Articles

The regulation of nonsense

 The most meticulous regulation of nonsense must still result in nonsense.

– Edzard Ernst, M.D., PhD., professor, Complementary Medicine, Peninsula Medical School, University of Exeter, UK

One necessity of licensing so-called “complementary and alternative,” or “CAM,” practitioners is to spell out exactly what is encompassed in the CAM scope of practice. This is unfortunate for the practitioners because it forces an exposé of the nonsensical precepts underlying their claims. For example,

‘Acupuncture’ refers to a form of health care, based on a theory of energetic physiology that describes and explains the interrelationship of the body organs or functions with an associated acupuncture point or combination of points located on ‘channels’ or ‘meridians’. . . Acupuncture points are stimulated in order to restore the normal function of the aforementioned organs or sets of functions.

(Delaware acupuncture practice act.)

[Chiropractic is] the science of adjusting the cause of the disease by realigning the spine, releasing pressure on nerves radiating from the spine to all parts of the body, and allowing the nerves to carry their full quota of health current (nerve energy) from the brain to all parts of the body.

(North Carolina chiropractic practice act.)

The practice of naturopathic medicine includes, but is not limited to, the following services:. . . ordering, administering, prescribing, or dispensing for preventive and therapeutic purposes: food, extracts of food, nutraceuticals, vitamins, minerals, amino acids, enzymes, botanicals and their extracts, botanical medicines, herbal remedies, homeopathic medicines, dietary supplements and nonprescription drugs as defined by the federal Food, Drug, and Cosmetic Act, glandulars, protomorphogens, lifestyle counseling, hypnotherapy, biofeedback, dietary therapy, electrotherapy, galvanic therapy, oxygen, therapeutic devices, barrier devices for contraception, and minor office procedures, including otaining specimens to assess and treat disease. . .

(Minnesota naturopathic practic act.)

Licensing also brings into sharp focus exactly how broad those claims are.

‘Acupuncture’ means a form of primary health care, based on traditional Chinese medical concepts and modern oriental medical techniques, that employs acupuncture diagnosis and treatment, as well as adjunctive therapies and diagnostic techniques, for the promotion, maintenance, and restoration of health and the prevention of disease.

(Florida acupuncture practice act, emphasis added.)

Any chiropractic physician who has complied with the provisions of this chapter may examine, analyze, and diagnose the human living body and its diseases by the use of any physical, chemical, electrical, or thermal method; use the X ray for diagnosing; phlebotomize; and use any other general method of examination for diagnosis and analysis taught in any school of chiropractic.

(Florida chiropractic practice act, emphasis added.)

In addition to prescribing a scope of practice, licensing imposes basic education requirements, testing, board oversight, continuing education requirements, and other measures supposedly designed to protect the public health and welfare.

Perhaps this is why there is no movement by other CAM therapists, such as reiki practitioners, crystal therapists, iridologists, and the like, to seek licensing. While having one’s own licensed health care practice act conveys a huge advantage in terms of protecting one from unlicensed practice of medicine prosecutions, it also means that one must set out one’s gibberish in a form that state legislators can be persuaded to pass into law. That this is not hard to do is evidenced by the above examples of naturopath, acupuncturist and chiropractic licensing. Still, having to take tests to demonstrate one’s command of the gibberish and having to attend continuing education classes to remain abreast of advancements in practices that never advance is burdensome. Besides, the medical boards don’t seem to be particularly interested in stopping the spread of CAM practices through prosecution for the unlicensed practice of medicine, so why bother? In fact, M.D.s themselves are joining in the fun via “integrative medicine.”

Nevertheless, it is interesting to contemplate what enlarging the pantheon of licensed CAM health care practices might look like. Just how far might the state legislatures willing to go in their Legislative Alchemy? After all, practices such as reiki, crystal therapy and iridology are no more implausible and have no less a claim to effectiveness than subluxation-based chiropractic, homeopathy and acupuncture.

May the force be with you

Let’s take reiki for example. Here’s an explanation of reiki (so to speak) from The International Center for Reiki Training:

We are alive because life force is flowing through us. Life force flows within the physical body though pathways called chakras, meridians and nadis. It also flows around us in a field of energy called the aura. Life force nourishes the organs and cells of the body, supporting them in their vital functions. When this flow of life force is disrupted, it causes diminished function in one or more of the organs and tissues of the physical body.

The life force . . . becomes disrupted when we accept, either consciously or unconsciously, negative thoughts or feelings about ourselves. These negative thoughts and feelings attach themselves to the energy field and cause a disruption in the flow of life force. This diminishes the vital function of the organs and cells of the physical body.

Reiki heals by flowing through the affected parts of the energy field and charging them with positive energy. It raises the vibratory level of the energy field in and around the physical body where the negative thoughts and feelings are attached. This causes the negative energy to break apart and fall away. In so doing, Reiki clears, straightens and heals the energy pathways, thus allowing the life force to flow in a healthy and natural way.

(I apologize for the lengthy quotes throughout this post. However, I find it very difficult to summarize nonsense. Besides, the actual language is so entertaining.)

As Steve Novella pointed out, reiki is simply another form of vitalism, a long-discredited, pre-scientific notion that a spiritual energy animates all living things. As he says, “[t]he notion of vitalism was always an intellectual place-holder, responsible for whatever aspects of biology were not currently understood.” It is the same concept that underlies subluxation-based chiropractic, where it is known as “Innate Intelligence,”or, more recently “nerve flow.” In acupuncture, this “life force” is called “qi.” In therapeutic touch, it is “energy,” as it is sometimes referred to in reiki. In craniosacral therapy, this force is the craniosacral rhythm. Like those practices, there is no good evidence that reiki has any effect beyond placebo, nor is there any evidence that such a “life force” exists.

The practice of reiki, as does chiropractic, therapeutic touch, acupuncture and other CAM methods, depends on the practitioner convincing the patient that he (or she) can influence this “life force” via some action on his part. In reiki,

. . . energy flows from the practitioners hands into the client. . . The practitioner places her/his hands on or near the client’s body in a series of hand positions.

Treatment sessions last between 30 and 90 minutes. According to one website, it costs about a dollar a minute, which is a lot to pay for anything and especially a lot for nothing.

As might be expected from a treatment that purports to affect all organs and tissues of the body, the advertised benefits of reiki appear to be virtually limitless. Here are some I found on the internet:

Stress relief, improves well being, minimizes discomfort from acute or chronic pain conditions, reduces recovery time from injuries, sets new habits, promotes emotional healing, reduces side effects of medical treatment including chemotherapy, post operative pain and depression, improves the rate of healing, reduces time in hospital, relaxation, improves sleep, accelerates the body’s self-healing abilities, reduces blood pressure, breaks addictions, adjusts the energy flow of the endocrine system, reduces side effects of drugs, postpones the aging process, aids spiritual growth, increases the vibrational frequency of the body, accelerates healing from bruises, aids mental/emotional imbalance, benefits pregnant women and their unborn children, relieves back problems, PMT, menstrual problems, sinus problems, head or stomach aches, bee stings, colds, flu, tension and anxiety, heart disease, cancer, leukemia, asthma and eczema. And, of course, it cleanses the body of toxins. As an added bonus, it can benefit both animals and plants. All in all, “reiki always helps and in some cases people have experienced complete healings . . .”

Oddly, though, the reiki practitioner “will not offer any diagnosis or prognosis.” Hmmm. If the practitioner doesn’t diagnose or prognose, then how does he know what the patient is suffering from and how can he tell that there has been an improvement in the patient’s condition? After all, reiki practitioners claim that reiki is always beneficial. One puzzles at this contradiction.

Are there side effects? As it turns out, yes.

. . . sometimes a person will have what is called a healing crisis. As a person’s vibration goes up, toxins that have been stored in the body will be released into the blood stream to be filtered by the liver and kidneys and removed from the system. When this happens, sometimes a person can get a headache or stomach ache or feel weak. If this happens, it is a good idea to drink more water, eat lighter meals and get more rest. The body is cleansing as part of the healing process so this is a good sign.

Despite its magnificent success rate, reiki is pretty easy to learn. In fact, even children can be taught reiki.

A beginning Reiki class is taught on a weekend. The class can be one or two days long. I recommend that the minimum time necessary be at least six to seven hours. Along with the attunement, it is necessary that the student be shown how to give treatments and also to practice giving treatments in class.

For the uninitiated, an “attunement”

. . . is the process by which a person receives the ability to give Reiki treatments. The attunement is administered by the Reiki Master during the Reiki class. During the attunement, the Reiki Master will touch the students head, shoulders, and hands and use one or more special breathing techniques. The attunement energies will flow through the Reiki Master and into the student. These special energies are guided by the Higher Power and make adjustments in the student’s energy pathways and connect the student to the source of Reiki. Because the energetic aspect of the attunement is guided by the Higher Power, it adjusts itself to be exactly right for each student.

Licensed Reiki Masters?

Assuming, arguendo, that the claims of reiki practitioners are true, then we can fairly state that:

  • Reiki improves, and in some cases fully resolves, a wide, perhaps unlimited, range of human and animal (and plant) illnesses and conditions.
  • Reiki requires training which includes establishing a minimum proficiency in giving treatments.
  • Reiki can have side effects.
  • Reiki practitioners say that they do not make diagnoses or prognoses. However, they necessarily employ some type of diagnosis in the form of measuring improvement in the patient’s condition. (Otherwise they could not claim effectiveness.)
  • Reiki is essentially based on the same principles (vitalism) as two other licensed health care practitioner types, chiropractors and acupuncturists.

States have the inherent power to regulate the practice of medicine, as well as other health care practices, to protect the public’s health, safety and welfare (called the “police power”). Based on the characteristics of reiki shared with other licensed health care providers, I conclude, by analogy, that the state could constitutionally regulate the practice of reiki by enactment of a reiki practice act, defining a scope of practice, authorizing oversight by a Board of Reiki, and instituting minimum requirements for training and continuing education requirements, whether the reiki practitioners desired such regulation or not.

We could go through the same exercise for any number of CAM practices, such as craniosacral therapy, Kirlian photography, iridology, crystal therapy, aroma therapy, angel therapy, Matrix Energetics®, reflexology and polarity therapy, to name a few. Just imagine – a Board of Polarity Therapy! A licensed and regulated Iridologist! Crystal Therapy continuing education! A Matrix Energetics® scope of practice act! Given the fact that all that is necessary to create a new CAM practice is to make something up, state legislatures would be working year-round just to draft and pass practice act legislation accommodating the seemingly endless varieties of CAM.

If all of this seems silly – and it most certainly is – it raises an important question: why do the states license any form of CAM practice? Homeopathy is no more plausible or effective than Matrix Energetics®. Subluxation-based chiropractic is no more plausible or effective than crystal therapy. Acupuncture is no more plausible or effective than iridology. If the prospect of licensing Matrix Energetics® practitioners, crystal therapists and iridologists is ridiculous, then why isn’t licensing homeopaths (or naturopaths who practice homeopathy), subluxation-based chiropractors, and acupuncturists equally ridiculous? What’s the difference?

In fact, the next time you find yourself in a discussion with an acupuncture proponent, heartily agree with him (or her) that of course acupuncture should be a licensed health care profession, available to everyone, as should angel therapy. When he demurs on the ground that angel therapy is totally absurd, ask him to explain exactly how acupuncture is any different.

Dr. Ernst is entirely correct. The regulation of nonsense must still result in nonsense. Rather than fooling themselves into thinking they are protecting the public with CAM practitioner licensing, state legislators should concentrate on protecting the public from CAM.

Posted in: Energy Medicine, Legal, Politics and Regulation, Science and Medicine

Leave a Comment (31) ↓

31 thoughts on “The regulation of nonsense

  1. DevoutCatalyst says:

    “If all of this seems silly – and it most certainly is – it raises an important question: why do the states license any form of CAM practice?”

    For the benefit of the schools, no? In California I believe you currently need 3000 curricular hours to become a licensed acupuncturist, and there have been talks of increasing this to 4000 hours. To me this is a great tragedy of CAM, useful minds deceived and derailed in the service of pretending to become a doctor. I can only hope that one day these students realize the worthlessness of the education they received, and that their time and money could have been spent towards becoming productive citizens instead of unwitting charlatans.

  2. I strongly believe one of the driving forces of rank stupidity, err, CAM, is the schools. They are extraordinarily profitable.

    I always refer back to a massage school in my area, because a very close friend teaches there on occasion. It’s a 510-hour program, which takes around 6 months of schooling if done on weekends, and around 4 months or so if done 5-days-a-week. The classes are set up in a staggered way so they are constantly pumping students out of there. They take classes in anatomy and physiology (high school level), overviews of disease and medicine (again, high school level), etc. It is stretched out so long and far, and they learn all sorts of things that they will *never* use, but this more lengthy schooling gives them the title of “massage therapist” instead of “masseuse.”

    The tuition is $4300 and the books are an additional $350. The owner of the school is also an author of the books, so the owner gets a kick-back on the textbooks in addition to the admission fees. Also, other schools use the book. The owner of the school is one of the wealthiest individuals in our area, solely because of this school. It’s making a killing by promising an “amazing” career and education to these typically high-school educated students. They then learn mickey mouse science, along with quackery such as reflexology, energy healing, acupressure, etc, and of course massage technique, and go on to believe that they are MEDICAL massage therapists, and that they should be part of a health care team. (Once I met a massage therapist and after an argument broke out, I simply asked him where the liver was, and he looked confused, then pointed to the left upper quadrant – get the f*** out of here, quack!)

    The schools that teach chiropractic, naturopathy, etc, are even more profitable. These are, sometimes, four year institutions! In the most recent chiropractic thread here, our resident quacks identified their schools, which ranged between $90,000 and $100,000 for the 4 year useless degree in quackery. Naturopathy is similar. Their licensing has enabled them to take out certain loans, etc, so that students can get into debt while pursuing such useless “education.” Consider this from a business point of view. If you already have the infrastructure in place to teach a 4 year degree in pure chiropractic quackery, wouldn’t it be easy to institute a naturopathic program and have several-to-many of the classes overlap? And go ahead and toss in a masters of “natural health science”, and overlap even more classes. It’s 2 for 1 from the standpoint of business. Who cares that you’re putting idiots into debt and perpetuating quackery that results in people like Danielle (in the Dr. Gorski thread) listening to idiots for breast cancer advice? Hey it’s just business, right?

    ………… Argh!

  3. Eugenie Mielczarek says:

    Jann
    Thanks for a great post. I’m amazed that no Reiki web site cautions new practitioners about accidentally waving hands in the wrong direction and making the patient worse. And most readers may not know that the American Association of Acupuncture and Oriental Medicine has recently petitioned the Department of Health and Human Services to have acupuncture declared an Essential Medical Benefit to be included under our health care plan.
    Jean Mielczarek

  4. RD says:

    Thanks for the article! I think the pursuit of CAMs requiring licensure also detracts from professions that do require licensure such as dietetics/nutrition. When dietitians try to strengthen their licensure to prevent people like…Oz and….oh everyone else from spewing false nutrition information, they are targeted as trying to monopolize the field. I guess if reliable information was being spread like wild fire through the public, then dietitians would not feel the need to be the primary voice in nutrition information. Surprise…I am a dietitian. I have had a couple of acquaintances say that they wanted to be a dietitian but the courses in chemistry and biology really deterred them. So what about nutrition do you like? Enjoying and eating food does not qualify a person to be a nutrition expert. I had to take a statistics course for my degree and I definitely do not feel I am an expert in statistics. It is mind boggling how someone that has had 0-1 courses in nutrition feel that they are experts!?!?!

    So, getting back on topic, I also feel that the pursuit of licensure is a waste of time and resources for CAM’s to be licensed. It also confuses the public and makes it hard for them to know who are qualified professionals and who to rely on for evidence based information.

  5. NYUDDS says:

    SkepticalHealth wrote: “I strongly believe one of the driving forces of rank stupidity, err, CAM, is the schools. They are extraordinarily profitable.” At first glance, I thought he was speaking of traditional Western medical schools (and centers) and not the for-profit diploma mills he presents. An excellent post! If one were to also search the curricula of many, many major institutions however, you will find entire departments devoted to alternative, complementary and, their usual term, “integrative medicine.”

    http://www.tuftsmedicalcenter.org/apps/Healthgate/Article.aspx?chunkiid=35926
    http://www.brighamandwomens.org/research/osher/
    http://www.massgeneral.org/bhi/basics/ together with this: http://www.cfim.org/providers/mcmanus.html

    What drives this? Is it money, recognition, patient request, insurance, empire-building (lit & fig), placebo effect, treatment-of-last-resort? Whatever it is, it is growing and the Holy Grail (Licensure), with medical center validation and verification, is not out of reach. Nonsense may be nonsense, but as I and others have written, legislators have the ability to turn nonsense into Law. We all have a tough row to hoe.

  6. Pman says:

    Hot off the presses:
    http://archinte.jamanetwork.com/article.aspx?articleid=1151703

    Will need to be replicated, but on the surface a nice win for acupuncture.

  7. ^^^ Utterly disgusting that people are still wasting money to study rank quackery.

  8. cervantes says:

    I’m applying for my astrology license.

  9. daijiyobu says:

    Here’s a great unlisted Youtube video of Senator Tom Harkin welcoming NDs to Washington and promoting them as the solution the ills of the healthcare system, posted on his Youtube account 2012-04-26:

    http://www.youtube.com/embed/tPf4B_fAGKo

    -r.c.

  10. gretemike says:

    SkepticalHealthon wrote, “I strongly believe one of the driving forces [behind CAM] is the schools.”

    I sort of agree. I think that the driving force behind CAM is anything that gives it respectability. That can be high-profile support, presence in mainstream schools and hospitals, bogus studies slipped into the mainstream, and legal support as discussed in this blog.

    I suspect that the key is respectability, and I think that matters. For example, Oprah promoting a particular form of CAM wouldn’t be as harmful, I suspect, as legislative foolishness as discussed in this blog entry. That’s because the legislative sanctioning of CAM gives it far more respectability than Oprah.

    Think about Wakefield, before his study there were plenty of people claiming the vaccine-autism link. But there was no respectability to the claim. After The Lancet published his paper, suddenly the claim had respectability, and for too many parents who saw the headlines, that was all they needed or wanted to know.

    So in my opinion that is why the focus of anti-CAM efforts should be directed at legislatures, schools and publications, with a secondary emphasis on encouraging responsible reporting in the media.

    That’s all, nothing too it! ;) But seriously, I do wonder whether chasing every Joe Mercola distracts from the bigger problem. Not that he isn’t a problem, but the people who believe in him, you aren’t going to change their minds. I’m more concerned about the people who might decide to make a naturopath their PCP if the law allows it, but who otherwise would go to a real MD.

  11. pmoran says:

    It is true that licensing may confer some unjustified legitimacy on unscientific practices and do harm to a few less worldly-wise souls via that.

    OTOH if people are already making considerable use of the services of naturopaths, chiropractors etc that activity may be made safer if such practitioners are required to have demonstrated some minimal level of intelligence and to have had some training (hopefully) in how to practice safely. .

    We are scientists. Can we find out what the relative risks are between states that license and those that do not? Or does it not make much difference in practice?

  12. Pmoran, when I was researching an article on naturopaths I came across several discussions of their licensure (they’re only licensed in a few states) that argued the point that requiring them to be licensed was dangerous, because the *more* schooling they had, the more quackery they learned, making them more dangerous. Of course naturopaths are one what unique because their quackery is not benign, it’s rather malignant (“asthma? Just bathe you kid in water with hydrogen peroxide, it will absorb oxygen through the skin making it easy to breathe!”)

  13. Jann Bellamy says:

    @pmoran

    ” . . . if people are already making considerable use of the services of naturopaths, chiropractors . . . ”

    It is unlikely that naturopaths and chiropractors could practice at all in a state unless they are licensed. Otherwise they could be charged with the unlicensed practice of medicine. That is why chiropractors sought licensure in the first place in the early 1900′s. Without licensure, people wouldn’t be using their services because their practice would be illegal. Licensure doesn’t protect the public by increasing the standards for practice — it allows the practice in the first place.

  14. pmoran says:

    Perhaps we are different. There are plenty of naturopaths practicing in Australia, but no national or state licensing. I am a bit out of touch in retirement and not clear as to their legal status (anyone?), but I suspect practitioners can get away with almost anything so long as no one complains.

  15. PJLandis says:

    @pmoron…”I suspect practitioners can get away with almost anything so long as no one complains.”

    Sounds like organized crime.

  16. weing says:

    “OTOH if people are already making considerable use of the services of naturopaths, chiropractors etc that activity may be made safer if such practitioners are required to have demonstrated some minimal level of intelligence and to have had some training (hopefully) in how to practice safely. ”

    Keep hoping. Why stop here? Why not license psychics?

  17. rork says:

    SkepticalHealth rightly notes the education received is useless, but that’s only in the sense of it not being true.
    Chiropractor offices are as common as fast food joints in my area. I conclude, with astonishment, that people pay for the services, and that some of the practitioners achieve their desired goal, which is to make money.

    Cooking meth is analogous, except payer’s harm is more likely. I see many people around me whose employment has no other goal than the money.

  18. Scott says:

    It is true that licensing may confer some unjustified legitimacy on unscientific practices and do harm to a few less worldly-wise souls via that.

    You grossly underestimate the number of people who assume that since they’re licensed, they’re legitimate. As in, it seems to be the substantial majority of the population.

  19. @pmoran,

    I think some of the confusion/difference is my (deliberate) incorrect use of terminology. I believe, in America, a naturopath doesn’t have to be licensed. They only have to be licensed to call themselves a “naturopathic doctor” or “doctor of naturopathy.” To be completely honest, a naturopath would be less harmful than a doctor of naturopathy, merely because they haven’t had 4 straight years of complete quack education.

    @rork, I appreciate the comparison of chiropractic clinics to fast food joints. Interestingly, they both do about the same “good” for customers!

  20. @Scott, that’s a great point. My mother used the same point when a fake quack PhD was convincing her that her teeth were causing all of her fatigue problems, and was trying to convince her to have them pulled. “But she has a PhD! Just because you’re a doctor doesn’t mean you know everything!”

    I’ll never get over quacks who get a fake PhD then run around calling themselves Doctor.

  21. gretemike says:

    Dr. Moran,

    I’m not sure that legislative regulation can enable a naturopath to act safely as a primary care physician (that’s been covered in previous blogs on this site). I fear that all it can do is increase the number of people who may choose to have one as a PCP, in the same way that Wakefield’s study being published in The Lancet caused more parents to shun vaccines.

    I don’t think we CAN reach people who are choosing CAM – I think the time spent with Danielle and her husband was a waste of time (even if it was an interesting waste of time). What I do think we can do is limit the number of people who turn to CAM in the first place by preventing the legislative sanctioning of nonsense.

  22. pmoran says:

    Gtetemike:I’m not sure that legislative regulation can enable a naturopath to act safely as a primary care physician (that’s been covered in previous blogs on this site). I fear that all it can do is increase the number of people who may choose to have one as a PCP, in the same way that Wakefield’s study being published in The Lancet caused more parents to shun vaccines.

    Yes, that could outweigh the benefits of requiring a basic standard of education, and exposure to (again hopefully) less gung-ho elements of the field.

    I admit I have no clear vision in this matter. Much of the relative risks will depend upon prior public perceptions and usage. (And nowithstanding Ernst’s portraying the matter as one of science versus nonsense public risk is surely the matter politicians must address.)

    For example there seems little doubt that Europeans, having grown up with it, have in the main adjusted to the safe use of homeopathy alongside of scientific medicine. Even in recent events in England, the main issue has been whether the NHS should fund it, not any inherent risk.

    In Australia naturopathy is generally positioned in the health care marketplace at its soft, “feel-good” end. Its shop-fronts offer naturopathy along with homeopathy, herbalism, aromatherapy, reflexology, massage and other modalities that should signal to all but the very dense that this is seriously “alternative” medicine. I thus think very few Australians would use naturopaths as exclusive PCPs (although 8% of Australian women have attended a naturopath in the last twelve months in the most reliable survey.)

  23. Jann Bellamy says:

    @SkepticalHealth: “I believe, in America, a naturopath doesn’t have to be licensed.”

    Unless they are specifically exempt by state statute or have their own state practice act, persons who do anything which falls within the statutory definition of “practice of medicine” can be prosecuted for the unlicensed practice of medicine. Definitions of “practice of medicine” vary among the states, but generally they look something like this, which is Florida’s definition:

    “‘Practice of medicine’ means the diagnosis, treatment, operation, or prescription for any human disease, pain, injury, deformity, or other physical or mental condition.”

    Thus, in states where N.D.s are licensed, they aren’t subject to prosecution as long as they stay within the definition of naturopathic practice in their state (which, unfortunately, is usually very broad.) However, a naturopath in a state without a naturopathic practice act (or who doesn’t comply with that act) or in a state that does not exempt naturopaths from the medical practic act, would be subject to prosecution if he claims to diagnose or treat any disease, pain, etc. Of course, enforcement is another issue. I imagine some get by without prosecution.

  24. @Jann, thank you for that information. Very informative. Question: at a store this evening I saw a bracelet which had a little printed sign next to it that said “This is great for migraines!” Is it illegal for people to make claims that any random device is good for a particular condition? I thought, at least for supplements, they could not claim that they are good for any particular condition. Or is it just the manufacturer that can’t make the claim?

  25. Jann Bellamy says:

    @SkepticalHealth

    Th U.S. has over 50 separate jurisdictions, state and federal, so I can only answer your question generally:

    No one can sell anything that claims to do something it can’t or doesn’t do, at least where a “reasonable person” knew or should have known this is the case — that is fraud, and subjects the seller to civil liability for common law fraud and possibly various consumer protection laws, such as those administered by the Federal Trade Commission and the state unfair trade practices/consumer protection offices. It is also possibly criminal fraud, depending on the cirucumstances. To the extent the bracelet might fall within the definition of a “medical device” it could also run afoul of the medical device clearance requirements administered by the FDA.

    Your question about supplements brings up an interesting issue — to a certain extent, in my view, Congress has provided cover for the supplement and homeopathic rememdy manufacturers in the form of federal laws, such as DSHEA, which (again in my view) allow manufacturers to make claims that, in the sale of other products, might be considered deceptive. However, these laws would not apply to the bracelet manufacturer.

    You might want to go back and look at an earlier post, “Is CAM Fraud?” where I discuss some of these issues.

    I am in favor of reporting devices like this bracelet to the Federal Trade Commission. You can do so on-line at the FTC’s website — you don’t have to be a purchaser to report a product. If you want to go further, it can be reported to your state’s consumer protection agency and the Better Business Bureau.

  26. nybgrus says:

    Peter

    The problem is that the licensing is done “in house” – by other quacks using their definitions. So requiring the license would in no way make for any improvement in basic intelligence nor their ability to practice safely. We can’t expect them to agree to enforce OUR standards as part of their license – they would fight that tooth and nail and it isn’t the paradigm already in place.

    The only thing it does – as was mentioned above – is make people think there must be legitimacy to it and thus be more happy to make use of their services and, in at least some cases, feel there its some sort of equivalency to actual medical care (especially when the practitioner with said imprimatur of legitimacy outright states this to be true).

  27. chaos4zap says:

    It amazes me how hard the SCAM proponents try to make themselves appear credible. In my opinion, they knowingly and intentionally deceive the public in a manner that gives them plausible deniability and relies on taking advantage of people that don’t know any better. Chiropractors are a great example. It is maddening that they are able to call themselves Dr, Sure it may say D.C. on the sign, but most people have no idea that there is a basic and fundamental difference between D.C. and M.D., people understand that a Dr with a Phd in economics is not the same as a MD, but a DC calls themselves Dr and practices what appears to be medicine. I was waiting for a haircut the other week and there was another guy waiting that was wearing scrubs. Since I work in a hospital (technically a ambulatory center), I thought I would inquire about what he did and kill some time while waiting. I was surprised when he told me that he was a Chiropractor and he was flat-out shocked that I knew so much about chiropractic. Every chiropractor I’ve ever talked too was genuinely surprised that I knew so much about its history and basic beliefs, which demonstrates perfectly that almost all people they encounter are clueless about what a DC actually is (they will often not care to speak with you much after they figure out that you know what you’re talking about). The one question I wanted to ask, but didn’t, was “Seriously, why are you wearing scrubs? You are a Chiropractor!” But of course, wearing scrubs helps muddy the water and further portray themselves as a legitimate Dr.

  28. Jeff P says:

    I recently started reading SBM and have found the info and perspectives very interesting. I wanted to comment on this blog post because I think that it is inaccurate to characterize all of a Naturopathic Doctors education or practice as utter quackery.

    To support my position, I wanted to share my experience in dealing with a N.D. from the (dreaded) Bastyr in Washington State. A number of years ago, I had a persistent sinus infection (6-months) that my regular PCP (an MD) treated with three courses of antibiotics, which knocked it back but never resolved it. One option was to look for nasal polyps to surgically remove, as they could be exacerbating my condition. I decided first to see the Bastyr N.D. and he subsequently put me through a food testing regimen to determine any food intolerances. In his view, eating foods I don’t tolerate well could have contributed to a constantly stuffy sinuses and thus conditions that support an infection/sinusitis. (see below for a description of the regimen) Once I eliminated the foods I don’t tolerate well from my diet, my sinus infection/sinusitis abated and I have not had problems since.

    In another visit, his recommendations for treating high cholesterol, such as prescribing Lovastatin, increasing soluble fiber and other lifestyle changes pretty much followed the guidelines outlined by the National Heart Lung and Blood Institute for dealing with high cholesterol. In yet another visit I was prescribed Ciprofloxacin drops to treat an ear infection.

    I don’t consider the treatments I just described as woo and I would be surprised if other readers here did. I’m not making arguments for all of the ND’s practices, but I can say that I very thankful to him for helping me identify foods that were really causing me trouble. It is certainly something an MD could/would do, but as it was, my primary care physician was just promoting another round of antibiotics and/or surgery. Yet it was the first approach the ND took.

    Its just a thought, but perhaps the SBM community would gain a following from people that are considering CAM by being critical of specific treatments or practices as opposed to tarring-and-feathering the entire movement. (The former may well be a common practice at SBM, but one that I haven’t seen as much of because I’m a relatively new visitor)

    Food testing regimen that I went through: I removed many of the common suspects from my diet for a couple of weeks and then added new things in, one at a time, on a timescale of a few days for each one. It was really performing experiments with/on myself. When I got to the two foods that I have real problems with (milk and soy), I had a pretty strong reactions that I could repeat by eating them again, including brief recurrences of the sinusitis and a flare up of my excema, headaches, severe GI issues, etc.

  29. Jeff P – that’s pretty cool that the food elimination thing actually worked, or at least seemed to work.

    I think the trouble with those food sensitivity tests is that, for people whose cases are not cut and dry, such as those with severe digestive disorders or other chronic debilitating conditions, it is not as simple as a food sensitivity issue. However, many NDs believe that and can lead patients away from conventional medical care because the idea of just changing ones diet can be very compelling.

    Also, there really isn’t any research on food sensitivities and sinusitis (that I’ve heard of.) If there are any positive results out there, it hasn’t yet trickled down into medical practice. It seems like an easy, gimicky blanket intervention that an ND can do, and it doesn’t mean it even hits the mark more than half of the time, even due to random chance.

Comments are closed.