California lawmakers should reject naturopathic doctors

naturopathic doctor

A little bird told me that California naturopathic “doctors” and their supporters are holding a meeting in Sacramento on March 9, 2016 to educate state lawmakers about naturopathic medicine in order to secure support for a stalled bill, S.B. 538, that would, in my opinion, dangerously expand their scope of practice far beyond their training.

S.B. 538 would allow California NDs to prescribe pharmaceutical drugs without the supervision of a physician. Currently, California NDs can prescribe a very limited number of drugs if they have an agreement with an MD or DO to monitor their prescribing practices. This bill would expand their formulary and remove medical oversight.

I want to send a clear message to lawmakers: naturopathic education and training do not give graduates the knowledge and clinical skills necessary to prescribe pharmaceuticals safely and effectively. I would argue that even current limitations for California NDs are too weak. If it were up to me, licensed naturopaths would not have the authority to prescribe drugs. Period.

I went to one of the “best” naturopathic programs (Bastyr University in Seattle) and actually believed that NDs were primary care physicians.  I stopped practicing upon learning that my former boss in Arizona (a licensed ND) had been importing an illegal cancer drug and giving it to terminally ill patients. After a former president of the American Association of Naturopathic Physicians urged me not to report the crime to the authorities, I decided to walk away and never look back, but not before I indeed reported my former boss. I began observing what other licensed naturopaths were doing across the country and discovered that illegal activity was common. My former boss had admitted this stark reality once to me: “all NDs are doing something borderline illegal.”

In order to find an explanation for how an aspiring medical profession could appear to be condoning such rampant transgressions, I begin scrutinizing my education and training at Bastyr University. What I learned is frightening.

What is a licensed naturopath?

Naturopaths are licensed or registered in 17 states, two U.S. territories and D.C., as well as five Canadian provinces. Their goal is licensure in all states and territories with a scope of practice equal to primary care physicians. Current ND scopes vary wildly. In Arizona, an ND is considered a “physician” and can prescribe controlled substances and perform minor surgeries. In Alaska, an ND is restricted to providing nutritional advice, counseling, herbs, homeopathy, and physical therapies. This causes consternation for naturopaths and should be a sign to lawmakers that something is not quite right with the profession, as state agencies view NDs so inconsistently. Even worse, naturopathy is illegal in South Carolina and Tennessee!

A licensed ND needs to have graduated from a program accredited by the Council on Naturopathic Medical Education (CNME), which happens to have programmatic accrediting status by the U.S. Department of Education. Many people, especially NDs, often confuse CNME accreditation with government endorsement. In fact, CNME has accrediting power because it meets administrative criteria, such as publishing a mission statement, not because the naturopathic curriculum is medically sound. Tellingly, naturopaths accredit their own programs without consultation from real experts in medical education.

NDs claim they are trained the same as medical doctors, but this is impossible. Much of the curriculum is homeopathy, herbalism, hydrotherapy, craniosacral therapy, chiropractic manipulation, and naturopathic philosophy. Some classes are taught with the same titles as courses in medical programs, but the content is indeed inferior. NDs take gross anatomy, histology, pharmacology, and other basics, but they are not all taught by faculty members with academic expertise. For example, a person who is a “doctor of naprapathy” taught me embryology, and other courses were taught by NDs, often using naturopathic textbooks.

Take a look at this chart comparing the number of hours that certain topics are taught to students in naturopathic, nurse practitioner, and physician assistant programs:

NDvNPvPA

It is glaringly clear that ND students get far less training in pharmacology than nurse practitioners and physician assistants. Now compare the number of hours ND students spend learning homeopathy, herbology, and naturopathic manipulation (most similar to chiropractic). Now remember that NDs want to be able to independently prescribe drugs. This should be alarming to lawmakers, especially since NDs have severely deficient clinical training in anything remotely close to real medicine.

Naturopathic clinical sciences, like pediatrics, contained material that would never be taught in real medical school. We read Dr. Bob Sears’s Vaccine Book and were lectured on flawed reasons why vaccines should be avoided or delayed. We learned to put sliced onions over a child’s ear for an infection and other folk remedies, like wearing wet socks at night to “boost the immune system.”

Naturopathic clinical training is mandated to be no less than 850 hours of direct patient care. From my clinical training handbook at Bastyr, I discovered this benchmark is attainable only through accounting tricks. For example, time counted when students reviewed a case with peers or when we observed advanced students perform physical exams. We were required to have contact with a minimum of 350 patients (now 450), with some having certain diseases. Yet, because Bastyr’s clinic generally gets patients with a limited range of minor problems, we could gain competency by giving oral presentations to other students on diseases we had not seen. All of this happens under the supervision of instructors, who were educated and trained under this system or one with weaker requirements before the 1990s.

Naturopathic students are not trained in medical standards of care, let alone reality. Instructors would commonly discuss a patient’s “vital force” as if this could be detected with magic. Frequently, patients presenting with nonspecific symptoms were diagnosed with dubious food allergies, chronic Lyme disease, adrenal fatigue, or yeast overgrowth. Patients would be prescribed an assortment of herbs and supplements, conveniently sold at the clinic’s dispensary, and handed a superbill for insurance reimbursement. Naturopathic residencies are rare and function as an encore to clinical training with more “real world” experience in naturopathic private practices or at the notorious Cancer Treatment Centers of America, for example, if one wanted to become a FABNO, a made-up board certification for naturopathic oncologists. (My boss who was importing illegal cancer medications was a FABNO.)

Licensed naturopaths do not deserve government endorsement

Compared to a physician (MD or DO), nurse practitioner, or physician assistant, naturopaths are not prepared to manage patients’ health care. Yet, NDs argue they are the solution to the great primary care shortage. This real health care problem cannot be fixed with blatant quackery, such as homeopathy, anti-vaccine propaganda, and paltry clinical training based on pseudoscience.

Naturopathic “medicine” appears to have an ethical framework unlike anything in the medical community.  I could not have learned this more abruptly than being discouraged by prominent members in the naturopathic community from reporting a federal crime. Months later, I fully realized the danger of naturopathic self-regulation when the state’s naturopathic board disciplined my former boss with a mere slap on the wrist in the form of a letter. NDs claim to be a profession of competent and noble doctors, but they train students to practice quackery and to look out for one another, not the welfare of their patients.

naturopathic doctor

California already faces a serious problem with naturopathic regulation. The California Naturopathic Medicine Committee and the California Association of Naturopathic Doctors have chosen to ignore scores of licensed NDs who are currently practicing a completely bogus and dangerous “treatment” in which ozone gas is infused into a patient’s bloodstream. According to the current Naturopathic Doctors Act, ozone is not a substance that can be legally given to a patient by any route of administration, but a simple Google search turns up countless NDs who advertise the therapy. This is a complete lapse of medical and moral judgement. Ozone is extremely toxic and corrosive, and the FDA has unequivocally stated that ozone is ineffective for any medical condition.

There is one naturopathic program in California. It has been reported to me by multiple individuals that the Bastyr San Diego campus is riddled with administrative problems and extremely low quality instruction, even by naturopathic standards. In 2014, there were rumors circulating that students were planning to file a lawsuit on issues related to education fraud. Recently, I’ve heard directly from those involved with the school that the program’s purpose has amounted to a great disappointment. I would be stunned if anyone visiting this quasi-medical school located in a corporate business park found the quality of education impressive.

Naturopaths seem so embroiled in alternative and old-timey practices that they tragically disregard standards and patient safety. Given their poor medical education and commitment to fanciful principles, NDs are bound to do more harm than good.

California lawmakers, please reject licensed naturopaths.

Image credit: 1) Wonderlane, some right reserved; 2) Thomas Hawk, some rights reserved.

87 Replies to “California lawmakers should reject naturopathic doctors

  1. I recently graduated from one of the programs. Before starting – I knew nothing of the modalities, but was inspired to change my medical school application to an ND one because the ND I met was really well trained and helpful, unlike the rushed, unhappy report I received from many family practice MD’s I had been shadowing. To be honest, I didn’t know anything about the modalities that ND’s learned. Hadn’t used any of them myself or really cared for that matter ….I honestly enjoyed her demeanor, the time and knowledge she presented (conventional included). That being said – I applied and finally finished the program, which was really f’ing hard. I spent time at Children’s Hospital, an Emergency Room, Community Health Clinics, the Integrative Oncology Research Center and more. After finally completing my training – it’s kind of hard to read some of these things for a variety of reasons. For one, after all the pharmacology I’ve had to learn and use (both for classes and patient visits and licensing exams), she makes it sound like nothing, which is really just lying. It may have been less when Britt was a student, but having the scope in WA has drastically changed the curriculum to include standards of care and so on and so forth. And I don’t think that 18hrs of pharmacology makes a PA a rock star at pharm anymore than an ND. And I just spoke with a ARNP who feels really disillusioned about her own training and felt that the pharmacotherapy was just algorithmic and of little use, like an automaton could do it. Just sayin. I will be completely honest though, which is the other part that makes reading this difficult. I agree with her on two things – #1. the cost of the education and the earnings afterward are very disproportionate – not cool. AND #2. Homeopathy should be removed from the curriculum with exception to a historical overview and at most, theory. The interview process in interesting and may help someone get to know their quirks, but the rest of it should be tossed out. At least no required shifts mandate its use in order to graduate AND I NEVER had a supervisor use it once during my entire time as a student. Seems as if its on its way out – and good riddance. Oh and before i forget, I also didn’t have any supervisors or profs harp on vaccines – the only one was the homeopath….see where i’m going with this. If anyone is an anti-vaccine monger – talk about Dr. Sears more or compare infant and childhood mortality rates in developed countries with varying vaccine schedules. At the very least – it would be nice though if Britt offered specific constructive solutions to some of the flaws rather than behaving like an entitled child. MD programs have their downfalls too (suicide for example – look at the date “he says sarcastically”) and MD’s who tout evidence, but actually suck in the office. Well, there’s plenty of that. I have many great friends who are MD’s that agree with me about all of this really. 13% of MD’s also report have used antibiotics as a placebo. Guess we should hunt them down and take their licenses too. Neither system is perfect, that’s kind of hard to disagree with, but apparently Britt’s a pack-dog I’m sure she’ll disagree not because she’s a whistleblower or seeks to make things better, but because she’s a attention seeker. That’s probably the reason she went to ND school in the first place anyway.

    1. Again i have to point out….why are you allowed to practice as a PCP with prescription rights whereas an MD still needs a 3 year residency working 80-100 hour weeks before they are deemed adequately trained

      1. I’ll totally validate this – but maybe not quite like you hope. My training was primary care from day one…… in all coursework and shifts. Even on the oncology shift – it was “what ancillary support can we provide” NOT – what ‘alternative cancer tx’ exists. So that does support the quicker motion to PCP. I do think a 1 year residency is necessary – that would be a good thing. There aren’t enough ND’s yet to support everyone, but I think it should be mandatory when the time comes. In regards to the 80-100hr work week thing. It think thats stupid. I put in 60-80hrs between classes and shifts easy, but thinking it makes me a better doctor to do 80-100 is just dumb. I’ve worked two jobs in my life before putting in that kind of hours and it was no way to assimilate anything except soda and chips to keep my blood sugar going. There’s no benefit or value in that kind of schedule….which is why conventional schools are revisiting those numbers constantly. 🙂

        1. I disagree. For example, if you work in ICU, conditioned change very rapidly. To learn properly, that patient needs to be followed quite closely over a 24 hour to 36 period. If you go home after 8 to 12 hours, and then return 24 hours later., that patient may be discharged to a step down ward or God forbid dead.
          Also, in order to see the huge volume of diseases and manifestations of diseases, I believe the long hours are necessary. Alternatively, one could extend the residency for a few more years. That is the problem is that naturopaths simply have no idea what they do not know

          1. If you work in an ICU, which PCP’s do not. duh. And the long hours discussion is a lost cause – many of your cohorts disagree so you can take it up with them. Nothing will ever be enough for you…which is why when you’re a fellow, you’ll look down upon your residents and likely tell them they know nothing as well.

            1. actually every MD PCP has worked in an ICU and I will bet that they will say it was perhaps the most important training they received. Maybe it would be useful for you to know that the medication you prescribed could land a patient up in ICU with SJS. Maybe then you will understand why we do not feel that naturopaths are trained to prescribe medications

              1. I think NDs are trying to redefine “primary care physician.” Sorry, Adam, it does not mean giving your patients vitamin injections after taking their pulse/blood pressure and a CBC panel.

                1. I agree! I think you’re confusing old “naturopaths” with recently graduated ND’s. It’s ok. 🙂 what do you do?

                  1. The self proclaimed “Harvard of naturopathy” Bastyr naturopathy has an acceptance rate of 68 percent with no entrance exam (as opposed to Harvard medical school which is 3.7%). That is laughable. I do no think it is possible not to be accepted into naturopathy school as long as you have a pulse That is the other elephant in the room that no one likes to talk about is the dramatic difference in intelligence and accomplishments of ND versus MD.

                  2. National college 82 percent acceptance. God imagine what is wrong with the 18 percent that did not get accepted

                  3. For one – that stat can’t be correct. I can say that because there’s no way there’s 591 ND students at Bastyr. Not even close – especially after you account for those that drop off the first year as the program drowns them. So whatever that is – i don’t know, but it’s not clearly not right. Either way, I personally took the MCAT – scored a 28, had 2000+ hours as a CNA and shadowing in all sorts of settings, including in an ER and OR, long term care, clinics, etc, had solid referrals, 3.6+ GPA with all the same pre-med requirements as you, etc… I just didn’t follow through on the application because I didn’t feel like the system would allow me to practice family med like I wanted (largely about time with patients). I will say that the MCAT was ridiculous though…..the computer mayhem of rapid fire questions that largely don’t apply to life. It’s good to have a handle on things, but having a crazy MCAT score doesn’t make you an excellent family medicine doctor. I also never said that all ND students were brilliant (definitely)….some are though, that much is true – and many work very very hard to be proficient in their field. Look. I’m done for the night – and with this. I’ll be the first to admit that there are standards that could improve, regulations that need to mature and I’m most certainly down for some changes, but what it is – is VASTLY different than you think and say. You’ve got your heels dug in and for some things may they should be. Many of them though its the case because you have misinformation. If you really want to get things ship shape – then help regulators get rid of “naturopaths” who don’t attend accredited programs and only advocate for ND’s, but WITH standards (probably those somewhat resemble that of ARNP’s) The field is constantly growing and so is the evidence. It’s not like its going away – and the medical system, though its great in many ways, has some serious issues as well. Don’t ignore your part in favor of finger pointing. It’s unprofessional and assumptive. Take care everyone and best to you regardless of your perspective.

                  4. you say the field is constantly growing and so is the evidence. I am curious to what you are referring too. I was under the impression that you were practicing the same medicine that an MD PCP is practicing except perhaps more emphasis on nutrition etc.

                  5. A few things before I shut the lights down. First – I apologize for the ICU comment. That’s what happens when we read about what others educations entail rather than experiencing it ourselves. My bad. Secondly, I never have thought that ND’s should replace MD’s, but there is a place for ND’s who pursue the PCP route (much like an ARNP as previously mentioned). Lastly, evidence for taking counseling classes (I had 3 and a mandatory shift), nutrition (I had 3 of those) as well as nutrient therapies and herbal therapies – which there are plenty of, but continues to grow as time goes on. There’s plenty of evidence out there for all these modalities and support for its use in preventative and primary care along with standards of care. That’s all. Thanks for the engaging discussion – much better than some of the other mud-slingers out there. 🙂

                  6. Adam. This is not about reading about other professions “rather than experiencing it for ourselves.” There is an entire organization dedicated to ensuring medical doctors receive the training required to be competent medical providers. This organization is made up medical education experts. They allow for independent and external reviews of medical licensing exams and the medical curriculum. AND, these reviews, the medical curriculum, and all the information covered on the USMLE exams are accessible and available to the public so that everyone knows how medical doctors are trained. You could have easily found the correct information.

                    Med schools (and MDs) do not operate in a secret, closed-off world that ignores criticism. They embrace criticism to ensure medical students are receiving the best, most science-based curriculum possible to keep patients safe and healthy.

                    In contrast, Naturopaths accredit their own programs. The CNME is literally made up of chiropractors and NDs. They keep their curriculum and board licensing exams secret. They refuse to allow independent and external audits of the information taught to ND students. There is not “plenty of evidence” for all these modalities taught in ND school. There is not plenty of evidence to suggest the safety and efficacy of all the herbs taught to us in herbal med class. We were taught a lot of wrong nutrition info (like giving oral vit K drops to newborns is ok instead of the vit K injection to prevent bleeding).

                    This is not a “let’s use the best of both worlds” situation. There is medicine. And then there is a teeny tiny amount of some naturopathic-y stuff, which is really not unique to naturoapthy, that can also be used in a PC setting. But how can naturopaths ever know what is real, and what is not, from their training?
                    When homeopathy is presented as evidence-based along side pharmacology, it becomes confusing to discern what is real, and what is not.

                  7. Britt, I totally agree re: homeopathy (100%). I’ve never heard of VitK drops, so that wasn’t in the curriculum (or isn’t anymore). I also did a search for what R1’s did in the ICU and after 4 sites (family med school sites), and one finally gave an observational report – so its not like I didn’t look beyond wikipedia. And the ACGME is all made up of MD’s…. so duh, accreditation boards are typically from the field they are monitoring. As for botanicals…really? That’s like writing off all cultures that use herbal medicine throughout history and modern ones that directly made pharmaceuticals from plants…… yeah, they’re all totally benign, useless and no evidence exists. Do you know what percentage of synthetic medicines make it to market – its something like 1/5000. I never said that ALL botanicals squelch disease, but many have inarguable track records. Also, how daft you sound when you say that all MD’s are open and embrace criticism. That’s such a farse and both you and I know it. Many are just as defensive as everyone else, particularly when uptodate didn’t work for a patient. I can’t even count the amount of people I know that asked questions to a doc and the doc got defensive. There are many many amazing MD’s, but its just plain stupid wrong to say they’re all grand and open minded. Isn’t that why many med schools are looking for students from liberal arts?! (because they tend more personable) I totally acknowledge that Naturopathic education has work to do and it’s coming along, but it’s clear that medicine is GIANT and assuming that MD’s are just gonna absorb it all and handle it all and manage it all is clearly not happening. Just look at the state of US healthcare system in comparison to other countries, costs, infant mortality….. It’s just bizarre how you worship MD’s and don’t acknowledge the so many flaws that are in the news every. single. day. And furthermore, that you think no ND can handle healthcare. Your fantastical writing hasn’t inspired any real change. In fact, you wrote off ND’s and other ND students that likely would have collaborated with you to improve standards and regulation, but because of the your polarized, non-specific, attn seeking behavior, there you are. There will always be ND’s and MD’s who practice weird shit and you’s can prevent that. And there’s sooooooo many MD’s who do (lest we not forget that). In fact, probably more by volume than ND’s combined. Many MD’s historically learned the hard way and ND’s will have growing pains too. Either way – your complaints are quickly becoming yesterdays news, just like your pulse on the field. Sorry you never learned constructive criticism or how to apply it. I won’t be visiting this site anymore as it seems to be no more than a place to gripe. You had a chance to make a real difference and regulate out the issues that many ND’s would agree with you on. Now you’re a blogger. Bravo.

                  8. Adam, botanical medicine as practiced by NDs suffers from two fallacies. First the appeal to tradition. Old knowledge is fraught with observational bias and false concepts which means that it is only to a certain percentage correct. Indeed reviews of studies of medically used plants show that roughly 10-20% display pharmaceutical effects that are large enough to warrant investigation. Second, ND philosophy assumes that nature somewhat made plants for humans. This is simply not true. Plants (like many other organisms) are incredible chemical factories. Their output serves their purposes which also may, by pure coincidence and only by pure coincidence act on certain cellular mechanisms in humans. However their chemical output is not tailored for the needs of humans but for the needs of the plant and therefore suboptimal and fraught with inerfering substances. A classic example is aspirin. The active compound, acetyl-salicylic acid can be found in willow-bark, but for the reasons mentioned above Aspirin is by far better suited to treat inflammations as willow bark extract. One has to distinguish sharply between botanical medicine and modern pharmacology. Botanical medicine almost never develops and optimizes a drug beyond simple preparations, whereas modern pharmacology takes an active compound and optimizes it for human use.

                  9. Actually, it’s the other way around. Salicylic acid is natural, whereas acetylation of salicylic acid resulted in what we call Aspirin. The inventor found that acetylation reduced the side effects of the natural compound. Be that as it may, only about 1/10,000 chemicals in any form ever reach the stage of clinical trials. But what I find most troubling is the paltry number of hours naturopaths are given in the study of pharmacology. If they are going to use plants as medicines, they had better know what they are getting into. That requires far more time in the study of plant constituents coupled with pharmacology. I would argue that they more they learn, the less likely they would be to rely on plants to treat patients; there being such a small number with sufficient evidence to support their use.

                  10. I stand corrected, the same time this is a prime example why botanicals without further optimization are in almost all cases suboptimal to treat diseases.

                  11. Right on Britt. Heck, when I was getting treated at the Stanford Cancer Center they had massage therapy and other alternative things like that–truly COMPLEMENTARY modalities to help the patient feel better. If aromatherapy helps your pain more than the vicodins, there isn’t an MD I have met that would want to deny you the pleasure of aromatherapy and force you on to the oxycontins, etc.

                  12. What exactly would the place for ND’s who pursue the PCP route be, that is not already occupied by NP’s?

                  13. What exactly would the place for ND’s who pursue the PCP route be, that is not already occupied by NP’s?

                  14. The MCAT does not rapidly throw questions at you, you just have to finish X amount of passages (old mcat 52 questions) in 70 minutes – now its 59 questions in 95 minutes. A 28, would have gotten you in a DO or second tier MD school provided your GPA was good and you had shown through volunteering that you were genuinely interested in (real) medicine. The application for real medical school (MD or DO) is grueling, but I will not understand why you would choose a nonsense degree such as ND – it’s akin to choosing acupuncture, Chiropractor or essential oil salesperson. Sure, you can chat with your patients, and milk more money out of them as you sell useless supplements that you provide, but eventually cognitive dissonance becomes hard and you have to choose to be an honest person like Britt or continue on the Bullshit road, while believing you know better than an MD/DO, like Gwen does…

                  15. I’ve called the schools and spoken directly to the admissions offices about these stats. Sorry to burst your bubble, Adam. They are correct. 100% guaranteed acceptance at the Uni of Bridgeport!!

                  16. The MCAT is a great equalizer; the MCAT shows whether you truly understand the chemistry, organic chemistry, biochemistry (genetics), biology (micro, evolution, genetics), research methods and physics involved in medicine. The new MCAT includes a lot of biochem and has added psychology and sociology – It is a great barometer as to how you will perform on the USMLE step I and/or COMLEX step I. To be considered for medical school acceptance (either MD or DO) you should have a score north of 28 (although stronger parts of the application might allow for very minor fluctuation south from 28 (old MCAT) and north of 500 for the new MCAT (way north!)).

                    You state “The field is constantly growing so is the evidence” – show us… It’s very hard to wish things into being, especially when one pursues nonsense – cognitive dissonance will always be there and only gets louder… Get out of the ND nonsense, if you want to become a physician go to MD or DO school… All ND schools do, in my opinion, is feed your need to be terribly unique, encourage contrived enlightenment and teach excellent marketing skills…

                  17. …the dramatic difference in intelligence and accomplishments…

                    You can get that just by noting the difference in writing skills between you and Adam. They may be attempting to clean up their act a bit, but that doesn’t equal medical school or residency at a real medical school.

                  18. None required. No GPA requirements. I even went to school with someone who did not finish his bachelor’s degree. He was the son of a naturopath. Apparently that was enough to get into school.

                  19. Nope, he is right. Naturopathic medicine is marketed by the schools and the profession as a “distinct form of primary care.” I am surprised you don’t know this. Naturopathy is desperately wanting to be considered a real medical field, but it won’t let go of pseudoscience. And really you saying that the newer NDs don’t give patients vitamin injections???

                1. When I did ICU I was up all night putting in central lines, admitting patients and titrating inotropic agents as well as making life or death decisions. I pronounced patients dead. Hell yeah it is working. I find it so funny when naturopaths and chiros like to say they have similar training when they do not seem to know what an md does in training. I remember my chiro friend was shocked when I said I delivered close to 50 babies and I am not a PCP. Residency is incredibly hands on. As interns we ran a 300 bed hospitals with no other MD in the hospital except the emergency doc in emerg.

                2. You think what R1s do in the ICU is observing??? You are an idiot. An ICU rotation as an intern is management of meds, vent management, central line management, arterial blood gas management, usually coding at least one patient a day, management of heart failure, renal failure, sepsis, DKA…sometimes all at once. There is nothing observational about it.

                  You’re an idiot, Adam. And an arrogant one at that.

              2. Yes, even on the Primary Care track of my residency program, I still did 3 months of CCU/ICU every year in my training program- so that’s a total of 9 months of ICU time.

                Of course, those are like 100 hour weeks, so thats like 3600 hours of ICU time during residency.

                Something that I’m sure in incomprehensible to any naturopath.

          2. None of them give two squirts about patients with rare diseases. They wouldn’t be able to diagnose it and any diagnosis they would give would be wrong! I have a rare disease and I was shuffled from MD to MD waiting for someone qualified who could diagnose me. NDs are dangerous to patients with rare diseases. The don’t know what they don’t know.

          3. None of them give two squirts about patients with rare diseases. They wouldn’t be able to diagnose it and any diagnosis they would give would be wrong! I have a rare disease and I was shuffled from MD to MD waiting for someone qualified who could diagnose me. NDs are dangerous to patients with rare diseases. The don’t know what they don’t know.

          4. I have to say, the hours I do question–80-100 per week does seem excessive to me. At some point, it’s just been too damn long since you’ve slept and that’s not good for anyone. I have seen friends go through residency and, I have to say, like a lot of American post-graduate education, there seems to be a point when it becomes about hazing rather than learning. It’s my understanding (though I could be wrong) that residents in modern, developed European counties don’t put in nearly the Xtreme hours of American residents (though they certainly still work long hours) and those countries don’t seem to be suffering from a lack of competent doctors.

            1. It’s really not excessive. There is a lot to be gained by following patients longitudinally throughout their stay. You miss a lot when you’re rushing to get everything done and signed out by 6 or 7 PM.

              1. I understand the argument but then do you feel that European doctors (and, by extension, their patients) are missing out due to inferior training? Not intended to be a hostile question, I’m actually curious.

    2. Some of the flaws? Apparently, you are too young to know that the primary reason that naturopathy schools exist is that naturopaths found they could make more money by preaching their beliefs than by practicing them. A low bar for entry coupled with a high cost for students may be a successful business model, but only at the greater expense of student and patient alike.

      1. If you look at the average income of graduating ND’s – you’d find you are quite wrong. Very wrong to be precise. If that was the case – being a health coach would be the solution. No education and sell everyone shitloads of supplements.

        1. How much of a naturopath’s income is from selling supplements? There are no end of supplement manufacturers catering to naturopaths with so-called professional lines. MediHerb, to name one, offers them a 20% discount to entice them to do just that.

          1. What? You mean these schooled “NDs” are buying off the shelf supplements instead of laboring over raw plant material and formulating for their patients themselves?

          2. What? You mean these schooled “NDs” are buying off the shelf supplements instead of laboring over raw plant material and formulating for their patients themselves?

    3. Adam, in medicine there is no complementary and school medicine. There are only treatments that work and treatments that do not work. Treatments that work are ipso facto conventional medicine. I guess 50% of all treatments taught in ND school do not work and the rest works in very subscribed areas (like acupuncture in some pain relief settings). That is no basis for a doctoral degree. Britt offers constructive solutions. Scrap ND school and do the real stuff. NOTHING prevents you as an MD specializing botanical medicine – with the benefit that as an MD you would know what works and what does not.

      1. All doctors should be rejected. Here’s evidence. http://www.telegraph.co.uk/news/uknews/law-and-order/11915178/Boy-6-died-after-negligent-doctor-mistook-him-for-child-under-DNR-order.html Oh – I meant this one…I get so confused when there’s so much “evidence out there” for shitty doctors. http://www.nydailynews.com/news/national/georgia-doctor-arrested-36-patients-die-article-1.2498832 wait wait, there’s probably more “evidence” but the list goes on. such a poor argument.

        1. You are correct. I should not have used the word evidence. But it does point to a dangerous mindset where patients are using naturopathy for life threatening illnesses. The naturopath who this patient saw has probably never seen meningitis

          1. We’re trained to recognize and refer meningitis to the Emergency Dept and pass national exams that test us on the whole scenario from top to bottom. That incident is all on that ONE provider, just like the examples I gave. Therefore, it is also a dangerous mindset to assume that all MD’s giving drugs are super-heroes saving lives. I’m certain there’s more to this story, but either way, if you’re using evidence – correlation doesn’t mean causation. You can’t take one case and apply to to everything. (taking notes?)

            1. How are you trained to recognize and refer meningitis…by reading it in a book or hearing a lecture. You do not have any real world experience with any of these diseases and therefore would be very unlikely to recognize and diagnose such a disease. While you are sitting in classrooms learning predominantly from other naturopaths….medical students are seeing real patients with these diseases and learning from specialists in the field—and residents are dealing with these diseases with real world consequences.

              1. It’s pretty easy to recognize and refer meningitis – i hope you’d know that at least. And the chances that you’ve seen everything in the medical world are pretty low. I know you want validation for all that you’ve done – and I commend you for your hard work, but putting ND’s on the same level as health coaches and being derogatory toward all of them is really lame, but it appears you fit the MD role well. Always need to feel power over others – like you did something that no one else can and acting like you know it all. You also say “with these diseases” as if primary care offices don’t see anything and its impossible to learn while in a primary care office. That’s like saying…. I watched C-sections all day – so i know all about birth and no one else can supervise a birth or identify a red flag. Thank you for proving that this blog is about complaining rather than being constructive. You talk as if only you and what you’ve done makes you prepared to manage everyone and everything. I know for a fact that I need to refer a whole host of conditions and presentation and I’m not pretending that I know it all. You on the other hand appear narrow minded and are an egoist. I’m sure you learned that in MD school. Have all Nurse Practitioners seen everything?! There are countless programs out there that allow a NP to go straight through a bachelors program to NP and they haven’t spent countless hours seeing everything in a hospital….. they offer primary care and refer/consult when necessary. Cherry picking is not evidence, is blindness.

                1. Actually early diagnosis of meningitis in an infant is notoriously difficult and even well trained emergency docs or paediatricians may miss it. However at least they have been put in this situation thousands of times such that they have a much higher chance of recognizing the diagnosis.
                  At least naturopaths are better at recognizing adrenal fatigue, sub clinical thyroid disease, sub clinical Lyme disease, and candidiasis. Apparently, I always miss those diagnoses

                  1. Lol! me too! :). Yes – in an infant for sure! But you’re talking about emergency docs or pediatricians. Yes – THEY have been put in the situation before (thousands….hmmmm). I’m talking about when a kid enters a primary care office. None of those people have seen it “thousands” of times – and I doubt you would say the same of NP’s because you are bias. What I suggest is the same as NP’s, where they have extra training in pediatrics in order to diagnose and treat that population. In fact, there’s group of ND’s who are trying to do that right now….. see how solutions can come up when you keep an open mind. 🙂

                2. In all seriousness …all my acquaintances that have seen naturopaths have come back with a diagnosis of adrenal fatigue, systemic candidiasis, gluten allergy or Lyme. Whenever I hear someone has seen a naturopath I rattle off those four diagnoses and I am batting a 100 percent. Am I wrong?

                  1. I have authentic IgE mediated yeast (Saccharomyces) allergy which is one allergy I carry an epipen for. All of the above diagnosis sound like complete BS if you’ve ever almost choked to death like I have. None of the above are real diagnosis. There is no ND who would ever be able to diagnose me correctly because I actually have authentic yeast allergies. lol. I also have several rare autoimmune diseases that eluded MDs and specialists for years, one that I had to have radiation treatments for. No way in hell that anyone but the most qualified MDs could have helped me…NO ONE.

                  2. I have authentic IgE mediated yeast (Saccharomyces) allergy which is one allergy I carry an epipen for. All of the above diagnosis sound like complete BS if you’ve ever almost choked to death like I have. None of the above are real diagnosis. There is no ND who would ever be able to diagnose me correctly because I actually have authentic yeast allergies. lol. I also have several rare autoimmune diseases that eluded MDs and specialists for years, one that I had to have radiation treatments for. No way in hell that anyone but the most qualified MDs could have helped me…NO ONE.

                  3. They seem to be really obsessed with Hashimoto’s thyroiditis these days too. Maybe add that one?

                3. Gwen, with all respect you do not seem to see the problem with naturopathic educatioon. Sure, an MD training to be a PCP will not see everything but, s/he will be trained by specialists who are very often even scientifically top in their field. Compare that to Bastyr. The entire university has an abysmal scientific record, and most of the faculty would not qualify even for a PhD program elsewhere. This is like learning mechanics of a modern car with the car mechanics in residence of Last Gulp Junction. Additionally these NDs wasted the majority of their time as students with subjects beonging to the realm of pseudoscience. The danger with such an approach is that the mind is quasi poisoned in a way that prevents scientific, rationale thinking. A prime example is homeopathy which is taught as “science” despite violating most basic laws of physics.The training of NDs ist not even remotely on par with MDs, therefore they are generally not allowed to serve as PCPs, except in Canada and the US.

                  1. We recently had a “guest” on this board who I believe was also a 3rd year student at Bastyr and he was arguing vehemently about the scientific merits and efficacy of homeopathy and other pseudoscientific phenomena. So it does not seem like all the new naturopathic trainees are abandoning these treatments as historical like you and Adam suggest.

                  2. I remember. If you look at the recent study on modalities offered by NDs in Canada it is the same. However, the argument of non-effective therapies does not only apply to homeopathy. Botanical medicine is similar. There is a review covering 1000 plants, showing that only a fraction have actually been investigated and of this fraction only 10-20% showed enough pharmacological effect to warrant further investigation. I.a.W. 80% of what Adam learned in botanical medicine is hearsay.

                  3. Whenever someone trumpets the efficacy of traditional botanical medicine it’s useful direct their attention to aristolochia

                4. “, but putting ND’s on the same level as health coaches and being derogatory toward all of them is really lame”
                  It would seem to be inappropriately denigrating to health coaches

                5. “, but putting ND’s on the same level as health coaches and being derogatory toward all of them is really lame”
                  It would seem to be inappropriately denigrating to health coaches

  2. As an real food, cosmetic, and environmental allergy patient with authentic IgE mediated allergies that require lifesaving medical intervention with an epipen (funny how I always have to clarify myself this way these days because of the scammers people think you are lying about allergies until you pull out your epipens) any legislation that would give NDs the powers of a real doctor is frightening to me. I have seen these fake IgG “allergy tests” that NDs foist on people along with a bunch of other fake stuff. These IgG tests cannot determine if you have a life threatening or life impairing allergy. The measurement is fake and the theory behind the test is fake. End of story. I have the epipens to prove it.

    That being said–how are these people getting pharma writing powers? And if they are so called natural doctors, why the hell do they want to play around with pharma? They just want the money and status of MDs without all of the hard work? I mean, really. This is what this whole “ND as primary care” sounds like to me.

    I am a home herbalist and I’m also a wellness book author. I enjoy herbs at home, and let my MDs do their work at their office. There was a time in history that herbalism WAS the realm of ‘home doctoring” –this ND and woo school stuff is not the stuff of traditional home herbalism. Nowadays the “natural wellness” crowd insists that you do not have credentials without attending one of their schools. LOL. And do not get me started on homeopathy. There are lots of interesting clinical studies about herbs but homeopathy is just straight up bunk. Yet, this seems to be a major course of the learning track in ND school, WTF. And they want pharma writing powers? Really?

    I’ve had some of my book fans curse me after revealing to them that I think they should see their doctors. Herbalism at home is fun, it’s satisfying, I personally get a lot of benefit for my chronic pain and menopause issues–but damned if I am going to be an advocate for the woo industry! I don’t understand why we can’t enjoy our herbs at home and see our doctors (MDs) too. But that’s how it goes in woo world.

  3. I’ve always had better experiences with NDs than MDs. I think both styles of medicine are difficult to practice, and there will *always* be plenty of good and bad NDs *and* MDs to be found. I don’t think it’s fair to shoot down the whole idea of naturopathy based on the negatives one has experienced during ND school and several years spent in clinical practice. I think *outright* rejecting naturopathy is like throwing the baby out with the bathwater.

    When I said I’ve always had better experiences with NDs than MDs, I’m not talking about bedside manner. I’ve had true and significant improvements in my health with NDs, and I can’t say the same about MDs. (I’ve met a few ND lemons along the way, too, but I’ve always had the good sense to know when I was dealing with inferior practitioners and gotten the heck out). But the smart NDs, the true doctors, the ones with vast medical knowledge and critical thinking abilities, the ones who are always learning and keeping up with the literature, are worth their weight in gold.

    I’m a licensed acupuncturist, but I’m not currently practicing. I could tell you stories about acupuncture school that would make your toenails curl, but I won’t go into that here. What I’d like to say is that even though my educational experience was lacking, and I see many problems in the acupuncture and herbal medicine professions as a whole, I’d never condemn acupuncture and herbs in their entirety. I’ve seen acupuncture work very, very well, and I’ve seen it fail, just like any other form of medicine, “science-based” Western medicine included (thalidomide, anyone?).

    Not all modalities will work for all people, Rx drugs included, surgery included. I know people who are worse off after surgery than before surgery, and worse off after beginning Rx drugs than before starting them. All medical modalities are a mixed bag, and that’s an unfortunate fact of life. I think *all* medical practitioners need to work at bettering the form of medicine they practice, MDs, NDs, LAc’s, nurse practitioners, chiropractors, etc. There’s room for improvement in all of these professions . . . and there’s good to be found in all of them, as well.

    1. I will point out the obvious. The whole point of evidence based medicine is to tease out what works and what doesn’t and not base it on yours and others anecdotal and personal experiences.

    2. Yana, sure, every treatment may work in a particular person or not, but, this is a matter of optimizing probability. If I select a treatment by random, there is a certain probability that it will work for my particular disease. However, the goal is to optimize the probability to select the optimal treatment by applying – lets call it educated guesses. If one include a large proportion of treatmens of questionable or non existent value in the modalities (like NDs do), the probability that they select the best treatment worsens a lot.

    3. Yana,
      It’s very reassuring to have one adept in a field of magic vouch for and recommend another field of magic. Did you also attend Hogwarts?
      Could we have a homeopath and TCM tiger grinder weigh in as well?

      ND = Not a Doctor.

    4. Yana,
      It’s very reassuring to have one adept in a field of magic vouch for and recommend another field of magic. Did you also attend Hogwarts?
      Could we have a homeopath and TCM tiger grinder weigh in as well?

      ND = Not a Doctor.

    5. There is no baby in the bathwater is the thing. And if there are any NDs with “vast medical knowledge,” they sure aren’t getting it from ND training. Have you read Britt’s descriptions of her (lack of) training at what is considered the best ND program in North America? Can you honestly say that this sounds like adequate medical education too?

      Also, did you really see thalidomide “fail?” Like personally? Because that was a long time ago and the window in which it was prescribed for pregnant women ended up being quite small. Because the medical profession realized its connection to birth defects and, based on this evidence, stopped prescribing it. And, as a result of the entire crisis, many countries introduced tougher regulation for licensing new drugs. That is science-based medicine in action, trying to account for mistakes, as opposed to magic-based “medicine” which insists on the repeating the same old mistakes, no matter how ineffective or harmful they may be, because it’s based on a dogma that centers anything “traditional” or “natural” rather than on a value of evidence and accountability.

    6. …entire industries are set up whose sole purpose is to develop elaborate stories to distract patients from realizing that all they’re getting is an expensive placebo.

    7. Yana, Thalidomide did not fail. Thalidomide had some side effects /specifically impairment of growth of blood vessels) which where not investigated at the time it was introduced because the concept of antiangiogenesis was not known. However, as soon as it became clear that these side effects exist, prescription was stopped and now Thalidomide is in research as anti-cancer drug.

      1. And not to mention that thalidomide was never actually prescribed in the US, because it was blocked by the FDA due to concerns about lack of safety data…just as science-based “Western” medicine should work.

    8. “I Confronted the Doctor Who Missed My Cancer”

      http://www.elle.com/life-love/a32907/i-confronted-the-doctor-who-missed-my-cancer/

      The comments following the above article are also very telling. Neglect, mistreatment of patients, and wrong-treatment of patients is rampant in modern medicine. MDs routinely miss major diagnoses just as NDs do (this was one of Britt’s complaints about her ND colleagues, missing diagnoses and red flags).

      People commenting on this blog can rail all they want against naturopathic medicine — and other forms of holistic medicine such as functional medicine — but they’re not going to make it go away. The reason it’s around and gaining in popularity is two-fold. One, because people are discovering that naturopathic treatment is oftentimes more effective than mainstream treatment for chronic disease. The other reason is because mainstream medicine is failing people all too frequently and they *have* to look for other answers, and so they turn towards the “alternatives,” such as naturopathy, homeopathy, chiropractic, acupuncture, etc.

      The bottom line is, if mainstream medicine was so fool-proof, the growing interest in these alternatives wouldn’t be so strong.

      Like Britt, I’ve also struggled with a serious and debilitating health problem (more debilitating than hers in terms of being able to function in everyday life), but, unlike her, I was helped the most by NDs (and MDs who practice functional medicine). I owe my recovery to them. I did not *imagine* this recovery, I actually experienced it, physically. The regular MDs who I was able to see through my insurance network did absolutely nothing for me, and I really wish they had been able to help me, it would have saved me a lot of grief and a lot of money.

      The important thing is that we maintain a climate of tolerance in this country so that people can seek out the type of medical treatments that they feel are effective for *them.* That might mean seeing an MD for some types of problems and an ND for others. I’m grateful to have that choice. Can the education of NDs be improved? I’m sure it can, just as the education of MDs can and should be improved.

      And re: thalidomide, it’s just the tip of the ice berg. I mentioned it because it’s notorious, most people of a certain age are familiar with it, as opposed to some newer drugs with devastating side effects that are less well-known. The harm that’s been done by pharmaceutical drugs (and iatrogenic illness) is too vast a topic to go into in the comments section of a blog. The information is out there, it’s very easy to research these things on the internet now (via respected sources such as PubMed). It’s shocking to me that anyone would attempt to defend thalidomide (and company) as an honest mistake, and otherwise try to explain it away.

        1. Actually, I’d call it the Nirvana Fallacy. Since medicine isn’t perfect, it’s worthless.

      1. Also, I do not see the point of your referenced article. The surgeon missed an extremely rare cancer that is not often seen in the patients age group. If instead this patient went only to alternative med how would this have ever been diagnosed. The acupuncturist is going to diagnose the rare tumor?!?
        In fact, chiropractors and naturopaths routinely rely on md to diagnose such diseases for them and then they take a stab at curing them with their hokey treatments. I just do not see your point of the article because any reasonable MD or even alternative doctor would not have expected nor diagnosed this tumor on presentation! Granted, one should think of alternative diagnoses when the first couple of surgeries were ineffective.

      2. Yana, your post is fraught with logical fallacies. Re missed diagnosis. The probability that an ND would have missed the diagnosis is way higher. Also, to conclude from a bunch of comments that mistreatment is rampant in modern medicine is a classic case of observational bias since people who have been treated correctly are far less likely to speak up. Re: Naturopathic treatment being more effective. In 90% of the cases it is not. the real reason why naturopathic medicine is still quite popular is a) the false claim that it is natural and b) the false claim that it treats the cause of the disease instead of only the symptoms (as conventional medicine does). This is appealing to certain people because things natural are being perceived as good. The claim to treat the cause and not only symptoms is also very appealing. However, both are marketing gags. Re – lets call it “genesis” of naturopaths. Many naturopaths enter the field in following way: They can not be cured by modern medicine (or perceive the cure as ineffective), have been cured by some naturopathic method, have a helper personality and therefore turn to naturopathy. In almost all cases this turning to naturopathy as accomanied by a grave deficiency in formal medical or scientific education. If you look at the fathers of American naturopathy (Lust, Kent, Bastyr, etc, etc) you will find this same pattern. I.o.W. naturopathy has been built by a bunch of dilettantes. Re Thalidomide: Today Thalidomide and it’s derivates is successfully used in leprosy and cancer treatment. With all respect Yana, your statement shows that you have little knowledge in pharmacology. Some of the most effective treatments in leukemia are based on mustard gas, yes, the one used in chemical warfare in WWI.

        To put it bluntly, this is a matter of probability. Of course you can have your car repaired by a hobby mechanic. Sometimes this person will be able to repair a car when a professional fails. However, the probability that he will make things worse is much, much higher.

      3. Another thing Re Contergan: The real problem was that the compamy marketed Contergan over the counter and made safety claims without sufficient tests about side-effects, efficiacy etc during R&D. Yana, 80% of naturopathy works exactly like that.

        An example is botanical medicine in cancer treatment where herbs claimed by naturopaths to be safe can and do interfere negatively with standard therapy.

    9. “I Confronted the Doctor Who Missed My Cancer”

      http://www.elle.com/life-love/a32907/i-confronted-the-doctor-who-missed-my-cancer/

      The comments following the above article are also very telling. Neglect, mistreatment of patients, and wrong-treatment of patients is rampant in modern medicine. MDs routinely miss major diagnoses just as NDs do (this was one of Britt’s complaints about her ND colleagues, missing diagnoses and red flags).

      People commenting on this blog can rail all they want against naturopathic medicine — and other forms of holistic medicine such as functional medicine — but they’re not going to make it go away. The reason it’s around and gaining in popularity is two-fold. One, because people are discovering that naturopathic treatment is oftentimes more effective than mainstream treatment for chronic disease. The other reason is because mainstream medicine is failing people all too frequently and they *have* to look for other answers, and so they turn towards the “alternatives,” such as naturopathy, homeopathy, chiropractic, acupuncture, etc.

      The bottom line is, if mainstream medicine was so fool-proof, the growing interest in these alternatives wouldn’t be so strong.

      Like Britt, I’ve also struggled with a serious and debilitating health problem (more debilitating than hers in terms of being able to function in everyday life), but, unlike her, I was helped the most by NDs (and MDs who practice functional medicine). I owe my recovery to them. I did not *imagine* this recovery, I actually experienced it, physically. The regular MDs who I was able to see through my insurance network did absolutely nothing for me, and I really wish they had been able to help me, it would have saved me a lot of grief and a lot of money.

      The important thing is that we maintain a climate of tolerance in this country so that people can seek out the type of medical treatments that they feel are effective for *them.* That might mean seeing an MD for some types of problems and an ND for others. I’m grateful to have that choice. Can the education of NDs be improved? I’m sure it can, just as the education of MDs can and should be improved.

      And re: thalidomide, it’s just the tip of the ice berg. I mentioned it because it’s notorious, most people of a certain age are familiar with it, as opposed to some newer drugs with devastating side effects that are less well-known. The harm that’s been done by pharmaceutical drugs (and iatrogenic illness) is too vast a topic to go into in the comments section of a blog. The information is out there, it’s very easy to research these things on the internet now (via respected sources such as PubMed). It’s shocking to me that anyone would attempt to defend thalidomide (and company) as an honest mistake, and otherwise try to explain it away.

  4. If naturopaths believe what they themselves peddle, why do they even want the ability to prescribe pharmaceuticals? Aren’t “big pharma” medications just some kind of ineffective profit-driven mass conspiracy in the naturopathic worldview?

    The very fact that they want to prescribe pharmaceuticals is just further evidence that naturopathic “doctors” are, in fact, the quacks who are only after whatever will get them more money. If they want to prescribe real medicine, make them become real doctors; to do otherwise is just to endanger people even more than alternative medicine quackery already does.

    1. No naturopath should be allowed to prescribe pharmaceuticals until they first acquire sufficient training in their use and take the “hypocritic” oath.

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