Getting out of the rabbit hole of naturopathic medicine

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I’ve received interest about my departure from naturopathic medicine and exactly how I left and started a new, science-based career. Last Fall, I decided to apply to the Medical Life Sciences program at the University of Kiel, which is a Master’s of Science program focusing on biomedical research. I saw this opportunity as a way for me to get training in the science of medicine so I could contribute to helping people get well.

I think it is unusual to post my application statement of purpose, but it succinctly captures my history and motivation for becoming a scientist in medicine. This essay has served as my manifesto, and from it, I have distilled my new elevator speech when answering the question, “what did you do in America?”

Germans seem especially interested in this answer, because it’s not easy to explain that I was a naturopathic doctor. I always sense anticipation while I stumble about trying to explain myself in English that makes sense to a German speaker. My story is humbling, hard to talk about, and humiliating. I am embarrassed to admit that I fell prey to false advertising and lots of pseudo-scientific theories. To Germans, I can provide some meaningful context because homeopathy is widely popular here. So, I was “that” kind of doctor.

For interest, posted below is my application statement which I gave to such German scientists (that is, the ones who don’t believe in homeopathy):

13 October 2014

To the committee:

I made a mistake. I entered naturopathic medical school at Bastyr University with idealistic and naïve notions that naturopathy could surpass modern medicine. The program at Bastyr University cleverly weaved together medical sciences with pseudoscience to create the allure of something special. I loved my biochemistry, cadaver anatomy, physiology, and pharmacology coursework, but I hesitated and struggled with understanding why courses such as homeopathy were required.

Upon graduation, I won one of the few accredited naturopathic pediatric residency position offered in North America. In addition to patient care, I helped administer randomized, double-blind, placebo controlled clinical trials testing the effectiveness of phytotherapy for insomnia. The results of these studies were negative, and despite my insistence, were unfortunately never published. I worked hard to collaborate with the wider medical community by precepting with medical doctors and speaking at medical grand rounds and resident journal clubs. I lectured on topics ranging from the diagnosis and management of croup to the use of therapeutic diets and exercise for metabolic disorders.

After completing my residency, I relocated to Tucson, Arizona, where I unwelcomely discovered an abundance of fringe medical practitioners. Compared to Seattle, alternative medicine in Tucson was extreme: blatantly false, unethical, and dangerous. I saw that I had wandered down the rabbit hole. Edzard Ernst and Simon Singh’s book Trick or Treatment reminded me of the necessity of applying the scientific process to all medical therapies, and I reignited my passion for rational inquiry and research methods. This personal and professional watershed manifested as a deep and thoughtful self-assessment of my ethics and aspirations.

My drive to pursue a degree and career in biomedical research is fueled by my love of medicine, demand of truth, and yearning for scientific understanding. In the time since denouncing naturopathic medicine, I taught immunology and dermatology which sparked an interest in further understanding the pathophysiology of a disease I struggle with, plaque-forming psoriasis. Through literature reviews I galvanized my biomedical research goals in the exciting new area of psoriasis research that seeks to understand the aryl hydrocarbon receptor as a physiologic modulator of immune responses.

Although well studied, some essential physiognomies of the ligand-dependent transcription factor aryl hydrocarbon receptor remain mysterious.1 The full three-dimensional structure of the receptor and its conformational changes upon ligand binding are still not fully known in humans, even though a murine model exists.2 Furthermore, the mechanism of action underlying this conformational change and the downstream AHR signaling pathways triggered by ligand binding are not well understood, although it appears that AHR functioning may be both tissue and species specific.3 Both of these ambiguities have captured my attention as research routes for my thesis.

I am especially fascinated by studies demonstrating that AHR has physiological roles beyond the clearance of xenobiotic compounds. AHR appears to be a main player in the development and regulation of the immune system.1 The immunomodulation effects of AHR seem to occur in a ligand-specific manner with effects depending on the type of ligand, the strength of binding, or the ligand’s in vivo half-life. For example, Quintana et al. showed that the toxic ligand 2,3,7,8- tetrachlorodibenzo-p-dioxin (TCDD) inhibited the differentiation of Th17 cells and provoked the differentiation of Treg cells from immature T cells, resulting in a reduction of symptoms in murine experimental autoimmune encephalomyelitis (EAE).4 In contrast, the same study also demonstrated that the binding of the endogenous ligand 6-formylindolo[3,2-b]carbazole (FICZ) interfered with Treg differentiation and boosted Th17 differentiation, resulting in an exacerbation of EAE.4 Both of these ligands are AHR agonists but they created very different responses. These findings are significant because murine EAE is used as a model for multiple sclerosis, for which limited treatment options exist.

I want to explore how AHR ligands, such as TCDD and FICZ, can result in two very different clinical outcomes, and intend to apply this research to the pharmaceutical development for psoriasis and inflammatory diseases. This research is prudent as our current knowledge of benign AHR ligands is limited to weakly-binding compounds, such as dietary flavonoids or FICZ, that generate negligible or even deleterious downstream effects. Furthermore, understanding how environmental exposures, like foods, may alter the pathogenesis of chronic inflammatory disorders via AHR opens research doors beyond disease mitigation or treatment and into disease prevention and other insights regarding the biological pathways of related ligands.5

Walking away from naturopathic medicine is the first step to correct my mistake. Personal critique of my education, career, and ethics has been challenging. I’ve grieved over wasted time, money, and effort, but I’ve found comfort in my resolve to move forward. I seek to excel at earning a Master of Science with a renewed capacity for self-assessment, autonomous thinking, and an unwavering ethical commitment to scientific research. I have replaced immature and naïve principles with an evolved understanding that valid contributions to medicine manifest from hard work, rigorous methods, and critical analysis. Now that I know better, I want to do better.

Despite my critical self evaluation, I know that I have received solid training in the basics of molecular biology and genetics that will enable me to fit hand in glove with the curriculum in Medical Life Sciences. I look forward to being trained at a higher level and in the rigorous scientific principals necessary to contribute to a more complete understanding of inflammatory diseases. I am eager to work collaboratively with other dedicated students like myself on complex problems in order to come up with novel research findings. Through earning an MSc at the University of Kiel, I ultimately aim to make my research relevant to patients who have suffered as I have my whole life. I aspire to eventually take my career to the doctoral level, where I can combine my interest in patient care with fundamental advancements of medical science. At least from this point forward, I am out of the rabbit hole. Thank you for the consideration of my application.

Sincerely,

Britt Marie Hermes

 

References

  1. McMillan, B. J. & Bradfield, C. A. The Aryl Hydrocarbon Receptor sans Xenobiotics: Endogenous Function in Genetic Model Systems. Mol. Pharmacol. 72, 487–498 (2007).
  2. Wu, D., Potluri, N., Kim, Y. & Rastinejad, F. Structure and Dimerization Properties of the Aryl Hydrocarbon Receptor PAS-A Domain. Mol. Cell. Biol. 33, 4346–4356 (2013).
  3. Esser, C., Rannug, A. & Stockinger, B. The aryl hydrocarbon receptor in immunity. Trends Immunol. 30, 447–454 (2009).
  4. Quintana, F. J. et al. Control of T(reg) and T(H)17 cell differentiation by the aryl hydrocarbon receptor. Nature 453, 65–71 (2008).
  5. Zhu, C., Xie, Q. & Zhao, B. The Role of AhR in Autoimmune Regulation and Its Potential as a Therapeutic Target against CD4 T Cell Mediated Inflammatory Disorder. Int. J. Mol. Sci. 15, 10116–10135 (2014).
Image credit: Flickr user Samantha Marx under a CC License

60 Replies to “Getting out of the rabbit hole of naturopathic medicine

  1. So I just found this blog via Jann Bellamy at SBM and I’m very interested. While I never went so far as you did in my education towards alt med, I was definitely heading that way. I also entered biomedical research, maybe initially as a way of proving the alt-med ideas, but ultimately that’s obviously not how it went. I find myself advocating more and more for science education because of this.

    I look forward to reading more from you!

  2. So you took the red pill!

    I found you via a post on SBM today and really am curious about your journey that eventually brought you to Kiel. I’m one of those Germans who is watching in horror that the esoteric quackery scene seems to be getting more popular despite science and logic/reason. All those (homeopathic) healers, Waldorf kindergartens and schools, anthroposophic medical doctors… I do feel they act like they are in a cult, especially now with that measles outbreak in Berlin and elsewhere.

  3. I also await future blogs with interest. I appreciate your intellectual honesty and humility, and the good that you can do from your unique position to help prevent others from going down the rabbit hole. You communicate well; good luck to you.

  4. I also arrived here from SBM. Found your posts to be interesting – combining great subject matter and enthusiasm. I’m intrigued about how we maintain beliefs – some of your commenters provide some relevant material for me to ponder about. Thanks heaps.

  5. Also here via SBM. I’ve lived in and have connections to Germany and I’d be particularly interested in your observations about the role of and attitudes towards homeopathy and the like there.

  6. Also an SBM reader. Very interested to hear your story. It’s brave of you to throw away your training and practice. Most people wouldn’t be able to leave it after all the time, money, and effort you spent. I’m returning to university to study nutrition, and I’ve developed an interest in pseudoscience because it seems SO prevalent these days. Good luck!

  7. Another SBM recruit! I, too, have a German connection. While on a trip to Alaska, I met a young German woman also traveling. She has a thyroid condition (she was having serious symptoms) and had stopped her medication, thinking she would “try homeopathy or acupuncture instead”. I calmly lectured her for some time and got her to a walk in clinic the next day for a prescription. I received a lovely email from her parents after she arrived back in Germany and as far as I can tell she has dropped her flirtation with CAM.

    Also I’m German (second generation) and will soon be visiting the Motherland and my new friend. I also have a granddaughter with a very serious case of psoriasis (and RA) which she has suffered since age 9–she will be 26 tomorrow! So if I were superstitious, I guess I’d say the stars brought me to you and your blog, but as it is I’ll just be happy with this serendipitous coincidence.

  8. Britt, this blog is honest, academic and thought provoking. I do know you from your days in the ND community and believe there are many like you in a similar struggle – I myself professionally face these same questions frequently. I have to agree that there is not consistency within practices of Naturopathic physicians, and oft you will find pseudo-science and lack of science all together. This reality will cause many to be “embarrassed” by stating their profession (at times myself included due to the connotations of the title) and I’m sure that to validate oneself outside of the field does require a denouncement to distinguish oneself from those in the realm of pseudo-science and belief based practice.
    I also need to step into the corner of clinical medicine for a minute. I have worked and pursued during my time as a Naturopath and before experience in both realms of medicine and in the practice of evidence-based medicine. Clinical medicine does not behave as well as other sciences, perhaps the inconsistency is in the methods, yet clinical pictures in their complexity may wash out in large studies. We know not everyone gets the desired result from such evidence-based practice. Medications like antibiotics are wonderful with an n of 1 when prescribed correctly, yet we know that overestimation of risk may unnecessarily cause harm to some individuals when we over-treat – on a population scale this is acceptable risk as harm is usually low. With vaccinations I fully support their use as we are talking about infectious disease. Yet clinically, when the benefit/harm is personal- patients, knowledge and appropriate application of evidence, and informed consent are paramount. Clinical medicine humbly does not operate from “perfect” science and we are left with “science in the now and best we know.” This leaves many patients suffering when our best scientific knowledge fails. I believe in best practices, evidence-based medicine, patient choice, societal obligations and the humility of bench medicine not always working in clinical medicine. I tend to call myself out in this and say the focus should be on the patient – not my personal belief, ideology, etc. – this is why I agree with your issues of “believers.” Medicine as an institution is effective yet bloated in areas for profit-driven reasons. This I believe is across all medical professions – everyone wants a “job”.
    The practice of medicine is humble, many physicians on all sides have doubts – from standard of care practices to fringe pseudo-science. The good ones work to provide the best care possible putting patients in front of their own egos. This is why shared decision making is a huge evidence-based medicine movement.
    Your blog is refreshing and the polarity of opinions highlights the need for discussion and progression if the field of Naturopathic medicine. Will the field break – I believe it will as there will always be folks who wish to be “alternative” and those that just want to provide high quality evidence informed practice with greater focus on what you called “common sense health advice (diet…)”. The answers are not all out there, science is not done, yet patients seek care -this is the predicament of medicine. It is humble when they come and your best practices and pseudo-science fails.
    Clinical practice requires that we keep working to decrease suffering. As you said about your psoriasis, the change in diet, tonsillectomy, medications and supplements may all play in and we can not guarantee the extent of effectiveness of each agent in isolation – this is the crux – did you get better in a safe manner -hopefully. I believe a bigger problem is our ability to quickly take credit for any “therapy” working and to discredit everything else.
    Your blog is inspiring, it brings up great discussion, makes folks uncomfortable for good reason. On this side, in the profession of Naturopathic medicine, I hope this inspires a positive debate and growth towards improvement. In my own bias, I believe your academic stance is excellent and pragmatically I disagree with the belief of conventional medicine as “do-no-wrong science.” Medicine doesn’t behave as purely as science such as physics. At the end, many readers will validate themselves or hate you – emotions that are as fallible as any dogma – science evolves with the notion that it can do better – approach a “true” effect. Unlikely one side of this debate is 100% correct.
    ~One of my rare rants Britt, thanks for a forum, I hope it sparks the debate more.

    1. This is just a bunch of hooha, to find some validation why “naturopathic medicine may have some validity – it does not… It is that simple, when you have modalities such as homeopathy, hydrotherapy etc. you are just a quack. The vague complaints re antibiotics and vaccinations do not undermine science-based medicine; the problems with overuse of antibiotics are not something NDs discovered ’cause they care more’; it’s a phenomenon scientists and physicians (both MD and DO) discovered, warned for and continue to warn for. This annoying need for naturopathic non-doctors to have a ‘positive debate and growth towards improvement’ is nothing but a poorly disguised plea to be accepted as full physicians such as MDs and DOs. It’s funny to me, you seek acceptance while at the same time belief you are a full-fledged primary care physician after 4 years of mostly nonsense education, while an MD or DO has to have three additional years of training post graduation of medical school. I include an example of delusion from a current Naturopathic Medical Student – he is not alone in his belief that once graduated from his nonsense program that he is a full-fledged primary care physician: http://maxjcohen.com/?p=417

      1. Unfortunately, in Oregon, Naturopaths *are* full fledged primary care physicians. They have prescriptive privileges and everything.

        1. actually, I’m pretty sure they can’t prescribed scheduled substances that an MD can. Thank goodness…

  9. I live in Az where one has to wonder what happened in our state. Originally te Naturopathic Board Manage (who was our former Gov.’s husband) was found to not actually have a ND degree. We are turning out many of these graduates and their scope of practice in Az allows them to prescribe just about any medication. NDs have done more medical marijuana prescriptions than any other discipline. Soon they will have board certified minor surgeons, psychiatrists, and cardiologists NDs. It is madness…..

  10. I have a relative who is an ND who just missed out on getting into medical school and fell back on naturopathy to fill her dream. The beginning of your journey reminds me of her. Thank you for starting this blog and sharing your story. It gives me hope that one day she too will see the light.

  11. Here via SBM

    Since i study philosophy and plan to continue my studies on bioethics i can’t express enough how important i find the whole idea of your blog. Personally i support your decision but also don’t feel bad if i say we can all learn a lot from cases like yours.

  12. Stories like these bring joy and hope to science lovers from all over the world.

    Salutes from Romania, a country where homeopathy is taught in Med School and where naturopathy is ready to make some real damage, especially when its promoted by guys like Olivia Steer, a self appointed medical journalists who promotes all the quackery you want.

    Nice to see that seeking the truth has guarded you from becoming a maturopathic zombie.

  13. I followed a link from Science Based Medicine, and, I must admit, I was very surprised to see the content of your application statement to the German university. My working hypothesis during my doctoral studies was that tissue and species specific factors are responsible for the variety of effects seen after TCDD exposure. Of course, this work involved extensive study of both the AhR and its partner, ARNT. I completed my doctoral work over a decade ago without ever answering the question, and have not studied the AhR since, but I still find the subject fascinating. Your thesis topic sounds fascinating. Best of luck with your studies!

  14. Also an SBM reader, and always delighted to hear about people who come around to science! Look forward to reading more.

  15. Wow… Polar opposite experience here! I have an MSc and PhD (molecular epidemiology) under my belt, with more than 15 publications in international peer reviewed journals and was totally disillusioned during my postdoc. I’m now a third year naturopathic medical student and couldn’t be happier. Perhaps my graduate studies and life experience have allowed me to approach my naturopathic education in a different way. Good luck with your new endeavours!

    1. It sounds like you have always had an imperfect understanding of the scientific method — what it is, how it works, and how it acts to ‘strip’ human biases from testing and evaluation. And that’s probably why you became ” …disillusioned during my postdoc.” Non-scientific belief systems are very seductive, because they allow the believer to keep-on believing in whatever they find appealing. The ‘true believer’ is shielded from scientific criticism by a worldview that thinks of the results of the scientific process as “Just another opinion, as equally valid as mine.” Instead, these communities of believers favor fallacious arguments that largely appeal to emotions, and use reasoning that appeals to the full spectrum of cognitive biases. For the most, they start their investigation by having the ‘answer’ first, and then tailor the evidence to fit this ‘answer.’ If, perchance, an investigation actually produces negative results, then the study is disregarded. I believe Ms. Hermes mentioned just such an occurrence, in a study in which she participated. Practitioners of the scientific method have no trouble abandoning a hypothesis, if testing proves it false. But, if you have an emotional stake in your (pseudo-scientific) belief system, then nothing in how you examine evidence will ever disrupt your worldview.

      1. Exactly right, Bud. As a biologist, I can testify that doing science takes a bit of mental toughness–I’ve long since lost count of the times I’ve gotten slapped upside the head over various ideas. Thing is, most of those whacks turned out to be well-deserved, and I learned from them.

        Not everyone can take that kind of feedback, which could very well be what happened to Laura. And of course, no such feedback is allowed in any of the quackopathic modalities, which would be bound to make them very comfortable niches. I sometimes think it would be way cool to be in a profession where I could just make stuff up and still be taken seriously!

  16. Yet another SBM junkie. 🙂 Your blog is now bookmarked and sitting right next to my SBM bookmark for easy daily reading. Good luck going down your new path!

    By the way – I’m a System Administrator who (believe it or not) tries to apply Science Based Computing (the idea (mine at least) of ignoring any and all hype/marketing, and only using methods and applications that have been proven to work). I am finding it just as hard in the world of computing as it seems to be in the world of medicine right now.

    Cheers!

  17. It is great to read someone’s journey through critical analysis along their path of person integrity. Thankyou and the best of luck on your continued journey 🙂

  18. I guess I’ll jump on the bandwagon and also express my relief to find your writing.

    I had a strong science background before getting into the world of “medical herbalism”. It was more of a hobby/obsession with botany, phytochemistry, and ethnobotany that went nuts (me and some buddies made hard root beer from Sassafras we’d dug up at a landscaping job and I got hooked). I signed up for some basic training and several years later I was an increasingly respected voice in that world but saw the harm it did. They’re so incredibly and proudly disconnected from the ways we figure out how the world works (science).

    Simply, there are sick people who are spending a bunch of money they don’t have on stuff that’s bunk. I couldn’t continue to be a part of that industry “Big Herba” and left a really good job to move to the related “Big Spice” industry (still ethnobotany but I’m using plants to make people’s lives more fun, the spice must flow).

    But I spent years doing that and it’s been hard to look at it from the outside. I imagine that must be hard for you too but it’s good to know we’re not alone in moving on. I know quite a few science-based people who lament that entire sections of their “fields” and interested have been subsumed by nonsense. It’s a bummer.

  19. Interestingly enough, the Germans are huge believers in pseudo science so I’m sure they would just nod and say “Oh, interesting” if you’d mention naturopathy. Otherwise intelligent, educated people I know in Germany believe in every possible ridiculous belief relating to; crystals energizing water, water having feelings, horrible “chemicals” in their food, homeopathy and so and so on. So many people are believers there that it isn’t even considered ‘alternative’ to do so.

  20. I am another led here from SBM. I just want to add my support and thanks to you for sharing your story.

    I understand how you got involved with Naturopathy, from living in Seattle myself and having many beloved friends at various levels on the crunchy-meter. It IS very attractive, and I can see how intelligent, generally well-informed people are pulled into it. Everyone wants to believe in something special, and I’m no exception. For me, it was a lot like religion in that something always seemed just a little off about it.

    Again, thank you for sharing your experience, I look forward to following your blog.

  21. You are one brave and honest person. I find a comparison to Ayaan Hirsi Ali appropriate. Thank you for your courage!

  22. Actually, it is an advantage to throw yourself into something and find out you were seriously wrong instead of being a middle-of-the-roader who never learns anything of value. This has been my personal experience and I applaud your following of the same strategy.

  23. Hi!

    I’m also here from SBM (via SGU) and your story is fascinating. I’m glad your determination to seek the truth pulled you through and has lead you into what will know doubt be a fruitful Masters. As a new Biomedical Science PhD student I am in a very similar position.

    Good luck with your research and your blog!

    Alex

  24. As tragic a manifesto as I have ever read. Unfortunately, Bastyr University attracts a number of students each year who really wanted to be medical doctors but who were not bright enough to get into conventional or osteopathic medical schools. Thankfully, the university still graduates a cohort of students who would have been bright enough to get into conventional medicinal school but who treasure real naturopathic medicine enough to learn to heal according to its principles. Without this love and the dedication it provides, students receive a hybrid education from Bastyr which is second-class in both disciplines.

    1. Well, well, what a thinly veiled insult! Your need to leave such a comment speaks to your lack of comfort with your chosen profession, “Dr.” Cist, ND.

      1. No, it speaks of my total joy in my profession and my knowledge of the educational milieu at Bastyr.

        1. …and he expression of your joy is to hurl unfounded insults at those who feel differently?! I’d sure hate to see how you express dissatisfaction!

          1. No. My expression of my joy is to defend this magnificent medicine against its detractors on this site. These detractors include a) commenters who know nothing about the medicine and b) the blogger, who was so unintelligent that she graduated from Bastyr – after spending a whopping $250,000, without developing the necessary skills to practice naturopathic medicine effectively. If she had succeeded, she – too – would be experiencing the daily joy of participating in her patient’s recovery from chronic pathologies which conventional medicine can treat only by prescribing endless toxifying medication.

      2. After reading “Dr.” Cist’s comments, I am reminded of the Dunning-Kruger effect where the individual doesn’t recognize their level of incompetence. She reminds me of my nephew who has stated to me that if you attempt to do anything, you should do it confidently.

        I would much rather see competence than confidence. I’ve seen an ER resident, very confidently, pass filliforms & followers through the urethra into the rectum because he wasn’t competent in using those instruments.

        1. The absurdity of citing the incompetence of a medical doctor to support the claim of incompetence of a naturopathic doctor hardly deserves comment.

    2. The insult comes from the “were not bright enough to get into…” Let me just say this, even at nowadays standard cost of med school, Bastyr is still less expensive – the reason for this isn’t substandard education at all; it’s lack of funding from Big Pharma, pure and simple. When allopathic medicine is only graduating blithering regurgitators of pharmaceutical dosing directions from well-combed and busty reps, Bastyr does not. And while med school graduates live on credit cards and still have a take-home pay of >$80,000 their first year, Bastyr grads make on average their first year a whopping $20,000 – yet still somehow manage to pay off their student loans relatively quickly. In this age where the PA’s now are doing the work and consultations of medical doctors, the conventional family physician seems to be more like a Business Manager than a healthcare practitioner. They really don’t seem to have a clue other than Symptom = Medication = Symptom = Another Medication model and at least Bastyr Grads attempt to “First Do No Harm” and look at the body from a top-to-bottom, functional level – For this I have greater respect for them than any conventional MD, any day of the week.

      1. Bastyr costs as much as many medical schools, if not more. I have over 250K in loans, JUST from Bastyr (no other schooling costs.) Before Bastyr students were allowed to borrow federal money for school, students were taking out private loans, and then claiming bankruptcy to avoid paying them back. (I have this written testimony in an email from a Bastyr grad who graduated in the 90s.) Also, most students nowadays understand how to sign up for Income-Based Repayment. So with a salary of around 20K, you either don’t have a student loan payment, or it is very, very small. Hardly an argument for NDs being able to manage their money better. And MANY NDs I know had large credit card debt, including myself for a short while, because we didn’t make a liveable wage. Lastly, Bastyr is financially funded by large anonymous donations. When I was in school there, Bastyr received a 1 million dollar anonymous donation. Who knows where this money came from, could be big pharma, could be supplement companies… This anonymous donation business is a common theme in alt med. Bastyr just received another 3 million dollar donation for cancer research, from an anonymous Canadian donor. Can you imagine the outrage by the alt-med community if med schools used anonymous donation money for their research? At least med research adheres to research ethics and academic standards for disclosing conflicts of interest and investors. And when they don’t, they are called out by their own peers for misconduct. Alt-med seems to just keep turning a blind eye to their peer’s professional misconduct. I was once told to do this exact thing (ignore bad ND behavior by a peer) by an elder naturopath… he said, “Britt, you are a NATUROpath after all.” Instead, I decided to start this blog.

        1. Britt, I know where one of those huge donations came from. And, I can guarantee that it was from an individual with absolutely no prior connection to Bastyr and no potential to gain financially from naturopathic medicine. It was someone who is in the movie and real estate business in southern California – the son, actually, of a medical doctor. The Canadian donor I don’t know. But, there is no Canadian company whose products Bastyr uses in its clinic. So, the odds are that that donation, too, came from someone who had received great value from holistic medicine and wanted to quietly give back.

  25. Yet another SBM reader here. I just wanted to compliment you on your bravery and thank you for starting this blog. My story is entirely different from yours but I too recognize the immense difficulty in abandoning deeply held beliefs after investing so much in them for years. Thank you for sharing this, it really means a lot.

  26. I’m curious. You mention spending 250k dollars on your education. We’re those usa federal student loans? Did you pay them off? Or have you defaulted and just left the country?

  27. Thank you for your bravery and integrity in coming out as a skeptic of (at one time) your chosen profession. I am going through a similar process with traditional manual osteopathy – seven years including what amounts to ersatz research in a field that could have modest clinical benefits able to be demonstrated if we could dial back the magical thinking enough to produce foundational (bottom of the hierarchy) research and actually EARN a level of scientific credibility. CAM therapies seem to be under the delusion that you don’t have to climb the research pyramid, you can just start at the top. Until that changes, a professional shift is a very reasonable choice to make.

  28. Thank you for your brutal honesty regarding Bastyr and ND’s all over the US.
    I am a ’96 graduate of Bastyr (Nutritional Sciences/Dietetics) who had hopes of leaving there after graduation to pursue a degree in Biochemistry – Fortunately, or un-fortunately – however you look at it, the day of my graduation I met an ND at the after-ceremony party (you know, the one at the house near Capitol Hill?) who was in need of an Sales Assistant. I got a job with a major nutriceutical within the month and eventually, over a 4 year timeline, developed a lucrative territory that spanned AK, HI, OR, WA and ID. I later transferred to an open position in Texas, where there are essentially NO qualified or degreed ND’s from an accredited program; just lonely, misinformed and broke NMD’s and look-alike’s, having spent a large amount on a worthless correspondence course degree from Clayton, Trinity or Bridgeport. In this state, you can call yourself whatever you want, and in most cases it doesn’t mean a thing. The state of Texas doesn’t give a damn about Naturopaths, but does recognize RD’s and Certified Clinical Nutritionists, as long as you are current. I chose to go with CNCB (CCN’s) because the word “Naturopath” is unheard of and is often confused with terms such as “Homeopath” – But folks down here never pronounce it right; I’m called “Nutritionalist” or “Naturalpathic” all the time… Really doesn’t bother me much any more, I’ve been scraping away a living for myself here for the last 15 years or so.

    We could use more people like you down here to weed out most of the fakers and MLM’s along with me. Email me if you ever want to visit or discuss.

    -Christina

  29. P.S. Wenn Ich hier Deutscher kennenlernen sein, sag Ich, “Ich bin Ernaehrungsmittelspezialist” oder “Naturheilpraktiker” – Es klingt ueberhaupt besser als “Homopathischer,” oder was…

  30. LETTER TO BRITT MARIE HERMES> ON NOTICE!
    Dear Britt,
    I have written this letter over many times in my head since I read your missive to us and am finally taking the time to put it to paper.
    Often, when I am with patients who have been to a number of allopathic physicians and they walk away feeling that they have finally been heard and that someone is going to attempt to sort through their myriad of complaints, records and a whole amazing variety of tools, I am absolutely proud and grateful that I am a naturopathic physician. I reflect on your ‘On Notice’ and am mystified.
    Allow me to introduce myself, Britt. I graduated from Bastyr in 1989 and have built a thriving family medicine practice in Billings MT, beginning in 1992. My route to Bastyr took me through educational and practice experiences in nursing, and as a Navy Corpsperson . While engaged thus in a typical conventional family practice, seeing people every 20 minutes, managing them through assessment, diagnosis and treatment under the supervision of rotating physician specialists, I became disenchanted with the limitations inherent in that level of provider/patient relationship. I thought becoming a physician would allow me to create relationships with my patients that were more beneficial to them. Accepted into pre-med at UCDavis and working as a nurse in that facility, only deepened my disenchantment. Additional seminal experiences clarified for me that the service I wanted to offer was found through naturopathic medicine.
    Yes, there was much to be desired in naturopathic medical school. However, I have direct experience with multiple institutions of higher learning and am confident that there is no such thing as a guaranteed stellar program, anywhere. Depending on one’s values, practice and personal philosophy and core motivations, every educational institution has arenas of excellence and aspects that are deficient. Like all things in life, we are the authors of our own experiences. I realized that the

  31. the environment at Bastyr was such that I could find all the education I needed. Deficits exist in every system; this fact is by no means exclusive to naturopathic medical education. As individual practitioners, we decide what and how to make it whole. The success of my practice, the thousands of individuals whose well being has been restored under my guidance or with the assistance of one of the many resident physicians and colleagues employed at Yellowstone Naturopathic Clinic, attest to the facts of the quality and effectiveness of our education.
    I have been wondering what occurred in your life that has caused you not only to abandon your place in our profession but to take this actively attacking stance? The amount of effort both you and your spouse are dedicating to your public efforts at denigrating naturopathic medicine on your website evokes a sense that something personal to you, rather than a truly rational assessment, is what keeps you tied in. Your prolonged efforts and continuing connection imply some unresolved passion regarding naturopathic medicine persists in you. I read that you had a couple years of clinical experiences after school. I wonder if these experiences were what you found so disappointing, and caused you to look for something to blame for a failure you cannot reconcile.
    I would like to invite you to come to Billings at my expense and spend at least a few days in our clinic where I have practiced for 23 years. Join me and my ND associates and residents as we sort out complex cases, and interact with patients who have felt lost and desperate in the conventional realm and now experience themselves as educated and empowered drivers of their own health and well being.
    In every arena of life, whether it be medicine, plumbing or retail clerking, you will find those who are not as committed, whose capacity for self-reflection, for taking responsibility for their own experience or the quality of service they offer is less that optimal. Exc

    1. “…the environment at Bastyr was such that I could find all the education I needed. “

      Then you obviously didn’t need much education.

      Based on the above statement, it appears your “education” ended more than 2 decades ago, and that you haven’t learned anything since.

  32. Excellent medicine is a spectrum and includes acupuncture, homeopathy, botanicals, and all that conventional medicine has to offer, as it is appropriate, indicated and as patients choose, with the proper information. Naturopathic medicine is in fact not illegitimate for the reasons you and your spouse are promulgating. You will certainly find supporters who agree with you, that is, who are blind to anything but the tangible and the familiar. The support you so fervently seek by publically bashing traditional practices of medicine on line may soothe the distress you express. There is a certain security in being wedded to the dominant paradigm; there may be additional benefits you reap from your current stance and aggressive behaviors that I cannot imagine.
    However, based on your obvious intelligence I’m guessing that you do know that the concept of ‘scientific medicine’ is a fallacy. Reductionist science simply does not own the mechanisms that can answer the all questions we have. Naturopathic medicine is part of the whole; the marriage of functional medicine, founded on the biochemistry, physiology and function of the body, INFORMED by ever changing research, including examination of the wisdom of the ancients, is sustainable. It is sustained in part by the efforts of those developing methods to accurately examine complex questions. It’s simply human progress, and we are all participants.
    I am very puzzled about why people expect that something as complex as a system of health care belief and practice is anything other than a work in continual process. Criticizing the naturopathic profession’s ongoing development, which demonstrates integrity via relentless self-examination and responsive adjustment, in the manner that you have been, suggests that your agenda is a bit muddled. I am sincerely willing to assist your personal process of reconciliation and the integration of your experiences with naturopathic medicine.
    Please do come our clinic to see how wonderfully

    1. Homeopathy not only does not work but CANNOT work–in order for the fundamental priniciples of homepathy (‘Theory of Miasma, Law of Similars, Law of Infinitessimals, etc.) to be valid quite literally everything we know about chemistry, physics, physiology, etc., would have to be wrong.

      Thin-needle acupuncture as practiced today was invented around the time of the cultural revolution in China for political reasons, to address a shortage of trained physicians, and bears no resemblance to traditional practice where it was a form of bloodletting using lancets. Acupuncture has never been shown to perform better than placebo or sham acupuncture controls as a treatment for non-self limiting injuries or illnesses.

      So my question to you is exactly what evidence has convinced you that acupuncture and homeopathy qualify as ‘excellent medicine’—that they are anything more than an elaborate placebo?

      “You will certainly find supporters who agree with you, that is, who are blind to anything but [medical interventions for which actual evidence of safety and efficacy exists].
      Fixed that for you.

      “…INFORMED by ever changing research, including examination of the wisdom of the ancients, is sustainable.”
      Logical fallacy alert: appeal to tradition.

      “I am very puzzled about why people expect that something as complex as a system of health care belief and practice is anything other than a work in continual process.”

      So much for relying on ‘the wisdom of the ancients’, if the process of identifying the best health care practices is a continual process. In fact, a large part of that continual process, however, is discontinuing or discarding previously embraced methods once they have been found to provide no benefit or to be actually harmful (consider the traditional “western medicine” practice of bloodletting, and how long physicians clung to its use even after it had been shown to result in increased mortality).

    2. "Excellent medicine is a spectrum and includes acupuncture, homeopathy, botanicals,"

      You forgot bloodletting, leeches, and hemiglossectomy.

  33. wonderfully naturopathic medicine works and how we practice safe, effective and cost-effective care to patients, in a health care environment that is losing its soul to the highest bidder.
    I am hoping that an experience with us will, at the very least, contribute to your stepping onto a path embodied by the idiom ‘Physician Heal Thyself’, and possibly allow you to rethink and expand your present stance. There is a reason that you became a naturopathic physician after all, and it doesn’t look like you have truly identified why it is.
    With sincerity,

    1. Your posts have been approved as written. They were sitting in moderation because they were long and many.

    2. Margaret, please refer to the comment etiquette page. I actually made an exception and posted your lengthy response in full. Thank you for your comments and offer to visit you. I am available this summer to travel.

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