Respectful Insolence

The whole concept of “complementary and alternative medicine” (CAM) and “integrative medicine” (IM), the former of which “complements” science-based medicine with quackery and the latter of which “integrates” pseudoscience-based with science-based medicine. The reason I start out by saying this is to emphasize that CAM/IM is all about using language to persuade that pseudoscience is actually science-based. It’s far more about marketing than accurately communicating concepts. In CAM, everything is “holistic,” and doctors “care for the whole patient,” while “Western medicine” is “reductionistic” and “allopathic.” At the very heart of this language is a false dichotomy: That you either embrace woo or you can’t provide care as compassionate and caring as what the quacks supposedly provide. and can’t provide for the emotional needs of your patients. Two false dichotomies, actually, in that the world is divided into “Eastern” and “Western” medicine, “holistic” versus “reductionistic,” with not-so-subtle implication being that you can’t be “holistic” without–you guessed it–embracing pseudoscience.

It turns out that this use and abuse of language for propagandistic purposes in CAM/IM is not limited to just these examples. In fact, it infuses the whole enterprise to the point that its adherents, not content with being mere “practitioners,” are trying to claim the very title of “physician” for themselves. I learned this from John Weeks, who first let me know about Andrew Weil’s attempt to put together a board certification in woo. This time around, he’s educating me about how alternative/CAM/integrative practitioners now covet the title of “physician”. He begins with the story of a non-physician (i.e., non-MD, non-DO) practitioner of CAM distinguished chiropractors, naturopaths, and acupuncturists from physicians. To me, of course, that’s an utterly appropriate distinction (it’s not for nothing, after all, that I frequently refer to the naturopath’s ND title as meaning “not a doctor”), but to Weeks it’s “stepping into a militarized zone”:

All of us knew that this studied academic was referring to licensed medical doctors, a.k.a. the kings (and queens) of the hill in U.S. medicine. At the same time, many of us were acutely aware by his comment that, while common and even professional usage of the term “physician” may connote MDs, legal realities are shifting. In fact, trends suggest that one endpoint of the movement toward integrative medicine is that “physician” will increasingly umbrella a rainbow of disciplines.

It turns out that there is a conscious effort under way by promoters of CAM/IM to co-opt and appropriate the title of “physician” for themselves. Unfortunately, they’ve apparently had some legislative and regulatory success. Weeks reports that the United States Department of Labor recently published something called O Net Online which replaces the Department’s Dictionary of Occupational Titles and that in that online dictionary there is reference to “naturopathic physicians” and “chiropractic physicians.” Worse, if you look under the sample of reported job titles for chiropractors, a synonym for chiropractor is apparently just “physician.” I also can’t help but notice that the descriptions of these jobs are pretty funny in a morbid sort of way, for example, listing one of the functions of a naturopath as administering “treatments or therapies, such as homeopathy, hydrotherapy, Oriental or Ayurvedic medicine, electrotherapy and diathermy, using physical agents including air, heat, cold, water, sound, or ultraviolet light to catalyze the body to heal itself.” Yes, it’s depressingly accurate, but it’s funny in that there is no recognition that homeopathy is quackery, as is much of what naturopaths do.

Even acupuncturists are apparently getting in on the act, trying to claim the title of “acupuncture physician,” even proposing an abbreviation of AP. In Florida, for instance, acupuncturists are legally entitled to work under this title, although “not through accredited, doctoral-level educational means. Of course not. Acupuncturists are not physicians, nor should they ever be referred to as physicians unless they also have an MD or a DO degree. (And in that case I’d seriously question whether a physicians who has become an acupuncturist and practices acupuncture deserves the title of “physician” any more.) Somehow, apparently acupuncturists managed to get the legislature to give them the right to refer to themselves as “physicians,” and boy do they take advantage of it! Meanwhile naturopaths in 15 of the 16 states in which naturopaths are licensed are allowed to call themselves “physicians.” (Apparently California is the only holdout willing to put its foot down.”

Weeks is shockingly (to me, at least) honest about the reason for this:

Success in claiming the physician title, linked to privilege, status and particularly third party payment – some insurers will only cover certain services if provided by a “physician” – figured heavily in an October 2, 2009 mailing to members from the American Chiropractic Association (ACA). The ACA credited its hard work for insuring that the title stayed in the language defining the Federal Employee Benefit Plan. Blue Cross Blue Shield, which manages the plan, attempted to demote chiropractors to a status as “other health care providers.” (6)

As I said, it’s all about the status. Chiropractors, acupuncturists, naturopaths, and other specialties of woo crave the respectability that comes with being a physician. They also have delusions of grandeur in thinking that they can do what physicians do, namely provide primary care services, even though none of them have adequate training in the administration of drugs, the proper screening for cancer, heart disease, and other common diseases to function as primary care doctors. Nor can they deal with common diseases, such as diabetes, hypertension, coronary artery disease, or other diseases, at least not using science- or evidence-based guidelines. Unfortunately, this delusion of grandeur leads them to want to blur the line between real physicians and practitioners of pseudoscientific medicine.

Which is why Weeks is very unhappy at the quite reasonable attempts by physicians to protect the title of “physician” by opposing the licensing of naturopaths, as if it were a bad thing to prevent the state from putting its imprimatur on specialties taht are not based in science and evidence. He also confirms something that I’ve always suspected about the near-obsessive use of the word “allopathic” to describe conventional MDs and DOs:

Then again, the AMA leaders in keeping “physician” out of reach of other professions are probably not as comfortable with the additional 2008-2009 language: “MDs are also known as allopathic physicians.” The modifier “allopathic” is a hole in the dike through which may flow naturopathic physicians, chiropractic physicians, perhaps more acupuncture physicians, and the first through, osteopathic physicians.

Of course, the way that osteopathic physicians (DOs) practice medicine, at least in the U.S., is usually indistinguishable from the way that MDs practice medicine. They do the same residencies, are subject to the same standards and board certifications, and are licensed in the same way. In most osteopathic medical schools, osteopathy is a historical vestige that continues to be taught even though very few DOs actually ever use it or practice it anymore. Most, in fact, are rather embarrassed by these reminders of the chiropractor-like beliefs that used to be central to osteopathy. We can only hope that naturopaths go that way, but it’s highly unlikely, given the sheer extent of woo practiced by naturopaths, who are not only not embarrassed by their woo but downright proud of it.

If you want to get an idea of how far Weeks and presumably his non-science-based holistic cohorts are willing to go to redefine what a “physician” is, look to the last part of his post, where he actually invokes Webster (as in the dictionary) to convince his readers that physician should mean what he wants it to mean. He lists various definitions of “physician” that he’s found in different versions of Webster and picking the ones he likes, the ones that are seemingly most inclusive. In other words, he exercises one of the lamest arguments known to humankind. When you’re reduced to arguing based on dictionary definitions, you’ve sunk about as low as you can go.

My amusement at such lame arguments notwithstanding, I can’t resist pointing out Weeks’ one last envious broadside at physicians:

The physician term is power. Professions so denominated stand at the top of the hill, waving about highfalutin reasons why their recognition as such is in the public good. The sub-text includes the know motivator that the title lands one on the road to the bank.

I must conclude by saying again that I’m surprised at just how honest Weeks is about the motivation for trying to redefine the term “physician” to include quacks. It’s all about power, money, and prestige, and the quacks want as much of all three as physicians have. Unfortunately, they appear to be succeeding in co-opting the term in order to achieve their goal of more power.

Comments

  1. #1 Fred Magyar
    November 2, 2011

    Woo and the MSM are going to win this war…

    http://news.yahoo.com/doctor-wife-nearly-split-over-cancer-diagnosis-holistic-213430540.html

    Doctor and Wife Nearly Split Over Cancer Diagnosis, Holistic Healing

    Parker said he has no idea why the holistic route his wife traveled seemed to work. “Most doctors are more tempted to laugh at it,” he said.

    Since his wife has had cancer, he said, “I am much more understanding of what a patient goes through and much more willing to listen to their thoughts. Doctors can easily forget.”

  2. #2 T-reg
    November 2, 2011

    The “power” that this moron is talking about is not something hereditarily bestowed upon the physician. It is attainable by anyone who can work hard and get into med school and then through med school. This just reeks of a lazy and childish fantasy of trying to grab what has actually has to be earned.

    After getting the “power” of the physician what makes them think that they can carry out the responsibilities that come with it, while practicing woo?

  3. #3 Dangerous Bacon
    November 2, 2011

    A major part of these efforts to get woo specialists labeled naturopathic PHYSICIAN, chiropractic PHYSICIAN etc. is that, apart from the greater prestige and income they think they’ll get, there’s less emphasis on their bogus training.

    When I see articles by or references to woo providers on the Internet, or letters to the editor of newspapers and magazines, a high percentage of the time they are referred to as “doctors”, with no allusion to the fact that they’re actually naturopaths, chiros or holistic gurus of one sort or another. Apparently they believe (with good reason) that they’ll be less influential if their training, such as it is, is revealed.

    Or could it be that they think the title of “doctor” is being devalued, what with all the rug doctors, basement doctors etc. that advertise their services these days? :)

  4. #4 lilady
    November 2, 2011

    Years ago, although we didn’t know the ramifications of it, the AMA lost an anti-trust suit about the use of “doctor” as applies to chiropractors.

    Now DCs, NDs, homeopaths, acupuncturists and other assorted “practitioners” want the right to call themselves “doctors”, prescribe their woo and be reimbursed for their “healing” powers as REAL medical doctors.

    Many hospitals have already put their seal of approval on these “practitioners” by opening special CAM and Integrative Medicine centers. I’m so glad that the university-affiliated, terciary care, teaching hospital where all my doctors are affiliated, have no CAM/Integrative Medicine practitioners on staff.

    Can we ever rid the practice of medicine of these charlatans, now that these “Not Doctors” of every persuasion have infiltrated our hospitals, are reimbursed by insurance companies and have their own division (NCCAM) in the National Institutes of Health?

  5. #5 attack_laurel
    November 2, 2011

    “Success in claiming the physician title, linked to privilege, status and particularly third party payment…”

    They’re also co-opting the language of civil rights activists. “Privilege”, in the activist lexicon, refers to the societal advantages given to the members of society who are born with the “right” colour skin, the “right” gender, etc. It’s not something that is earned, it’s something one has no control over (again, in the way that activists use it, and in the way that it is being used by Weeks). It is not a “privilege” for people who have gone through many years of training to be given respect, it’s a function of recognizing those years of training.

    They really are such scamsters, they’ll use *anything* to try and advance their cause, even claiming that they’re oppressed. They disgust me.

  6. #6 Mu
    November 2, 2011

    Are you surprised? In a country where you can get a CD, ND, DOM etc from an unrecognized diploma mill and advertise it, why protect the physician’s title? If the AMA hadn’t slept through the proliferation of doctor titles they wouldn’t have to worry now.

  7. #7 Denice Walter
    November 2, 2011

    Well, since alt med blurs lines of demarcation ( or creates new ones) and re-defines words to suit its own purposes should we expect any differences here?

    However reality has this pesky habit of intruding: woo-meisters often acknowledge “emergency medicine” as being worthwhile and effective- after all, re-attaching severed limbs, re-starting stopped hearts, and enabling people to breathe when they couldn’t on their own are downright spectacular: however they simultaneously proclaim SBM ( the basis of emergency medicine ) *incompetant* to deal with most situations- chronic or acute. As if they were intrinsically un-related. Now, do Naturopathic “physicians” want to be responsible for medical care in emergency situations? I wonder why they’re not going after that one? “Rescue” formula will not cut it I fear.

    Amongst the idiots I survey there is much shuffling and dancing linguistically: they like using “doctor” as a title, hoping that the mystique of “physician” might rub off ; similarly they speak about doing “consultations” and “counselling”, of being “professionals”, “scientists”, “researchers”, and “clinicians”. In the realm of Woo-topia, a nutritionist may be a “dietician”, a “clinician”, a “spiritual practitioner”, a “psychologist”, and advise you on your finances. When words can mean anything they lose their value in communication and become weapons of obfuscation: providing instant cred without the hard work.

  8. #8 Mrs. Woo
    November 2, 2011

    What disgusts me most, I think, is that they want the titles of ‘doctor’ and ‘physician’ without dedicating the huge amounts of money and time that were invested by the real ones.

  9. #9 Edith Prickly
    November 2, 2011

    @T-reg and Mrs. Woo – yes, exactly. They want the prestige that comes with the title of physician without doing any of the hard work. I’m sure that’s the motivation for most of the MDs who move into woo as well. It’s way less hassle than practicing real medicine.

    @Denice:

    Now, do Naturopathic “physicians” want to be responsible for medical care in emergency situations? I wonder why they’re not going after that one?

    Oh, I think we all know the answer to that – of course not! Emergency care is messy and scary and there are real consequences if you screw it up. The naturopaths want to stay in their nice clean quiet clinics diagnosing non-existent food allergies, qi blockage and giving vitamin shots while “allopathic” physicians treat the difficult stuff.

  10. #10 JA Bahk
    November 2, 2011

    Hey Orac, did you see Mercola and NVIC are engaged in Vaccine Awareness Week? Looking forward to your comments, they’ve attacked flu vaccines, pertussis vaccines, even herd immunity…

  11. #11 hfghfh
    November 2, 2011

    http://health-med-news.com
    As if they were intrinsically un-related. Now, do Naturopathic “physicians” want to be responsible for medical care in emergency situations? I wonder why they’re not going after that one? “Rescue” formula will not cut it I fear.

  12. #12 Crommunist
    November 2, 2011

    Looks like people have been reading their Orwell (and perhaps Ayn Rand too, kind of). The sad thing is that by leaning on the heft of the title of “doctor”, they hope to elevate their own profession. What will end up happening is, as people begin to recognize how full of snot they are, they will end up destroying the credibility of practitioners of actual medicine as well.

    Not that I don’t think that the status of MDs could do with a little adjusting, but I’d prefer that the veneer be stripped by conscientious, science-based critiques than by raving loonies with magic water and bags of chicken entrails.

  13. #13 Dangerous Bacon
    November 2, 2011

    So if it’s deceptive and ludicrous to refer to naturopaths et al as physicians, what do we do with MDs who go over to the dark side and starting pitching woo? Like this guy (a “homeopathic physician”) for instance. He says his conversion started after a homeopath(ic physician) helped one of his patients with complex problems (after the experts had given up on her, naturally):

    “To the homeopath, her intense cravings for ice cream and salt, her fear of thunderstorms, her bleeding tendency and sympathetic nature indicated the use of Phosphorus.* Not believing that it could help, but since a common nutrient in a low dose couldn’t hurt, we commenced treatment. I was astonished at the good results and wanted to see more.”

    He has an online store too.

    *the ice cream/salt cravings, fear of thunderstorms and sympathetic nature sound a lot like my Labrador retriever. She doesn’t need phosphorus though, just a good belly rub.

  14. #14 Prometheus
    November 2, 2011

    Are there any faux-physicians out there (chiropractors, naturopaths, needle-pushers, etc.) who actually want to take over primary medical care of patients? Do they really want that kind of responsibility?

    It’s one thing to say that you’re a “holistic healer” in television advertisements, but how will they manage when someone calls them in the middle of the night with chest pain or an asthma attack? When faced with a real medical problem, one their fake medical degree didn’t prepare them for (and their fantasy-based “medicine” can’t treat), what will they do?

    My guess (and my hope) is that the chiropractors, naturopaths, accupuncturists, etc. have enough sense to know that even a mild case of hypertension or pneumonia is “out of their league” and will think up some excuse to refer the patient to a specialist (“The chi flow in your chest seems to be blocked – I’m referring you to a cardiologist.”).

    Of course, even the sort of medical problems that a generalist (e.g. family practitioner, internist, etc.) could easily manage will be beyond the scope of the faux-physicians, so the insurance companies (if not the patients, themselves) will soon figure out that having quacks as “primary care physicians” is a losing proposition, since every real medical condition will require a “referral” (“I suspect that you have a real medical condition, Mr. Jones, so I’m referring you to a real doctor.”).

    I’m not going to panic just yet, because I see this trend as inherently self-limiting. After a few years with faux-physicians as “gatekeepers”, the insurance companies will realise that using a simple iPhone app – iReferral, for example – to direct patients to the appropriate physician would more efficient than having all their customers cracked, herbed and punctured (all for a modest fee) prior to being referred out to get real diagnosis and treatment.

    Even the patients will eventually see the benefit of real medical care. Or, if they don’t, they will be eliminated from the gene pool in the usual fashion.

    Prometheus

  15. #15 Scott Cunningham
    November 2, 2011

    attack laurel

    They’re also co-opting the language of civil rights activists.

    “The Man won’t let you play doctor just because you aren’t one! Fight the power! All disagreement is personal attack! Any denial of our positive self-assessments and personal fantasies is political oppression!”

    Except that The Man will let you play doctor, because he’s all about personal delusions of grandeur, Orwellian language and selling illusions, too. And he’s easily swayed by emotional ploys. They’re all he knows.

    If I don’t become a doctor it’ll be for the perfectly sensible reason that I don’t qualify for med school. Reality can be a bitter pill. That’s why there’s the homeopathic alternative.

  16. #16 Calli Arcale
    November 2, 2011

    Prometheus:

    Are there any faux-physicians out there (chiropractors, naturopaths, needle-pushers, etc.) who actually want to take over primary medical care of patients? Do they really want that kind of responsibility?,

    In short, yes.

    Chiropractors in particular have been pushing for recognition as PCPs, and in some areas are starting to actually obtain it. You can actually have a chiropractor as your primary care practitioner. This is because many chiropractors do not limit their care to uncomplicated low back pain; many still think that, like Palmer, they can cure all manner of ailment by adjusting the flow of the innate through spinal manipulation. They believe they can do it. They are not afraid of the responsibility because they are arrogant enough to think there will be no problems. It’s amazing it has gone as far as it has, but then, confirmation bias can be a heckuva thing.

  17. #17 Mutant Dragon
    November 2, 2011

    I love the part about “using physical agents including air, heat, cold, water, sound, or ultraviolet light to catalyze the body to heal itself.” The cluelessness is wonderful.

    On a more serious note, however, Weeks is being remarkably honest. This is EXACTLY what it’s all about — how can he (and “naturopathic doctors”) get the same prestige as members of the medical profession and pass their quackery off as a legitimate branch of knowledge. And the MSM’s gullibility has given them the edge.

  18. #18 Dangerous Bacon
    November 2, 2011

    “They’re also co-opting the language of civil rights activists.”

    This is a woo tactic most notoriously (and hilariously) employed by Terry Rondberg of the World Chiropractic Alliance, who flew into a major tizzy when a patient group placed ads on buses in Connecticut to protest chiropractic-induced neck injuries:

    ““This is like a hate crime committed against our profession,” said Rondberg. “The WCA won’t stand for it.”
    …Rondberg likened the battle to the civil rights movement of the ‘60s.

    “Selma, Alabama is where the civil rights movement began. It started with a single bus and the refusal by Rosa Parks to take a seat in the back of that bus,” he told an enthusiastic audience during the WCA Summit in Washington, DC…He added: “If those bus signs aren’t taken down immediately,the WCA is prepared to go to federal court and give them an adjustment they won’t forget! The WCA is ready to take on those allopathic skinheads and make this a national issue and the best-known bus ride since Rosa Parks.”

    ht_p://www.worldchiropracticalliance.org/news/busads2.htm

    Yessiree, and if you oppose calling chiros and other altie practitioners physicians, you’ve got to be an allopathic skinhead. (band name!)

  19. #19 Anton P. Nym (aka Steve)
    November 2, 2011

    I wonder how much a homeopathic or chiropractic MD would have to pay in malpractice insurance? (heh heh, a Palmer adjustment by Adam Smith’s invisible hand?…)

    — Steve

  20. #20 Scottynuke
    November 2, 2011

    “allopathic skinhead”

    Sounds more like something requiring the talents of a good dermatologist. Or hairdresser.

  21. #21 Beamup
    November 2, 2011

    Are there any faux-physicians out there (chiropractors, naturopaths, needle-pushers, etc.) who actually want to take over primary medical care of patients? Do they really want that kind of responsibility?

    The real trick, I think, is that they want all of the rights associated with being a real primary care physician, but are unwilling to accept any of the responsibilities. It will be interesting to see what happens with the malpractice suit when a naturopathic PCP sees a patient having a heart attack and sends them home with a bottle of magic water, where they die. Something along those lines IS going to happen. Probably first in Oregon.

  22. #22 Chris
    November 2, 2011

    Beamup:

    Something along those lines IS going to happen. Probably first in Oregon.

    Actually it has happened, just a wee bit north of Oregon.

    I have also seen the treatment (or lack there of) of a family relative. I was not impressed. Actually it got to the point where she was not impressed and wrote them a letter explaining that the homeopathy was not working, especially not as well as the real meds she was told to not take.

  23. #23 Don't Touch
    November 2, 2011

    At this rate the U.S. is going medically backwards, I would not be surprised to see within a few years of restaurants selling basic meals that “strengthens the immune system” and “remove toxins” and other nonsense, psuedoscientific claims I have seen a lot in Singapore food courts. (Imagine Burger King selling fries that “promote youth!” Okay, it probably won’t be THAT extreme, but still…)

  24. #24 Mrs. Woo
    November 2, 2011

    @Chris

    I remember when that was first published. I read it to hubby who insisted that she would have died regardless because sometimes asthma attacks kill people. I wish there were some rational way to deal with the ones who have gone so far into the rabbit hole that light doesn’t penetrate. I know that I should drag him to the doctor for a physical because there are unwell feelings he is hiding from me. If I can get my doctor to clear the space but he has the right to leave is it unethical to surprise him with an appointment?

  25. #25 lilady
    November 2, 2011

    Wow Chris…that article about the needless death of a sixteen year old girl is unbelievable. It provided a bit of the family dynamics which may have had quite an impact on the course of the teen’s fatal status asthmaticus attack.

    Mom is a trained nurse, who apparently rejected all the education and the experience gained while working during her early nursing career in labor and delivery at a hospital. Dad sounds like an ignorant individual, who managed to gain control by keeping mom pregnant and delivering his own children at home.

    The “Not a Doctor” was busy with other “patients” so an acupuncturist stuck some needles in the youngster to relieve the symptoms. Neither the N.D. nor the acupuncturist is willing to take responsibility at all for the deplorable (non) care they rendered as the child slipped away.

    Am I the only one who questions the statement from another N.D. about improving care by having N.D.s in “residency programs” just like REAL doctors do, in REAL hospitals? If I were ever hospitalized and an N.D. appeared at bedside, I wouldn’t permit the “Not a Doctor” to even take my body temperature on check my blood pressure…empty my bedpan, maybe.

    I think Dr. Kimball Atwood who served on an ad hoc committee to evaluate N.D.s in Washington, is OUR Dr. Atwood who blogs on the SBM website.

  26. #26 Mrs. Woo
    November 2, 2011

    @lilady

    If we were lucky, it might actually make them realize what being a real doctor requires and either make them go to medical school or maybe into nursing (getting real degrees through real accredited programs) and abandon the belief that a couple of years at a homeopathic college or a mail order degree entitles them to make possible life or death decisions about patient care.

  27. #27 Krebiozen
    November 2, 2011

    Who needs formal studying, writing essays and dissertations, exams, qualifications and a title when anyone can become an expert in anything in just a few hours by using Google and Wikipedia? [/sarcasm]

  28. #28 Denice Walter
    November 2, 2011

    In 2010, a local accupuncturist was sentenced to 5 years for failing to take his 2 year old daughter to the emergency room although she had been ill for nearly a week: she later died of a ruptured appendix. Facing the judge, he was surrounded by a “large number of supporters”( the Record; Bergen Cy.,NJ; 4/30/10).

    People with imaginary educations and training like this father may think of themselves as PCPs. Perhaps woo-fuelled re-definitions such as those cited, as well as the perpetually flowing nonsense provided by woo-meisters, may contribute in creating believers like him: he thought his knowledge was sufficient for treating his daughter and making medical judgments. Isn’t this the real message of woo:”SBM doesn’t know everything, your judgment is just as good as so-called experts”?

  29. #29 Mrs. Woo
    November 2, 2011

    @ Denice

    How tragic! Is it wrong for me to hope that he has nightmares the rest of his life and has moved on to a job he is qualified for, like working as a cashier at any local drive-through?

  30. #30 Prometheus
    November 2, 2011

    Wow!

    And here I was thinking that the chiros, herbalists and needle-freaks were just trying to make a quick buck (pound or euro) off the worried well (and be able to call themselves “doctor”). I had no idea that they actually thought they were competent to treat real diseases!

    I guess that’s what happens when you start believing your own propaganda.

    Prometheus

  31. #31 Denice Walter
    November 2, 2011

    Alt med proselytisers call SBM the “cult of the experts” or “scientism” jealously guarding its exalted and exclusive status shutting out all competitors as if it were a club: nothing about studying and training.

    When I hear the usual suspects “talk psychology”: it is either directly cribbed from a 50 year old Psych 101 text, new age spiritualism, or a short explique *a la* Time magazine; somehow- I know this might sound rather mean**- I imagine that their *average reader* might have at least as much information as that which they’re being sold.

    So why do they listen to these sages? Perhaps they identify with their in-expertise and like the woos, resent real experts and their superior knowledge. However realistic adults know that you cannot be master( mistress) of all you survey and respect the greater skills and judgments of real experts *especially* in matters involving serious illness.

    ** don’t worry I’m above the mean.

  32. #32 woo
    November 2, 2011

    @denice walter
    How dare “they” (“woo people”)criticize my science-based botox injections, breast implants,
    facelifts, liposuction,Prozac, Lipitor!!! I will never need spiritually based advice!

  33. #33 Kimball Atwood
    November 2, 2011

    “Are there any faux-physicians out there (chiropractors, naturopaths, needle-pushers, etc.) who actually want to take over primary medical care of patients? Do they really want that kind of responsibility?”

    Oh yes. A typical claim, in this case from the National College of Naturopathic Medicine in Portland, OR, is that NDs are:

    “…primary care physicians, most of whom are in general private practice [and] trained to be the doctor first seen by the patient for general healthcare, for advice on keeping healthy, and for the diagnosis and treatment of acute and chronic conditions.”

    For more info, look here: http://www.medscape.com/viewarticle/465994 (you might have to sign in, but it’s free)

    In Washington, the “every category of provider” law requires that NDs be reimbursed as though they were real doctors. How is the unwary public to distinguish? I’ve discussed the case of girl who died of asthma in more detail here:

    http://www.sciencebasedmedicine.org/index.php/another-state-promotes-the-pseudoscientific-cult-that-is-naturopathic-medicine-part-2/

    Notice the double standard of standard-of-care that NDs insist upon, and how clueless state lawmakers must be not to recognize the hypocrisy and the danger.

    Calli is right that chiropractors also want to be “primary care physicians”; they can pose as that in Illinois, at least. Look here: http://www.sciencebasedmedicine.org/index.php/how-physician-regulators-shoot-themselves-in-the-foot/

    I am the Kimball Atwood of SBM, but the state commission was in Massachusetts. If anyone is interested, my report of 2002 is here:

    http://tinyurl.com/63auhk9

    Depressing that it was the “minority report,” huh? Well, the good news is that Ns are still not licensed here, but they keep knocking at the door each year. A lot of what happens in a democracy is little more than legislators getting tired of listening to wheels squeak, and quacks know that very well. It’s the sole reason that chiropractors are licensed in every state. Activists are successful because they know what they want; most people who would oppose them aren’t even aware of the implications until it’s too late.

    KA

  34. #34 Mephistopheles O'Brien
    November 2, 2011

    @woo,
    I’m confused. What spiritual advice do you have to counsel you against Lipitor? What “woo person” has ever come out against breast implants?
    Inquiring minds want to know.

  35. #35 herr doktor bimler
    November 2, 2011

    Odd. I had been informed that homeopathy and naturopathy and chiropraxis and so forth all work. One would have thought, then, that the titles of each of these specialties would carry so much prestige that there would be no need to borrow the title “physician”; indeed, physicians should be lobbying for the right to call themselves ‘ND’ and ‘DC’ even without undergoing the training. Where is the flaw in my logic?

  36. #36 medrecgal
    November 2, 2011

    My instinctive reaction to this was something along the lines of “oh, yuck!”, i.e., the sense that there’s something wrong at a gut level about the woo-meisters trying to claim the professional title of physician. Then the part of me that wanted to become an actual physician said, well, yeah, of course that’s not anywhere near appropriate. These quacks didn’t spend many years getting an education that’s soundly based in the sciences like actual physicians (i.e., MDs and DOs) do. I have more education in the foundations on which medicine is based than any of these quacks ever do, and I am only on the periphery of it in HIM a/k/a medical records. (I’m sure I got more even with only two semesters each of bio and anatomy/physiology.) If the government has any sense left at all, they will continue to reject the notion that anyone else can call themselves “physicians” and keep licensure out of their slimy, sleazy little hands. Keep up the good fight, Orac!

  37. #37 lilady
    November 3, 2011

    Herr Doktor Bimler: No need to proceed beyond your first sentence to discover the flaw in your logic. I don’t know of any REAL doctor or REAL dentist who might want to exchange their M.D. or D.D.S. degrees for a “doctorate” in quackery.

  38. #38 T-reg
    November 3, 2011

    I don’t think the legislators who are granting these sCAMsters privileges have given much thought to how they are going to evaluate a malpractice case against a sCAMster.
    To be able to conclude that malpractice has occurred, there has to be a particular standard of care which can be evaluated objectively. sCAMsters are always denying objective assessment of their efficacy (studies which almost always prove them to be false) making an argument against it on subjective grounds.
    So when malpractice occurs (and a lot of it will occur once these people supplement supplant SBM) how will the law determine it when everything is so subjective?
    This is something the lay public supporting these people should also ponder upon.

  39. #39 T-reg
    November 3, 2011

    @Lilady: I believe herr doktor bimler meant it sarcastically :)

  40. #40 lilady
    November 3, 2011

    @ T-reg: I know what Herr Doktor Bimler meant by his clever statement…and I failed somewhat in MY effort at sarcasm.

    I love Dr. Bimler’s dry sardonic comments.

  41. #41 lilady
    November 3, 2011

    @ Dr. Atwood: I am posting at this time after reading your excellent post…and each and every one of the linked articles you provided.

    These “Not a Doctor” charlatans have infested health care with their totally bogus treatments and have indeed committed sins of omission and sins of commission, yet are given “a pass” by State and national regulatory agencies, when their “sins” result in serious harm or death of their “patients”.

    Every licensed health care professional is held to a standard of care by their licensing boards and by State Health Department regulations. They face censure, suspension or revocation of their licenses to practice, when they deviate from those standards. Yet the standards of care for quacks are poorly defined or not defined. Because of these non-existent standards, quacks cannot be held responsible for poor or deadly outcomes for the “patient” who is under their care.

    I quite agree with the findings so eloquently stated in your minority (dissenting) report. Licensing of quackery gives them the legitimacy they crave and the stamp of approval from the State. Real doctors would be violating their code of ethics to permit such licensing. The well-earned trust that the public has in State and local health departments would be destroyed, when such “practitioners” are given licenses to practice voodoo medicine.

    From a political standpoint, the hiding of these controversial licensing proposals or allocations for pet programs within Budget bills, are a favorite trick of State and Federal legislators. Small wonder then, why there is great distrust of government and our elected officials.

  42. #42 Dangerous Bacon
    November 3, 2011

    “I don’t know of any REAL doctor or REAL dentist who might want to exchange their M.D. or D.D.S. degrees for a “doctorate” in quackery.”

    The best strategy is to keep those Allopathic degrees, but append a bunch of woo-rific titles, like the homeopathic M.D. I cited earlier. Then you can set yourself up as a holistic-type person who Treats The Whole Patient with altie goodness, but with the implied ability to employ your mainstream skills if the woo doesn’t seem to be working, or if it’s one of those rare conditions homeopathy may not help, like major trauma.

    Of course, you don’t necessarily need the extra titles, not if you’ve studied with the Masters, like this homeopathic M.D.

    “Using a multi-dimensional treatment model, he is a master classical homeopath as well as a cutting-edge integrative and anti-aging medicine doctor. Equally at home with Chinese medicine theory as well as modern bio-identical hormone therapy, he blends profound ancient wisdom with modern technology. His practice is on the forefront of medicine.”

    Don’t miss his blog, in which he shares insights like “Breast cancer is caused by persistent toxic energy in the pericardium meridian of Chinese medicine.” and another article in which he links autism and vaccination, urging parents to avoid vaccines for their kids (Gomer Pyle: “Suprise! Suprise! Suprise!”).

  43. #43 Denice Walter
    November 3, 2011

    @ woo:
    Let me see, now: are you saying that because SBM provides cosmetic procedures and pharmaceuticals of which *you* disapprove then it’s alright for people without legitimate medical training ( NDs, DCs, Accu.,etc) to act as PCPs?

    And.. when does SBM discourage people from consulting spiritual advice from clergy? Rather than consulting nutritionists, “healers”, and supplement-hawkers on “spiritual” ( or psychological) issues- if you cannot tolerate counsellors- you would probably be better off talking to friends and family, at least they might have *your* best interests in mind.

    Anyone can call themselves anything- in ad copy: it doesn’t mean that their services are based in reality or have even the slightest chance of working.

  44. #44 Kathryn
    November 3, 2011

    One of my art major friends told me she was checking out TCM training courses because she wanted to help people get well, but couldn’t handle the science prerequisites for medical school. [facepalm]

    …Yeah, the classes that would’ve told her how the body really works and the difference between TCM and real medicine.

  45. #45 T-reg
    November 8, 2011

    Ha ha. This pretty much sums up the (s)CAM movement:

    A SHORT HISTORY OF MEDICINE: “Doctor, I have an ear ache.”
    2000 B.C. – “Here, eat this root.”
    1000 B.C. – “That root is heathen, say this prayer.”
    1850 A.D. – “That prayer is superstition, drink this potion.”
    1940 A.D. – “That potion is snake oil, swallow this pill.”
    1985 A.D. – “That pill is ineffective, take this antibiotic.”
    2000 A.D. – “That antibiotic is artificial. Here, eat this root!”

  46. #46 g.a. whitney
    November 9, 2011

    I have several comments in response to the ignorant hateful garbage I am reading on this page. Firstly and quite simply; Get your facts straight!! my fiancee whom is a recent graduate of Bastyr University in Seattle, is far from a “quack”. Several of you speak of N.D’s wanting the privilige and earnings and title of physician without the responsiblity and without the hard work and debt. Hmm,really you think so? You are obviously completely ignorant. Bastyr is in fact an accredited university. It requires a bachelors degree to be even be considered for admittance and is nearly identical in the first 2 years to allopathic medical school in its curriculumm. It is a grueling 5 year program that requires incredible amounts of self sacrifice and hard work, not to mention over 200,0000$ in tuition and fees. Quackery!! You are total idiots!! n.d.’ s do pay malpractice insurance and are bound by laws and regulation. Refer to the laws in the states where naturopathic medicine is licensed and then explain to everyone truthfully about responsibility.

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