Mark Hoofnagle has a PhD in physiology from the University of Virginia and is currently a 3rd year medical student. His interest in denialism concerns the use of denialist tactics to confuse public understanding of scientific knowledge.
I guess it's not just doctors watching this one---an alert reader and a fellow SciBling both picked up on this one. Apparently, in my neighboring state of Minnesota (really, check the map), home to Greg Laden, PZ Myers, and lutefisk, doctor wannabes have legislated themselves into "doctorhood". You see, there is this entity called a "naturopath", or "naturopathic doctor", which is some sort of shaman that likes to think that if you study woo long enough, it becomes science.
OK, OK, I'll settle down, but let's examine this "naturopath" thing. You see, to be a real doctor, you must attend a medical school that is certified by a national organization, and to be licensed to practice, you must finish an accredited residency program and apply to the state for a license. Medical schools and residencies are very closely monitored and must meet exacting (and consistent) standards. There are a few associations for naturopaths, but no requirements equivalent to say, being a certified master plumber. For example, the American Naturopathic Certification Board, one of the entities that "certifies" naturopaths, states:
The preferred credential for taking the examination in Nutritional Wellness is a masters level degree in nutrition, while the preferred credential for taking the examination in Traditional Naturopathy is a doctoral degree, either N.D. or Ph.D.However, recognizing that education can be a combination of formal education, practical experience, apprenticeships or other modes of experiential learning, applications from individuals with such education will be evaluated.
In other words, they prefer education, but, hey, if you can't manage that, just make sure you've been an uncertified practitioner for a while.
They claim to have a science-base education but teach such ridiculous and disproved ideas as homeopathy.
Naturopathic "medicine" is a funny idea. It is, according to one organization (and they all pretty much say the same thing):
... a system of medicine that assists in the restoration of health by following a set of specific rules. A basic assumption is that nature is orderly, and this orderliness is designed to result in ongoing life and well being. This dependable orderliness is believed to be guided by a kind of inner wisdom that everyone has. This inner wisdom can be assisted to return a person to their best balance by naturopathic treatments."Inner wisdom"? Excuse me, but WTF?!? Science-based medicine is all about learning to avoid reliance on "inner wisdom" and common sense, as these tend to be poor guides as to what treatments are and are not effective.
Minnesota is in trouble. Arizona has gone down a similar road with homeopaths and other non-doctors, and they've had some serious problems. The reason we have a consistent and regulated system of bestowing the title of "doctor" and the license to practice is that we, as doctors, have a unique ability to heal and to harm. Having a consistent and well-regulated system takes out some of the guess-work. Even if we cannot be sure of the excellence of every licensed physician, we at least know that they have received the same or similar education and training as their peers. Real doctors receive a proven, science- and evidence-based education. All the others are just wannabes.
Look, if naturopathic school is so rigorous, just go to medical school. We can always use compassionate, intelligent primary care physicians, and we promise to give you an education in the real science of healing.
Sorry, but we don't teach inner wisdom. We gave that up a few decades ago when we realized it didn't work.
Medicine & Health
Comments
On a related topic, do you think we need more doctors and/or medical schools? Medical schools turn away so many candidates; surely at least some of those would make decent enough doctors.
Posted by: synapse | June 10, 2008 12:13 AM
Posted by: Dan | June 10, 2008 6:37 AM
I consider naturopathy the ultimate in quackery. Some people say that about homeopathy (because they tell you there is no remedy in their remedies); but naturopathy exceeds homeopathy by adopting it, along with every other stupid idea. One ND advocates taking a bath in water with a little hydrogen peroxide in it as a treatment for asthma. Apparently, she is unaware that peroxide is not oxygen, and that the technical term for trying to absorb oxygen (in water) through the skin is "drowning."
http://www.naturowatch.org/ (a subsite of www.quackwatch.org) has a good description of this quackery. Dr. Atwood also has an article in Medscape (2003) and two articles in "The Scientific Review of Alternative Medicine" (2005). He estimated there were 34 naturopaths seeking licensure in Massachusetts in 2002. I live in the most rural county in the state; but there are two (yes, 2!) within walking distance of my apartment (I feel blessed). They practice "medicine" here, without licenses.
One can often find a list of "naturopathic principles" that begins:
1. the body heals itself.
2. First do no harm ...
Do they know what "first" means?
I find the Minnesota regulation interesting because they seem willing to license anyone; whereas, in the other cases I am aware of, the NDs argue licensure should only be granted to those who have N.D. degrees from accredited schools. The inclusiveness must represent "Minnesota nice." Oh yah, you betcha.
Posted by: Joe | June 10, 2008 7:36 AM
Isn't it against the law to practice medicine without a license? Is there some legal definition of "practicing medicine without a license" that keeps these people out of jail? Or are there just too many to prosecute?
Posted by: Oldfart | June 10, 2008 8:45 AM
Just to emphasize a point, it's my understanding that becoming a certified plumber - or electrician, or any kind of contractor - will be significantly more difficult than becoming a certified naturopath "doctor".
Posted by: jeffk | June 10, 2008 9:47 AM
It seems to me that *some* "alternate therapies" *may* have some beneficial effect. Consider acupuncture. The explanation for its action presented by practitioners is all hooey (channels of energy) yet people report positive results. Proper (double blind) studies could be done to determine if the procedure is both safe and effective.
Big Pharma won't do it as there is no money for them in it. That leaves government- and university-funded research. I imagine any researcher of note would be reluctant to propose such a study.
Gotta run, but you have the basics of my idea here.
tomS
Posted by: tomS | June 10, 2008 9:58 AM
Dan: Not any more. As Orac has frequently pointed out, real medical schools are now teaching woo right along with science based medicine.
They should be teaching woo. GPs are going to run into it, and they need to know both what woo practicioners are doing to their patients, and how to talk to their patients. On top of that, some good medicine is done by woo practicioners, on top of the woo -- a lot of the long-term tracking (for diabetes, etc) is done by chiros and acupuncturists, which GPs often nowadays ignore in this age of 15 minutes, pay by the cap, practice.
The problem isn't that kind of woo --- it's this woo they call "case management" which is just following an algorithm with your patients --- aka, try different shit until your patient gets better or dies. That's "science woo" --- imagine an engineer who argued that bridge repairs should be done that way!
Posted by: frog | June 10, 2008 11:05 AM
I believe that one can also go the ND route in Connecticut.ND's advertise in our free local Woo Age magazine, one "practices" in NJ( she's also Ayurvedic) and others in southern NY state, the Hudson valley, which is a vortex for this sort of thing.Come to think of it: with all of these imaginary diseases popping up, imaginary doctors just might find their work cut out for them.(An added benefit: no competition from EBM!)
Posted by: Denice Walter | June 10, 2008 11:38 AM
@frog,
Where do you get your information? The quackery taught in medical schools is almost always presented as if it were real therapy. That is not good. On the other hand, if it were explained as the nonsense it is, that would be valuable.
As for chiropractors and acupuncturists dealing with diabetes- that is disturbing, if true. They know nothing about it, and their "treatments" are particularly irrelevant.
Woo practitioners do not practice medicine at all, let alone "good medicine." There are a small number of rational chiropractors who disavow the core of chiropracty (subluxations and Innate Intelligence) and only offer massage and some mobilization; but they are not chiropractors, except in title. They say the difference between a rational chiro and a large pizza is that the pizza can feed a family of four.
@Oldfart,
How can they practice illegally? It's a good question and I will ask around; but I don't think I will have a timely answer (for this thread). I think they fly below the radar (at least until they kill, or seriously harm, someone).
I recall James Randi trying to get police/prosecutors to pay attention to a "psychic surgeon" practicing in Florida, and they thought Randi was a joke.
Posted by: Joe | June 10, 2008 12:06 PM
tomS,
A number of acupuncture studies have been performed already, which show no skill beyond the placebo effect. This includes "sham" acupuncture in which the needles were inserted randomly or incorrectly. The latter type of study is single blind. I don't know if a truly double blind study has been performed, where the practitioner doesn't know if the needles are being inserted properly or not. I remember reading about the development of special needles for this purpose (you activate a plunger which may or may not actually insert the needle). I don't know if studies using them have been performed yet.
Posted by: Ambitwistor | June 10, 2008 1:04 PM
Actually, it goes well beyond that Ambitwistor. At least one person that was "previously" an advocate of acupuncture tested it using bandaids that had a small bit of rubber or something in them (for sanitation). Apply the bandage, then stick in the needle, which is "held" by the bandage, but never actually goes into the body. Same identical results. They featured the guy on Penn & Teller's show on showtime, I think. And, he did the same thing with acupressure. Finding that what mattered was if the "practitioner" seemed to believe in it and had a complicated and technical sounding enough "explanation" for how it was supposed to work. Gosh! Sounds almost like "placebo". lol
Posted by: Kagehi | June 10, 2008 1:30 PM
Where can I get one? I'd like to be a therapist for post-fundamentalism stress disorder (PFSD) in religious de-converts.
Posted by: TheNerd | June 10, 2008 2:27 PM
The American Naturopathic Certification Board (quoted in the article above), is not a legitimate organization and their members are not eligible for licensure in the 16 states that license naturopathic doctors, including Minnesota. In fact, it brings to light the necessity of licensing legitimate naturopathic doctors.
In order to be licensed as an ND in states that recognize naturopathic doctors, graduates must attend a 4 year naturopathic medical school and also pass a national licensing exam. To be accepted into a naturopathic medical school, students needs to obtain a bachelor's degree with the same premed requirements as someone that attends a conventional medical school. Naturopathic medical schools are also accredited through the federal government by the same accrediting agencies as conventional medical schools. Students of naturopathic medical schools must complete around 5000 hours of classroom and clinical rotations, the same and in some cases, more than many conventional medical schools. The only deficit that naturopathic doctors face is in residency training. Because the profession is still very small, there are not enough opportunities for students to complete 1-3 year residencies, which is changing. Osteopathic doctors had the same problem 30 years ago, however in many states residencies for MD's and DO's are not mandatory either.
This brings me to the point that naturopathic doctors should be licensed in all 50 states, because they do receive adequate medical training and licensure allows the general public to differentiate between a true naturopathic doctor and someone that takes a couple online courses.
Posted by: Ted Suzelis, ND | June 10, 2008 2:38 PM
Joe:
Where do you get your information?
I do research in a medical school. Of course, those who teach it are practicioners, therefore they will teach it as working. Do you expect the medical schools to hire anthropologists? We're not talking about teaching 8 year olds, but medical school students -- if they can't distinguish woo from non-woo, you ain't going to "teach" them by telling them what is woo.
As for chiropractors and acupuncturists dealing with diabetes- that is disturbing, if true. They know nothing about it, and their "treatments" are particularly irrelevant.
That's laughably over-simplistic. A great deal of diabetes treatment is a) recognizing it early b) tracking nutritional habits often and explicitly. An decently trained acupuncturist is actually more likely to do a good job of that than an MD. They see their patients more often, they apply old-fashioned diagnoses such as looking at their patients closely and smelling them closely (which is much more likely to id diabetes very early on than waiting for an acute episode), and talk to their patients regularly about their nutritional habits.
Treatment of many chronic conditions doesn't require medical school and residency, but basic training in psychology, nutrition, close observation, and a basic physiological knowledge. Even for some acute conditions, a decent acupuncturist is more likely to pick up on melanomas and such earlier than the GP so they can be referred up the chain.
Just like public health has done more to help health than all the MD of the last century, the most efficacious treatment that in general extends life is not the acute treatment that medicine excels at, but the old fashioned shamanistic work of having a basic knowledge of physiology and psychology. A well-trained woo practitioner can do that --- if they're trained well enough to know when to refer folks up the chain. They can do what GPs used to do, but are no longer trained to do, are economically incapable of doing, and are positively mistrained for.
The fact that their treatments are placebos is irrelevant -- for the right conditions. If I have pain, and a placebo makes it go away, I could give a crap about "scientific significance". If woo can convince someone to eat their veggies, or make them less depressed, why should they pay someone at 10-100x the rate to get some scripts that are likely to do significant harm? Woo which disregards medicine is dangerous, but woo which supplements and respects medicine can be the most efficacious means of delivering basic health.
Posted by: frog | June 10, 2008 3:04 PM
I knew lutefisk couldn't be good for you.
Posted by: Cherish | June 10, 2008 3:04 PM
Ted Suzelis,quack,
As I said, your kind berate other NDs. Their information is as well founded (not) as yours. Go to www.naturowatch.org and tell us which, critical, articles are wrong. Beware, nobody has ever returned from such a mission.
Posted by: Joe | June 10, 2008 4:00 PM
The new Minnesota law registering naturopathic doctors was not opposed by the State Medical Association. Registered NDs will be under the jurisdiction of the State Board of Medical Practice just like MDs.
The American Naturopathic Certification Board has absolutely nothing to do with the practice of naturopathic medicine as regulated in 15 states, including Arizona, California, and now Minnesota.
Organizations such as ANCB owe their existence to the the fact that naturopathic medicine is not regulated in majority of the states.
The fact that the author considers ANCB as representative of the naturopathic medicine shows that people do not understand the difference between qualified naturopathic doctors and those individuals who receive correspondence school 'Doctor of Naturopathy' diplomas, and who are not eligible for licensing or registration.
Licensed naturopathic physicians attend regionally accredited schools with professional accreditation by the CNME, recognized by the U.S. Department of Education, similarly to the professional accreditation of MD programs by the LCME.
Legitimate naturopathic medical schools are listed in the
Princeton Review 'Best Medical Schools' guide, just as all legitimate conventional and osteopathic medical schools.
The AMA does not hold the monopoly on providing health care, its historical efforts notwithstanding.
Obviously schools do not teach inner wisdom, but I would not dismiss it facetiously out of hand.
Posted by: Hermano | June 10, 2008 4:14 PM
"Obviously schools do not teach inner wisdom, but I would not dismiss it facetiously out of hand."
Why not?
Posted by: PalMD | June 10, 2008 4:16 PM
@frog,"Just like public health has done more to help health than all the MD of the last century ..."
Public health measures are entirely based in scientific medicine. Can you be any more ignorant?
Posted by: Joe | June 10, 2008 4:16 PM
Dr Ted, could you provide links for us? In my admittedly too-brief research, I was unable to find any clear info on accreditation of ND's, educational requirements, course content, etc.
I would like to see it written that they actually receive a "MD plus" sort of thing, and what that "plus" represents---evidence-based med, or wishful thinking woo.
Posted by: PalMD | June 10, 2008 4:18 PM
"A basic assumption is that nature is orderly, and this orderliness is designed to result in ongoing life and well being."
Wait, what? The entire basis for naturopathy is the belief in some grand cosmic order? That sounds suspiciously like religion and not science.
Posted by: Radioactive afikomen | June 10, 2008 5:12 PM
Projecting much, frog?
Real doctors take the time to figure out what's actually wrong with a patient and treat accordingly. Of course, since the human body is complex, there's no such thing as "one size fits all" treatments. Some people will have an adverse reaction to a certain medication that works just fine for 90% of all the other patients and need to be switched to a different treatment.
And for the record... Yeah, that's exactly how people in other technical fields troubleshoot problems, too. I'd know, because I'm an engineer. (Electrical not civil, but the methods are universal.) You determine what the problem is, find out what's worked to fix similar problems in the past, then adjust the solution to fit the unique circumstances of the case at hand.
The only real difference is that most engineering fields have robust models and computer simulations that allow the "trial and error" to take place in a controlled environment. Doctors don't have that luxury; the best they can do is to conduct as much research as they can and test as many variables as they can before adding a drug or technique to their armamentarium. That's exactly what EBM is.
By contract, woo just looks up the answer in their standard cookbook and prescribes the same treatment to everybody. ("Take this tincture! Same one we've used for 200 years!" Or the Eddie Izzard chiropractic version: "Crack your bones! Crack your bones!") And if that doesn't work? Do the same thing some more! And if it still doesn't work, it's because that lousy bastard patient didn't think happy thoughts enough. God, it's like he wants to be sick, or something! But it's never, ever the woo's fault. Oh, no, the woo is flawless.
Posted by: Joshua | June 10, 2008 5:32 PM
@Hermano,
There are accredited schools of astrology, that does not validate astrology. At minimum, accreditation means the facilities exist and the organization is financially sound. I challenge you, too, to go to www.naturowatch.org and tell us which articles are wrong. Beware, nobody has ever returned from such a mission.
Posted by: Joe | June 10, 2008 5:37 PM
@radioactive,
You may be right, how does one distinguish a religion from a cult?
Posted by: Joe | June 10, 2008 5:41 PM
Joe,
You and Doctor Atwood remind me of the denizens of San Francisco as portrayed in the South Park 'Smug Alert!' episode.
A tiny amount of hydrogen peroxide added to bath water to relive asthma is just one of maybe a hundred folk practices reviewed in an online article by an Alaskan naturopathic doctor. She does not make any claims to its efficacy and just lists it as one of many things people do.
I see no problem recognizing that human body has an innate ability to heal, and afterwards saying 'First, do no harm'.
They are both principles, from Latin 'principium' meaning
beginning or first part.
And yes, there are several of these first parts, and the order is arbitrary. 'First, do no harm' refers to DOING, in other words, treating a patient, when the physicians' first duty is not to cause harm.
Which brings us back to H202. A regulated naturopath
might know that some people add a teaspoon of substance to
bath water, which is harmless. An uneducated unlicensable naturopath with fake credentials might inject his patient's veins with hydrogen peroxide and kill him, as Brian O'Connell did in Colorado in 2003.
But you know best, ALL naturopaths are quacks.
They say a bond of shared prejudice is one of the sweetest connections people may enjoy.
So, have fun making sweeping generalizations and sniffing whatever you and your anesthesiologist pal Atwood do.
Posted by: Hermano | June 10, 2008 6:27 PM
Joshua, have any idea how MDs are being trained nowadays? Have you been to a "Real" doctor?
Real doctors take the time to figure out what's actually wrong with a patient and treat accordingly. Of course, since the human body is complex, there's no such thing as "one size fits all" treatments. Some people will have an adverse reaction to a certain medication that works just fine for 90% of all the other patients and need to be switched to a different treatment.
And for the record... Yeah, that's exactly how people in other technical fields troubleshoot problems, too. I'd know, because I'm an engineer. (Electrical not civil, but the methods are universal.) You determine what the problem is, find out what's worked to fix similar problems in the past, then adjust the solution to fit the unique circumstances of the case at hand.
Today, non-specialist (the GPs that do most treatment) do not "determine what the problem is". You can't possibly do so with 15 minute consults. In engineering, when you troubleshoot, you have the time to go altering one variable after another, attempting to isolate a fault, given systemic conditions. If you just hack away, hoping that a fix will work --- well, you're just not an engineer -- you're a tech (and not a very good one, at that).
That's not what case management is. In case management, you try different solutions without ever trying to isolate the problem. You never have the leisure to actually think about it systematically -- you try treatments in order of success rates until one "works". That's hardly scientific.
I've known quite a few old-timey doctors --- they've all been itching to retire because they don't want to be involved in today's quackish, assembly line medicine. Really, get to know some real doctors. Ask them what they do --- the guys in their fifties and up will repeat exactly this. It's not engineering, and it's not science, it's following a cookbook. They're techs.
And for the idiots out there who will scream "But that's not what I do!", of course there are exception. But this is what the training regime is for pediatricians, GP and other non-specialists. Some folks are smart enough to disregard their crappy training, and find some way to make it work economically.
Posted by: frog | June 10, 2008 6:35 PM
@Joe: Public health measures are entirely based in scientific medicine. Can you be any more ignorant?
Can you possibly have a lower level of reading comprehension? My metaphor was pretty clear --- and it wasn't an analogy on scientific basis, but an analogy on acute vs. chronic. Yee Gods, reason by idjits is still idjitery, no better than irrationalism and often worse.
Posted by: frog | June 10, 2008 6:39 PM
Joe,
I am rather fond of various xxxxxwatch.org's Stephen Barrett and wish him well.
He amassed a great deal of valuable information unavailable elsewhere about various dubious activities.
But, Joe. Astrology? Really? That is so weak.
Here is a better one: prefrontal lobotomy.
Egas Moniz received the 1949 Nobel Prize in Medicine for it.
It must be super terrific.
But please, don't rush to schedule one to go along with your next Botox treatment.
I repeat, do not get the lobotomy just for the fun of it.
Just because the medical establishment once thought it was the greatest thing ever does not really make it so.
Posted by: Hermano | June 10, 2008 7:11 PM
@Radioactive afikomen
Does having a Geiger counter really makes this night different from every other night?
Is science the new religion?
@PalMD
Inner wisdom is that very quiet voice deep inside your heart. It does not come from the outside, is not taught at CalTech, and is not conferred by the Swedish Royal Academy of Science. Just the opposite, the outside noises make it hard to hear.
It is the quiet voice Moses hears after the burning bush fireworks.
Posted by: Hermano | June 10, 2008 7:37 PM
@Hermano,
Emily Kane is not just an Alaskan, she is (was) an editor of the most prestigious naturo magazine. Why would she write http://dremilykane.com/2001/09/25/asthma-i/ "For an acute asthma attack ... Some doctors recommend taking baths with a cup or so of 3% hydrogen peroxide in the water to bring extra oxygen to the entire surface of the skin, thus making the lungs somewhat less oxygen hungry." If she did not believe it was useful? An acute asthma attack is a serious problem. If she had even the slightest knowledge of science, she would know peroxide on the skin does not "make the lungs less oxygen hungry." It was not presented as a review of folk practices. Hydrogen peroxide was not available to ancient folk.
And I'll take the rest as a "No" you cannot refute anything at naturowatch.
Posted by: Joe | June 10, 2008 9:06 PM
frog wrote "Can you possibly have a lower level of reading comprehension? My metaphor was pretty clear ..."
Yes, I could have a lower level of reading comprehension. In your case, the answer to "What is a metaphor?" is "It's for grazing cows."
Posted by: Joe | June 10, 2008 9:31 PM
If they want to practice any kind of "medicine", they should be subject to the same risks and expenses that we real practitioners take.
"Malpractice" insurance (actually, pissed-off patient insurance). And the risk of lawsuits.
Posted by: MMOToole | June 10, 2008 9:31 PM
@Joe
I did find some things objectionable at the naturowatch.org, and contacted S. Barrett regarding them.
He did reply and clarify some questions I had.
My main objection is not recognizing a distinction between
licensable and unlicensable naturopaths.
By the way, Barrett is very happy to use statements by Joe Pizzorno ND, the founder of Bastyr University in Seattle when it suits him to discredit some serious fraudsters.
Thanks for providing the link to Emily Kane's article, I had trouble finding it earlier today.
H202 reference is mentioned in passing within broad review of various alternative treatments that may be used in conjunction with conventional Prednisone and Albuterol.
I just might write E. Kane and ask what she thinks about the continued brouhaha by Atwood, who keeps writing about it year after year.
I suspect she does not care too much about it.
As far as I know, the prestigious journal she edited does not have that much traction among trained naturopaths, who are just as likely to read the Journal of Family Practice (from a survey of 1).
I am grateful for the opportunity to hang out with you in cyberspace, Joe, but Emily definitely sounds way cooler.
Good for her.
About Dr. Kane (from her site)
Emily A. Kane was raised in North Africa. Her parents were with the United States Foreign Service. She came to America at age 16, graduated from Harvard University in 1978, and lived in Paris, Washington DC and New York City before coming to Seattle to begin naturopathic medical training. Her first career was in contemporary performing arts as a promoter, manager, designer and performer.
A graduate of Bastyr University in Seattle (class of 1992), she completed both the Naturopathic and Acupuncture/Oriental Medicine programs. Her preceptor work (similar to residencies) took place in Seattle, West Virginia and China, with emphasis on gynecology, counseling, herbal medicine and naturopathic manipulation (body work). She worked as a Licensed Massage Therapist in Seattle during her medical training for 7 years.
Dr. Kane maintains an active clinical practice and sees patients of all ages.
She writes a column for Better Nutrition magazine called Ask the Naturopath, and she also recently published a concise and informative book on achieving and maintaining excellent health entitled Managing Menopause Naturally, available through this website or at Amazon.com. She is the former senior editor of the Journal of Naturopathic Medicine (1989-96), the scientific, peer-reviewed journal of the American Association of Naturopathic Physicians. She regularly leads retreats and therapeutic fasts, and teaches health classes through her local community college. (Occasionally, she holds retreats further afield!)
She continues to enjoy the arts, especially music and theatre. In 2001 she completed a Danskin triathlon as part of her dedication to “physical culture,” and has participated in the relay race called the Klondike (from Skagway, Alaska to Whitehorse, Yukon) each year since 2001. She is a registered yoga teacher (RYT) and teaches introductory Ashtanga classes in Juneau, where she lives with her husband and daughter. During the deep winter months she can be found on Big Island, Hawaii, in a little solar-powered home with a backyard organic orchard of exotic fruits.
Emily A. Kane, ND, LAc
Naturopathic Doctor
Licensed Acupuncturist
Posted by: Hermano | June 10, 2008 11:41 PM
@MMOToole
Basically, malpractice insurance IS what qualified naturopaths
get out of the new law.
They will be very happy to get it. It will allow them to join a practice with other providers who require their colleagues to carry insurance.
Registered NDs will be under the jurisdiction of the MN Board of Medical Practice just as MDs are.
I am certain the Board will be happy to investigate and prosecute any wrongdoing.
Posted by: Hermano | June 10, 2008 11:50 PM
This post is not about the fake naturopaths who have twisted the political process to get themselves included in the new law in Minnesota. I cannot speak to that and am sick at heart because of it. This post is solely in response to the uninformed attacks on naturopathic physicians.
Apparently the author has not done even the most basic research into the curricula and training of naturopathic physicians who train at accredited, four-year institutions. Most of the courses in these programs are the same as in medical school. There are some that are of course different. Describing this as "studying woo long enough" is simply showing ignorance of the training of NDs.
Naturopathic physicians meet all the criteria listed for being "real doctors" except one, with which I will take exception. NDs train at schools accredited (certification is not the correct term, sorry you are not familiar with even the most basic concepts of how education works) by the Council on Naturopathic Medical Education (CNME, recognized by the US DOE) and the standard regional accrediting agencies that accredit all institutions of higher education. They are licensed by many states (granted, not all) to practice. Unfortunately, due to politics, NDs are not given the government-subsidized residency opportunities given to MDs, despite the ongoing inability of MDs to put these residencies to good use often (do we really need more brain surgeons, plastic surgeons, anesthesiologists and orthopedists when so many people are without access to primary care doctors, especially in rural areas?). If they were, then every ND would have a residency. That being said, the profession is working hard to create its own privately-funded residencies, and so a portion of graduates get these. The residences are also accredited by CNME. Only one state that licenses NDs requires a residency to practice as an ND, Utah. Others do not, so it is not necessary to complete a residency to be a "real doctor" in this legal framework. Naturopathic medical schools and residencies are monitored by the same processes as conventional ones. Legitimate NDs currently have board certification in only a small number of areas, but a "real doctor" MD doesn't have to be board certified to practice. I don't see how that is relevant. The "certification" boards for these fake naturopaths is a whole other ball of wax and completely unsupportable; there is no question about that. I'm sorry the author can't tell us apart from them.
I would agree that homeopathy is not scientific. However, as far as I know, arthroscopic surgery for knee osteoarthritis continues to be taught and practiced by many MDs, yet it has been shown to be no better than sham surgery in at least one controlled clinical trial. How can medical education be legitimate when it continues to promote the ridiculous and disproved idea of this surgery? Don't throw stones while you live in a glass house, as they say.
I am sorry that conventional medicine assumes that healing can't occur without intervention. If you review, for example, how antibiotics work, I think you will find that they are actually doing something similar. Antibiotics do not kill every single bacterium in a person's body--they instead knock enough of them down that the immune system can get a leg up and kick the rest out. And why does one person exposed to the same bacterial load get sick while someone else does not? Perhaps the one patient's immune system was weak in some way, they were really stressed out, they weren't eating well, who knows what. These are the simple and I think very valid and important tenets we're talking about with the belief in naturopathic medicine that nature has a healing tendency, if not perfect.
Legitimate naturopathic physicians want the same thing MDs have--a consistent, regulated system. In the states that license us, we have that. The schools of naturopathic medicine teach a consistent curriculum and we have one set of national naturopathic board exams (along with Canada). Why do the MDs get to have the only legitimate medical system? Are you saying then that nurse practitioners, physician assistants, osteopathic physicians, and any other medical practitioner has no legitimacy and doesn't have the "unique ability to heal or harm?" You are really incredibly obnoxious to ignore these hard working people and to see that there are many players in the health care system, and that MDs are not at the top of the food chain, much as they want to think they are.
You really have the arrogance to think you're fixing everyone and that they are completely passive in the process of healing? This ridiculous god syndrome has consistently disempowered patients, made them helplessly dependent on prescriptions that mask symptoms all too often and don't engage them in a healing process. If MDs were so powerful and mighty and wonderful why the hell can't they deal with obesity, diabetes, and cancer, pretty much all of which have continued to get progressively worse under the tyranny of the "well-regulated system" that monopolizes health care?
The reason to avoid medical school and go to naturopathic school is that the current disease management "system" in the US and the rest of industrialized world has reached the limits of what it can do. Now it is just spending ever huger sums of money for vanishingly smaller gains. The major health problems today are just not amenable to pharmaceutical and surgical therapy, and in fact are often worsened by them because they don't treat the cause of disease. For instance, continually trying to find pills to combat type 2 diabetes is insane when clearly the causes of this disease are lifestyle related. When will MDs acknowledge that their complete lack of information about basic nutrition is a huge roadblock to many people getting truly well from the most common chronic diseases? If medical school is so rigorous, just go to nutrition class. We can always use people that know the tiniest bit about the most basic, fundamental aspects of life.
We can debate how healing occurs, but simply saying that "a few decades ago" someone decided that naturopathic medicine's ideas about how people heal were discredited is insane. How do you explain someone's bone healing after a fracture? Of course it has to be set to heal non-crooked, but it's not like the bonesetter makes the bone heal. Anyway, this really isn't that big an issue.
The much bigger issue that is being ignored here is that 100,00 people in hospitals in the US each year are killed by pharmaceutical drugs properly prescribed, over 2 million are injured, and god knows how many people in the community are sickened or killed by drugs (if I have to give you the references to the research that backs up these numbers, you really are missing the boat). And that's also not counting the complications of surgery which are huge. How can one argue that this is a sustainable, acceptable medical system when it is killing so many of its patients? Real doctors do not accept such high rates of lethality and harm from their "treatments" without raising a lot more questions.
If you have failed to read The Truth About the Drug Companies by Marcia Angell, MD (former editor of the New England Journal of Medicine), then you better get on the ball. Conventional medicine is incredibly rife with fraud, deceipt, bribery, and scandal. I sometimes wonder how I can trust any medical research given the widespread documentation of corruption in medical publishing and research. How can a system of medicine allow to continue unchallenged that is so rotten? This is what naturopathic medicine seeks to change. This is the true set of charlatans, who are publishing studies with falsified data, ghost authored, paid for by drug companies that profit from skewed results, killing millions a year. Just talk to all those left behind by the murderous poison that was Vioxx or the ongoing trail of withdrawn drugs and revelations of hiding side effects, and you'll find out about modern quackery.
To summarize, I don't see how you have any basis to criticize legitimate naturopathic medicine when conventional medicine has got its own enormous challenges. Clean up your own mess and don't worry about us--we're doing our best to fix all those people who were maimed and deceived by rigorously brainwashed, arrogant, ignorant MDs.
Posted by: Eric Yarnell, ND | June 11, 2008 3:29 AM
Hermano wrote "My main objection is not recognizing a distinction between licensable and unlicensable naturopaths." We have a saying that "a difference only matters if it makes a difference." In other words, it does not matter how rigorously one studies sham ideas, they are still fakes. There are (were?) schools of astrology; a licensable astrologer is no better than an unlicensable one; the same holds for NDs.
Posted by: Joe | June 11, 2008 4:02 AM
E. Yarnell, ND said: "I don't see how you have any basis to criticize legitimate naturopathic medicine when conventional medicine has got its own enormous challenges."
That's using tu quoque in a logically fallacious manner: the arguments against naturopathy -- naturopathy's deficiencies, shall we say, politely -- stand or fall on their own merits.
I have highly criticized naturopathy for years and will continue to do so -- because it is so heinous (see http://aanpalliancesciencebasedclaim.blogspot.com/ ).
Posted by: daijiyobu | June 11, 2008 7:17 AM
Astrology again, Joe?
The DIFFERENCE you refuse to acknowledge was significant enough for the Minnesota Medical Association, the state AMA branch, to not block this bill. The MMA had enough influence at the State Legislature to kill this legislation if they so chose, furthermore, without the MMA consent it would have never seen the light of day.
The strongest support for this bill came from individual medical doctors whose erudite, articulate testimony during the numerous committee hearings made the DIFFERENCE.
Joe, the sum total of your arguments is cheap insults.
You are a troll and a windbag.
Go suck your astrology thumb.
Posted by: Hermano | June 11, 2008 9:54 AM
Daijuobu,
I've seen your 'work' online!
Speaking of heinous, your zillion blogs and youtube videos are in extremely poor taste. To set aside the subject matter, they are absolutely hideous.
I sincerely hope you are getting some serious meds.
Here is a haiku for you:
Pass on homeopathics, go straight to antipsychotics.
Hontoo ni, anata wa daijuobu ja nai
Anata wa baka mono, bakaro, baka
Posted by: Hermano | June 11, 2008 10:18 AM
I want to add to Eric Yarnell, ND's statement about "MDs complete lack of information about basic nutrition".
I took 3 quarters of biochem as an undergrad, taught by the very same faculty who taught med students, at a school ranked ahead of Stanford and Yale med schools in research.
One of my professors, himself an M.D., spent an hour lecture arguing before hundreds of students that, for humans, consuming carbs solely in the form of refined white sugar was nutritionally an excellent idea. He thought himself very clever for saying that.
Posted by: Hermano | June 11, 2008 11:39 AM
Isn't better to regulate than not regulate no matter your own personal feelings about ND's?
Please don't flame me. I really want to know your opinion.
Posted by: marcus welby | June 11, 2008 6:04 PM
That's a great question.
It's sort of like asking if we should legalize drugs, or if we should regulate tobacco.
Why regulate a profession whose very foundation is cotton candy? I mean, we license hair dressers, but they perform a valuable service. I'm not sure what good it does to license NDs other than to track their body count.
Posted by: PalMD | June 11, 2008 6:07 PM
PalMD,
Thanks for your response. Well we do regulate drugs and tobacco. But don't you think that saying that the foundation is cotton candy is, um, not an accurate description.
I must admit that the body count comment concerns me. I read that there a huge numbers of deaths every year from properly prescribed medicines that were taken properly. Honestly, beyond the entire glass houses and rocks analogy, don't you think that the comment is below your dignity?
If you factored out the ND's who just took out a yellow pages ad or went to a diploma mill [a practice the Minnesota law may stop ... with a little modification] then how high is their body count? I mean there is plenty of mud to be slung here. Do you really think you need to participate?
Sorry. That was a rant. Sorry.
But given that I work in legal circles, formerly enforcement and now confinement - there ain't no prisoners like super max prisoners - I favor regulation over anarchy. What are your views on that?
Posted by: marcus welby | June 11, 2008 6:33 PM
I lost my dignity during my first surgical rotation while standing in a puddle of feces, but it was for the good of the patient.
Your comment hardly qualifies as a rant...you may have a point. It's like licensing firearms...they are dangerous, so it's better to know where they are.
I do mean that. As to the "harm" comment, please see this post.
I'm working on a post on Naturopathy for ya but the problem is, it is a profession based on a profound misunderstanding of science. Most of its practices are invalid, as opposed to real medicine whose practices are mostly valid.
Posted by: PalMD | June 11, 2008 6:38 PM
Did you really lose your dignity, or did you find out how expansive it could be? I myself have never stood in a puddle of poop created by a patient but I have dodged bodily fluids and solids that were flung at me. There was this one guy... but I digress.
I wonder if you know anyone who practices naturopathy or if all of your examples are anecdotal. I know I am playing devils advocate here, but it seems like a lot of people on this and other blogs make blunt statements and then react, um, somewhat, um, maniacally when questioned about them. The sequence I have observed in my 2 hours [yahoo - I'mm an expert now - sarcasm alert] is statement, question, prove it works, prove it doesn't, no you, no you, asshat, douchebag ... Sorry for the language.
I am not suggesting that you go out and find an ND to hug, but maybe you should call or visit a few so you can have some personal perspective. I always find it helpful to put myself in another's shoes and to try to understand where they are coming from. Working in a prison environment [former enforcement officer now DOC Special Operations Rescue and Tactics - SORT member] I find that it cuts down on arguments.
I feel I should explain about my take on bad language. I feel that the use of it engenders a less congenial, and thus less safe, environment. It seems to me that in a blog that is about the discussion of science you would want to encourage a collegial and polite discourse. It isn't that I can't swear like a sailor on leave, it's just that I have decided that I have better things to do with the few remaining brain cells that I have.
Thanks,
Posted by: marcus welby | June 11, 2008 7:02 PM
Devil's advocate is a useful role, and it is protected from ass-hat-itude because you are expected to disagree on principle.
There is a small problem with the logic of your argument, and reconstructing it will strengthen it.
Personal interaction is not required to form a valid opinion. I don't need to meet a bear to find out it is an omnivore---safer research will suffice (although I have seen bears from very close up, and I can confirm that at least a few black bears like peanut butter, granola bars, and possibly plastic bags).
Researching naturopathy through their own literature and other sources should suffice.
As I said, I will be working on a more comprehensive post, but naturowatch isn't bad (although it needs updating---CMNE is now re-recognized by SecEd).
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June 11, 2008 7:12 PM
PalMD,
I respectfully disagree. There are many things that research will NOT suffice for. There is huge difference between reading about a bear and having experience with them. Much like there is a huge difference between reading about diagnosis and actually having done it.
To stretch your analogy, then you should have been able to become an MD through distance learning. Devil's advocate again.
I humbly submit that you may not have all the facts and that some field research is called for. Of course you can just continue to hold your prejudiced view ... or you can find out if what has been written is indeed accurate. My concern here is the assumption [or maybe it's satire] of many of your posters who seem to think that they know what every ND does in their office. What could it hurt except the blank space on your appointment calendar.
[Doctor Joke alert] Heck, just cancel a round of golf. You can fit it in. [smile]
Thanks for your kind responses to my questions. I appreciate it greatly.
Posted by: marcus welby | June 11, 2008 7:21 PM
Ah, well. That come into a fundamental disagreement about the nature of reality. Also one more logical fallacy. You've stretched your analogy a bit too far and must reach for a new one (I'm sure you're up to the task).
While there is a difference between learning about bears and meeting one (trust me, I know), it is not a necessary condition of "knowing" about bears. In order to know enough about bears to perform most bear-related discourse, it is not necessary to meet one. This is why we have experts, lest we all must directly experience something to become familiar with it. I do not need to overdose on tylenol to truly understand that it is a very, very bad idea.
To finish, you said that research does not suffice for some things. Speaking to an expert (ND) is a research technique, but reading what they write about themselves is equally valid.
The difference on the nature of reality is that I believe (as do most scientists) that ALL reality is amenable to investigation.
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June 11, 2008 7:31 PM
Lovely discussion.
Naturopathy, bears, how very pleasant.
Let me ramble on a little.
I am not a doctor of any stripe, but I do have close family relations who are NDs and who are MDs.
They all enjoyed school and succeeded in science courses as undergraduates and doctorate candidates.
The MDs have definitely got a big chunk of the God Syndrome in school. Sometimes I wish the NDs had more of the MDs' assertiveness and certainty. That may just be the nature vs nurture thing.
For the NDs, the philosophical foundations of naturopathy are mostly a non-factor, a curiosity.
NDs were trained first and foremost as primary care physicians, I believe all alternative medicine courses were electives, not totally sure.
On the other hand, all science and conventional treatment courses, gross anatomy, biochemisty, pharmacology, differential diagnosis, etc... were NOT optional.
I believe what attracts students to naturopathy is the emphasis on treating the whole patient, meaning that new patient visit are 90 to 120 minutes long, time well spent when the doctor focuses on getting to know the patient, the patient's lifestyle choices, nutrition, etc...
No, the NDs I know are not dismissive of conventional therapies, and yes, they do like those little homeopathic sugar pills.
Then again, they say bears like honey.
Posted by: Hermano | June 11, 2008 8:27 PM
The thing is, that's what doctors do. The real ones. Naturopaths, from what I can tell in their literature and in these comments, do not follow evidence-based guidelines commonly, and when they do follow some, they fold in disproved and unproved modalities. That's not helping someone----it's the myth of compassion.
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June 11, 2008 8:30 PM
PalMD,
I respectfully disagree about doctors routinely seeing their first-time patients for 1.5 to 2 hours.
Maybe for $5,000 during the executive physical at the Mayo Clinic, but not for $150 that naturopathic doctors charge.
As far as the EBM, I think it is a great thing, my MD relative is an attending at a teaching hospital and swears by it.
I also think it will be a great addition to the practice of naturopathic medicine.
On the other hand, I have read Ian Ayres' 'Super Crunchers'.
Ayres has a chapter about the EBM and the reluctance of medical profession to implement it. I also recall reading (may also be from 'Super Crunchers') about what difficult struggle it was to implement Goldman's prediction rules at the Cook County Hospital in Chicago.
Posted by: Hermano | June 11, 2008 9:23 PM
@ Hermano:
What I was saying in a more polite fashion was: wait until they start getting sued.
As for the Boards of Licensure and Discipline investigating and prosecuting wrongdoing, sorry, it doesn't quite work that way. Most Boards only get involved when a patient sends in a complaint or after a malpractice suit is won against the MD. They may be organizations which handle general oversight of quality of care, but the actual enforcement where individuals are concerned, unless a doctor loses a suit or loses their staff privileges at a hospital, is left up to the hospitals where MDs have privileges. Are naturopaths going to be applying for hospital privileges (most chiropractors, I think, don't have hospital privileges; DOs, who are essentially another type of MD at this point, do)? If so, the hospitals will determine what they may and may not do within the confines of the hospital and how the quality of the care they give is evaluated.
"Malpractice", a good deal of the time, has nothing to do with quality and appropriateness of care given. It has everything to do with how unhappy a patient is with a doctor, and that may be for many reasons having nothing to do with the care given.
A better term would be "maloccurrence". Yes, true malpractice happens (much less often than some people think, and even when it does, only a percentage of cases result in lawsuits), but many "malpractice" suits are brought because of bad outcomes, not bad medical care. If it's for in-hospital care, the hospital is sued as well. So hospitals are a little careful about what kinds of practitioners they allow to practice within their walls (even leaving aside the "competition" aspect), or they at least should be.
Posted by: MMOToole | June 11, 2008 10:50 PM
MMOToole,
Thank you for writing back.
The new law will allow qualified NDs in Minnesota to purchase malpractice insurance, a requirement to join a practice with other health care providers who carry such insurance.
There is a desire to obtain hospital privileges, of course these are granted by specific hospitals at their discretion.
From the MN statute 147e:
"(b) A registered naturopathic doctor may admit patients to a hospital if the naturopathic doctor meets the hospital's governing body requirements regarding credentialing and privileging process."
I hope I answered to your satisfaction.
Posted by: Hermano | June 11, 2008 11:29 PM
PalMD wrote "... CMNE is now re-recognized by SecEd."
SecEd recognition of accreditation means very little, as can be seen by their recognition of chiropractic and astrology schools. It only means that, if a student with a federally subsidized loan shows up for classes, they (hopefully) don't report to a vacant storefront. The "school" must demonstrate that it has the "faculty" and facilities as advertised (and is financially solvent). Of course, accreditation by the AMA goes far beyond that; but the SecEd minimum is, well, really minimal.
Posted by: Joe | June 12, 2008 1:01 AM
PalMD,
Regarding the title of your article, naturopathic medical schools are medical schools.
At least according to one guide for prospective medical students, The Princeton Review guide to '168 Best Medical Schools'.
The 2005 version was '162 Best Schools', probably because it did not include the 6 naturopathic medical schools in the U.S. and Canada.
The guide lists all conventional (allopathic, I know MDs who hate this term), osteopathic, and CNME accredited naturopathic medical schools in North America.
The big difference between CNME and LCME is that while both
are the sole agencies recognized by the SecEd to grant, respectively, the Doctor of Naturopathy and the Doctor of Medicine degrees, ALL Doctor of Medicine degrees are accredited by the LCME, but not all Doctor of Naturopathy "programs" are accredited by the CNME. Do a google search for naturopathy and you will see online ads for correspondence schools granting ND degrees. They exist because naturopathic medicine is not regulated everywhere.
Lastly, what do you think trained naturopathic doctors do?
The non-CNME correspondence schools dispensing ND degrees teach a couple courses on kinesiology, aka muscle testing, iridology, and who knows what else.
Not one of the 6 or 7 qualified NDs I personally know performs this 'muscle testing', they may have tried it
at some point but that is not what they do.
This practice of kinesiology is very common, find out for yourself what type of practitioners perform it in your area.
Same for iridology, I have never heard of any qualified ND performing it.
Posted by: Hermano | June 12, 2008 10:07 AM
MDs and NDs: if you believe in the National Institutes of Health(NIH) here is some information about all sides of Naturopathy, including its history: http://nccam.nih.gov/health/naturopathy/
I believe that as the alopathic paragigm of chronic prescription drugs and mere treatment of symptoms fails to meet the healthcare needs of our growing, aging populations, there will be a need for both qualified NDs and MDs. We need to shift from treatment of disease focus into promoting and maintaining wellness if we are to survive.
-CP
Posted by: Clarke | June 12, 2008 7:08 PM
B.S. Doctors are not flowcharts in a diagnositic book.
That being said, shamanism exists in the realm of M.D.s too, but not to the extent it exists in the chiropractor's world, in my unscientific and limited survey.
Posted by: William Wallace | June 13, 2008 3:49 AM
PalMD,
I have a quick note before I go to work.
First of all. I greatly and deeply respect your blog. You seem to be open to new ideas and to looking at evidence more and in libelous statements less. I am thinking of some of the posters on pharyngula, who, although not wrong, can be a tad, um, heated in their comments, which does not always lead to respectful conversation.
I am not talking about myself here at all. I found that I was treated well on that sight, especially for a layman with no formal training in the sciences past my bachelors degree. I just found some of them, um, dismissive and even hostile to ideas that they didn't agree with. Some of them may be suffering from experts syndrome, which is where an expert in one field assumes that s/he is an expert in all field. Or as my soon to be departed mother would have said, an insufferable boor.
Ok. Transformers! Babble off!
My second comment [s] is about your assertion that reading both what the ND's say about themselves and what others say about them is not the entirety of the picture. We have a saying in orienteering; the map is NOT the terrain. The map represents the terrain, but if it does not provide the experience of traversing the terrain, thus my suggestion to actually get to know an ND or 2 who has the training in question. The map doesn't show you where the brambles are, or the poison ivy, or the pissed off badger, or that nest of mud wasps you just stepped into. The map, while highly useful and absolutely necessary, is not the entire picture. And so I would still suggest that you put boots to ground.
And if you don't, I will still respect your opinion.
I have just read Hermano's post to you about the ND schools and I think that you have to ask what YOUR assumptions are and if they are founded or unfounded, when you reply to "Lastly, what do you think trained naturopathic doctors do?"
Not all MD's follow the evidence based medical model. In fact I met an IME once, who in addition to being a complete pompous ass, was also verifiably incompetent, and censured for his actions in writing my IME report. I won the lawsuit, but this idiot is still an MD, and still solely employed by insurance companies. Should I take that one case and generalize it to all MD's, and assume that they are all old bilious gasbags with no moral compass, no ethical standing, and all willing shills for the insurance industry?
I don't think so and I urge you not to fall into that trap as so many seem to have. That path is strangely similar to prejudice.
Having said all of that I feel that you will do what your ethics demand of you. Good luck in this journey of life. Sorry for the long post and thank you for all your careful and considerate responses to someone who doesn't have the science qualifications to be here.
Posted by: marcus welby | June 13, 2008 8:17 AM
Ted Suzelis, ND: "...however in many states residencies for MD's and DO's are not mandatory either."
Great. Please let us know which states allow MDs and DOs licensure to practice independently without successfully completing at least on year of residency after medical school? Since there are 'many' it should be easy for you to name one. Right?
Eric Yarnell, ND "If you have failed to read The Truth About the Drug Companies by Marcia Angell, MD (former editor of the New England Journal of Medicine), then you better get on the ball. Conventional medicine is incredibly rife with fraud, deceipt, bribery, and scandal."
I've read that book, though I am not certain that you have based on your use of it in your argument. Dr Angell's book was a well written and well documented indictment of the Pharmaceutical industry not allopathic medicine. In her work with PNHP it becomes obvious that there are three evils that prevent physicians from providing safe, evidence based, and consistent health care to Americans: the insurance industry, pharma, and for profit medicine (in all its corporate manifestations.) "The Truth About the Drug Companies" was the truth about the *DRUG COMPANIES*, and was in no way an indictment of allopathic medicine.
Eric Yarnell, ND: "...killing millions a year."
And you know what, cops and EMS and the fire department kill people every year. Would you like us to get rid of the cops, EMS, and fire department in your town? Seatbelts, airbags, and helmets definitely kill people too. Are you going to forgo their use as well?
Or should an intervention be judged based on the benefits and risks that its provides?
Its easy to make the fools argument that something you don't like 'kills X number of people a year.' I can't count the times I've been told by some dumb redneck that he didn't wear his seatbelt because his "cousin's friend's brother-in-law was thrown from a car that went into a ravine and burst into flames, and the cops told him he woulda died if he'd been wearin' his seatbelt." This is generally while he's being imaged, sutured, reduced, or otherwise being treated for the traumatic injuries he sustained as an unrestrained vehicle occupant.
Chemotherapeutic agents are toxic chemicals that no one should ever want in their bodies. But as PZ pointed out if your kid has ALL, you'd be a fool if you were not desperate to feed that toxin directly into your child's body. If your child undergoes chemo today he's got about an 10% chance of death or a serious adverse event. But 40-50 years ago, 10% was the chance of your child surviving at all. Of course you can say that chemo is a poision that kills 1 in 10 kids with ALL who receive it. But then you would be a moron who can't do basic math and who probably plays the lotto as well.
Posted by: NickG | June 13, 2008 8:35 AM
addressed mostly to marcus welby -
First, you, too are relying on anecdote -- anecdote about bad doctors of evidence-based mendicine, which is fact seems to be used to defend the idea that, however bad naturopaths may be in terms of treatment, MDs can be bad too, so it's only fair to allow naturopaths to practice at the same level. Stated like that, hopefully the basic logical fallacies stand out a bit.
Second, yes, it is easy to point the finger at how many people have been killed by evidence-based medicines, poor doctors, poor hospital treatment, etc. This is because there are records. Part of EBM is that there are formal patient records, reporting systems, and tracking of statistics!
Where does this exist for treatment by naturopaths?
It's absolutely true that we cannot point the finger at an absolute number of deaths due to malpractice or mistreatment by this group, because there are no integrated records or formal reporting system. It is even more complicated by the fact that we already know, from past cases, that there are people in the world who voluntarily eschew treatment by EBM in favour of naturopathy, homeopathy, herbalism etc. until the point that they are very, very ill, and frequently past the point where intervention by EBM would do any good. THEN, they go to a conventional d