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bike mike

Naturopaths are driving me nuts

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I just don’t see how these “providers” (I’m using this term loosely) can advise patients to stop taking potentially life saving medications. I just saw a post CABG pt who was told to stop his ASA and statin and was told to start taking some “natural supplements”. His LDL has gone from the 60’s on a statin to 120 on this “better, more natural medication” and he refuses to take ASA. The kicker is that the naturopath wants the patent to get a Calcium score.....hello, he is s/p CABG. Friggin idiots that have their patients blindly following their advice and ignoring all others advice.  

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1 hour ago, bike mike said:

I just don’t see how these “providers” (I’m using this term loosely) can advise patients to stop taking potentially life saving medications. I just saw a post CABG pt who was told to stop his ASA and statin and was told to start taking some “natural supplements”. His LDL has gone from the 60’s on a statin to 120 on this “better, more natural medication” and he refuses to take ASA. The kicker is that the naturopath wants the patent to get a Calcium score.....hello, he is s/p CABG. Friggin idiots that have their patients blindly following their advice and ignoring all others advice.  

I'd ask the patient who they want as a provider? If they choose the VooDoo Doctor I would discharge them from the practice with a certified letter explaining their unwillingness to follow the standards of care along with the practices unwillingness to knowingly violate these standards. If this VooDoo Doctor wants anything they can order it themselves, I wouldn't be a party to this fallaciousness.

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I live in an area with an unusually high number of NDs etc. and see a TON of this. I'm not saying that all NDs are terrible. I think that naturopathic practice and allopathic medicine can coexist and be quite beneficial to the patient, but only in the right situation.

There's a few main groups of patients that I see who come from these practitioners near me:

1. Thyroid: Dessicated hormone therapy, specialty compounded blends of thyroid supplements, often with lab values far outside the normal. ("Ma'am, your TSH has never been abnormal until your ND started you on high T3 compounded/ dessicated replacement therapy and since then your T4/T3 have been through the roof and your TSH nearly undetectable" Pt: "But its natural. Oh, and my ND has a list of labs they want you to order and draw for them (hands me sheet of paper...because these "practitioners" cant even order their own labs) *face palm*"

2. Chronic Lyme Disease: These are often pts tx'ed by one-off GP and Internal Med MDs gone awry. AKA "Lyme-competent physicians" per patient lingo. They are cash only and like to place patients on unfounded treatment regimens like daily double ABX therapy (ie: Cipro and Azithromycin at max doses per day every day, planning for years if not lifetime of treatment) and often use independent labs for testing, because as one pt recently stated "Your lab, Quest or Labcorp or any of the hospitals really, will show false negative testing" *face palm*

3. BHRT: Weird dosing on compounded BHRT. Unopposed estrogen therapy, etc.

 

There's a lot of gray area in the science and even the guidelines leave room for discussion, but overall are pretty clear on how to manage the above patient populations. I explain to patients that I follow current evidence based guidelines and do not practice medicine that I have legitimate fears would introduce more risk than benefit for them. I explain the R/B/SES and current reasoning to them as much as they will listen. Encourage them to use other natural, evidence supported, treatments for things (think zinc oxide sunscreens, fish oil, ginger tea for nausea, exercise and diet to reduce their cholesterol and blood pressure if their #s are safe enough to go that route, etc)

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I watched a documentary yesterday on vitamins. Today, virtually all vitamins come from just a handful of chemical factories, most are in China. Most vitamins are created from petroleum (source of the carbon chains) and end up as a powder in big barrels. From there they are shipped to all the major supplement companies. The companies then create the pills and labeling. The labeling says, "Vitamins from an all natural plant source." There is no federal guidelines to ensure safety, consistency, or labeling of these supplements. If the "natural" patient only knew. 

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5 hours ago, bike mike said:

I just saw a post CABG pt who was told to stop his ASA and statin and was told to start taking some “natural supplements”. 

Sorry, I see that as practicing medicine without a license.  They can prescribe whatever woo they want, but if a patient is stopping a legitimately prescribed medicine on the basis of their advice, that's a naturopath practicing medicine without a license in my book.  Not sure how the laws of any particular state would see it, but if there was a specific instance like the CABG patient where the naturopathic quacktitioner advocated against evidence-based medicine in a way that provides a clear harm to the patient, I'd consider complaining to the medical board (NOT the naturopathic board, assuming there is such a thing).

90% of what naturopaths provide for patients is just good listening skills, albeit often couched in terms of coddling unjustified fear of actual medicine.  If they want to stay in their lane and peddle their placebos, fine.  Who knows--there might actually be something real among all the overpriced supplements.  When they lose the 'complementary' and focus on the 'alternative' they need to be held liable for any resultant patient harm. 

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1 hour ago, rev ronin said:

consider complaining to the medical board (NOT the naturopathic board, assuming there is such a thing

I tried that.  State med board said they dont handle these quacks.

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3 hours ago, Boatswain2PA said:

I tried that.  State med board said they dont handle these quacks.

Interesting.  Wonder where the line is.  Can an ND take out an appendix?

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Just like physicians have lost the control of "practicing medicine" to nurses (why is it "advanced nursing" when a NP puts in a central line, but "medicine" when a Doc or PA does it), they have lost it to these quacks.

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Medical board will only get involved for people who have no medical-related degree at all.  So if a guy with an associates in art history starts giving medical advice, the medical board will send a "cease and desist" letter.  But if it's a nurse, naturopath, faith healer, or any kind of charlatan with a cracker jack box medical certificate, they won't touch it.

BTW, I believe NDs in Arizona have full practice autonomy and can write for every drug out there including schedule IIs

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23 hours ago, jmj11 said:

I watched a documentary yesterday on vitamins. Today, virtually all vitamins come from just a handful of chemical factories, most are in China. Most vitamins are created from petroleum (source of the carbon chains) and end up as a powder in big barrels. From there they are shipped to all the major supplement companies. The companies then create the pills and labeling. The labeling says, "Vitamins from an all natural plant source." There is no federal guidelines to ensure safety, consistency, or labeling of these supplements. If the "natural" patient only knew. 

Hearing the term "Natural"  out of these fakes or their brainwashed or brain dead (your choice) followers produced either disgust or anger and depending on how quickly I exit the conversation maybe both!

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21 hours ago, JoeM said:

Darwinism still exists

I just wish those traveling along that highway, wouldn't take rest stops in my office!

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