Naturopathic Medicine

[zoopeda]

I honestly wish I had more time to look this stuff up for you.  I also wish our medical establishment wasn't completely bought and sold by the pharmaceutical industry and that there wasn't so much financial incentive out there to slander natural remedies and squash alternative care providers.  There is research out there, but it's hard to get funding when the treatment goals are so different (i.e. using few drugs vs using more).  Chicken and the egg, I guess...

[PACdan]

I honestly wish I had more time to look this stuff up for you.  I also wish our medical establishment wasn't completely bought and sold by the pharmaceutical industry and that there wasn't so much financial incentive out there to slander natural remedies and squash alternative care providers.  There is research out there, but it's hard to get funding when the treatment goals are so different (i.e. using few drugs vs using more).  Chicken and the egg, I guess...

 

I don't think every academic medical researcher across the globe is in the pocket of big pharma. Do pharmaceutical and insurance companies have too tight a grip on the practice of medicine; in my opinion, absolutely. But as complex as the web is, drug therapies work, and in the last 70-odd years have changed the world. People survive things they never would have before, procedures extend lives decades, and the evolution of care has resulted in ways to improve quality of life in many disease states.

 

Naturopathy doesn't push for the development of the CT scanner, or the MRI, or the implantable pacemaker, or genome research, or the production of vaccines. Naturopathy would be just as comfortable in 1895 as 2015. It applies old techniques and ideas to newly discovered problems, sometimes dubiously. In medicine we should be restless and hungry, always questioning and always searching. 

 

Some guy came up with "rolfing" in 1930, and because he wrote and spoke from a position of authority, it was accepted. We used to do the same thing with MDs. Some medical doctors had crack-pot ideas, and because they believed in them and purported them to be useful, and wrote extensively on them; we accepted it for awhile. But a revolutionary thing happened, we stopped just accepting the word of those in a position of authority and said, "Hey, let's test that." And test it again, and test again, and try to remove bias, and remove confounding variables. All in an attempt to discern fact from fancy.

 

I do not discount complementary medicine. I truly think some of it has a place alongside best-evidence therapies. I'm not so closed minded as to believe that the Greeks, or Chinese, or others were unable to discover things that worked, even without fully understanding why. The ancient Romans had excellent battlefield medicine for their time! They also used lead pipes for their water, but we have learned since then... We make many medicines derived from botanicals, but in concentrations that are bioavailable, quantifiable, and produce measurable and testable effects.

 

Our standards are higher than they were 70 years ago, because though science we seek to further our understandings of how & why things work or don't work.

As a scientist I need to hold naturopathy and its practitioners to those very same standards.

[LT_Oneal_PAC]

.

[zoopeda]

PADan, you're obviously a smart person.  We've reached the limitations of online forums and the time I have to contribute here.  We've failed to convince one another.  I feel this is largely due to the fact that I don't have the time and energy to go into great depth, nor do I have the time and energy to read what would likely be a deluge of a response.  You are undoubtedly busy as well.  (Although I do sort of hope Maverick eventually gets around to explaining that situation a little better!)  I'm glad you're passionate about medicine, and I'm glad, at the very least, licensed NDs really aren't out there killing people left and right.  Actually, I think you'd be surprised to find that although NDs are not licensed in other countries, MDs include many "ND therapies" throughout most of Europe and the developed world (be they essential oils or herbs or colonics or hydrotherapy)--very often reimbursed by national insurance.  Hopefully, the more the ND profession evolves in this country, we'll see more quality NDs out there, and the goofy ones will fall by the wayside.  Maybe you think they're all goofy; I dunno.  It doesn't really matter any more.  Silicon Valley is on in 15 minutes, and an entire thorax worth of anatomy awaits after that.  I gotta tuck in my kids.  

[Deanj59]

I honestly wish I had more time to look this stuff up for you.  I also wish our medical establishment wasn't completely bought and sold by the pharmaceutical industry and that there wasn't so much financial incentive out there to slander natural remedies and squash alternative care providers.  There is research out there, but it's hard to get funding when the treatment goals are so different (i.e. using few drugs vs using more).  Chicken and the egg, I guess...

The temptation is to assume that research on various herbal/naturopathic medicine has not been done, but there have been great volumes of research on a variety of natural compounds and their healing properties. I'm surprised to see only one link to an individual evidenced based link to NIH's CAM division so I'll post it here for reference. Take some time to review the data here: https://nccih.nih.gov/health/atoz.htm

 

In that link is a LARGE list of both herbal and alternative medicines and the evidence behind each. I don't know which program you are set to attend, but I would bet that they practice evidence based medicine. Bottom line is that the therapies that are regarded as standards of care in the practice of medicine must meet the standard of evidence through good statistical validation. Are there tons of compounds that have yet to be studied because of less incentive or difficulty creating a trial? Of course, the sheer number of potential compounds to test presents a both financial and logistical challenge. I don't think anyone here would refute the power of certain plants/herbs with medicinal compounds given we have synthesized many drugs from plants for some time, just that any remedy must have the statistical support of it's efficacy before one uses it.  

[acozadd]

To go with the story listed above, I have had a similar experience. A friend's father was diagnosed with Lymphoma. He was presented with the option of therapy chemotherapy. He went to an ND who said not to take that, all he had to do was change the acidity of his diet (cannot remember if he meant more acidic or more basic)... regardless, he went with the traditional therapy and has now been in remission for several years. This was from an ND who came highly recommended to him.

 

I have nothing against natural supplements. I take a number of supplements myself. I do feel that while many have been shown to have some effect, there happens to be better pharmaceutical options available in most cases that are more standardized, regulated, tested.

[zoopeda]

The temptation is to assume that research on various herbal/naturopathic medicine has not been done, but there have been great volumes of research on a variety of natural compounds and their healing properties. I'm surprised to see only one link to an individual evidenced based link to NIH's CAM division so I'll post it here for reference. Take some time to review the data here: https://nccih.nih.gov/health/atoz.htm

The valid studies conducted on many natural products on this site are extremely scant.  I've been there before, and I just looked up a few at random and saw one or two small studies for each substance.  We need a lot more research into much of this in the US, but as long as it's impossible to patent a flower, I'm not holding my breath.  What is helpful, however, is all the double-blind studies that come out of medical systems that actually use these remedies (much of which are out of Europe and Asia).  ENORMOUS amounts herb research out of China, Hong Kong, Japan, India, Korea, and Taiwan.  Quite a bit on essential oils out of France and Germany.  Acupuncture out the wazoo throughout Asia.  At a future time, I will try to dig those up and post them here.  

[Maverick87]

This is a strange ending to the story; let's discuss.  

 

First, we need to find out if this "naturopath" was licensed.  You're probably aware that only 17 states (last I checked) license NDs and that in order to get a license, one must achieve certain standards (graduate from an accredited institution, etc etc).  This means that in 33 states right now, anybody--you, me, anybody--can call themselves a naturopath.  Likewise, in some states, NDs are licensed to order tests, diagnose, prescribe, etc.  In others, they do not have these rights and are simply "lifestyle counselors."  (CEUs, accreditation standards, etc all affect licensing standards by state.)  

 

So the next question is: in what state did this incident occur?  Was this person licensed to make the judgements he/she did?  Did this ND at least graduate from an accredited ND school?  If you answer one way, the story falls apart; if you answer the other, we very well might have malpractice here.  

 

Another issue to rule out is patient interest.  In our society, if a patient disagrees with or declines mainstream care, he/she is often viewed as either crazy, irresponsible, or having been coerced by someone who is.  I've met people who have survived cancer via radiation and chemo who have said if they have to do it again, they'd forgo those treatments.  Not my choice, but it is the patient's choice.  So what's the story?  Did this patient and her mother really feel set against chemo/radiation from the get-go, or were they all set to start treatment when this ND swooped in to change their minds?  Did this ND claim to be able to cure this patient?  Claim his/her treatments were more effective than the standard of care?  Was this patient initially open to radiation and chemo?  

 

If it turns out this ND was a graduate of an accredited school, licensed in a state allowing NDs to make these kinds of recommendations, and coerced a patient into alternative treatments, then obviously this should be an open and shut malpractice case.  Did the family sue?  Is this ND still in practice?  Or was there some other factor that helps better explain the series of events.  I'm truly interested in understanding the truth of this matter, but it seems to me that there's either more to this story or, had the family or state felt this ND had committed malpractice, he/she would have been held accountable by the state medical board and court system.  I just know when I see statistics like "15-25% of all physician diagnoses are incorrect" (via NPR last week) or "one of the leading causes of death in the US is medical treatment related death" (loaded statements, I realize), sometimes I get the sense that we're not always comparing apples to apples on this forum.  Regardless, if a practitioner--any practitioner--is caught harming patients, he/she should, no hesitation, be investigated swiftly and fairly to the full extent of the law.  If this person is still in practice, in a state that licenses NDs, there's a good chance he/she did not kill the patient in question (or, at the very least, the family was ok with the ND killing the patient--less likely, I'd imagine).  

I have no idea what the credentials were of the ND that she saw.

 

In any event, as a practicing provider, I would not see a naturopath for my own health and would not recommend that a family member see one. Therefore, I cannot recommend this method to any of my patients.

 

In general, I don't view any patients that don't want to take medication as crazy. I view them as non-compliant. At first, I will try to guide them. If they consistently refuse my advice, then I just let them do what they want (and I document their refusals). It's their life.

 

If you're so passionate about ND, then why don't you become one? You won't find many people in traditional medicine that fully share your viewpoints.

[zoopeda]

I have no idea what the credentials were of the ND that she saw...

 

If you're so passionate about ND, then why don't you become one? You won't find many people in traditional medicine that fully share your viewpoints.

Do you even know what state it was in? Either you made up this story or you truly didnt know if this person was a licensed ND before you used the example to slander an entire profession...

 

See above, multiple times, for the answer to your question.

[LT_Oneal_PAC]

I have no idea what the credentials were of the ND that she saw.

 

In any event, as a practicing provider, I would not see a naturopath for my own health and would not recommend that a family member see one. Therefore, I cannot recommend this method to any of my patients.

 

In general, I don't view any patients that don't want to take medication as crazy. I view them as non-compliant. At first, I will try to guide them. If they consistently refuse my advice, then I just let them do what they want (and I document their refusals). It's their life.

 

If you're so passionate about ND, then why don't you become one? You won't find many people in traditional medicine that fully share your viewpoints.

Same reason people like Dr. Oz become an MD. It provides legitimacy and cash.

[LT_Oneal_PAC]

And let's not pretend there isn't money is selling herbs and the like. ND, acupuncturists, and chiropractor are some martyrs being crushed underneath the foot of big pharma. Money can and is made off of diets and exercise plans. Chiropractors make you come in 2 a week for 3 months and then more to twice monthly adjustments for years. No different than acupuncture. Before you spout off how I'm in the pocket of big pharma, I've been trained to perform certain acupuncture techniques for pain by the navy and use it regularly, and my sister is a DPT/acupuncturist/credentialed in manipulation. Even she will admit to the quackery of NDs and, even worse, homeopathy.

[rev ronin]

Is there anyone in this discussion who DOES NOT think homeopathy has zero non-placebo medical value?  People keep bringing it up, but I'm not hearing a lot of disagreement about how useless and dangerous it is.

[NLRP3]

I have been observing this discussion from the outside and would just like to express my sincere encouragement at how most of the individuals here hold ALL treatments to the same standard, that is evidence based medicine. There is no Alternative or Mainstream medicine, there is medicine that works, and then everything else. "Alternative" medicines have been tested ad nauseum, and when something is promising, it is isolated purified and controlled, then used prescriptively. When something doesn't work, we should throw it out, not scream that "Big Pharma" is out to get us! The supplement industry is a multi-billion dollar industry, hardly the little guys the CAM providers would have you believe. And for folks who say that homeopathy, acupuncture and other oddities actually do work consider this. A moderate claim requires a moderate amount of evidence, while extraordinary claims require extraordinary evidence. If I were to claim that a new drug worked to reduce inflammation by well established means (i.e. COX1/2 pathways) the level of evidence needed to convince people would be low. This is an established and classical mechanism. However if I propose that actually you can cure cancer by putting needles in someone's meridians, which are based off of the geography of rivers in China, this would be a huge claim. Just like telling me that drinking water, which retained the "memory', of some ingredient long gone to dilution will heal me. This would require us to rewrite the laws of physics and chemistry. To completely rethink medicine. I for one am willing to do this, but there has be more than just statistical noise that will inevitably happen when you throw enough junk at a wall.

 

I agree Western Medicine is problematic. Science based counseling on diet and exercise doesnt happen. Maybe because people are lazy, uninformed, too busy, or maybe just because it is a hard talk to have. Pharmaceutical companies are a little skeezy. However just because airplanes crash doesn't mean that a valid alternative is that we all take flying carpets. It means as providers that we change how we practice, and our compass in how to do this is science and evidence. Real medicine evolves and changes. It is not based on ideologies. It is slow and imperfect but it helps strip us of our biases. Because our brains evolved to survive reality, not understand it. So any time we say "because I experienced it" or "I know someone who" we should take a good hard look at what we are saying, especially if we are responsible for someon elses' health.

[Maverick87]

Do you even know what state it was in? Either you made up this story or you truly didnt know if this person was a licensed ND before you used the example to slander an entire profession...

 

See above, multiple times, for the answer to your question.

The state was New York.

 

If you think that I made it up, there are famous versions of it too. Ever hear of a guy named Steve Jobs?

 

For someone that hasn't even been accepted to school yet, you sure think you know a lot about medicine.

[zoopeda]

The state was New York.

 

If you think that I made it up, there are famous versions of it too. Ever hear of a guy named Steve Jobs?

 

For someone that hasn't even been accepted to school yet, you sure think you know a lot about medicine.

 

Until very recently, any Joe on the street in NY could legally call himself a naturopath. They were only recently licensed there yet still cannot order tests or diagnose or treat medically. At least NOW if your friend had that experience, the nd could be prosecuted under the medical board. Don't waste our time with distracting stories about non licensed bolagna.

 

Steve Job's acupuncturist recommended he stick with conventional treatment.  There was a big investigation--as reported by the CA news media.  That was his choice, against the advice of his "CAM" provider--as documented in her chart notes and reported all over the place.

I practiced medicine for 4 years as a Chinese medicine practitioner.  I am currently in PA school.

 

Where do you get all this stuff?  

[zoopeda]

It's important to draw a distinction between efficacy and safety.  I am not advocating for all kinds of expanded rights for NDs as PCPs.  In fact, I feel their clinical training of 12 hours per week for a year is far too low for anyone to be calling himself a PCP.  This is a huge reason why NDs are not achieving licensure faster and a huge reason I wouldn't consider ND training.  (I bypassed NP school application for the same reason.)  But there are two separate conversations happening here: one regarding SAFETY (i.e. Are NDs harming patients?) and one regarding EFFICACY (i.e. Are the treatments NDs employ getting results?).  

 

No matter what far out stories people are making up and tossing onto this forum, the bottom line is that licensed NDs are just not killing people.  At least not as many as mainstream medicine.  We are all aware that preventable medical errors are still a top cause of death in the US and that nearly 1 in 5 diagnoses by mainstream doctors are simply incorrect.  Yet there's a double standard.  As a Chinese medicine practitioner, I remember a few years ago when a small handful of people grossly misused an herb called Ephedra and died.  I use ephedra all the time in clinic--kids, adults, most people--and, used properly, have never had a problem.  But when one or two deaths occurred in the 90s, lawsuits were flying, Chinese medicine was slandered, and the herb was prevented from entering US ports.  On the other hand, when someone drinks 50 espresso shots from Starbucks and puts himself in the hospital, we all just call him an idiot and keep on sipping those lattes.  (Yes, herbs are still regulated as foods, like coffee beans or tea, in this country.)  Or, more to the point, when a patient experiences severe side effects, usually some legal disclaimer and whole bureaucratic department is on hand to diffuse the event.  The difference, on could argue, is a massive amount of money and public exposure behind one and not the other.  The bottom line is that NDs are spending enormous amounts of effort and money to advance licensure, and they've been largely unsuccessful despite those efforts.  They're simply outmatched, financially.  You can agree or disagree with the reasoning behind both sides of that battle all you want, but the point here is that the playing field is slanted and that, unlike within mainstream medicine, a single slip up can make front page news across the country.  The purpose of this paragraph is not to justify anything about ND practice.  It is simply to point out that if NDs were truly harming patients--licensed NDs in states that, well, license NDs--it would be all over the news and those patients' families would be winning lawsuits rather than going online and posting about how an incident turned out not to hold any water in court after all.  NDs are not dangerous.  Some of their treatments may do nothing at all, but as long as they've not recommending homeopathics instead of appendectomy, I am happy US residents still have the freedom to make our own medical choices.  

 

By the way, I once bought a tube of homeopathic pellets just to see what the hubbub was all about, and it cost me $6 for a week.  No, that was not after insurance covered half.  Sure there are people who abuse their supplement pharmacies and sell a bunch of bottles to an unknowing patient.  There are also surgeons out there who want to put new knees on everything that walks in the door.  Sure, they're both unethical, but I'd hardly put the two in the same category.  

 

As for the second discussion--efficacy--this actually is a "big pharma" problem.  You've got people leaving the NEJM giving interviews and writing books like "The Truth About Drug Companies" talking about how a significant amount of research coming out of establishment laboratories is unreliable and "fixed".  Someone brought up Evidenced Based Medicine.  Sure, in PA school we do take that class, and the first thing the teacher brought up is how you can literally design a study to say whatever you want.  We're entering a phase of nihilism in medical research, and the reason is that the people who stand to benefit from a study's outcomes are the same people who are designing the study (and therefore, that study's outcomes).  You know this.  So when you're sitting at a big fancy Pfizer event where the entire culture of practitioners present revolves around the dispensing of those and similar drugs, it only stands to reason you'll be primed to that way of thinking about medicine.  

 

We've got people above claiming to have been trained in acupuncture technique through whatever certificate program.  Give me a break.  In China, acupuncturists have to study for at least 5 years (most 8-10) and treat "10,000" patients before they're allowed to license.  In Japan, it's longer.  In the US, we reduce everything down to what we think we know having ridden this wave of immense hubris through the last few decades, and test those poorly informed methods against the monster that is our research culture in the US.  It's easy to, in retrospect, say "Oh yeah, I could have done that.  I see how that xD used some diet and exercise recommendations to get his patient off of whatever drug."  But the bottom line is that mainstream providers are not doing those things.  And when you have a bunch of people (here NDs, as an example) hellbent on getting people off the drugs that fuel the entire culture and educational model we depend upon for mainstream training and care, people get all kinds of insecure and knee-jerk slander this way and that.  People on here are literally making up stories (or at the very least embellishing the hell out of them) to justify conclusions they've already arrived at.  That is not the way a scientist thinks.  I'm also certain that readers here are projecting enormous amounts on how I must practice and what modalities I probably support--many of which are incorrect.  Again, not the way a scientist should think.  And a scientist should never depend upon a research culture that rewards fixed studies that do not genuinely seek the truth.  

 

The smartest thing that was said above is that "There is no "alternative" and "conventional" medicines.  There is medicine.  There is what works and what does not work."  At every PA interview, people have said to me, "Why are you switching professions?"  My answer everywhere: "I'm not.  I'm looking to expand my knowledge of medicine."  Chinese medicine.  Western medicine.  Naturopathic medicine.  These are all groups of people who are treating illness in humans--all seeking the same goal working on the same body terrain.  It should all be the same damn thing!  If it works, great.  If it doesn't work, and it's harmful, ban it.  If the jury is still out but patients claim to get benefit without seeing any hard whatsoever, who the heck cares.  Sometimes we simply don't understand why something works (like acupuncture).  Keep studying, keep asking patients why they prefer that treatment, and see what we can't learn from them.  NDs are licensed in 17 states truly against all odds.  Insurance companies don't reimburse for their treatments.  They're not licensed most places.  They can't even market themselves as care providers in 33 states.  Yet, demand for their services is on the rise.  What a peculiar thing.  

 

I'd never want to be an ND, but I sure as hell root for them to become integrated and honestly, genuinely examined (face to face) within establishment research rather than maligned from afar by a bunch of people who have literally never so much as met one.  

 

"And that's all I've got to say about that." 

[LT_Oneal_PAC]

 

NDs are not harming people through action, but by not providing proven treatments.

 

I never said I had a certificate or anything of the like. Good to see your observational and reading comprehension are on par with my initial reactions. I said that I've been trained to use limited techniques, I find them useful, and this was to proactively counter any argument you make about me being anti-CAM.

 

Finally, stop saying you'll quit and actually quit. Geez. You've said it no less than 5 times that you were done. The reason people aren't listening to you are responding well to your arguments is because you are rude, inflammatory, and arrogant. Go back home, [removed name since all CAM promoters on this board have the same first name coincidentally]

[zoopeda]

You're right.  I regret not quitting sooner.  Couldn't resist, I guess.  Some of the intentionally misleading posts got under my skin.  Maverick claimed an ND killed his friend in a state that doesn't even license NDs.  I hate that.  At this point, I'm not sure if I should be more annoyed at those folks or the ND posters who are sitting around too afraid to stand up for what they supposedly believe in.  I'm done now.  Thanks for the banter.  

[db_pavnp]

The reason people aren't listening to you are responding well to your arguments is because you are rude, inflammatory, and arrogant.

 

This is not the correct interpretation of an internet forum dog pile.

[LT_Oneal_PAC]

This is not the correct interpretation of an internet forum dog pile.

So we are bullies when he calls maverick, essentially, a liar? Noted.

[rev ronin]

So we are bullies when he calls maverick, essentially, a liar? Noted.

He pointed out that the "ND" in question, being in New York State, was not subject to any licensing laws at the probable time of the incident.  It's hard to refute someone else's anecdotes, but that's not a bad way to do it: ask for details, and point out the flaws in the anecdote on the basis of the reteller's own words and objective external reality.  He didn't call Maverick a liar, just pointed out the ND in question could not have been state licensed.

 

I think the descriptions of other posters' conduct and motives have gotten a bit heated here.  Had I not already posted as a participant in the thread, I would close it as a moderator, since it appears to have gone past the point of useful dialogue and is quickly devolving.  I would encourage all participants to step back (and actually do it, not just say you're going to...) and let it die out, or at the very least calm for a day or two before reengaging.

[LT_Oneal_PAC]

No matter what far out stories people are making up and tossing onto this forum, the bottom line is that licensed NDs are just not killing people.

No implication there.

[PACdan]

The debate about ND methods completely aside. There is a rational self-interest to oppose ND expansion in medicine, as there is DNP.

 

Here we have yet another profession that is not as comprehensive in its medical training as PA education, putting on a white coat, getting a doctor title, and trying to expand their practice rights around the country.

 

Yet here we sit: PAs taking more classes, taking as many credits as I took for a 4-year undergraduate degree, and rotating though many more clinical settings and hours. Yet we get a master's, referred to as "assistants", and are made to look inferior by those with less comprehensive training expanding their scopes.

 

Maybe let's not be the door mats for these people.

[BruceBanner]

While those references certainly appear damning, I note that only one is directly from a (presumably peer-reviewed) scientific journal, while the other 11 links are from an anti-naturopathy organization.  Now, being a partisan organization of any sort isn't a bad thing per se, but it does mean that I expect the arguments to be one-sided and present their position in the best possible light, which the one I read in depth (the first one) certainly appears to do.

 

I'm sure everyone would welcome randomized controlled trials of naturopathic medical techniques, although their focus on individualization of therapies would render creating a RCT problematic.

 

I suppose I'm a little late returning to this debate, but that's fair critique. SBM is strongly anti-CAM, so one could argue they are biased.

 

I did a cursory Google Scholar search and what you find when looking for real peer-reviewed data on naturopathic practice and remedies is...well, not that much. The 'studies' tend to be case studies, very small case series, or "discussions". I imagine if you looked at a specific therapy vs the allopathic standard of care there would be a lot more data.

 

What I think is useful in those links (the first link in particular) is the light they shed on the dubious practice and regulation of naturopathy. Plus I just don't see how anyone could take seriously a profession that endorses so many unsubstantiated treatments.

[db_pavnp]

Out of curiosity, when you say that the profession endorses unsubstantiated treatments, do you mean the profession or individuals within the profession?  I do not know what their official training entails.