The University of Arizona Mel and Enid Zuckerman College of Public Health teams up with quacks

Naturopathy is quackery.

I like to start most, if not all, posts about naturopathy with that simple statement. The reasons are simple. First, it's true. Second, most people—including doctors—are unaware of this simple fact. Finally, it irritates naturopaths and their fans. It also has the benefit of setting the tone I want to convey whenever I hear about naturopathy being granted the appearance of academic legitimacy by being embraced by a real academic medical institution. Such were my thoughts when I was made aware of this press release entitled SCNM Offers Dual-Degree Program for Master's of Public Health and Naturopathic Medical Degree in Collaboration with University of Arizona:

In collaboration with the University of Arizona Mel and Enid Zuckerman College of Public Health, Southwest College of Naturopathic Medicine (SCNM) is pleased to offer a dual-degree program for a naturopathic medical degree (ND) and a master’s degree in public health (MPH). Naturopathic medical students will begin classes in the fall 2016.

Students must apply and be accepted into both programs in order to qualify. For the master’s degree in public health, students can choose to concentrate in either public health practice (PHP) or in health services administration (HSA). “For a student interested in leadership positions in public health at government agencies, international health organizations and non-governmental associations, this is a tremendous opportunity to develop a career path,” said SCNM President Paul Mittman. “For SCNM, this collaboration represents another milestone in our strategic plans to grow the college’s academic side as well as our ability to reach and engage more students, faculty and staff.”

Yes, you heard that right. The UA's College of Public Health has made a deal with a school of naturopathy to offer a dual degree consisting of a fake degree from a fake medical school, namely a degree in naturopathic medicine (ND, or, as I prefer to call it, "not a doctor") and a real degree from a real school of public health, or an MPH. It's like a bizarro world copying of a trend that's been going on in medicine for a while, namely for physicians to obtain both an MD and an MPH in order to be able to do a combination of medical research and public health research. It's a powerful combination; so I suppose it shouldn't be too surprising that naturopathy schools, mimicks of all things medicine as they are, saw this trend and tried to copy it for their not-doctors. What I am surprised at is that any reputable school of public health would fall for it. On the other hand, I suppose if medical schools have gotten into bed with naturopathy schools before, as the the Georgetown University has done with Bastyr University and National University of Health Sciences.

So what is the rationale for this collaboration? This:

“Students of naturopathic medicine seek formal public health training. The fundamental principles of naturopathic medicine are similar to those of public health in such areas as health promotion, prevention, and patient education,” said Dr. Cecilia Rosales, assistant dean of Phoenix programs at the UA Zuckerman College of Public Health. “NDs are trained to be more proactive in their approach to wellness than reactive approaches to disease management and treatment.”

“We think it is important to offer public health training to all health-care providers responsible for individual care. This is especially important with the new health-care law that seeks to keep the population well rather than treating and managing illness.”

Dr. Rosales said the collaboration enhances career opportunities for SCNM students as well as opens up wider inclusion of naturopathic medicine in the broader public health community. “At the same time, we are at the very front end of what we expect to be a tremendous partnership with the Southwest College of Naturopathic Medicine.”

No, the fundamental principles of naturopathy sound superficially similar to those of public health, but that's it. Naturopaths claim to be about health promotion and prevention. When their teachings overlap science-based medicine, which they sometimes do by coincidence alone coupled with their co-opting of the science-based modalities like exercise and diet, there is a tiny amount of truth to the claim. However, naturopathic "prevention" comes at a high price, and that price is exposure to pure quackery. As I like to say, you can't have naturopathy without homeopathy. It's a mandatory part of the curriculum in naturopathy schools. It's even in the examination naturopaths take to become certified, the NPLEX. Many naturopaths use it in their practice. Given that homeopathy is The One Quackery To Rule Them All, the very fact that naturopaths so readily embrace homeopathy should tell you all you need to know about how weak their commitment to science is and how much their specialty is infused with pseudoscience.

Homeopathy, of course, is not the only quackery that naturopaths learn and practice, just the most quacky. As Britt Hermes, a former naturopath who gave up naturopathy up when she realized how ridiculously full of pseudoscience it is, points out, naturopathy school also requires its students to master hydrotherapy, herbology, acupuncture and energy medicine (or, as I like to call it, faith healing).

Of course, among all medical institutions, the University of Arizona would have been one of the first ones I'd expect to team up with quacks because the University of Arizona School of Medicine is already highly infused with quackademic medicine, thanks to its resident "integrative medicine" guru, arguably the most famous quackademic in the world, Andrew Weil. Indeed, a year and a half ago, I learned that the University of Arizona Cancer Center was offering the faith healing that is reiki to its pediatric cancer patients, indeed to all of its cancer patients. Meanwhile, Dr. Weil has founded an "integrative medicine" residency program and developed a board certification in this specialty that "integrates" quackery like naturopathy into medicine. Meanwhile, UA rakes in the dollars from the National Center Complementary and Integrative Health (NCCIH) to study acupuncture and other alternative therapies. So, unfortunately, the precedent had been set. It also doesn't help that Arizona as a state is about as quack-friendly as it gets, licensing homeopathic physicians and naturopathic not-doctors.

Britt Hermes makes an excellent point about the claim that naturopaths like to make that they are all about "prevention" while regular doctors are not:

This notion accuses the medical community of being incompetent and misguided. It is an old argument from the late 19th century when scientific medicine was still figuring itself out while homeopaths, osteopaths, chiropractors and naturopaths aggressively marketed fanciful methods designed “to treat the root cause of disease, not just symptoms.” For buying into this archaic ideology, the UA is being academically disingenuous, hindering the scientific process and tarnishing its reputation.

To be clear, there is nothing “proactive,” let alone safe, about giving patients sugar pills, recommending severe dietary restrictions, prescribing untested plant extracts, discouraging vaccines or injecting a cornucopia of substances from high-dose vitamins to ozone gas into patients’ veins.

Exactly. It is not a good thing to be "proactive" when being "proactive" involves subjecting patients to homeopathy, IV ozone, unproven supplements, using thermography to diagnose breast cancer and many other diseases (as naturopaths like to do). Being proactive should involve applying the best science to medicine and prevention. Good MPH programs teach their students how to do just that. By embracing the quackery and pseudoscience that is naturopathy, the University of Arizona Mel and Enid Zuckerman College of Public Health has abdicated its responsibility to teach their students about prevention, health maintenance, and public education about medicine.

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From the linked LTTE by Britt Hermes:

In the press release about the SCNM alliance, UA’s assistant dean at the College of Public Health program in Pheonix, Dr. Cecilia Rosales, reiterates a common naturopathic trope of prevention: “[Naturopathic doctors] are trained to be more proactive in their approach to wellness than reactive approaches to disease management and treatment.”

As Ms. Hermes correctly notes, this is premium fertilizer. In order to be "proactive", one must have some idea what the bad outcome needs to be prevented. And it needs to be more specific than "the patient gets sick".

There are things that SBM doctors do that are proactive. Vaccines prevent specific diseases. Doctors who know the patient's medical history can spot susceptibilities to certain conditions, e.g., cancer or heart disease, and recommend steps to reduce the risk. Likewise, naturopaths are being reactive when they advise their patients to take 60C nihilis nostrum or whatever homeopathic "remedy" is "indicated" for the patient's symptoms (and even taking the claims of homeopaths at face value, their remedies are specifically designed to treat the symptoms).

The main difference is that SBM doctors actually have reasons other than wishful thinking to believe that their treatments will work. Wishful thinking is all the naturopaths have.

By Eric Lund (not verified) on 01 Oct 2015 #permalink

Developments like these ( UA, Georgetown) enable woo-pushers to claim that paradigm shift has occurred: I hear this frequently "even MEDICAL SCHOOLS are changing". Or "Research at the UNIVERSITY of wherever shows.." Or " DR So and So at HARVARD".

Interestingly, (from Hermes's quote about the late 19th century being a time when SBM was "figuring itself out")
I've heard via PRN that this era was when alt med practitioners were being forcibly replaced by the Rockefellers' coal-tar based pharma-based medicine using unscrupulous tactics aimed at eliminating their art forms entirely through governmental regulation and the funding of universities.

Thus, the alties provide alternative history as well as alt med.

By Denice Walter (not verified) on 01 Oct 2015 #permalink

Thanks for the info, Orac.

I did my pediatric residency at the U of A in Tucson. I will be writing a letter to the Dean of the Medical School as well as the chair of pediatrics demanding they oppose this dual-degree program based especially on the anti-vaccine stance of naturopaths. I hope there is someone at Arizona Mel and Enid Zuckerman College of Public Health that understands how large a contribution vaccines have made to improving public health.

Arizona has one of the highest non-medical vaccine exemption rates in the country and this year's CDC vaccination survey shows AZ with the worst (of all 50 states) MMR vaccination rates in the US.

This is a boneheaded and dangerous move, Arizona Mel and Enid Zuckerman College of Public Health.

By Chris Hickie (not verified) on 01 Oct 2015 #permalink

I’ve heard via PRN that this era was when alt med practitioners were being forcibly replaced by the Rockefellers’ coal-tar based pharma-based medicine using unscrupulous tactics aimed at eliminating their art forms entirely through governmental regulation and the funding of universities.

Which is quite a trick considering that the FDA and the NIH didn't exist at the time. And a remarkably ineffective conspiracy at that, since homeopathic remedies have never been subjected to the sort of federal regulations that apply to Big Pharma's products.

But it points to a major problem we are facing in this country (one which, alas, is not limited to medicine): certain groups of people believe they are entitled to their own facts. There is no way to win an argument with such people.

By Eric Lund (not verified) on 01 Oct 2015 #permalink

@ Eric Lund:

How I understand his tale:
the Rockefellers had excess coal tar/ petrol products which they wanted to aggressively market so they attacked the alt med folk in order to supplant the latter's wholesome healing herbals with coal/ oil pharma so they introduced governmental controls, bribed officials, encouraged journalistic outrage and used generalised sculduggery in order to tarnish the alties' sterling reputations amongst the public and then replaced that natural artistry with high priced chemical poisons and university-trained MDs! They continue to oppose natural medicine to this VERY day!

-btw- I perused Mikey's Truth Wiki and stumbled upon the entry about esteemed host ( under his real name).

By Denice Walter (not verified) on 01 Oct 2015 #permalink

This is very sad to read. My daughter just graduated from UA with her MPH. I'm forwarding this to her.

Thank you, Orac, for giving this news wider attention. As an alumnus of the UA, I am very disappointed. It has not been fun defending this letter to some very upset cultural anthropology friends.

Is quackademic medicine on the march like this in the rest of the world,or is it just a North American thing?I have read very little about this outside of your blog,and over at SBM.This is a subject that the media at large seems to have completely ignored.It seems to me the rise of quackademia is just another symptom of the increasing revolt against science as a whole in America.Dan Rather wrote a very good article last week about the movement against science by both the left and the right in America.Rather admits the media helps promote this bias against science,by not educating the public at large about science.

Is it possible more universities are offering programs like this because this is what the tuition paying public,and big donors want?That universities and medical schools may just be doing this just to get money?

By Roger Kulp (not verified) on 01 Oct 2015 #permalink

Is it possible more universities are offering programs like this because this is what the tuition paying public,and big donors want?That universities and medical schools may just be doing this just to get money?

It wouldn't be so much the tuition-paying public (in many cases, tuition payments, even without the state subsidy, don't cover the cost of educating the student), but big donors, definitely. Campuses want top-notch facilities to attract prestige, top-notch faculty, and the best students they can recruit. So if some deep-pocketed prospective donor is offering umpteen million dollars to found the $DONOR Center for Integrated Medicine at a university with a medical school, he'll get an audience, just as if the request were for a new $DONOR Biological Sciences Building. The President (or equivalent) of the university may not know the difference; depending on his academic background, he may not have had a hard science course since high school. All he knows is that $DONOR wants to give his university a bunch of money, and his job is to get people like $DONOR to give bunches of money to his university. Every university I have ever been affiliated with operates this way; the only reason my current employer will never have a $DONOR Center for Integrative Medicine is because we do not have a medical school.

For a state university like UA, insufficient state subsidies is part of the problem, but Georgetown (to take an example mentioned upthread) is a private university, so this constraint does not apply.

By Eric Lund (not verified) on 01 Oct 2015 #permalink

NDs are real doctors, with equal training and hours as MDs in the USA. The U of A has been open to NDs for a long time via Andrew Weil, MD and NDs on that board; but we keep getting paid assassins like this (paid by the AMA, etc) and others who are conventionally trained (and brain washed, really, via politics and a strict agenda based on money and rarely science). And Britt Hermes was an unhappy student from Bastyr (probably flunked out) who moved to Germany and continues to slander NDs, even has a group of "editors" (assassins) on Wikipedia, which long has had a bias as well! So NDs continue to get no respect, publicly. But their patients sure are happy. My insurance agent even said there is so little complaints and virtually no law suits against real NDs that they can offer extremely low premiums. I guess we will just have to be content with those last two points, for now!

Is quackademic medicine on the march like this in the rest of the world,or is it just a North American thing?

Not at all. It's a global phenomenon seen in most developed countries. Particularly affected are the UK, Europe, and Australia, but it's not limited to there.

For most of my life, I shared that same erroneous opinion about Naturopathic physicians, chiropractors, etc. After all, this is what I was taught by my medical profession. It was only after I began to witness first hand the incredible successes achieved in many lives where traditional Allopathic medicine was limited or failed, did I then have to admit THE TRUTH. There IS a place SIDE BY SIDE for these two modalities for the purpose of achieving optimal health for patients. I truly applaud these honorable institutions of higher learning for incorporating Naturopathic training and the possibilities that it brings.
By doing so, we are taking the medical profession forward rather than limiting patient care by our own lack of knowledge, prejudices or "soap boxes". It is humbling to admit that we can be wrong but also a good place to start in moving forward in health care!

By Dr. Susan Werner (not verified) on 01 Oct 2015 #permalink

NDs are real doctors, with equal training and hours as MDs in the USA.

Come on, this is obviously false. How many MDs learn homeopathy?

a strict agenda based on money and rarely science

please, do describe the science that supports homeopathy, let's discuss that!

ND's are real doctors; really. I guess this technically true in that they received a piece of paper that states they received a degree. However, when I hear of an ND that has a woman jump up and down to induce labor I know they are a real doctor.

Currently there is a news story about a group of US medical tourists that received live cell therapy and contracted Q fever from it. Yep real medical doctors.

Brad: "And Britt Hermes was an unhappy student from Bastyr (probably flunked out) ..."

You are obviously illiterate. You should probably have someone help you to read and understand the articles she wrote at SBM.

Plus you must be innumerate. This is why you are confused about the number of hours taken, and the length and type of residency training. I have seen MD and DO graduates as residents at local hospitals, but never an ND. The only way anyone would think studying homeopathy is worthwhile (and it is required at Bastyr) is that they flunked both basic arithmetic and chemistry.

@Chris Hickie #3:

This is a boneheaded and dangerous move, Arizona Mel and Enid Zuckerman College of Public Health.

Yes yes yes, but does it mean the college will profit? After all, what use is a college to anyone if it can't make money from what it does?

By Rich Woods (not verified) on 01 Oct 2015 #permalink

To Whomever you are @ #12
If you have to capitalize "THE TRUTH" it's probably not true.

Dear NDs:

You don't know crap. You've never cared from critically ill patients. You don't understand science, anatomy or physiology. And, since you are anti-vaccine, allow me to tell you as a pediatrician to go jump in a damn lake with your "equality" claims. You are quacks through and through.

Sincerely,
a real physician

By Chris Hickie (not verified) on 01 Oct 2015 #permalink

I would challenge our newest visitors to name a specific evidence-based treatment offered by NDs that isn't offered by MDs or DOs (or MBBSs, or MBChBs, of course!).

Or rather, let me clarify: I would do that, but then we all know it's futile to bother.

we keep getting paid assassins like this

You should always request a paid assassin if you want a quality job. I'm not saying you couldn't find an amateur assassin who would be suitable for, say, a wedding or bar mitzvah, but why would you risk your important assassinations on an amateur who might bungle it? If you want the job done right and you don't want to do it yourself, spend the bucks and hire a professional. And remember to look for the union label.

By Mephistopheles… (not verified) on 01 Oct 2015 #permalink

I began to witness first hand the incredible successes achieved in many lives where traditional Allopathic medicine was limited or failed,

Could you please tell us:
- what were these successes?
- what were the treatments?
- why do you think the successes were a result of the treatments rather than in spite of them?

Thanks.

Oh, by the way, "allopathic" is a term used to distinguish any medicine that isn't "homeopathic". Did you really mean to use that term?

By Mephistopheles… (not verified) on 01 Oct 2015 #permalink

Naturopathy is quackery.

I like to start most, if not all, posts about naturopathy with that simple statement. The reasons are simple. First, it’s true. Second, most people—including doctors—are unaware of this simple fact. Finally, it irritates naturopaths and their fans.

Mission accomplished, at least with Susan Werner and Brad. :-)

It is humbling to admit that we can be wrong

'Dr.' Werner:

I began to witness first hand the incredible successes achieved in many lives

Could you be wrong about what caused these 'successes?' What, hypothetically, would convince you that these successes had nothing to do with whatever alternative treatment you're referencing?

Oh, looks like the Kid missed out on the perfect program to meet his distorted view of reality.

By Chadwick Jones (not verified) on 01 Oct 2015 #permalink

My insurance agent even said there is so little complaints and virtually no law suits against real NDs that they can offer extremely low premiums.

As noted above, NDs tend to have low-risk patients. So they rarely have things go catastrophically wrong. That doesn't exclude treatments going wrong in non-catastrophic ways, such as having no efficacy beyond the placebo effect. And they have been using many of these non-efficacious treatments for a century or more. At least science- and evidence-based practitioners eventually weed out treatments that don't work.

Furthermore, extraordinary claims require extraordinary evidence. For homeopathy and energy medicine to be correct, much of what we know about chemistry and physics would have to be wrong. Specifically, aspects of chemistry and physics that have been thoroughly tested to high precision would have to be wrong. So not only do you have to come up with versions that allow homeopathy to be correct, you would have to come up with something that passes these experimental tests at least as well as our existing framework. You're welcome to try it. You'll almost certainly win a Nobel prize if you succeed. But I won't wait up nights for these new theories to come in.

By Eric Lund (not verified) on 01 Oct 2015 #permalink

"There IS a place SIDE BY SIDE for these two modalities for the purpose of achieving optimal health for patients. "

Dr. Werner, what exactly does naturopathy offer that standard of care evidence -based medicine does not, such that we'd reasonably expect patients receiving both naturopathic and standard of care evidence-based treatment to acheive better outcomes than patients receiving standard of care treatment alone?

Orac,

Yesterday, I was able to irritate a "believer" using you and this site. One of our wellness team nurse (real medical) came into my office and I showed this site and commented about it to her.

Her reply was that this site would never make any good comments about alternative medicine. I told her yes good comments could be had if some treatment by alternative medicine was actually proven to work.

Of course we all know how soon that will be.

Susan Werner and Brad-- After reading through a substantial amount of the conversations in a Yahoo group between ND's regarding treatments, I was thoroughly convinced that they didn't have nearly enough training of clinical relevance to do anything. It was almost like they would play Boggle with medical literature, just looking for a specific term here or there.

By Chadwick Jones (not verified) on 01 Oct 2015 #permalink

this is what I was taught by my medical profession.

Are you an MD, by the way? Because there is no MD with that name in Arizona. Did you mean to type Stefanie by any chance?

Naturopaths without borders...what a joke.

And Susan? May I ask what field your doctorate is in? The Arizona State Medical Board has no record of a licensed MD or osteopath named Susan Werner.

To Chris Hickie #3:

“I did my pediatric residency at the U of A in Tucson…Arizona has one of the highest non-medical vaccine exemption rates in the country and this year’s CDC vaccination survey shows AZ with the worst (of all 50 states) MMR vaccination rates in the US. This is a boneheaded and dangerous move…”

I have nothing against vaccinations, personally, but I’d like to play Devil’s Advocate.
Specifically, Devil’s Advocate from the point of an evolutionist, an evolutionist who is also
a) AGAINST “stupid” and “religious” people, and
b) FOR population control, and even, perhaps, reducing the world’s population.
(I think most contributors and commenters here fit this description.)

The smart people who get vaccinated have nothing to fear from the dumb people who don’t. The smart people are protected by their vaccines.
And if the dumb people who don’t get vaccinated die as a result, it serves them right, and will be a lesson to the possibly-dumb people who are still on-the-fence about vaccinations.

The silver lining is that the world would then have fewer people, and more importantly, fewer “stupid” and “religious” people.

No coercion, no murder involved here. Just natural societal evolution, a type of social Darwinism, if you will.

So, my Devil asks: What’s the problem, Chris?

By See Noevo (not verified) on 01 Oct 2015 #permalink

#31 The dumb people still risk infecting people, especially vulnerable populations.

By Chadwick Jones (not verified) on 01 Oct 2015 #permalink

Wikipedia, which long has had a bias as well!

True, they do aspire to be reality-based.

By herr doktor bimler (not verified) on 01 Oct 2015 #permalink

SN: "The smart people who get vaccinated have nothing to fear from the dumb people who don’t. "

So what is your plan to protect babies under age one from measles, mumps and chicken pox? Do you consider their parents as "dumb people" because they wait until the child is eligible for those vaccines, which after their first birthday?

According to the CDC the last measles outbreak included "26 (16%) were aged <12 months." (sorry for the wonky grammar, direct cut and past from the report)

There IS a place SIDE BY SIDE for these two modalities for the purpose of achieving optimal health for patients.

Are you saying you're ragged and funny? Inquiring minds want to know.

By Mephistopheles… (not verified) on 01 Oct 2015 #permalink

See, vaccines aren't 100% effective: some 'smart people' who get vaccinated are expected to fail to develop protective antibody titers, just as people contract an infectious disease sometomes fail to develop sufficient antibody titers to protect them against subsequent reinfection by teh same disease (my son, for example, has had chicken pox 3 times).

Finally there are a significant number of people who for legitimate medical reasons aren't suitable candidates for vaccination (people undergoing chenotherapy, for example).

These people can rely on herd immunity for preotection from infectious disease, and those 'dumb people' (your characterization, not mine) compromise that herd immunity, placing them at increased risk of infection.

There is also the little fact of hundreds of thousands of babies, who are too young for some vaccinations....so I'd rather protect them then watch them suffer from measles, mumps, rubella or the other host of childhood VPDs that they could be exposed to.

The smart people who get vaccinated have nothing to fear from the dumb people who don’t.

This is at best an exaggeration. As you're doubtless aware, no vaccine is 100% effective. While it can reduce the chances of infection by, say, 90% * on average, some people will not receive full benefit, some may temporarily become more susceptible due to a depressed immune system, and some may be exposed before being vaccinated. Thus being vaccinated (or intending to be vaccinated) does not provide an absolute protection against the disease.

And if the dumb people who don’t get vaccinated die as a result, it serves them right, and will be a lesson to the possibly-dumb people who are still on-the-fence about vaccinations.
The silver lining is that the world would then have fewer people, and more importantly, fewer “stupid” and “religious” people.

The guiding factor in being unvaccinated until the age of majority is not one's own views, but one's parents' views. While there is certainly a genetic component to intelligence, this oblique form of eugenics is unlikely to raise the overall intelligence of the race. Additionally, remember that diseases like polio or measles may cause non-fatal but undesirable side effects like, say, paralysis or permanent deafness which don't necessarily preclude one from contributing to the gene pool even if one were to later decide "I survived measles, my kids can too."**

* Number given for illustrative purposes only, since IANAENDIPOOT.

** I do not know anyone who had a permanent injury from disease who has ever said that , and I probably am excessively insensitive in positing that someone could. I apologize, but use it for effect.

By Mephistopheles… (not verified) on 01 Oct 2015 #permalink

And remember to look for the union label.
The Assassins' Guild does not encourage free-lancers.

Britt Hermes was an unhappy student from Bastyr (probably flunked out)
If only there were some way to look up information on the Intertubes, and encounter facts such as

[Hermes] graduated from Bastyr University with an N.D. degree and practiced as a naturopath for about 3 years

Alas, such possibilities remain in the realms of fantasy.

By herr doktor bimler (not verified) on 01 Oct 2015 #permalink

he Assassins’ Guild does not encourage free-lancers.

Lord Vetinari would agree.

By Mephistopheles… (not verified) on 01 Oct 2015 #permalink

Next from the U. of Arizona Astronomy Department:
"Students of astrology seek formal astronomy training. The fundamental principles of astrology are similar to those of astronomy in such areas as calculation of orbits, eclipses and other significant astral events."

This will then lead to a comment like that from Dr. S. Werner (#12)
"It was only after I began to witness first hand the incredible successes achieved in many lives where traditional Astronomy was limited or failed and destroyed their families (all these night shifts observing stars) , did I then have to admit THE TRUTH.
There IS a place SIDE BY SIDE for these two modalities for the purpose of achieving optimal predictions of the future, be it eclipses or your love life."

have nothing against vaccinations, personally, but I’d like to play Devil’s Advocate.

No, you're just an attention whore.

The smart people who get vaccinated have nothing to fear from the dumb people who don’t.

That you would post that places you squarely in the "dumb" camp.

How many of those babies in Chicago last winter who caught the measles were old enough to be vaccinated?

This sort of stuff really makes me want to not live on this planet anymore.

By David N. Andre… (not verified) on 01 Oct 2015 #permalink

Additionally, remember that diseases like polio or measles may cause non-fatal but undesirable side effects like, say, paralysis or permanent deafness which don’t necessarily preclude one from contributing to the gene pool

And there's always mumps, which can keep a young man from contributing to the gene pool, ever.

I’d like to play Devil’s Advocate

To be fair, the role of Promotor Fidei in the canonisation procedure was really just to lend a vague air of skeptical credibility to the marketing charade; the Advocatus Diaboli was not expected to advance serious or convincing reasons or evidence against the candidate

By herr doktor bimler (not verified) on 01 Oct 2015 #permalink

Chris Hickie@3

I will be writing a letter to the Dean of the Medical School as well as the chair of pediatrics demanding they oppose this dual-degree program based especially on the anti-vaccine stance of naturopaths.

I fear that the antivaccine criticism won't hold sway. The current AANP statement[1] is very wishy-washy but doesn't actually say anything bad about vaccines. The new draft one[2] specifically advocates the CDC schedule. Never mind what goes on in reality, no true naturopath is antivaccine.

Especially when there's money involved I imagine the University will take the official statement at face value and dismiss evidence like Britt Hermes posts and the Read what naturopaths say to one another subreddit as false flags.

Maybe being affiliated with a real university will shine some light on their syllibi and textbooks. I think it's possible that there's no blatantly antivax stuff in their coursework but a good chance that homeopathy is taught as an alternative to the flu vaccine. I think the flu vaccine specifically (rather than general AV leanings) will prove to be the weakest point in this proposal. Both their stance on giving it to patients and getting it themselves as healthcare workers are potentially problematic.

[1] h[]p://www.naturopathicdiaries.com/wp-content/uploads/2015/02/Immunizations.pdf
[2] h[]p://www.naturopathicdiaries.com/wp-content/uploads/2015/08/AANP-vaccine-pos…

By capnkrunch (not verified) on 01 Oct 2015 #permalink

In (slight) defense of Dr. Cecilia Rosales, and the Zuckerman College of Public Health:

We think it is important to offer public health training to all health-care providers responsible for individual care.

...seems like a valid interpretation of mission to me. And since

Arizona as a state is about as quack-friendly as it gets, licensing homeopathic and naturopathic not-doctors.

...it's kind of the University's responsibility to offer Public Health education to whoever the state licenses as "health-care providers responsible for individual care."

Or – since we're being realistic about funding – imagine what might happen to the budget of the Zuckerman School if it took a vocal public stance AGAINST 'health-care providers' validated by the State of Arizona. Once-excellent public universities all over the country have been decimated by round after round of budget cuts since The Reagan Era, when governors' houses and state legislators began to be populated by Norquist-pledging Republicans who put education at the top of their list of expendables.

As an alum of The Uni of Iowa, I know the budget reversions there have resulted in any number of precipitous declines in academic programs, and if that's happening in a 'purple' state like Iowa, I can only that the public unis in solid-red Arizona have to be even worse off. Dr. Rosales might need to scramble for every dime she can get to keep the doors open (ok that's figurative, but speaking literally they may be struggling to keep faculty lines open when professors jump ship for institutions where they can paid a competitive wage and maybe get some research support...), and in addition to sucking-up to 'integrative health' friendly donors be properly concerned not to agitate the legislators who passed those laws licensing the homeo-and-naturo-pathetic-excuses-for-doctors. Being tuned-in to that kind of stuff was probably a pre-requisite for becoming a Dean.

Poop rolls down-hill, and I'll target my ire at the folks taking dumps at the crest, which in this case would seem to be the elected officials of Azizona, and the bone-head 'conservatives' voting them into office...

'Hey, we've got GREAT education institutions in this state. Just look at The University of Phoenix!'

#2 @Denice Walter

”DR So and So at HARVARD” is all too often a charlatan, like Granjean and his cronies, from the Chan School of Public Health. That place has become a disgrace to the entire University.

Interesting, then, to see Arizona as well going for a blend of public health and naked quackery.

By Robert L Bell (not verified) on 01 Oct 2015 #permalink

@ Roger Kulp #8:

I checked the Rtaher article. it's awful. Call it 'false balance' or 'fallacy of the appeal to the middle' or whatever, there is simply no comparison much less equivalence when it comes to Dems vs. the GOP on science. ALL the major GOP players support loopy policies impinging on sound scientific practice. On the other side, there's Bernie Sanders – who is not actually a Democrat, but a Socialist (yay, Bernie!) – who authored an amendment to the Farm Bill that would allow states to require GMO labeling. That's it. One major candidate, who doesn't want to restrict practice in any way, doesn't even demand labels, just asks that states be allowed to require labels if they want them.

The assertion that Sanders is somehow 'anti-science' because he's against legislation that impinges states from requiring GMO labels is patently absurd. There's a question of precedent and general principle here. If the Feds can restrict consumer-information requirements on one type of product, they can do it on another, and every lobbyist representing an industry with something to hide – the supplement industry, for example, and (yes) the organic and 'natural' food industries (which often rely on pest control practices arguably worse than glysophate) – gets a wide open door to plead for whatever they want NOT-labeled written into law, too.

Ingredient labeling is information, not rhetoric. The anti-labeling argument is based on the premise that consumers are so bamboozled they'll panic if they see a 'GMO' ingredient on a product. (As if the average consumer reads the 'Ingredients' and 'Nutrition Information' on frozen pizza or Count Chocula...)
____
Hey, Monsanto and Genetic Literacy Project! Ever hear of "the marketplace of ideas"? If GMOs are the great world-saving innovation you say they are, it's YOUR responsibility to make that case to the public. See, if your PR people were actually good at their jobs, GMO labeling would be to your advantage, because plenty of people would prefer products employing technologies that could help reduce starvation and human misery (...if, you know, that was actually happening instead of just profit maximization by establishing functional monopolies in seed markets...).
And a good number of other people would buy your stuff just to spite the 'health' scolds. While McDonald's financial fortunes are sinking, the big winner in the fast-food biz of late is CKE Restauarants, which operates Hardee's and Carl's Jr. They're making bank on being proudly UN-health-conscious. The big item at Hardee's is the Monster Thickburger – 1,410 calories (5,900 kJ), 107 grams of fat, and 2,740 mg of sodium. The State of California requires a warning label to be displayed at restaurants that serve certain types of food:

Chemicals known to the state of California to cause cancer, or birth defects or other reproductive harm may be present in foods or beverages sold or served here.

The law requires the warning to be a certain minimum size and displayed in a certain way. If you look, you'll find the warning in every fast food outlet, usually at the bottom of a 'Nutrition Information' poster off to the side of the main counter, and in that minimum size box. Carl's Jr. posts it right on the front door in a bold-face sign maybe 4-5 times larger than required. So they're doing that by their own choice and killing most of their competitors in sales in the process.
Dudes, your problem with GMO labels isn't 'Big Guvment', it's private enterprise. Really, what does it matter if a 'contains GMO ingredients' notation is added to that 'Nutrition Information'panel on the side or back of the package, when General Mills, of all people, blazons "Not made with genetically modified ingredients" right on the front of every box of Cheerios?
_____

Taking a step back, the whole idea of an "anti-science left" is a crock. There ain't no such thing. What does exist is a population of people who are both decidedly not-conservative and not-science-minded. They're not 'anti'-science, in that while they may not accept certain principles validated by science, they're not working to undermine science in public policy the way creationists and AGW-deniers are. And by-and-large they're not the 'left' in that they're not significant players in electoral politics or the functioning apparatus of liberal/progressive Democratic Party campaigns. Neo-hippies tend not to vote, and they're not the folks manning phone banks and stuffing envelopes in the offices of any sort of partisan political organization. In contrast, the creationists and AGW-deniers are indeed on the (far) right, because they're extremely active in the nitty-gritty everyday work of politics. They vote, they volunteer, they go to rallies to cheer Ben Carson and Donald Trump...

But if you're concerned about anti-science politics, the first thing you might do is take Deep Throat's admonition and "follow the money." A major funding source for the worst anti-science Republicans is the corporate lobbying group ALEC, which in turn has among its biggest donors... Surprise!.. virtually all of the major pharmaceutical companies.

In short, then, Dan Rather's attack on Bernie Sanders is (to employ a Rather-ism) "shakier than cafeteria Jell-O". What's the frequency, indeed?

Wow, most of you are so angry and ignorant of the facts. NDs who graduate 4 year medical school in the US and Canada are accredited by the US Dept of Ed and licensed by their state. Every state is different bu the scope of training is the same in all 8 schools. Very similar amounts of basic science courses (actually NDs have more hours and labs and are required to attend classes and pass all courses, unlike most MD/DO schools). NDs do have residencies, though not as rigorous ( where most of the brain washing occures for allopaths - think "forget your biochem and physiology and jsut Rx this drug, you only have 7 minutes with the patient".) NDs have 4 years of nutrition and all thousands of clinical hours of training in all the 'ologies, so that they can start as a family doc right after graduation. NDs do have to study a few homeopathy courses but most are electives and most never use it (as its too far of a leap, like it is for most of you, though there is strong evidence it works when done correctly).

NDs are real doctors because the Govt, schools and accrediting agencies make sure they well trained by graduation with thousands of clinical hours and more actual course work and time than MDs because they have to study all of allopathic, naturopathic and chiropractic medicine.

NDs are real doctors because they follow the Hippocratic oath and first due no harm (drugs and surgery as a last option); treat the real cause by spending much more time, often hours HOURS with patients taking a history, ordering and reviewing complex, much more detailed blood work and putting together evidence-based or clinically proven treatment plans, while educating the patient how to better take care of themselves, and OMG,, cure themselves.

NDs are real doctors (and better doctors most of the time) because of all of the above... the training, ability to step outside the box of conventional, allopathic, pharmaceutical-based-driven medicine, to listen, care about the patient, spend time teaching (doctor=docere) and be brave enough to attempt a medical practice in such a hostile env't, mostly because they have seen the vis medicatrix naturae, the healing power of nature, work on themselves, family and patients for decades. It is real traditional medicine; using science, traditional and conventional wisdom as well as real evidence based and clinically supported medicine (not just DBPC trials which are geared and steered by the pharmaceutical industry) because there is no hidden agenda, dogma and false science/research driven by pharmaceutical dollars. Like all MD association, hospitals and medical schools.

NDs have strong training in emergency medicine and minor surgery but rarely use it because most states (due to medical associations and their lobbyists). And NDs do not specialize in advanced surgeries because there is no platform for that due to the fraternity of allopaths and the lack of need. Because most of the need in medicine is for chronic care and true prevention (diet, lifestyle, staying away for doctors, drugs and hospitals - the number 1 and 3 killers of Americans), not acute care. The US and its allopathic MDs are #1 in the world at acute and emergency care, according the WHO but 41st in chronic care(where it is needed by far, the most). Behind costa rica and Morocco. Very sad.

So, just keep beating your chests, spewing the fictitious party line and ignorantly slandering NDs if you must, but you are gravely mistaken.

Should have said:
NDs have strong training in emergency medicine and minor surgery but rarely use it because most states (due to medical associations and their lobbyists). And NDs do not specialize in advanced surgeries because there is no platform for that due to the fraternity of allopaths and the lack of need. Because most of the need in medicine is for chronic care and true prevention (diet, lifestyle, staying away for doctors, drugs and hospitals – the number 1 and 3 killers of Americans), not acute care. The US and its allopathic MDs are #1 in the world at acute and emergency care, great, but according to the WHO just 41st in chronic care (where it is desperately needed - think out of control diabetes, autoimmune, Lyme, Cancer and heart disease rates!). Behind costa rica and Morocco. Very sad and reversible if we can just grab our power back from the politicians and corporations (lobbyist and pharm industry, to be exact).

Super hard to swallow this perspective and these truths, I am sure Dr 'orac' and others. But do some more research, get to know some NDs and talk to others besides Bret Hermes and wiki.

Brad
Homeopathy is taught in the naturopath schools. Homeopathy is on the NPLEX. 'Nuff said.

By capnkrunch (not verified) on 01 Oct 2015 #permalink

Orac: Yours are among the most ignorant writings I have ever heard. You don't piss me off, you just make me aware of how much work still needs to be done on educating the public about naturopathy. And you make me laugh. When I cover for a board certified M.D. and write the exact some prescriptions and refills and do the same testing they do, I'm a quack, but when they do it they are not a quack. LMAO.

By Dr Anna Nordin (not verified) on 01 Oct 2015 #permalink

Should have said:
NDs have strong training in emergency medicine

You really should have quit when you were behind.

Brad, given that you have averred the strength of naturopathic "doctors" in the realm of emergency medicine, which, you know, generally requires poor, deluded MDs to complete a nonsensical, additional three-year fellowship, how do you feel about playing a bit of Naturopath Meets Emergent Condition?

Allow me to remind you in advance that the "MCSE" certification is well known as shorthand for "must call somebody else."

NDs have strong training in emergency medicine and minor surgery
"Have arrived at the crash site. We have two closed-head traumas with possible cervical damage; one abdominal injury, probable ruptured spleen; one crushed rib-cage with pneumothorax. Send all available naturopaths."

By herr doktor bimler (not verified) on 01 Oct 2015 #permalink

^ Oh, and...

The big item at Hardee’s is the Monster Thickburger – 1,410 calories (5,900 kJ)

Please (1) state the meaning of "big item," as this tends to suggest "most popular,"* and (2) explain, in your own words, what the 'J' in "kJ" means.

I mean, you'd look pretty freaking stupid if you were just thoughtlessly embellishing cut-and-paste jobs, wholly aside from their failing to do anything other than illustrating to the commentariat that you're not even competent to read your lines.

Seriously, where's the "allopathic" [sic] training only includes 45 minutes two hours a negligible amount of hopelessly misguided "training" in "nutrition" bit?

* This made news, what, 11 years ago? "If anyone eats this and can’t clearly see that it is a novelty item, the issue isn’t the burger, it is education." Hence... naturopaths?

“Have arrived at the crash site. We have two closed-head traumas with possible cervical damage; one abdominal injury, probable ruptured spleen; one crushed rib-cage with pneumothorax. Send all available naturopaths.”

Is it just me, or is this the the best OMICS link ever?

But anyway, Brad, PT presents to ND ED with sudden-onset flaccid paralysis. First symptoms were tingling around the mouth, followed by symmetric blurred vision and drooping eyelids. The condition is descending.

1. What's the immediate naturopathic management plan?

2. What information does the naturopath need to elicit about what preceded the onset?

3. It is ascertained that PT hasn't yet pursued his regular naturopath's offhand recommendation to consume homemade fermented foods. Where does the naturopathic differential go from here?

@Brad #50:

Wow! I couldn't have said it better myself. But then I can't see any grounds for saying any of it at all...

though there is strong evidence it works when done correctly

How do you define 'correctly'? Wait,let me guess. Is it 'when no-one is looking at all'?

By Rich Woods (not verified) on 02 Oct 2015 #permalink

I gotta say, the regular commentariat here are absolute masters of the art of calling out nonsense and handing people's behinds to them.

It's an education in itself, and oftem very entertaining as well. Thanks, everyone!

Also, I know the commenter earlier suggesting that the U of A astronomy dept was going to give equal time to astrology was making a funny (and a pretty good one), but itt should be noted in passing that the U of A department is very strong.

By palindrom (not verified) on 02 Oct 2015 #permalink

Dr. Nordin -- Glad to hear that you actually use so-called allopathic methods.

I'm curious, though. Do you also prescribe homeopathic medicines? Do you think that they have any mechanism of action other than as a placebo?

By palindrom (not verified) on 02 Oct 2015 #permalink

Dr. Anna Nordin's LinkedIn profile states that "Scope of practice includes alllopathic treatment including pharmaceuticals, urgent care, minor surgery, botanical medicine, acupuncture and Chinese Medicine, homeopathic, physical adjustments, hydrotherapy, lifestyle counselling, psychotherapy, rejuvenative/anti-aging medicine...I use only integrative methods with strong scientific demonstration of their efficacy."

Would love to hear what the "strong scientific demonstration of...efficacy" is for the homeopathy, acupuncture and "rejuvenative" treatments she offers.

By Dangerous Bacon (not verified) on 02 Oct 2015 #permalink

NDs do have residencies, though not as rigorous

That's one way of putting it.

Almost one-quarter (22.5%) of naturopathic doctors licensed in Washington had completed at least one year of post-graduate residency training compared with only 8.5% of those in Connecticut. (Residency training is not required for licensure in either state.)

^^And that's another.

The only prevention that the MDs practice is by using vaccines. That too only because the law requires it. Otherwise it is prescribe, slash and burn. There is barely a whisper about healthy eating, healthy lifestyle. The folks at SBM and their fans must live in some alternate universe. They usually want to talk about emergencies and acute situations where MDs do hold a major advantage. But most health issues, in fact most people even before they have any health issues, do not require prescription medicines or any medical intervention. Instead they need guidance about how to live a healthy life. This is the advice that our MD community is utterly incapable or unwilling to give. No wonder US is one of the least healthy country in the Western Hemisphere.

Having engaged in a protracted argument (it was raining, there was nothing on TV) with a naturopath on NN about the plausibility of germ theory and whether pathogens could cause disease I would say naturopathy has nothing to do with medicine.

Strangely he did turn down the opportunity to be injected with the rabies virus offered by another commenter, so I guess he hadn't had enough turmeric that week.

From Ms. (Not a Doctor) Nordin's LinkedIn page, under "Scope of Practice":

"... recommend integrative therapies where appropriate such as herbal medicines, homeopathic medicines, counseling, chiropractic care, acupuncture."

She also uses the word "allopathic" a lot.

Quack quack.

By Woo Fighter (not verified) on 02 Oct 2015 #permalink

Dangerous Bacon:

I am SO SORRY! I'm using a new borowed laptop and the scrolling function is wonky. Of course I only saw your post after I posted the identical comment.

Oh well, it never hurts to emphasize how useless homeopathy is and how the NDs scam their customers.

By Woo Fighter (not verified) on 02 Oct 2015 #permalink

@ herr doktor bimler

one crushed rib-cage with pneumothorax

They could always follow the Mad Max's school of emergency medicine and use a knife to puncture the ribcage, and then do a transfusion of their own blood to treat the internal bleeding.*

I prefer myself the Taltos treatment, as described by Steven Brust in Teckla. Only issue is finding two sword-sheaths, a jug of water and a candle, for the sterile intubation of the lungs' cavity.

*Don't try this home, kids. It won't work.

@ Narad

homemade fermented foods

OT, sort of. Just be reading on maize overly contaminated with Fusarium mycotoxins in Summer 2012 in Italy, as reported by a local scientist.
Bit of nightmare fuel...

@ Anna Nordin

When I cover for a board certified M.D. and write the exact some prescriptions and refills and do the same testing they do

There is a bit more to MD work than filling prescriptions.
And that worries us is not when you do as a MD would, but when you don't.

By Helianthus (not verified) on 02 Oct 2015 #permalink

@RK: I don't know about what doctors YOU are seeing, but I've never been to my primary care doctor where they haven't reviewed my diet, encouraged me to exercise more, and asked about smoking, alcohol, work, life.

None of them have suggested slash and burn. I've only been put on medications (BP) AFTER the diet and exercise steps failed to keep my blood pressure in check. And at every visit the doctor reviews whether they can be stopped. (Unfortunately, genetics is against me in that circumstance.)

Maybe you just need to see a better set of doctors, and don't start off by antagonizing them as pill pushers!

"There is barely a whisper about healthy eating, healthy lifestyle.The folks at SBM and their fans must live in some alternate universe."

In my universe, my family doc focuses on things like optimal weight, correcting low vitamin D levels, avoiding excess drinking etc. I am sorry that your world is so different, and invite you to visit Earth instead.

"They usually want to talk about emergencies and acute situations where MDs do hold a major advantage."

Funny, but it's alties who seem to obsessively focus on advantages of "allopathic" medicine in emergency care (probably because it's hard to convince people to schedule an appointment with a naturopath when experiencing severe belly pain or when they've been in a car crash).
I've also never been able to figure how alties can accept evidence-based medical principles when it comes to emergency care, but throw those same principles out the window when deciding on how to get their diabetes, heart disease, kidney problems etc. treated. I'm pretty sure ER docs get the same basic training and employ many of the same diagnostic methods and drugs as internists and other primary care physicians.

By Dangerous Bacon (not verified) on 02 Oct 2015 #permalink

The "[alt practitioners] spend [vast amounts of time] with each patient" rather amuses me. They can do this for the simple reason that the ratio of practitioners to patient demand is extraordinarily low.

^ should be extraordinarily high

No wonder US is one of the least healthy country in the Western Hemisphere.

Maybe you could tell us what the most healthy countries in the Western Hemisphere are.
And then you could tell us what system of medical care they use.

"The only prevention that the MDs practice is by using vaccines."

What doctor do you see, chum? Because I'd really like to find one who'll stop nagging me about caffeine intake, stress management, diet and exercise.

@shay...you and me both....

@Dangerous Bacon,

There is a big difference between acute health issues and chronic issues. Chronic issues can be prevented in most cases by good lifestyle and diet choices. This is where your MD fails miserably. I have no objection to acute treatments such as antibiotics in severe infections, surgery when absolutely needed, and other short term procedures. Your medical science may be short sighted and limited, but it may be the best in such situations.

In my universe, my family doc focuses on things like optimal weight, correcting low vitamin D levels, avoiding excess drinking etc.

Just by the by, does anybody know how much good this does? I ask this not in the sense that I doubt it does any good, but just as a literal question. My de facto primary care doc had me get my D levels tested a couple months ago, and they were waaaaay down in the basement. (She said she almost doesn't need to have most Michiganders tested, she can just assume their levels are low.) Anyway, I looked up the symptoms of a deficiency, and some of them look similar to, say, a depressive episode, but I think I've read that supplementing with vit. D doesn't actually do anything to help with depression per se. Just thought somebody here might know more than me.

^ I mean, I did what she told me to regardless, which was to take 8 high-dose capsules over 8 weeks, then start taking 2,000 IU daily.

Chronic issues can be prevented in most cases by good lifestyle and diet choices.

Citations needed, RK: which chronic issues, prevented by what lifestyle and diet choices, and what is the evidence demonstrating those choices can actually prevent those chronic diseases to any clinically significant degree?

After that, you can attempt to demonstrate that standard of care evidence based medicine does not already advocate for those same good lifestyle and dietary choices.

RK,
I'm an RI fan but hold no illusions about conventional medicine. My doctors are quick to prescribe, slow to counsel and hampered by restricted thinking. But how in the heck does that mean I want something worse, and to pay dearly out of pocket for it? I would like medical care delivery improved not replaced by BS. And, I don't need to pay for knowledge about lifestyle changes. I can find that anywhere; I need an invested individual and see no reason why that can't be my GP/PCP if we could work on changing the current system instead of diverting attention to a totally bogus alt med practice paradigm.

Yes, I went to a Bayster grad ND once and she was as bad if not worse than MDs Threw herbals at problems I wasn't asking her treat, guessing what would work and advising me to raise melatonin dosages until it worked even if I reached 21 mg a night. WTH?

JP - Vit D supplementation (Rx variety D2) which nautropaths claim doesn't work made a world of difference to me. I noticed a change in how I was feeling just shy of a month of taking it. Prescription was for 12 weeks and I needed that long to get levels in high normal which is where i feel best.

By Not a Troll (not verified) on 02 Oct 2015 #permalink

RK: "Chronic issues can be prevented in most cases by good lifestyle and diet choices."

Oh, do please tell us how to prevent obstructive hypertrophic cardiomyopathy, cystic fibrosis and type 1 diabetes.

Helianthus@70

They could always follow the Mad Max’s school of emergency medicine and use a knife to puncture the ribcage, and then do a transfusion of their own blood to treat the internal bleeding.*

My mom swears up and down that in lifeguard school when she was in highschool they were taught to stick a pen through someone's neck into the trachea to help them breath. I think she remembers wrong but it was in Canada...

Brad@51

NDs have strong training in emergency medicine and minor surgery

Pfft. As always, here's the obligatory satires.

Company president and naturopathic physician Mort Fishman, who leads the team and is certified in Acupuncture Cardiovascular Life Support (ACLS), says that in situations like this there is a golden hour where appropriate intervention can make the difference between life and irreversible chakra degradation.

That Mitchell and Webb Look: Homeopathic A&E - https://youtu.be/HMGIbOGu8q0

By capnkrunch (not verified) on 02 Oct 2015 #permalink

RK,

There is a big difference between acute health issues and chronic issues. Chronic issues can be prevented in most cases by good lifestyle and diet choices. This is where your MD fails miserably.

My MD doesn't make my lifestyle and diet choices, I do, nor do I expect her to motivate me to make better ones, I take full responsibility for that. Everyone has a pretty good idea of what is a healthy lifestyle and diet these days.

I don't believe people who go to see a naturopath generally require additional motivation to make lifestyle changes. I would love to see a naturopath try to persuade some of the patients my colleague saw in her lipid clinic in one of the most deprived areas of London UK. She told me that the great majority were either unable or unwilling to make the changes she suggested, had mental health or other serious health or social problems, and were often poorly compliant even when she prescribed medication. She confided in me that she wondered at times if what she was doing made any difference at all to most of her patients. Other than telling people they will die or suffer serious disability if they don't change their diet and lifestyle, what do you expect an MD to do?

By Krebiozen (not verified) on 02 Oct 2015 #permalink

"Chronic issues can be prevented in most cases by good lifestyle and diet choices. This is where your MD fails miserably."

Well, it's true that physicians should stop stuffing their patients with cheeseburgers and Krispy Kreme donuts and insisting that they give up exercise in order to hang out on the couch and watch TV.

Doctors have a lot to answer for, you betcha.

Patients, too. In addition to the chronic issues Chris describes (which are the patients' fault), how about those women with BRCA mutations who brought their breast cancer on themselves by not living right, or the people with Lynch syndrome who are susceptible to multiple cancers because they didn't fix their bad genes by drinking apple cider vinegar and coconut oil.

By Dangerous Bacon (not verified) on 02 Oct 2015 #permalink

@ Narad #58

Yes, I pasted the stats on the Thickburger from Wikipedia without proofing them, not that I would have cared what kJ is. Upon reading your query, my first thought was a wild-ass-guess that the J is for 'Joule', which – again according to Wikipedia – actually turns out to be the case.

[calories] have been superseded in the International System of Units by the joule... one [dietary] calorie is about 4.2 kilojoules

Not that I care, or that this has anything to do with my point, which had nothing to do with naturopathy.

I used 'big item', which is vague by intent, as it seemed to fit the self-consciously cheeky tone of that part of the comment. More literally, I was not suggesting the Thickburger is the most popular entree offered by CKE, but rather the 'signature' item that is cited regularly as establishing the chain's brand identity and market positioning.

From a 2011 press release posted on the Carl's Jr. website:

"[Our ads] communicate the core of what we are all about: big, indulgent burgers with no apologies and no B.S." said Brad Haley [executive VP of marketing for CKE]. "The ads speak to the straight-shooting mindset of our core audience of young, hungry guys... The campaign focuses on basic truths about our food and our attitude..." These “truths,” which are boldly outlined in the commercial, include... “We believe in burgers. Big, fat, juices-running-down-your-arm kind of burgers... We believe that life is short. So if it feels good, do it, and if it tastes good, eat it.”

Yes, none of this is 'news', not that I claimed it to be. CKE actually began the 'indulgence' marketing in the late 90s, and by 2004 had indeed ramped it up to be more explicitly un-health-conscious. The fact this has been a highly profitable marketing strategy for well over a decade only enforces the point: thumbing your nose at health food scolds sells.

As for the quote from GrubGrade (also from 2011): food reviewer 'Chefprotoss' is just showing Dunning-Kruger about marketing, and the economics of the fast food biz. I don't know what he means by "novelty item" exactly, but products don't stay on the menus of chains for 7+ years if they don't sell, no matter what the marketing department wants. And lack of education in nutrition has nothing to do with those sales. The whole point of the Monster Thickburger is that it hides nothing, and requires no special knowledge for consumers to understand what it is: 'heart attack on a bun.' "Life is short. So if it tastes good, eat it."

Thus, CKE's appeals are more-or-less opposite to those of naturopathy, which ARE based in false advertising and mis-information we might expect would be countered by better general education in medical science.

But, I wasn't discussing naturopathy – which I consider to be the most dangerous form of medi-woo, and regard with utter contempt. So how anything I wrote might connect to totally bogus comparisons between naturopathic and "allopathic” [sic] training is beyond me...

@capnkrunch: your mom actually remembers correctly. That was taught as a way to establish an emergency airway until the patient was in trained medical hands. Note that the "pen" was a fountain pen, which in those days had a fairly nice sharp nib and open tube to hold ink.

Dr Anna Nordin@54

When I cover for a board certified M.D. and write the exact some prescriptions and refills and do the same testing they do, I’m a quack, but when they do it they are not a quack.

No, when you use homeopathy, naturopathic manipulation, and acupuncture you are a quack. When you advocate against vaccines you are a quack. When you use untested treatments for imaginary diseases you are a quack.

A doctor doing the same things would also be a quack. The difference in the professions is that a doctor doing that would be far outside of best practices while this junk is baked into naturopathy.

By capnkrunch (not verified) on 02 Oct 2015 #permalink

I don't think I would want to live in a state where a ND can cover In an ER for someone with medical training. That's just scary to me.

Kreb:

I just shake my head when anyone on RI makes comments of the "I do just fine with the way my MD does it" form. It's one of the worst forms of anecdota, as there's no warrant whatsoever to assume you or your MD are typical. As far as lifestyle choice goes, even if you're in the majority, there's still a hell of a lot of people for whom a lecture that they'll "die or suffer serious disability if they don’t change their diet and lifestyle" does absolutely nothing, and not just folks like your colleague encountered with issues that make them all but intractable. It's hardly scientific to chalk this up to simplistic concepts of "choice", wrapped up in dubious mythology about poor character, lack of willpower, etc. Many if not most patients with lifestyle issues do try to make changes, they just fail. [sarcasm] If only those laggards could indeed grab their inner power and pull themselves up by their bootstraps! The solution seems obvious: MDs should just hand out prescriptions for Tony Robbins seminars after they give the 'change or die' lecture. [/sarcasm]

Whatever 'choice' is, it's hardly moral to say "Well, let 'em get heart disease and type 2, because they made their own choices." (Like your colleagues patients 'chose' to be poor and vulnerable.) It's also poor public health policy, since one way or another society winds up paying for treatments of too many cases of illness that could have had reduced incidence at lower cost.

RK's comment is so reductive and hyperbolic it obfuscates the grain of truth that may lie behind it: the delivery systems of conventional medicine have structural barriers that mitigate against patients receiving the support they need to actually implement lifestyle changes. That's not the fault of individual MD's, who indeed should not be expected to have the skills or time to motivate patients to eat right, quit smoking etc. Nor is it the fault of "our MD community". PCPs are just working stiffs, bound by the mandates of short-sighted bean-counter management. It's not like programs that do have good success rates for countering chronic conditions (obesity, for example), are unknown to conventional medicine. They're just not readily available to most patients of typical means, and/or too 'out-of-system' to be available to PCPs for referral. That's wrong, and reform is in order, but that's a matter of moving deeply entrenched bureaucracies, not hectoring MDs already over-burdened by Taylorist speed-ups.

NaT's experience suggests naturopaths may merely be boasting about their claimed focus on lifestyle, rather than actually delivering better results. (Got any valid evidence, naturofans? And, no, self-reports don't count.) And you make an excellent point that if indeed naturopaths do have better results, that may be largely due to the predispositions of the patients they see. I suppose it's possible some naturopaths have developed skills in supporting lifestyle change that are unknown to dieticians and clinical psychologists, and we might be able to learn something useful from their practices, but I doubt it.

Chris:

To be fair, RK said "most cases" of chronic illness could be "prevented" by "good lifestyle and diet choices", not most chronic conditions. My lay person's understanding is that the majority of chronic illness cases fall under heart disease, type 2, obesity, hypertension – in which lifestyle certainly does play a role. However, my lay person's understanding is also that it's seriously woo-ish to claim lifestyle choices "prevent" anything, that it's all a matter of relative odds.

The quote from RK functions as sophistry, framing a direct connection between a straw-man characterization of practice ("prescribe, slash and burn" with "barely a whisper about healthy lifestyle") and a straw-man standard of results ('failure to prevent'). The implication seems to be that if medical practitioners only talked about lifestyle change more and/or in some different way, "prevention" would indeed occur. But, grammatically, RK's claim reduces to 'MDs fail to prevent chronic health issues', which is both 'Captain Obvious' obvious, and pointless. If 'failing to prevent a chronic health issue' is cause for delegitimation, then if any patient of a naturopath gets heart disease or type 2, naturopathy's no good either. Now, if there was an RCT that showed naturopathic care was more effective than conventional care at reducing the incidence of chronic disease among similar populations, RK would have something to talk about. I'd like to think the absence of a coherent and meaningful claim ought to speak for itself. But, alas, these days I find any such optimism has been thoroughly Trumped.

I have a doctorate in education and teach in public health sciences at a large state university. Additionally, I spent almost two decades working in graduate medical education.

On top of that, I have a chronic condition of rheumatoid arthritis and high cholesterol. My MD primary care physician had no problem with me changing my diet when I had a cholesterol test of over 300. I changed my diet which was already vegetarian and also began taking red rice yeast and fish oil. Six months later, my cholesterol hadn't changed. I now take medication.

With a serious, degenerative, painful chronic condition of rheumatoid arthritis, I cannot tell you how angry I get at those who suggest if my diet were changed, if I drank cabbage juice, or take vitamins, or use a magnetic pad to reduce my symptoms and pain. If only it were that simple! I would happily do all of those things for my condition if only they worked.

sadmar: " My lay person’s understanding is that the majority of chronic illness cases fall under heart disease, type 2, obesity, hypertension"

Hypertrophic cardiomyopathy is a type of heart disease, and occurs at a rate in the population at about one in five hundred, though the obstructive bit does not always occur. It is the most common cause of sudden cardiac death in young athletes. There are other "heart diseases" like Long QT and Marfan's syndrome that are also genetic.

When my son had open heart surgery at the Mayo Clinic a few years ago we got to talk to other families. At least two were families of children who born with congenital heart defects, and one wife of a man in his forties who just found out that his heart had been mis-plumbed since birth.

I learned from this book that the first heart surgeries attempted were to repair heart damage from rheumatic fever caused by strep infections. I don't think suffering from strep infections before the age of antibiotics is much of a life style "choice."

My stepmother's family had a genetic form of hypertension (it had something to do with their kidneys). They used die a slow and painful death in their forties. Then the first diuretic blood pressure medication came in the middle of the 20th century. While one of her brothers died the very slow death, she and her four surviving siblings lived into their 80s and 90s.

Do not try to tell me that heart disease and hypertension are just from life style choices.

There is a problem when someone decides to denigrate real medicine by using the "chronic disease" gambit. They do not realize that many they think are preventable are actually genetic. This ignorance is pathetic.

Though what is more pathetic is claiming naturopaths have a better handle in treating health style decisions. Dear hubby brought down his blood sugar on the advice of our family doctor with diet and many many many miles on his bicycle (including doing a 25 mile ride for a cystic fibrosis charity).

Renate:

Thanks for the link! There's are 'translate choose language' links near the top right of the page.

Headline: "Witch Doctor: powerfully depicted indictment against quackery"

Torre Florim - lead singer of De Staat :
"It's a cynical view of alternative medicine. In essence, it is about people being dragged from a gut feeling with the masses, without a scientific basis."
And then the Google translation flails at Dutch syntax:
"I'm in a kind of clip demagogue people physically excites the finger."
Great dada poetry as is, but if anyone can offer a better translation, I'm curious.

The source article in Volksrant is on a page that won't translate directly for me due to a cookie thing. I cut and pasted the text into the translator. One possible note of interest: the 'Witch Doctor' video is new, coinciding with the release of a new album, but the song is from an album released two years ago. I wonder if he choice to use this track to promote a new release reflects concern over an increased spread of quackery in Holland during the intervening years, or, on the contrary, that opposition to quackery there has increased, creating a larger audience for the video than it would have had at the time of the song's original release.

In my very first class of my MPH out of (prestigious state) I was horrified to discover that I had a substantial number of quacks for classmates. I was so upset I e-mailed the program directors, asking (politely) if the program was science and research based, and if not I wanted my money back.

They were *very* quick to assure me that, yes, of course the program was reality based (my words) and always would be. I still haven't figure out why so many acupuncturists want an MPH. (Oh, and some of them have MDs, too.)

Here's my personal test for NDs: When you can give me something that works as well as 12 hour Sudafed, then we can talk. Until then, I'll keep my modern pharmacopoeia.

By JustaTech (not verified) on 02 Oct 2015 #permalink

@ JustaTech:

So true. Decongestants achieve miracles in a short time.
Never have had an herb or a supplement act like that.

By Denice Walter (not verified) on 02 Oct 2015 #permalink

My mom swears up and down that in lifeguard school when she was in highschool they were taught to stick a pen through someone’s neck into the trachea to help them breath.

That sounds familiar -- I also remember from combat first aid training (this would have been in 1979) learning how to treat a sucking chest wound using the plastic wrap off a pack of cigarettes*. I seem to remember the term "field expedient medicine" being tossed around a lot.

(*I guess smoking is good for you, under certain circumstances)

Since we got on the subject of battlefield medicine, a quick note before I run off for a meditation retreat for a couple days:

I've been translating these interviews of Soviet Jewish World War II veterans lately. (I really like doing it, and it pays decently.) So I've been hearing and reading (they send me transcripts in Russian, which helps) quite a bit about battlefield medicine, wounds, etc. Anyway, I just wrapped up this one interview which could have been appropriately titled: "Breakin' out the hospital. Three times." I wish I could tell the story, but I had to sign an NDA. But man, incredibly tough people.

My mom swears up and down that in lifeguard school when she was in highschool they were taught to stick a pen through someone’s neck into the trachea to help them breath.

It's called a cricothyroidotomy, or cric for short, as in "cric him." It's a way to rapidly establish an airway that, while less permanent than a good tracheostomy, is far quicker and safer to perform, particularly under less than optimal conditions. I've never actually had to do a field cric, but some of my fellow residents when I was doing trauma did.

http://www.nejm.org/doi/full/10.1056/NEJMvcm0706755

In the field, straws, a ball point pen with the pen part removed, or any solid tube of approximately that diameter or a bit larger can be used. As an aside, I watched an episode of "The Knick" the other night where Dr. Thackery performed an emergency cric on the dealer of the opium den he frequented, who was choking. I believe he used a fountain pen.

So true. Decongestants achieve miracles in a short time.
Never have had an herb or a supplement act like that.

Well ... Sudafed is pseudoephedrine, which, along with its diastereomer, ephedrine, is found in (minor ta-da fanfare required) Ephedra.
I used to use psuedoephedrine occasionally to deal with horrible congestion from getting swimming pool water up my schnoz. I'm pretty sure it would make my heart explode it I took it now.

And it's only one oxygen atom away from methamphetamine.

Just today I watched an episode of Call the Midwife where the doctor cric'd a woman with diphtheria. He actually used a scalpel and metal stoma thingy (intended for a proper tracheostomy ??)

Doc Martin used a pocket knife and some sort of hose that just happened to be lying conveniently at hand. Somebody in Leverage used a knife suitable for dicing a bison, but I don't remember what was used for a tube.

Hey Chris:

I wasn't trying to tell you heart disease and hypertension are just from life style choices. As I'd hope my reply to Kreb indicated, I completely sympathize with anyone facing illnesses beyond their pragmatic control having to hear they could have prevented their troubles by making different choices. The last thing anyone with a condition tied to chance splashes in the gene pool needs is a scolding that it's their fault they got sick and/or can't 'deal with it' like everybody else and make themselves better. I've got one – depression runs in my family independent of 'inherited' interpersonal influence – nowhere near as clear cut as a congenital heart defect, so it's hard for me to say how much of troubles were coded into my DNA, and how much they might be 'my fault'. But I've sure been judged like it's ALL 'my fault', which I'm pretty sure it's not, and yeah, it stings.

The reason I wanted to note that 'lifestyle choice' does seem to be a factor in many individual cases of chronic illness is that being as fair to RK's comment as possible, the whole idea of 'prevention' is still a load of horsedung.

Take this gem of faux argument by grammatical contortion:

But most health issues, in fact most people even before they have any health issues, do not require prescription medicines or any medical intervention. Instead they need guidance about how to live a healthy life.

Let's say we untangle that to two claims: 1) most health issues do not require prescription medicines or any medical intervention. 2) most people do not require medical intervention; instead they need guidance about how to live a healthy life.

Both would probably be true, but trivial in substance, and deflecting in implication if technically 'correct'. Let's say the majority of cases of "health issues" in the U.S. are minor self-limiting conditions having no cure, but only symptomatic relief, e.g. the common cold. That hardly moots the need for MDs, as the population is so large that the 'minority' of cases requiring medical intervention is still massive in number. And, duh, most people don't require medical intervention because most people aren't sick. So of course, "guidance about how to live a healthy life" is more useful to them — which most of them get without ever visiting a naturopath.

The implied meaning of that mash-up, though, would seem to be something like 'most health issues can be avoided by receiving guidance about how to live a healthy life'. Which would be bat guano wrong in at least two ways, but let's remove one of them, and pretend the assertion 'most health issues can be avoided by living a healthy life' (also bat guano wrong in the real world) is actually true. That wouldn't in any way warrant a claim that any sort of "guidance" had anything to do with it.

Thus, I agree it's pathetic to claim "naturopaths have a better handle in treating health-style decisions." But that doesn't mean MDs are good at it. Not only is the case of your hubby irrelevant being merely one anecdote, he may well have cleaned up his diet and taken up vigorous cycling without the advice of his physician, or for reasons other than receiving that advice from an MD. Like, maybe you'd have dropped a hint, it's pretty much a no brainer plan if your blood sugar is elevated, and maybe he just wants to take care of himself because he loves you and your son.

Here's my anecdotal evidence: I've had plenty of good advice on 'lifestyle' from conscientious physicians; I absolutely know what I should do for my health; I've gotten over the death-wish tendencies that made me not care about my health in the past; and I still do a horrible job overall of taking care of myself. Having successfully addressed a few of my health issues, I think I know what works for me – a level of psychological support initiated by some small measure of pro-active intervention beyond "just say no" admonitions. I don't, can't, get that from my health plan, which pisses me off. And as far as i can tell, there's a lot of other folks in similar shoes, which makes me more pissed off... [Not that I blame my physicians, or imagine a naturopath would be anything but worse... somehow I don't imagine homeopathy, acupuncture, reiki, exotic plant extracts, or high-dose vitamins make good advice on diet/exercise/hygeine/self-destructive habits any more persuasive :-) ]

To be perhaps too honest about an emotion-colored response, it occurs to me that those who sufferings fall into the categories conventional medicine can address effectively with a good rate of success might consider themselves lucky, and show some compassion for those whose maladies either cannot be resolved with existing treatments, or who face economic, bureaucratic or psychological barriers impinging them from accessing proven care, or following the path of known best-practices.

Yeah, keeping them away from naturoquacks is undoubtedly part of that, but methinks it's not enough...

sadmar, one reason why this is a sore point with me is that the company's health insurance company has decided to remind us on healthy life style choices... they are usually in nag mode.

It took all I could to not yell at the kind nurse calling from the insurance company after my son's surgery wanting to talk to him about preventative measures. I really wanted to know what in the bloody blue blazes we were supposed to do to prevent what seems to be a de novo mutation that caused his heart muscle to grow during puberty so that it almost blocked his aortic valve. But I just muttered it as I handed the phone to my autistic son... smirking about her trying to understand what he said (he has a speech disorder... obviously something that Brad and RK have some special way to prevent).

@ diug:

Believe it or not, I've never experimented with Ephedra. But I've heard from women I knew years ago that it is an effective weight loss drug.

By Denice Walter (not verified) on 02 Oct 2015 #permalink

I don’t think I would want to live in a state where a ND can cover In an ER for someone with medical training.

The "five year internship at the Carl Jung Institute" is an interesting touch, but... I've found it to be a somewhat confusing exercise to compare the (seemingly semiliterate) LumpedIn profile of "Dr. Anna Nordin," "Phoenix, Arizona Area" (hereafter "Nordin 1") with the entry from the Arizona Physicians Licensing Board ("Nordin–2"; if one starts from the top, "dispense for profit" No. 13-745 expired at the end of June).

The former is a noteworthy artifact in and of itself, but the only thing that seems to glue them together is the locum middleman association, which leads me to wonder about the core fantasy is either (1) financially unsustainable or (2) just so much crap that be chucked overboard – in the hope that nobody will notice the difference from the rest of the cargo – in the Great State of Flag Failure.

I usually refrain from commenting on this site as, being a farmer, I have no training in science or medicine. But since I did spend a lot of years studying my profession, at least as long as @Brad implied NDs spend studying theirs, let's see if I can use my not-a-doctor AG training to provide some of that complicated lifestyle advice my MD never provides:
1. Don't smoke
2. Get regular exercise, at least 1/2 hour a day if not more
3. Drink moderately
4. Eat a balanced diet, plenty of fruits and veg, lean meats
5. Watch your weight
6. Get enough sleep
7. Wear your seatbelt
8. Never run the PTO with the guards removed (I know this one's obvious but a reminder is always good)

Did I miss anything? Everyone from farmers to fishers know this stuff - I don't need my highly-trained MD to tell me. What I want my MD to do is to use the best available science to determine whether my body is operating correctly and if not, to fix it if possible. The fix may include advice about correcting operator error, but just as well may involve identifying a faulty component or worn out part. Sometimes the part can be replace and sometimes you just have to figure out how to get along with it as is.

Oh yeah, now that I think about it, my AG training didn't include homeopathy. I guess that's the added value an ND brings.

By Canadian Shepherd (not verified) on 02 Oct 2015 #permalink

^ Sorry, the "Arizona Naturopathic Physicians Licensing Board"; the real one has never heard of an Anna Nordin (but, NPI 1871713214, yay). That was part of why I was perplexed about these entries from Nordin 1:

Certifications

license to practice medicine, Arizona
State Board of Medicine, License on file
December 2005 – December 2013

license to practice medicine, California
State Board of Medicine, License on file
January 2008 – January 2014

The California Board of Medical Examiners, by way of "BreEZe," also reports only two entries under "Nordin," both canceled likely as a matter of retirement. I am thus intrigued about where this, ah, "file" is.

But I'm sure that this will all be cleared up in short order.

I've haven't been exposed to this many who've wanted to play doctor* since elementary school.

*not to mention the scientist or grad student posers here.

By Not a Troll (not verified) on 02 Oct 2015 #permalink

MI Dawn@90

@capnkrunch: your mom actually remembers correctly.

Well, apologies for doubting her were in order and given.

Orac@100
What's bizarre to me was that anyone thought teaching it with pens to laypeople as first aid was a good idea. Every part of that sentence makes me shudder.

By capnkrunch (not verified) on 03 Oct 2015 #permalink

@Orac,
You did trauma at University of Chicago right? Did you ever ride with UCAN?

By capnkrunch (not verified) on 03 Oct 2015 #permalink

^^ I was taught about the emergency trachetomy hack in a high school health class (about the same time I was informed not to place a tornique around someone's neck for a bleeding head wound). But it wasn't to teach how to do it; it was to let us know that it was possible with a pen and that we should not attempt it unless it we were medically trained to do it.

Btw, I went to the first half of medic school in the military and it wasn't taught at that point. I don't know if they ever addressed it. I went onto my choosen MOS training before the medics even hit the IV starts.

By Not a Troll (not verified) on 03 Oct 2015 #permalink

Yeah, my baby sister was a Navy orthopedic surgical tech. She doesn't remember the field expedient tracheotomy part, either.

She's now an ambulatory care nurse with the VA, and like the cap'n, the thought of letting a bunch of Marines work on a casualty equipped only with a Ka-Bar and a fountain pen terrifies her.

Yeah, my baby sister was a Navy orthopedic surgical tech. She doesn’t remember the field expedient tracheotomy part, either.

It was featured in a 1976 episode of MASH, just by the by.