Shouldn't This be Manslaughter?

So, I saw this patient back yesterday. I must have a thousand like her. She comes in once a year on her endless search to find the "cause" of her disabling chronic migraines. Yet, over the years she has never allowed me to treat her. The reason is, her PCP is a naturopath and has convinced her that virtually all western medicine is dangerous and evil (controlled by the drug companies for profit). He has taken her through many, many so-called diagnoses and treatment protocols (enemas, hundreds of supplements, "craniosacral" threapies and etc. I explain each time that she has chronic migraine. I explain in detail the cause and mechanism. She doesn't believe me though. She refuses all medication treatment, which is sad, because I could get her headaches under control easily.

But that is just about suffering. This is the part that I think could be manslaughter. Her B/P yesterday was 177/110. I looked and a year ago it was 180/108. She tells me that it is always up like that and has been for ten years. She has never taken a single pill for HTN. She told me that her naturopath told her that all anti-HTN medications work by "injuring the heart to the point that it can't pump very hard." He added, "Once someone goes on these chemicals, they rarely live more than 5-10 years because their hearts give out."

On the other hand, he has been trying to "cure" not only her headaches but her HTN. He tells her that her HTN is being caused by adrenal damage from pesticides in her food. He has her on strict diets and bags full of supplements . . . which he happens to sell.

I was livid with her. I did prescribe a beta blocker for both HTN and headaches but she probably won't fill them. So, if she dies from HTN related illness, why can't these lying Bozos be held in criminal court for manslaughter? Okay, a rhetorical question.

report the doc to the board of medicine....... let them deal with it

This is the norm here. The largest Naturopathic school in the country is not far from here. If I went to the board of medicine, I might find that it is controlled by naturopaths. So seriously, this is very widespread thinking here in the beautiful northwoods. But I just don't know how these people are never sued or help accountable for this misbehavior. I have had breast cancer patients throw away their chemo for herbs . . . and die an unnecessary death and no one is held responsible for lying to them. It is more than just a different philosophical orientation. It is lying. I told the patient yesterday, with a lot of strain in my voice, "Bring me one paper supporting what he is telling you. I can show you a hundred where people lived longer with their HTN treated with meds!"

Naturopathy and homeopathy are practically religions. That "doctor" is despicable, but I guess it is really no different than any other religion that deliberately turns away beneficial care in favor of superstitious remedies.

You can lead a patient to Maxalt, but you can't make them take it...

Cancer is related to diet and not fixed by chemo...look back 40 years of research and the sub-types of cancer and tell me which ones have decreased due to chemo...look at the cancer rates in this decade! Good lord it has sky-rocketed, there is no way this is linked to our food supply, fluoride water, aspartame, MSG, pesticides, vaccines, etc. You need to watch "Healing Cancer from the Inside Out" and watch the food summit on refined vs. unrefined foods, "Pediacide" and Adrenals. Get real people and talk to your grandparents and ask them about their food and what has changed of the years...Please start doing research on all these topics and not JUST listen to the CDC. There was a report yesterday stating that organic food is no better than non-organic food!!! Seriously! You want to have GMOs, BT in your corn, pesticides, etc...If all the GMOs are safe then how come they want put GMO labeling on food or put fluoride in our water when it is known to be TOXIC...Also, sign up for natural news and start some research there also...look at the studies and make sure they are not reporting in relative numbers and if so do a easy calculation and make it into a relative numbers...the numbers are skewed from all these research companies, big pharma, etc...

I can't talk to my grandparents or great grandparents. They all died from simple cancers.

Wow. So simply inhibiting B1 receptors is injuring the heart? Well, I guess my world has just been turned upside down.

I would never argue that there is no merit to the "natural" approach when it comes to certain things. Of course there is some truth to some natural remedies, eating as few pesticides as possible, the importance of diet in cancer, etc... The problem is that, like many religions, people tend to take things a little too far and ignore logic, science, and sound advice. There needs to be a balance and recognition that neither one has all the answers or is all evil.

I would never argue that there is no merit to the "natural" approach when it comes to certain things. Of course there is some truth to some natural remedies, eating as few pesticides as possible, the importance of diet in cancer, etc... The problem is that, like many religions, people tend to take things a little too far and ignore logic, science, and sound advice. There needs to be a balance and recognition that neither one has all the answers or is all evil.

I agree. In the midst of the radicals there are many local naturopaths that are rational and complimentary to the common goal of helping people get well. It is the beating your chest, conspiracy theorist that are harmful.

I also know providers in western medicine who would prescribe for your harmful meds, or stand up at a PA conference (or any conference) and tout a bad treatment as being good because the makers of that treatment paid them a few grand for speaking.

I will say, the point I was bringing up in the first place has to do with Einstein's equation . . . no the other one . . . the one where he said insanity=doing the same thing over and over but expecting different results.

So, in the cases of these patients who come to me year after year, suffering terribly, but doing diets and supplements and some bizarre treatments and etc over and over . . . but are NO BETTER, that's where it becomes irrational. If this lady's naturopath cured her headaches or her hypertension then I would send the guy a medal and study up on what he had done so I can do the same or send him more patients.

I spend 30 minutes of each new patient visit, discussing non-drug treatments for their headaches . . . but I don't just make stuff up. These treatments must have some validation in studies and not just my opinion.

My gripe is where anyone tells someone I'm going to make you better, but over years and years they are no better, but then I tell them it would be evil to go somewhere else and they must stick with my (failing) treatments . . . that is the part that is unethical, especially when it brings harm to patients. If such behavior causes the death of a patient, then that provider should be held accountable.

I agree jmj11!

There are tons of valid articles about natural ways of curing illnesses. Just because you tell your patient to do something, doesn't mean they are truly doing it. So, you cannot make a valid argument against the N.D. unless you follow that patient every day. Also, the natural way of doing things takes time and lots of patients don't have the time or don't see results right away so they quit doing what the N.D. told them to do. Western medicine gives a pill and it works within hours to days, but does NOT fix the problem, just mask it.

Absolutely NOT true and I am very highly offended that you suggest that we have spent our careers "masking" symptoms.

tah731, if you don't have anything constructive to add to this serious discussion, for the love of whatever you pray to, shut up.

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Mike, I can imagine your frustration. I would love to drag out all the JNCVI data on HTN and heart disease risk, and beat this guy senseless with it, but it would do no good. If he doesn't have eyes to see and ears to hear, any attempt to reeducate this naturopath will be wasted effort for you.

I too would have assumed the responsibility to treat her dangerous HTN. After 10 yr of that you can bet she has end-organ damage--and knowing as much as we do about PREVENTION of heart disease, cerebrovascular and renal disease as we do (and have for several decades), I posit that the naturopath's advice to this woman is actually criminal.

Write the complaint to the BME and hope for the best. I cannot imagine the BME will ignore hard science and evidence-based medicine over naturopathic mumbo-jumbo.

BTW can you give me some of your articles that prove flu vaccines are working so I can read up on those...

http://www.who.int/bulletin/volumes/86/2/07-040089/en/

Be sure to read ALL of the linked articles that are properly cited throughout.

Who am I kidding? You won't read that entire thing. But you should.

The funny thing about these types of arguments......the person that is pro-ND will commonly 'discredit' any citation as being influenced by 'Big Brother' or 'Big Pharma' and therefore is not valid. And of course any argument to the contrary is simply discredited using that same 'logic'.

So, why argue with you about this? Conspiracy theorists are notorious for being unwilling to listen to the other side of the argument. They tend to be so wrapped up in what they 'know' they close off to Evidence Based Medicine.

I'm actually more interested in YOU. Where are you attending school? What did you do before school? What are your plans after school?

A small anecdote:

A family member of mine was diagnosed with breast cancer many years ago. She was successfully treated with chemotherapy. The breast cancer unfortunately occurred again over 30 years later. At this point my family member was so taken by the "natural medicine" world that she refused to be seen by an oncologist. Her axillary lymph nodes became so enlarged the lymph fluid was unable to drain from her arm, it subsequently swelled to twice it's normal size. She traveled to see and ND, was told that she had 'mold' and payed him $300K for treatment. Yes, that's $300,000. She returned home from her 'successful' mold treatment and died 2 months later.

I agree with you and think there is a balance also. There is a need to not push medications on people when there is a fix to a problem. Modern medicine is all about medication, medication, medication and not on prevention (life style changes). There needs to be more emphasis on diet diet diet because this is what is ultimately killing our patients.

BTW learn to use the quote button. It's on the lower right hand corner. Then we can see who the heck you are replying to (if anyone).

For JMJ

OMG David that's fantastic!

Are you sure your a PA student? This statement suggest otherwise to me. Disease prevention and lifestyle modifications are discussed extensively in my program and continued in the clinic. Every clinical rotation I had would stress the importance of these changes to patients newly diagnosed as well as those living with the diseases. You make the statement like nobody in medicine other than naturopaths follow these standards of practice and you are mistaken on your assumption. I counsel all my patients on such lifestyle modifications but not as means to avoid or come off whatever medication is needed but to improve their overall health. IF the numbers support discontinuing certain medications then I'll suggest it accordingly. Medical management is not the end all of patient care just like diet and exercise is not the end all. Diet does nothing for HTN related to CKD or renal artery stenosis just like it won't effect Type 1 DM, it will improve overall health but won't change the outcome if left untreated. As a healthcare professional that is responsible for the lives of people we care for, we owe it to them to give such care in the best possible manner to reduce complications from the disease as well as limit any adverse effects of the medications we use to manage their disease.

Just my own observation when I was an ER nurse during the H1N1 scare. The big push to get everybody vaccinated that year made for a very easy flu season in the ER. Our numbers were way down that year compared to previous years. It doesn't really prove anything but we noticed the change and it was a pleasant deviation from the norm.