Sh*t naturopaths say, part 2: Naturopathic education and science

Well, Naturopathic Medicine Week 2014 (or, as I like to refer to it, Quackery Week) is fast drawing to a close; so I figured I’d end it with one last post. Since several of you liked my post a couple of days ago Sh*t naturopaths say and agreed with me when I suggested at the end that I ought to make this a recurring feature on the old blog here. So, how better to finish off Naturopathic Medicine Week 2014 than with another installment of Sh*t naturopaths say. In fact, I might even have to make it a tag. After all, I’m sure naturopaths will continue to provide me with quackery to deconstruct, and my only regret is that I didn’t think of this tag a long time ago. I’m sure it will serve me well in the future.

After I decided to do one more installments, I was immediately faced with the problem of choosing the next batch of pseudoscience and nonsense from the Read what naturopaths say to one another. Conclusion: manipulative, poorly trained, and a threat to public health subreddit. Sadly, I hadn’t exhausted what was there in my first post. But then I was made aware of this exceedingly “target-rich” environment by a naturopath named Michele Burklund entitled What Everybody Ought To Know About Naturopathic Doctors, and I knew that I had to start there, first, although a couple of key quotes from the subreddit will help me tie everything together.

I will admit that Burklund does have a bit of a sense of humor in that she includes a couple of pictures in her article. One, captioned “What a naturopathic doctor looks like” shows a woman whom I presume to be Burklund in a lab coat with a stethoscope around her neck. The other, captioned "what people think we look like" shows a model dressed up looking like shaman or aboriginal who is nonetheless obviously a model not just because the photo is credited to a Vogue editorial shoot. I couldn’t resist doing a quick Google image search, which led me straight to this photoshoot of Hailey Clauson shot by Sebastian Kim (second photo, to be precise), which is one of the more ridiculous photoshoots I’ve ever seen. I mean, look at the designer try to make a model look like she’s in some sort of prehistoric tribe. Very silly indeed, not to mention condescending (perhaps even a little racist), although I can see why Burklund would want to look like Clauson, given how gorgeous she is, even made up to look as though she's a member of a prehistoric tribe. (One of these days I'll have to compare myself to John Hamm in a post, because, you know, I'd really like to look like him. Or maybe John Slattery would be more realistic, given how gray my hair has become.) I can also see how appropriate that photo is, because just as naturopaths are fake doctors they're also fake "shamans," made to look as acceptable as possible to white, affluent people, hiding the superstitious, vitalistic, and pre-scientific nature of most of the treatments they like to use.

[NOTE: Since this post went live, it would appear that Burklund removed that photo and substituted one of her with her face painted, which is probably an improvement over the original, at least taken in context.]

Be that as it may, it’s obvious that Burklund wants to make fun of the image of naturopaths as witch doctors, which is self-deprecatingly great, but in reality, when you look at what naturopaths advocate and what they do, it’s hard not to conclude that they have much in common with witch doctors or shamans. As a commenter said in my earlier post, if you transplanted 16th century “healers” into present-day society and gave them access to drugs (and human beings to experiment on), the results would be much the same as what naturopaths do. I’d go a bit further and say that you could transplant shamans from aboriginal tribes or possibly even Egyptian priest-healers from 3,000 years ago and the result would be similar. The reason is that much of what naturopaths do is rooted in prescientific vitalism.

So back to Burklund’s point, which begins:

It seems like if you don't live on the West Coast or in a large city people have absolutely no idea what naturopathic doctors are or the training they have. They will probably confuse a ND with a nutritionist, homeopath, health coach, witch, or some weirdo selling snake oil. ND's are definitely the underdog in the medical system with roughly 5,000 practicing in the United States while there are 893,851 practicing MD's. But that's no reason to give up... some of the most inspiring people in the world came from situations that bet against them. The solution is education, if people really knew the training and education that naturopathic doctors have they would be lining up at their clinics begging for a fresh perspective on their health. That is where Naturopathic Medicine Week Comes in! Education is empowerment.

Burklund might have a point if what she was doing was actually educating about naturopathy, but that’s not what she’s about. She’s about trying to “prove” that naturopathy is just as good as conventional medicine, and she goes to ridiculous extremes to do it, in the process recycling every deceptive argument naturopaths make to try to make it appear as though they really and truly are “scientific.” It’s the same reason why she keeps using the term “naturopathic physician” rather than “naturopath.” Hilariously, she shows graph after graph that supposedly shows that naturopaths take just as much or more basic science as medical students in terms of sheer credit hours. Of course, credit hours mean nothing if what is being taught is substandard and/or being used in the service of teaching quackery.

And, boy, is there a lot of quackery in the curricula of naturopathy schools, as demonstrated by Burkland herself. She tries to differentiate what is taught in the seven “elite” schools of naturopathy; i.e., the accredited ones, which include:

  • Bastyr University
  • National College of Natural Medicine
  • National University of Health Sciences
  • Southwest College of Naturopathic Medicine
  • University of Bridgeport
  • Canadian College of Naturopathic Medicine
  • Boucher University

This is the table:

Naturopath

What leaps right out at me that differentiates real doctors from naturopaths is not so much the hours of basic science but rather the clinical instruction. Sure, Yale, Johns Hopkins, and the Medical College of Wisconsin (not sure why Burkland chose that one) have similar hours of instruction in basic and clinical sciences, including anatomy, cell biology, physiology, histology, pathology, biochemistry, pharmacology, lab diagnosis, etc., but conventional medical schools have more instruction in clinical clerkships in the main specialties, like family medicine, surgery, pediatrics, OB/GYN, etc. The difference is made up in naturopathy schools by the woo, with 500-600 hours of homeopathy, hydrotherapy, manipulative therapy, botanical medicine, naturopathic philosophy, and advanced naturopathic therapeutics (whatever that means). Let’s just put it this way. Naturopaths have taken around 750 hours away from the core clinical specialties and moved them to quackery like what I just listed above and 150 hours of “therapeutic nutrition,” or the “food as medicine” schtick. This leads Burkland to warn people against those “other” naturopaths who haven’t undertaken the rigorous coursework she claims for naturopaths like her.

Again, any training that includes homeopathy and traditional Chinese medicine as scientifically valid treatments cannot be considered either science- or evidence-based, concluding:

Upon graduation a naturopathic doctor will have completed over 310 doctorate level credit hours and over 1500 clinical hours seeing a minimum of 350 patients and 144 preceptorship hours (with our choice of an MD, ND, DC, or DO). Naturopathic doctors are trained as primary care physicians from the first day of medical school which is much different than M.D's which choose a speciality upon completion of school.

Uh, yes, but that’s because a medical doctor isn’t considered fully trained until he or she has completed a minimum of a three year residency. That’s the minimum. For instance, internists do three year residencies, after which they can sit for the internal medicine board exam. Other residencies are longer. General surgery, for instance (and most surgical specialties, like urology or orthopedics, for example) are five year residencies, often with a year or two of research thrown in. Then many physicians add a fellowship ranging from one to four years after that to subspecialize. Even so, the least “differentiated,” least “specialized” primary care medical doctors have at least three years of residency. Many have a lot more. I’m referring to the residencies that used to involve 100+ hour weeks and call schedules ranging from every fourth night to every other night. The call and hours are less brutal now, but naturopathic residencies are nowhere near as rigorous, either in time or clinical practice, as the training for MDs. Jann Bellamy detailed this disparity very well not too long ago. It’s well worth a read. As she pointed out, the Council on Naturopathic Medical Education (CNME) only requires:

CNME requires a total of 1200 clock hours (15 weeks) of clinical training. Of these, only 850 hours (less than 11 weeks) must involve primary or secondary responsibility for patient care. The student must have at least 450 “separately scheduled patient interactions” during this training (including those in preceptorship). In 225 of these patient interactions, the student must be working in “primary capacity in assessment and/or treatment” under faculty supervision. No further definition of “patient interaction” is given, but, by way of comparison, a family practice M.D. will typically see 20-25 patients per day. Making the (likely safe) assumption that each of these constitutes the M.D. acting in a “primary capacity in assessment and/or treatment,” and using an average of 22.5 patients per day, the entirely of N.D. clinical education involving primary responsibility for assessing and treating patients is the equivalent of as little as 10 days of real-world family practice. Even being extremely generous, and counting all 450 “patient interactions,” that’s 20 days in a family practitioner’s office.

To be fair, a family practice residency includes a lot of inpatient rotations on the core specialty services, like medicine or OB/GYN and is not all clinic. However, residents generally maintain their own outpatient clinic during the course of the three year residency during their rotations and then rotate on various services where they cover clinic; by any reasonable measure they see and do a lot more than any naturopath trainee. Also, as Jann pointed out, much of what naturopaths learn has little or nothing to do with how to use prescription drugs, using instead for “treatments” like IV vitamin “cocktails,” hormone prescriptions, antibiotics for parasites or infections as part of “detoxification” therapy, or injection therapy for pain (neural, trigger point and prolotherapy). The sheer number of instruction hours in medical school does not a physician make, nor does the sheer number of instruction hours in a school of naturopathy make it as rigorous as a medical school.

Unfortunately, these arguments resonate, because numbers are easy to compare. It’s far easier to compare, for example, number of instruction hours among institutions than it is to compare the rigor of the programs and the appropriateness of what is taught. Let me tell you that the instruction in medical school is incredibly content-dense. An incredible amount of material is covered in a very short period of time, far more material per time period than in schools of naturopathy, I'll warrant.

We can see the results of this sort of instruction in the Read what naturopaths say to one another subreddit, specifically the Defense of naturopathic medicine. The thread starts out with a naturopath asking for, well, let me just quote her:

Although I am generally a very non-confrontational person and avoid argument as much as possible, I would really like to have an arsenal of the most irrefutable, scientifically based evidence for naturopathic medicine, for those instances when I feel I need to defend our profession to those who will only listen to this sort of proof.

In that spirit, I am hoping to start a thread where you, my colleagues, will post links to the best studies proving that what we do works. If you don't have links, journal/article information is great, too. The more iron-clad the study, the better (e.g. double blind, placebo trials, etc), but feel free to submit anything you feel is worthy.

Obviously I know what I do works, and obviously my patients know. This is for those who are hell-bent on denying, and may only be swayed by scientific proof.

Note the final sentence. “I know what I do works.” Taken in context, what this naturopath, Ruth Galbraith, says is basically: I don’t need no steekin’ evidence for what works. I know. But those pesky skeptics demand evidence! So could you guys spoon feed me some studies that I can use to deflect that criticism? Evidence here is not needed to support what Galbraith does in her practice, but rather as a shield and a sword to wield against those annoying skeptics who will only accept evidence from science and randomized clinical trials.

In response, one naturopath, Jim Prego, demonstrates one of the most massive cases of projection I’ve seen in a long time:

In my interactions with the above type of person, I have found that they are never swayed by the scientific proof they say they are only swayed by. Every person I have ran into that is against naturopathic medicine because "there is no research to support it" or "its not evidence based medicine", etc, has always made excuses as to why they wont look at or belive any research I show them that dosen't support their position. Thats why I have given up on doing it. They just have a position and they only will belive research that supports their pre-determined conclusion.

Or maybe Mr. Prego just isn’t very good at providing evidence to support his viewpoint that is of sufficient scientific quality to convince a skeptic. As I’ve said time and time again, show me the science. Show me the evidence. I keep looking, hoping that sometime someone will show me to have been wrong about some treatment in alternative medicine, for the simple reason that it would be cool if some of these modalities actually did something greater than placebo. I’m still looking.

Of course, it doesn’t take long for a naturopath named Daniel Crupper to make charges of corruption, ignoring the lack of evidence for naturopathic interventions themselves:

...when we look at the reality of our position we must really understand what game we are playing and how it is played. Right now the game is called "Evidence Based Medicine" and in every major medical school across the nation that is the phrase used to teach MDs and DOs that what they are doing is the best medicine and that our medicine is fold medicine with no scientific evidence behind it. We could complain that their system isn't fair (because it isn't) or that it fails to look at individuals outcomes (because it doesn't) but that misses the point. That is akin to sitting down at a blackjack table and arguing that the odds aren't fair and we should all play poker. Those complaints won't make a change. The point is the current medical system is the controlling system and therefore chooses how medicine is defined. To be able to overcome that system we need to understand it's rules and beat them at their own game. Unlike Ruth, I am argumentative and take any confrontation as a challenge. I like to look for holes in the current model and specifically in the "evidence based medicine" argument. I also like to look for research articles that uphold naturopathic medical values. That is the way we beat them at their own game! 1) There is already a tremendous amount of "evidence based" research in our favor that never comes forward because there is no company marketing it. Steve Austin does a great job of compiling nutrition literature every year and presents it at the AANP conference. For instance, last year he had journal reference for topics such as increasing water intake decreases colon cancer 92%, flaxseed lignan decreases BPH and likely cancer, antioxidants create 25-45% hearing improvement, antioxidants statistically improve arthritis and psoriasis, the list goes on and on! He specifically asked if anyone would be willing to start a compendium of "evidence based" botanical research. 2) I like to tell challengers how naive it is to believe the "evidence based" medicine they hear about when it is funded by the company that stands to gain from it. I start using recent evidence of research tampering and fear tactics to prove my case. For instance, the use of medical ghost writers for research...

Increasing water intake decreases colon cancer by 92%? WTF? This is research I have never heard of; so I did some searching. What I found was a study that concluded that water consumption did correlate (although in a barely statistically significant manner) with a lower risk of colon cancer in women and that “water consumption was marginally associated with a decreased colon cancer risk among men as well (OR for > 4 glasses/day versus no statistically significant effect. I finally located the study. It’s small, and it found a statistically significant effect only for men; for women it wasn’t statistically significant. Also, it wasn’t clear if the effect was due to exercise (which is associated with more water intake) or the water intake itself. All in all, the evidence for this assertion is thin gruel. Of course, even if this observation held up, then science-based practitioners would recommend more water intake. It would cease to be “alternative” or “naturopathic” medicine and be just medicine, which is as it should be.

Later in the same e-mail, Crupper admits it’s all about the marketing:

Oh, and one more thing. I agree with Dr. Godby that we need a marketing campaign so that people know who we are. However, I think it would be wise if we had our "evidence based" arguments in order so that when people start asking us questions pertaining to the current medical model we have research to argue within that construct. Otherwise, to the public, we come away sounding like we are trying to make excuses for why it isn't fair to judge our medicine by the current standard. If we are armed to the teeth with "evidence based" retorts we sound better educated at their own system than they are. Then we are ready for a marketing campaign.

Notice a theme here? Crupper sees science and scientific evidence as nothing more than a tool to “prove” that naturopathy is evidence-based. I’ll give him credit for recognizing the perils of special pleading (“we come away sounding like we are trying to make excuses for why it isn't fair to judge our medicine by the current standard”) as a logical fallacy, but it’s only strategic. On the other hand, some naturopaths live by special pleading. Jim Prego, for instance:

So, because MD/DOs do something, why do we have to? Yes, they are the dominant system, but why let them define the terms for OUR sucess? They choose how their medicine is defined, not ours. To use your analogy, Blackjack might be the big popular game but if I am a poker player and I show up at a blackjack table, I will just leave and go to the poker table. If there is no poker table, and I am motivated enough, I will open a casino for poker players without trying to make it look like blackjack, or trying to convince the blackjack die-hards that poker is just like blackjack.

In other words, screw evidence-based medicine. We naturopaths don’t need it and don’t want it. It’s a “game.” There’s the difference between naturopathic education and "science" and medical education and "science. Unfortunately, I fear some of the attitude of naturopaths is infiltrating itself into conventional medicine in the form of quackademic medicine.

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DR (MD I guess).

Only 1 question for you, and a little story?

Question, why MD's cannot cure Acid Re-flux?

Story., Based on a ND direction, Seth that suffer 13 years from Acid Reflux while on medications, with severe side effects in the supervision of 3 different MDs, was Acid Re-flux FREE in 4 DAYS.

A month later he was free from all his side effects , sleeping like "never" before and full of energy.

"Your" MD's were screwing him up for 13 years.

So can you please answer to me why your Smart MD's can not cure something so basic like Acid Re-flux?

Giora Zeevy
Health Coach

By Giora Zeevy (not verified) on 10 Oct 2014 #permalink

This is for those who are hell-bent on denying, and may only be swayed by scientific proof.

Funny. We are just expected to take the ND word for it.
And mainstream medicine/science is the one seen as patronizing or elitist.

By Helianthus (not verified) on 10 Oct 2014 #permalink

"They will probably confuse a ND with...some weirdo selling snake oil. "

Well, yes.

By Dangerous Bacon (not verified) on 10 Oct 2014 #permalink

I suspect that alt-med advocates don't want their treatments to gather evidence of efficacy. If (and that's a big IF) one of their cures for cancer repeatedly provided positive results during (non alt-med) trials, it would, as you say, leave the world of alternative medicine and become medicine.
I wonder what their position would be if their cure was sold by Big Pharma. Would it be supported and held as a triumph of alternative medicine or dropped in favour of an average, evidence-less, cure. Are there any recent examples of this happening?
There must be a balance between gathering enough evidence to appear creditable to the public, but not enough to attract conventional medicine's attention. Anecdotal evidence does just that.

By Rational Bee (not verified) on 10 Oct 2014 #permalink

"So can you please answer to me why your Smart MD’s can not cure something so basic like Acid Re-flux?"

We're quite good on lifestyle/diet and drug remedies for reflux.

Re-flux, not so much. It's a dis-ease, and only alties can cure a dis-ease.

By Dangerous Bacon (not verified) on 10 Oct 2014 #permalink

“They will probably confuse a ND with…some weirdo selling snake oil. ”

Well, yes.

No confusion there, actually. More like perceptiveness.

Maybe its just me, but I am heartened by the fact that there are only about 5000 of these screwheads out there.....though even 1 is one too many.

There are only around 5,000 naturopaths who have a "real" ND and are "approved" or licensed. There are lots more naturopaths who went to schools considered substandard by naturopaths like Burkland, which is a scary thought.

So can you please answer to me why your Smart MD’s can not cure something so basic like Acid Re-flux?

They *could* but it's a matter of asthetic -- The waiting room would be pretty bland if not plastered with Purple Pills art and liturature explaining how 'proton pumps' emmit antimatter in the presence of magnesium, iodine, and B12 and why it's ok for food to rot in the stomach. Ohh, and how instances of induced goiter, crumbling bones, and vaginitis (especially in males) is pretty low so long as one doesn't actually follow the recommended dose too tightly after the edema, vomiting, abdominal bloating, and paint-peeling flatulence begin to set in. Also, the material is provided free courteousy of the makers and doctors would have to pay for National Geographic and Woman's Day subscriptions otherwise.

@Giora
13 years and you didn't think to find another doctor? Get a second opinion? Try on your own to alter diet?

Seriously flawed support for NDs. Absurd story of human stupidity.

@ Giora Zeevy

I am curious about the details of the acid refllux case you mentioned:
Were the medications Seth took for 13 years FOR reflux, and did they just not work?
Or were the meds for some other condition, and did the ND conclude the reflex was a side -effect?
What exactly were these meds?
Again, did the MDs diagnose the reflux, but fail to cure it, or was the reflux somehow unknown to them?
If the MD's did NOT diagnose reflux, what complaints or symptoms had 'Seth' reported to them, and what diagnoses for them was he given?
How old was he when he visited the ND after 13 years of suffering?
Did the ND diagnose the reflex the MDs had overlooked, or merely prescribe a treatment for the condition the MDs had noted but not treated effectively?
If the ND made the first diagnosis of reflux, how so? Just via description of symptoms? Tests? What sort?
What did the ND prescribe that had Seth reflux free in 4 days?
Is this cure verfied only by Seth's self report, or has he had an 'upper' inspection by a gastroenterologist since ND produced cure?

I'm just curious about a naturopath approaches this problem...

Oh Orac! That fashion shoot!
And I really needed a laugh today!

Actually I wouldn't be at all surprised if the archaically adorned model knew at least as much about SBM as the ND.

By Denice Walter (not verified) on 10 Oct 2014 #permalink

Sure, Yale, Johns Hopkins, and the Medical College of Wisconsin (not sure why Burkland chose that one) have similar hours of instruction in basic and clinical sciences, including anatomy, cell biology, physiology, histology, pathology, biochemistry, pharmacology, lab diagnosis, etc., but conventional medical schools have more instruction in clinical clerkships in the main specialties, like family medicine, surgery, pediatrics, OB/GYN, etc.

As Orac noted, NDs like to compare classroom hours as opposed to the content. Much like chiropractors, an anatomy class (e.g.) that is taught over three credit hours in med school is taught over six credit hours in chiro or ND school. So sure, the hours may be comparable but the content falls short. Additionally, NDs, like chiros are taught by other NDs and not experts in the discipline so they are getting a very incestuous, low-quality education.

By Science Mom (not verified) on 10 Oct 2014 #permalink

Well I had IBS for many years (starting as a kid). My mother took me from the doctor and was overwhlemingly pissed off when he didn't prescibe any little pills but recommended a change in diet ('who the f**k does he think he is critizing - I know how to feed my child blah blah'). To here credit she did make some dietary changes, but clearly her expectancy and many peoples I believe was that doctors cure with medicine not advice - the medicine is taken, the advise often unheard

So maybe, this patient has gone to a doctor for 13 years with preconcieved notions that the doc will produce a magik pill that cures their ailment and gets pissed off and ignores the docs basic and sound advise to change diet, exercise etc - but then pays someone for the same advice and gets given some groovy sounding supplements (which of course aren't made of chemicals in any way) and woohoo your cured.

Probably should have listened to the first advice their doctor gave them 13 years ago....

About 10 years ago, I was undergoing a great deal of stress and developed reflux. Although I'm not an ND ( thankfully), I was able to successfully treat my condition with over the counter meds and slight dietary changes. Because many relatives suffered from more serious conditions I mimicked what doctors did for them ( I knew I probably didn't have anything more serious because I had no additional symptoms and the reflux was not constant). I found an antacid that functioned as a coating agent and an acid blocker at lower than rx dose.
So far so good ( Knock wood/ touch wood)

So do I get an automatic ND certificate? Not That I want one.

By Denice Walter (not verified) on 10 Oct 2014 #permalink

Question, why MD’s cannot cure Acid Re-flux?

I don't know about acid re-flux (is that like dis-ease?), but in most cases they can cure regular acid reflux, if the patient follows their advice to lose weight, get more exercise, quit smoking, and to avoid food and drink that exacerbate symptoms. Medication and surgery are, or should be, last ditch treatments if lifestyle changes are ineffective, or more often when patients are non-compliant.

Story., Based on a ND direction, Seth that suffer 13 years from Acid Reflux while on medications, with severe side effects in the supervision of 3 different MDs, was Acid Re-flux FREE in 4 DAYS. A month later he was free from all his side effects , sleeping like “never” before and full of energy.

I find it hard to believe any treatment could eliminate GERD in 4 days. Assuming this is a true story, rather than the advertising spiel it resembles, what was the treatment?

By Krebiozen (not verified) on 10 Oct 2014 #permalink

After reading this, I opened my email and found the joke for the day from last night is about shamans!

A shaman told his scout that if he crossed seven rivers, he would come upon a bacon tree. So the scout went across seven rivers, but there he found five men with bows and arrows aiming at him. He went back across the seven rivers and said to his shaman, "There was no bacon tree, and I nearly died!:

The shaman nodded gravely, "I got it wrong. It was actually a hambush."

Somehow it seemed appropriate.

By squirrelelite (not verified) on 10 Oct 2014 #permalink

Kreb @#16
I suffered from GERD for years. I even went so far as to consult a surgeon, who told me if I would just lose 100 pounds it would go away. So I did. And it did. It took longer than 4 days, though. :)

I apologise for my ignorance… Are there naturopaths in the UK who are actually licensed to practice medicine and legally allowed to call themselves physicians or [even worse] primary care physicians? If so then I hope none of them work for or in conjunction with the NHS.

Whether they call themselves naturopaths or need licenses I don't know but ...

from nhs.co.uk

'...but there are several NHS homeopathic hospitals and some GP practices also offer homeopathic treatment.'

And

'Acupuncture is occasionally available on the NHS,'

'Opportunities for CNHC registered practitioners at Barking, Havering and Redbridge University Hospitals Trust Barking, Havering and Redbridge University Hospitals Trust is seeking a complementary therapist to join its small team delivering complementary therapies to cancer patients and their carers. CNHC registered practitioners are invited to apply.more >
Two complementary therapy roles at the Myton Hospices in Warwickshire CNHC registered practitioners are invited to apply for two complementary therapy roles at the Myton Hospices in Warwickshire more >

Last above is from CNHC site and explicitly includes naturopathy and reiki amongst the rest of the woo that these hospitals require - Barking indeed!

Oy, there is a massive amount of fail in that first paragraph.

It seems like if you don’t live on the West Coast or in a large city people have absolutely no idea what naturopathic doctors are or the training they have.

I live in a small town (population 1X,XXX) in New England, and I know what naturopathic "doctors" are. So does regular commenter palindrom (whom I know IRL), who lives in a different, smaller New England town. Naturopathy is not quite as obscure as Burklund would have us think.

They will probably confuse a ND with a nutritionist, homeopath, health coach, witch, or some weirdo selling snake oil.

That would be because naturopaths fall into one or more of those categories. I have no evidence that any of them are witches, but all NDs are homeopaths, many are nutritionists and/or health coaches, and most of them do sell snake oil.

ND’s are definitely the underdog in the medical system with roughly 5,000 practicing in the United States while there are 893,851 practicing MD’s.

Like ancient priestly classes, NDs are purported to have special knowledge known only to a few. Which knowledge they will share with you, for a price. And like those priests, NDs don't actually know anything useful that the public doesn't know.

But that’s no reason to give up… some of the most inspiring people in the world came from situations that bet against them.

Now she goes for the Galileo gambit. Maybe they did laugh at Galileo and Einstein. They also laughed at Bozo the clown. Comparing Burklund to Bozo would be unfair…to Bozo.

The solution is education, if people really knew the training and education that naturopathic doctors have they would be…

…running away as fast as they can.

Thanks for the laughs.

By Eric Lund (not verified) on 10 Oct 2014 #permalink

That crack about NDs having a low quality incestuous education was mean-spirited.

Many of these people are superbly trained, like naturopath Shauna Young, who got her degree via a "regimented correspondence curriculum" recognized by the American Naturopathic Medical Association (which if you say its initials real fast, sounds like the AMA). Moreover she has a PhD from the University of Natural Medicine in Sante Fe, and other degrees including a CBS whatever that may be, but I know Orac doesn't have one.

Dr. Young is renowned for her 2012 book describing her unique and fantastic success in treating autism (it's all about manganese, in particular "manganism"). Do check out the book, her picture's on the cover:

http://www.amazon.com/Naturopaths-Quacks-Then-Guess-Duck/dp/1470093359

By Dangerous Bacon (not verified) on 10 Oct 2014 #permalink

Interestingly, there are NDs who are trained in conventional standards of care and practice accordingly. While naturopathic medical education is, indeed, flawed, with the residency options laughably poor; allopathic medical education has its flaws, as well, leaving much to be desired in the way of lifestyle modification training (pretty key in effecting change in chronic disease).

I don't practice IV therapy, prolotherapy, or many of the alternative therapies my colleagues might, and I'm not particularly interested in defending them. I prescribe pharmaceuticals that I know enough about (yes, we are trained in pharmacology, but admittedly, less so than MDs) and consult/refer if I feel something beyond my training is required (whether it's in my legal scope or not). However, I do believe that as a naturopath, I learned more about nutrition, dietary interventions (yes, plenty of literature on those), and counseling, so you may ask, "Aren't you *really* a dietary counselor?" Well, perhaps, but with sufficient training to diagnose, and treat/refer primary care concerns appropriately. Frankly, I practice responsibly and conservatively, and spend a fair amount of time with each patient. True, I didn't get the patient contacts that MDs get, but I also don't practice that way - I don't see 20-something patients a day - more like 8.

I get that it's pretty hilarious to mock naturopaths, and yes, there are a fair number that make it all too easy, but I'd love to see MDs and NDs working together to improve healthcare. Is there a lot that needs to change within the world of naturopathic medicine? Yes - I'll be the first to admit to that. But please don't assume that every single naturopath out there is a total moron.

So, go ahead and laugh it up - to some degree, I'll laugh with you, but please don't be a total jerk. Not really necessary, is it?

By Careless Whispers (not verified) on 10 Oct 2014 #permalink

Having a discussion about scientific merit is one thing, but crossing over into personal cruelty is another. I know Michelle, and she is a kind and sincere individual. You may or may not agree with the merits of her profession, and I'm not asking you to. She does not deserve your personal attacks. This is middle school shit, and it just makes you seem like a bully.
I see you are following my Twitter account. If you want to take me to task, go ahead, I can take it. But leave Michelle the hell alone.

By Matt Brignall (not verified) on 10 Oct 2014 #permalink

"Personal attack." You keep using that term. I do not think it means what you think it means.

But seriously. Criticizing what Burklund wrote ≠ personal attack on Burklund.

the seven “elite” schools of naturopathy; i.e., the accredited ones

This is among the scariest thoughts in this post: that there is a body that offers accreditation to these schools of naturopathy. Even scarier is the implication that there are people with ND degrees from schools which fail even to meet those standards, and that some of these NDs have nonetheless been allowed to set up practices. Wouldn't an MD who obtained his degree from an unaccredited medical school have trouble obtaining a medical practice license in the US?

We could complain that their system isn’t fair (because it isn’t)

No fair requiring naturopaths to adhere to the same standards of evidence that govern standard medical practice in the West. They might be forced to admit that naturopathy is total hogwash. How will NDs pay off their student loans? How will professors at these naturopathy schools maintain the lifestyle to which they have become accustomed? People might even be forced to admit that evidence means something, and we can't have that, not in this society--people might realize that many politicians and pundits are full of it, too!

By Eric Lund (not verified) on 10 Oct 2014 #permalink

The other shows a model dressed up looking like shaman or aboriginal who is nonetheless obviously a model not just because the photo is credited to a Vogue editorial shoot.

Looks like someone is paying attention - the picture on the Healthy Fashionista web site doesn't look like anything I can find on the Clauson page, but instead looks like "Doctor" Burklund playing dress-up.

@Careless Whispers,

How would you rate your education as an ND and why? Why, in your opinion, does the ND educational system include treatments which clearly have little or no validity according to current science? Besides having lots of time for your patients, what makes you effective and how do you measure that?

Thanks.

By Mephistopheles… (not verified) on 10 Oct 2014 #permalink

She changed the picture.

And the link appears to be gone as well.

By Mephistopheles… (not verified) on 10 Oct 2014 #permalink

And how could I forget?

Another reason it is inadvisable to seek out NDs:
most of the woo-centric websites I peruse recommend NDs over SB physicians- esp Null, Adams and many anti-vax mavens.

By Denice Walter (not verified) on 10 Oct 2014 #permalink

Interestingly, there are NDs who are trained in conventional standards of care and practice accordingly. While naturopathic medical education is, indeed, flawed, with the residency options laughably poor; allopathic medical education has its flaws, as well, leaving much to be desired in the way of lifestyle modification training (pretty key in effecting change in chronic disease).

False equivalence.

I don’t practice IV therapy, prolotherapy, or many of the alternative therapies my colleagues might, and I’m not particularly interested in defending them.

And:

But please don’t assume that every single naturopath out there is a total moron.

No true Scotsman fallacy, perhaps? Or you seem to be implying that you're somehow better than the run-of-the-mill naturopath, perhaps? (Quick to throw your fellow naturopaths under the bus, eh?) Maybe you are; I have no way of knowing. What I do know is that it is rare that I come across a naturopath who isn't into homeopathy, traditional Chinese medicine, various forms of functional medicine woo, or all of the above and more. It's rare that I find naturopaths who aren't virulently antivaccine. (Possibly this one, for example.) In other words, it's rare that I find a naturopath who practices anything resembling science-based medicine.

C'mon, I do know what a personal attack means. And some of your comment thread crosses a line into really nasty stuff. If you want to take her to task about the claims she makes, go get it. But comments #12 and now #27 - that's just middle school mean kid stuff. You'd never say that to someone's face, and this is petty bullshit. Mean spirited.

By Matt Brignall (not verified) on 10 Oct 2014 #permalink

Neither of which was posted by me. If you've been here before, you know that I don't moderate the comments except on rare occasions when someone really gets out of hand.

You opened the thread, and you moderate the comments. Oh, and "although I can see why Burklund would want to look like Clauson" is pretty damn mean, too.
I hope you continue to take naturopaths to task for saying stupid shit on the internets. I indulge in a fair amount of this behavior myself. But please remember that these are human beings, and bullying and cruelty is always wrong.

By Matt Brignall (not verified) on 10 Oct 2014 #permalink

Wouldn’t an MD who obtained his degree from an unaccredited medical school have trouble obtaining a medical practice license in the US?

The trick is that most states don't license NDs, which is arguably just as well, since it's a credibility-building maneuver.

One thing that irked me about that Burklund item was her repeated use of the term "doctorate level" for the coursework (the "how can you learn 900 level biochemistry," as though course numbering had some external referent, was just bizarre; apparently biochemistry can't be learned without dissecting cadavers).

You typical Ph.D. program does not involve starting from scratch. Consider NCNM's curriculum and course catalog (PDFs). This coursework looks for all the world like a specialized undergraduate degree. What I'd really like to see are the course texts for, say, CLS 516/526, the pharmacology sequence.

C’mon, I do know what a personal attack means. And some of your comment thread crosses a line into really nasty stuff. If you want to take her to task about the claims she makes, go get it.

But he did so what is the problem? No personal attacks from him.

But comments #12 and now #27 – that’s just middle school mean kid stuff. You’d never say that to someone’s face, and this is petty bullshit. Mean spirited.

Oh please you are really scraping to find something to be indignant about. And why isn't Ms. Burklund here commenting if she takes issue with the post/comments? It seems awfully "middle school" to send someone else in or for you to determine she needs a knight in shining armour.

By Science Mom (not verified) on 10 Oct 2014 #permalink

Yikes: NPH 411, "Naturopathic Retreat," counts as 18 lecture hours.

This weekend retreat provides an opportunity to discuss and experience nature-cure and related therapies in a natural setting.

Personal attack? Me?

Our host verifies that "Doctor" Burklund did indeed change the photo in question, as I suspected.

The photo in question does indeed look to me to be "Doctor" Burklund, wearing what could be reasonably de described as 'war paint'. I assume this isn't her normal attire, so I believe 'playing dress-up' is a reasonable characterization. A lot of full grown women, and more than a few men, do this daily. I've done it myself on more than one occasion. There is a whole day dedicated to playing dress-up later this month. It ain't a sin.

If you are referring to my use of quotes around the word Doctor, that reflects my opinion of her chosen profession, not her. ND's are not, in my opinion, real Doctors.

I do the same for "Doctor" Wakefield, but it is, I admit, in that case, intended as a personal insult.

I don't think that what I said was so terrible:
anyone who pays good money to study homeopathy et al probably DOESN"T know as much about SBM as a random model or anyone else off the street.

By Denice Walter (not verified) on 10 Oct 2014 #permalink

Oh, and “although I can see why Burklund would want to look like Clauson” is pretty damn mean, too.

Oh, holy hell. I only meant that in the sense of how any of we "normal"-looking people would like to look like a fashion model. I, for instance, would like to look like John Hamm or, perhaps more realistically given how gray my hair has become, John Slattery or George Clooney, both of whom are much closer to my age. (OK, they're not that realistic a hope, either.) It was an expression of admiration for how beautiful Claussen is, not a dig at Burklund.

You really are scraping now, but if it'll make you happy and stop your tone trolling I'll add a blurb about it's because Clauson is so beautiful.

As a 4th year student at MCW, I have no idea why they would choose our school along with the other two. Really odd.

Either way, I think the hours are vastly underrepresented in both basic science education and clerkships.

By Skeptical Badger (not verified) on 10 Oct 2014 #permalink

In all those zillions of hours of instruction, you'd think there'd be time for a discussion of the significance of Avagadro's number, but I guess not.

By palindrom (not verified) on 10 Oct 2014 #permalink

A lot of full grown women, and more than a few men, do this daily. I’ve done it myself on more than one occasion. There is a whole day dedicated to playing dress-up later this month. It ain’t a sin.

Apparently Mr. Brignall has never heard of cosplay, too.

Orac
If you’ve been here before, you know that I don’t moderate the comments except on rare occasions..
Matt Brignall
You opened the thread, and you moderate the comments.

There is something ironic about complaining of a blogger's incivility in the same breath as calling him a liar.

By herr doktor bimler (not verified) on 10 Oct 2014 #permalink

so you may ask, “Aren’t you *really* a dietary counselor?” Well, perhaps, but with sufficient training to diagnose, and treat/refer primary care concerns appropriately.

But maybe without the actual training to be allowed to call yourself a registered dietician? I'm only guessing, because 'dietary counselor' is one of those terms that people use when they want people to thing they're a real dietician but without the legal liability of claiming a protected term.

By The Grouchybeast (not verified) on 10 Oct 2014 #permalink

@Careless Whispers #23

I prescribe pharmaceuticals that I know enough about (yes, we are trained in pharmacology, but admittedly, less so than MDs) and consult/refer if I feel something beyond my training is required ... However, I do believe that as a naturopath, I learned more about nutrition, dietary interventions ... I practice responsibly and conservatively, and spend a fair amount of time with each patient

Thank you. Sounds like just what I'm looking for. I'm currently *un-doctor'd* and sorely in need of one. My 'dropped' allopath of 31 years on his records had discounted and condensed everything I had ever related to him as 'non contributory to primary diagnosis' and his wife/secretary's art adorning the walls next to the purple pill ads were so bad as to make George Bush lavatory selfies look as though they were Rembrandts.

Orac,

Clooney's a tool.

There is something ironic about complaining of a blogger’s incivility in the same breath as calling him a liar.

In fairness, he did go back and dig into the post itself to find something he considered insulting to Brucknell's. Even though I didn't mean it that way and don't think the original version was that bad, I decided to alter the text to make it absolutely clear what I meant. Not that I think that'll stop him from tone trolling.

Either way, I think the hours are vastly underrepresented in both basic science education and clerkships.

It certainly doesn't jibe with this.

Orac, regarding your comment, "false equivalence," I say, "missed relevance." I'm not trying to purport that NDs are equivalent to MDs, but simply demonstrate that there are some big pieces missing in allopathic medical education, as well. I'm not attacking it, trying to "prove it wrong," or make MDs out to be idiots, but is there something missing? In my opinion, yes. Are naturopaths "the answer"? No, not entirely. I feel the answer lies somewhere in a less ego-driven realm, where health care professionals can work together to make health care better, overall.

Regarding the no true Scotsman fallacy, I suppose I'd be guilty of it if I were claiming that a "real" naturopath wouldn't do those things. Clearly, naturopaths are a fairly diverse bunch, and while love/defense for my fellow naturopath (no matter how zany or terrifying) may not be my deepest conviction, I will say that attacking the profession, as a whole, is likely misguided.

While your stereotype of a naturopath may be some cavalier, anti-vaccine nut job, I'm simply saying that MANY naturopaths practice evidence-based medicine, which includes administration of vaccines per the recommended schedule.

Should you care to step away from your deeply entrenched confirmation bias, you'll likely find a fair number.

And, Mephistopheles O'Brien, I can say I wasn't totally satisfied with my education as an ND, but I'm fairly certain I wouldn't have been satisfied with my education as an MD - I'm not sure that's a reasonable assessment of its validity. I did learn therapies and techniques that I'll never use because I'm not convinced of their efficacy and have concerns about their safety. I'm guessing you'd find MDs who'd say the same about their training, though perhaps their example would be a bit less "out there" (i.e. a pharmaceutical that's fallen out of favor d/t an unfavorable risk:benefit ratio). When I entered medical school, there was no perfect option, so I made a choice, and adapted accordingly. How, exactly did I adapt? Am I making up my own way of practicing? Am I a total charlatan who thinks I know better? Um...I was just a patient who didn't get the care I needed (yes, for recognized, diagnosable conditions) within the standard health care paradigm.

I once went to a doctor for depression, whose first words were, "you know you're obese, right?" An extreme example, and no, I'm not trying to use it to discredit MDs. She happened to be an MD, but lo and behold there are MDs out there with more compassion and a better grasp of the human condition - a fair number, in fact. Do I sound absurd? Of course I do, but maybe some of you are getting my point?

As to whether I'm an effective doctor, I suppose you'd have to ask my patients. I do my best to listen to my patients, understand their goals, and provide education and support as they work toward them (and no, I don't use time unnecessarily to fluff my paycheck). And, to pre-empt any snarky comments about making things bigger than they are, no, I do not mean that I'm spending my time asking a patient with acute otalgia to tell me about their relationship with their father (though, a thorough history once the acute issue has resolved *could* reveal that said father has a penchant for punching children in the ear).

So, have at it, Orac. Criticize away. While you're busy with that, I have articles to read, papers to write, and patients to see.

By Careless Whispers (not verified) on 10 Oct 2014 #permalink

I hope you continue to take naturopaths to task for saying stupid sh[*]t on the internets. I indulge in a fair amount of this behavior myself.

Do tell. Please. I'd like to see how to do this while avoiding (what you perceive as) personal attacks.

In other words, 'pic, or it didn't happen'.

I’m not trying to purport that NDs are equivalent to MDs, but simply demonstrate that there are some big pieces missing in allopathic medical education, as well.

Is there some reason you're trotting out this Hahnemannianism? Do you think "naturopathic" lies on some continuum between "allopathic" and "homeopathic"? Is there another axis, leaving all to wonder what the name of the missing quadrant is?

As to whether I’m an effective doctor, I suppose you’d have to ask my patients.

Strictly speaking, whether you're a doctor at all is purely a matter of what state you happen to be in.

"While your stereotype of a naturopath may be some cavalier, anti-vaccine nut job, I’m simply saying that MANY naturopaths practice evidence-based medicine which includes administration of vaccines per the recommended schedule."

Such as (a link to the website of an ND who practices evidence-based medicine would help convince those who doubt that such an entity exists)?

Your definition of "MANY" is curious.

A recent survey of naturopathic students at an "accredited" college found that only about a fourth of them said they planned to prescribe or recommend immunization to their patients, and only 12.8% supported the full pediatric vaccine schedule.

http://www.no-naturopaths.org
http://www.sciencebasedmedicine.org/naturopathy-vs-science-vaccination-…

"Are naturopaths “the answer”? No, not entirely. I feel the answer lies somewhere in a less ego-driven realm"

Hopefully, such a realm does not involve naturopaths like the one quoted in Orac's article, who doesn't need scientific validation because he "knows" his treatments work (this attitude is not unknown in mainstream medicine, but is far more virulent among altie practitioners).

"Criticize away. While you’re busy with that, I have articles to read, papers to write, and patients to see."

Ah, the old "I have better things to do with my time" flounce.
Too bad you wasted time here that you could instead have wasted by writing papers extolling woo.

By Dangerous Bacon (not verified) on 10 Oct 2014 #permalink

Orac: "Apparently Mr. Brignall has never heard of cosplay, too."

He has obviously never been to the Convention Center in downtown Seattle during Easter weekend.

“Are naturopaths “the answer”? No, not entirely. I feel the answer lies somewhere in a less ego-driven realm”

Hopefully, such a realm does not involve naturopaths like the one quoted in Orac’s article, who doesn’t need scientific validation because he “knows” his treatments work (this attitude is not unknown in mainstream medicine, but is far more virulent among altie practitioners).

It's not clear to me whether CW was endorsing the proposition that seeking a quasi-medical* credential in the context of suggesting that it's only poor marketing that prevents people from "lining up at their clinics begging for a fresh perspective on their health" represents an ego-driven phenomenon or not.

* Or pseudo; it didn't seem worth wasting much effort on.

@ Chris:

Oh I see that Sakura-con used to be called team OTAKU!
*Otaku* is a useful concept for English-speakers who frequent RI.
Basically, *I'd* translate it as 'obsessive interests' in general (not just in cosplay,anime, manga etc).

By Denice Walter (not verified) on 10 Oct 2014 #permalink

I've wondered how naturopaths are going to be able to continue those hours-long consults if they start taking insurance payments.
Judging from one of the reddit posts nd's, looks like they won't be able to: "We will also begin charging for prolonged appointment time in order to chart appropriately according to insurance standards with the new insurance coverage."

I read these posts and comments daily, but rarely comment. I am not a Physician. My wife is, but my qualifications end with combat medic, USN trained, but working with the USMC. I know a little about what it takes to become a good physician. I paid for my wife's med school (UTMB), I endured a thousand practice physicals, and administered God only knows how many flashcard quizzes. My son is a senior in High school, but he started taking pre-med college courses last year. this year he has an internship under another doc at my wife's clinic. He will put in 600 hours this year in the clinic, and he is still at least three years from starting actual med school under a USAF scholarship. Then a real internship, then a residency. When you compare what my wife or son have to go through to be considered competent physicians, the Naturopaths and other loonies cannot even begin to compete.

By toadboy65 (not verified) on 10 Oct 2014 #permalink

mho: "I’ve wondered how naturopaths are going to be able to continue those hours-long consults if they start taking insurance payments."

I went to Burklund's website and did not see any real evidence of an actual office where she meets with patients face-to-face. She has these Virtual Visits where for $290 you can talk to her via Skype or phone for an hour.

When you compare what my wife or son have to go through to be considered competent physicians, the Naturopaths and other loonies cannot even begin to compete.

I have a very, very dear friend who has set upon a midlife goal to attend medical school. I have tried to gently suggest that the premed coursework already undertaken could be quite helpful in pursuing something such as, say, what Jake is supposed to be doing, but he will have none of it.

Check your email Narad.

By Science Mom (not verified) on 10 Oct 2014 #permalink

I don't care. Cosplay is why my youngest can actually sew!

My daughter managed to sew a nun's costume; she played a nun in the The Sound of Music, in high school. (She also wore the nun's costume with an inflated balloon in lieu of a baby bump to a Halloween party).

A conventional doctor might say, "Mr. Bazalgette you have GERD, probably because you are overweight -cut back on the donuts, get a bit more exercise, lose a few pounds, come back and see me in 3 months and we'll see how you're doing. If things haven't improved I'll prescribe you a proton pump inhibitor". A naturopath might tell Mr. Bazalgette that his yin liver meridian is out of balance, and he would benefit from weekly acupuncture, a homeopathic remedy, living on nothing but wheatgrass juice for a month, and doing chi gong every morning. Is the first or the second scenario most likely to result in Mr. Bazalgette dropping a few pounds and getting relief from his GERD?

There's also the large number of idiopathic conditions, where the patient complains of general aches and pains, mental fog, GI distress, and all tests are negative. A doctor might suggest the patient is mildly depressed and suggest counseling, or taking up a hobby. Given the stigma still attached to mental illness, the patient may feel as if they have been labeled a hypochondriac, and may be resistant to treatment. A naturopath will tell the patient they have adrenal fatigue, colonic candida overgrowth and gut dysbiosis, probably due to having been prescribed too many antibiotics by the allopathic doctor, the one that just told them they are just neurotic.

Such a definitive diagnosis, even better a condition that is someone else's fault, and a confident treatment regimen that the practitioner will assure them will help is surely going to perk a patient up. Especially so if that regimen is something that takes a bit of time and effort, like juicing vegetables, or taking a number of supplements, or that gets the person engaged socially, like an acupuncture session or taking yoga classes. Most of these activities will result in weight loss, which is probably the main reason for any objective improvements in health.

By Krebiozen (not verified) on 10 Oct 2014 #permalink

To clarify, I'm not supporting naturopathy, but wondering if the reason it is so popular is less to do with the longer time the ND spends with a patient, and more to do with giving definitive diagnoses and treatments for conditions that a conventional doctor doesn't recognize as being real.

Lying to patients does seem to make them happier, but it's unethical, and encourages belief in supernatural BS. There's the root of the problem, in my opinion. There must be a solution, but it isn't clear to me.

By Krebiozen (not verified) on 10 Oct 2014 #permalink

Matt Brignall really needs a better class of pearls to clutch at. I mean really, based on the "examples" provided I'd say cheap plastic Mardi Gras beads are being clutched here... :-)

By Scottynuke (not verified) on 11 Oct 2014 #permalink

My rotten luck that when really good back-and-forths are happening I have a day when I'm nowhere near a computer.

If you are anti-vaccine, then any claim you make about being a competent healthcare provider is worthless. If you can't grasp the science behind vaccines as well as how critical vaccination has been to individual and public health, then you are a fool and an idiot.

If there is a naturopath out there who isn't anti-vaccine, please speak up. All I run into online are anti-vaccine naturopaths, hence why I put them in the same dustbin of uselessness as chiropractors and homeopaths.

By Chris Hickie (not verified) on 11 Oct 2014 #permalink

This is the closest I've ever come to finding a naturopath who is not antivaccine:

http://scienceblogs.com/insolence/2013/10/09/naturopaths-and-vaccines/

Quote:

Krumbeck seems very eager to reassure her readers that she really and truly isn’t antivaccine and that she even goes so far as to vaccinate her children. Good for her! Unfortunately, if she’s like most other naturopaths I’ve encountered, her “knowledge-based approach” is in reality an example of what I like to refer to as “misinformed consent.” You can see it right here in her paragraphs above through her use of false balance. Sure, she tells us, there are naturopaths who are rabidly antivaccine. It’s nice that she’s admitted that. But, she assures us, there are naturopaths who are “vocal supporters of rigidly following the CDC schedule. Now, personally, I’d love to meet these naturopaths who try to out-Offit Paul Offit, but I’ve never encountered a naturopath who advocates “rigidly following the CDC schedule.” Ever. And I’ve looked. If they exist, they appear not to blog or maintain websites. Whenever I see what naturopaths have to say about vaccines, it’s either a whole lot of easily shot down antivaccine tropes, or it’s a mush, wishy-washy false equivalence between the antivaccine and pro-science-based medicine viewpoint much like Krumbeck’s blog post.

Even in her blog post, you can see that she’s trying desperately to follow the fallacy of the golden mean, also known as the argument to moderation the “middle ground” fallacy. You can tell from her post that this is what she is doing by how she characterizes antivaccine naturopaths as “vehement opponents of vaccination” and these mystical magical (and probably nonexistent) pro-vaccine naturopaths as “vocal supporters of rigidly following the CDC schedule.” Having thus set up the two sides as unreasonable and rigid, she then portrays herself and “most” naturopaths as taking a “third stance.” She even goes so far as to characterize this stance as being “knowledge-based.” Of course, given what passes for “knowledge” about vaccines among naturopaths, what Krumbeck is most likely really recommending to her patients is a “misinformation-based” set of recommendations, resulting in what I like to call “misinformed consent.

In other words, she's the naturopath equivalent of "Dr. Jay" Gordon and "Dr. Bob" Sears. She even has videos in which she spews misinformation about mercury, although she does admit that MMR doesn't cause autism. On the other hand, she goes on and on about aluminum overwhelming a baby's ability to "detoxify." You get the idea.

OT but are anti-vaxxers shrieking madly about the media ever truly OT @ RI? (@ AoA)

It appears that they finally got their wish - the current CDC scandal being covered by the mainstream- but they didn't like the results:
the Thompson-Hooker brouhaha was featured by liberal commentator Ronan Farrow on two separate occasions- now the youngster is fast headed into Anderson Cooper territory in their eyes, i.e. *persona non grata*, shilldom, 'presstitute', good looking but evil etc.
He spoke with one of the TMs ( Lisa Goes) as well.

Unfortunately I am on my way out so I haven't located any videos but I believe these interviews occured on Thursday and Friday.

By Denice Walter (not verified) on 11 Oct 2014 #permalink

@ Scottynuke:

Ha ha.
And it's surprising with the price of decent cultured pearls becoming much more affordable of late.

By Denice Walter (not verified) on 11 Oct 2014 #permalink

Cosplay is why my youngest can actually sew! demonstrate proficiency as a recursive coupling engineer.

fixed.

"To clarify, I’m not supporting naturopathy, but wondering if the reason it is so popular is less to do with the longer time the ND spends with a patient, and more to do with giving definitive diagnoses and treatments for conditions that a conventional doctor doesn’t recognize as being real."

My take on the "popularity" of naturopathy (still very much a fringe deal) is more along the lines of philosophically appealing unreal remedies for real but non-life threatening afflictions. "Detox" and magic water are good for vague aches and pains and that sluggish feeling, but it's reassuring that real medicine will still be available for serious ailments. That's the "best of both worlds" that a naturopath was referring to.

By Dangerous Bacon (not verified) on 11 Oct 2014 #permalink

Tim, you are an idiot.

"Tim, you are an idiot."

That's been evident for a while.

Yes, they are the dominant system, but why let them define the terms for OUR sucess? They choose how their medicine is defined, not ours.

My question, of course, is would they be willing to have the terms they have defined for success applied to products developed by big pharma, or would they have a problem with Merck or Sanofi marketing a new vaccine with no proof of safety or efficacy offered other than "Obviously we know what it does works, and obviously our subjects know"?

Somehow I think they'd demand a far, far more greater level of proof than they expect others to accept when they're the ones who are claiming success.

"far more greater"? Errr--generations of Catholic school grammar teachers are turning in their graves...

“To clarify, I’m not supporting naturopathy, but wondering if the reason it is so popular is less to do with the longer time the ND spends with a patient, and more to do with giving definitive diagnoses and treatments for conditions that a conventional doctor doesn’t recognize as being real.”

I have a bright, talented friend who has suffered for decades; some condition of being allergic to her environment, and she spends considerable time having to be reclusive. Desperation has driven her, and I don't know how many times she has exultantly declared that she has finally nailed the answer: reflexology! de-tox! imbalance! After going through every hoop the alties have to offer (although there's always a crazy new one on the horizon), the light finally went on that these people make a living dealing with things they "know", but don't really know at all. She is back with her real doctors, accepting their honest appraisal about the world she lives in, realizing that their recommendations are based on reality, having paid the price of a real, very difficult education.

I know it's an anecdote, but to actually witness the whole thing has been profound. I've seen it many times: these almost religious experiences with alt med often come with revolving doors.

@JCL #20
Many thanks for your comment — your final statement "Barking indeed!" sums up the barking madness of quackery that deeply concerns me regarding the increasing integration of cow pie into the apple pie of science- and evidence-based medicine.

I'm distressed to learn that UK University Hospitals are recruiting quacks. In my naivety I had assumed that all universities would strongly decry pseudoscience, quackery, and medical fraud.

The idiom "horses for courses" has taken on a whole new meaning that I shall never forget!

Further insight posted to Natchat today:

tdtf5
Message 3 of 3 , Today at 5:07 PM
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Hi Mona-maybe this is a good time to reconsider getting out of the yahoo format and getting a private group together. A lot of this information that we share is really cutting edge and many of the protocols that our incredibly savvy naturopaths have come up with could be considered proprietary information. We also do sometimes share some very personal information on here about patient health historys and business practices.

I can't help but think this breech is more about data mining then caring about what we are doing with our medicine. I mean really-who cares what we do? I haven't seen a pitchfork or a ring of garlic in ages. Data miners tend to be looking for what they can sell, resell and make money off of themselves. I would worry that continued access might lead to something more damaging on a business level for one or more of our practitioners rather then it being a belief system thing......

I think we had all shared a while back how much we really appreciate this form and utilize it on a regular basis for researching protocols and new ideas for treatment as well as for posting ourselves. And I believe that many shared that they didn't mind if there was an extra charge involved. Perhaps there can be a front website where advertising can be sold as well. If there was recently reported that we have 3,000 plus members here then that should be a supplement advertisers dream come true:)

Anyway-thats my 2 cents
Always appreciative of our community
Anne Hill, ND
Portlandia, OR

By naturowhat (not verified) on 11 Oct 2014 #permalink

I'm guessing "sharing very personal information about patient health histories [via yahoo chat groups]" wouldn't quite meet HIPPA standards.

A lot of this information that we share is really cutting edge and many of the protocols that our incredibly savvy naturopaths have come up with could be considered proprietary information.

There's nothing that says "evidence based" like worrying that someone is going to steal your "cutting edge" naturopathic secrets.

Are cutting edge protocols different than cookie-cutter approaches? I get all confused with these slice-n-dice metaphors.

Perhaps there can be a front website where advertising can be sold as well. If there was recently reported that we have 3,000 plus members here then that should be a supplement advertisers dream come true:)

Or maybe they can be like the other loonies and continue their chat at a camera forum.

Perhaps there can be a front website where advertising can be sold as well. If there was recently reported that we have 3,000 plus members here then that should be a supplement advertisers dream come true:)

Or maybe they can be like the other loonies and continue their chat at a camera forum.

Orac, regarding post #74 "but I’ve never encountered a naturopath who advocates “rigidly following the CDC schedule.” Ever. And I’ve looked. If they exist, they appear not to blog or maintain websites"

No. You and your pal hacked a yahoo group and stole private information and shared it on Reddit, and now on this blog. Now that you stole this information, you can clearly read the number of posts in support of the CDC vaccine schedule. But you are not interested in that. You are only interested in hand selecting what will fuel your anti-CAM agenda. Would you like to tell your followers how these private conversations got onto Reddit?

Oh, please.

I "hacked" nothing. I do not know who got these Yahoo! Groups messages, nor do I have the whole database mentioned in the subreddit. One of my readers let me know of the subreddit's existence in the comments of a post, and all I have access to is what's on that subreddit, which I linked to. There, there were a couple weakly provaccine comments, which is about it. These were shot down by the likes of Doug Cutler.

And I don't know who posted that subreddit or downloaded all those messages.

You and your pal hacked a yahoo group and stole private information....

Maybe it's just me, but at worst you have a case of the keen insights and standards of "Mona" being not particularly good, as there is no "hacking" in evidence.

I'm interested in the claim of theft, though. It's true that the Y—!'s TOS disclaims any intellectual-property rights to comments in private groups, but it doesn't therefore assign them to "Mona" or any other group creator.

So what, really, is the "private information" that has been "stolen"? One's name isn't "private information." Reproducing 62 MB, or whatever it was, of comments verbatim isn't defamatory. So the only things left are individual claims to intellectual property, such as copyright – which is toast as a practical matter – and Calgon.

I'm eager to hear which you choose.

^ If you're going to fall back on a civil theory of invasion of privacy, I would request that you be specfic up-front.

^^ For completeness' sake, CFAA is right out.

So, have at it, Orac. Criticize away. While you’re busy with that, I have articles to read, papers to write, and patients to see.

It has occurred to me to wonder whether Dr. Whispers has any policy regarding whether it is possible to "fire" a noncompliant patient and, as well, whether there is, in general, among proper NDs a formal procedure for orderly transfer of care in such an eventuality.

Pete A,

I’m distressed to learn that UK University Hospitals are recruiting quacks.

The last few years has seen a wave of UK hospitals becoming University Hospitals, including my local hospitals (Barking and Havering are just a few miles away too). In my local hospital's case, it is because the hospital trust has been taken over by Bart's and the Royal London Hospital Trust, which is affiliated with London University. Having trained in an old teaching hospital, I'm a bit sceptical about the standards in the new University Hospitals, but perhaps that's just me being elitist.

That said, by "complementary care" for cancer patients, they mean aromatherapy, reflexology and Indian head massage. There's no sign of acupuncture or homeopathy, thankfully. They also ask for donations, which suggests to me that the complementary therapists are not being paid by the NHS. I'm not too concerned; I see few signs we are following the lead of the US in quackademic medicine, yet.

By Krebiozen (not verified) on 12 Oct 2014 #permalink

I second Orac's account, as I made the original comment linking to the subreddit.

To naturopaths reading this:

Just to be clear, someone got a hold of your Yahoo! group conversations (https://groups.yahoo.com/neo/groups/NaturopathicChat/info), and posted them to Reddit, and this blog reported on that. The Reddit post is over 2 months old.

There are +3400 members in your Yahoo! group. How is that a private forum, intellectual property, or proprietary? How can you account for all of those members falling in line? Why would you discuss private patient information when you are bound by HIPAA?
----

It's very upsetting that naturopaths discuss "medical" treatments that are dangerous and probably illegal. It is even more upsetting that these discussions are based on the actual practice of their "medicine." What is the deal with naturopaths billing to medicare? That seems illegal too. Some wrote in those Yahoo! threads that they were aware that such billing was possibly illegal or not well defined by HHS.

What is the deal with so many unethical and illegal practices being discussed by naturopaths, but no naturopaths seem to be raising alarm? It would be a great public service if representatives in states where naturopaths are licensed or trying to be licensed were to read such leaks. News agencies should stop writing unscrupulous articles extolling the benefits of NDs and stop using the hollow term "accredited doctoral program" as some kind of seal of approval for the legitimacy of naturopathic medicine, i.e., http://www.huffingtonpost.com/david-katz-md/the-nature-of-medicine-an_b…

Larger question: why doesn't the AMA, state medical associations, or other professional health organizations publicly oppose naturopathic medicine? How are medical doctors who support such pseudoscience not sanctioned? Is the AMA still suffering from PTSD from their battle with the chiros in the 70s?

VOR's accusations of 'hacking' come down to a claim that not one of the 3400 members was honest enough to blow the whistle (in disgust at the discussion of illegal / unethical practices, and the circulation of confidential information). Does VOR really want to go that far?

By herr doktor bimler (not verified) on 12 Oct 2014 #permalink

Dr. "Quack" Krumbeck here again,

I must admit I find myself a little surprised to be commenting again. Mr. Orac, I had sworn myself off of your blog, no offense, after the last encounter of ours.

I just want to add a few cents of my own, and then I promise once again to stay off your comment roll and de-troll myself.

First, I want to state my disappointment with your blog. I am frankly a little amazed at the depth to which you will go to scrape up anti-naturopathic propoganda, even if it is from select members of my own profession.

Mr. Orac, I appreciate your goal in making this website: to keep pseudoscience out of medicine, to hold your (and our) profession to the highest intellectual standard, and to constantly question mainstream medicine (and mainstream media).

But, at this point, to call this website "ScienceBlogs" is a misnomer. It is just as easy for you to distort evidence to further your own gains as it is for me or any other member of my profession. Let your readers know: as a member of the naturopathic community, Mr. Orac's quotes, taken completely out of context and cherry-picked, are NOT representative of the whole of our profession.

I am astounded that you claim to be morally and ethically superior to naturopaths and chiropractors, but you use information taken from a *private* forum and then pick the most inflammatory statements you can find from 1000's of posts to illustrate your point. My dear sir, that is not far from me watching Dr. Oz in an afternoon (representative of "your" profession) and then telling everyone how ridiculous you are for practicing medicine in that way.

I highly respect any physician who is willing to have a civil discussion about science. But attacks on character, taste, looks?
Shouldn't you well know that these are fallacies? Or does Ad Hominem only apply when someone else writes those words? How about association fallacy? Confirmation bias?

No, if this were truly "ScienceBlogs" then you would analyze EVERY post in the NatChat archive for scientific validity.

There, I have again said my share.

- Erika Krumbeck

Let the Ad Hominem attacks on myself commence!!

By Dr. Krumbeck (not verified) on 12 Oct 2014 #permalink

"Climategate" this ain't.

In that case, tens of thousands of emails -- presumed private -- were hacked, and a few quotes that sounded bad out of context were trumpeted as evidence of scientific fraud by professional ratfkers.

In this case, the audience was thousands of subscribers, and anyone who thought it was private was basically a fool. And one apparently doesn't have to cherry-pick at all to find examples of egregious lack of standards.

By palindrom (not verified) on 12 Oct 2014 #permalink

Yazd, In Colo., the medical society did lobby against the naturopath's bill and had/has a pretty good policy no naturo statement online.
The problem seemed to be that only a few docs really spoke out, and the leadership wasn't convinced enough to be firm about making no concessions. It just wasn't important enough to them.
Another big problem is the AAFP (family physicians) seems to think they can work with naturopaths. They've bought into the "experts in natural med. hype", and they think they can manage the fringe patients better if they "collaborate." I MD's they still naively believe they can give ND's some privileges but they themselves will still be seen as the ultimate authority. MD's don't get it that naturopaths are taught from day one that medical doctors are inferior.
So, the family MD's are either shruggies or very naive.
The pediatricians refused to budge on some issues and got some limits into the bill, but those will get chiseled down soon enough. Still, they gave up and let the ND's treat kids over 2 yrs. old, instead of allowing adults only.--which would still have been a bad idea.
The medical societies get accused of only opposing naturopaths because of turf protection and legislators buy that to an extent.
Also, I think if the med. society has a history of working with one party, and then the chambers switch dominance, MD's end up not having great relationships with the new guard.
I'm not a medical practitioner though so these are just my observations.

Colo. has very high vaccine exemption rates, and even with pertussis epidemics we only got a bill for minimal data collection passed. The anti-vaxers were in full force at the Capitol and they had impact.

Out of curiosity, I had to see what offerings there are for ND's out here in my little corner of Scandinavia.

On the plus side, apparently ND's are not covered by the universal health care benefits, so my taxes aren't supporting them (they might have paid for their 'education' though).

On the down side, HOLY F**K they're expensive. $205 dollars (rounded up) for the initial consult. That doesn't include any homeopathy (HA!) or any other BS snake oil they might peddle.

@ Dangerous Bacon:
"Re-flux, not so much. It’s a dis-ease, and only alties can cure a dis-ease."

Dangerous Bacon, you are an ignorant prick for patronizing someone's argument based on spelling. This person made a good point, and if the best reply you can think of in response is to comment that, heaven forbid, they spelt reflux "re-flux",
then you have no valid argument. Egotistical jerks like you are why people get turned off of skepticism and rationalism. You aren't helping the cause!!!

By Karen Smith (not verified) on 12 Oct 2014 #permalink

In case anyone doesn't remember Erika Krumbeck, here she is:

http://scienceblogs.com/insolence/2013/10/09/naturopaths-and-vaccines/

As I described, despite her claim not to be "antivaccine," she sure does promote some antivaccine ideas as though they have scientific validity. (They don't.) She sells a video that sure does sound a lot of antivaccine notes falsely "balanced" with pro vaccine notes. She wants to portray herself as science-based, but she panders to antivaccine fears, much in the same manner that "Dr. Jay" Gordon and "Dr. Bob" Sears do.

As for the rest, I would be happy to spend some time analyzing the entire database of that Yahoo! Groups naturopathy group if I actually had access to the entire database. From what someone who apparently did have access to it wrote earlier in this thread, it would seem that there's a lot of stuff there that's worse than what I cited from this small sampling in the subreddit, such as HIPAA violations and even more pseudoscience and quackery.

In any case, I examined what I had access to, which was that subreddit and its contents. What was there was plenty bad, man, as they say. Nor did I pick the most "inflammatory" statements; I picked exchanges on topics that interested me. In addition, once I noticed he featured prominently in the vaccine discussions, I focused on Doug Cutter because he's in my neck of the woods. Frankly, that worries the crap out of me, particularly after I perused his website, because he could see patients I'm treating.

Oh, and, contrary to what Krumbeck says I didn't make fun of anyone's appearance. I don't do that because (1) it's uncool and irrelevant and (2) I'm not one to talk about anyone's appearance. So when it was pointed out that what I wrote might be interpreted that way, I immediately changed it to clarify and make sure it couldn't be reasonably interpreted that way. It's what I do when I realize I've made a mistake. I try to fix it.

Ms. Krumbeck, "Mr. Orac" did take and pass the US Medical Licensing exam. What kind of score did you get with the USMLE?

Also, he has an additional PhD. The proper moniker is "Dr.", where as ND is more accurately called "Not a Doctor."

You said: "Mr. Orac’s quotes, taken completely out of context and cherry-picked, are NOT representative of the whole of our profession."

Good, then you can answer this question on how naturopathy is superior to the medical care we used on these conditions our extended family have experience:

1. An infant having seizures, that first start with a shiver and then start getting longer and stronger and more often?

2. Obstructive hypertrophic cardiomyopathy where the abnormal heart muscle growth starts to block the aortic valve?

3. A genetic form of hypertension, where almost everyone in the family could expect to die a slow painful death between forty and fifty.

4. Massive asthma attack from mold after a swamp cooler was turned on.

5. Recurrent strep throat infections in two out of three kids, all under age eight, for three months (hint the actual number of kids with strep was three, can you figure how that was found out?)

6. Cancer

7: Broken bones

8: Bacterial pneumonia

This person made a good point

In what way?

Karen Smith: "Dangerous Bacon, you are an ignorant prick for patronizing someone’s argument based on spelling."

My, Karen, but you're in a most foul mood.

I note that you ignored the snide tone of that someone's rant as well as my comment about evidence-based medicine's effectiveness in dealing with reflux esophagitis based on both lifestyle suggestions and drug remedies, in order to focus on "tone" which you say isn't "helping the cause".

I detect the not-so-subtle odor of a tone troll shooting herself in the foot by resorting to ad hominems.

*by the way, using unnecessary hyphenation (i.e. "dis-ease") is a well-known and bizarre characteristic of numerous quacks and quackery enablers (it's not a matter of "spelling"). If you don't like my making fun of it, well, too bad.

http://scienceblogs.com/insolence/2013/03/19/disease-dis-ease-whats-the…

By Dangerous Bacon (not verified) on 12 Oct 2014 #permalink

Dr. Krumbeck,

My dear sir, that is not far from me watching Dr. Oz in an afternoon (representative of “your” profession) and then telling everyone how ridiculous you are for practicing medicine in that way.

You are certainly entitled to criticize Dr. Oz for what he promotes on his show, and many have. If you can show that the thing you criticize is widely practiced by MDs, then you'd have a case.

Do you have data to show that NDs don't practice in the way that Orac comments about? If so, I'm sure that people would be glad to hear about it.

By Mephistopheles… (not verified) on 12 Oct 2014 #permalink

My, Karen, but you’re in a most foul mood.

Just out of curiosity, some myopic third-eye gazing got me to wondering about what goes in Canada.

"Certain medicines are more effectively delivered to the body by vaporizing them and inhaling them. One of them is glutathione - one of the most important molecules in the body for detoxification, cellular repair and immune system balance. Taking glutathione orally is not well absorbed however it is well absorbed through inhalation."

It's not clear, for example, that this "absorption" business is necessarily a good idea.

Then again, the ranks of the 3 σ naturopathic outliers continue to swell: bit[dot]ly[virgule]1CbbUqV

“Certain medicines are more effectively delivered to the body by vaporizing them and inhaling them. One of them is glutathione – one of the most important molecules in the body for detoxification, cellular repair and immune system balance. Taking glutathione orally is not well absorbed however it is well absorbed through inhalation.”

I don't understand this obsession with "detoxification" and all of the quackery recommended to achieve this. Don't NDs, chiros and the like learn about things like diet, exercise, livers and kidneys in their respective "schools"?

By Science Mom (not verified) on 12 Oct 2014 #permalink

...they spelt..."
Hey arrogant shit. Here in the colonies we spell the past tense of spell 'spelled."

Taking glutathione orally is not well absorbed however it is well absorbed through inhalation.

Since the lungs are apparently better at the role of nutrient absorption, I look forward to the brave new future of totally inhalable food when we can dispense with gut function altogether..

By herr doktor bimler (not verified) on 12 Oct 2014 #permalink

…they spelt…”
Hey arrogant sh!t. Here in the colonies we spell the past tense of spell ‘spelled.”

Ah doug, that was a target-rich post, I don't know why that would be an issue especially considering the international commentariat here.

By Science Mom (not verified) on 12 Oct 2014 #permalink

"I don’t understand this obsession with “detoxification” and all of the quackery recommended to achieve this. Don’t NDs, chiros and the like learn about things like diet, exercise, livers and kidneys in their respective “schools”?"

I think you're missing the point of naturopathic and chiropractic training. It involves taking lots of classroom hours in anatomy, biochemistry and human physiology, then countless more hours in training and practice rejecting everything they learned.

By Dangerous Bacon (not verified) on 12 Oct 2014 #permalink

"...I don’t know why that would be an issue..."

Specifically because she is in Toronto (the ever so, Windsor was never so... - qv The Brothers In Law, c. 1965). We use "spelled" here. I spent too long in proximity to the English Mafia at the University of my servitude. Too many of them practiced their sassenaccents in front of mirrors. Too many of them regarded themselves as much superior to those of us who suffered the fate of being born in the colonies. So I get annoyed when they deliberately use spelling or pronunciation that is not the standard in the country where they dwell. Arrogant bugger is not pronounced arrogant buggah here. Or in hog town.

that should be Hogtown

Taking glutathione orally is not well absorbed however it is well absorbed through inhalation

Lots of things are well absorbed through inhalation - doesn't mean that's the proper way to distribute them through the body.

As HDB said, that'll be the day - when we can just inhale our nutrients. I'm sure there's a quack out there somewhere who's going to market the next big weight loss scam for inhaling vitamins, etc rather than ingestion.

when we can just inhale our nutrients

It will make a welcome change from the usual alt-health fixation with enemas as the most natural mode of absorption.

By herr doktor bimler (not verified) on 12 Oct 2014 #permalink

I'll never understand the whole fascination with inserting liquids into the rectum - like coffee.

Just... no.

the whole fascination with inserting liquids into the rectum

This was brought to my attention the other day, in connection with "GcMAF ", one of the newer cancer scams (basically magic yoghurt):

I went to PROF MARCO RUGGIERO in Switzerland, had a 5 day treatment, suppositories, yoghurt up my bottom too, vial injected in groin daily and nebulizer.. Felt no side effects good or bad.. Clinic said one of my tumours shrank by 25% but when I had my CT it showed no shrinkage at all

It must be a tradition, or an old charter or something.

By herr doktor bimler (not verified) on 12 Oct 2014 #permalink

Daily groin injections and 'no side effects' - is this person dead from the waist down?

Wendy Swanson MD (aka Seattle Mama Doc) has a column from 2013 about a pro-vaccine naturopath (Mary Alison Higi, ND, http://seattlemamadoc.seattlechildrens.org/yes-vaccines-are-naturopathi…). Note, however the tone of the writing is "look, hey, I found a pro-vaccine naturopath!". The column mentions Higi's naturopath mentor (Candace Aasan, ND) who is an alternative schedule vaccinator and one of Bob Sears' "vaccine friendly doctors, http://cascadenaturalmedicine.com/Our_Providers.html , and http://www.askdrsears.com/topics/health-concerns/vaccines/find-vaccine-… ). And if you peruse Sears' list of what are really anti-vaccine "doctors", you will see a very large number of them are naturopaths, including one that is faculty at Bastyr "university".

And then, of course, you can see how little vaccination is mentioned in the "classic" textbook that I'm sure all naturopaths have--"Textbook of Natural Medicine, 4e", by Joseph Pizzorno ND, 2012). If you look at the index (go to the web site of the company that makes the Kindle) you can see that "vaccination/immunization" is only mentioned in 2 sections in the whole book, and one section titled :"history of the fight against vaccination/immunization". which sure sounds anti-vaccine to me.

Finally, there are sites like the Maine Association of Naturopathic Doctors with a vaccine page that is clearly anti-vaccine and chock full of lies and misinformation about vaccines (http://www.mand.org/Maine-Naturopathic/the-news/47-vaccination-perspect…).

So I stand by my assertion that naturopathy is inherently anti-vaccine, and that alone shows how little grasp of science-based medicine that is taught to and understood by naturopaths.

By Chris Hickie (not verified) on 13 Oct 2014 #permalink

I came across a fascinating account of how one true naturopath (he is an award-winning graduate of the National College of Naturopathic Medicine) practices. It did not fill me with confidence about the profession; here are the ND's own words, shamelessly cherry-picked for your reading pleasure:

Nothing in my four years of naturopathic school quite prepared me for the patients whom I began seeing immediately after opening our practice in an unlicensed state. None were those easy cases that I had come to expect in the school clinic; no kids with earaches, no women with yeast infections, no sore throats. Twenty years later, I still recall in detail the woman who presented with a chronic bladder infection. She questioned why I kept smiling at her and I had to confess that she was my first patient whom I knew how to treat.

I found a new mantra, a phrase that rarely left my workday consciousness: "They never taught this in school." [...]

Twenty years later and I still don't know what to do much of the time, but I'm used to it. It's part of the job. If it were easy, the patient's "regular doctor" would have figured out what to do. Every workday there's another surprise quiz. Somehow, I've found a rhythm, a routine for dealing with the unknown, a way to work that doesn't involve pretending I know what I'm doing when I don't. [...]

My immediate reaction in my first years in practice would have been to adopt a trout face, my mouth wide open, staring blankly at the patient and waiting for inspiration. Now I've learned to hide my ignorance; I turn to my computer, click my way to PubMed.gov, all the while chattering away that we "are going to the National Library of Medicine ..." and chanting inside my head, "It's an open-book test." [...]

This is all about translation. We translate the near gibberish found in the scientific journals into clinical relevance, into supplement names and suggested doses. I guess this is what they mean by "translational medicine." It certainly is what the process means to me. [...]

After two decades of practice, as you can see, I still don't know what I'm doing. Each patient comes in with a unique story. It's still a rare day when I say to myself, I've seen this before. It doesn't bother me the way it once did. Perhaps it was all the Lycopodium I took.

This account is woven around a case history of a young man with hypertension secondary to hydronephrosis, who was prescribed beta blockers by his regular doctor, but didn't like the side effects. The ND did a quick search for the condition on PubMed, found a study that suggested damage to the kidneys involves oxidative stress and nitric oxide deficiency, so he prescribed curcumas [sic], L-arginine, and melatonin.

Looking at the studies he cites to support his treatments:
1. I see that in rats a huge dose (60 mg/kg/day) of curcumin reduced oxidative damage during hydronephrosis (blockage of urinary output leading to back pressure and damage to one of both kidneys). It seems to me that since this patient's hydronephrosis resolved years before, giving him curcumin isn't going to help.

2. A study found that spontaneously hypertensive rats had impaired l-arginine transport, leading to reduced NO in the kidneys. I don't see why anyone would conclude from this that giving supplemental l-arginine to a patient who presumably does not have impaired l-arginine transport would improve his hypertension. There is some evidence that supplemental l-arginine can improve high blood pressure, but it can also interfere with some medications for the condition.

3. A study found that renovascular hypertension in rats (due to poor blood supply to the kidneys) could be ameliorated with large doses of melatonin. How this relates to hypertension secondary to hydronephrosis in humans, is anyone's guess. A dose of melatonin of 10 mg/kg/day in a 70 kg human would be 700 mg/day, which seems an awful lot to me. The cheapest melatonin I can find is 180 3 mg capsules for about $10, so the dose that reduced blood pressure in rats would cost about $13/day, and even assuming the patient could afford this, and although it is unlikely to have any immediate toxic effects at that dose, it would probably cause drowsiness, which may not be very sensible in a keen swimmer and lifeguard..

What concerns me more is that this patient was prescribed medication for a potentially life-threatening condition. Hypertension isn't called "the silent killer" for nothing, and strokes and heart attacks are seen depressingly frequently in young people (coincidentally I was just interrupted by a friend who told me she recently attended two funerals of young men in their 30s who had died of MIs, probably due to anabolic steroid abuse). Trying to manage a condition like this without the proper medication prescribed by a real doctor strikes me as extremely irresponsible.

By Krebiozen (not verified) on 13 Oct 2014 #permalink

I'm coming late to the party here, but . . . reflux disease for 13 years, and then a naturopath cures it in 4 days? As a lifelong GERD sufferer (due to anatomic causes that run strongly in my family; diet and lifestyle mods made it less painful but didn't cure it), I find myself just a touch skeptical that we've got the whole story here (assuming the whole thing wasn't just invented out of thin air).

Some folks have already suggested possible explanations. I've got another. What if the patient was taking proton-pump inhibitors but taking them *wrong*? You take Pepsid AC or Tums or Pepto-Bismol when you feel symptoms. They neutralize the acid and you feel better. But PPIs have to be taken daily, on a very regular schedule, or you get something really nasty: rebound reflux. The body has detected an abnormally low acid level in the stomach and is trying to respond by increasing production. But the PPIs are blocking production. So if the level of the PPIs in the blood go down, suddenly all that stuff starts working again and BAM, way more acid than you need to digest your food, and really spectacularly bad reflux. So if this guy kept taking them for short periods, and then trying to go cold turkey off of them, of course he'd get horrible hearburn and go right back on them. And that would last about four days before his body found its new normal again. Maybe what he really had was an underlying conidition 13 years ago, which he's resolved with diet and exercise in the meantime, but because he wasn't tapering off the PPIs, he was getting this horrible heartburn because he wasn't giving it enough time to fully resolve.

By Calli Arcale (not verified) on 13 Oct 2014 #permalink

@ Calli:

Exactly. I unfortunately know all about GERD and ulcers as many members of both of my parents' suffered from these conditions. Thus I knew how to use OTC meds when I suffered a months-long bout of reflux 10 years ago.

More relevantly, my cousin, who is 50, had bleeding ulcers at age 4! His mother found a doctor who imported experimental acid-blockers from Sweden which helped him immensely. Over the years, he learned via endoscopy that he had a physiological anomaly that directed the acid up rather than down. Now, he's manages his condition through diet and OTC meds and is fine. He is -btw-my relative who creates visual movie magic for a living.

By Denice Walter (not verified) on 13 Oct 2014 #permalink

While critiquing naturopaths and other quackery promoters for their antivax activities, we should praise those wooists who have less destructive viewpoints.

Take for example this spokeswoman for the American Holistic Medical Association, who has a practical suggestion in response to a question about vaccines:

(Q): "My un-vaccinated 19 year-old college student would like to spend the spring semester abroad in Oaxaca, Mexico and the local hospital travel vaccine clinic is recommending 13 vaccines for this province. How would I then pick and choose and learn percentages of each disease in the region and how would I advise her? She would be getting them all close together as well. What should I be concerned about? I choose not to vaccinate her as a baby for I wasn't convinced she was at risk of getting the diseases and I feel they are unnecessary chemicals."

(A): "This is a tough one. These shots have brought these really bad diseases under control but some times do have adverse effects. One thing you can have her do is, as soon as she gets home from getting the shots, get into a hot epsom salt bath and stay there until she breaks into a good sweat. During this time, have her visualize the toxins being removed as she sweats, and allowing the helpful aspects to do their job. I have used this for many years as I have been in many areas where the diseases were active. Good luck!"

http://holisticmedicine.org/content.asp?contentid=109

Neat, huh? Though a really strong-minded person should be able to "visualize" the "toxins" leaving their body without needing an Epsom salt bath. Shouldn't reiki be effective in this regard?

By Dangerous Bacon (not verified) on 13 Oct 2014 #permalink

DB: " get into a hot epsom salt bath and stay there until she breaks into a good sweat."

The visitors we had while living in the Panama Canal Zone would get a shock from the tropical heat. We found that they adapted better after they had a hot soak in the bathtub.

It wasn't "toxins", it was dealing with temperatures and humidity much higher than what you are used to!

@Krebiozen #97,

Thanks for your reply. I detest quackery because it is a multifaceted alternative-to-medicine business empire that maximally exploits ill people using obfuscation, science denialism, and fraud. However, things such as aromatherapy, reflexology, and Indian head massage can be usefully soothing adjuncts to professional medical care, provided that the alt-med practitioners involved never pretended that they can diagnose or cure illness: they are simply providing human touch and conversation, aka tender loving care (TLC), which can be highly beneficial to patients who are not receiving appropriate/enough/any TLC from their family and friends.

Provided that these alt-med practitioners working in NHS hospitals are adequately supervised and monitored, I think that they may be able to provide a service that has a useful cost-benefit ratio with acceptably minimal risks. Of course, what we need is not opinions, we need scientific evidence of their efficacy and risk factors.

Hot water burn baby....

FYI-
This was just passed along to me. There is also a "Naturopathic Physicians" FB group which might function similarly to their Yahoo! group:

http://pastebin.com/myFQqJYh

Probably more HIPAA violations (as they discuss) and woo exchanging.

By naturowhat (not verified) on 13 Oct 2014 #permalink

Kreb@125
Hydronephrosis doesn't cause hypertension, renal artery stenosis does. The proper treatment of hydronephrosis is relief of obstruction. That quack really was out of his league.

By MadisonMD (not verified) on 13 Oct 2014 #permalink

From naturowhat's link:

Setareh Shabafrooz-Tais Michael I agree with you. Our group needs to be more mindful about what we share on Facebook, including being more careful about patient identifying information.

Michael Long I have personally stopped posting clinical cases on this group, as well as the Canadian ND group. Instead I've mainly been using it for clinical pearls or discussing practice management or political issues. If these threads ever moved in to the public realm, it would be simple for patients to search their ND and see what they've written. This could be problematic on so many levels.

Great...just great.

By Science Mom (not verified) on 13 Oct 2014 #permalink

Darwy: "when we can just inhale our nutrients."

If you think humans *can't* inhale nutrients already, you've clearly never been around teenagers. I swear for about six years I thought my little sister was part vacuum.

By Politicalguineapig (not verified) on 13 Oct 2014 #permalink

Aargh, blockquote fail. The "Great...just great." is my own comment, the two preceding ones in italics are copy pasta from the link.

By Science Mom (not verified) on 13 Oct 2014 #permalink

ORAC if you spent the same amount of time caring for your patients, instead of proselytizing about your extremist views, you could probably help a lot more people. You and your cronies will eventually be caught for stealing private information. It is a matter of time. Karma. Oh, wait, is that too woo woo for you too.

ltbk,

What did you do all day today to help your fellow men, or do you think a life of relentless and breakless grind of altruism and succour without allowing for other interests only for others?

@137 :
... "Private information" ? Do tell ; what exactly was "private" ?

I would be very careful about inhaling nutrients.

For one thing, I need a fair amount of fiber in my diet. I don't think that would get to the right place.

But, more importantly, about 20 years ago I accidentally aspirated a little bit of spit and wound up in the hospital for two weeks with a nasty anaerobic bacterial infection.

So, chew and swallow carefully.

By squirrelelite (not verified) on 14 Oct 2014 #permalink

As HDB said, that’ll be the day – when we can just inhale our nutrients.

Clearly, neither of you have ever been in the mess hall at Parris Island.

Just to clarify and to make a point. I am 3rd year ND student and our anatomy professor is an MD who teaches also at ucla medical school. He teaches the same material here and Ucla and gives exactly the same exams. I feel that my education is very comparable to an MD.

By Nd student (not verified) on 14 Oct 2014 #permalink

Orac, please refer to her as Dr Burklund. She has earned that honor after 5 years of medical school and countless hours of clinical training. You would demand the same respect given what you earned as an MD & Ph.D.

Thank you for your passionate disdain of alternative medicine. It will be individuals like you and your outspoken negative attitude towards natural medicine that will cause naturopathic medicine and doctors to thrive even more.

If you had a dialogue with Dr Burklund you would find her knowledge of medicine to be equal to yours and superior in many ways.

With only 217 likes to Dr Burklund's 4500 Facebook likes (and growing) you seem to be fighting a losing battle. There is room for both modalities of medicine to flourish, but please keep up your antiquated viewpoints. It will only serve to enhance the credibility of passionate medical professionals like Dr Michele Burklund.

Why should I refer to her as “doctor”? She isn’t one.

I'm too tired to go look at the law in Washington State, but I strongly suspect that use of the title by Burklund herself would require postfixing "N.D.," which just gets unwieldly if one isn't, you know, getting paid to advertise for her.

Perhaps David would settle for "seemingly failed real estate agent."

Re: #143...
There we have it, folks, clear proof of the effectiveness, validity and ultimate eventual triumph of CAM: way more Facebook likes! And to think of all the money given to NCCAM for research! It was wasted...all that one needed to do was compare the number of Facebook likes between the two "modalities." I guess Orac will have to shut down his blog and learn psychic surgery or Reiki or something.

(I hope it's obvious I'm being sarcastic here.)

By Harrison Bolter (not verified) on 14 Oct 2014 #permalink

It is a matter of time. Karma. Oh, wait, is that too woo woo for you too.

To the extent that you seem to be too lazy to even bother to pick one of the detailed, extant elaborations, sure.

I am 3rd year ND student and our anatomy professor is an MD who teaches also at ucla medical school. He teaches the same material here and Ucla and gives exactly the same exams.

Well? He does have the same name at the Bastyr satellite campus as everywhere else, right?

I feel that my education is very comparable to an MD.

And your basis for comparison is the presence of a lone, unnamed UCLA anatomy instructor?

Narad & Harrison,

I suppose I do deserve a little good natured ribbing for using the highly credible "Facebook Likes" as a defense. Touche to you both....

The thing I love most is that all the press is going to increase Dr. Burklund's sales and increase her brand recognition. Read this analysis from Stanford's Business School: http://pubsonline.informs.org/doi/abs/10.1287/mksc.1090.0557

Why doesn't Orac say his real name? Is he afraid he might get fired from Barbara Ann Karmanos Cancer Institute? or Wayne State University if they know who he really is and his personal attacks?

The thing I love most is that all the press is going to increase Dr. Burklund’s sales and increase her brand recognition.

What "press"? This?

Why doesn’t Orac say his real name?

You're really going to need to break a sweat running to catch back up with the turnip truck.

"David" # 149:

Why doesn’t Orac say his real name?

He does. On this very page, one click on an obvious link, and reading four lines YMMV, depending on your display device settings) on the linked page: there it is.

Is he afraid he might get fired from Barbara Ann Karmanos Cancer Institute?

Certainly not. Such institutes deal with science-based medicine, and therefor oppose imagination-based 'medicine'. Why would they object to Orac telling the truth?

or Wayne State University if they know who he really is and his personal attacks?

The University also opposes imagination-based 'medicine'. They have gotten multiple complaints from IB'M' supporters, and they have encouraged Orac to continue his recreational activities.

By Bill Price (not verified) on 14 Oct 2014 #permalink

My response to #149 is lost, somewhere, with a mistyped email address. I hope Orac can find it and forgive my screwup.

By Bill Price (not verified) on 14 Oct 2014 #permalink

^ "I’m too tired to go look at the law in Washington State California"

Told ya I was too tired.

ND Student: "Why doesn’t Orac say his real name?"

Because it is the worst secret on the internet. It has become a running meme to see who makes a big deal about it. Usually it is from folks too lazy to click on the blue letters that spell "Orac" under the title of the article.

In short: it is an intelligence test.

Narad,

Yes, I am that David and you have way too much time on your hands... This has nothing to do with my "shared public interest". I simply noticed the ScienceBlogs post and got caught up in the debate. My interest is in supporting someone that I admire beyond words. I watched her go through every step of the process in her 5 years of school (not including the 2 years of pre-requisites through undergraduate) and through the countless hours of clinic work. I can't believe the amount of dedication and commitment it took to earn her title as a doctor as it does with MD's as well. I am taking a stand for someone I respect. I would do the same for you, if I respected you (currently, I do not).

Yes, blog posts, websites, and other media is defined as "press". Every negative or positive post will help increase her brand recognition. So, the more we talk on this the more she will increase her presence on Google and other search engines. Keep up the good work.

By the way, did you read about her in all your extensive research? Her story is pretty impressive as to why she decided to be an ND vs an MD. I find her very inspiring and courageous. Here is the link, but be careful, you may actually find that you like her and could learn something from her. http://www.thenaturaldoctorclinic.com/about/

Feel free to go on davideshoup.com and comment on my blog posts too. Maybe the motivational nature of the posts will inspire you to get off all these negative sites and live your life more fully.

Have a great day!

Thanks Chris, I know who he is (not personally) and have put his name in a previous post, but he chose to take it off. I don't appreciate that, but he obviously has his reasons.

Have a great day!

"Her story is pretty impressive as to why she decided to be an ND vs an MD."

No, no it isn't. ND is Not a Doctor.

Doesn't matter how many times you link to her site (or your own). Intelligent folks aren't buying your special brand of BS.

Yes, I am that David and you have way too much time on your hands… This has nothing to do with my “shared public [sic] interest”. I simply noticed the ScienceBlogs post and got caught up in the debate.

"Simply noticed"? You mean while scouring G—le Alerts for opportunities to try to get away with not declaring your screaming conflict of interest? It seems pretty clear that you don't frequent "all these negative sites," whatever that's supposed to mean.

You and your cronies will eventually be caught for stealing private information. It is a matter of time. Karma. Oh, wait, is that too woo woo for you too.

I like to think that when Gautama Buddha laid out the 2 Nidanas of the Chain of Causation, he was not doing so to provide small-minded curtain-twitchers with more vivid and more enjoyable fantasies about the inevitable downfall of people they dislike. Or maybe he did. He knew what his audience wanted to hear.

By herr doktor bimler (not verified) on 14 Oct 2014 #permalink

Bad karma made me write '2 Nidanas' rather than 12.

By herr doktor bimler (not verified) on 14 Oct 2014 #permalink

Wow, David. My emphasis:
#149

The thing I love most is that all the press is going to increase Dr. Burklund’s sales and increase her brand recognition.

#155

Every negative or positive post will help increase her brand recognition.

That’s what it’s all about? Brand recognition? At least you are honest about it. Forget the patients – just promote your brand!

For the record, I’m not impressed with your (plural) brand.

If that's the best he can do - point out that she's in it for the Marketing, that definitely says something about her particularly "skills."

David,

I went to the web site you linked to, and I was left with questions.

1. It says that by going to school to be a naturopath she took all the classes that an MD would, plus "botanical medicine, physical medicine, counseling, nutrition, and hydrotherapy". Do medical schools not teach these things? Would she have been unable, were she interested, to learn nutrition or physical therapy in a conventional medical school?
2. I'm given to understand that medical school is quite a full schedule. Where did the time come from for these additional courses?
3. She makes a big deal about treating patients as individuals. Do medical doctors not do that and, if your answer is yes, how do you know that?
4. She says that she can "offer far more treatments than just pharmaceuticals". Once again - what's the evidence that medical doctors can't or won't do that?
5. I notice that the Bastyr University 4 year track includes five semesters of homeopathy. Why is that?
6. Given that she spent $400,000 on ND training and has the expenses of an office, staff, and so on required for someone in private practice (N.B. many medical doctors are in private practice as well, so when she says "I would also be an employee with a nice salary and financial stability," that is not necessarily true), how does she have the extra time she provides and still manage to make ends meet? Certainly this suggests she sees fewer patients in a day than is typical for a general practitioner, internist, or physician.

Thanks.

By Mephistopheles… (not verified) on 15 Oct 2014 #permalink

"She makes a big deal about treating patients as individuals. Do medical doctors not do that and, if your answer is yes, how do you know that?"

At my internist's office, everybody is herded into chutes based on A.M.A. guidelines, given a battery of tests and stuffed with drugs. No one actually sees the doctor. We're just a barcode on a chart to these people.

Thank God for the NDs!!!!!

By Dangerous Bacon (not verified) on 15 Oct 2014 #permalink

Why doesn’t Orac say his real name? Is he afraid he might get fired from Barbara Ann Karmanos Cancer Institute? or Wayne State University if they know who he really is and his personal attacks?

Silly rabbit. You're going to feel very stupid when you find my real name on this blog and realize that, when time gets tight, I sometimes crosspost the very same material here and at another blog under my real name. Not this post, but I'm half tempted to do it just to annoy naturopaths.

Feel free to go on davideshoup.com and comment on my blog posts too. Maybe the motivational nature of the posts will inspire you to get off all these negative sites and live your life more fully.

I prefer this motivational speaker.

http://www.hulu.com/watch/4183

" I am 3rd year ND student and our anatomy professor is an MD who teaches also at ucla medical school. He teaches the same material here and Ucla and gives exactly the same exams. I feel that my education is very comparable to an MD."

So when you go into ND practice, will you follow your colleagues' example and ignore most of what you learned about human physiology, biochemistry, anatomy etc.? What's the point of spending all those hours studying and passing tests, unless it's just to claim that you had an education comparable to that of an M.D.?

Seems like an expensive waste of time for such a tiny marketing benefit.

By Dangerous Bacon (not verified) on 15 Oct 2014 #permalink

I know who he is (not personally) and have put his name in a previous post, but he chose to take it off. I don't appreciate that, but he obviously has his reasons.

My "reason" is simple: To annoy people like you who think that "outing" me has any effect whatsoever on what I write or that they can in any way intimidate me by invoking my real name. Oh, don't bother denying that that's the reason you did it. There is no other reason supporters of quackery like you do that, their contorted other explanations notwithstanding.

@Dangerous Bacon,

At my internist’s office, everybody is herded into chutes based on A.M.A. guidelines, given a battery of tests and stuffed with drugs. No one actually sees the doctor. We’re just a barcode on a chart to these people.

Ah, that explains how I got this ear tag.

By Mephistopheles… (not verified) on 15 Oct 2014 #permalink

David - one other point, could someone please explain what Detoxification means in the context of "Medical Detoxification preceptorship"? Thanks again.

By Mephistopheles… (not verified) on 15 Oct 2014 #permalink

So, the more we talk on this the more she will increase her presence on Google and other search engines.

Actually, Orac made sure that all her links have rel="nofollow", so it won't.

By justthestats (not verified) on 15 Oct 2014 #permalink

Orac, please refer to her as Dr Burklund. She has earned that honor after 5 years of medical school and countless hours of clinical training.

I think the obvious point made on this blog post is that she did NOT attend medical school. If she had, she'd be an MD.

David: " have put his name in a previous post, but he chose to take it off. I don’t appreciate that, but he obviously has his reasons."

I see reading comprehension is a problem for you.

Orac: "You’re going to feel very stupid when you find my real name on this blog and realize that, when time gets tight, I sometimes crosspost the very same material here and at another blog under my real name."

Even worse, I explicitly told him how to find the name. He obviously failed the intelligence test.

David, don't waste your efforts on these piranhas. ORAC spends most of his hours bashing CAM, NDs, anything that is not aligned with his narrow-minded thinking. Unfortunately, his only listeners are those who already believe what he believe, and in essence he is only preaching to his own choir. This can never be a productive dialogue, or a disciussion, it will always be one-sided. Let the piranhas stew in their own narrow-minded juices.

This can never be a productive dialogue, or a disciussion, it will always be one-sided.

I'm having trouble figuring out how this objection might allow the communication model of "motivational speaking" off the hook.

This can never be a productive dialogue, or a disciussion, it will always be one-sided.

And yet here you are commenting freely with what kind of "productive dialogue or a discussion" exactly?

By Science Mom (not verified) on 15 Oct 2014 #permalink

Let the piranhas stew in their own narrow-minded juices

Fusion cuisine again?

By herr doktor bimler (not verified) on 15 Oct 2014 #permalink

Fusion cuisine again?

Maybe just complementary. Or alternative.

Oh, lord! What's it going to do to gut flora?

Piranhas?
Seriously! I went to grad school with piranhas. I think that we're more like monitor lizards or gila monsters.

By Denice Walter (not verified) on 15 Oct 2014 #permalink

Can you make lutefisk from piranha, one wonders.

It's not the lutefisk you have to worry about. It's the surstrømmningsfilet.

The stench from that will clear a room. Permanently

Can you make lutefisk from piranha, one wonders.

The piranha version has more bite.

By Mephistopheles… (not verified) on 16 Oct 2014 #permalink

Not that anyone cares, but I did ask what I thought were relevant questions as politely and respectfully as I could. If David, or someone else familiar with the training required to be a naturopath could answer, that'd be appreciated.

And what happens in the piranha tank stays in the piranha tank.

By Mephistopheles… (not verified) on 16 Oct 2014 #permalink

This can never be a productive dialogue, or a disciussion, it will always be one-sided.

You may, completely by coincidence, have made a valid point here. The problem is that you're in error about why the argument will be one-sided: it isn't because of narrow-minded thinking or preaching to a choir.

It's instead because there is evidence in support of one side (for convenience we'll call it the anti-CAM side) but no evidence in support of the other (the pro-CAM side). Until the pro-CAM can produce a significant body of actual evidence (not anecdote, no-personal testimony, not appeals to 'other ways of knowing' or tradition, etc.--in support of their claims the dialogue must remain one-sided.

Believe me: we would all love to find out we're wrong. I'd be ecstatic if it turned out handwaving (reiki) could cure serious illnesses or plain water (homeopathy) could cure rabies or Ebola. But it will take more than repetitive claims without any evidence behind them to demonstrate we're wrong.

Lutefisk is a method of reconstituting dried and salted whitefish (which is otherwise so stiff you could beat someone to death with it). Crucial to this is that cod is low in fat, as fattier fish are harder to salt. So I guess it would depend on the fat content of the piranha, whether or not you could do this. I would think the relatively small size of the fish could be a problem, as it might not have enough bulk to hold together during all the abuse it will get.

Piranha surstrømmningsfilet would probably work. I would think you could ruin just about any fish that way. ;-)

By Calli Arcale (not verified) on 16 Oct 2014 #permalink

Crucial to this is that cod is low in fat
So Lutefisk is the piece of cod that passeth understanding/

By herr doktor bimler (not verified) on 16 Oct 2014 #permalink

BWAHAHAHAHAHA!

Oh, that cracks me up, herr doktor, because, and I absolutely kid you not, I actually have a novelty sign on my cube wall (a joke gift given to me years ago) that says exactly that!

By Calli Arcale (not verified) on 16 Oct 2014 #permalink

http://pastebin.com/iVU6RvSa

74495Naturochit Update: Chipping In To Stop The Traitor
Expand Messages

Mona Morstein
Oct 14 12:14 AM
Hello, all,

Well, the saga continues a bit. I guess the fellow put some stuff on FB. I appreciate everyone understanding this is not the end of the world. I am calling the AANP tomorrow to chat with them for some ideas. I also feel we should not be ashamed AT ALL at who we are, what we believe, what we write. There are always cowardly jerks out there in Internet Land who feel compelled to hate behind the safety of their computer screens. I strongly suggest we all stand firm and proud and not cower from him.

I have changed things on the email list so only I can see, edit, upload any databases on Yahoo. I'm not sure but I hope that includes the archives. Yahoo so far has not responded to my emails, but Yahoo hates customer service and can rarely be bothered with offering it.

I am working with Reddit, too, in my lame way. I am not very good with technology.

Last, Dr. Igor put me in touch with an IT specialist who feels quite certain he can track down the problem and get this situation under control.

He charges $100/hour and wants a retainer of $300 to get started.

If anyone in their good graces will help me out and chip in financially in this regard, I, NatChat and the profession would be very grateful.

I am on Paypal at my email address of monam@... and I'm happy to give my home address to anyone emailing me privately.

Thanks so much everyone!

Mona Morstein, ND, DHANP
Tempe, AZ
www.diamend.info
Official Sponsor of NatChat--Doctor's Data Labs

By naturowhat (not verified) on 17 Oct 2014 #permalink

I'm late to the party--the lutefisk has already been brought out! as have the piranhas, apparently; is it too much to hope that they will eat the lutefisk?--but Krebiozen's excerpt at #125 struck me in the upper flabbergastic region.

As a science-oriented undergrad considering medicine or at least a career on its periphery (pharmacy or radiologic tech, e.g.,) one of my worries is that there's too much in too many scientific disciplines for me to learn effectively: that I'll be confronted with situations where I don't know what to do, or can't put the pieces together well enough or quickly enough, and will fail to make the best decision for treating the patient. If I decide to make a go of medicine, it'll be because I think I can store and process all those huge wodges of information well enough to make mistakes rare, and increasingly so as I gain experience.

Krebiozen's quoted essay is terrifying. The excerpted ND, Jacob Schor, admits to feeling each day that he doesn't know what to do for his patients, and describes his process of making things up as he goes based on whatever his PubMed search turns up. He’s got the anxiety that I sometimes get when I imagine people relying on my knowledge and skills, only he’s persuaded himself, somehow, that it doesn’t mean he lacks knowledge or skills. He has no clue how vast the tracts are of what he doesn't know, or how much training actual medical schools put students through to make sure they're prepared. He's not prepared to treat patients--but he thinks that's normal, and that real doctors go about their business in the same way he does, in a perpetual fog of ignorance, just making it up as they go along. The thought that people trust their health to him, and to thousands of people just like him, makes me ill. Now and forever, “ND” must stand for "Not a Doctor."

To Orac and the regulars of the commentariat, thanks for spending so much time pushing back against pseudomedicine, and thanks for being quirky, knowledgeable, and funny. :)

I'm curious about this ND training. What criteria do they teach to determine when to use actual real medicine and when to use the other stuff? Obviously, the criteria for when to use a homeoplacebo should be when there isn't anything with ingredients that is known to work better, but what about the other kinds of non-medicine?

By justthestats (not verified) on 21 Oct 2014 #permalink

justthestats, let the light of Krebiozen's find @125 illumine you (from a part of the essay he/she didn't quote:)

"
These days I know that naturopathic students get trained in a philosophic approach to naturopathic treatment that has been formalized over the years by Jared Zeff and Pamela Snider, in which the determinants of health and all sorts of hierarchical approaches are considered. Having myself been a onetime recipient of the AANP's Vis Award, I feel a certain obligation to take some sort of enlightened approach and adopt one of these strategies.

But I don't. For me it's more a process of elimination. Can I think of a homeopathic remedy that I think will fix this kidney? Not yet, so I don't prescribe one. The kid is pleasant, nothing in our visit has given me a nudge toward a constitutional remedy, nothing in the details of the disease process has shouted out to me, "Give this remedy!" so I simply skip it. For the time being.

Same with botanical medicines. I'm keeping a list of herbs to consider in the kid's chart but not rushing to tell him to take any of them. I'm not sure he will. Not unless I find one that tastes really good.
"

As you can see, it is utterly scientific: the ND reads the patient's medical history, listens as the symptoms are described, then carefully monitors his own brain to see what treatments pop into mind first. If no pseudomedicine seems obviously appropriate, he might have to resort to searching PubMed for studies that seem relevant, even if they're done in rats rather than humansl:

"I keep wondering, though, if there is some way to localize the effect of the supplements which he is taking that would direct their impact to where we want it, in this case to the damaged kidney. The pathology seems centered in that kidney.

When I play "fetch the ball" with our dog and she is searching the wrong area, I will whistle and point. Is there some way to whistle and point those supplements to the kid's kidney, to where they are really needed?

I am debating using low level laser therapy. These "cold lasers" apparently stimulate release of NO in the tissues treated. This NO release and resultant increase in blood flow is often used to explain their benefit in healing injuries. Interestingly, with reperfusion injuries, the laser treatment also appears to protect other organs injured by hypoxia. In a 2012 study of reperfusion injuries in rat colons, laser treatment appeared to protect the rats' lungs. (6) "

Snark aside, is laser treatment to heal kidneys an actual thing, even though he justifies the idea by citing a study that isn't about kidneys and wasn't done in humans?

*humans, not humansI, whatever those are--probably the first version of our impending mechanical replacements.

Low level LASER treatment is a thing, if by thing you mean 'scam'. Our host has covered it several times in the past - you can find the entries by entering 'low level laser' in the search box. Also see
http://www.sciencebasedmedicine.org/lower-level-lasers-n-rays-in-action/
because the world needs more Mark Crislip.

Basically, any LASER that could get any type of energy to the kidney can hardly be called 'low level'. Most energy is absorbed at a depth of 0.5mm, or about .02 inches.

Just keep that laser pointer away from your eyes, Pickwick.

Aww, but Chris, I just splurged on one of these:
http://www.wickedlasers.com/arctic

(as mentioned in
https://what-if.xkcd.com/13/
)

Alright, I won't point it in my eyes or at passing airplanes. Just let me know if anything needs to be medically vaporised, whether it's a kidney or a regular knee .

And, thanks, good Johnny. I should have remembered; I've been reading for years. Many and various are the quackeries our host has covered in that time.

People with damaged kidneys should not be taking random herbs.

By justthestats (not verified) on 23 Oct 2014 #permalink

Plus people with damaged kidneys should consult someone who has passed the medical licensing exam and who did a residency in nephrology.

In a 2012 study of reperfusion injuries in rat colons, laser treatment appeared to protect the rats’ lungs.

Turns out that our man Schor cannot tell the difference between "colon" and "jejunum". In the study, "A laser diode (70 mW, 650 nm) was applied to the serosal surface of the jejunum at a dose of 0.5 J/cm(2) either immediately before or following initiation of reperfusion." So a surgical procedure, with direct application of the laser to the damaged organ (the result was to worsen the damage from cutting off blood flow). Don't try this at home!

I have no idea why the authors imagined that warming the guts with a bit of orange light would improve them.

By herr doktor bimler (not verified) on 23 Oct 2014 #permalink

I have no idea why the authors imagined that warming the guts with a bit of orange light would improve them.

Sounds like an awesome placebo to me!

By justthestats (not verified) on 23 Oct 2014 #permalink

People with damaged kidneys should not be taking random herbs.
There's potential there for a punchline about "grass houses" and "stowing thrones", but I am too lazy to work on the joke.

By herr doktor bimler (not verified) on 23 Oct 2014 #permalink

There’s potential there for a punchline about “grass houses” and “stowing thrones”, but I am too lazy to work on the joke.

'I'm Sorry I Haven't a Clue' did that joke in the late 70s (if memory serves), about a South Sea Island chief who was given a new throne every year, and stashed the old ones in the loft of his grass house until the inevitable happened.... It stuck in my mind along with the one about the koala tree of Murphy making it all the way to Ireland from Australia without getting sprained.

By Krebiozen (not verified) on 23 Oct 2014 #permalink

You can't have your kayak and heat it, Krebiozen!

By herr doktor bimler (not verified) on 23 Oct 2014 #permalink

Pickwick,
I'm glad someone else shared my astonishment at that naturopath's admission that he simply winged his consultations with an amateurish and incompetent look at PubMed. It would be funny if people's health wasn't put at risk by these people.

By Krebiozen (not verified) on 23 Oct 2014 #permalink

I have no idea why the authors imagined that warming the guts with a bit of orange light would improve them.

On the other hand, it's pretty good at entertaining cats.

Krebiozen:

‘I’m Sorry I Haven’t a Clue’ did that joke in the late 70s (if memory serves)

Are you sure it wasn't "My word"? That sounds like the sort of thing they would do.

By Julian Frost (not verified) on 23 Oct 2014 #permalink

That a really old and really bad joke

I'm a really old and really bad joke-teller.

By herr doktor bimler (not verified) on 24 Oct 2014 #permalink

Yea verily, Krebiozen, that essay wanted to be hilarious, but it was awful to read! And worse even than I knew--I didn't think to look up the study he mentioned.

Jejunum =/= colon is taught in some k-12 health classes, as well as in the one-credit pre-req Healthcare Terminology class at my community college. And to read the abstract of the paper and come away with the opposite of its conclusion... herr doktor bimler, I thought I was done goggling. Thank you for correcting me.

One of the reasons I started thinking about medicine was my family's experience with cancer. When an aggressive kind struck our family, a rushing tide of con artists and exuberantly ignorant quacks started swirling and eddying around us in search of money. Orac has covered just about every individual "therapy" and many of the specific practitioners who came up in my family's discussions, but at the time I knew nothing about integrative medicine and knew only enough to shoot down a few of the proposed treatments as deeply unlikely or completely insane. (When it came to the idea that inhaling negative water ions launched into the air by waterfalls would bolster the immune system and kill cancer cells, I doubt any of us believed it, but it made a good excuse to take a last vacation to Niagara together.)

NDs and integrative medicine practitioners thrive on others' tragedies and offer nothing but false comfort and hope. There isn't always real hope to offer, but when there is it comes from real medicine.

"On the other hand, it’s pretty good at entertaining cats."--Shay

That is one good thing about the study: it brings together two traditional sources of feline entertainment, rats and lasers. Now, if there were a medically plausible reason to inject catnip solution into the rats...

A naturopath wouldn't need a medically plausible reason to inject the catnip solution.

By justthestats (not verified) on 24 Oct 2014 #permalink

You are all down right dumb!!! More than half of you all are so brainwashed by the big Pharmas of which brainwashers the whole world and doctors for the $$$!! I'm sure a lot of the doctors wanted to be a doctor for particular reasons as to help the individual but was never taught the things they really wanted to know as the best cures are kept away from the systems and so the doctors only get to teach the minimum to their patients.
I have constantly been going to the doctors more than someone my age should be, and it is only because of the doctors stupid knowledge and advice they are giving me that I am sick to death of them and am now very excited to start studying my natural therapies course next year.
Doctors have done nothing for me but listen to my problem and then sit back on their chairs printing out prescriptions.
I can't be given antibiotics for every damn issue I have for the rest of my life!!
I am so sick of them and their "quackery".

Also incase most of you did not know there is a video out on youtube that talks about how a man once created a device that could cure cancer. and funny enough the pharmas became aware of this and soon enough the man was dead. his device was destroyed and not one little bit of paper work and filing was existent anymore as they were all put on fire. (wow funny about that)
You people need to stop talking about things you all clearly know nothing about. Most people these days give out opinions just because they can and are in the right to have one. Just because you have or can give an opinion doesn't mean it is right or stands to be valid.

G.E.O. I'm not interested in an hour and a half of bad science. Let's just hear it - what are the "forbidden cures"? Lemme guess - cannabis, laetrile, gerson therapy...

By AngryScience (not verified) on 27 Oct 2014 #permalink

"Also incase most of you did not know there is a video out on youtube that talks about how a man once created a device that could cure cancer. and funny enough the pharmas became aware of this and soon enough the man was dead."

Did he forget to copy and send it to 10 other people?

You know, there's also a video on YouTube showing a rainbow in a garden sprinkler's spray, accompanied by the filmographer's explanation that this means They are putting stuff in our water, since rainbows in garden sprinklers is not normal.

So, "I saw it once on a YouTube video" is not a particularly convincing bit of evidence.

By Calli Arcale (not verified) on 27 Oct 2014 #permalink

They've been doing it since the time of Newton as well! Insidious!

Besides, isn't it pretty well known that water treatment involves, well, treatment?

Come to thinking of it, wouldn't homeopathic water treatment be basically infinitely effective?

By justthestats (not verified) on 27 Oct 2014 #permalink

“Also incase most of you did not know there is a video out on youtube that talks about how a man once created a device that could cure cancer. and funny enough the pharmas became aware of this and soon enough the man was dead.”

His body is buried right between the bodies of the guy Big Oil killed when he invented a pill that lets cars run on tanks of water and the guy who invented the first working perpetual motion machine.

I just realized how powerful #216 is. Got any unexplained result in physics? Single photons through a double slit displaying interference patterns? They're messing with the photons! Michelson-Morely? Them again!

Obviously, they're in league with Maxwell's demons!

By justthestats (not verified) on 28 Oct 2014 #permalink

Wu Tang Forever

ORAC is an agent provocateur; obviously. This is COINTELPRO at its finest, hook-line and sinker. This is the same old song and dance that the chiropractic profession has dealt with for greater than a century. He's great with the keyboard, there's no doubt; however, the article and following comments are meant to divide. An uninformed profession, such as that of which orac belongs, that practices primarily symptomatic treat without considering less invasive methods other than pharma and surgery is not a physician in the least. Naturopaths aren't doctors; they're physicians.

By Sharon Peters (not verified) on 29 Oct 2014 #permalink

there’s no doubt; however, the article and following comments are meant to divide

Divide what? An amorphous mass?

ORAC is an agent provocateur; obviously

Orac is working for the chiropodist conspiracy, trying to discredit conventional medicine? O RLY?
I confess that it is easier to believe that Sharon Peters is blitheringly ignorant of the meanings of terms like "agent provocateur" and "COINTELPRO".

Needs more "False Flag!!".

By herr doktor bimler (not verified) on 29 Oct 2014 #permalink

@herr doktor bimler, no no no. Orac is an agent of the great naturopathic conspiracy, seeking to discredit real medicine by over-the-top criticism of naturopathy. The conspiracy has likewise deployed agents to discredit chiropractics, although Orac is not one of them. The goal is to divide the natural alliance of real doctors and chiropractors to prevent them from fighting against the advances of naturopathy. Isn't that obvious?

Where do the reverse vampires fit in?

By herr doktor bimler (not verified) on 30 Oct 2014 #permalink

An uninformed profession, such as that of which orac belongs, that practices primarily symptomatic treat without considering less invasive methods other than pharma and surgery is not a physician in the least

That argument would have more weigh if naturopaths behaved differently.
But prescribing drugs in function of the observed symptoms? That's exactly that homeopathy, chinese traditional medicine, and half a dozen other traditional/alternative medicine do.
And i don't know about you, but myself, I would describe acupuncture as invasive, especially the form where the practitioner inserts the needles a few inches inside the patient's body.

At least with modern conventional medicine, there may be some time some real connection between the symptoms and the treatment.

@GEO

Just because you have or can give an opinion doesn’t mean it is right or stands to be valid.

Very true. If only we had some way to validate our opinions.
I don't know, like doing a comparison between people receiving a new treatment and other people receiving either nothing or the old treatment...

By Helianthus (not verified) on 30 Oct 2014 #permalink

I suspect that G.E.O will be a shining success for woo. Sounds like a hypochondriac. Sugar pills should do the trick.

By the way, I once saw this documentary about a man who could fly and shoot laser beams from his eyes. When I did a search for his name (Clark Kent) there was no evidence he'd every existed. Wow, funny about that. Big Airline and Big Laserpointer teamed up and he was never heard of again.

By NumberWang (not verified) on 30 Oct 2014 #permalink

"the article and following comments are meant to divide."

You forgot "conquer".

It's not COINTELPRO by the way, it's HAARP.

By Dangerous Bacon (not verified) on 30 Oct 2014 #permalink