Naturopathic Scope of Practice Expansion Killed in North Dakota

5958353077_f17dd4ef57_o

Today, I received news of what I consider to be a nice victory for the effective regulation of medicine to protect the public.

A bill to expand the scope of practice of naturopaths in North Dakota (SB 2194) failed to pass in the state’s house and, now, is effectively dead. The house issued a resounding defeat: 35-Yeas vs. 56-Nays.

I submitted written testimony to provide lawmakers with an accurate picture of the education and training of naturopaths and why this training does not confer them the ability to prescribe pharmaceuticals, perform minor surgery, and practice midwifery, which SB 2194 would have permitted for the seven licensed naturopaths in North Dakota.

I consider this a small but important victory in line with my mission at NaturopathicDiaries.com, and I am glad to share the news and help others roll back the scopes of naturopaths across the country.

Brief History of NDs in ND and the bill

Naturopaths received licensure in North Dakota in 2011 with SB 2271. The licensing bill was introduced by Senators Unruh, Armstrong, and O’Connell and Representatives D. Anderson, Kempenich, and Schatz.

In January 2015, SB 2194 was introduced by Senators Unruh, Dever, and Mathern and Representatives Boschee, Meier, and Seibel to expand the scope and practice of licensed naturopaths. The bill started in the senate and was defeated with a vote of 22-25. Then, the naturopaths seemed to have wooed a few senators and convinced then to reconsider their votes. SB 2194 returned to the senate floor the following day and passed, 25-22.

Perhaps the flipped senate vote shows the influence the naturopaths had over these senators with misinformation that portrays naturopaths as well trained and competent to practice medicine. After the passing the senate, SB 2194 then moved onto the house.

Enter NaturopathicDiaries.com

In early March, I became aware of SB 2194, which was probably about a week after I launched NaturopathicDiaries.com. I remember chatting with my hosting company about high web traffic and reading about SB 2194. I decided that this bill and the growing exposure of Naturopathic Diaries meant I had a timely opportunity to help defeat naturopathic scope of practice expansion.

I have family in North Dakota. The idea of any of these family members seeking medical care from a naturopath bothers me, even though the odds were low. Over the years though, more NDs would probably move in. National University of Health Sciences in Chicago is the closest naturopathic program to North Dakota, and since Illinois doesn’t license NDs, NUHS graduates are motivated to move to surrounding licensable states, Minnesota and North Dakota, or go on in an unlicensed practice. (Many NDs who are eligible for licensure in states who license NDs instead practice in unlicensed states.)

Initially, I decided I would write a letter outlining the details of my education at Bastyr. Later, I realized I would need to put together a chart comparing the pharmacology training of PAs, ARNPs, and naturopaths in order to refute the claim that NDs have more training than PAs and ARNPs.

My letter

March 7, 2015

To the House Human Services Committee of North Dakota:

My name is Britt Marie Hermes. In 2011, I graduated from Bastyr University (an “accredited” naturopathic medical school) with a doctorate in naturopathic medicine. I passed the Naturopathic Physicians Licensing Examination (NPLEX) and landed a competitive, one-year residency in family medicine and pediatrics at an out-patient clinic in Seattle. When I completed my residency, I remained in naturopathic medical practice as a primary care physician in Arizona until 2014.

My mother was raised in Moorhead, MN on a beet farm. She attended Moorhead University and then moved west to California after marrying my father. While I technically grew up in California, I consider both Minnesota and North Dakota to be my second homes. I spent nearly every summer fishing on Cotton Lake in Detroit Lakes and having slumber parties with my cousins on the patio of my grandmother’s Fargo apartment. I still have many family members in North Dakota; in fact, the flower girl from my recent wedding lives in Watford City and my favorite aunt still resides in Bismarck. When I learned that naturopaths were attempting to expand their scope of practice in North Dakota to include prescription rights, minor surgery, and midwifery, I knew I needed to contact you immediately and share my story.

I watched my colleague, Elizabeth Allmendinger spearhead the political movement to get naturopaths licensed in North Dakota in 2011 from Bastyr’s classrooms. I remember the excitement I felt about North Dakota “gaining licensure.” With so much of my family still residing in the midwest, the hypothetical possibility of practicing near family was an enticing fantasy. North Dakota passed legislation right before we graduated and I watched Elizabeth travel back home to fulfill her dream of practicing naturopathic medicine in her home state, while I went on to fulfill my dream of practicing in a pediatric clinic.

Sadly, it did not take much time for my dreams to come crashing down around me. During my brief time in practice as a naturopath, I witnessed dangerous, illegal, and unethical naturopathic medical practices from licensed naturopathic doctors who graduated from accredited schools. I had previously believed that only the “fake- NDs” who earned online degrees engaged in menacing medical practices, such as intravenous hydrogen peroxide therapy for the treatment of cancer or chronic disease. In reality, an abundant number of licensed naturopaths from accredited universities use dubious diagnostic methods and unsound therapies. I personally witnessed the illegal importation of cancer therapies for use on terminally ill patients. I found this type of egregious behavior so common within the profession of “real” naturopathic doctors that I felt like I had no other choice than to change professions. I have since left the profession to study biomedical research in Germany.

Based on my educational and professional experience as an accomplished member of the naturopathic community, I can say that naturopathic medicine might be a distinct form of something, but it is not any form of primary health care. I am saddened to report that not only was I misled, but so were hundreds of legislators, thousands of students, and tens of thousands of patients. I do not want to see legislators in North Dakota fooled by false information regarding the education, training, and medical capabilities of naturopaths.

The issue of this deceit boils down to the education and clinical training of naturopaths and how the American Association of Naturopathic Physicians (AANP) and its members manipulate this information for political advancement. The naturopathic profession perpetuates a series of false assertions to justify its progress, which unfold in a closed-loop system that eschews external criticism. Two examples of this dynamic show that naturopaths are the sole regulators of naturopathic medicine. The NPLEX, the naturopathic licensing exams administered by the North American Board of Naturopathic Examiners (NABNE), is written entirely by naturopaths and not made publicly available like the USMLE or COMPLEX-USA for MDs and DOs. The NPLEX continues to be kept secret by NABNE, making it impossible for legislators and health organizations to assess the quality of the licensing examinations and to assess claims that the exams are as rigorous and comprehensive as the USMLE or COMPLEX-USA.

The Council on Naturopathic Medical Education (CNME) is an accrediting agency that approves naturopathic medicine programs in North America as designated by the U.S. Department of Education. This accreditation does not mean what naturopaths were taught in school or what legislators are told. It actually means that the CNME meets administrative criteria and conducts its own evaluation process of naturopathic programs which it approves. The CNME board members have numerous conflicts of interest with naturopathic and alternative medicine, in general. The founder of CNME, Joseph Pizzorno ND, is also one of the co-founders of Bastyr University. This historical conflict of interest alone is enough to suggest that CNME and the accredited naturopathic schools are likely mutually profiting from their relationship. In 2001, the U.S Secretary of State recommended that the U.S. Department of Education not recertify CNME as an accrediting agency for naturopathic medical schools due to CNME’s prime role in covering up extensive debt at the accredited Southwest College for Natural Medicine in Tempe, AZ. I suspect that there are many more conflicts of interests and corrupt activity yet to be revealed.

Despite the use of the term “accreditation” by naturopaths, naturopathic organizations and their universities, this term does not vouch for the quality of the education provided at the institutions. It simply means that certain administrative criteria are in place and that the university is willing to participate in a self- assessment process. Naturopaths are led to believe that the specific content of their education is “U.S. Department of Education approved” and flaunt this fact to lawmakers to help push through licensing laws. In fact, the only thing approved by the U.S. Department of Education is the university’s administration management, its mission statement, and its willingness to partake in a self-evaluation.

Furthermore, the AANP and its members like to say the the naturopathic medical degree is classified “on par with medical degrees and doctor of osteopathic medicine degrees.” This statement is a lie.

Naturopaths love to use education comparison charts to show that they are qualified to practice medicine as a primary care provider, write prescriptions for pharmacologic medications, and perform procedures like minor surgery or intravenous procedures. I’ve found several charts comparing naturopathic education to the education of other health care providers. They are all a bit different in how hours are categorized for comparison, which tipped me off that there was some manipulation of the data. To clarify the training of naturopaths for you, I have attached my transcript and a chart of my education hours which shows you exactly what was required for me to earn my naturopathic medical degree.

You will be interested in the following points from my transcript and the accompanying spreadsheet detailing the hours I spent in each class and in clinical training.

Clinical Training:

1,100 hours of primary care medicine training in “direct patient contact” including

  • 748 total clinical training hours on “patient care rotations”
  • 44 hours on a counseling rotation
  • 176 hours on physical medicine rotations (chiropractic therapy)
  • 132 hours spent shadowing any kind of health practitioner (ND, MD, DO, DC, LAc, Homeopath, PT, PA, NP, etc.)

748 Hours Patient Care Rotations:

A patient care rotation is scheduled in 4 hour shifts, once per week, for an 11-week quarter. One of these four hours is spent discussing patient cases and information on every shift. Three hours are spent in direct patient care, reducing the total numbers of hours spent in clinical training down to 561 hours. Clinical training on patient care shifts encompassed debunked medical theories, pseudoscience, energy medicine like homeopathy, hydrotherapy like colon irrigation, physical medicine like chiropractic adjustments (called naturopathic manipulation in your bill), and yes, some primary care concepts. However, the primary care training is diluted with the sheer amount of experimental medical practices and quackery.

My clinical training included such a small amount of pharmacological experience that it hardly seems worth mentioning. I spent far more time learning how to write a prescription for botanical medicines than how to prescribe appropriate pharmaceutical medications. I specifically befriended a pharmacist at a local pharmacy in Seattle so I could ask questions about drugs, dosages, interactions, and protocols.

Of note, there are no naturopathic standards of care. Students and residents at Bastyr University have compiled documents explaining the diagnosis and treatments for a variety of diseases, which are available to students and faculty on the university’s online portal. A review of these documents reveals a large degree of untamed variability that is reflected in naturopathic medicine. For example, the entry on angina includes a variety of treatment options: nutrient therapy with selenium, CoQ10, magnesium, and niacin; limiting fat intake, removing sucrose, alcohol and caffeine from the diet; botanical medicine doses of ginger, ginkgo biloba, aconite, and bromelain; at home exercises; recommendations to address a type A personality; a detoxification diet; colon hydrotherapy; castor oil packs; food allergy elimination; juice fasts; hormone replacement therapy; lifestyle changes; and monitoring of uric acid levels. Of the documents I’ve reviewed, all fail to mention any standard of care, which for some conditions, at a minimum should include an immediate referral to the emergency room or medical specialist. I know it sounds cynical, but naturopathic medical care is like picking treatments out of a magical hat.

The theme of not making firm clinical or public health recommendations rooted in science is apparent in the profession’s position papers. Most notably, the AANP position paper on vaccinations does not mention any vaccine schedule specifically nor does the paper recommend an adherence to any standard of care regarding immunizations. The paper instead clearly leaves room open for exemptions and custom inoculation schedules between parents and practitioners “within the range of options provided by state law.” Since many states have major loopholes in public health law regarding vaccine exemptions, this statement basically means vaccinate as you like or even not at all. This type of weak public health care policy results in infectious disease outbreaks like the pertussis outbreak in California in 2010. I can imagine that strong public health policies regarding immunization is very important in North Dakota right now given the state’s large workplace flux with the energy industry.

Course Training:

BC 6305 Pharmacology for ND Students: “pharmacology for the ND student population”

  • 55 lecture hours in one course
  • No additional pharmacology training provided in other courses
  • Minimal, if any, additional pharmacology training provided in clinical training hours

NM 7416 Minor Office Procedures: Lecture course that covers suturing techniques, use of anesthesia, performing biopsies, managing wounds, infections, and complications with natural therapies, homeopathic remedies for wound healing and infections, and insurance billing for these procedures. Technique and skills are practiced on pig feet.

  • 96 lecture hours
  • No required clinical training
  • No clinical competency exam required for graduation or licensing

NM 7417 Medical Procedures: Lecture course that covers common “primary care procedures” such as epi-pen injection, intravenous therapies, heavy metal testing, injections, IV cannulation, safety issues with IV therapy, sinus irrigation, naso- sympatico, eustachian tube massage, ear lavage, nebulizer use, how to use an oxygen tank and CPR/ first aid

  • 33 hours lecture hours
  • No required clinical training
  • No clinical competency exam required for graduation or licensing
  • This meager class meets the “16 hours of IV training required” to be licensed as a naturopathic doctor in the state of Washington.

It is my opinion, that naturopathic “doctors” or “physicians” are not qualified to practice primary care. Yet, I hope that my description of the clinical training provided by Bastyr propels this claim closer to the realm of fact. I find it extremely troubling to have been the victim of so many layers of deceit: from naturopathic medical school promotional material, the education and clinical training, the AANP’s political efforts, and information promulgated by my former naturopathic peers, colleagues, and elders. I sincerely hope that I can help shed light on the truth, which is why I decided to start my own blog.

In short, naturopathic clinical training is not on-par with medical or osteopathic doctors and is in fact far less, in terms of quantity and quality–also less than nurse practitioners and physician’s assistants. Of the hours that Bastyr provided to me and my classmates in purported primary care training (748 hours), one quarter of this time was spent in case preview and review. The remaining 75% (561 hours) contained dubious diagnostics and experimental treatments that were so embedded within a pseudo-medical practice that the student clinician loses the ability to assess what is truth and what is make-believe. When homeopathic remedies are presented on the same level as antibiotic treatment, the naturopathic student is lost, and I don’t blame them.

I think it is quite apparent that the 561 hours of what I calculated to be “direct patient contact” in clinical training are nothing of the sort that would instill confidence in anyone that naturopathic education can produce competent primary care physicians. There is no way that such training produces better health care that is affordable or more efficacious than what is currently available. Yet, this is exactly the rhetoric fed to federal and state lawmakers about naturopathic medicine, and it is wrong.

I recognize that it is a common position of governing bodies to promote freedom of choice. And by that logic, it is easy to license naturopaths, expand their scope of practice, and state that you are allowing citizens to make their own decisions regarding who is providing primary health care to them and their families.

However, granting naturopaths an expanded scope of practice that includes prescription rights, minor surgery, and midwifery practices provides the false illusion to North Dakotans that they are choosing between equally qualified health care physicians. I graduated from naturopathic medical school with no midwifery training whatsoever, a meager amount of pharmacology training, and the bare minimum amount of minor surgery training; all of which, by the way, was taught in a lecture format and not in a clinical setting. Any naturopath claiming to be adequately qualified in these areas, without having sought extensive training outside of naturopathic medical school, is simply regurgitating lies from their governing organization.

Furthermore, I would never recommend that any of my family members or friends seek naturopathic medical care for any medical condition, and certainly not for primary care.

If naturopaths are going to continue to argue that their scope of practice should reflect their training, then they need to accept that their scope of practice should be severely, severely, severely dialed back or they need to conduct a massive overhaul of their training, as the DOs did in the 1970s. Furthermore, naturopaths are not required to complete residencies (except for those practicing in Utah who need one year of residency), which is where any physician will argue the real practice of medicine is learned over the course of a multiple-year residency in a teaching hospital.

Realistically, if I were to practice naturopathic medicine according to my training at Bastyr, I honestly do not even know what I would be qualified to do.

Please do not support SB 2194 to expand the scope of practice for naturopathic “physicians” in North Dakota. Please continue to limit the scope of naturopathic “physicians” that is commensurate with their minimal training in primary care medicine. To act otherwise, is to risk the well-being and safety of every North Dakotan.

Sincerely,

Britt Marie Deegan Hermes

I included my transcript and chart of course hours as attachments with this letter.

ND textbooks compared to MD textbooks

PhrenologyPix

I also thought it would prudent to share the very off-beat and downright pseudoscience educational material Bastyr assigned to their students in basic sciences courses.

NDs often argue to lawmakers that naturopathic schools “use the same textbooks as medical students use in medical school.” I have no idea if this is true, as I have not reviewed the syllabi from medical schools. I suspect that some of the books are the same ones used in first year medical courses, like histology, biochemistry, and physiology.

I argue, however, that the similarity of a few textbooks does not demonstrate that naturopathic education is equivalent to that of a medical doctor’s.

In fact, many of my basic and clinical sciences courses at Bastyr assigned or recommended books that teach pseudoscience or unproven folk medicine. My gastroenterology and endocrinology classes required reading texts written only by naturopaths.

Here is a short list of the medically worthless textbooks used in naturopathic school from my Bastyr syllabi of some basic and clinical sciences courses.  I included a full list for the North Dakota lawmakers.

(Please forgive the incomplete citations.)

MW 7320 Normal Maternity:

  • Davis, Elizabeth. ​Heart and Hands, A Midwife’s Guide to Pregnancy and Birth, 4th​ Edition (​2004). Celestial Arts. “This introductory and concise text outlines the basics of normal ​maternity​ care in a warm and engaging fashion. It is noteworthy for it’s inclusion of information on homeopathic and herbal remedies utilized in maternity care.”

NM 7307 Eyes, Ears, Nose and Throat:

  • Unknown Author. ​Naturopathic Approach to Ophthalmology and Otolaryngology. (2004). Healing Mountain Publishing

NM 7313 Gynecology:

Hudson, Tori. ​Women’s Encyclopedia of Natural Medicine, 2nd​ edition.

NM 7311 Neurology:

  • Weintraub, Michael I. ​Alternative and Complementary Treatment in Neurologic Illness. (2001). ​Churchill Livingstone.

NM 8309 Rheumatology:

  • Vasquez, Alex. Integrative Rheumatology,​​ 2​ ed.

NM 7315 Pediatrics:

  • Herscu,​​ P.​ The Homeopathic Treatment of Children
  • McIntyre, Anne. ​Herbal Treatment of Children: Western and Ayurvedic Perspectives.​(2005) Elsevier.
  • Sears, Robert.​ The Vaccine Book. ​(You may recognize this author as the Orange County physician who popularized the delayed and alternative childhood immunization schedule.)

ND vs. PA vs. NP pharmacology and clinical training

Another fact I wanted to share with lawmakers was that NDs do not receive more clinical or pharmacology training than Physicians Assistants or Nurse Practitioners.

I tallied the number of pharmacology hours at Northwest College of Natural Medicine (NCNM) and University of Bridgeport from their published course catalogs and curricula. At each school, naturopathic students receive 72 hours in classroom pharmacology training.

While these numbers appear better than Bastyr’s 55 hours in pharmacology, they are still inadequate to master the complexity of practicing medicine using prescription medications.

Physician Assistants receive much more pharmacology training. I blindly picked three PA programs across the country and counted up their pharmacology training. Salus University in Pennsylvania, Lincoln Memorial University in Tennessee and University of Utah provide their students with 90, 90, and 120 hours in pharmacology, respectfully. A very important note to make is that in addition to this classroom training, PAs and NPs learn how to use prescription medications in teaching hospitals and large clinics by working alongside seasoned Physicians.

Despite such rigorous training, Physician Assistants must always practice under the supervision of a Physician. There is no possible way that a naturopath who gets under 75 hours of pharmacology training, very little clinical training in managing patients with prescription medications, and no guarantee of a paltry residency training at best can practice independently as a primary care physician.

When compared to the pharmacology training for Nurse Practitioners, naturopathic programs still fall short. From Nurse Practitioner programs at Long Island University, Vanderbilt University, and Ohio State University, graduates will have received 105, 115, and 101 hours, respectively, in pharmacology. Again, like Physician Assistants, Nurse Practitioners are trained in hospitals and medical clinics where they see lots of many different kinds and presentations of disease.

The bottom line is that naturopathic programs do not adequately train their graduates to practice at the same level as a Physician Assistant or Nurse Practitioner.

In fact from the chart below, we see that naturopathic programs spend nearly twice the hours teaching homeopathy and botanical medicine than pharmacology. Even more interesting, ND programs spend around 200-300 hours teaching chiropractic manipulations, hydrotherapy, and cranio-sacral as an integrated topic called “naturopathic manipulations.” Homeopathy, botanical medicine, and naturopathic manipulations are an utter waste of time.

NDvNPvPA

Legislative lies for political advancement

Naturopathic training is not as naturopaths present to lawmakers. The education is riddled with pseudoscience, debunked medical theories, and experimental medical practices. They are falsifying their medical training.

I think it is very important to note that naturopaths are nice people and believe they are doing the right thing. From my experience in the profession, I used to believe what I learned in ND school too. I can strongly say that these false beliefs originate in the professional organizations and naturopathic schools and are presented to students as the truth. A noticeable effect is that naturopaths have the most difficult time explaining clearly and factually how their training enables them to diagnose and treat diseases. The numbers of hours and type of textbooks used do not add up.

The naturopathic profession, organized by the American Association of Naturopathic Physicians (AANP), perpetuates false claims to meet its political goals. Lawmakers have been told that naturopathic schools are accredited by the US Department of Education, but this is only partly true. An independent body run by naturopaths and chiropractors acts as the agency that is responsible for accrediting naturopathic programs, called the Council on Naturopathic Medical Education (CNME). The organization that administers the naturopathic licensing exam, North American Naturopathic Board of Examiners (NABNE), is also run solely by alternative health providers. State naturopathic associations, like the North Dakota Naturopathic Medical Association, simply reproduce this rhetoric from the AANP and the naturopathic schools.

Lawmakers often look to these organizations in order to make decisions regarding the safety of licensing naturopaths and expanding their scopes of practice. Lawmakers also often hear from naturopaths themselves and sometimes from their patients. Lawmakers need to be wary of anecdotal evidence from alternative health providers, as it is not representative of the diversity of experiences and it cannot replace the testimony of esteemed medical experts.

Prior to what I have shared about my time at Bastyr, naturopathic education was mysterious to those outside the profession. Naturopathic education has been understood as being on-­par with MDs or DOs, better than Physician Assistants and Nurse Practitioners, and of high quality. Based on what I have shown from my education to become an ND, all of the above statements are false.

Dr. Stephen Barrett, who is recognized as an author of reliable online health information by the American Cancer Society, US Department of Health and Human Services, among others, wrote about naturopathic medicine in November 2013. He ended his article with this historical fact:

In 1968, the U.S. Department of Health, Education, and Welfare (HEW) recommended against Medicare coverage of naturopathy. HEW’s report concluded:

Naturopathic theory and practice are not based on the basic knowledge related to health, disease, and health care which has been widely accepted by the scientific community. Moreover, irrespective of its theory, the scope and quality of naturopathic education do not prepare the practitioner to make an adequate diagnosis and provide appropriate treatment.

I could not have said it better myself to describe the profession as it is today. Naturopaths claim to have undergone reforms and evolution based on scientific research, but nothing could be further from the truth.

The education of naturopathic doctors is just as dismal as it was 47 years ago.

  • Ian

    “I have family in North Dakota. The idea of any of these family members seeking medical care from a naturopath bothers me, even though the odds were low.”

    So, you are against free will and would rather see no choice in healthcare. Healthcare is the most personal topic a person will make a choice in. Did you know people don’t have to go to NDs or MDs. They can decide with whom they feel safer with. You think you have the answers because you went to naturopathic school and lets face it, failed as an ND? Your story is unique to YOU and is confined to YOUR experiences. We don’t see NDs coming out in droves to support you. Even your family may have low odds of going to NDs but high enough odds to “bother” you.

    • Travis

      She didn’t say she was against their choice to do so, but just as I would not want someone I love being cared for by someone who rejects the germ theory of disease. She doesn’t want her family or others believing that naturopaths have equivalent training and expertise as medical doctors and physicians.

      Calling her a “failed naturopath” is probably a compliment, considering how little their beliefs and practices reflect the scientific evidence

      BTW, did you have criticism of the points she raised or are you just going to try to paint her as someone who is against freedom to poison the well?

    • Beth

      You apparently feel yourself that government licensing means that naturopathy is “legit and worth investing in”.
      If licensed naturopaths are allowed to prescribe pharmaceuticals and perform minor surgery, that might similarly give people the impression that an ND degree qualifies someone to do these things.

    • http://www.theunwholesome.com Bec

      So why are you so pro-ND? Is it because, let’s face it, you failed too much as a student to get into any real medical course?

    • (Fake) David Gorski

      No, he’s right. What hermes has done is terrible. She should be ashamed of herself.

      From what I hear, students at MD school are pretty burnt out and unhealthy, while ND students live a much more pro active and healthy lifestyle. just saying.

      • Ken Hamer

        From what I hear, people who lie about who they are will lie about anything and everything.

      • https://www.naturopathicdiaries.com Britt Hermes

        Oops, Hi Jennifer! This one slipped through before I realized it was you from the same IP address. I’m happy to see that you have decided to stick to the Gorski pseudonym. I’ll leave your silly comment up for others to enjoy.

        • Travis

          This is actually hilarious.

          I find it difficult to stomach the idea that even after being called out int he previous article for faking multiple personas, that someone would then be so dishonest as to pretend to be someone else of the other side of the debate. Disgusting

        • Petticoat Philosopher

          Hehehe, this response is pure class. 🙂

      • http://www.sciencebasedmedicine.org The Real David Gorski

        Actually, what Hermes has done is fantastic, which is why I was more than happy to publish her work on SBM.

    • JGC

      Being opposed to family members making poor choices isn’t the same thing as opposing freedom of choice in healthcare, Ian.

  • Beth

    thumbs up, Britt!
    Your anger seems to have energized you to do a great job of laying out the facts for lawmakers.
    Any USA legislature that is considering a bill involving naturopaths should read it.

  • Linda

    Yay! Are you testifying at the FDA’s homeopathy hearings in April too? We need your help on a national level.

  • nut

    Another excellent post. Thanks for sharing.

  • Oliver

    Thank you for your first hand insight into the world of unproven claims and treatments in the clinical setting. Working as an ER Registered Nurse, I find it unsettling that naturapaths and others practicing fringe medicine are pushing their way to become primary care providers. Whats even more frightening are patients presenting with acute onset of cardiac type chest pain. Bastyr University’s naturapathic treatment for angina is extremely inadequate and dangerous. These people need to know that heart muscle damage are time dependent in order recieve drug treatment from time of onset, angioplasty, cardiology consultation. Other chest pains can be a pulmonary embolism. Are NDs competent enough to diagnose without proper lab work and CT scan? Even something minor when patients present with tolerable epigstric, abdominal or back pain. The patient goes home with homepathic pills or whatever–who knows, it can be an abdominal aortic aneurysm, or a bowel obstruction. I would like to know what naturopathic schools offer in their curriculum in terms of emergency type situations. Hopefully NDs would have the common sense knowledge to send patients straight to ER where the presenting signs and symptoms are way over the NDs head. The scope of practice of naturapaths need to be scaled way back. In ER medicine, we stick to evidence based practice.

    Yes, there are incompetent MDs and nurses out there that misdiagnose, perform wrong treatments and med errors. Yah, I get it. Therefore there is no need to put a spin on that discussion. Events are reported to the college of physicians and college of nurses that governs us. The reported events are audited and health professionals are grilled and scrutinized in front of a panel. So there’s transparency in conventional medicine.

    • Beth

      Are NDs competent enough to diagnose without proper lab work and CT scan? Even something minor when patients present with tolerable epigstric, abdominal or back pain. The patient goes home with homepathic pills or whatever–who knows, it can be an abdominal aortic aneurysm, or a bowel obstruction.

      Or an asthma attack, treated by a naturopath with acupuncture, a shot of B12 and an herbal tincture.

  • David

    Ian! She is not saying that naturopaths cannot practice in their small realm of expertise. She is protecting the public against them trying to practice as primary care doctors. Her relatives still have the choice to visit one of these naturopaths. They just won’t be trying to suture someone after they tried it out ok a pigs foot

  • Don A in Pennsyltucky

    I am so grateful for this information. It’s amazing how many “healers” I am noticing now that I have learned what to look for. I’m all for things that help people feel better even when the therapy they receive is a harmless way to evoke the placebo effect — I participate in drum circles to help me deal with stress but I have no delusions that anything else is happening despite occasional references to “transforming dark energy into light”. For me it’s more like an active meditation .
    However, my association with some of the hosting facilities has put me into the proximity of a variety of Reiki masters, aroma therapists, and it seems more and more of them are advertising themselves as “Board Certified Healers” of one sort or another. What I learn from you and from other science-based medical professionals helps me to shield my children from those who spout pseudo-scientific claptrap.

    Detroit Lakes. What about Perham?

  • Glen MacDonald

    Here’s a satirical take on homeopathy from the perspective of Canada; specifically, Ontario.

    http://www.theglobeandmail.com/globe-debate/columnists/homeopathy-should-make-my-column-100-per-cent-more-compelling/article23787723/

    Cheers,
    Glen

  • Alison

    Firstly thank you for creating this wonderful and insightful blog. It is heartening to see someone championing rational thinking for a change. Maybe one day there will be a book and documentary exposing naturopathy the way “going clear” exposed Scientology for the cult it is!

  • NH Primary Care Doc

    Great job, Britt!

    How scary that part of the required reading for Pediatrics was The Vaccine Book. Proof, in black and white, that naturopathy is anti-vaccine at its heart.

  • Jenny Hambrecht

    Britt, I’m assuming you have learned, or will learn, in your biomedical research program that financial incentives have the potential to bias purportedly objective research. For the integrity of your name, this blog, and the information contained herein, you’re going to tell us if you are being compensated for your work here, correct? We deserve to know. Thanks.

    • Cruz

      ahh, there it is, a poorly disguised accusation of pharma- shilliness!

      • https://www.naturopathicdiaries.com Britt Hermes

        Yes. We were all patiently waiting for it 🙂

    • Beth

      I wish people would be compensated for work like this.
      People make a lot of money promoting alt-med – but not much money in critiquing alt-med.

    • Ken Hamer

      Jenny:

      Did you or did you not refuse payment from Boiron to post that comment?

      We deserve to know.

    • Renata Kane

      Because naturopaths never receive money for their work and have no financial incentives.

      Oh, wait…

  • https://www.naturopathicdiaries.com Britt Hermes

    Jenny, All volunteer work. My bias is based solely on my experiences as an ND.

  • kosk11348

    Thank you, Britt, for another insightful post. I was wondering if during your schooling you were ever exposed to Reiki? I have heard that this particular pseudoscience is becoming popular among RNs. Googling “reiki nurses” returns a slew of websites specifically advocating the inclusion of Reiki in standard nursing practices. I’m unsure if Reiki is considered part of the naturopathy curriculum or not, and would be interested to hear what you know.

    • https://www.naturopathicdiaries.com Britt Hermes

      No Reiki was not part of the curriculum. Although I learned of it at Bastr, I know little about it. My SBM post has my transcript and a chart detailing all the classes I took, including electives, if you want more specifics. Thanks for your support!

  • Katatonic

    Thank you for another great post!

    One thing: if and when you have the chance to inform government bodies considering this type of legislation, please please post your reply/advice with links to the appropriate officials. Then the locals being affected can contact their rep’s and point out the pseudo-science of naturapathy and maybe generate more support for science-based medicine.

  • Vinny

    Hi Britt,

    What changes are needed for the ND program in north america to be better recognized?

    • Linda

      Cease and desist.

      • Ken Hamer

        On the contrary, the better recognized they are the easier they will be to avoid, challenge, and/or prosecute.

        I like the idea of a “scarlet letter” – a giant red “A” – to indicate that they are promoters of an assinine, er, I mean, alternative reality.

    • JGC

      I’m not sure I understand what you mean by ND programs in North America being ‘better recognized’–if you mean being widely recognized as valid courses of study preparing graduates to operate independently as effective health care provideres, I’m afraid it would require abandoning large portions of the typical ND curriculum (homeopathy, acupuncture, Ayurvedic medicine, etc.) for which no real evidence of safety and efficacy exists as well as instituting an internship/residency requirement following graduation.

      More critically, it would also be necessary to establish well-defined standards of care across the profession that all naturopaths abide by, instead of the current situation where, as another commneter has suggested a feature of naturopathy is that “You take from it what you want and when you are in practice, you decide what is best”.

  • Laura

    >”Then, the naturopaths seemed to have wooed a few senators”

    Excellent wordplay

  • http://www.charleycropley.com Charley Cropley, N.D.

    Hi Britt;
    I agree Naturopathic Medical education has its shortcomings. We are still a young, emerging profession without the support of big Pharma’s funding. Yet since 1975 our profession has grown enormously and has spearheaded today’s renaissance in medicine and Healthcare. Including nutrition, herbal and homeopathic medicines, physical medicine and lifestyle education.
    Among physicians competent in “alternative” medicine, we N.D.s are esteemed as the best educated physicians in the field; the least “woo woo”, and most qualified to discern how to best integrate conventional and alternative therapies.
    You seem to hold conventional medicine and its education as the standard by which to judge all medicines. Really? Conventional medicine bears primary responsibility for and has minimal answers for the rampant disease in our country.
    We desperately need a completely different approach, a revolution in medicine. Naturopathic Medicine offers precisely that.
    Our very view of illness is revolutionary. We hold illness to be wise and purposeful. Painful, dangerous, but when understood, seen to be beneficial.
    Therefore we do no harm. We are incredibly safe.
    We find real causes that make sense; that link our patients’ ways of eating and living to their Health problems. We listen closely and with great interest to our patients.
    We have amazing success with the most common illnesses of today: obesity, heart disease, diabetes, digestive complaints, etc and the most serious of diseases (which are largely “uncurable” by any means) we can almost always bring valuable improvement, reduction of medications etc.
    Although you seem quite bitter, I do understand and agree with some of your criticisms; e.g. increase our interns exposure to patients and expand our residencies.
    But denying us licensure would be obstructing perhaps the most beneficial, intelligent and safe approach to medicine in America today.

    • David

      Wow. Someone has a bit of a god complex. But as we said in public health school, Charles Crowley, unless you are god you must bring data.

    • Taylor Hermes

      Charley, I visited your website. You call yourself a doctor and help patients manage their health issues. You especially seem keen on getting patients off of medications. You write that you suggest labs or other diagnostics to your patients and then have them demand they get these tests through their medical doctors. You review these results with your patients. You are practicing medicine.

      I looked you up on the Colorado Department of Regulatory Agencies. You are not a licensed/registered naturopathic “doctor” in Colorado: https://www.colorado.gov/dora/licensing/Lookup/LicenseLookup.aspx

      Your use of the title “doctor” may be illegal: http://www.leg.state.co.us/CLICS/CLICS2013A/csl.nsf/fsbillcont3/CDCEE234E81BA08287257AEE0058374A?Open&file=1111_enr.pdf

      You were licensed in Oregon from 1979 to 1995: https://hrlb.oregon.gov/OBNM/licenseelookup/detail.asp?num=100013&searchby=INDEXNAME&searchfor=CROPLEY&stateselect=NONE

      Are you denying yourself licensure?

      I’d also like to add that residencies, medical school, and most medical research is supported by the federal government.

    • Beth

      Conventional medicine bears primary responsibility for … the rampant disease in our country

      Really? What makes you think so?

    • Beth

      @Charles Cropley
      What would you do if you got cancer?

    • Greg

      Our very view of illness is revolutionary. We hold illness to be wise and purposeful. Painful, dangerous, but when understood, seen to be beneficial.

      1. How exactly is sticking to an idea that stands in opposition to basic chemistry and physics and has largely been unchanged for last 200 years, without any relevant breakthroughs or new discoveries a “revolutionary” stance? It seems rather reactionary to me.

      2. The quote above? Nice to know that Naturopathy is shamism. Or at least sounds like it. Since you are already ascribing attributes of sentience to the disease, here’s an idea for free – start a new therapy based on appeasing the Spirit of [Insert the Name of Illness Here]. It is about as valid as other vitalism based modalities and spiritual, hippie types will eat it up!

    • Alexander

      “Although you seem quite bitter, I do understand and agree with some of your criticisms; ”

      Subtle!

      Really? She seems bitter to you?! You couldn’t keep yourself from including that little passive aggressive stab, could you?
      Just FYI, to us out here, this makes you look bitter.

    • JGC

      I’m not sure what you’re referring to as ‘physical medicine’—could you clarify? Nutrition and lifestyle education are integral parts of science based medicine and nothing that’s been pioneered or spearheaded by naturopathy. Herbal medicine has not been shown to produce better outcomes than science based medicine (and in fact, in many cases has been found to been harmful—consider aristolchia). Homeopathic medicine has been found to perform no better than placebo treatments and the principles upon which it is founded—Law of Similars, Law of Infinitessimals, etc.—are imaginary.

      What evidence suggests integrating conventional medicine and alternative (i.e., unproven or demonstrably ineffective) therapies produces better outcomes than conventional medicine alone? Be specific.

      That conventional medicine cannot cure all illness doesn’t argue alternative medicine is effective, any more than the fact airplanes sometimes crash argues in support of relying on flying carpets.

      Illnesses possess neither intelligence, nor sentience and are inherently incapable of ‘being wise’ or acting in a goal oriented manner.

      Re: illnesses are beneficial, by what rational argument could contracting Ebola, or testicular cancer, or congestive heart failure, or COPD or eclampsia (to name a few illnesses off the top of my head) be seen to benefit the person suffering from them?
      But denying us licensure would be obstructing perhaps the most beneficial, intelligent and safe approach to medicine in America today.”
      Please provide evidence that interventions unique to naturopathy generate equivalent or superior outcomes for these illnesses as do interventions either unique to science based medicine (Statins, insulin, etc.) or common to both SBM and naturopathy (diet and nutrition, exercise, lifestyle changes, etc.)

      Citations truly, madly, desperately needed: provide evidence that naturopathy is “the most beneficial, intelligent and safe approach to medicine in America today”.

    • Beth

      @Charles Cropley
      You’re doing something right – you look a lot more fit and healthy than most people your age.
      And maybe you’re good at inspiring other people to adopt healthy habits.
      But what if someone comes to you who needs more than a good attitude, healthy diet and exercise?
      Suppose it’s an emergency and you don’t realize that?
      Suppose they urgently need some medication, and you don’t realize that?

    • Brett Williamson

      This is the worst, moronic comment I have seen from someone who wishes to be licensed.

      Specifically, to quote you “We hold illness to be wise and purposeful.” Tell that to any parent of a child with cancer. There is absolutely no scenario where this comment has any validity except in the mind of an ideologue.

      You have just proven why your honorific is meaningless (and certainly shouldn’t gain any semblance of credibility from government licensing.) You also demonstrate that any esteem you perceive ND possess “..as the best educated physicians..” is based upon the thinking of a man possessing not a single whit of critical thinking.

      Simply disgusted that you believe you have anything to offer society. Society needs less of your nonsense (and that of your fellow believers), not more!

      • Beth

        This is the worst, moronic comment I have seen from someone who wishes to be licensed

        What it is, is blissful ignorance arising out of the benefits of mainstream medicine, such as vaccination and antibiotics to prevent people dying young, in often unpleasant ways.
        Mainstream medicine has helped so much that its helpfulness has become invisible, taken for granted, something that happens as an exception to the normal healthy state.

    • Ballena

      “I agree Naturopathic Medical education has its shortcomings.” Only reasonable thing you have said… apart from it everything is one big pile of self-grandiosity babbling without real content.

      A couple of comments anyway that have not been made yet:

      “We are still a young, emerging profession”: I thought you were the continuation of traditional therapies from ancient times… do not try to have it both ways… Moreover, some therapies such as homeopathy have been used now for 220 years… Enough time to provide evidence that it works, don’t you think?

      “without the support of big Pharma’s funding”: the 330 million euros a year of revenue of Boiron (Source: English wikipedia) or the 60 million pounds a year of Holland&Barrett (Source: http://www.retail-week.com/sectors/health-and-beauty/holland-and-barrett-profit-up-as-sister-company-julian-graves-remains-in-administration/5038253.article) should be more than enough to fund high quality clinical trials instead of playing the victim role.

    • Ken Hamer

      In a rational world, this post would seem like nothing more than an over the top “false flag” stunt, a satire worthy of The Onion.

      Alas, it’s all too typical of witch doctors. I mean naturopaths.

    • Ken Hamer

      On the other hand, imagine the response of legislators if they heard one of these snake oil salesman say something like “Our very view of illness is revolutionary. We hold illness to be wise and purposeful.”

    • NH Primary Care Doc

      Naturopaths do no harm?

      Tell that to my patient who got endometrial cancer from her naturopath prescribing estrogen to her, without bothering to also give her progesterone.

      Tell that to my patient who got c. diff from unneeded antibiotics for the Lyme disease that she never really had.

      Tell that to my numerous patients who spent thousands of dollars on useless supplements.

      • Beth

        Since they were prescribing for their patients, I suppose these were licensed naturopaths …
        So much for licensing as a way to protect the public.
        NH naturopaths have prescribing rights, and in 2015 they became able to prescribe even more drugs.
        I can see why you’re concerned.

        • Beth

          oops, that second link was for Vermont, not NH.

  • Chris P

    “Our very view of illness is revolutionary. We hold illness to be wise and purposeful. Painful, dangerous, but when understood, seen to be beneficial.”

    Just how “revolutionary”? As “revolutionary” as alchemy, or geocentrism? And how, exactly, is AIDS or leukemia “beneficial”? Or smallpox for that matter? Is it troubling to naturopaths that society can no longer enjoy the unique benefits of smallpox due to its eradication?

    “We have amazing success with the most common illnesses of today: obesity, heart disease, diabetes, digestive complaints, etc and the most serious of diseases (which are largely “uncurable” by any means) we can almost always bring valuable improvement, reduction of medications etc.”

    Evidence for this? Oh wait, I forgot. Big Pharma has suppressed all the evidence. Of course, things are changing and more people are waking up to the fact that virtually all medical doctors are nothing but henchmen for Big Pharma. Once the Truth gets out, it’s all over for Big Pharma, and then the heroic altruists of alternative medicine will provide all our medical needs, right?

  • Linda

    Our very view of illness is revolutionary. We hold illness to be wise and purposeful. Painful, dangerous, but when understood, seen to be beneficial.
    Therefore we do no harm. We are incredibly safe. We find real causes that make sense; that link our patients’ ways of eating and living to their Health problems. We listen closely and with great interest to our patients.

    This might sound really deep and valuable to gullible people who’ve never experienced homeopathic or other natural treatments, or thought about it for 2 seconds. Homeopathy, for instances, promises to “treat the whole person” by taking into consideration the patient’s personality. They base their remedies on this, not on the symptoms or the disease itself, because sickness is the natural state of things. When they figure out your personality, they prescribe a remedy for it, which has no active ingredients (DOES NO HARM!!), because the water they’re diluted in “remembers.”

    What part of this sounds sane to a rational person?

  • Dean Hughson
  • Tara

    Lets be clear on this whole issue! Bastyr School and the others are not TRUE NATUROPATHIC SCHOOLS!!!!!! They were and are set up and owned through various tentacles by the AMA and were created to eliminate the Traditional Naturopaths while brainwashing the public into believing that drugs, surgery, etc…are part of natural care….ie….therefore….go to your regular doctor who touts alternative care and you will get the best of both worlds.
    Traditional Naturopaths (Yes the ones who went to the schools that have now been labeled as non-accredited) actually do know more than most medical doctors and use only natural methods. They do not have a desire to do surgery or prescribe drugs.
    We as Traditional Naturopaths have been put on trail through misdirection and deceptive practices such as licensure, Bastyr, CMNE, and others.
    Traditional Naturopaths (the real ones) can cause no harm, because we aren’t using any of the above described surgeries, therapies, drugs etc….
    People need to educate themselves and look behind the manipulation of big money and big business.
    There is NO MONEY in Traditional Naturopathy because those who use it correctly as it was meant to be, actually do get people well, and they don’t have a revolving door of illness like the Bastyr False Naturopaths and the Medical Doctors.
    Unfortunately the Big Agenda to stop us from healing people is the collusion of the AMA with Big Pharma and the government.
    Thanks to Codex and Obama Care, traditional naturopathy (God’s Medicine) is being eliminated. God’s doctors are being persecuted, thrown in jail, and even murdered.
    It’s about the money!
    If you research deep enough, you will find many reliable and effective modalities and nutritional products listed on quackwatch.com. This is another smear campaign by the AMA and their buddy Stephen Barrett to eliminate anything natural and non-harmful.
    There is not a single “Traditional Naturopath” that has caused harm to anyone! Bottom Line…..Free Will Choice!

    • JGC

      “Traditional Naturopaths (the real ones) can cause no harm, because we aren’t using any of the above described surgeries, therapies, drugs etc…”

      What do traditional naturopaths use then, and by what rational argument can whatever they do use be incapable of causing harm?

      You are claiming, after all, to be offering interventions that have some real biologic effect–i.e., that cause actual physiologic change–and anything that does so must be capable of producing not only beneficial changes if used in the correct manner at correct dose for an appropriate indication but also of producing harmful changes if used in an incorrect manner or at an incorrect dose for an inappropriate indication.

    • Ken Hamer

      So I guess you’re off your meds, eh?