Can't get into med school? Legislate your own doctorate!

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.

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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.

Real doctors receive a proven, science- and evidence-based education.

Not any more. As Orac has frequently pointed out, real medical schools are now teaching woo right along with science based medicine.

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.

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?

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".

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

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!

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!)

By Denice Walter (not verified) on 10 Jun 2008 #permalink

@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.

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.

By Ambitwistor (not verified) on 10 Jun 2008 #permalink

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

Where can I get one? I'd like to be a therapist for post-fundamentalism stress disorder (PFSD) in religious de-converts.

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.

By Ted Suzelis, ND (not verified) on 10 Jun 2008 #permalink

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.

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.

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.

"Obviously schools do not teach inner wisdom, but I would not dismiss it facetiously out of hand."

Why not?

@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?

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.

"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.

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.

@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.

@radioactive,

You may be right, how does one distinguish a religion from a cult?

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.

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.

@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.

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.

@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.

@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.

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."

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.

@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

@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.

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.

By Eric Yarnell, ND (not verified) on 10 Jun 2008 #permalink

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.

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/ ).

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.

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

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.

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.

By marcus welby (not verified) on 11 Jun 2008 #permalink

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.

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?

By marcus welby (not verified) on 11 Jun 2008 #permalink

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.

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,

By marcus welby (not verified) on 11 Jun 2008 #permalink

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).

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.

By marcus welby (not verified) on 11 Jun 2008 #permalink

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.

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.

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...

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.

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.

@ 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.

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.

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.

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.

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

"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.

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.

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.

By marcus welby (not verified) on 13 Jun 2008 #permalink

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.

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 doctor. And they die while under conventional treatment. And become a statistic under conventional treatment. And naturopathy can sit back shaking its head over how EBM lets people die, while dodging all the blame.

We know, from documented incidences, that it DOES happen that way at least on occasion, because it HAS happened that way at least on occasion. That doesn't mean that it is easy or even practical to get the real statistics on how many people die under this sequence of events. But surely you do know better than to argue that the fact we don't have the numbers means that it isn't a real problem or worthy of consideration. Right?

By Luna_the_cat (not verified) on 13 Jun 2008 #permalink

@Luna_the_cat
You express your concern 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."
The new MN law regulating NDs https://www.revisor.leg.state.mn.us/laws/?id=348&doctype=Chapter&year=2…
states in part:
"Subd. 2. Patient records. (a) A registered naturopathic doctor shall maintain a
record for seven years for each patient treated, including:
(1) a copy of the informed consent;
(2) evidence of a patient interview concerning the patient's medical history and
current physical condition;
(3) evidence of an examination and assessment;
(4) record of the treatment provided to the patient; and
(5) evidence of evaluation and instructions given to the patient, including
acknowledgment by the patient in writing that, if deemed necessary by the registered
naturopathic doctor, the patient has been advised to consult with another health care
provider."
These record keeping requirements are typical of the laws regulating naturopathic doctors.
Would such record keeping satisfy your concerns, if not, what other kinds of records would you require?

Off the subject, are you related to stellaluna_the_bat?

Golly! It is unbelieveable at the amount of mis-information that apparently runs rampant even in those with more education than the norm; not to mention the arrogance and total ignorance that goes along with it. Even Socrates discovered that he was the wiser man, due to the fact that he could at least say that he knew he did not know all the answers. I don't see much wisdom being displayed here in many cases.

Lets not forget the fundamental truth of healing and medicine and that is it is an "art" as well as a "science." This is where traditional MD's get nervous. They do not like art, they like black and white in written, visible form - science. There is nothing wrong with that, I like that too; although even with these 1,000's of years that have passed up to the present day, science still cannot figure out in black and white the totality of the functioning of the human body. Perhaps that is due in part because of "energy" the human body possesses that remains abstract to the viewer. This is just an example of where the dividing line starts, and not something I wish to delve into at the moment.

What I do want to state is that MD's, traditional MD's do have their place. Allopathic medicine does extremely well with emergency and acute situations. However, it does fail miserably with chronic conditions, where the goal is always "treatment" and a lifelong sentence of expensive harmful drugs. It is cookbook medicine at its finest. Due to the "busyness" of life, most MD's believe in the fallacy that they have the "right" medicine in all situations. Many MD's are content to be spoon-fed by a profit driven, generating, monopolized medical modality that wears a white coat with a happy face....their name is Big Pharma, who walks hand in hand with Allopathic medicine. They present themselves as here to help, while the only one who seems to benefit is themselves, as evidence by pharmas's unfathomable profits and the incredibly huge numbers of people adversly affected by this approach.

I don't believe I need to convince anyone that corruption in our present day system is a reality. If you chose to deny this, either you are lazy and do not do proper research or you are satisfied with your own status quo within the system. I would like to speak to those who truly would like to help their patients lead higher quality life's without their entire retirement funds going to pharmacy. Is this what you would call good medicine?? Which brings us to the difference between Naturopathic medicine and allopathic medicine.

Allopathic medicine, pharmaceutical based medicine in the US, is all about "treating" the patient. The ultimate MLM factory?? This is where the profits are, and the inevitable 10 minute return visit to the physician to get their current script. There is not much profit for this monopoly in "cures." Allopathic medicine will however always have a market, because there are those out there who have been brainwashed that a silver bullet exists or they are uninterested in changing themselves to improve their own health. This is where Natural Medicine comes in.

Natural Medicine or Naturopathic works WITH the body to attain health, utilizing the bodies own intelligence and known needs. If you don't believe the body is intelligent, when is the last time you had to think about breathing, or think about releasing your fight or flight instinct? The body is a miracle all of its own, one that should be respected and acknowledged. There is obviously only one God, and he doesn't appear to wear a white coat. Natural medicine does not use drugs, it more or less focuses on utilizing natural substance or therapies to regain balance within the system. This may be the reason that the deaths and injuries caused by chemical medicine is almost non-existent in this approach. It is safer practice.

There are only five accreditated schools in the US that I am aware of that graduate ND's within the MD system. Those doctors have to go through all the education of the traditional MD. Although I personally feel this is un-necessary since they have not chosen to follow Allopathic medicine, it is a requirement. This may prove to be beneficial as the ND obviously is not totally ignorant of the MD's approach, and it will help when and if a patient should be referred for an acute or emergency situation. I only wish they made MD's go through more education to learn what the value of the ND is as well.

I believe that it is totally a dis-service to the allopathic trained physician to not require him/her to have a more extensive education in nutrition as well. Basically the pharmaceutical industry is the one educating the allopathic physician and it is unfortanute that they have steered you away from this fundamental knowledge base. Nutrition is the fuel that the body utilizes in its functioning and seems to be the most logical approach to better understanding the human system. Just for the record, I would also like to mention here, that the chiropractic curriculum is more extensive than an MD's curriculum and requires much more study in the nutritional subject matter.

Many ND's and chiropractors I am in association with are embarking upon a new "field" of medicine that I'm sure allopathic medicine would also be appreciative of. It is very much science based, in the black and white. It is called Functional Medicine, and it may very well change the landscape of how medicine is practiced in the near future. This approach makes the most sense to me, along with the understanding of the mind - body connection, to bring an individual back to their highest functioning potential. It is based on the belief that some imbalance within the system is causative of the manifested symptoms one is experiencing. It focuses on the bio-chemistry of the individual, and everything is by the way individualized, and never considers a blanket approach. Functional medicine is analogous to being a medical detective, which takes alot more time than allopathic medicine has the luxury of. If you would like to investigate this approach further, you can google "Institute of Functional Medicine" for find more information.

I think it serves no one to sit here and bicker back and forth as to who is better as if your legitimacy is at stake. People's health are at stake along with the quality of their lives. I don't believe anyone has all the answers, I believe that it is an on-going passion for truth that can allow one to remain un-biased and calculate the benefits of each approach for the greater good of the indivdual. Doctor does not mean God, it means teacher. Maybe its time some of us came down off our high horse and realize that fact as well.

Just as a final side note, I do not know much about homeopathy other than its supposed mechanism of action is based on an energetic level, but I do believe that the creation of vaccines in pharmaceutical medicine is based on the very same principals. Many medicines came from herbology and were changed and re-strutured only for the purpose of the ability to patent it. Allopathic medicine owes much of its utilization to natural medicine. Of course, natural medicine is not something one can patent, and therefore not as profitable, but never the less .... very useful.

Maybe the time has come to understand each other better, and to focus not on ourselves but on the people who are counting on us to assist them in living life to the fullest.

All the best,
Belinda

Golly! It is unbelieveable at the amount of mis-information that apparently runs rampant even in those with more education than the norm; not to mention the arrogance and total ignorance that goes along with it. Even Socrates discovered that he was the wiser man, due to the fact that he could at least say that he knew he did not know all the answers. I don't see much wisdom being displayed here in many cases.

Lets not forget the fundamental truth of healing and medicine and that is it is an "art" as well as a "science." This is where traditional MD's get nervous. They do not like art, they like black and white in written, visible form - science. There is nothing wrong with that, I like that too; although even with these 1,000's of years that have passed up to the present day, science still cannot figure out in black and white the totality of the functioning of the human body. Perhaps that is due in part because of "energy" the human body possesses that remains abstract to the viewer. This is just an example of where the dividing line starts, and not something I wish to delve into at the moment.

What I do want to state is that MD's, traditional MD's do have their place. Allopathic medicine does extremely well with emergency and acute situations. However, it does fail miserably with chronic conditions, where the goal is always "treatment" and a lifelong sentence of expensive harmful drugs. It is cookbook medicine at its finest. Due to the "busyness" of life, most MD's believe in the fallacy that they have the "right" medicine in all situations. Many MD's are content to be spoon-fed by a profit driven, generating, monopolized medical modality that wears a white coat with a happy face....their name is Big Pharma, who walks hand in hand with Allopathic medicine. They present themselves as here to help, while the only one who seems to benefit is themselves, as evidence by pharmas's unfathomable profits and the incredibly huge numbers of people adversly affected by this approach.

I don't believe I need to convince anyone that corruption in our present day system is a reality. If you chose to deny this, either you are lazy and do not do proper research or you are satisfied with your own status quo within the system. I would like to speak to those who truly would like to help their patients lead higher quality life's without their entire retirement funds going to pharmacy. Is this what you would call good medicine?? Which brings us to the difference between Naturopathic medicine and allopathic medicine.

Allopathic medicine, pharmaceutical based medicine in the US, is all about "treating" the patient. The ultimate MLM factory?? This is where the profits are, and the inevitable 10 minute return visit to the physician to get their current script. There is not much profit for this monopoly in "cures." Allopathic medicine will however always have a market, because there are those out there who have been brainwashed that a silver bullet exists or they are uninterested in changing themselves to improve their own health. This is where Natural Medicine comes in.

Natural Medicine or Naturopathic works WITH the body to attain health, utilizing the bodies own intelligence and known needs. If you don't believe the body is intelligent, when is the last time you had to think about breathing, or think about releasing your fight or flight instinct? The body is a miracle all of its own, one that should be respected and acknowledged. There is obviously only one God, and he doesn't appear to wear a white coat. Natural medicine does not use drugs, it more or less focuses on utilizing natural substance or therapies to regain balance within the system. This may be the reason that the deaths and injuries caused by chemical medicine is almost non-existent in this approach. It is safer practice.

There are only five accreditated schools in the US that I am aware of that graduate ND's within the MD system. Those doctors have to go through all the education of the traditional MD. Although I personally feel this is un-necessary since they have not chosen to follow Allopathic medicine, it is a requirement. This may prove to be beneficial as the ND obviously is not totally ignorant of the MD's approach, and it will help when and if a patient should be referred for an acute or emergency situation. I only wish they made MD's go through more education to learn what the value of the ND is as well.

I believe that it is totally a dis-service to the allopathic trained physician to not require him/her to have a more extensive education in nutrition as well. Basically the pharmaceutical industry is the one educating the allopathic physician and it is unfortanute that they have steered you away from this fundamental knowledge base. Nutrition is the fuel that the body utilizes in its functioning and seems to be the most logical approach to better understanding the human system. Just for the record, I would also like to mention here, that the chiropractic curriculum is more extensive than an MD's curriculum and requires much more study in the nutritional subject matter.

Many ND's and chiropractors I am in association with are embarking upon a new "field" of medicine that I'm sure allopathic medicine would also be appreciative of. It is very much science based, in the black and white. It is called Functional Medicine, and it may very well change the landscape of how medicine is practiced in the near future. This approach makes the most sense to me, along with the understanding of the mind - body connection, to bring an individual back to their highest functioning potential. It is based on the belief that some imbalance within the system is causative of the manifested symptoms one is experiencing. It focuses on the bio-chemistry of the individual, and everything is by the way individualized, and never considers a blanket approach. Functional medicine is analogous to being a medical detective, which takes alot more time than allopathic medicine has the luxury of. If you would like to investigate this approach further, you can google "Institute of Functional Medicine" for find more information.

I think it serves no one to sit here and bicker back and forth as to who is better as if your legitimacy is at stake. People's health are at stake along with the quality of their lives. I don't believe anyone has all the answers, I believe that it is an on-going passion for truth that can allow one to remain un-biased and calculate the benefits of each approach for the greater good of the indivdual. Doctor does not mean God, it means teacher. Maybe its time some of us came down off our high horse and realize that fact as well.

Just as a final side note, I do not know much about homeopathy other than its supposed mechanism of action is based on an energetic level, but I do believe that the creation of vaccines in pharmaceutical medicine is based on the very same principals. Many medicines came from herbology and were changed and re-strutured only for the purpose of the ability to patent it. Allopathic medicine owes much of its utilization to natural medicine. Of course, natural medicine is not something one can patent, and therefore not as profitable, but never the less .... very useful.

Maybe the time has come to understand each other better, and to focus not on ourselves but on the people who are counting on us to assist them in living life to the fullest.

All the best,
Belinda

Golly! It is unbelieveable at the amount of mis-information that apparently runs rampant even in those with more education than the norm; not to mention the arrogance and total ignorance that goes along with it. Even Socrates discovered that he was the wiser man, due to the fact that he could at least say that he knew he did not know all the answers. I don't see much wisdom being displayed here in many cases.

Lets not forget the fundamental truth of healing and medicine and that is it is an "art" as well as a "science." This is where traditional MD's get nervous. They do not like art, they like black and white in written, visible form - science. There is nothing wrong with that, I like that too; although even with these 1,000's of years that have passed up to the present day, science still cannot figure out in black and white the totality of the functioning of the human body. Perhaps that is due in part because of "energy" the human body possesses that remains abstract to the viewer. This is just an example of where the dividing line starts, and not something I wish to delve into at the moment.

What I do want to state is that MD's, traditional MD's do have their place. Allopathic medicine does extremely well with emergency and acute situations. However, it does fail miserably with chronic conditions, where the goal is always "treatment" and a lifelong sentence of expensive harmful drugs. It is cookbook medicine at its finest. Due to the "busyness" of life, most MD's believe in the fallacy that they have the "right" medicine in all situations. Many MD's are content to be spoon-fed by a profit driven, generating, monopolized medical modality that wears a white coat with a happy face....their name is Big Pharma, who walks hand in hand with Allopathic medicine. They present themselves as here to help, while the only one who seems to benefit is themselves, as evidence by pharmas's unfathomable profits and the incredibly huge numbers of people adversly affected by this approach.

I don't believe I need to convince anyone that corruption in our present day system is a reality. If you chose to deny this, either you are lazy and do not do proper research or you are satisfied with your own status quo within the system. I would like to speak to those who truly would like to help their patients lead higher quality life's without their entire retirement funds going to pharmacy. Is this what you would call good medicine?? Which brings us to the difference between Naturopathic medicine and allopathic medicine.

Allopathic medicine, pharmaceutical based medicine in the US, is all about "treating" the patient. The ultimate MLM factory?? This is where the profits are, and the inevitable 10 minute return visit to the physician to get their current script. There is not much profit for this monopoly in "cures." Allopathic medicine will however always have a market, because there are those out there who have been brainwashed that a silver bullet exists or they are uninterested in changing themselves to improve their own health. This is where Natural Medicine comes in.

Natural Medicine or Naturopathic works WITH the body to attain health, utilizing the bodies own intelligence and known needs. If you don't believe the body is intelligent, when is the last time you had to think about breathing, or think about releasing your fight or flight instinct? The body is a miracle all of its own, one that should be respected and acknowledged. There is obviously only one God, and he doesn't appear to wear a white coat. Natural medicine does not use drugs, it more or less focuses on utilizing natural substance or therapies to regain balance within the system. This may be the reason that the deaths and injuries caused by chemical medicine is almost non-existent in this approach. It is safer practice.

There are only five accreditated schools in the US that I am aware of that graduate ND's within the MD system. Those doctors have to go through all the education of the traditional MD. Although I personally feel this is un-necessary since they have not chosen to follow Allopathic medicine, it is a requirement. This may prove to be beneficial as the ND obviously is not totally ignorant of the MD's approach, and it will help when and if a patient should be referred for an acute or emergency situation. I only wish they made MD's go through more education to learn what the value of the ND is as well.

I believe that it is totally a dis-service to the allopathic trained physician to not require him/her to have a more extensive education in nutrition as well. Basically the pharmaceutical industry is the one educating the allopathic physician and it is unfortanute that they have steered you away from this fundamental knowledge base. Nutrition is the fuel that the body utilizes in its functioning and seems to be the most logical approach to better understanding the human system. Just for the record, I would also like to mention here, that the chiropractic curriculum is more extensive than an MD's curriculum and requires much more study in the nutritional subject matter.

Many ND's and chiropractors I am in association with are embarking upon a new "field" of medicine that I'm sure allopathic medicine would also be appreciative of. It is very much science based, in the black and white. It is called Functional Medicine, and it may very well change the landscape of how medicine is practiced in the near future. This approach makes the most sense to me, along with the understanding of the mind - body connection, to bring an individual back to their highest functioning potential. It is based on the belief that some imbalance within the system is causative of the manifested symptoms one is experiencing. It focuses on the bio-chemistry of the individual, and everything is by the way individualized, and never considers a blanket approach. Functional medicine is analogous to being a medical detective, which takes alot more time than allopathic medicine has the luxury of. If you would like to investigate this approach further, you can google "Institute of Functional Medicine" for find more information.

I think it serves no one to sit here and bicker back and forth as to who is better as if your legitimacy is at stake. People's health are at stake along with the quality of their lives. I don't believe anyone has all the answers, I believe that it is an on-going passion for truth that can allow one to remain un-biased and calculate the benefits of each approach for the greater good of the indivdual. Doctor does not mean God, it means teacher. Maybe its time some of us came down off our high horse and realize that fact as well.

Just as a final side note, I do not know much about homeopathy other than its supposed mechanism of action is based on an energetic level, but I do believe that the creation of vaccines in pharmaceutical medicine is based on the very same principals. Many medicines came from herbology and were changed and re-strutured only for the purpose of the ability to patent it. Allopathic medicine owes much of its utilization to natural medicine. Of course, natural medicine is not something one can patent, and therefore not as profitable, but never the less .... very useful.

Maybe the time has come to understand each other better, and to focus not on ourselves but on the people who are counting on us to assist them in living life to the fullest.

All the best,
Belinda

@Bebe
You are on very thin ice saying "There is only one God" in this forum.
Most people who write here are like the character from 'Nacho Libre' who says "I don't believe in God, I only believe in Science".
Even if Einstein were to make one of his statements about God here he would very likely get immediately doused with excrement.
These forums are the playground for the so-called 'rational skeptics', to give you an idea, if you ever had a crazy vegan house mate, these are rabid vegans on steroids.
Their main source of pleasure lies in dehumanizing those they do agree with and subjecting them to the most venal invectives.
You are dealing with the most dogmatic bunch you are ever likely to meet, supremely self-righteous and convinced of their own superiority.
Your proposal to "Maybe the time has come to understand each other better, and to focus not on ourselves but on the people who are counting on us to assist them in living life to the fullest." will very likely be ridiculed.
Your only "hope" for mutual understanding is that someone will suck up to you because you are a woman, just as in a typical chat room full of socially maladjusted males.
You have been warned.

Correction to previous comment to Bebe, please read:
dehumanizing those they do NOT agree with

I didn't mean to say that evidence of bad practitioners in MD circles should invalidate the profession, but rather that perhaps what you fear is happening in the ND circles might not be, at least in the cases hermano mentioned, actually happening. From his example of the record keeping provision of the law it seems to me, a layman admittedly, that they are required to keep records. A quick google search has confirmed that the legal requirements of MD's seem to be pretty similar in Minnesota.

I don't think that anyone who wants to should be able to practice, but I am not sure that the anecdotal evidence and questions posed on this and other blogs [schools of astrology, etc] constitute and a thought out well researched refutation. I expect that the answer to this is that "they" have to prove themselves to "us." I am not sure that dualistic thinking [discovery institute seems to engage in this a lot] is the answer that will yield the results your are looking for.

The problem with small communities is often that they become insulated and when any negative behavior or idea is accepted there is no outside opinion to question it. I am not accusing here but just asking for introspection. Is there anything wrong with asking questions? For those of you who teach, is how many of you have responded to Hermano, SOP for your students?

Perhaps the unwashed and disheveled, such as myself, are missing what you seem to accept as gospel. I am asking you to point me to something more substantial than naturowatch. I've looked at it and I find at least some of the articles as informative as fox news. WTF am I missing?

Pardon my french. Excuse my ramblings and kudos for being willing to discuss this topic.

Marcus Welby, not MD

By marcus welby (not verified) on 13 Jun 2008 #permalink

"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."

Programmatic accreditation for naturopathic medical schools is provided by the CNME: www.cnme.org

Institutional accreditation, educational requirements and course content are, like allopathic medical schools, slightly different depending on the school, so here are links to these requirements for each of the 4 schools:

Bastyr University:
www.bastyr.edu/academic/accred.asp
www.bastyr.edu/education/naturopath/degree/prerequisites.asp
www.bastyr.edu/education/naturopath/degree/curricula.asp

Southwest College of Naturopathic Medicine
www.scnm.edu/college/accreditation.php
www.scnm.edu/admissions/requirements.php
www.scnm.edu/admissions/curriculum.php

National College of Naturopathic Medicine
www.ncnm.edu/academics-at-ncnm/accreditation.php
www.ncnm.edu/admissions-home/admission-requirements.php#1
www.ncnm.edu/academics-at-ncnm/naturopathic-program.php

University of Bridgeport College of Naturopathic Medicine
www.bridgeport.edu/pages/3229.asp
www.bridgeport.edu/pages/2679.asp
www.bridgeport.edu/pages/2632.asp

As far as malpractice insurance, even NDs in states that do not recognize naturopathic medicine carry malpractice insurance. In fact, it is very affordable, since NDs are almost never sued.

When it comes to evidence based medicine, NDs do use evidence based medicine. The only problem is that there are not billion dollar studies done on nutrition, herbs, and vitamins, since they cannot be patented and sold by the drug companies for exorbitant amounts of money. NDs use conventional intakes and diagnostic procedures, we just use different therapies to treat the disease process. Much of our therapies are based on basic biochemical processes, for instance, the use of 5-hydroxytryptophan to increase the substrate for the manufacture of serotonin in the brain instead of prescribing an SSRIs or MAOIs. Another example is supplementing CoEnzyme Q10 to patients that are on statin drugs, since HMG Co-A reductase is needed to manufacture CoEnzyme Q10 and statins can cause a nutrient deficiency. There is a large body of scientific literature to back the use of both of these practices, yet MDs will still label it "woo" just because they haven't bothered to do their homework on the subject.

By Ted Suzelis, ND (not verified) on 13 Jun 2008 #permalink

@Marcus "Perhaps the unwashed and disheveled, such as myself, are missing what you seem to accept as gospel. I am asking you to point me to something more substantial than naturowatch. I've looked at it and I find at least some of the articles as informative as fox news. WTF am I missing?"

Sorry to say, and I am not meaning to insult, what you miss is the background to understand what you are reading. A prominent npath says you don't need antibiotics for strep throat (it is in the source you dismiss); but I bet you will be unhappy with the subsequent problems if you don't use them. Lack of knowledge of heath care is what you are missing. If you understood things better, you would not doubt naturowatch.

Cranks complain about Nwatch; but, they can never refute anything there. They say it is too negative- that is like complaining a social worker is "too negative" when it comes to child abuse.

So, here is the challenge: take an article from naturowatch and show how it is fatally flawed. I warn you, many people have accepted that challenge; and the were never heard from, again. Do you think you can do better?

Ted Suzelis, ND has opened a door I'd like to comment upon, the University of Bridgeport's Naturopathy College:

Well, I cover my experience there here http://aanpalliancesciencebasedclaim.blogspot.com/ .

In short: UB labels the program "health science" and "scientific medicine" while teaching that one's physiology is run by a "life force" or "god power within" and that a human is made up of a "body, mind and spirit" all the WHILE stating that they are specifically "not a belief system" aka "nonsectarian."

ISYN.

Naturopathy is THE 'unethical sectarian pseudoscience:' labeling their 'sectic articles of faith set' as able to survive scientific scrutiny and themselves as able to fulfill medicine's fiduciary obligations.

Joe,

OK I took a look at an article on there [sorry it was referred to on another blog and found at least 1 piece of information that was out of date, to wit the article stated that ND residential schools were not accredited by the DOE but a google search found that they were.

Does not Mr. Barrett update his information? As for the science information, you have me there as I have little time to establish the background. You might as well ask a horse to dance, er, excluding the lipizzaner stalions. But what is your background? Can you explain why his articles are not kind of woo-ish?

Here is where I am coming from. I think you guys are losing the battle and I think you know it. To the average joe six pack who watches nascar and BBq's on the weekend, all he knows is that his wife likes her ND and it keeps her happy. He is content with that and he votes.

If you can't explain to me, someone who is better read than joe six pack, then you will lose this battle. Several of you have already noted that what you call 'woo' is already making inroads at established mainstream medical centers.

One of my chemistry professors once told me that if couldn't explain it, to anyone, then I didn't really understand it.

I don't take umbrage at anything that has been written here but I must say my impression is that several of you are dismissive towards others who you don't consider worthy. [note: this has not been my experience, but rather my observation AND INTERPRETATION of other interactions]. Joe Six pack will see an interview with a science person and come away with the impression that they are insufferable jerks.

Now one of my neighbors is a Ph.D of bio at one of our local universities and several of our friends work there as Ph.D.'s My wife and I know MD's, ND's, DC's and DO's socially. I do not consider myself prejudicial, but many of the people I work with find doctors [and here they are referring to MD's] arrogant and dismissive. They don't like them. They have good things to say about the chiros and naturos.

You are losing the PR war. What I am trying to say here and on other blogs at this point is that perhaps you should consider that and try another tactic.

That is just my 2 cents. I will step off my soap box and yield the floor.

Thanks for your responses.

By marcus welby (not verified) on 13 Jun 2008 #permalink

I fundamentally disagree with your observations. For one thing, people are, with their doctors, much like they are with politicians---they may not like "congress" but they like their own congressman.

Also, respect for MDs still runs very deep. You underestimate "Joe sixpack". I live in the heart of the industrial midwest. People here like and respect doctors, and are generally suspicious of snake-oil salesmen. When patients ask me about the latest woo, and I give them my considered opinion, they realize I've done my homework and generally value my opinion more that that of their chiropractor.

Your interpretations just don't fit with my experiences.

Marcus,

First, DoE accreditation only means the school has the faculty and facilities they promise, and is financially solvent. That was the explanation when they recognized an astrology school in 2001. They don't want government-sponsored loans used for tuition; and when the student arrives in September they only find an abandoned storefront.

It is a common expression that "if you can't explain it you can't understand it." However, some explanations take a very long time. A smart fellow once asked me how we know the composition and structure of benzene. Everything I said led to the next logical question, about how we determined that. I realized it would take at least a semester.

Npathy is a huge and slippery enterprise. If we have to start with the basics, I simply cannot do it here. However, I think I can quickly explain why chiropractic is quackery. They maintain that all organs rely on connections, through the spine, to the brain. Transplanted organs have no nerve-connections; yet they work fine.* Also, in spine injury, the involuntary organs continue to work well. Moreover, in 1972 an anatomist at Yale demonstrated that a chiro cannot alter spinal processes, short of applying enough force to break the spine; thus, if the nerves were hampered by the spine, the chiro couldn't fix it.

Npaths have their own version of chiropracty. They also rely on on homeopathy and acupuncture; which are irrational,and scientifically unsupported (except by anecdote and high-school level, unreliable, research).

You cannot verify my credentials, so there is no point in describing them- except to say I have been interested in quackery (as a hobby) for more than 30 years. and I hate seeing people harmed, physically or financially, by charlatans.

*Some transplanted organs may undergo reinnervation; but it takes years and is of no consequence.

"Natural medicine does not use drugs, it more or less focuses on utilizing natural substance or therapies to regain balance within the system. This may be the reason that the deaths and injuries caused by chemical medicine is almost non-existent in this approach. It is safer practice."

So you are saying that if you don't use drugs, you almost never have deaths or injuries from drugs. You know, I think you are selling yourself and your colleagues short. You really should claim that you *never* have deaths from drugs. Get rid of that 'almost' before 'non-existent'.

However your conclusion, that since you never have deaths from drugs your practice is safer is inane. By the same logic since children under age 14 almost never are the drivers involved in deadly motor vehicle crashes obviously they are the safest drivers.

The problem (and this is the reason that woo is so dangerous) is that if you offer a useless treatment to a patient whose problem can be ameliorated or solved with allopathic treatment, you *have* harmed the patient. About a year ago I treated a guy who was seeing a chiropracter for about a week for back pain. The pain was absolutely classic for renal stone pain, and indeed when I scanned him, he had a (thankfully only) partially obstructing stone. In. His. Solitary. Functional. Kidney.

He also had a creatnine of 2.5. And left to the treatment of quacks he would be dead. Of course the medicine he was given, the sedation he underwent, and the ureteroscopy and stone removal the urologist performed could have killed him. But that is a small chance compared to the nearly 100% chance of irreversible renal failure he would have without treatment. Quackery is unsafe not because it uses medicines that have some risk of adverse effects, but because of the danger you place people in when you keep them from seeking proper care.

"Natural Medicine or Naturopathic works WITH the body to attain health, utilizing the bodies own intelligence and known needs. If you don't believe the body is intelligent, when is the last time you had to think about breathing, or think about releasing your fight or flight instinct? The body is a miracle all of its own, one that should be respected and acknowledged. There is obviously only one God, and he doesn't appear to wear a white coat."

And oddly enough that's the very reason that you still have a following. The body is amazingly capable of healing itself. Probably a third of the people I see in my ER practice and in the clinic need only tincture of time to get well. Sprains heal, colds and flu will get better, skin closes of its own accord, ovarian cyst rupture resolves, most kids with ear infections get better without antibiotics. I will certainly offer all of those people symptomatic and supportive treatment in the interim, but I could just as easily offer to cast a spell for all the difference it will have in their long term outcome.

That very 'miracle' of the body is also what you cash in on. You cast your spell, give people placebos, and wait for the natural tendency of the body to heal. And when it does, you get the credit. And if all you did was treat 4 year olds with colds, back sprains, and dysmenorrhea, I would have no problem with your existence. (Hell I would jump for joy that I don't have to see them on a busy night in the ER!) The problem is that patients don't select themselves so a child with meningitis, an ectopic pregnancy, or a kidney stone in a solitary kidney may walk in your office. And if you delay them getting the real treatment they need you are culpable. To be honest, I don't think that should qualify for malpractice though, more like negligent homicide.

NickG,
It would really be a tragedy were someone with "meningitis, an ectopic pregnancy, or a kidney stone in a solitary kidney" misdiagnosed and their treatment were delayed.
I agree totally.
NDs are also trained in differential diagnosis.
What is it that makes an MD general practitioner, or a nurse practitioner, as opposed to NDs, capable to recognize these grave conditions?
What kind and amount of additional training would NDs need to have the competencies you see them lacking?
NDs are licensed as primary care providers in many states.
If you could not get your first choice (make all NDs go away) and your only other option was to mandate their training, including CE, what requirements would you put in place?
I believe that having ER experience is extremely valuable for anyone. I am not a health care provider and I consider having volunteered at a regional trauma center in the past one of the very best things I have ever done.
My personal vote is to get NDs into trauma centers.

@Hermano,

What, specifically, qualifies NDs as health-care practitioners? We know the ones you support study nonsense for 4 years. Chiropractors do the same. What distinguishes those two, or is it all good?

These are some naturo beliefs, support them:

detoxification
homeopathy
applied kinesiology
acupuncture

(Hint, they are all debunked in the scientific literature.)

I am looking for concrete advantages for n'paths, not arguments, especially about legality.

Joe,
You are extremely critical of NDs' educational and professional credentials.
I am merely curious,
where did you get your education and what do you do?

Mi hermano, I don't know where Joe gets his info, but I get mine from the websites of North America's most prominent naturopathic schools.

Perhaps if their literature is misleading you could provide us with some pdf's of course materials that show that the curriculum is equivalent to "medicine, plus".

Hermano: "NDs are also trained in differential diagnosis. What is it that makes an MD general practitioner, or a nurse practitioner, as opposed to NDs, capable to recognize these grave conditions? What kind and amount of additional training would NDs need to have the competencies you see them lacking?"

When I was in school, there was a program that the university did called 'mini-medical school' where people from the community could come in for classes over a semester that touched on some of what was taught in medical school. The lectures were done by our faculty and were actually quite good. However, 60 hours of med school education does not qualify you as a primary health care provider.

Now, I agree that mid-level providers are a good thing. And one could make the argument that NDs are like MLPs. That is, they have the clinical training of a PA or NP 'plus' all the woo. However there is one problem with that: most MLPs don't work independently. None of them do the first several years that they practice. That is if you are a new grad NP, you must first work under the supervision of an MD or DO several years and then in some states may become an independent practitioner if your supervising physician(s) feels that you are competent.

So they are not limited as are MLPs, and they are most definitely not trained in an equivalent manner to MD/DO students. (First off, 4 years of medical school is packed as is. Adding a significant amount of woo will have to subtract from that because already there are not enough hours in the day. Secondly, there is no requirement for post-graduate education for NDs, while MDs/DOs must complete at least one year of residency to get an independent license and realistically must complete a residency to get any real job as a physician.)

In the case of NDs then they misrepresent their training. They call themselves primary care physicians when they obviously don't have the medical school and post graduate education of MD/DO primary care physicians. To most people, PCP implies a level of training that they don't have. Moreover, they don't class themselves in the more limited category MLPs and don't have the supervisory requirement that MLPs have in order to practice.

Though in short, if you want to call yourself a primary care physician, go to allopathic or osteopathic medical school and then complete three years of real post-graduate training like everyone else. If you want to study all the woo you like after that or in addition to that, fine. But don't call yourself a PCP if you are not.

PalMd,

I did not express my curiosity to Joe about his education regarding naturopathy, I already knew about his love for
naturowatch.org.
I meant education as in "where did you go to school?".
I believe I asked you some questions earlier which I am not sure you answered, no worries.
Now, I am very interested in your opinion about the idea I expressed to NickG about dumping NDs to a big time trauma center on a busy Friday night shift to learn about critically sick and injured patients.
Would a year of weekly busy night shifts enough to train someone? Bi-weekly?
Regarding obtaining pdf's of actual course materials, I will ask, but I have no idea if or when I will find any.
I recall taking 2 quarter org sequence at a university, one with a top conventional med school,
first quarter was during the summer and taught by someone who normally taught at a community college and created incredibly detailed and useful lecture outlines, I loved the class, and got a high A. The second quarter was a condensed course taught by a research professor, a native speaker of Japanese, who was totally incomprehensible to the students.
I draw a total blank about it. I think I did well, but there is no memory except sitting in lecture hall wondering "what did he just say?". This in neither here nor there, I am tired, pardon my rambling.

Ramble on...it's only electrons...

Almost every doctor I know remembers every class, every professor...it's a very, um...significant experience. Also, the content is essentially the same from school to school, so it's quite easy to communicate with colleagues in a meaningful way.

I don't think I'd want to toss NDs into a trauma center...i'd rather toss them into a medical school (the good ones, at least)

By Anonymous (not verified) on 14 Jun 2008 #permalink

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.

As an ecology Ph.D. student, I make sure to visit my field sites myself, as many times as possible, and not just have assistants collect samples. You never know when you'll see something important. Getting a "feel" for the site and the organisms is crucial.

Anonymous,
Regarding my incomprehensible orgo prof,
I did well in the class, not thanks to his lectures and class handouts, but to reading Solomons and doing problem sets.

In response to Nick....

Nick commented on: "Natural medicine does not use drugs, it more or less focuses on utilizing natural substance or therapies to regain balance within the system. This may be the reason that the deaths and injuries caused by chemical medicine is almost non-existent in this approach. It is safer practice."

Nick's response to comment: So you are saying that if you don't use drugs, you almost never have deaths or injuries from drugs. You know, I think you are selling yourself and your colleagues short. You really should claim that you *never* have deaths from drugs. Get rid of that 'almost' before 'non-existent'.

Response from Belinda: I prefer to leave the "almost non-existent" clause due to the fact that natural medicine often times will utilize herbs as a natural drug. Due to the individuality that exists amongst us all, adverse effects are also possible with natural herbs and even with foods being used as medicine. When a pharmaceutical drug is created, they isolate out what they consider to be the substance within the herb that is causing the desired action. Then they add the fillers and binders to the isolated substance, thereby enabling the substance to be patented. The difference between a natural herb and its counterpart (pharmaceutical drug) is that the natural herb has additional substances in it to create a synergy in most cases that decrease or minimize the undesired side effects found in the pharmaceutical drugs. This is why less adverse effects come from natural medicine or food. Hence the clause, "almost non-existent" especially in comparision to pharmaceutical drugs is appropriate.

*****************************************************

Nick states: However your conclusion, that since you never have deaths from drugs your practice is safer is inane. By the same logic since children under age 14 almost never are the drivers involved in deadly motor vehicle crashes obviously they are the safest drivers.

Response to Nick: I understand what your saying, if you don't drive you can't wreck!...lol. This link here is the reported prevalence and incidence of Adverse Drug Reactions (ADR�s) as reported by the Institute of Medicine and reported on the FDA�s website:
. It reports the prevelance of Adverser Drugs Reactions (ADR's): over 2 million serious ADR's yearly, 100,000 deaths yearly and as the fourth leading cause of death ahead of pulmonary disease, diabetes,AIDS, pneumonia, accidents and automobile deaths. If anyone drove this way, surely they would take their license away from them, wouldn't you think??

******************************************************

Nick states: The problem (and this is the reason that woo is so dangerous) is that if you offer a useless treatment to a patient whose problem can be ameliorated or solved with allopathic treatment, you *have* harmed the patient. About a year ago I treated a guy who was seeing a chiropracter for about a week for back pain. The pain was absolutely classic for renal stone pain, and indeed when I scanned him, he had a (thankfully only) partially obstructing stone. In. His. Solitary. Functional. Kidney.

He also had a creatnine of 2.5. And left to the treatment of quacks he would be dead. Of course the medicine he was given, the sedation he underwent, and the ureteroscopy and stone removal the urologist performed could have killed him. But that is a small chance compared to the nearly 100% chance of irreversible renal failure he would have without treatment. Quackery is unsafe not because it uses medicines that have some risk of adverse effects, but because of the danger you place people in when you keep them from seeking proper care.

Response: there are alot of assumptions here in your statements. First you are assuming that allopathic approach is safe or better than anything at least that you are aware of. I refer you back to the previous discussion on the driving comment and the ADR facts.

Secondly you assume that all ND's are quacks and would not recognize when the need to refer comes up. You are assuming also that there are no quacks in MD / allopathic medicine. I can not justify any naturopathic doc or chiropractic docs bad decisions, anymore than you can justify the MD's who have made terrible, costly mis-diagnoses and judgement calls. Believe it or not, there are bad, good and better MD's just as their are ND's in the same catorgories. Also, MD's are not immune from error anymore than any other human being despite their level of education.

We are comparing apples to oranges here. ND and MD are not the same animal. MD is VERY good with emergency medicine and or trauma situations. ND is not necessarily the ofject of desire in these types of situations. I'd say go to the MD until one is stablized and out of crisis, but after the crisis subsides return to the ND to address and work with you on finding the causative factors which resulted in the manifestation of the symptom. The ND can assist with re-balancing the bio-chemistry of the system or institute lifestyle changes to eliminate what imbalance created the kidney stone to begin with.

Thirdly, although technology is sometimes absolutely wonderful, not everyone (an extremely large number of people actually) cannot afford it. Many do not have the insurance to pay for such care nor the money to pay out of pocket. What good is the technology to the majority if they cannot even access it when needed??

Fourthly, you say "quackary" is dangerous because natural docs will keep them from seeing you. I don't see natural docs promoting anything in every tv commercial that I see allopathic approach utilizing. If they are going to see a natural doc it is their own decision which could stem from a multitude of reasons and dissatisfication with the current regime. Does that guarentee that they will find an excellent ND? No. When they go see an MD, does it guarentee that they will find an excellent MD? No....
I wonder if you would be just as angry in the above situation if the doctor in question was an MD rather than some other form of practioner? My guess is....probably not.

*********************************************************

Nick commenting on: "Natural Medicine or Naturopathic works WITH the body to attain health, utilizing the bodies own intelligence and known needs. If you don't believe the body is intelligent, when is the last time you had to think about breathing, or think about releasing your fight or flight instinct? The body is a miracle all of its own, one that should be respected and acknowledged. There is obviously only one God, and he doesn't appear to wear a white coat."

Nicks response to comment: And oddly enough that's the very reason that you still have a following. The body is amazingly capable of healing itself. Probably a third of the people I see in my ER practice and in the clinic need only tincture of time to get well. Sprains heal, colds and flu will get better, skin closes of its own accord, ovarian cyst rupture resolves, most kids with ear infections get better without antibiotics. I will certainly offer all of those people symptomatic and supportive treatment in the interim, but I could just as easily offer to cast a spell for all the difference it will have in their long term outcome.

That very 'miracle' of the body is also what you cash in on. You cast your spell, give people placebos, and wait for the natural tendency of the body to heal. And when it does, you get the credit. And if all you did was treat 4 year olds with colds, back sprains, and dysmenorrhea, I would have no problem with your existence. (Hell I would jump for joy that I don't have to see them on a busy night in the ER!) The problem is that patients don't select themselves so a child with meningitis, an ectopic pregnancy, or a kidney stone in a solitary kidney may walk in your office. And if you delay them getting the real treatment they need you are culpable. To be honest, I don't think that should qualify for malpractice though, more like negligent homicide.

Response: ummmmm......i guess you and some of your collegues are well versed in malpractice and negligent homicide. As I said before, a good ND knows when to refer for crisis or critical treatment sometimes only in the hope that they will not be turned away due to their inability to pay for incredibly expensive treatment or recieve sub-standard care due to their financial situtation.

In addition, I do not know any ND's who uses "spells" or placebos. You use sweeping generalizations and are very hostile to anything that is out of your realm. Anything not AMA approved of , I'm sure. Perhaps you could deal with your anger and hostility by learning more about natural / functional medicine. Usually, if something has no merit, it will not survive. If you believe that natural medicine has no merit, then you need not worry, it will disappear with tomorrows wind. People will not continue on with something that does not work for them. If it is worthy of merit, it will yet continue to flourish. Time will tell. Time has told and taught us much thus far.

You also say, "And oddly enough that's the very reason that you still have a following." You make it sound like a cult. Do you believe it may be possible that more and more people are utilizing natural doctors and or natural theparies because they are recieving some benefit from it? Perhaps more and more people are turning to natural modalities because what is available is not working for them efficiently enough. Is it possible that allopathic medicine is not the best call in all situations , just as naturopathic medcine may not be the best call in all situations? Is that possible Nick??

Sometimes you don't need ten to twelve years of education to see the obvious. Sometimes, the proof is in the pudding, and not everyone needs a 10 million study to tell them Vitamin C is good for you or that you should be eliminating your bowels on a very regular basis and it is NOT "what is normal for you is normal", which is the speech MD's love to give. Common sense alone can refute that.

Also, as a final note...if you have lost your own ability to see, view and percieve the human body for the awesome creation it is and respect it as such, maybe you are in the wrong type of work or possibly you are in it for the wrong reasons? If you truly care for your patients, then I appreciate your skepticism, but that skepticism will only be eliminated by educating yourself in the school of thought natural medicine comes out of. You do have to do alot of your own research to decifer what is truth and what is propaganda or distorted. Something tells me that you are quite capable of doing this. I suggest you start with what you like, scientific proof, and go take a course in functional medicine at the Institute of Functional medicine
http://www.functionalmedicine.org/ . You may also like to look into Dr. Weatherby and Dr Grisanti's course. Their course is https://www.functionalmedicinetraining.com/

Belinda

Posted by: NickG | June 14, 2008 9:53 AM

Belinda and NickG,
I want to comment on NickG's reference to NDs' use of "spells and placebos" and Belinda's response.
There are several ways to look at this.
One is "Belinda is being dissed by NickG who compares her methods to inert pills or worse".
Another one "placebos can be very effective. in absence of something better, they are better than nothing".
Spells themselves can be very powerful, people die after being cursed by a witch doctor because in their culture they think that's how things work.
Ted Kaptchuk 'Web that has no weaver' was used in an introduction course to Chinese Medicine at Bastyr. I borrowed this book from a student and really enjoyed it.
I also read about T. Kaptchuk's further adventures. He was
challenged by one of his Harvard colleagues on whether or not the effects Ted attributed to Chinese Medicine were simply due to placebo effect.
He took this challenge and actually became a noted researcher into placebo effect. One of his studies I recall reading about showed that having a receptionist, wearing a white coat and a stethoscope around one's shoulders were all very significant in convincing the patients that the practitioner they were seeing was someone capable.
Placebos are all around us.
Using them effectively could make a world of difference, I imagine a truly great doctor using them to a most beneficial effect. I recall one example in 'Web that has no weaver'.
An old Chinese doctor who is an incredible diagnostician. He recognizes that the patient who just walked into examination room is missing a spleen (I think) within seconds without ever exchanging words with a patient.
NickG, Belinda, is this something you could easily accomplish?
If this indeed something very difficult to do, I imagine someone so observant can do a lot of good using a treatment that is 'just' a placebo.

@Hermano -- sorry about taking so long to respond --

Would such record keeping satisfy your concerns, if not, what other kinds of records would you require?

Actually, no, they wouldn't satisfy me. They are a start, but the real problem is attached to (5) evidence of evaluation and instructions given to the patient, including
acknowledgment by the patient in writing that, if deemed necessary by the registered naturopathic doctor, the patient has been advised to consult with another health care provider. -- This is good but doesn't go far enough. It does not provide any guarantee as to the skill of the naturopath to recognise conditions which require consultation with another health care provider. It does not provide a legal requirement for the the naturopath to provide the advice to see another health care provider in the case that such a condition is detected.

What I want is some sort of audit/guarantee that the education of a naturopath includes the knowledge of conditions and diagnostic pathways that MDs get. There is no way that education alone can eliminate either stupidity or incompetence, but there has to be a minimum standard. We have some reason to trust that MDs meet a minimum standard. If naturopaths are offered as an alternative, then they need to demonstrate the same minimum standard of knowledge and legal obligation to act in the patient's best interest, even if it deprives him of business. Do you think that is unreasonable?

Off the subject, are you related to stellaluna_the_bat?

Not to my knowledge. Do I even know stellaluna_the_bat?

I've been asked by Greg Laden if I were a reincarnation of his pet moggy, too. I am unrelated to any such mammals, to any close degree.

By Luna_the_cat (not verified) on 16 Jun 2008 #permalink

@Luna
Stella Luna is an illustrated children's book about a baby
fruit bat, http://www.amazon.com/Stellaluna-Janell-Cannon/dp/0152802177.
As far as "What I want is some sort of audit/guarantee that the education of a naturopath includes the knowledge of conditions and diagnostic pathways that MDs get."
ND students do study differential diagnosis. I have not found anything comparing ND and MD training in DDx in 1 minute online search.
Here is something from the CCNM (Canadian College of Naturopathic Medicine, an CNME member school, approved for
those who want to register as NDs in Minnesota)
http://www.ccnm.edu/files/pdfs/prospective_students/Viewpiece_13sept06s…

"Clinical internships augment classroom training in subject areas such as:
BIO-MEDICAL SCIENCES

ANATOMY
PHYSIOLOGY
PATHOLOGY
BIOCHEMISTRY
IMMUNOLOGY
PHARMACOLOGY

NATUROPATHIC SCIENCES

CLINICAL NUTRITION
BOTANICAL MEDICINE
ASIAN MEDICINE
HOMEOPATHY
PHYSICAL MEDICINE
LIFESTYLE COUNSELLING

CLINICAL EDUCATION

DIFFERENTIAL DIAGNOSIS
LABORATORY DIAGNOSIS
INTEGRATED CLINICAL STUDIES
PEDIATRICS
PRIMARY CARE
WOMENS HEALTH"

Hermano,

I do agree with you in the power of a placebo, or rather the power of suggestion, the mind and that of belief....which is what apparently activates the success of the placebo.

This forum strikes as the more analytical, only give me science in black and white type of individuals. And thats perfectly okay, they are just as badly needed. There are other people out there who are intrigued enough by the subject of energy medicine and the mind/body connection and they will continue to study and learn more. That will be beneficial for us all. It certainly intrigues me, I find it quite fascinating myself!...:) I am not fearful of having an open mind, and researching something the AMA or FDA states is bunk! I'm an independent thinker and always try to maintain an open mind and an unbiased stance. I don't mind giving credit where credit is too, I do not have to have the credit for my own ego. Not until I see that it's bunk will it be classified as bunk in my mind. I do consider what the AMA and FDA bases their decision on, but I do know very well that politics is a huge part of healthcare in these United States. I take it with a grain of salt, they do not speak gospel in my mind. I don't necessarily desire to fit in, what I desire is truth. I know that corruption is just an unpleasent reality of the day, so in order to by-pass the bias sometimes present or decietfully presented, I try to do my own homework.

For example, there is a doctor in Mexico that was run out of the US due to his "unapproved approach." He is reported to be one of Hitlers "perfect" children when Hitler was trying to create the perfect race. This man is a doctor but he was also a genius by the age of 9. He treats people with cancer in Mexico now. The cost is $12,000 (it may be 22,000, can't remember the price she said) and he utilizes a painless type of energy medicine approach to achieve the results, which are according to my biology teacher astounding. She has friends who went to him and the treatment was a success. He will also be honest with you and tell you if the treatment will work for you or not. Evidently he reports that if the cancer is in the deep tissues of the brain, the energy frequency machine he has created (does Rife ring a bell?) seems to have a lesser impact. Once the cancer is gone, should it ever return he will re-treat you at no cost. This of course is hearsay at this point, but I have asked her to please get his name for me so that I can search him out. Just in case I or someone in my family ever need him...:) I have no problem learning from these types of individuals either, I'd like to see for myself.

Cancer is probably the only emergerent type case I would anguish over referring to allopathic medicine. They are so locked into their box of cut, burn or poison to cure?? and too many times the treatment is a failure that only succeeded in creating total misery for those in their last days. I, personally, do not sway people either way, because I understand that power of belief and the medicinal effect it can generate. If someone believes strongly something works, it creates a greater possibility that it will. And since I know I don't have all the answers, I will offer common sense approach for biological and psychological support if they decide (on their own) to go the allopathic way of treating cancer.

Cancer is a billion dollar business, whose profits grow daily and whose disease process is epidemic at this point, in my opinion. The two cancer societies are the two richest "non-profit(?)" in the history of the world, yet have done little in the area of research to prevent, they are focused only on treatment...of course, patentable treatment. They have made very little headway in all these years in the area of cancer cure; the word cure seems to be one of those four letter words in allopathic medicine. They are aware however (the cancer institutes), thanks in large part to Dr. Epstein, of major causative factors of cancer, yet have done nothing to address eliminating these causative factors from our lives. Nor do you hear its wisdom or truth broadcast over the airwaves. Will I consider an alternative should I ever be faced with dealing with cancer? Absolutely, there is not a doubt in my mind.

I am a bit different than most of those here on this forum possibly. I don't necessarily always need a billion dollar study to back up my beliefs or tell me how to think or to give me proof something works. For example, to just use a car as an analogy. I don't have to know all the intricacies of how an engine works, I just need to know that if I keep fuel, oil and water in it, when I turn the key it works and gets me where I need to be. I guess I could go invest a million dollars to figure out every little mechansim of action before I turn the key but I see others who have turned the key on the road and are cruising along just fine. I would learn and understand more information should I spend that million dollars and it may produce further development and discovery in the future. But in the lack of such an approach and the lack of a million dollars to study it....I can learn by simple observation that no harm is done, and that the car actually thrives when I give it fuel, oil and water. Some areas of natural medicine and energy medicine are akin to this. Since it is not patentable, there is little incentive to invest in the research of it. Just a simple case of economics. Many other countries have done studies and are more knowledgeable in some of these areas, and you can also learn from them. They do better in their countries in the area of healthcare than we do, so they must be doing something right!

Some doctors are very fearful of looking as the king in the emperors' new clothes, and they do not wish to pursue "scientifcally unproven" modalities that by observation are producing benefit. These types of individuals find their comfort zone in the proveable realm. This is where they do best. And there's nothing wrong with that. Thank God we are all so different, and each of us has talents, gifts, and different interests. But thank goodness there are those who thrive on pioneering and discovery, they will continue to learn and make more visible the un-visible realm.

As Arthur Schopenhauer, Philosopher, 1788-1860 said, "All truth passes through three stages. First, it is ridiculed, second it is violently opposed, and third, it is accepted as self-evident." Natural medicine and alternative medicine are in that phase of ridicule and violent opposition, some of that is due in part to pride, fear and ignorance. Some of it is due to a lack of ability to control, therefore profit. Some is due to fear of change. Some of it is due to looking foolish as the process is understood more fully. But I believe Arthur was a very wise, insightful man and he was correct in his assessment.
One day more will be understood as self-evident, thanks in part to those who are out there that are brave enough or curious and interested enough to think out of the box.

Have a good day Hermano. (And yes, I did mention God again here didn't I....lol. Thanks for the warning though!)

Belinda

Belinda,
I am not sure naturopathic medicine will ever become recognized as a "self-evident" truth.
The reason has to do with the fact that, as some say, there is only one medicine.
It contains an awful lot of junk whether it is labeled "alternative", "conventional", or "traditional".
It is messy, like life.
Ultimately medicine is only as good as its practitioner. Arguing advantages of one type over another boils down to the puerile kung-fu argument: "My kung-fu is stronger than yours".
All have much to offer.
There is definitely more than science to life and to medicine.
The tradition of rigorous scientific inquiry is one of the greatest achievements of humanity.
Yet, to paraphrase Einstein, "Things must be made as scientific as possible, but no more scientific than that."
The pseudo-skeptical pseudo-scientific reductionism of fixing naturopathic medicine as quackery is the manifestation of extremism that will never prevail in medicine, science, or in general. Not because most of the people are morons, but because there are brilliant people such as Stephen Jay Gould who recognize that there is more to life than this crass materialistic reductionism, or whatever you would call it.
It is imperative not to accept all fads without questioning. I just heard about someone in my neighborhood, who simply "adores" going to an unlicensed health care provider with all kinds of "machines".
I suspect these machines are the same ones profiled in this
investigative report http://seattletimes.nwsource.com/html/localnews/2004020598_miraclesplit….
I only know one person who went to Mexico to seek cancer cure.
While there, she became extremely ill, and was fortunate to come back in time to get the treatment her "conventional" oncologist recommended in the first place, a bone marrow transplant. She has been doing well last few years.
I think the more bizarre claims are the most suspicious you must be. Hitler's "perfect child" curing throngs in Mexico.
I don't know what to say. He would be in his 60s now.
Could he actually be from South America and not from Central, with one of the "Boys from Brazil" for father?

Hermano,

I think many things in the future will be considered "self evident" that are perhaps not viewed that way today. Just think of the guy who first said, "not washing our hands before surgery or deliveries is doing harm to the patient." Seems extremely logical and a no brainer, yet the "experts" of the day riduculed the man unmercifully for his acute observation. Yet today, we considered it common knowledge, as if everybody should just know that!...lol. It was an unfortunate episode and if memory serves me correctly here, it destroyed this man's career for his very simple perspective and solution that turned out was truth.

There are multiple schools of thought out there, allopathic and naturopathic just the primary here. They all have gold nuggets to be found and to be used by the keen observer. I'm not sure where this .... there is only one medicine thinking comes from. Just as there are many roads to Rome, perhaps there are also many roads to health. It doesn't matter which road you use, as long as it gets you there.

I think to reduce medicine or healing using a materialistic reductionist type of mindset is allowing yourself to believe in a fallacy that you are determined to make truth. Just as cancer is a multi-factorial disease process, so in many ways is healing. Reductionist type thinking which is popular in allopathic medicine has resulted in "compartmentalized" health approach. I believe that things are not always that simple. We are complex entities and are more than flesh and everything is interconnected within the human form. I stand in more agreement in the holistic or wholistic viewpoint that naturopathic medicine holds.

I don't not know either who the guys father is in Mexico that came out of Hitler's prodigy. I'm not sure of its relavence. But one other thing she said, the biology teacher, was that as a young child if he rebelled and refused to study he was punished. His punishment was standing in a barrel of water on his tippy toes for 24 hours, if he went flat on his feet for long, he would drown. He is reported as saying that after the third time in the barrel, he just decided to study! This may be a good one for the nature vs nuture people to argue all the day long. The point I was really trying to convey with that story, was to give you a case in point. This mans was run out of town for his approach to cancer, yet people have seemed to follow him across the border. They pay out of pocket for treatment by him and according to the biology teachers acquaintances, successful treatment. I was just saying that this type of individual, although black balled by the "experts" of the day, I find interesting. I would not hesitate to sit down and discuss and converse with this man his approach without a prejudice frame of mind. If he would let me hang around a while and see for myself how he believes this is all working to produce health in the human form, I would be most grateful. I would be most interested in learning how he navigates and what his thoughts are about how the process is working. After the time spent, it may or may not resonate with me, but the only way I can find that out is to experience such a visit and sit down and pick this mans brain, so to speak...lol.

I believe in this country, if MD's and ND's would / could work together, we may for the first time be #1 in healthcare here in the US. I do understand that some standards need to be instituted and it would be helpful for us all to be on the same page when conversing with one another. But I would hate to see ND's confined to a box as MD's are and to be under AMA and insurance agencies control and dictorship. People pay out of pocket, they pay cash, in most instances for ND care mostly in part due to the fact that AMA has not granted its holy grail "stamp of approval" on it." I know some ND's who stay booked, and the people come back for follow ups, all the while paying cash. I find that very interesting, and I don't consider that all people are unintelligent and just too stupid to realize they are getting ripped off. I know many intelligent people that utilize natural medicine. Even the Queen of England that passed recently at a very old age had a naturopathic doctor. She could have had anyone, but her choice of physician was a natural doc. Isn't that interesting?

I find politics in medicine to be the biggest obstacle here for growth in our ability to heal others. That is unfortunate and a dis-service to the people it reports to serve. Things do need to change, and if it has come to a point where the people are now demanding change, perhaps this will motivate those who control medicine here in the US to re-think their position.

Belinda

Just as an additional note to the above entry, I would also like to say that the reductionist, compartmentalized approach has served allopathic medicine well in its excellence in emergency situations. When time is a huge factor, finding out quickly how to stablize this patient, is the priority of the moment. This is perhaps why allopathic medicine surpasses naturopathic medicine in emergency situations. Cleansing, re-balancing and re-building the system takes time. Here however, is where naturopathic medicine excells.

Belinda

Cleansing, re-balancing and re-building the system

Perhaps you could explain what that means, with useful references?

Belinda,

you wrote "I think to reduce medicine or healing using a materialistic reductionist type of mindset is allowing yourself to believe in a fallacy that you are determined to make truth."
I just read a brilliant thread regarding this on this very blog
http://scienceblogs.com/denialism/2008/06/why_good_medicine_requires_ma…
I am extremely impressed with the comments by Bob Koepp,
I hope you will reading them as much as I did.

Regarding excellence of conventional medicine as trauma medicine, there is no question. Much of this expertise came out of the experience treating wounded during the wars.
Incidentally, osteopathic medical profession gained parity with MDs by first gaining access to national service in the medical corps of the armed forces in the 1960s.

Regards.

Hey....just wanted to say I haven't forgotten about you guys. Just extremely busy, but I will get back to this as soon as I can.

Have a great day!

Belinda

Hermano,

I did review the article by Bob Koepp, and frankly I am unimpressed. I respect his viewpoint, but I feel he only holds one piece of the puzzle. I do not see medicine and healing as the one dimensional entity that he obviously feels very strongly about. To believe in this philosophy he prescribes to only leads to a short sighted, narrow minded approach which will only have limited success. Humans are more than flesh, which is all he obviously can see or is the only "safe" belief for him. Safe because he has the "proof" there that he can see in the black and white, and no one can refute him or the fact that .... yes we are flesh. But aren't we so much more than that?? To believe that we are merely flesh or to believe in this fallacy he promotes is pure ignorance in my opinion.

Belinda
PS...Sorry, its taken so long to get back here.

Dear PalMD,

You wrote: Cleansing, re-balancing and re-building the system
Perhaps you could explain what that means, with useful references?

Posted by: PalMD | June 19, 2008 10:46 AM

RESPONSE:
Please forgive my delay in getting back to you but...

You very short question would take mounds of information to explain and more time to research the references to support it, and quite frankly I do not have the time to do anyones homework for them. It will be more meaningful to you anyway, if you do your own research. I will however, do my best to explain from a very logical standpoint what it all means.

Cleansing: based on some of the following thought process.....
1. exposure to more enviormental toxins than previous generations..ie..personal care products, air, water, food, pharmaceutical meds etc.
2. greater intake of fast food, unhealthy nutritional choices and processed foods.
3. greater number of toxins, preservatives, hormones, colorings etc in the food supply which we ingest and leave the body to detoxify.
4. greater incidence of sedentary lifestyles in this generation.

For these reasons and some not mentioned we have a sluggish system that cannot adequately handle the load our generation endures. Yes, we do have a built in detoxification system, of which I am sure you are aware of....phase 1 and phase 2 and the various detoxification pathways within the body. Although the FDA does admit that these factors we are exposed to are indeed harmful in large amounts, it allows for a certain percentage of these ingredients into our food supply and other products. They seem to hold on to the belief that our bodies can handle a certain dose of poison, however, they totally disregard the accummulative effect of these toxins. Also, they assume that each and everyones built in detoxification systems are working efficiently. Most ingredients however, the FDA does not even research or know what the effects on the body are, yet they are still allowed in our everyday products. Add to this equation, allopathics belief that frequent and consistent bowel eliminations are not a priority, and you get a recipe for increasing the possiblity of a disease manifestation / ill health.

This leads to the next logical question.....how do you cleanse? That would be a book in itself, not due necessarily to its complexity but due to its various and numerous approaches. I do not have time to write that book today.. ;)

RE-BALANCING:
based on the following thought processes:
--- the body functions most efficiently and effectively if its biochemical system is balanced. The chemistry should be analyzed and brought back to an acceptable balance. This can be done in most cases by supplementing its needs for short periords of time, as well as improving quality of the diet, educating the patient and altering / improving lifestyle factors.

RE-BUILDING
----- much of this is addressed in the re-balancing phase, but also if the individual has been exposed to antibiotics, birth control pills and some other pharmaceuticals etc, probiotics should be considered. Probiotics are strongly associated with ones immune system and are depleted due to various factors. Antibiotics wipe out the good and bad bacteria and it is not widely advised by the most popular mainstream medicine to replace that good bacteria in the form of probiotics once the antibiotic is completed. This is a practice allopathic should be looking at if the health of a patient is the desired outcome. To ignore this basic practice / principle is to set the patient up for a less than efficient immune functioning system which can lead to poor health down the road and the greater possibilty of disease occurence.

This is the process in a nutshell, and I do apologize for the lack of time to provide you with a more thorough explanation. Alot of what you seek or are interested in questioning is not neatly packaged and you will have to seek out the information for yourself. Having to ability to think independently, utilize common sense and put pieces together will serve you well in your pursuit.

Have a great day!
Belinda

You very short question would take mounds of information to explain and more time to research the references to support it, and quite frankly I do not have the time to do anyones homework for them. It will be more meaningful to you anyway, if you do your own research. I will however, do my best to explain from a very logical standpoint what it all means.

And therein lies the problem. I've done my research, you have not. EVerything you state is fantasy with no grounding in medical science.

Do you think it is possible PalMD that the true problem lies in your arrogance?? A good place for you to start learning some true science is at the Institute of Functional Medicine, a simple google can land you there.

Good luck to you,

Belinda

By Anonymous (not verified) on 20 Aug 2008 #permalink

Yeah, PalMD! You, the person who spent many years in medical school and more years doing research and actually WORKING in medicine, are arrogant for knowing all of those actual "facts" and exposing the ignorance of someone who... um... hasn't.

Lance.....

I was in no way insulting PalMD, I was simply making an observation based on his attitude and words. He was assuming that he has done all the research and I have done none, and the truth is that no one could possibly have studied, reviewed, and comprehended all the research that is out there. That is the only fantasy I see prevailing in this correspondence. There is an overwhelming volume of research and more continues to come forth everyday. There is no way, unless you have absolutely no life, and even then it would be difficult for one person to digest all the research available. Also, there are different schools of thought which produces different research, and it is quite possible that we research in different areas. For one person to assume that he knows all there is to know and he can be taught no more is pure folly, pure arrogance. With all due respect, there is only one "all-knowing" God in my opinion and I do not believe his name is PalMD. PalMD may have been a bit peeved because I did not spoon feed him his requested information due to a lack of time, so he decided to come back at me with a cheap shot. I have no doubt that he is an intelligent man who has done research, I'm just saying he has not covered all the research. However, I did point him in one direction of valid, scientific research in case he is sincerely interested. Arrogance can be a huge stumbling block to anyone who is seeking truth.

Another point I would like to make to you Lance, and you may take this as a total shock, but I have no desire to become or be an allopathic physician. If my passion lie in emergency medicine, plastic surgery or orthopedics then I would consider allopathic, but my interest / passion is not in this area. I am, however, thankful for those whose have pursued this path. There are many intelligent people out there Lance who have not chosen allopathic medicine, so please don't make the mistake of discounting their value and their worth.

Have a good day!

Belinda

I'm confused, Belinda. Are you saying that because research is hard, you shouldn't do it? I've done my research, despite the fact that it's "hard".

I'm sorry PalMD, but I do not recall saying doing research is hard. You have misunderstood / misinterpreted my response. What I said was that there is an abundance of research out there, and you could not have possibly reviewed it all. Perhaps in your own mind, you feel you know it all. I do not pretend to know it all. Thats the difference between me and you.

Belinda

Exactly what I said.

I have extensively reviewed the available literature, and you've made it up as you went along. Excellent.

Which available literature?? Which particular area have you reviewed? What is it you research exactly PalMD?