Massachusetts takes a big step towards licensing naturopathic quackery

Living and practicing surgery in Michigan, it’s not surprising that I am very concerned about a bill being considered in the Michigan House of Representatives. The bill, HB 4531, would license naturopaths as health care providers. In fact, it would give them a very broad scope of practice, defined by a newly created board of naturopathic medicine. Basically, HB 4531 would give naturopaths a scope of practice almost as broad as that of primary care providers, like internists, family practitioners, and pediatricians. The only difference, if HB 4531 passes, would be that naturopaths would not be able to prescribe controlled substances. Given how utterly riddled with pure quackery naturopathy is as a “profession,” HB 4531 has spurred me to write a lot more about naturopaths, in particular the quackery they practice and routinely talk about.

As alarming as seeing HB 4531 pass the House Committee on Health Policy here in Michigan was, our state isn’t the one in most danger of seeing naturopaths licensed to ply their quackery. After all, it’s quite possible that it won’t get past the House. The last time naturopaths got a bill introduced into the Michigan legislature in 2013, it didn’t go anywhere. However, naturopaths are nothing if not relentless, and they have supplement manufacturers supporting their lobbying effort. No matter how many times naturopathic licensing bills are defeated, the American Association of Naturopathic Physicians keeps coming back year after year. Advocates of science-based medicine have to succeed blocking such bills every time; the AANP and its allies only need to succeed once because, as Steve Novella notes (and I paraphrase), naturopaths are like the Terminator: Utterly relentless, and they absolutely positively will not stop until they have naturopathic licensing bills in all 50 states.

The situation in Massachusetts is more dire in that last week the Massachusetts Senate passed S.2335. As Jann Bellamy notes, this will be, by her count, the eleventh legislative session in which a naturopathic practice bill has been introduced. Alarmingly, she also notes that a bill actually passed one year, “thanks to some questionable legislative shenanigans at the end of session,” but, fortunately, it was vetoed by the governor. (That should give you an idea of how utterly relentless these quacks are.) S.2335 has moved on to the House Ways and Means Committee.

Reading the text of S.2335, I’m struck at how similar it is to Michigan’s bill. It allows naturopaths to do basically what they claim they should be able to do, function as, in essence, primary care providers, even though, as I’ve described time and time again how woefully undertrained they are to function as anything close to the role of family practitioners. If you don’t believe me, just ask an ex-naturopath, who has explained how inadequate naturopathy training is.

As I did with naturopaths in Michigan, I thought I’d look around to see what sorts of quackery naturopaths in Massachusetts are offering. So I did a very simple thing and just Googled “naturopathy Massachusetts.” Then I perused the websites of some of the results. It’s not that I expected to find anything different than what I found for Michigan, but you never know. I also recognized a couple of names from my Sh*t Naturopaths Say series, for instance, Shiva Barton of Winchester Natural Health Associates.

Not surprisingly, Barton offers acupuncture and traditional Chinese medicine (pretty much all naturopaths do). He also offers The One Quackery To Rule Them All, Homeopathy (pretty much all naturopaths do, because, as I like to say, you can’t have naturopathy without homeopathy):

Homeopathic medicines (also known as homeopathic remedies) are made differently than other natural remedies. They are made by creating a very diluted solution of a plant, mineral, animal, chemical or food substance. The remedies come in many dilutions and unlike conventional drugs, it is thought that the more dilute the solution the more powerful the effect. Scientists are not certain how homeopathy works. Some think that it works similar to a vaccine: give a small amount of a substance to help promote cure. In any event, it has been shown to be a valuable tool.

Homeopathy has a wide range of uses. It can be very effective in treating acute conditions, such as colds, flu, bronchitis, urinary tract infections, food poisoning, etc. It also shows tremendous value in treating chronic conditions and mood disorders, phobias, etc.

Naturopathic Doctors are the only doctors who are trained in the use of homeopathy in their medical education. Let us help you use this therapy to help you feel your best.

Thank you, Mr. Barton for confirming what I’ve been saying all along. I just love it when physicians, real honest-to-goodness MDs who have been seduced by “integrative medicine” strenuously deny that they would ever have anything to do with homeopathy and even admit it’s pure quackery at the same time they are collaborating with and referring patients to naturopaths, nearly all of whom use homeopathy. Be that as it may Mr. Barton is a Very Important Naturopath, having been the past president of the Massachusetts Society of Naturopathic Doctors and the Massachusetts Acupuncture Society. He’s also a big wig in the American Association of Naturopathic Physicians (AANP).

I continued my perusal and tried to see what else I could find. There is, for example, Peter Swanz, whose website is vitalforcenaturopathy.com. You know, if I were a naturopath trying to convince legislators that naturopathy is not quackery and is science-based, I would try to refrain from reminding people of the prescientific vitalism at the core of naturopathy with a name like “Vital Force.” Not surprisingly, Swanz uses homeopathy and something I’ve never heard of before called Scenar Therapy. Yes, as hard as it is to believe, there are still some forms of pseudoscientific medicine that I haven’t heard of.) Swanz describes it thusly:

The SCENAR device uses active biofeedback, constantly changing its own electrical impulses to more accurately respond to the body’s own neurological impulses. The EMF impulses from the SCENAR device are a dynamic energy directed to help guide the body in its own healing process – the release of neuro peptides and regulatory peptides; and the release of endorphins. This is a totally unique and revolutionary means for supporting our body’s own healing ability, and is only available through SCENAR therapy.

That’s some serious woo to be attributed to nothing more than a weak electrical current run through the skin. It’s basically a scam, not unlike a Scientology e-meter or Hulda Clark’s Zapper.

Then there’s Ian Bier at Human Nature Natural Health. Bier, not surprisingly, offers homeopathy, acupuncture, traditional Chinese medicine, and the usual naturopathic quackery. To this, he adds oxygen quackery, including hyperbaric oxygen. Then there’s the immersion bath:

This is a wonderful, relaxing, enjoyable therapy that gives lasting relief from pain and stress. It is effective on many levels simultaneously, as the warm water soothes and relaxes, the jets promote circulation, colors can be chosen for various effects, and essential oils of selected herbs are added to deliver a wide array of desired outcomes.

Because of its versatility and enjoyable effects, this treatment can be tailored to suit almost any patient.

New immersion bath technology from Germany contains an oil dispersion nozzle which atomizes botanicals and essential oils added to the bath water. This process provokes a thousandfold expansion of the oil surface so that it can be absorbed intensively by the skin. A specially designed bubble mat keeps mixing the water and herbal oils around you while allowing the bath to take place in quiet comfort. Human Nature Natural Health's bath solutions are all-natural herbal formulas, containing no synthetic chemicals.

Serious woo. It’s basically a bubble bath with essential oils and oxygen. Still, you know what I consider to be an infallible sign of a quack? This:

The German Footbath is used to clear the blood and lymphatic circulations of impurities. For reasons that are not yet understood by science, the soles of the feet have a special relationship to the body as a whole.

This relationship has been utilized for thousands of years in reflexology, Traditional Chinese Medicine and Ayurveda, the natural medicine system of India, among others. Detoxification of the circulation and tissues is among the primary goals of natural medicine systems around the world, as it enhances recovery of many conditions and promotes overall health and vitality.

Patients immerse their feet in the basin of water, to which has been added a blend of imported herbs and minerals. The activator is switched on, and within minutes the patient experiences a burning or tingling sensation on the bottom of the feet. This is the signal to turn the activator off, as the burning can become painful. The thermometer clearly shows that the burning sensation is not related to an increase in water temperature. Treatment time is 20 minutes per session.

A “German Footbath”? This is nothing more than what we know as the detox footbath. Basically, it’s a footbath with minerals through which a weak current is passed. The claim is as above: That the water changes color because the foot bath is drawing “toxins” out through the person’s feet. Of course, it’s utterly ridiculous on a strictly physiological basis to posit that any significant “detoxification” can occur through the feet. Also, it’s been shown many times that the water changes color whether a person’s feet are in the bath or not, as I’ve explained many times. It’s all just another bit of “detoxification quackery,” a form of quackery of which naturopaths are particularly fond. No wonder Bier also offers colon cleanses, lymphatic drainage massage, and far infrared sauna.

Yes, Massachusetts naturopaths are much like Michigan naturopaths and offer the same sort of quackery. I could have gone on, as there were many websites that I didn’t cover, but if you’re interested in more, Britt Hermes has looked at some sites that I haven’t. Of course, this is not surprising, given the nature of naturopathy as a pseudoscientific specialty.

We are currently witnessing a concerted push by naturopaths to achieve licensure in as many states as possible, their goal to have licensure in all 50 states by 2025. They’ve scored a victory in Massachusetts that can still be reversed if the citizens of Massachusetts make sure that S.2335 never gets through the House. In the meantime, I will be keeping an eye on HB 4531 in Michigan to try to find out when it comes up for debate in the House. This could be a more difficult task than you might think at first, as the Michigan legislature is very good at debating and passing bills under the radar without much press coverage. If you don’t have someone on the inside, you can easily miss when a bill comes up for debate. I learned that when the Michigan legislature sneakily passed our “right-to-try” bill in 2014.

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My little post on naturopathy was more controversial than I had anticipated. Some of the commenters gently (and otherwise) suggested that I should learn more about the subject, so I've been doing a little reading. Here are the basic questions: what is naturopathy, and what might it have to offer…

"Scientists are not certain how homeopathy works."

Ohahahahaha. Ow ow... ow... my sides.. Aye, the scientific consesus on homeopathy is that it is literally magic! It just works, we don't know how!

A naturopath, doing what naturopaths do best.

Drinking the kool-aid? He seems to have already achieved some stupor state.
And without opening the bottle first. I suspect placebo effect.

For reasons that are not yet understood by science, the soles of the feet have a special relationship to the body as a whole.

Yes, this special relationship is called "enduring the body's weight". In some cases, they have to endure supporting massive amounts of stupid.
And indeed, science is still baffled about this. Why would our soles accept to put up with such an abusing relationship?

More seriously, I could go with a good foot massage right now.

By Helianthus (not verified) on 20 Jun 2016 #permalink

I'll try to get to it tomorrow, but if anyone has a spare 10 minutes, please archive these websites in the Wayback machine. The Nds are learning to clean up their webpages. Not clean up their bad practices, just put a slicker veneer on them.

That bubble bath with oils actually sounds pretty nice. Not for therapeutic reasons, but I can imagine enjoying such a session.

Maybe if Naturopaths requalified as SPA providers they could still do some good for the world?

By The Smith of Lie (not verified) on 20 Jun 2016 #permalink

@The Smith of Lie: I was thinking the same thing! A nice, warm, soothing bubbling bath, with nice scents, candles, a glass of wine. But, I can have that at home anytime, and not worry about who was in the tub before me and if it was cleaned well between patients.

I heard through the grapevine that the bill was passed by voice vote in an informal session of the Senate, meaning that there were probably only a couple of senators present. It's also thought that the bill won't have much traction in the House.

But, if anyone happens to live in Massachusetts, get in touch with your representatives, especially if they're on the House Ways and Means committee.

But, I can have that at home anytime

I was thinking along similar lines myself. But the oils aren't essential. Just have a nice relaxing hot bath. And it's much cheaper than what Mr. Bier is selling.

Then there's that bit about imported herbs and minerals for the foot bath. As if the sourcing of these additives should have a significant effect on anything other than the price of the treatment.

By Eric Lund (not verified) on 21 Jun 2016 #permalink

I have come to appreciate the way the State of California reports legislators' votes, even committee votes. Easy to see who is leaning which way.

The Boston Globe recently spoke out against anti-science GMO and Lyme bills. I don't think the Naturopath bill was on anyone's radar.

By Concerned (not verified) on 21 Jun 2016 #permalink

Not sure this is going anywhere but better safe than sorry. Every Legislator has phone calls answered and tallies messages. More effective than emails. Be clear and concise about why you feel the way you do about the legislation. The best time to act may be the middle of July. This, if it goes anywhere, would likely be heard during the end of session (last day of July) crunch. You can sign up for alerts from the MA Medical Society's advocacy alerts: http://www.massmed.org/Advocacy/Action-Center/Action-Center/#.V2lYlqb2b…

SCENAR, German Immersion Therapy Devices, Hyperbarics. Man, those natupaths are cutting-edge hi-tech. Of course the state home to MIT will be getting on board with that wizardry. Coming soon to Cambridge: Prevent Disease The All Natural Way With The Machine That Goes "PING!".

It seems that everything from a land far away is the best.

I would think that they should be using the finest African lark's vomit, Peruian crunchy frog and fresh pumped water from the southern Mississippi River for all there cures.

I like to put Dr. Teal's Epsom Salt Soaking Solution with Lavender ($4.87 for a 3# bag at Walmart) in our spa tub because it makes the water all fizzy! I bet it atomizes stuff too!

By Thomas Johnson (not verified) on 21 Jun 2016 #permalink

Prevent Disease The All Natural Way With The Machine That Goes “PING!”.

That sounds like something Bill Watterson might have written. There is a collection of Calvin and Hobbes cartoons called Scientific Progress Goes "Boink".

By Eric Lund (not verified) on 21 Jun 2016 #permalink

If the not-a-doctors get legislative approval to pretend to be real doctors, can they then be sued for malpractice? Or can you not "mal"practice medicine if you don't actually practice medicine, but instead prescribe water and machines that go "ping"? I've wondered about the consequences part of the equation for quite some time.

Eric Lund -- it does sound like Calvin & Hobbes, but it's actually a Monty Python reference. ;-) It's from "The Meaning of Life". Not their strongest movie, by a long shot, but it's got some good bits. A woman goes into labor and is whisked into the delivery room, BUT since some very important hospital administrators or somesuch as visiting that day, the doctors want to make a good impression so their hospital's budget is improved. So progressively more and more machines are ordered up, finally ending with "the machine that goes BING!" It's a machine with no other apparently function than to occasionally go "BING!"

By Calli Arcale (not verified) on 21 Jun 2016 #permalink

The C&Hobbes is "Scientific Progress goes Boink?"

( I really know it isn't polite to laugh at someone's name but when it is almost Yiddish for....... but I digress)

@ The Smith of Lie et al:

Which is I why I often refer to woo as either Spa medicine or Grandmother/ parent medicine.
They offer treatments that are really glorified self-care which anyone can do without highly rigorous training or a medical degree.. I realise that spas DO used trained people like massage therapists.

So teas, drinks, foods, magic oils, aromas and other specialities belong at the salon or a relative's kitchen than a 'medical' office.

By Denice Walter (not verified) on 21 Jun 2016 #permalink

I know that this viewpoint won't be a popular one on a medical blog given the hippocratic oath and the notion of standard of care, but I'm a physicist, not a medical doctor.

Maybe the better way to deal with this is to simply let naturopaths get licensed to prescribe controlled substances. I know this sounds crazy, but then the media will be able to pull them into the 24 hr news cycle and castrate them with "trial by mob" when they inevitably screw up. it would be messy and there would likely be lives lost, but the government would be compelled to clamp down on them in a graphic way and maybe the broader population would learn something from the experience. If they refuse to learn by example, people learn best when they're allowed to step on the rusty nail.

I would have expected that imported materials having a greater cachè would be more of a thing in less-developed countries.
Actual Filipino joke -
Doctor: "Now I'm going to give you a local anesthetic."
Patient: "Please, Doc, can't I have an imported one?"

By Old Rockin' Dave (not verified) on 21 Jun 2016 #permalink

@janet

Part of the problem with a malpractice case is that it is judged within the reasonable standard of care within the profession. So as soon as naturopaths are licensed, a separate standard from real medicine is established, and it is that new standard against which naturopaths will be judged. Prescribing homeopathy for a skin infection would certainly be malpractice for an MD, but that is part of established practice for an ND, and thus is not malpractice.

@viggen

Maybe the better way to deal with this is to simply let naturopaths get licensed to prescribe controlled substances.

Well, if we had an ethical standard equivalent to the quacks out there, sure. Sacrificing a bunch of innocent victims to achieve the goal might be effective, but the cost is too high.

Viggen@20: I'm going to agree with Todd W. - way, way, way too many people would have to suffer and die before the news media would pick it up.
Ounce of prevention, pound of cure and all that jazz.

By JustaTech (not verified) on 21 Jun 2016 #permalink

Here's a question I'd love to ask of anyone who practices TCM: How many products made from endangered animals do you use in your practice? Do you support the use of endangered animal parts?

I knew about the rhinos and bears, but just today I was reading about these wacky-looking siaga antelopes in Kazakhstan (honestly, they look like brown tapir) that are being poached for their horns (when 60% of the entire population isn't dying of a mysterious disease).

By JustaTech (not verified) on 21 Jun 2016 #permalink

The integrative medicine dept. at my cancer center has an acupuncturist working there who prescribes some chinese medicine (herbs? or whatever? ). I'd like to know where she procures them.

mho@25

The integrative medicine dept. at my cancer center has an acupuncturist working there who prescribes some chinese medicine (herbs? or whatever? ). I’d like to know where she procures them.

Once saw a patient in the ER with chest pain

Patient: I've been taking nitroglycerin all day and it hasn't helped.
Patient's daughter: We brought it with us.
*shows us a bottle of some herbal something*
Doctor: That's not nitroglycerin.
Patient's daughter: It's like a herbal nitroglycerin.
*facepalm*

They got it from a TCM practitioner of course. Luckily it wasn't cardiac related pain that time.

Todd W.@22

Prescribing homeopathy for a skin infection would certainly be malpractice for an MD, but that is part of established practice for an ND, and thus is not malpractice.

Exactly. How can you possibly sue for negligence when there's no standard of care. A "reasonable" naturopath makes sh!t up as he goes along so there's no way to show breach of duty.

On the other hand that seems so absurd that I have trouble believing there's not something that could be done. I would like to hear what Dorit or another legal beagle says about this.

By capnkrunch (not verified) on 21 Jun 2016 #permalink

@ mho:

I hope she isn't using any type of cupping;
as a recent ( now ex-) subject of TCM acu and cupping, I wouldn't recommend it to anyone with bleeding/ clotting issues which can arise from illness or treatments
( my own are rather mild and not due to a serious condition**).Lots of circular bruises***.

** and I'm not a descendant of Queen Victoria either
*** not from an octopus attack altho' it looks like it

By Denice Walter (not verified) on 21 Jun 2016 #permalink
Prescribing homeopathy for a skin infection would certainly be malpractice for an MD, but that is part of established practice for an ND, and thus is not malpractice.

Exactly. How can you possibly sue for negligence when there’s no standard of care.

IANDRR. "Standard of care" just means "breach of duty." (Really, it has tugboats; it's fun.) For state-licensed NDs, at least, there has to be a basis for the licensing – e.g., some diagnostic competence; I'm not doing a survey. Therein lies the duty.

So progressively more and more machines are ordered up, finally ending with “the machine that goes BING!”

That machine lets the doctors know that the baby is still alive, Calli Arcale #16.

Mother: Is it a boy or a girl?
doctor: I think it's a bit early to be imposing rolls on it; Don't you?

https://www.youtube.com/watch?v=arCITMfxvEc

Live births. Meh.

@sadmar

On the one hand, Massachusetts is a world class center of technology and education.

On the other hand, Massachusetts is a wretched hive of scum & quackery and simply teeming with woowootarians.

I don't get it either, but that's the brute fact of nature.

By Robert L Bell (not verified) on 21 Jun 2016 #permalink

Here’s a question I’d love to ask of anyone who practices TCM: How many products made from endangered animals do you use in your practice? Do you support the use of endangered animal parts?

That chaps my arse fiercely. I wonder how many ethical vegans/vegetarian woo-pusher/users either a.) don't know what many TCM nostrums are made from and/or b.) don't have an ethical issue with them.

By Science Mom (not verified) on 21 Jun 2016 #permalink

In Australia I've heard that certain political parties plan to introduce legislation which would limit rebates from private health insurance funds for 17 natural therapies, such as naturopathy, kinesiology etc. A political party has been set up, known as the 'Health Australian Party', running 2 Senate candidates in each of NSW, Victoria, Queensland and Western Australia – the HAP (Health Australia Party). Guess who one of the Victorian candidates is? Dr. Isaac Golden (well, he’s not actually a Medical Doctor), rather he was awarded a PhD for homoeopathic research. That would be an interesting read. In April 2016 he was invited by an Indian government department to advise on planned Dengue Fever immunisation programs in Delhi and Kerala State involving millions of people. I'd like to hear about the results.
And guess who the National President of HAP is? Professor Kerry Bone, the co-founder of MediHerb (a very profitable herb and supplements manufacturer) interestingly enough.

Cryer @32

I hadn't heard of the Health Australia Party so I turned to the great gazoogle. It turns out it was formed in 2013 as the Natural Medicine Party. It was founded by a naturopath. Inevitably, its manifesto features a typical laundry list of pseudoscientific tropes and conspiracy theories.

There's an article here. Best line from the article was a comment by Dr Sue Page, deputy chair of the Royal Australian College of General Practitioners, in reference to one of the claims of Isaac Golden:

Putting it as politely as I can, homoeopathic vaccination is crap.

By DrBollocks (not verified) on 22 Jun 2016 #permalink

If no one knows how homeopathy works, how can anyone say it addresses an illness's root cause? Yet I have heard naturopaths say just that.

By Lucas Beauchamp (not verified) on 22 Jun 2016 #permalink

I've lived in this County all my life, but I'm still misspelling it.

By Lucas Beauchamp (not verified) on 22 Jun 2016 #permalink

I’ve lived in this County all my life, but I’m still misspelling it.

Anybody would. :D

By Science Mom (not verified) on 22 Jun 2016 #permalink

My colleagues were wanting AO 442 some time ago and were informed of an online platform that has a lot of sample forms . If people need AO 442 too , here's http://goo.gl/CFVXJQ

By Jocelyn Smarte (not verified) on 27 Jul 2016 #permalink