How much studying do you need to be convinced that diluting and shaking a substance in a solvent makes it stronger? Really? Are you actually going to tell us that Nat Mur 30C has any actual sodium chloride left after being diluted by a hundred times the solvent thirty times? How many molecules of NaCl would be in a liter of water if it was diluted to one part NaCl to 10^60 (that is a ten followed by sixty zeroes) parts of water?

    Does studying homeopathy actually make one forget basic arithmetic and high school chemistry?

    ……………………………

    Now to what I really wanted to ask you is what would a naturopath diagnose a fourteen year old male with the following symptoms:

    He has literally been slowing down. During soccer practice he has to stop after running a bit because he is a bit dizzy, and gets a pain in his left arm. During a routine doctor’s visit a heart murmur is discovered.

    The young man is also a bit overweight.

    So what does your experience tell you is happening to cause those symptoms, and how would you treat them?

    …………………

    Also, you failed to provide a reference to this:

    while few have been harmed or have died from complications resulting from the care received through naturopathic medicine.

    Could you be so kind as to give us a reference to the statistical outcomes, good and bad, in naturapathy? Though I have seen this list of anecdotes: http://www.whatstheharm.net/naturopathy.html

  31. WilliamLawrenceUtridge says:

    I never said naturopathic medicine is strongly based on science (if we were able to match the funding the pharmaceutical world receives it would be helpful for alternative medicine research), but it is in no way dangerous in the way you and this site claims – and certainly no more “dangerous” than the trial and error method we exercise in the name of science.

    What’s the budget for the NCCAM? And how does this justify practicing medicine that has little to no scientific backing? Also, your argument applied evenly to all players would mean any pharmaceutical company that’s not very big and doesn’t have a lot of venture capital would be able to sell their products with little to no testing. Does that seem reasonable, or are you suggesting a double-standard?

    Herbal products can be acutely poisonous (foxglove has a much narrower therapeutic index than its purified and standardized equivalents, but can be just as deadly – but a lot easier to take the wrong dose), homeopathic treatments delay real treatment (and often are accompanied by dangerous medical advice such as avoiding vaccination), acupuncture can puncture lungs or pass along HIV infections and Ayervedic medicines often contain acutely toxic levels of heavy metals. Medicine must pass a risk:benefit test, you’re essentially saying patients must accept all of these risks without being able to provide proof that any of these risks are accompanied by benefits.

    There are thousands of medicinal herbs that have been used over hundreds of years to treat various illnesses (herbs that successfully treated people before modern medicine was born). So it might take a few years to become an expert on each of these so a patient can be recommended a proper treatment. The potency of herbs is well known and includes both positive and adverse reactions – I’d think you’d want anyone prescribing them to know what they’re talking about.

    If herbs were so successful, why did life expectancy rise with the advent of modern medicine? Why was smallpox so feared? Why did well-fed Native Americans die to the tune of 90-99% when exposed to it? Didn’t they have herbs too? How do you know herbs aren’t poisonous or carcinogenic over the long term? Is the potency of a herb always the same, or does processing, growing conditions and part of the plant the herb is taken from make a difference? What about rare adverse reactions?

    If herbs are effective, shouldn’t it be easy to demonstrate this through controlled trials? Why don’t you undertake them?

    Is Oriental medicine solely about herbs? Are acupuncture, acupuncture points, meridians, qi and 5 elements theories taught as well? What about tongue and pulse diagnosis?

    Rather than “anyone prescribing them to know what they’re talking about”, I’d rather know that there is a solid evidence base behind the efficacy of the herb. After all, many herbs were used because of a superficial resemblance to a part of the body, not any actual effects. And if herbs were proven to work, then real doctors could use them as well, as part of their regular evidence-based approach (i.e. the approach taken with St. Johns Wort, which it turns out has toxic as well as mood-benefiting properties).

  32. WilliamLawrenceUtridge says:

    Perhaps whatever books are used in traditional medical school? Do you think naturopathic doctors think the anatomy, biochemistry, physiology etc. of our bodies are any different from what allopathic doctors learn and what science has taught us? Such ignorance.

    Why not just become regular doctors then? If you use, universally, the same books as real doctors, what’s the difference? What books do you use to learn about Oriental medicine, herbal medicine and homeopathy?

    Homeopathy – What length of study have you done on homeopathy?

    I read Homeopathy: How it Really Works by Jay Shelton, as well as books by Edzard Ernst, numerous blog posts on a variety of web fora, many, many peer-reviewed journal articles, and to date there is both no indication for which homeopathy appears to have specific effect, and no mechanism by which it might work (beyond a strong placebo effect due to the lengthy, caring interview process). I’ve done a lot of background reading, and I’m also familiar enough with the laws of physics (including quantum physics) to realize it can’t work.

    I’ll respectively listen to and consider your thoughts then.

    Why not listen to me now? How do you think homeopathy works? I can almost certainly explain to you why this is not the case. What’s your evidence base convincing you it works? I’m pretty sure I can explain why that is also flawed.

    Whether you think homeopathy is worthless or not, the fact is that sometimes it work. There might not be a scientific explanation at this time (and perhaps there never will be), but no harm was done.

    You should read Shelton’s book, he explains how it “works”. Also, R. Barker Bausell’s Snake Oil Science does an excellent job of explaining why regression to the mean, the natural course of illness and minor subjective improvements (i.e. placebo) can appear to give homeopathy specific effects when really it’s nothing of the sort. Really, you should at least read Shelton’s book. It’s quite interesting.

    That same patient could have also been successfully treated with a drug, but perhaps they would have experienced side effects. Or perhaps not. Regardless, the same outcome was received, so what is the harm?

    Yes, What’s the Harm? indeed. Homeopathy is a form of self-soothing for minor, self-correcting ailments. But it’s a waste of time, a waste of money, and tends to be accompanied by corrosive, anti-scientific rhetoric with significant public and personal health consequences like antivaccination, “cancer is a fungus” or “chemotherapy is just cut, burn, poison”. If you reach for homeopathy when something is seriously wrong, you could die.

    No doctor is just going to let a patient worsen if they aren’t responding to treatment – a PCP trained in naturopathic medicine is no different. Jesus, naturopathic doctors aren’t Satan.

    Satan doesn’t exist, but jingoism and cheap, wrong answers do.

    Do you know what a healing crisis is, by the way?

  33. WilliamLawrenceUtridge says:

    HERE is a list of sites that outline deaths caused by pharmaceuticals deemed “ok” by science.

    http://www.drugwarfacts.org/cms/Causes_of_Death#sthash.ZnyQtLR7.L8RMmSqb.dpbs

    Here’s one just for the state of Georgia alone:
    http://gbi.georgia.gov/press-releases/2012-08-14/deaths-related-prescription-drug-overdoses-decline-2011

    Here’s an article on the number of malpractice deaths here are each year (by “real doctors”):
    http://www.justice.org/cps/rde/justice/hs.xsl/8677.htm

    How does this in any way support the practice of naturopathic medicine? Yes, medicine needs to reduce adverse effects, overdoses and malpractice. But that doesn’t mean naturopathy works, this is a CAM talking point that proponents never think through (and the logical fallacy known as false dilemma – one you share with creationists who think if they can prove evolution isn’t true, that means God exists). Whether medicine is perfect or naturopathy works are two completely different questions with unrelated answers.

    Where is your proof that drug-related deaths are “OK” by science? Each stage of the clinical trial process involves safety and efficacy testing, as well as post-approval monitoring, which are all efforts to reduce morbidity and mortality. The withdrawal of Vioxx is proof that medicine is both self-critical and has built-in mechanisms to look for and reduce the hazards of medications. What is the equivalent in naturopathy?

    These are yearly numbers, and for the US alone – pretty stark difference to the 200 names listed on the site you provided, which spans 10 years, and the globe. I also wonder how many of those harmed by alternative medicine were receiving treatment from some sham of a person, one without an education from an accredited school. I would guess all of them.

    What is the evidence base for the interventions that naturopathy prescribed in each case? Medicine has risks. It must offset those risks by evaluating the benefits. Doctors don’t simply crack open chests for fun, the do it to restart or replace a heart.

    Also, without an evidence base backing your practices, how do you tell a “sham” from a “real” ND? Medicine uses empirical evidence to evaluate risk to benefit. What does naturopathy use?

    There are a lot of bogus “naturopath doctors” out there (without proper training), just are there are a lot of bogus MD’s out there – I don’t judge the entire allopathic medical community on those people.

    Except for the part where you cited statistics on adverse drug reactions, malpractice and overdoses to justify naturopathy. Since naturopathy is predicated on unproven medicine, you have no way of determining what “proper training” is. Just a circle-jerk of poor citations and hoary, untested legends.

  34. doctorbull says:

    Chris, you provided the reference. 200 people apparently harmed by “naturopathy” over a 20 year span, across the globe – you cannot tell me that could be a statistically significant number, and it is not even known if these people were treated at the hand of a licensed and properly trained naturopathic doctor. How does this make naturopathic medicine any more dangerous than modern medicine, under which thousands of people die from each year. And yet, I’m not even denouncing modern medicine or science! I support it! I’m simply refuting the claim that naturopathic medicine is so dangerous. I am thankful that the broader medical community is not so close-minded.

    I am not a naturopathic doctor, so I will not address your case study, but I will tell you that an ND would take up to an hour talking to that boy and his parents to address all aspects of his health and health history – that alone is comforting to both patient and family, much more so over dismissing them in 5-15minutes along with a prescription that “might” work. The truth is, no one can be absolutely certain about anything. Even with all the science out there, there are new studies that come out and dismiss the latest one all the time – the “hard” evidence can often be quite fickle.

    I absolutely understand a desire for treatments that are scientifically based, and I hope one day there is more evidence in support of alternative therapies, but what would you do when those options fail you? Naturopathic medicine is not the answer to all health problems, but neither is modern medicine. Therefore people should have access to all modalities of treatment, through properly trained individuals. And, one would hope, a patient would be competent enough to critically think about their treatment options and not just make their choices based on something this website has to say or what a single study may suggest. Dismissing licensure for NDs would only increase the number of incompetent practitioners in these alternative modalities – and THAT is dangerous.

  35. WilliamLawrenceUtridge says:

    Your vendetta against nature – We are just another organism that has evolved among the thousands of others we share this planet with. Therefore, it is common sense that our bodies are able to process natural compounds much more efficiently and much more gently than it can process man-made compounds. No science needed to understand that.

    I don’t have a vendetta against nature, I just acknowledge that we are part of nature, nature is mutable, and nature doesn’t care if we live or die on an individual or species level. I also see no reason to believe that nature evolved to benefit humans (and can note many, many instances when nature is acutely detrimental – smallpox, polio, parasitic worms, cobra venom, lions, favism, PKU, any of the myriad acutely poisonous plants, meteors and so forth). Evolution drives survival at a genetic level, and it is competitive. Humans are the competitors, not the judges, and certainly not the finish line. Your facile claim of common sense may appeal to you, but it is rather obviously contradicted by reality. Plants that benefit humans generally do so because humans intervened to improve their utility to humans. Not nature.

    And again, to pick one example – manufactured aspirin is far better processed by the human body than willow bark, causing far less gastric bleeding. Science evaluates each molecule on an individual basis, it doesn’t assume everything is good for us.

    Are you aware that there is a severe shortage of PCPs in this country? Having more people capable of treating mild to moderate health concerns would only be beneficial.

    I think the solution is training more PCP and certified nurse practitioners, not a whole bunch of pretend doctors with dangerous assumptions. Your solution is akin to solving world hunger by producing more olestra.

    Matthias Rath – had to Google him. Trained in allopathic medical school, by the way, not in naturopathic medical school. Clearly he has extreme views on the treatment of HIV/Aids and cancer. I assure you that the ways of “Dr. Rath” are not what is taught in any medical institution – allopathic or naturopathic.

    Do you prescribe vitamins to treat anything but vitamin deficiencies? If so, you are practicing in the ways of Rath.

    This is another example of your ignorance. As naturecurepath stated previously, a properly trained ND would clearly work with a specialist when severe health concerns are present, just as any PCP would. I do not understand why you have trouble accepting this fact.

    A “properly trained” ND would be completely redundant to a real doctor because they would base their decisions on evidence, not on myth and old practice. Modern medicine had to go through a painful period of peeling away and destroying their myths in order to base their practices on reality. For a long time, medicine had little to offer beyond the knowledge of what not to do (i.e. stop bleeding and purging patients). When medicine finally dropped its unfounded beliefs and adopted evidence-based practices, more children lived and more lives were saved. Naturopathy is deliberately turning away from this and returning to the discredited myths that happen to be found in non-European cultures (and homeopathy).

    I still fail to see what an ND adds to any actual medical consultation beyond a sympathetic ear and extra expenses. If your practices are evidence based, how are you different from doctors? If they’re not, why should you be allowed anywhere near a patient?

    I think I will take my own advice to naturecurepath – it is mpossible to argue with ignorance and people that are so set on their ways of thinking that they are not open to discussion.

    Agree to disagree.

    Given the very few specific arguments you have provided have lacked substance or been outright logical fallacies (like nearly every naturopathic practitioner that shows up here) you’re not really arguing very much or very well. You may disagree with my points, but at least my points are based on reason and empirical evidence rather than special pleading, double-standards and redundancy.

    Every time a CAM proponent shows up, all we ever see are the same tired talking points and rhetoric. There’s a reason I can type out my responses quickly, they require very little in the way of new thoughts because I’m facing the exact same arguments I saw last time.

  36. WilliamLawrenceUtridge says:

    Chris, you provided the reference. 200 people apparently harmed by “naturopathy” over a 20 year span, across the globe – you cannot tell me that could be a statistically significant number, and it is not even known if these people were treated at the hand of a licensed and properly trained naturopathic doctor. How does this make naturopathic medicine any more dangerous than modern medicine, under which thousands of people die from each year. And yet, I’m not even denouncing modern medicine or science! I support it! I’m simply refuting the claim that naturopathic medicine is so dangerous. I am thankful that the broader medical community is not so close-minded.

    What is the system naturoapths use to track the systemic nature of their mistakes? How does one distinguish between a “properly trained” naturopath versus a quack, when neither relies on empirical evidence? You haven’t refuted anything, you’ve merely said that real medicine has side effects. Real medicine knows this, real medicine tracks this, and real medicine systematically attempts to reduce these side effects using reason and research. Naturopaths rely on whatever was printed in a book a couple hundred years ago, as long as it wasn’t in English. The world has moved on since 1800.

    I am not a naturopathic doctor, so I will not address your case study, but I will tell you that an ND would take up to an hour talking to that boy and his parents to address all aspects of his health and health history – that alone is comforting to both patient and family, much more so over dismissing them in 5-15minutes along with a prescription that “might” work. The truth is, no one can be absolutely certain about anything. Even with all the science out there, there are new studies that come out and dismiss the latest one all the time – the “hard” evidence can often be quite fickle.

    This again seems like an argument to increase the amount of time physicians are reimbursed for when caring for patients. A laudable goal. The solution is again – more real doctors. Do you have a positive argument to make for naturopaths, or are you merely going to point to the flaws in current American medical practice? Flaws that are well-documented and decried in the mainstream medical literature (the only reason you know about them). If “comfort” is all you offer, why bill yourselves as “doctors”, why not train as “medical counselors” and solely devote your time to listening to patients about their medical complaints instead of pretending to cure them with unproven nostroms?

    I absolutely understand a desire for treatments that are scientifically based, and I hope one day there is more evidence in support of alternative therapies,

    Why is it OK for you to practice “medicine” without an evidence base, but it’s not OK for Big Pharma to do so? Why is there a double-standard here? It seems quite hypocritical for you to say it’s OK for you to prescribe unproven drugs (or worthless water) but no doubt would decry the practice if undertaken by an actual physician.

    but what would you do when those options fail you? Naturopathic medicine is not the answer to all health problems, but neither is modern medicine.

    The difference is, medicine is involved with an ongoing effort to produce more options and refine the ones we have now. Naturopathy is either parasitic on this effort (and thus redundant to real doctors) or substituting conjecture based on people who didn’t know what a cell was as a substitute for real evidence.

    I’ve never understood why Ancient Egyptian medicine wasn’t a course of study for naturopaths. It’s older than acupuncture, doesn’t that mean it’s better?

    Therefore people should have access to all modalities of treatment, through properly trained individuals. And, one would hope, a patient would be competent enough to critically think about their treatment options and not just make their choices based on something this website has to say or what a single study may suggest. Dismissing licensure for NDs would only increase the number of incompetent practitioners in these alternative modalities – and THAT is dangerous.

    Ha, “based on what a single study may suggest” is the core of many of Andrew Weil’s recommendations.

    One way to reduce the number of incompetent practitioners – convict people for practicing medicine without a license if they attempt to address illnesses using unproven (or disproven) modalities.

    Seriously – if naturopathy works, why not take the time to prove it before using it? If it works, you’re keeping an effective treatment out of the mainstream. If it doesn’t, how on earth can you defend using it?

  37. Chris says:

    WLU:

    Why was smallpox so feared? Why did well-fed Native Americans die to the tune of 90-99% when exposed to it?

    A minor point here: The one reason so many died is because they starved. The explanation I remember reading from McNeal’s Plagues and Peoples was that measles and smallpox were very contagious, and in Europe it hits those who have not had it before: children. So even if a third to half of the children die before adulthood, the remaining adults are immune. The problems is when everyone in the community is vulnerable to an infections. This means that the adults would become too sick to provide the food for their community, and perhaps a good portion of the deaths on both American continents were due to starvation.

    Some interesting reading is both 1491 and 1493 by Charles C. Mann.

    And as far as homeopathy goes: Penelope Dingle had a treatable form of cancer, but was treated by a homeopath. This page is a series of links about what happened to her. Have fun reading it, doctorbull.

  38. Chris says:

    Oh, I missed his comment. So exactly where are the statistics on the effectiveness and safety of naturopaths.

    I am not a naturopathic doctor, so I will not address your case study, but I will tell you that an ND would take up to an hour talking to that boy and his parents to address all aspects of his health and health history – that alone is comforting to both patient and family, much more so over dismissing them in 5-15minutes along with a prescription that “might” work. The truth is, no one can be absolutely certain about anything. Even with all the science out there, there are new studies that come out and dismiss the latest one all the time – the “hard” evidence can often be quite fickle.

    That naturopath would be implicated in the death of my son. Who ten years later is still alive because he was referred to an echocardiogram, and a cardiologst. And, trust me, those are not five to fifteen minute exams. And the treatment last year was several days of testing, several hours of surgery, a few days in the hospital and finally months of cardiac rehab.

    My son had obstruction hypertrophic cardiomyopathy. It is the most common cause of sudden cardiac death in young athletes. He still has hypertrophic cardiomyopathy, but without the bit of heart muscle that partially blocked the aortic valve.

    You see, this is an example how NDs should be really mean: Not a Doctor.

  39. doctorbull says:

    A licensed and trained naturopathic doctor would have had the knowledge to refer him to a specialist. Spending more time with your son simply would have meant gathering a more thorough medical and health history, therefore providing more information on which to base a treatment of action on, which most certainly could have been referring to a cardiologist. But since you did not visit an ND, you cannot infer that one would have caused his death, nor can you be sure that another MD wouldn’t have done the same thing, so this is not at all an “example”. I am grateful your son is well today and saw a competent professional, whatever their credentials.

    There are a lot of references to one-time, single episodes where some sort of “naturopathic” treatment has gone wrong. They are all weak rebuttals. For every poor experience with an “alternative” therapy, there are hundreds and thousands for modern medicine.

    I understand no one on this site will be happy until “science” has proven them wrong, but there should at least be SOME rebuttals to the defamatory comments on here. An entire field should not be dismissed based on the criteria you find lacking; not everything in life is so black and white. There will always be people that seek out alternative therapies, and that population is only increasing. Statistical surveys would likely attribute this to a “disappointment” in modern medicine. In other words, science is letting them down. It is not the be all, end all of medicine that you want it to be.

    Also, the reference to Dr. Weil as a sort of pinnacle of naturopathic medicine is again an ignorant comment. He was also trained as an allopathic doctor. Following suit on the number of inferences made on this website, one could infer that MDs are the quacks.

  40. WilliamLawrenceUtridge says:

    @Chris

    A minor point here: The one reason so many died is because they starved. The explanation I remember reading from McNeal’s Plagues and Peoples was that measles and smallpox were very contagious, and in Europe it hits those who have not had it before: children. So even if a third to half of the children die before adulthood, the remaining adults are immune. The problems is when everyone in the community is vulnerable to an infections. This means that the adults would become too sick to provide the food for their community, and perhaps a good portion of the deaths on both American continents were due to starvation.

    I’d also read that it had gone through “cycles of lethality” – selectively killing off those less able to resist death in cities and leaving behind those with some measure of innate immunity (selection pressure to surviving smallpox, akin to SIV and the apes of Africa). The next generation is slightly better at surviving, and smallpox correspondingly gets slightly more lethal. By the time it reached the Americas, it had been through so many cycles that it was far more lethal than the virus that originally infected humans in Ancient Egypt (from a mole rat or something similar I believe). So even given the “hits everyone at once” effect, the virus was inherently very dangerous and it was also reaching a population not adapted to surviving it. Whoever survived immediate death by smallpox may have starved in the resulting aftermath.

    I think that’s an accurate summary of the book I read on smallpox, can’t remember the title now.

    Some interesting reading is both 1491 and 1493 by Charles C. Mann.

    Two of my favourite books, they are superb. Right up there with Guns, Germs and Steel.

  41. Chris says:

    doctorbull:

    A licensed and trained naturopathic doctor would have had the knowledge to refer him to a specialist.

    How do you know? Does a naturopath even know how to use a stethoscope, or know what to listen for?

    How come Penelope Dingle was not only referred to a specialist, but was actively told to stay away from real medicine?

  42. Chris says:

    WLU:

    I’d also read that it had gone through “cycles of lethality” – selectively killing off those less able to resist death in cities and leaving behind those with some measure of innate immunity (selection pressure to surviving smallpox, akin to SIV and the apes of Africa).

    I have read about specific genetic sequences that confer better immunity to malaria, but can cause other issues like sickle cell anemia.

    Though the most fascinating is when bubonic plague wiped out a good chunk of Europe, it left many with a immunity mutation that protects against HIV (CCR5). Not everyone, but more than on the rest of the planet. According this Nature article, it is about 10% of Europeans, but it is being disputed.

    Unlike naturapathy, real medical research does look back and see what does and does not work. That also includes studies to show if something is actually helpful or harmful. That is something I do not see in naturopathy.

  43. WilliamLawrenceUtridge says:

    There are a lot of references to one-time, single episodes where some sort of “naturopathic” treatment has gone wrong. They are all weak rebuttals. For every poor experience with an “alternative” therapy, there are hundreds and thousands for modern medicine.

    On wikipedia that would get you a [citation needed] tag. Here, I’ll merely ask you for evidence of this. Medical doctors and hospitals track their error rates and deaths due to treatment. Does naturopathy? Where is your evidence?

    I missed this delightful bit of nihilism:

    Even with all the science out there, there are new studies that come out and dismiss the latest one all the time – the “hard” evidence can often be quite fickle.

    So, because evidence may change, we should simply do away with all of it and go with what people believed before we had microscopes? Or treat with homeopathy? Medicine responds to this challenge with more research, better research and more refined questions. So your response, the one that makes naturopathy better than real medicine, is to simply keep doing the same, untested thing and never discard anything as long as somebody who has been dead for at least two centuries recommended it?

    Actually, that does sound like naturopathy. Homeopathy doesn’t work, stop defending it.

    I understand no one on this site will be happy until “science” has proven them wrong, but there should at least be SOME rebuttals to the defamatory comments on here. An entire field should not be dismissed based on the criteria you find lacking; not everything in life is so black and white. There will always be people that seek out alternative therapies, and that population is only increasing.

    Bull, your entire field is defined by untested modalities, proven ineffective modalities or advice already part of mainstream care. Thus your practice is either unethical (untested modalities should only be used as part of clinical trials), unethical again (why would you continue to use something that doesn’t work?) or redundant (and again, parasitic). Have you ever seen this youtube video? You might find it interesting. Medicine changes, dropping what doesn’t work and picking up what does. Are there any naturopathic remedies that have been “dropped” from the curriculum? And merely because not everything in life offers easy answers doesn’t mean you should ignore all evidence and pick the fairy tale that most appeals to you.

    Statistical surveys would likely attribute this to a “disappointment” in modern medicine. In other words, science is letting them down. It is not the be all, end all of medicine that you want it to be.

    Actually that’s quite true. Now, for me the solution is to improve medicine through further research, better training, more practitioners and a better reimbursement system that prioritizes and incentivizes proper patient care. Not hiring a whole bunch of people who essentially believe in magic (“vitalism” if you prefer).

    Also, the reference to Dr. Weil as a sort of pinnacle of naturopathic medicine is again an ignorant comment. He was also trained as an allopathic doctor. Following suit on the number of inferences made on this website, one could infer that MDs are the quacks

    Believe me, nobody here thinks Dr. Weil is the pinnacle of anything (or, at least I don’t). Weil has repudiated his training (as can be seen here, here, here, here and here) thus do I hate him. You are receiving training that is profoundly antiscientific, predicated on rejection of empirical evidence, defines itself in opposition to medicine rather than adherence to anything meaningful, and you obviously haven’t thought through the implications of the rhetoric you are swallowing whole from your school. You aren’t like Weil, you didn’t have a real scientific starting point like he did, but you’re certainly firmly in the same camp.

    When you are a practicing ND, will you be selling the very products you prescribe? Do you think this is a conflict of interest? How do you think it compares to, and incentivizes prescribing practices? Is your COI better or worse than a doctor’s? A Big Pharma employee? Interesting questions to think your way through. I think your knee-jerk reaction will be to say “It’s different” but I don’t think you’ll come up with a reason beyond perhaps scale – as if the size of the perfidy is the crime, not the perfidy itself.

  44. doctorbull says:

    “Does a naturopath even know how to use a stethoscope, or know what to listen for?” What an ignorant and insulting comment.

    Thank you for showing me how little you actually know about today’s field of naturopathic medicine; now I know what little bearing your comments have. Very few people on this website have done the research to understand the education a licensed ND has undertaken. And when I speak of licensed ND’s, I speak of those that have attended the four year medical program at one of the 7 accredited institutions — all of which are in North America. An individual that is solely a homeopath, acupuncturist, herbalist, massage therapist, or whatever else you want to throw in there does not make them a naturopathic doctor, or capable of practicing the scope of naturopathic medicine. These school train these students to be primary care physicians, and 17 states in the U.S. license them as such. Do you think they’d allow licensure to someone that didn’t know how to use a stethoscope? Surely you are joking.

    Penelope Dingle was treated by a homeopath in Australia. I do not know where her provider received her “training” or in what capacity. Clearly anyone that tells someone to stay away from “real medicine” is an extremist – much like I view you and this site for the abhorrence to alternative therapies.

  45. daijiyobu says:

    doctorbull,

    I wonder if you’ve read this recent series in NDNR,

    http://ndnr.com/?s=kellum

    and I wonder if you’d care to comment?

    I’ve parsed and commented on much of it ,

    http://naturocrit.blogspot.com/2013/03/nd-kellum-in-ndnr-2013-spiritually.html ,

    and I wonder what your take is on ND Kellum’s proposal:

    that instead of become more scientifically rigorous, naturopathy needs a boundary definition of science that is much more lax so that, as I see it, science can

    “allow for fairies under the garden, magic beans, and unicorn tears [...] ND Kellum is upset that true science only supports the actual physically present in-evidence universe and not the universes of our fondest idealistic, metaphysical and religious wishes.”

    -r.c.

  46. JJ Borgman says:

    doctorbull,

    Hi. I am an SBM reader, less-than-part-time-participant and certainly no expert in any of this discussion. I am bothered by a few things.

    Why do you use the pejorative term “allopathic” when referencing medical physicians?

    Also, to claim what seems to be the ignorance of the masses as some kind of triumph and proof of legitimacy or need for “naturopathic” physicians rings hollow. As a member of a union delegation tasked with submitting to the presentation of an ND presentation to support adding their services to our medical benefits plan, I am familiar with the best arguments for naturopathy. The effort to equate naturopaths with our garden variety family doctors is troubling to me. Unconvinced by the presenter, why do you think I should vote for this inclusion in the benefits plan?

    Finally, you wrote, “Following suit on the number of inferences made on this website, one could infer that MDs are the quacks.” I don’t understand. This seems to me to sound like, at best, a severe misunderstanding of the self-examining problems of medical science and, at worst, an extreme diversion from the blog commentary.

    From where I stand, it seems you don’t like the idea that you should have to account for the tenets of naturopathy, but rather your views should be granted on special pleading or popularity.

  47. doctorbull says:

    Hi JJ,

    I actually wasn’t aware that “allopathic” was a pejorative term; I was just using it instead of saying traditional medical education. If it is derogatory, I am happy to use another term. My jab at MDs being quacks is quite contrary to my actual thoughts. I was making light of the slighting references made about Dr. Weil and Dr. Rath, both of whom are traditionally trained MDs. There has been reference to several “bad apple” naturopathy practitioners that have somehow translated into the entire field being a scam. So if Dr. Weil and Dr. Rath are being used as examples, then I was saying that one might infer that all MDs are like them. Of course this isn’t true.

    I wish I could have heard the pitch given to you for the inclusion of naturopathic medicine under your medical benefits plan, because I can’t comment on the accuracy or persuasiveness of what you were given to draw you conclusions on. Regardless, I appreciate the fact that you did hear an argument for it, and formed your opinion from there. Naturopathic modalities are generally less expensive than conventional medicine, so I would view that as beneficial and more cost-effective for insurers than traditional treatments. Naturopathic medicine, when practiced by a licensed ND, is also geared toward preventative medicine and getting to the underlying cause of a health concern, while I would say that modern medicine does an amazing job at treating symptoms. By treating just the symptoms, however, a patient may continually come back time and time again for costly medication and services. Getting to the root of a health concern would eliminate this need altogether, again saving insurers money.

    Yes, I would say the biggest flaw of naturopathic medicine is most certainly the lack of scientific evidence, as that is what today’s society wants to see. It is there, however, just not in the capacity and in the spotlight in which traditional medicine has. I hope with more time and funding we will see this change. Additionally, naturopathic medicine, as it is taught in the accredited schools, in not geared toward curing cancers, AIDS/HIV, or any other severe health issue. Again, they are primary care physicians taught to treat the variety of health concerns any traditional PCP would see.

    My biggest qualm with this site is the comments that naturopathic medicine is a deleterious practice. It is impossible for it to be any more dangerous than traditional medicine when practiced by someone licensed in the field. I understand any argument against it regarding it’s “proven science” – it is just not there in the capacity that traditional medicine is, but that doesn’t mean it will not ever be.

  48. Chris says:

    doctorbull:

    These school train these students to be primary care physicians, and 17 states in the U.S. license them as such. Do you think they’d allow licensure to someone that didn’t know how to use a stethoscope? Surely you are joking.

    Prove it. Show us where in the curriculum that they learn how to distinguish the actual sounds they hear. I checked Bastyr’s website for their curriculum for a naturopathic doctor. I saw two classes that had the syllables “cardio”, they were “Integrated Cardiovascular and Immune” and then just “Cardiovascular.”

    I also see there is an article on how well one of their graduates did as a PCP: Death by Natural Causes:

    What Messer did not do was perform tests used by conventional medical doctors to determine the severity of an asthmatic attack and whether a patient needs to receive emergency care. There is no consensus on whether such tests should be a part of naturopathic care. But most medical doctors agree that they are essential

    Now what really scares me about your training, or lack of training, is that you did not pick up on the obvious hints I gave you to the severe genetic heart problem in my son. You ignored the fact that increase in exercise made him out of breath and caused pain in his left arm, and worse ignored the actual audible heart murmur. As one nurse said in an emergency room over a year ago that the murmur was so loud he probably did not need the stethoscope.

    I can guess at how well a naturopath would treat a newborn with neonatal seizures that come every few minutes, each time stronger and longer (and yes, that happened to my kid too). What kind of herbs would a naturopath order that would be better than the phenobarbital that did stop the baby’s seizures?

    Naturopathy will get respect when they actually start teaching real medicine, and require a full residency treating real patients. Not the worried well that walk into Bastyr’s walk in clinics. That is what osteopathy did. They looked at their curriculum, and changed. In the USA osteopathic doctors take the national medical boards, and do residencies in real medical practices (the last ER doctor was a family practice DO doing his emergency medicine portion of his residency).

    DoctorBull, would a graduate of those seven naturopath schools be able to pass these exams: http://www.usmle.org/ ?

  49. WilliamLawrenceUtridge says:

    I actually wasn’t aware that “allopathic” was a pejorative term

    Yes, it’s a pejorative term that’s sometimes adopted by physicians who either are ignorant of it’s origins and use or are trying to repurpose it. It is meant to distinguish from “homeopathic medicine”, which means “same symptoms” (i.e. homeopathy’s spurious “law of similars/treating like with like”) because it doesn’t “treat like with like”. It was meaningless when it was neologized by Hahnemann and isn’t much better now. I would stick with “physician” if you need to make the point and distinction clear.

    I was just using it instead of saying traditional medical education.

    “Traditional” medical education is quite iconoclastic. Father of evidence-based medicine Dave Sackett said “Half of what you’ll learn in medical school will be shown to be either dead wrong or out of date within five years of your graduation; the trouble is that nobody can tell you which half—so the most important thing to learn is how to learn on your own“. Medicine is expected to advance as knowledge does, a traditional medical education teaches critical thinking, not just rote learning of technique and historical cures.

    I was making light of the slighting references made about Dr. Weil and Dr. Rath, both of whom are traditionally trained MDs. There has been reference to several “bad apple” naturopathy practitioners that have somehow translated into the entire field being a scam.

    …who have abandoned the primary tenants of their training – evidence-based medicine and adherence to the principles, knowledge of and ongoing developments in biology, chemistry, physics and more. These doctors are scorned because they turned away from their training and the mainstream. You’re rather missing the point of the criticisms of naturopathy, which are that it is inherently a worthless field. It has two approaches – either parasitic on and redundant to real medicine (parroting it’s injunctions to eat healthy, exercise and get enough sleep), or promoting unproven, disproven or essentially impossible treatments like herbal medicine, acupuncture and homeopathy. Plus a dollop of special pleading (“We shouldn’t have to prove our treatments work” – Really? Why not? That’s quite a double-standard), a lot of false dilemmas (“Big Pharma is evil therefore naturopathy works” – No, Big Pharma is evil and naturopathy doesn’t test or ignores tests of its modalities), and usually a heapin’ helpin’ of appeals to tradition (“Acupuncture is old, so it works” – no, acupuncture with filiform needles isn’t that old, it barely works for pain and nausea, and Ancient Egyptian medicine is older, why don’t you use crocodile dung as birth control?). Seriously, how can you defend a discipline that refuses to test its modalities and ignores the results it doesn’t like? You’d throw a fit if Big Pharma started selling placebos or active pills that don’t work, why the double-standard?

    I wish I could have heard the pitch given to you for the inclusion of naturopathic medicine under your medical benefits plan, because I can’t comment on the accuracy or persuasiveness of what you were given to draw you conclusions on.

    You should really look up the posts here, particularly the older ones. You should really think about the arguments, and see if they have any merit. It looks very much like you have never thought critically about your discipline. Surely if naturopathy is as safe and effective as you believe, it can stand some counter-arguments, right? If you want specific links, try this one and this one.

    Regardless, I appreciate the fact that you did hear an argument for it, and formed your opinion from there.

    My opinion is formed due to years of reading and critical thinking, as are my comments which you have failed to rebut.

    Naturopathic modalities are generally less expensive than conventional medicine, so I would view that as beneficial and more cost-effective for insurers than traditional treatments.

    For something to be cost effective, it must first be effective. If your argument is “naturopathic treatments are a cheap way to avoid adverse effects from treatment”, that may be true but it’s not necessarily good.

    Naturopathic medicine, when practiced by a licensed ND, is also geared toward preventative medicine and getting to the underlying cause of a health concern, while I would say that modern medicine does an amazing job at treating symptoms. By treating just the symptoms, however, a patient may continually come back time and time again for costly medication and services. Getting to the root of a health concern would eliminate this need altogether, again saving insurers money.

    How does this jive with antibiotics to treat bacterial infections? Vaccination? Weight loss and dietary advice for type II diabetics? Baby aspirin for strokes? Neonatal checkups? Annual checkups? Exercise to maintain bone and muscle strength? Adequate calcium intake during childhood and young adult years to stave off osteoporosis in senescence? What conditions can naturopathy “treat the underlying cause of” that medicine can’t? In response to this question, some naturopaths have mixed up medicine “treating the symptoms” for “patients not listening to their doctors”. If naturopaths are more successful at this, please provide a citation.

    Also, what again is a “healing crisis”? What do you do if a homeopathic remedy doesn’t alleviate a symptom? Does a homeopathic remedy “treat a symptom” or does it “cure a condition”? What about herbs? Acupuncture? Pick a modality, I’ll discuss.

    Yes, I would say the biggest flaw of naturopathic medicine is most certainly the lack of scientific evidence, as that is what today’s society wants to see.

    Without such evidence, your practice is unethical. You are either lying to your patients, ignoring evidence, or simply have none. Again, why is it acceptable for you to provide patients with untested herbs (which can be poisonous) but you would kick and scream and fight if Pfizer tried to do the same thing?

    It is there, however, just not in the capacity and in the spotlight in which traditional medicine has. I hope with more time and funding we will see this change.

    What is the current budget for the NCCAM? What treatments have its grants tested? Which of those treatments have been demonstrated to work? What treatments not shown to work are still being taught in your curriculum? Why does your curriculum include so many courses on homeopathy?

    Additionally, naturopathic medicine, as it is taught in the accredited schools, in not geared toward curing cancers, AIDS/HIV, or any other severe health issue. Again, they are primary care physicians taught to treat the variety of health concerns any traditional PCP would see.

    I can guess why to – in those cases, where the condition is not self-limiting and death is inevitable without treatment, naturopathy is most obviously worthless. There is no waxing and waning of symptoms, merely death due to untreated illness. Why is naturopathy so helpful for other conditions and so helpless here?

    Also, why are naturopaths advocating for the right to prescribe medications like antibiotics when “nature” so happily provides us with safe and effective treatments for our health woes?

    My biggest qualm with this site is the comments that naturopathic medicine is a deleterious practice. It is impossible for it to be any more dangerous than traditional medicine when practiced by someone licensed in the field. I understand any argument against it regarding it’s “proven science” – it is just not there in the capacity that traditional medicine is, but that doesn’t mean it will not ever be.

    Really. Tell that to a naturopathic oncologist. And again, why can’t you test your treatments before using them? Why the double-standard? Why does naturopathy get a pass on proving their treatments work (particularly when they are apparently so effective) but Big Pharma has to put billions of dollars into clinical trials? The only word I can come up with to describe such a practice is “hypocrisy”. Am I wrong? Why?

    Medicines and medical interventions carry risk, but also bring benefits. They undergo rigorous scrutiny to ensure the risk:benefit ratio is wide enough to merit continuing with treatments. How is naturopathy better when it is never scrutinized, when its benefits are never established? Ineffective treatments can never be anything but a net drain on any economic or human system.

    Why not start thinking critically about your chosen profession now, while you’re still learning? It could save you a lot of pain later on.

  50. Chris says:

    I have a comment in moderation.

    doctorbull:

    Naturopathic medicine, when practiced by a licensed ND, is also geared toward preventative medicine and getting to the underlying cause of a health concern, while I would say that modern medicine does an amazing job at treating symptoms.

    Real medicine is very much focused on preventative medicine. That has been discussed often on this blog. That included diet, exercise, no smoking and vaccines. The ironic part is that those who go to naturopaths as PCP are less likely get vaccines: Pediatric Vaccination and Vaccine-Preventable Disease Acquisition: Associations with Care by Complementary and Alternative Medicine Providers. So you can’t say naturopaths are “geared toward preventative medicine” when they actively do not try to prevent diseases like measles, pertussis, tetanus, influenza, etc.

    More studies on naturopaths and vaccines:

    Vaccine. 2001 Oct 15;20 Suppl 1:S90-3; discussion S89.
    Rise in popularity of complementary and alternative medicine: reasons and consequences for vaccination.

    Vaccine. 2004 Jan 2;22(3-4):329-34.
    A survey of attitudes towards paediatric vaccinations amongst Canadian naturopathic students.

    Pediatrics. 2005 Mar;115(3):e338-43.
    Characteristics of pediatric and adolescent patients attending a naturopathic college clinic in Canada

    Vaccine. 2008 Nov 18;26(49):6237-43. doi: 10.1016/j.vaccine.2008.07.020. Epub 2008 Jul 30.
    Attitudes towards vaccination among chiropractic and naturopathic students

  51. doctorbull says:

    Hi R.C.,

    I appreciate the invitation to read those the article and your blog. Dr. Kellum apparently sees a divergence in the ND field, and I can’t say I agree with the direction he is supporting, nor do I think the majority of today’s naturopathic medical students would agree either; you can say that I certainly would not be one of the ND’s willing to “embrace this challenge” that he speaks of – the challenge of trying to incorporate a spiritual science. I think it is important for NDs to understand the history and development of the medicine, but for anything to move forward in our ever-changing world, one must also adapt. I have never been one to embrace “spirituality” too heartily, but we also know this is a very subjective thing, and I’m not going to argue its existence or the “power” it may have for someone. I would agree, however, that it has no place in science. If naturopathic medicine is to move forward, it most certainly has to align itself with the demands of current times, while maintaining its main philosophies (note that anthroposophy is not one of them):

    * Recognizing the body’s ability to heal itself
    * Identify and treat the cause
    * First, do no harm (try less invasive treatments first)
    * Doctor as teacher (educating patients on their health)
    * Treat the whole person (mind, body….and yes, the spirit to some, whatever that may mean to someone)

    I think the points in your blog are valid, albeit a bit aggressive. Making over-the-top statements such as “fairies under the garden, magic beans, and unicorn tears” does not do much for me when I want to have a dialogue with someone – it is not a very good starting point for a constructive discussion, but at least you appear to be open to one. You are passionate about your view, as am I about mine, so I understand.

  52. doctorbull says:

    Chris,

    Vaccines are a touchy subject, even with NDs. I would not say that all NDs are against vaccines, although a large majority of them are. My individual thought is that it is a personal choice. Yes, there is a duty to protect the broader population, but there are enough studies and literature out there to cast some doubt on their potential for adverse reactions, that I can see the argument against them. Just because it has not been explicitly proven that X causes Y, does not mean that the chance does not exist; perhaps there is an angle that researchers have not looked into yet – what if there is a specific window of time in infant/child development where vaccines could be dangerous, or a genetic component that we just haven’t discovered it yet? I see both sides of the story and support an individual choice – not all NDs would be opposed to a similar thought.

    And I agree, “real medicine” (we’ve bantered back and forth enough – can we cut down on the condescending remarks yet?) does not abandon preventative measures, but it is often not its prerogative as it is with naturopathic medicine. It is the approach to treatment that differs with NDs.

  53. Chris says:

    DoctorBull:

    * Identify and treat the cause

    So even though when I gave you my son’s symptoms that included pain in his left arm after exertion, and even a heart murmur you said “but I will tell you that an ND would take up to an hour talking to that boy and his parents to address all aspects of his health and health history – that alone is comforting to both patient and family,”

    So with those big huge hints, you had no clue there might be something wrong with his heart. You really are not fostering much confidence in naturopathy’s ability to diagnose. And I challenge to to tell me how you can get the “body to heal itself” when it was the body doing its own thing with obstructive hypertrophic cardiomyopathy.

    I would love to hear how a naturopath would diagnose and treat the neonatal seizures that started two days after birth, which started small and short, and then progressed to more often, longer and stronger. Perhaps some kind of homeopathic treatment, and an nice long talk with the parents instead of calling for an ambulance.

    As noted in my comment that is in moderation, I checked Bastyr’s curriculum for a naturopathic doctor. I saw lots of generalities, you are going to have come with some specific classes that actually address diagnosing real diseases. You need t prove that naturopaths can do everything you claim they can do.

    The least an ND can do is pass the “United States Medical Licensing Examination.” Because if naturopaths want to be treated like real doctors, they should emulate the osteopaths by changing their curriculum and training to become real doctors. Someone with an OD after their name is just as qualified as someone with an MD after their name. Until naturopaths embrace real science, which means having nothing to do with fairy tale stuff like homeopathy, then ND will no longer mean Not a Doctor.

  54. Chris says:

    DoctorBull:

    And I agree, “real medicine” (we’ve bantered back and forth enough – can we cut down on the condescending remarks yet?) does not abandon preventative measures, but it is often not its prerogative as it is with naturopathic medicine. It is the approach to treatment that differs with NDs.

    Then don’t decide what science you like or don’t like if you want NDs to be taken seriously. Because in the paper I linked to the kids getting CAM treatment got sick with vaccine preventable diseases more often. Ignoring the very real science that vaccines, while they have some risks, are much much safer than the actual disease is not “practicing preventative medicine.”

  55. doctorbull says:

    As I stated, Chris, I am not a naturopathic doctor – that is why I didn’t take your “case study” test, so it wouldn’t be fair to use me as a measure of confidence in naturopathic medicine. Right? Right. I play fair – I can see that you don’t. I’ll continue to repeat this, but a licensed ND is trained as a PCP, and therefore taught to refer to specialists as needed. Your snarky comments (re: neonatal seizures) do nothing for your argument.

    I will be a naturopathic medical student this fall, and am more than happy to share the ins and outs of the curriculum with you and this community. I am approaching school with a healthy amount of skepticism and will be documenting my journey. I’ll be sure to share the site with you; more material for you to manipulate and misinterpret – get excited. However, I can’t assume that every SBM reader on here is as narrow-minded as you seem to be, and I hope I offer a candid insight at what my “fake” medical school is all about, for those that are willing to listen and respectively come to your conclusions. I’ll be learning along with you.

    Lastly, the homeopathy argument when it comes to naturopathic medicine is old. Not all ND’s practice it and I have nothing to comment on it until I see, or don’t see, it’s treatment effectively applied first hand. I get it – it seems hokey – but I’m not one to judge yet.

  56. weing says:

    ” I’ll continue to repeat this, but a licensed ND is trained as a PCP, and therefore taught to refer to specialists as needed.”

    Then they should have no problem passing part I, II, and III of the NBME. They should also have no problem passing the Family Practice or Internal Medicine boards.

  57. Harriet Hall says:

    @doctorbull,

    “* Recognizing the body’s ability to heal itself
    * Identify and treat the cause
    * First, do no harm (try less invasive treatments first)
    * Doctor as teacher (educating patients on their health)
    * Treat the whole person (mind, body….and yes, the spirit to some, whatever that may mean to someone)”

    That describes the approach of the MD.
    What naturopathy does that is good is not different from conventional medicine; what it does that is different is not good (homeopathy, unproven treatments, lower vaccination rates, etc.).

    How can you speak for naturopathy when you are not even a student yet? I submit that, just possibly, those of us who are trained in medicine and have the benefit of experience may know whereof we speak better than you do.

  58. Chris says:

    (not) doctorbull:

    but a licensed ND is trained as a PCP, and therefore taught to refer to specialists as needed. Your snarky comments (re: neonatal seizures) do nothing for your argument.

    No, they are not. You have no idea what it is to have a child with real medical problems. And, yes, I have also had to deal with real seizures. Even a person who has only graduated from high school would recognize the heart symptoms I presented. And to pile one: the kid also had seizures from a now vaccine preventable disease. So you really need to get some real science to defend the “controversy.”

    I will be a naturopathic medical student this fall, and am more than happy to share the ins and outs of the curriculum with you and this community. I am approaching school with a healthy amount of skepticism and will be documenting my journey.

    Then you have no idea what you are defending. You have never dealt with families that have real health issues, and the nuances of real illnesses that can seem minor at first, but later turn into several 911 calls and trips to hospitals.

    And to repeat a previous question: why are you not trying to become an MD or OD?

    If you did not have the high school or university grades to get into a osteopathic or medical school, then why not become a medical technician or paramedic? Those are the actual people who helped save my son’s life. Starting with the echocardiogram technician who alerted our family doctor to my son’s diagnosis before the radiologist saw it, so he could tell me not to let my son go to soccer practice… and the paramedics who came during the 911 calls a bit over a year ago when his symptoms became much worse. They are the real front line of medical care. Much more than someone pretending to play doctor, like naturopath.

    Lastly, the homeopathy argument when it comes to naturopathic medicine is old. Not all ND’s practice it and I have nothing to comment on it until I see, or don’t see, it’s treatment effectively applied first hand.

    You have got to be joking. Homeopathy is part of the actual curriculum at Bastyr (several classes, much more than cardiology, etc). Only a person who flunked high school chemistry would ever bother with homeopathy. Look where the staff of this homeopathic clinicgraduated from. Homeopathy is a joke. Any school that teaches it is a joke.

    Ah, my comment has left moderation. You can see how great a graduate of Bastyr was as PCP for a kid with asthma. I now personally how well a Bastyr graduate did in a the oddly named “Children’s Homeopathic Clinic” did with a relative of ours. They made her give up her real medicine for their expensive homeopathic nostrums, and now she is buried in the cemetery up the street due to sitting in a garage with her car running. Apparently you cannot treat schizophrenia with homeopathy. Who knew? Well, certainly not a naturopath!

  59. doctorbull says:

    WLU,

    I appreciate the abundance of armor you have against “alternative therapies” and it would take me an exhaustive amount of effort to read through, and attempt to refute, all of your points when I know you wouldn’t be convinced otherwise – so I concede right now. When my blog is up and running in the future, and I’m armed with all the support you want me to throw at you, we can have a heyday. One point, however: links to articles on “quackwatch” and similar sites, including this one, do nothing constructive to support your arguments. I am much more apt to consider support from unbiased individuals, which I’m sure you have plenty of.

    I am genuinely interested in your thoughts on the following personal experience I’ve had:

    I have suffered from recurring UTIs since I have been sexually active. Each month was another trip the doctor to do a urine test, and another round of antibiotics, which, as you may know, also readily causes yeast infections in women. It is a most pleasant cycle (said sarcastically, of course). The eventual conclusion was for me to take prophylactic antibiotics. So for the rest of my sexually active life, I was prescribed to take antibiotics. This was an upsetting prognosis for me to accept. You are not a woman, so I don’t expect you to be too sympathetic. Two years ago I went to my physicians office, which also happened to have several NDs on staff (integrated practices are becoming more common, whether you want to accept that or not). I chose to go to one for a general checkup. It was just like any other doctor visit, by the way – she asked me about my health history, took my blood pressure, listened to my heart and lungs, etc. Although I had already been to multiple physicians regarding my recurring UTIs and was well versed in drinking plenty of fluids, urinating before and after intercourse, and consuming 100% cranberry juice (perhaps you deem this “alternative”, who knows), I thought I’d ask her if there was anything else I could be doing. And you know what? There was. She asked if I had heard of D-mannose powder – never had. Didn’t see it mentioned in a single online search regarding UTIs, not one of the physicians I spoke to ever mentioned it, and to this day not a single physician I’ve spoken to has heard about it. And yet, I went from having 8- 10 UTIs a year without any sort of treatment, to having about 1 – 2 a year, just by taking this powder around the time of intercourse as my ND instructed me to – comparable to my use of a prophylactic antibiotic, but without the possible side effect of a yeast infection, and without the chance for the bacteria to grow resistant to future antibiotic use. Yet because scientists have yet to explore this treatment aggressively, it’s not recommended in most conventional practices. D-mannose powder is a naturally occurring component in fruit, including cranberries, and there are no known side-effect to its use. Do you think I was treated unethically here? Do you find its recommendation as a preventative treatment for UTIs to be dangerous or harmful because it hasn’t been aggressively studied, or because a study might show that it is no more or less effective than a prophylactic antibiotic? I am asking because these are the types of alternatives NDs offer to those seeking them, and you can bet there are far more than just my experience here.

    On a side note, this “experience”, nor any other specific event, is the reason I have chosen to pursue naturopathic medical school. I have always had an innate interest in “natural” and less invasive approaches to treating the body.

    I believe you asked why NDs would have a need to prescribe medications. Simple, sometimes medication is absolutely necessary for proper treatment. If I had a patient that walked in with a full blown UTI, you can bet that I would prescribe them an antibiotic. And what about patients that want to get off medication? Stopping certain medications abruptly can be dangerous – NDs need to be able to prescribe lesser doses to gradually, and safely, wean users off them.

  60. doctorbull says:

    Harriet, Chris, etc.: I have never had a desire to attend traditional medical school, but I certainly don’t discredit anyone who does. In my personal opinion, it has become a bit of an overwhelmed, and overcompetitive institution, which is an environment I, personally, don’t want to be in. The curriculum wouldn’t teach me the alternative modalities I am interested in either. Naturopathic medicine is not that hard to understand, but I’m learning there are just those out there who will never “get it”. I can at least “get” all of your concerns, but I suppose I am just a bit more liberal in my thinking to understand that naturopathic medicine is not going to undermine conventional medicine. It’s not its goal, either.

    I digress. So many of you are so obstinate; it is not a way of thinking or acting that I subscribe to, and I have involved myself far too much at this point. We all have our opinions, and I am happy that I was able to get a few supportive ones on here for naturopathic medicine, amongst the slew of defamations.

    There’s a lot of hate on here. I hope everyone finds time to smile today.

  61. Harriet Hall says:

    @doctorbull,
    “there are no known side-effect to its use”

    The Natural Medicines Comprehensive Database reports side effects: loose stools and abdominal bloating. There is concern that high doses (unspecified) might be toxic to the kidneys. Some clinical research suggests that d-mannose can increase HbA1C and it theoretically might worsen glucose control. It is teratogenic in rats, although there are no reports of teratogenic effects in humans. Because of insufficient reliable information, the NMCD recommends that it be avoided during pregnancy. Did the ND give you that information?

    And of course, your report is anecdotal. You have no way of knowing whether the frequency of your UTIs might have dropped due to fluctuations in the natural course of the disease.

  62. Jan Willem Nienhuys says:

    WUL on “allopathy”

    It was meaningless when it was neologized by Hahnemann

    I beg to differ. Hahnemann enumerated carefully what he saw as the bad points of 18th century
    medicine:

    - bloodletting
    - emetics
    - purgatives
    - laxatives
    - stimulation of profuse sweating
    - klysmas with ‘drugs’
    - artificial pussing sores
    - cauterisation and etching
    - killing all pain by opium
    - mustard plasters
    - spanish fly
    - cupping
    - acupuncture
    - electric shocks
    - mercury and lead preparations

    and more. In various places he provides lots of horrible details about what passed for ‘medicine’ in his day. And together he termed these methode ‘allopathy’ = treatment with unsuitable means. See Organon section 54 for Hahnemann’s own etymology. But in the third paragraph of his Introduction we read already:

    Simultaneously, but quite independent of all these theories, there sprung up a mode of treatment with mixtures of unknown medicinal substances for forms of disease arbitrarily set up, and directed towards some material object completely at variance with nature and experience, hence, as may be supposed, with a bad result – such is old medicine, allopathy as it is termed.

    and later, after lambasting ‘old school physicians’ for not knowing causes of diseases

    How could they then, without deceiving themselves, [...] prescribe for it medicines whose curative powers were likewise generally unknown to them, and even give several such unknown medicines mixed together in what are termed prescriptions?

    The absurdity of medicinal mixtures was perceived even by adherents of the old school of medicine, although they still continued to follow this slovenly plan in their own practice…

    Here Hahnemann protests against the habit of prescribing mixtures of very many herbs plus addition of other substances.

    quotations from
    http://www.homeoint.org/books/hahorgan/orgaintr.htm

    This Introduction of Hahnemann contains many details about medical practicen in his time, most of which would get a modern doctor stricken off the Medical Register if he or she was caught doing it once.

    So allopathy = 18th century naturopathy.

    Calling regular medicine ‘allopathic’ is an insult. The term is used by people who have no idea what modern regular medicine comprises.

  63. Jan Willem Nienhuys says:

    PS it was WLU I referred to, not WUL.

  64. WilliamLawrenceUtridge says:

    And of course, your report is anecdotal. You have no way of knowing whether the frequency of your UTIs might have dropped due to fluctuations in the natural course of the disease.

    I’m more concerned with the fact that vaccines are apparently too risky to recommend to all patients (despite thousands of studies and over a century of testing demonstrating vaccines safely prevent deadly diseases with minimal side effects), but mannose powder, with almost no testing in humans, no efficacy studies, and no indication of long-term human trials or post-approval surveillance is perfectly fine.

    If Pfizer produced and marketed mannose powder, without the years of study that clinical trials, efficacy and safety testing in humans requires, would you take it? Yet one naturopath says “try it” and you take it regularly, for years, I’m guessing daily? That is an interesting approach. Do you purchase this directly from the naturopath themselves? Is that a conflict of interest?

  65. WilliamLawrenceUtridge says:

    @Jan Willem Nienhuys

    Dictionary.com appears to have let me down, thanks for the correction!

  66. daijiyobu says:

    @Jan Willem Nienhuys, “calling regular medicine ‘allopathic’ is an insult. The term is used by people who have no idea what modern regular medicine comprises.”

    Agreed, but I do wonder if usage forward will submerge that reality.

    For instance, in a letter to the Alaska legislature in 2010, the Alaska State Medical Board chair used that ‘a’ word to describe regular medicine (see http://www.legis.state.ak.us/basis/get_documents.asp?session=26&docid=5842 ) stating:

    “contrast the four-year education received by the naturopath consisting of two years of didactic training and two years of clinical training against the typically eight to twelve years of education and training received by allopathic and osteopathic physicians.”

    Also, the Princeton Review in “The Best 168 Medical Schools” (see http://www.amazon.com/Medical-Schools-Edition-Graduate-Admissions/dp/0375427880 ) states:

    “the 2011 edition is our most complete medical school handbook to date; it contains 125 accredited allopathic schools in the United States [...] 17 accredited allopathic schools in Canada, 20 accredited osteopathic schools, and a section profiling 6 accredited naturopathic schools in the United States and Canada.”

    It’s very unfortunate because it severely distorts the knowledge status of 19th century and previous ‘-pathy’ prescientific ‘medical’ systems [naturopathy, osteopathy, homeopathy, allopathy etc.].

    Has modern medicine and consumer rights already lost this language battle?

    I saddens me that high school and undergraduate age young adults will believe this “best” label describing naturopathic education, and route their lives that way — and not to pun, but punning anyway — merely see so-called allopathy as one of many equal ‘path’s to physicianship.

    By the way, naturopathy has now attained status with the Indian Health Service (see http://indiancountrytodaymedianetwork.com/2013/03/04/introducing-naturopathic-doctors-indian-health-service-clinics-147984 ) by way of AANP and AANMC [who, IMHO, are hucksters]:

    “the future goal of the American Association of Naturopathic Physicians and the Association of Accredited Naturopathic Medicine Colleges is to work with licensed graduates and tribes to create beneficial partnerships that will lead to the better overall health of tribal communities [...] in order for naturopathic doctors to continue on the list of health professionals approved for the loan repayment program the tribes themselves need to advocate that naturopathic medicine is beneficial [...this is] ‘holistic heaven’ [...] ‘one of the great things about naturopathic medicine is that we have so many tools,’ said Dr. Orna Izakson, a Portland, Ore., ND [...like] acupuncture [...and] homeopathy.”

    I’m all for indigenous health measures…but really, hasn’t their been enough Euro-descendant deception upon indigenous populations?

    I hope high scientific standards triumph.

    -r.c.

  67. doctorbull says:

    Thank you for the information, Harriet. I learned something today then. However, I don’t find the side effects any more dangerous than that for antibiotics.

    I have yet to be to a doctor who has listed to me all the side effects, known or possible, of the medication he/she is prescribing, so unless that is what you practice on a daily basis, I don’t see the need for your condescending tone.

    D-mannose powder is available widely. My doctor’s office, like most, does not have items for purchase. What you are inferring, WLU, is no different from the perks doctors may get from pharmaceutical companies to prescribe their drugs.

  68. weing says:

    “I have yet to be to a doctor who has listed to me all the side effects, known or possible, of the medication he/she is prescribing, so unless that is what you practice on a daily basis, I don’t see the need for your condescending tone.”

    First of all, why would you prescribe a potential teratogen to someone who can get pregnant? Where is the testing for this indication? If you are the guinea pig being used for an off-label, shouldn’t you be informed of that fact? Does it even have a package insert? For the drugs I prescribe, I tell my patients about the main side effects to watch out for.

  69. Jann Bellamy says:

    @doctorbull:

    “I have yet to be to a doctor who has listed to me all the side effects, known or possible, of the medication he/she is prescribing . . .”

    All prescription medications must be accompanied by an insert listing all side effects, even those that have no proven connection to the drug. Prior to marketing, they must be extensively tested for safety and efficacy, and all adverse effects must be reported to the FDA after market. This is federal law. Dietary supplements, on the other hand, are not tested for safety and efficacy prior to marketing. Even after they are on the market, only serious adverse events must be reported to the FDA and this occurs only when a purchaser voluntarily notifies the manufacturer of a side effect. We have no idea whether most dietary supplements are safe and effective. This is why D-mannose powder is widely available despite lack of safety and effectiveness information.

    You are obviously convinced that naturopathic practice is beneficial and no amount of evidence is going to change that conviction. So be it. However, before you spend four years and a lot of money going to naturopathic school, I’d advise you to take a realistic look at your job prospects after graduation. Naturopaths are licensed as health care providers in only 16 states. They are covered by insurance in only a few states. Every statistic I’ve seen indicates that the demand for naturopathic services is minimal. Three tenths of one percent of American adults saw a naturoapth in 2007 — the last year for which stats are available (that I know of). In Washington State, where they are both licensed and covered by health insurance, 1.6 percent of the insured adult population saw a naturopath in 2007, and 1 percent of the pediatric population. I think you should compare these figures to the number of graduates from the 4 U.S. naturopathic schools each year. I don’t know this but I think simple math would indicate that there are many more graduates than jobs. I hope the school you are attending is not giving you a false impression of your job prospects. If they are you may want to rethink whether you want to attend that school.

  70. doctorbull says:

    oh, Jann, I appreciate the concern, and it is nice to hear from the lady herself. Please know that I have considered this career for many years and you can be sure I am well aware of the challenges ahead, including dealing with extreme opposition like yourself. Schools have not wooed me with ideas of false hope; they actually do quite a good job of making sure we understand the challenges before we are admitted. I have interacted with and contacted a number of practicing NDs to better understand their experiences post graduation – I think I’ll be just fine. The sincere people in this field do it because they have a passion for it and for helping others; I would have no other justification for leaving my current six-figure job. Money has little bearing, and the field has a very high satisfaction rate.

    I’m well aware of the inserts that come along with prescription medications – how can you miss them when they are 5 pages long? Few deaths from vitamin overdoses have ever been found (and the conclusions are not so concrete), yet thousands die each year from FDA regulated prescription medications, and at the recommended doses. So I am sorry that I fail to see why you all have such a strong conviction for the regulation of them, other than an argument that it is “not fair”? I’d much prefer the already overworked FDA spend time reviewing cancer drugs and other life-saving treatments than use its precious resources on regulating vitamins or other naturally occurring substances that have not yet shown to pose a threat to human lives.

    I appreciate the differences in our opinion, and how strongly we are both convicted of them. I, however, do not choose to uphold my opinion in such a way that I debase others, as so many on this site choose to do.

  71. weing says:

    Hogwarts or medical school? Tough choice.

  72. Chris says:

    Jann Bellamy:

    So be it. However, before you spend four years and a lot of money going to naturopathic school, I’d advise you to take a realistic look at your job prospects after graduation.

    Exactly. I know of a naturopath who is working as a counselor at a local high school (the type of counselor that makes sure the students get the proper number of credits to graduate, not like the counselor who works in the teen health center). This person insists on being addressed as “Doctor.” Many in the school, especially those who teach science, and some parents usually say “doctor” sarcastically when out of earshot.

    DoctorBull:

    I’m well aware of the inserts that come along with prescription medications – how can you miss them when they are 5 pages long? Few deaths from vitamin overdoses have ever been found (and the conclusions are not so concrete), yet thousands die each year from FDA regulated prescription medications, and at the recommended doses.

    Now you admit the opposite of what you said before: “I have yet to be to a doctor who has listed to me all the side effects, known or possible, of the medication he/she is prescribing . . .” Of course, you must not realize it is actually the pharmacist who is there to talk to. They have a graduate degree, and are always willing to discuss the medication, which they would know more about than the doctor.

    Vitamin overdoses may not always lead to death, they are still dangerous. For example: iron supplements are deadly to children, overdoses of Vitamin A lead to some very nasty birth defects, and Gary Null almost died from taking his own Vitamin D supplement. Check out the 2011 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 29th Annual Report. I see the tables also include “Dietary Supplements/Herbals/Homeopathic” along with a list of other things. There were not thousands of deaths, but there were tens of thousands of possible poisoning exposures from vitamins and supplements (though more from analgesics, household cleaners and a few other things depending on age, see Tables 17C and 17D). That is still quite significant, especially since many did have actual health effects.

    And you neglected to mention how many millions have been saved by those FDA regulated drugs, especially vaccines. Not to mention antibiotics, blood pressure meds (I am related by marriage to a family with a genetic form of hypertension, until the 1950s their average lifespan was early forties, now it is mid-eighties), insulin, etc.

    And I don’t hate naturopaths, I just have no respect for them. Especially if they ignore well tested ways to prevent disease (vaccines), and prescribe untested (possibly teratogenic) nostrums (mannose). You garnered absolutely no brownie points in your blind defense of an unscientific unproven mode of care that clings to old myths.

    Well, at least in the world of Hogwarts, magic is real. On this planet, not so much.

  73. WilliamLawrenceUtridge says:

    …and now I’ve got a bit of time.

    Thank you for showing me how little you actually know about today’s field of naturopathic medicine; now I know what little bearing your comments have. Very few people on this website have done the research to understand the education a licensed ND has undertaken.

    You might be surprised. And even if correct, I’ve seen the SCNM courseload. Some highlights:

    Mind-Body Medicine – 3 quarters about helping people feel better about their symptoms without addressing the problem.
    Oriental Medicine – 11 quarters of studying prescientific, unverified beliefs in China, often involving the cruel treatment of endangered animals or contaminated herbal products; why are uncertain doses of uncertain potencies of molecules from plants with uncertain actions better than well-validated, highly purified, tested, standardized and sterilized molecules from centrifuges?
    Pharmacology – three courses; why do you need drugs when nature cures so effectively?
    Botanical Medicine – 5 quarters, see comments regarding Oriental Medicine. Also, here is how pharmacognosy is actually done in an evidence-based way. Fascinating.
    Nutrition – two courses; doctors learn how vitamins and nutrients move throughout the body as part of their premed and med school curriculum. I’m also assuming, based on prejudice, this course will lean heavily on the idea that vitamins and minerals can substitute for medicines (they can’t).
    Homeopathy – 4 quarters. Please explain why learning about homeopathy is a good thing, I can’t see any reason to waste over a year of one’s life studying it. Read Jay Shelton’s Homeopathy: How it Really Works instead, it’ll take you less time and be more meaningful.
    Emergency Medicine – two courses. I thought the one concession to real medicine naturopaths made was that it was good at acute care. What does naturopathy offer here?

    1600 clinical hours, 372 lab hours, 2500 hours spent reading, for a grand total of 4500 hours learning and 372 hours in the lab. How does that compare to the time doctors spend in training? Why do you think this amount of time grants you comparable knowledge and treatment abilities as a genuine primary care physician, who will spend upward of eleven or more years, and 22,000 hours in training and still consider themselves underprepared for independent practice?

    And when I speak of licensed ND’s, I speak of those that have attended the four year medical program at one of the 7 accredited institutions — all of which are in North America. An individual that is solely a homeopath, acupuncturist, herbalist, massage therapist, or whatever else you want to throw in there does not make them a naturopathic doctor, or capable of practicing the scope of naturopathic medicine.

    You’re still licensing in nonsense and imagination. Again, how do you justify spending any time whatsoever learning about homeopathy? Why are herbs better than drugs? I think if you really examine what drives your devotion to naturopathy, it is rhetoric (Big Pharma is evil!) and assumptions (nature loves me!), not anything rational.

    Incidentally, if nature wants to cure humans, why was malaria found in Africa and Europe while the only effective plant-based treatment (quinine) was found on an unconnected continent? For nature’s sadistic amusement?

    These school train these students to be primary care physicians, and 17 states in the U.S. license them as such. Do you think they’d allow licensure to someone that didn’t know how to use a stethoscope? Surely you are joking.

    Licensure often has more to do with record keeping and billing than curriculum content. Fortunately less so for doctors, unfortunately more so for naturopaths. Your practices are either redundant to real physicians, or empirically indefensible.

    Penelope Dingle was treated by a homeopath in Australia. I do not know where her provider received her “training” or in what capacity. Clearly anyone that tells someone to stay away from “real medicine” is an extremist – much like I view you and this site for the abhorrence to alternative therapies.

    What sort of training does one need when discussing homeopathy? It’s magic. Do you plan on using homeopathy when you graduate? How can you defend this?

    Also, you should read this.

  74. WilliamLawrenceUtridge says:

    Vaccines are a touchy subject, even with NDs. I would not say that all NDs are against vaccines, although a large majority of them are.

    Why? Why do naturopaths think it is better to treat diseases rather than prevent them through vaccination?

    My individual thought is that it is a personal choice.

    What about if your unvaccinated child gives my newborn, who can’t be properly vaccinated for several months, whooping cough and I get to watch helplessly while my baby slowly chokes to death? There is no treatment for whooping cough, just the slow, strangling death of a helpless newborn – the kind these parents got to watch. The uninformed, ignorant, overwhelmingly stupid “choice” to not vaccinate kills people. Babies, grandparents, the immune compromised, the portion of people who do not form effective antibodies to their vaccines, and so forth. If you think vaccination is an individual choice and not a vital measure of public health, you are an idiot. An arrogant, terrifying, selfish, ignorant idiot. Uninformed morons who make the “personal choice” to not get vaccinated for serious diseases are responsible for spreading death, disease, morbidity, sterility and other horrors to the world around them.

    Yes, there is a duty to protect the broader population, but there are enough studies and literature out there to cast some doubt on their potential for adverse reactions, that I can see the argument against them.

    No, there aren’t. There very much aren’t. The only way you arrive at this conclusion is by cherry-picking the evidence and ignoring the massive benefits of vaccines in comparison to their tiny, tiny risk profile.

    Just because it has not been explicitly proven that X causes Y, does not mean that the chance does not exist;

    Do you know what has been proven? That measles, pertussis, chicken pox, influenza, polio, Hib B and any other disease you can get vaccinated against is in fact lethal. Those deaths are nearly 100% preventable. The risks of vaccination are offset thousandfold by the risks of the diseases they prevent.

    perhaps there is an angle that researchers have not looked into yet – what if there is a specific window of time in infant/child development where vaccines could be dangerous, or a genetic component that we just haven’t discovered it yet? I see both sides of the story and support an individual choice – not all NDs would be opposed to a similar thought.

    …except there aren’t two sides to the story. Have you read anything by Paul Offit, who actually studies, every day of his life, vaccines and the immune system? You should. The precautionary principle is an absurd thing to invoke when the known risk is a thousand times greater than a potential risk that a century of study and millions of data points have failed to discover.

    And I agree, “real medicine” (we’ve bantered back and forth enough – can we cut down on the condescending remarks yet?) does not abandon preventative measures, but it is often not its prerogative as it is with naturopathic medicine. It is the approach to treatment that differs with NDs.

    Bull. Shit. Name one thing that naturopathy prevents that real medicine doesn’t. Name one condition that naturopathy treats better than real medicine.

    To date you are showing quite clearly that you have learned your talking points quite well – but you still haven’t come up with any positive arguments or proof that validates naturopathy as an approach. You have shown yourself quite willing to put other people’s lives at risk by pretending the debate over vaccination has two sides. If you’ve got a 0.03% chance of dying from measles in the United States, 28% in countries with sub-optimal health care (reference) or 30% if you have HIV (reference), and some parents somewhere think perhaps their living child might have been affected by vaccination in an unproveable way (certainly not autism, that hypothesis has been dead for years), please explain to me how this is debatable. Your health recommendations have consequences, and you being willing to coddle people about antivaccination views have serious health consequences.

  75. WilliamLawrenceUtridge says:

    I’ll continue to repeat this, but a licensed ND is trained as a PCP, and therefore taught to refer to specialists as needed.

    You can keep repeating it, but that doesn’t make it true. Naturopaths are not primary care practitioners. It is a discipline that wholly rests on faulty assumptions, redundancy to real medicine or a lack of evidence. There are even “specialist” naturopaths, like naturopathic oncologist, so you’ve even got your own little walled garden of parasitic specializations to refer to. If you can’t justify your approach through evidence, you have no right to pretend to be a medical professional.

    I will be a naturopathic medical student this fall, and am more than happy to share the ins and outs of the curriculum with you and this community. I am approaching school with a healthy amount of skepticism and will be documenting my journey.

    No, you’re not. You should spend the time between now and the fall reading up on the vast skeptical literature on naturopathy. There’s a category for it on this website, start there. Read Trick or Treatment, Bad Science, Snake Oil Science and Homeopathy: How it Really Works. These are very easy to read books that step-by-step point out that naturopathy and other forms of complementary and alternative medicine have no evidence base and are in fact antiscientific. Certainly you should at least enter your “profession” honestly and stop pretending it has anything to do with science. You can’t mix science with Qi, vitalism or homeopathy.

    I’ll be sure to share the site with you; more material for you to manipulate and misinterpret – get excited. However, I can’t assume that every SBM reader on here is as narrow-minded as you seem to be, and I hope I offer a candid insight at what my “fake” medical school is all about, for those that are willing to listen and respectively come to your conclusions. I’ll be learning along with you.

    I’m not narrow minded. My mother believes in auras, takes homeopathic pills, practices therapeutic touch and craniosacral therapy. I used to believe in it. Then I started reading. I’m not narrow minded, I just know what science is, how medical knowledge is accumulated, how the body works, and that the claims made by naturopaths are not only internally contradictory, they are simply wrong. The reason we reject and belittle your evidence isn’t because we are narrow minded, it’s because we know you are simply wrong and that you can’t prove anything you believe is true. I’ve seen the best arguments that can be made for naturopathy, homeopathy, orthomolecular medicine, acupuncture and the like, and they’re terrible.

    Feel free to admit you are doing this out of faith, that evidence doesn’t matter, that it’s a “spiritual” thing. I’ll respect that. Just don’t pretend you’ve got an ounce of empirical evidence to support it.

    Lastly, the homeopathy argument when it comes to naturopathic medicine is old. Not all ND’s practice it and I have nothing to comment on it until I see, or don’t see, it’s treatment effectively applied first hand. I get it – it seems hokey – but I’m not one to judge yet.

    Why not learn about it before you go into school? Why not pick up a copy of Trick or Treatment or Homeopathy: How it Really Works and see what the criticisms are? Why not click on the “homeopathy” category to the right and start reading some of the posts? Then perhaps you will realize that any school, any practitioner that pretends homeopathy works and uses it without irony, immediately loses nearly all credibility.

  76. WilliamLawrenceUtridge says:

    I appreciate the abundance of armor you have against “alternative therapies”

    I don’t have “armor”, I have reason, facts and logic. And citations, if you ever made a specific claim.

    and it would take me an exhaustive amount of effort to read through, and attempt to refute, all of your points when I know you wouldn’t be convinced otherwise

    Nope, you’d actually fail at it. Unlike you, I know both sides of the argument. I also know that humans are unlikely to face how wrong they are because of cognitive dissonance. You should read Mistakes were Made (but not by me) by Carol Tavris and some other guy. I know why you aren’t even trying to refute anything, it’s because you can’t. But you’re still here, because you want to feel like you’re right.

    But happily, if you like pick one point and we can stick with that. I’ll pit my pubmed against whatever you bring.

    links to articles on “quackwatch” and similar sites, including this one, do nothing constructive to support your arguments. I am much more apt to consider support from unbiased individuals, which I’m sure you have plenty of.

    Quackwatch and SBM are excellent sources, because the authors have done the reading, done the thinking and done the criticizing. If sources are “biased”, show me how. Show me the evidence that supports your points, instead of just asserting them. Quackwatch and SBM use references, lots of them, and also don’t mince words. CAM practitioners hate them because they are blunt and don’t play the journalists’ game of “telling both sides”. There are no “sides” when it comes to homeopathy or vaccines.

    I have suffered from recurring UTIs since I have been sexually active. [snip]drinking plenty of fluids, urinating before and after intercourse, and consuming 100% cranberry juice (perhaps you deem this “alternative”, who knows)

    There’s another reason why it wasn’t working, turns out cranberry juice does nothing. You know what worked for my wife? Antibiotics.

    I thought I’d ask her if there was anything else I could be doing. And you know what? There was. She asked if I had heard of D-mannose powder – never had. Didn’t see it mentioned in a single online search regarding UTIs

    You should have looked on pubmed. There’s lots.

    Yet because scientists have yet to explore this treatment aggressively, it’s not recommended in most conventional practices.

    A science-based way of describing this would be “real doctors wait for evidence before changing prescription habits”. Do you know the long-term consequences of consumption? Is it carcinogenic? Does it cause kidney stones? What are the pharmacokinetics (Scott Gavura has a great post on pharmacokinetics somewhere but I can’t find it right now)? Does it accumulate in tissues?

    You might also try reading this by Scott.

    D-mannose powder is a naturally occurring component in fruit, including cranberries, and there are no known side-effect to its use.

    I’ve added some emphasis there.

    Do you think I was treated unethically here?

    Yes, for two reasons – one individual and one collective. Individually, you have no idea what the long-term consequences are. It may cause gangrene after years of use. Collectively, if it is effective, by prescribing it without researching it, naturopaths are delaying the amount of time it will take to enter general usage and thus the number of people who could benefit from its use. Real scientists, doctors and researchers will have to do the heavy lifting, and the fact that naturopaths prescribe it before it’s properly tested for safety and efficacy will increase the skepticism it is met with in the medical and research community.

    So yes, unethical.

    Do you find its recommendation as a preventative treatment for UTIs to be dangerous or harmful because it hasn’t been aggressively studied, or because a study might show that it is no more or less effective than a prophylactic antibiotic?

    Dangerous and harmful, I don’t know – but neither do you and neither does your naturopath. Doc Spock casually recommended babies sleeping on their bellies because, at the time, nobody knew if it was better or worse for kids. Turns out he killed something on the order of a couple hundred thousand kids over the years, because of SIDS.

    Casual, ignorant and uninfomed recommendations can harm and can kill (for instance, your casual dismissal and ignorance of vaccination as “possibly, maybe, perhaps, in some people, might be bad”). You are mis-applying the precautionary principle here – vaccines, well-studied, few risks, enormous benefits, you are skeptical of. D-mannose, which is unstudied for safety and efficacy in treating UTIs, you casually accept. What’s the difference? Why this grotesque imbalance? Why the double-standard?

    Naturopaths like to pretend they’re cutting-edge, but generally they’re actually recommending on shoddy evidence – test tubes, studies in rats, n=30 trials. Doctors wait longer for their knowledge, but at least they’re far more likely to be right.

    I am asking because these are the types of alternatives NDs offer to those seeking them, and you can bet there are far more than just my experience here.

    The plural of anecdote is not data. It is far too easy for humans to fool themselves.

    On a side note, this “experience”, nor any other specific event, is the reason I have chosen to pursue naturopathic medical school. I have always had an innate interest in “natural” and less invasive approaches to treating the body.

    You are essentially admitting to a life-long failure to think critically, as well as the fact that you’ve lived most of your life in a first world. There are people in Bangladesh who would happily knife you if it mean just getting the vaccines you’ve had, let alone clean drinking water.

    “Natural” is not “better”, it’s often deadly, painful and horrible. I really must learn the name of the worm that burrows into the eyes of children. It’s a very natural way to go blind (as is cataracts).

    I believe you asked why NDs would have a need to prescribe medications. Simple, sometimes medication is absolutely necessary for proper treatment.

    Plus, you can prescribe real medicines and some herbs, then pretend the herbs did something instead of just being a complete economic sinkhole (except for the fiber).

    If I had a patient that walked in with a full blown UTI, you can bet that I would prescribe them an antibiotic.

    I hope you never get the chance.

    And what about patients that want to get off medication? Stopping certain medications abruptly can be dangerous – NDs need to be able to prescribe lesser doses to gradually, and safely, wean users off them.

    I think you mean doctors. Who put in thousands of hours learning about medications, interactions and biochemical processes, including pharmacokinetics and applying them in a supervised setting. Not 370 hours in a lab. Patients who want to get off medication should be very carefully evaluated to determine if this is a good thing or not. Being on medications can keep people alive, their risk to benefit ratio should be carefully evaluated. Again, evolution is only geared to keep you alive long enough to breed, it doesn’t much care past that point. Viz. Huntington’s disease, a gene-dominant lethal disease that lets you live long enough to pass it along to your children.

    I don’t think, after 1/4 the training of real doctors, much of it on nonsense and magic, you are in any way equipped to recommend going on, or coming off of medication. Why don’t you try getting into real medical school instead?

  77. WilliamLawrenceUtridge says:

    Harriet, Chris, etc.: I have never had a desire to attend traditional medical school, but I certainly don’t discredit anyone who does. In my personal opinion, it has become a bit of an overwhelmed, and overcompetitive institution, which is an environment I, personally, don’t want to be in.

    I’d much rather a highly competitive system, which ensures a higher standard of care, doctor, knowledge and training.

    The curriculum wouldn’t teach me the alternative modalities I am interested in either.

    No, because by definition medical school doesn’t teach unproven modalities. Why you think this is a virtue in naturopathy, I’m not sure. And for that matter, a lot o medical schools are now going “integrative”, which is a shame. When you mix apple pie and cow pie, you don’t get better cow pie – you just make the apple pie taste worse.

    Naturopathic medicine is not that hard to understand,

    Agreed, seeing as it is not based on reality. Actual biology is devilishly complicated as it is based on evolution – and evolution is expedient, not elegant. The non-reality based modes of treatment, like homeopathy, acupuncture and TCM, are much simpler since they’re based on stories the mind can tell itself. They don’t try to take reality into account. They don’t even account for the existence of cells.

    Certainly, axiomatic medicine is easier to practice than one based on empirical research. It just tends to be horribly wrong.

    but I’m learning there are just those out there who will never “get it”. I can at least “get” all of your concerns

    Oh, no, we get it. You prefer pleasant lies and comforting simplifications over reality. We totally get that. You aren’t more liberal in your thinking, just less sophisticated in your reasoning, less tethered to reality, less aware of the complexities of the human organism. For instance, thinking humans run on magical “energy” rather than an extremely complex series of interacting loops of molecules.

    but I suppose I am just a bit more liberal in my thinking to understand that naturopathic medicine is not going to undermine conventional medicine. It’s not its goal, either.

    There’s being open minded, then there’s being so open minded your brain falls out. It is not a flaw to expect proof, evidence and replicability. In fact, these are the levers by which reality can be controlled to the benefits of humans.

    Incidentally, naturopathy and its ilk are already undermining conventional medicine by being introduced into mainstream curriculum. Doctors are being open minded about alternative medicine, but sadly do not do sufficient research into the topic, and most never realize the emperor has no clothes. Again, CAM, including naturopathy is either evidence-based (and thus redundant to real doctors) or evidence-free (and thus dangerous, wasteful and stupid).

    So many of you are so obstinate; it is not a way of thinking or acting that I subscribe to, and I have involved myself far too much at this point.

    By asking for proof before we pretend your claims have any validity? How is that a flaw? And you’re certainly both obstinate and closed-minded, since you aren’t willing to engage on any specific points. You merely drop an opinion, lecture about things you know little, then flit off without awareness of how dangerous your unfounded opinions may be.

    We all have our opinions, and I am happy that I was able to get a few supportive ones on here for naturopathic medicine, amongst the slew of defamations.

    Defamation is “a false accusation of an offense or a malicious misrepresentation of someone’s words or actions.” For one thing, the criticisms of naturopathy ventured here are not false (though they might be offensive). For a second, you can’t defame an idea. Only a person. Your supportive opinions came from the “already convinced” camp.

    Again, I looked at the evidence and changed my mind. You’re still on step zero. You should read some of the criticisms of the field that you’re about to enter. Doctors do so every day, that’s how medicine gets better and life expectancy keeps climbing. Now if only we could get all the lardasses to put down the chips and start exercising, it might keep going up.

    There’s a lot of hate on here. I hope everyone finds time to smile today.

    I don’t hate you, I just think you’re naive, and soon to be in training to be dangerous.

    Smiled a lot today, I love playing whack-a-mole with SCAMsters and wanna-be scamsters. It’s very easy since they never bring any new arguments.

  78. WilliamLawrenceUtridge says:

    Thank you for the information, Harriet. I learned something today then. However, I don’t find the side effects any more dangerous than that for antibiotics.

    If the side effects are occult, like high blood pressure, uncontrolled prediabetes or the onset of kidney damage, you wouldn’t even be aware of them. You weren’t aware of these potential threats before either.

    I have yet to be to a doctor who has listed to me all the side effects, known or possible, of the medication he/she is prescribing, so unless that is what you practice on a daily basis, I don’t see the need for your condescending tone.

    Unlike the black box warnings that accompany all drugs (and if your doctor didn’t inform you of the major and most common ones, you should sue since that’s probably close to malpractice), d-mannose’ safety profile is still unknown. It’s black box warning is a big question mark. And again, the ethical thing that naturopaths should do (and doctors pretty much have to do) is test it for safety and efficacy before recommending it. You should submit a grant proposal to the NCCAM, they’ve got pots of money, and it would be nice to see it thrown at something with some prior probability for once.

    D-mannose powder is available widely. My doctor’s office, like most, does not have items for purchase. What you are inferring, WLU, is no different from the perks doctors may get from pharmaceutical companies to prescribe their drugs.

    Uh…very different actually. I was suggesting that your naturopath might sell d-mannose powder direct from their office, thus incurring a direct profit upon the sale and recommendation, and accordingly have a direct, money-in-their-pocket-with-every-product incentive to convince their customers (not patients, customers) that they might benefit from a little preventive supplementation. Does your naturopath sell vitamins? How about homeopathic products? My doctor gives me free stuff if I need it, does not own the pharmacy I get my rare prescriptions from, and my dentist is actually prohibited from selling me anything at a profit.

    Geez, and I am really not sure why d-mannose is OK but vaccines are questionable. That’s a truly bizarre double-standard.

  79. WilliamLawrenceUtridge says:

    Please know that I have considered this career for many years and you can be sure I am well aware of the challenges ahead, including dealing with extreme opposition like yourself.

    You’ve considered it for years, but not once looked into even the most basic criticisms of the discipline? What a curious approach.

    The sincere people in this field do it because they have a passion for it and for helping others;

    Doctors kinda have that going for themselves too, with the added bonus of actually curing people.

    I would have no other justification for leaving my current six-figure job. Money has little bearing, and the field has a very high satisfaction rate.

    I bet, considering most of your clients are wealthy, middle- and upper-class white people with vague, self-limiting conditions. It’s nice when your client base is self-selected to be the “worried well”.

    I’m well aware of the inserts that come along with prescription medications – how can you miss them when they are 5 pages long?

    Yes, the benefits of lengthy and detailed safety testing and post-marketing surveillance. You know, what completely doesn’t exist for naturopathic, homeopathic and herbal remedies. Big Pharma is legislated to have full disclosure (and even then they’re still bastards about it; good thing medicine is self-critical) mean while there are essentially no restraints on the practice of naturopathy. How could there be, how can you decide what is good practice and what is bad when there is no research and no empirical testing?

    Few deaths from vitamin overdoses have ever been found (and the conclusions are not so concrete), yet thousands die each year from FDA regulated prescription medications, and at the recommended doses.

    Why are you comparing vitamins and drugs? Vitamins are not medicines, they are micronutrients you should get from food. Your statement makes about as much sense as saying “there are few deaths from puppies, yet look how many people are killed in car crashes every year”. Why do you think this is a relevant comparison? This is another false dilemma and CAM talking point spoon-fed to customers and CAM students as if it were meaningful. Yes, vitamins are generally not deadly, but vitamins also don’t treat cancer, acute sepsis, tuberculosis or diabetes. Vitamins treat vitamin deficiencies. Vitamins are not medicine!

    Also, Gary Null. You should look up “Gary Null vitamin D”. It’s hilarious.

    So I am sorry that I fail to see why you all have such a strong conviction for the regulation of them, other than an argument that it is “not fair”?

    This is an example of a market failure, specifically asymmetry of information. Companies know vitamins don’t really do anything but treat deficiency, most customers do not, and without legislation there is tremendous money wasted on expensive urine. I’m personally offended that vitamins can be marketed as treating diseases when they manifestly don’t (or are only trivially true – vitamin A does “promote eye health” in that you’ll go blind if you are deficient; in fact, vitamin A deficiency is the number one cause of childhood blindness in the third world). I don’t see why vitamin pushers get a free pass at lying to their customers.

    Incidentally, Big Pharma makes both vitamins and drugs. Vitamins are hugely profitable for them, since they don’t have to put any money into research. It’s pure overhead and materials.

    I’d much prefer the already overworked FDA spend time reviewing cancer drugs and other life-saving treatments than use its precious resources on regulating vitamins or other naturally occurring substances that have not yet shown to pose a threat to human lives.

    You should read this and try plugging “DSHEA” into the search box to your right. You might find some very good, well-thought-out reasons why the DSHEA is a bad law.

    But I agree, the FDA should definitely have more resources.

    Also, vitamins are a threat to human life. Try a bite of polar bear liver one day and see how you feel. You might also want to look up “hypervitaminosis”.

    Finally, the following substances are both natural, and dangerous:
    - Vitamin A
    - Cobra venom
    - Peanuts (choking hazard and allergen)
    - Water (drowning, hyperhydrosis, hyponatremia, hypokalemia, think about that the next time you recommend 8 glasses a day to flush out “toxins”)
    - Rocks, both very small and very large
    - Puffer fish
    - Fava beans (a personal favourite, look up “favism”)
    - Cassava
    - Potatoes
    - Vitamin D
    - Belladonna

    Nature doesn’t want to save your life, nature doesn’t care if you live or die.

    do not choose to uphold my opinion in such a way that I debase others, as so many on this site choose to do.

    So you don’t care if you’re wrong or right, just that you don’t change your mind? It sounds like naturopathy might just be the perfect career for you then.

  80. Chris says:

    Wow, WLU. And I thought I was the angry critic of naturopathy. It is obvious that DoctorBull had his/her mind made up, so I held back (a little).

    Sorry, I cannot make the assumption that anyone who has suffered with UTIs is female. It does happen to men! Though while I did suffer through them during my late 20s until my mid-30s I found a solution. It was to toss the *&^%$#! diaphragm away, then get pregnant with my third child. Plus, the most important thing of all, give my darling spouse on only two choices in birth control: abstinence or a vasectomy. He chose the latter, and we have been happily UTI free for almost twenty years. Absolutely no untested magic powders required.

    WLU:

    You can keep repeating it, but that doesn’t make it true. Naturopaths are not primary care practitioners.

    Especially if they cannot refer an adolescent with a very obvious heart murmur to a cardiologist.

    There’s a category for it on this website, start there. Read Trick or Treatment, Bad Science, Snake Oil Science and Homeopathy: How it Really Works.

    May I add Natual Causes by Dan Hurley?

    You can’t mix science with Qi, vitalism or homeopathy.

    :-)

    All of those are in the category known as “magic.”

    The reason we reject and belittle your evidence isn’t because we are narrow minded, it’s because we know you are simply wrong and that you can’t prove anything you believe is true.

    Did DoctorBull present any data, or at least any peer reviewed paper? I included at least a couple in my replies, but all I saw from this person was “argument from assertion.” Do correct me if I am wrong.

    Agreed, seeing as it is not based on reality. Actual biology is devilishly complicated as it is based on evolution – and evolution is expedient, not elegant.

    And, oddly enough, on chemistry. It seems DNA, RNA and all of the genetic material create proteins, factors and lots of ‘ases that work on chemical/physics molecular models. It is very complicated, from shapes to attractions and on an on. In other words: it is complicated. But it is much more intersting in the fairy tale explanations put forth by the humors, miasms, and whatever of naturopathy thought. I am presently reading Mutants by Armand Marie Lerol. It is amazing how one genetically created chemical signal can affect the formation of a fetus, and eventually a human being. This make me remember when one of my sons asked why the speech therapist had only one hand. I had to tell him that making a baby is very difficult, and sometimes something goes wrong.

    You aren’t more liberal in your thinking, just less sophisticated in your reasoning, less tethered to reality, less aware of the complexities of the human organism. For instance, thinking humans run on magical “energy” rather than an extremely complex series of interacting loops of molecules.

    Um, yeah. Why do I have the feeling that DoctorBull did not do very well in high school chemistry? Anyone who passed that course and understands Avogadro’s Number would know why it is nonsense.

    I was suggesting that your naturopath might sell d-mannose powder direct from their office, thus incurring a direct profit upon the sale and recommendation, and accordingly have a direct, money-in-their-pocket-with-every-product incentive to convince their customers (not patients, customers) that they might benefit from a little preventive supplementation. Does your naturopath sell vitamins? How about homeopathic products?

    My relative who is buried in the cemetary up the street from me did complain about the prices the naturopath charged for the homeopathic remedies that replaced the real medications.

    Finally, the following substances are both natural, and dangerous:

    Often when those who say “natural” is safe, I offer them foxglove tea. They never take me up on that offer.

    I’m a gardener, and I learned that several very lovely plants are very poisonous. This is why there are no foxglove flowers in my yard. But as kids got older I did put in delphiniums (belladonna) and daffodils (lycorine) when I knew they would not gnaw on the foliage. If you look at the link I gave to poison exposure, one the top 25 exposures to children under age five was to “plants.” I had to stuffle an astonished guffah at a landscaping seminar when the slide came up showing the artistry of the leaves in a garden that paired elephant ear (oxalic acid and asparagine) with castor bean (ricin)!

    What amazes me is that someone is so willing to believe in the fantasies of fake medicine like homeopathy or naturopathy, when the real world is so much more interesting. There are things being discovered through genetics, chemistry, geology, physics and elsewhere that are much more fascinating. It boggles the mind.

  81. WilliamLawrenceUtridge says:

    @Chris

    I’m a seething volcano of typing rage, what can I say?

    Especially if they cannot refer an adolescent with a very obvious heart murmur to a cardiologist.

    I’m not even close to a doctor, and I thought “left arm pain? Man, that sounds like a heart problem”. Of course, it’s probably just running piglets.

    Did DoctorBull present any data, or at least any peer reviewed paper? I included at least a couple in my replies, but all I saw from this person was “argument from assertion.” Do correct me if I am wrong.

    You’re not wrong, it looks like the arrogance of youth mixed with the arrogance of ignorance.

    What amazes me is that someone is so willing to believe in the fantasies of fake medicine like homeopathy or naturopathy, when the real world is so much more interesting. There are things being discovered through genetics, chemistry, geology, physics and elsewhere that are much more fascinating. It boggles the mind.

    The downside to the world is you have to put so much time and effort into learning a whole bunch ‘o basics first before you realize just how fascinating the details are. Nonsense is much more rewarding up front (and comes custom-designed for the human mind to like it).

    Ever read A brief history of nearly everything by Bill Bryson? Great book. And anything by Simon Winchester, particularly in audiobook form read by the author. So British!

  82. Calli Arcale says:

    WLU, that was a work of artistry. I’m going to save one of your bits into my quotefile because it is awesome:

    Incidentally, if nature wants to cure humans, why was malaria found in Africa and Europe while the only effective plant-based treatment (quinine) was found on an unconnected continent? For nature’s sadistic amusement?

    Chris:

    But as kids got older I did put in delphiniums (belladonna) and daffodils (lycorine) when I knew they would not gnaw on the foliage.

    Nitpick: delphiniums are not belladonna. They’re great for attracting butterflies — unlike Atropus belladonna, the deadly nightshade. They are also quite toxic, of course, just with a different toxin than the deadly nightshade.

    About UTIs — I wish it was that easy for me to stop having them! I have a urinary diverticulum; only surgery would fix that, and the risks of the surgery far outweigh coping with occasional UTIs. You are correct that men can also get them. My brother was actually hospitalized for one; he’d seen a doctor earlier in the infection, but curiously had a negative urinalysis (UAs rarely give false negatives, but rarely is not never), so it was assumed to be something else. Didn’t help that there was a GI bug going through the family at the time, presenting a big fat red herring. And my grandpa has had several in recent years as his health has declined and he’s had more difficulty staying properly hydrated and getting to the bathroom on his own.

    The idea of an ND treating UTIs with antibiotics scares me. Better than untreated UTIs, I suppose, but do they understand drug interactions, which are common with antibiotics? (Many bind to calcium, so you even need to be careful about taking them with food — don’t wash Cipro down with a glass of milk, for instance, or it won’t get absorbed as much as it should be.) Do they understand the risks of causing an upset in the digestive tract, or breeding resistant germs? Can we trust NDs to get the person tested *before* prescribing antibiotics? There are enough conditions mimicking the symptoms of a UTI that no person should be treated without a UA and perhaps a UC — too much risk associated with needless antibiotics.

  83. Chris says:

    WLU:

    Ever read A brief history of nearly everything by Bill Bryson? Great book. And anything by Simon Winchester, particularly in audiobook form read by the author. So British!

    The problem is that I own it, and it is somewhere in this house. If I actually own a book I am less likely to get around reading it as I try to get the books from the library read (desperately trying to finish two before picking Bad Pharma from the library this weekend).

    Rats, Calli, you are right. I know I had misremembered a label I had read. Oh, well, I have discovered as my garden grew up and there is more shade, I can’t even grow larkspurs.

    Oh, and my UTI story is actually meant to be humorous. I also cringe every time I remember a male co-worker telling me about his UTI.

  84. daijiyobu says:

    @JB from the post, speaking of “their opposition to vaccination”

    there’s the long-running newspaper column of ND Deville, in the Tuscon Citizen,
    wherein she recently stated

    (see http://tucsoncitizen.com/natural-medicine-tips/2013/03/01/vaccines-what-to-keep-in-mind/ ):

    “I am not completely against vaccines. Although they sometimes come with side effects, they’ve certainly saved a lot of lives. There was a time when there was absolutely no question that the risks of not vaccinating were much higher than the risks of choosing to vaccinate. That said, the cost/benefit analysis is no longer quite so cut and dry.”

    We should trust her expertise! I particularly like her homeopathy page

    (see http://www.drlaurendeville.com/therapies/homeopathy/ ).

    Cost/benefit analysis indeed.

    -r.c.

  85. WilliamLawrenceUtridge says:

    “I am not completely against vaccines. Although they sometimes come with side effects, they’ve certainly saved a lot of lives. There was a time when there was absolutely no question that the risks of not vaccinating were much higher than the risks of choosing to vaccinate. That said, the cost/benefit analysis is no longer quite so cut and dry.”

    Yes, side effects like sore arms and not dying.

    So what vaccines should we do without, and how do we deal with the resulting resurgence of vaccine-preventable (but no longer prevented) diseases?

    Every time someone makes a statement like this, they should be brought to the parents of a child who died of a vaccine-preventable disease and explain why it was OK. Went to the doctor today (it’s a canker on the back of my throat. My doctor prescribed nothing, and said it would get better in a couple days. Said I could pop a couple advil a half hour before eating. Did not sell them to me) and his office was plastered with pro-vaccine posters. He was a brown guy with an accent, I’m wondering if he takes them so seriously because he had seen kids die of the diseases we are ignorant of here in North America.

    Anyway, opposition to vaccination is stupid.

    Chris, you should really get around to reading Bryson’s book, it’s great. He says, having owned A Dance With Dragons for months now without having read it.

  86. Chris says:

    Of course, I have to find it first. I am presently working on actively reducing stuff, and that includes hundreds of books. When the bookcases are stacked with books sideways, and on top, and in piles on tables… it is time to go through them. So far there have been two trips to the used book store.

    They like getting the Easton Press science fiction editions.

    And I did manage to buy only five books after getting rid of four boxes of books.

  87. WilliamLawrenceUtridge says:

    Of course, I have to find it first. I am presently working on actively reducing stuff, and that includes hundreds of books. When the bookcases are stacked with books sideways, and on top, and in piles on tables… you’ve done something right with your life

    Fixed that for you.

  88. Chris says:

    :-)

    I have put a library hold for the audio version of Bryson’s book. Thanks.

  89. Chris says:

    WLU, I just found my copy of Bryson’s A brief history of nearly everything .

    It was literally at my knees, in the bookcase I use under my laptop. Still, I just picked up Bad Pharma at the library, and have another book to read. So it will be a while.

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