What’s the point of acupuncture? A TCM practitioner wants out

needles

Britt’s note: In this anonymous post, an acupuncturist describes the difficult process of turning one’s back on pseudoscience and facing reality. It is an extraordinarily vulnerable position to renounce colleagues and friends in a public forum. I know this first hand. As other anonymous posters have mentioned to me, writing about their experiences is important for understanding personal biases and moving forward.


I have been going through the difficult and saddening process of leaving my field. I was not a naturopathic doctor. I went down the path of Traditional Chinese Medicine (TCM) and became a licensed acupuncturist and herbalist. While searching for encouragement online, I happened upon NaturopathicDiaries.com. I felt connected to Britt’s story of leaving a pseudo-medical field and admire her for taking a stand against the dangerous misinformation in the alternative health care industry.

Like many people who venture into alternative medicine, I recall my childhood experiences with doctors as negative. I was chronically ill and frequently taking antibiotics. I remember my family being “anti-doctor,” despite having a limited understanding of science and medicine. By adolescence, I had adopted the self-victimizing belief that doctors were simply pushing pills on me, rather than nurturing me back to health.

In hindsight, I think blaming the medical system was my way of coping with the frustration of not having absolute control over my health, which led me to visiting a doctor of TCM in my hometown. That was who I wanted to become!


How to rationalize the study of acupuncture

When I enrolled in my 4-year TCM program, I was 20 years old and brimming with optimism. I bought into the fallacy that mainstream medicine only treats symptoms and that alternative medicine treats the body as a whole and gets at the “root of the problem.” I went in genuinely believing that I would come out benefiting people using the power of traditional wisdom that had been tested for millennia. My family strongly believed in me and happily made sacrifices so I could afford the exceedingly expensive tuition.

After about two years into my program, I started to have doubts. There were so many things that seemed blatantly wrong. From the vitalist concept of qi to the curious mishmash of science classes and antiquated anatomical theories. The concepts were contradictory, and problems seemed endless. Even though I began questioning my faith, I was so deeply invested that I felt like I couldn’t back out.

For the remainder of my program, I found ways to rationalize the logical inconsistencies and focus on my future career in a positive light. I surrounded myself with peers and instructors who abated my fears. I learned Chinese, traveled to China, graduated with good grades, and eventually became licensed as a Diplomate of Oriental Medicine and Acupuncturist. I got a good job working at a local clinic, but soon thereafter my beliefs began to unravel.

I was already prolifically reading about acupuncture from sources such as The World Health Organization and Cochrane Collaboration. Initially, I was able to justify staying in practice by only treating patients with pain. After I became employed, however, this restriction became impossible. People with a wide array of serious health problems would arrive at my clinic. Some of them were desperate and willing to try anything to relieve their suffering, perhaps even cure their ailments. There were times when patients would seem to improve and would praise me for being such a great practitioner. With more experience, however, I realized that the truly sick and disabled would eventually end up as miserable and ill as they were when they had first met me.

Though my acupuncture practice was thriving, I was overwhelmed with guilt and depression. I struggled with the real possibility that I wasn’t helping people. The ethical debacle set in. Was I misleading my patients?

Enter ScienceBasedMedicine.org

I began reading articles from science-based and skeptical organizations. I contrasted information discovered from these sources against the rebuttals of acupuncturists defending their practices.

In the end, it was reading ScienceBasedMedicine.org that ultimately inspired me to quit. It became clear that science and sound logic beat out the vitalistic notions that underlie Traditional Chinese Medicine.

Like many in alternative medicine fields, I was mislead by well-meaning people who do not realize that the foundations of their practices are inconsistent with well-established scientific understandings of health, disease, and nature. We used acupuncture textbooks, for example, that confidently explain that examining the tongue is scientifically proven (whatever that means) to accurately diagnose health problems in other parts of the human body. I remember faithful professors talking about how scientific research was coming out to support acupuncture “all the time” and that Chinese herbal medicine was backed by modern pharmacology. Once I had a better understanding of research, I looked up many of those claims and found the science was simply not there. The research studies that we were taught had been of such low methodological quality that they could only feed into our preexisting beliefs. In many cases, the research simply never existed in the first place.

TCM-cupping

TCM is inside an echo chamber

I sometimes still catch myself hoping to find validity for acupuncture and TCM. I think it is indeed “hope” that drives people to alternative medicine. We want to believe that when scientific knowledge falls short, there is another way to gain control of our bodies. The desire for hope is so strong, that perfectly intelligent people can blind themselves beyond basic reason.

I’d like to think that the four years and tremendous effort that went into my education amounted to something more than the ability to legally sell people false-hope. Occasionally, I see some of my former classmates struggle with aspects of the cognitive dissonance that I experienced. They always seem to find a way to muddle through it by surrounding themselves with like-minded individuals who uncritically cheapen their scientific opponents. I’ve been inside this echo chamber, and I can say with great certainty that it’s full of special pleading and magical thinking, rather than any semblance of reality.

The feeling of being wrong is dreadful, but continuing to practice a faith-based system of medicine with indifference is terribly worse. I am hopeful that more people who are wrapped up in holistic health fields will begin questioning the validity of alternative practices. Better yet, I hope these people will open their minds to the possibility that they have been deceived.

Image credit: 2) JaySome rights reserved.
This entry was posted in Acupuncture, Anonymous Guest, Critical Thinking, Ethics, What's the harm?. Bookmark the permalink.
  • NS Alito

    The mental state after shaking off a sincere belief is intense disorientation little different than a feeling of madness. The lingering guilt for having been an active proponent doesn’t help, either. I sympathize.

  • Brent

    It’s the hope that TCM gives people (when all else fails) that drives people to acupuncture. It is what drove me to it. It is also what made my health worse.

  • wearylondoner

    Your comments that faith in dubious practices needs to be reinforced by being surrounded by believers shows how alternative medicine has some of the qualities of religious beliefs. Only exposure to people with other views and to scientific challenges to the system are likely to help believers to break away.

  • Adam Iannazzo

    Decompression cups work well on ITB syndrome but little else. You got one!

  • Thomas Mohr

    The problem with TCM is the scientific fallacy of appealing to tradition – because it is chinese it must be correct b/c ancient chinese are perceived as wise people. The problem, however, with any traditional medicine, be it chinese, european or out of the rain forests is observational bias and beliefs that are not based on reality. Statistically, even a random choice of therapies will lead to a certain percentage of success, even quite low. The percentage will be slightly better in research fraught with observational bias and even better in conditions where a success can be seen immediately. Overall, however, it will remain low. A recent study by Cravotto et al. (Cravotto G, Boffa L, Genzini L, Garella D (February 2010). “Phytotherapeutics: an evaluation of the potential of 1000 plants”. J Clin Pharm Ther 35 (1): 11–48.) demonstrates the problem very well. They reviewed evidence for 1000 medically used plants, of which only 156 have been subjected to clinical trials. Nine (that is less than 10%) have been found to display pharmaceutical effects strong enough to warrant further examination. 5 have been shown to be toxic and/or allergenic. There is no reason to believe that similar numbers don’t apply to other forms of traditional medicine including TCM. In conclusion, traditional knowledge has to be used with a very high level of scrutiny..

    • Lippy6

      If ancient Chinese tradition was such a good thing no girl would get past the age of seven or so without having her feet broken – and bound so that they stayed broken all her life. IMHO a culture that can practice this kind of brutality for 1,000 years isn’t a culture that we should look to for any kind of wisdom, let alone healing arts…

    • Harry Palm

      The funny thing is that acupuncture was actually banned in China for centuries because most people knew it didn’t work. It got unbanned by the Emperor 150 years ago and used as some form of traditional, national pride thing, but that Emperor didn’t even believe it worked.

      • JGC

        The acupuncture being promoted today–thin needles, inserted at meridian points–also bears no relationship to the traditional form of acupuncture used for centuries, when it was a form of bloodletting with lancets. The form it takes today was created following China’s cultural revolution, out of necessity due to an acute shortage of qualified physicians.

    • Avishek Saha

      The people I know who employ Chinese medicine (my school has a classical Chinese medicine program which is a bit different than TCM) don’t believe in it just because it appeals to tradition. That is one aspect but if the tradition was completely and utterly bogus I don’t know why in your right mind you would think anyone would continue with their education. As I said in my reply to someone else, what you are in essence are saying is that people who believe in TCM believe in complete bullshit. Everything they see clinically is a placebo effect. Absolutely everything. When patients who have not been helped by conventional medicine come to an experienced Chinese medicine doc and they find relief, it is a placebo effect.

      I would call that an opinion and a belief that is not based on evidence.

      • Thomas Mohr

        You don’t understand the logical fallacy of the argumentum ad traditionem. What I am saying is that just because something has been practiced for years does not mean that it works. The reason is manyfold, placebo effects, observational bias, belief systems etc. Therefore traditional knowledge has to be treated with extreme care, especially if it is derived from theories that do scientifically not hold water.

    • Avishek Saha

      The people I know who employ Chinese medicine (my school has a classical Chinese medicine program which is a bit different than TCM) don’t believe in it just because it appeals to tradition. That is one aspect but if the tradition was completely and utterly bogus I don’t know why in your right mind you would think anyone would continue with their education. As I said in my reply to someone else, what you are in essence are saying is that people who believe in TCM believe in complete bullshit. Everything they see clinically is a placebo effect. Absolutely everything. When patients who have not been helped by conventional medicine come to an experienced Chinese medicine doc and they find relief, it is a placebo effect.

      I would call that an opinion and a belief that is not based on evidence.

  • Dick Macgurn

    Right up there with faith healing. Placebo effect can only do so much.

  • David

    I still do not think the WHO has ever retracted their whole hearted support of acupuncture. Many acupuncturists quote the WHO overwhelming endorsement in their advertising.

    • mikerbiker

      Yes and there’s only one debunking of the WHO report online.

      The book Trick or Treatment also talked about it.

  • David

    I still do not think the WHO has ever retracted their whole hearted support of acupuncture. Many acupuncturists quote the WHO overwhelming endorsement in their advertising.

  • Travis

    Thank you for sharing your story.

  • mikerbiker

    Thank you for sharing your experience- I wonder how many other former alt med people there are out there- When I first started learning about alt med, I looked hard for them and only found a few former chiropractors.

  • https://uw.academia.edu/JakubZawi%C5%82aNied%C5%BAwiecki Jakub Zawiła-Niedźwiecki

    You did the right thing! Well done!

  • Marcel

    Artificially inflating the status of traditional Chinese medicine with capital letters is unwarranted and the same is true of ayurveda and ayurvedic medicine. Whereas Chinese traditional medicine is 1000s of years old, the construct of TCM is a relatively recent phenomenon created by the Communist Party of China to deliberately deprive the masses of more costly scientific medicine. Chinese pharmacologists are currently among the most vocal critics of the medicinal plants used in Chinese traditional medicine or TCM. What they have found is that the quality of the clinical trials conducted in China on Chinese traditional medicines in the past is so poor that they can’t be relied upon. They conclude that the only way to determine the efficacy and safety of numerous plants and plant-based formulas historically used in Chinese medicine is with well controlled clinical trials based on accurate diagnoses in place of the archaic ones of the past.

  • PrimaryCareDoc

    I spent over $6000 attending the Harvard Medical Acupuncture course. I mistakenly thought that Harvard would not associate itself with pseudoscience.

    I was wrong.

    Like Agent Mulder, I wanted to believe. I really did. But it was obvious that there was no substance to any of it.

  • BobHoltzman

    Good commentary. Of course I don’t know your personal situation, but it would be more meaningful if you could attach your name to it. Perhaps that would make you more vulnerable to lawsuits from former patients — don’t know. It would be an act of courage, but there are limits to what one can undertake. I expect you considered this already in your decision to make it anonymous.
    BTW: second-to-last paragraph; last line: should be “semblance OF reality.”

    • http://www.taylorhermes.com Taylor

      Thanks for pointing out the correction!

    • Anonymous Acupuncturist

      As you said, there are limits to what one can undertake. I am grateful to have had the opportunity to speak plainly and remain anonymous. If you would like to ask me questions, however, I am happy to answer here.

    • Anonymous Acupuncturist

      As you said, there are limits to what one can undertake. I am grateful to have had the opportunity to speak plainly and remain anonymous. If you would like to ask me questions, however, I am happy to answer here.

  • Jefe Mixtli

    I find it particularly galling when CAM supporters use the term “Western Medicine”.

    There is no such thing. The way medicine is practiced the western world has NO cultural component to it. It’s evidence-based.

    • http://www.taylorhermes.com Taylor

      I think you’d be surprised at the cultural context of science. It is a belief system, but one that is more reliable and consistent than any other in terms of reflecting reality.

      • Vic Nurcombe

        That is incorrect. Science does not rest on “beliefs” at all. What I “believe” has no bearing on material truth. Science rests on only two assumption…1. Any phenomena can be understood as an effect of the laws of nature. 2. The laws of nature are the same everywhere (i.e., not only are we in a special place, there are no special places).
        Certainly there is an extensive cultural context……some ideas gain favour for a while, some correct ones don’t. But in the end……Science self-corrects. If something proves to be an inadequate model for Nature….sooner or later it falls as inadequate.

        • http://www.taylorhermes.com Taylor

          Even scientists have to believe in the system of science in order for it to work. It’s a problem of phenomenology. We are flawed at perceiving our existence in nature, so we use scientific methodologies to understand our biases and limits. If we don’t see science as the best system we have for understanding reality, albeit still a flawed one, we are failing ourselves.

          • Vic Nurcombe

            But that way of arguing gets you nowhere….it’s its own solipsism. Science is not a belief system, it is a technique for determining the quality of an idea. Science is a tool, an instrument.

            When I need to nail two boards together, I think a hammer is a great tool. When I need to know how valid and reliable a piece of information is, I think science is the best tool.

            Is my confidence in the practical application of a hammer a belief system?

            “I believe in science” really means, “I believe science is the best tool for discerning truth (or as close as we can get to truth)”

            • JEM

              yes, but if you ask ten different scientists what science means to them, you get ten different answers. The EBM community contends that randomized trials with low levels of bias are the most desirable forms of evidence (and many will throw out anything but high quality RCTs); US physicians (typically less EBM focused) place a reasonable amount of evidence on biological mechanisms in addition to observational studies and RCTs, and biochemists often use methods that don’t apply blinding/randomization/ adequate sample size/etc (particularly when they do animal research. It is clear we all have beliefs we accept and reject depending on the type of evidence we value.
              I spent ten years as a prof at one of the most well-know research medical schools, the home of EBM. Having left there a few years ago to work in industry, I now see how dogmatic and uncomplex their interpretation of evidence was. I would no longer trust any clinical trial or analysis coming from that institution.

              • Vic Nurcombe

                I don’t think you’d get 10 different opinions at all…..I’ve been in Medicine and Science for over 40 years, and I think the agreement is pretty total…..confusion comes as to whether at the time you are using the word Science in an active sense, or whether you are referring to the body of knowledge that has accumulated as a result of the method. They are separable. I can’t think of any biochemists of repute, and I trained in Biochemistry, who don’t power their studies for statistical significance…..I presume you’re talking about PAGE, but I don’t know anybody who’d only ever run one gel and still maintain integrity. The EBM you are describing/biological mechanism divide you describe are not beliefs, they are ingrained habits. In the face of superior evidence, these sorts of things melt away in my experience. Superior data, allowing better hypothesis formation, and the better collation of past data is the final arbiter, at least in my experience. There is also no doubt that EBM is a bridge too far for most, mostly older, physicians, who keep insisting their “experience” trumps data. In some poorly researched areas, that can be true…..but as evidence accumulates, that’s less and less true. Look at how Warren and Marshall blew apart Zantac, and how much clinical “opinion” went straight down the toilet as soon as the superior evidence was acknowledged. Animal research is hard, because prevailing ethics is always trying to restrict animal numbers to an absolute minimum, and animals are complicated……it can certainly be a weakness. Molecular biology is helping us out, but animal trials, and I’ve done a LOT……are difficult. The trials are certainly better if you are not “expecting” a particular answer. I’m aware how many studies away from the lab bench can’t be replicated elsewhere……but then, that research tends to die right there, if the companies/labs have any integrity. Even if they don’t, the lack of reproducibility is usually, in my experience, a death knell. I’ve seen close how up nefarious trials run by multinationals keen to get an ROI……particularly spinal fusion and the “infuse” device…..read Carragee in “Spine”, for the famous case. Best one can do is to adhere to the highest possible standards, and not entertain data which don’t meet them.

                • JEM

                  Thank you Vic for your consideration and I’m sure we agree on far more than we can disagree with. Let me be clear that I am not an advocate for pseudoscience, etc., but I’m also quite sure that within the scientific community, many of us disagree with what translates as evidence.
                  As you point out, those at the more pre-clinical stage have their methods and these are often refuted at the clinical stage and even at the later post-marketing stage. Within the academic halls, we define science as at least being reproducible. But any statistician knows that chance alone can affect findings in important ways. I personally buy into well-done meta-analyses, but lets be honest, it is also reasonable for someone to not buy into meta-analyses when half-the trials are non-significant and then they magically become significant when we add enough of them.
                  I think my bigger issue, having left the standard EBM academic world, is that those folks may claim to be scientific, but they certainly don’t apply the most rigorous ways to evaluate things. I think there is a division within science of those who accept poorly conducted experiments versus those who don’t, and usually people don’t quite know where they sit in this division (I’d like to think I do, but that would be naive). I’d love to say I agree with the idea of applying the best standards, but the best standards are usually a consensus based on a very low common denominator (I say that having been involved with CONSORT and related standard setting).
                  One of the reasons I left academia and went into industry was because I felt academic science was deluded in its importance and was frequently arrogant about how it represented its importance. I personally feel the quality of science is much higher at biotechs than at academia or in the medical journals (because the stakes are much higher), but most of it never gets reported.

                  • Vic Nurcombe

                    I agree that we are in almost complete accord. I have also seen rigidities in the systems you describe, some of which are just the operations of simple human nature….territoriality, hierarchies…..you know the drill. And there is no doubt there has been an explosion in sloppy science, which is indeed a worry. Shrink research budgets, and the temptations to fraud increase. This doesn’t worry me as much as the sloppy science….if you go outright fraud, and the fraudulent data is trivial…..no one will read it….so most frauds are colossal…..but that causes many labs to try and replicate….lack of replication brings down the fraud. The shame being that precious time and money can be wasted. I concur with your comments about the problems with “confirmation bias”…..it’s a problem for everybody, always will be. I straddle academia (well, Singapore government research institute/University Hospital) and business (our spin-off going well)….we have several biotech partnerships…some of the research in industry is mindbogglingly good…..but industry keeps coming back to us in the Ris for new ideas and advice. I think the back-and-forth is good for both, as long as the excellence in the basic science is maintained. Some of the pressure in biotechs can be so extreme, that’s worrying…..have you read “The Antidote”? I know about the arrogance of which you speak…….ego maintenance stuff. It’s not that heard to discount….just hard to swallow!!!!!! All power to you.

          • JGC

            No, you don’t have to believe in the ‘system of science’ )I.e., the scientific method), you only need to employ it.
            You can believe to your heart’s content that supernatural entities and forces are constantly interacting with the natural world to affect outcomes, including those of scientific studies and experiments, but as long as you embrace methodological naturalism, use appropriate blinding and controls, etc., when conducting those studies and experiments you’ll produce reliable data and predictive and testable conclusions.

            • http://www.taylorhermes.com Taylor

              I am not saying that science is an ideology in order to denigrate the enterprise. Rather, it is important to understand that it is a cultural construction nonetheless, but it is one that is the best means of producing and organizing human knowledge. I suppose this makes it special compared other ideologies. I mean, we are pretty much on the same page, on the same planet, whereas the alt-med folk are on some distant icy and dark world.

              • JGC

                ” Rather, it is important to understand that it is a cultural construction nonetheless”
                To no greater extant than statistical analysis is a cultural construction: like statistics, the scientific method is simply a means to derive an accurate understanding of the natural universe and phenomena that are seen to occur within it.

              • JGC

                ” Rather, it is important to understand that it is a cultural construction nonetheless”
                To no greater extant than statistical analysis is a cultural construction: like statistics, the scientific method is simply a means to derive an accurate understanding of the natural universe and phenomena that are seen to occur within it.

                • http://www.taylorhermes.com Taylor

                  Yes, and if you spark a debate between frequentist and Bayesian statisticians, the cultural dependencies will be quite entertaining!

    • Avishek Saha

      No it is Western medicine, or more appropriately American medicine because medicine isn’t practiced in Germany or France the way it is here. Pharmacy students learn homeopathy and prescribe homeopathy in these Western nations.

      There is a cultural component to American medicine and that culture is a mix of crony capitalism and big business.

      • Marcel

        Crony capitalism is alive and well in homeopathy and the dietary supplement industry in any country you care to mention.

      • David

        Yes that is the ironic thing. Pharma in the US and Canada is now highly regulated with regards to their interactions with MDs. The days of old where they can wine and dine doctors is long gone. Nowadays a pharm rep can get in trouble buying an MD a coffee without there being a specified and recorded educational goal attached to the meeting.
        On the other hand! my friend who is a chinese medical doctor has full reign with the supplement and herbal medicine companies. He is being wined and dined by them like crazy and getting so many freebies in a completely unregulated fashion.
        So avishek do not try to pretend that homeopathy, supplements and herbal medicine are not huge business.
        Even worse Avishek…do you make a profit off selling your prescribed medications? because MD certainly do not.

        • Avishek Saha

          That’s definitely a good thing, as you can still look up which doctors are receiving which kickbacks very easily. It’s funny how you guys are sidestepping this issue. It’s a pretty big deal to me when my friend is prescribed some antipsychotic medication for a condition he doesn’t have because his doctor is the leading kickback receiver for that drug. It is despicable. And I’m sure there are some naturopaths that like to make money off of supplements (we all need to make money), but all of the naturopaths I know carry the medicines they carry because that’s how they want to treat their patients. We are taught to first do no harm (oh please shut up that you think we harm patients because we prescribe placebos, because then I will simply tell you that we do not prescribe placebos and we will not reach a resolution) so ethically I would think we are far superior to the average MD.

      • Anonymous Acupuncturist

        David is absolutely correct. Many herbal and supplement companies
        even advertise schemes to help practitioners get a bigger slice of
        financial pie when they sell their products.

        Crane Herb Company and MediHerb through Standard Process are two very good examples that are popular in the United States right now.

      • Xerxes Croes

        Really, because I lived in a Western European nation (Netherlands) – in fact, I grew up there, and my physicians regarded homeopathy as pseudoscience…

      • LouVeha

        This french commenter “loves” when homeopathy is presented as completely part of medicine in France. It is not part of the general cursus for doctors ; at best, you have to follow a “Diplôme universitaire”, which are in supplement of the general cursus.
        The fact that homeopathy is widely used is hardly surprising given that
        one the biggest homeopathy labs, Boiron, is french. However, the
        “Conseil national de l’ordre des médecins”, which regulates medical
        practice, has clearly stated recently that homeopathy’s efficacy is not
        proven. A pretty official non-endorsement.
        http://www.conseil-national.medecin.fr/sites/default/files/cn_webzine/2015-07/www/index.php#/page-4

        • Avishek Saha

          Why don’t you come up with an equally elegant argument for why this study found that when homeopathy is done PROPERLY (not given just to treat symptoms but the person’s constitution as that is what homeopathy is) it works? http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359147/

          I’m awaiting what the arguments will be. Here are some guesses:

          “Oh! It’s placebo! It must be because the placebo effect has been demonstrated scientifically and as usual I do not possess the ability to wrap my head around something that hasn’t really been studied yet!”

          “Homeopathy cannot work. It’s water. Therefore, even though it worked in this study it cannot work. It’s just water. Yea true, I guess I can’t wrap my head around it so I’ll just keep repeating myself.”

          “France’s council on medicine said homeopathy’s efficacy is not proven! Therefore it doesn’t work! Therefore I will not investigate this study or homeopathy because I know it doesn’t work! I know everything! CAM doesn’t work! It only works after there is published research because I cannot make sense of it when the data is not in a published format in a journal somewhere!!!”

          • LouVeha

            I will leave the commenters who were already discussing the studies to discuss it with you.

            My only point wasn’t an argument from authority from the CNOM ; but the fact that you present homeopathy as part of the french practice of medicine, as if we had an entirely different and exotic medical philosophy.

          • LouVeha

            I will leave the commenters who were already discussing the studies to discuss it with you.

            My only point wasn’t an argument from authority from the CNOM ; but the fact that you present homeopathy as part of the french practice of medicine, as if we had an entirely different and exotic medical philosophy.

  • no longer drinking the koolaid

    I closed my home birth midwifery practice because I could no longer believe the woo involved in the natural childbirth/home birth movement. It was also a long and twisted road extricating myself.
    I am much happier as a farmer, except for all the people who believe in non-GMO and organic. However, it is much easier to work around that than the people and ideas I dealt with as a midwife.

  • Charles Sublett

    Another tiny error: “well-established scientific understands” should be “understanding”. Great read, thank you!

  • Harry Palm

    “I am hopeful that more people who are wrapped up in holistic health
    fields will begin questioning the validity of alternative practices.
    Better yet, I hope these people will open their minds to the possibility
    that they have been deceived.”

    More likely, they’ll call you a corporate shill for Big Pharma and a closed-minded sheep even though they’re the ones with the closed minds.

    • Avishek Saha

      What about when these practices are accepted by researchers and the scientific community? Like yoga, meditation, diet, exercise, fiber, and probiotics?

      • JGC

        What about it?

        There’s a name for proposed treatments that have either not been shown to work or have been shown not to work (and both acupuncture and homeopathy fall into the latter category): alternative medicine.

        And there’s also a name for treatments that have been shown to work: medicine.

        • Avishek Saha

          Yes, homeopathy = medicine.

          • JGC

            Yes, homeopathy = [magic water that somehow only remembers all the good things that has been in and forgets everything else]
            FTFY

            • Thomas Mohr

              You would be astonished, but water actually HAS a memory that can be measured. However, compared to water, Alzheimer patients are giants in keeping information. Plus, you have to work darn fast, because water memory lasts 50 femtoseconds, that is 0.0000000000000050 seconds.

  • Avishek Saha

    Acupuncture is based on the belief that energy channels of various organs connect at points throughout the body. What’s interesting to me as a naturopathic medical student is that these points were used in Ayurveda as well. How did two independent systems of traditional medicine come up with such similar theories? What are the chances of that?
    As another thought experiment, consider the herbs used in the formulation of Ayahuasca, a hallucinogenic healing spirit medicine in the Amazon. The chances that they would be able to find the right plants to prevent vomiting by the hallucinogenic plant is extraordinarily small. This suggests they had some other way of figuring out which plants would work well together. In fact, they claim that they directly talk to the plants.
    Growing up in a science based culture and having a father who has a PhD in Organic Chemistry and is a skeptic himself, I am all for evidence-based. However, I believe evidence-based thinking isn’t intelligent in many respects, because it relies on science instead of doing science. I have read enough of sciencebasedmedicine to simply distrust the authors’ thought processes. I think the way they perceive reality directly prevents them from seeing it.
    Is there evidence that acupuncture works?
    Before that question is answered, “works” must be defined. So far, Western medicine (no I disagree that it’s a term that shouldn’t be used because it has a reputation of being overly reductionist compared to thinking holistically as in Eastern medicines) has decided to study acupuncture’s effect on pain.
    Well if you look at why acupuncture would be used for pain, you quickly realize how incomplete of a research question that is. Of course acupuncture works for pain, but people have different constitutions which are assessed by the practitioner. Each patient may need different points to be stimulated all of which may result in a reduction in pain via various mechanisms (for one person it may be balancing their spleen meridian, for another their liver–ignore the seemingly pseudoscience of that for now to focus on the main point).
    Certainly Western medicine can accept the fact that the same outcome can be reached in different patients with different mechanisms due to slightly different etiologies of whatever disease they have. Take diabetes. Not everyone with diabetes simply eats a poor diet and is overweight. Some people may need a simple stress reduction training. Other people may need to improve their sleep. Other people may need to change their diet. And other people may be completely unresponsive to that.
    This is what naturopathy is all about. The main point is: treat the patient, not the disease. By attempting to do so, we realize that for diseases with multifactorial etiologies, there may be something the patient is doing that could be fixed. This is VASTLY different from what happens at an appointment with an MD who would just look through some lab work and prescribe some drug he gets kickbacks from.
    The acupuncturist does the same thing. I’ve thoroughly enjoyed my visit with Chinese medicine doctors because they really look into emotional causes of diseases. The whole belief there is that diseases have a strong psychological component. THAT’S NOT PSEUDOSCIENCE.
    I feel like the average person reading a website like this simply wants to jump on a bandwagon and condemn all of natural medicine. Well, that’s idiotic and unscientific thing to do, because EVERYTHING I personally believe in is evidence-based. Where the evidence perhaps isn’t strong (homeopathy), it’s a matter of a difference in perception.
    Ultimately, there is the truth. And haughty people who think they are “evidence-based” think they know the truth–that acupuncture doesn’t work–but ultimately in my opinion, their train of thought is incomplete; obviously, as an article like this does nothing to disprove that acupuncture works. To me it just shows a weak-minded person who would rather be swayed by popular opinion than the thousands of years of texts and research on acupuncture. This person read Cochrane reviews to learn about acupuncture when a diligent student would read the Materia Medica and at least study thousands of different cases to decide if it works or not.

    • http://scienceornot.net/ Graham Coghill

      “…evidence-based thinking isn’t intelligent in many respects, because it relies on science instead of doing science”
      “I think the way they perceive reality directly prevents them from seeing it.”
      “Where the evidence perhaps isn’t strong (homeopathy), it’s a matter of a difference in perception.”

      I’m sorry, but these statements sound like pseudoscientific doublespeak to me, and the rest of the comment only goes to confirm my impression.

      • Avishek Saha

        Sounds like pseudoscience. Therefore it must be. Excellent logic!

        • R3d

          Coming from the guy that said “interview homeopaths to find out if homeopathy works”???!!!! ROFL Lets interview flat earthers to determine the shape of the planet, or interview holocaust deniers to find out if our WW2 history books are accurate.

    • Gone_Walkabout

      Your writing doesn’t make a sound case for your beliefs at all. You need to realise that you just want to believe in those alternative systems and are grasping straws to try to find anything that supports them.
      But you are starting with very flawed foundations. You say that what are the chances that Ayurvedan and Chinese systems came up with similar systems? Pretty high actually if you open history books! Indian and Chinese cultures have mutually influenced each other over thousands of years. Where do you think the Chinese got their Buddhism from? India!, go figure. It’s highly likely then that one of those cultures came up with the basis of the healing system and then the other one adopted it for themselves.
      You say that ‘everything you personally believe in is evidence-based’. Well you’re wrong because your understanding of what constitutes evidence is flawed. Is not what you think it is. You actually made that very clear immediately in the next sentence when you stated that it was ‘a matter of difference in perception’. Evidence is not subject to individual perceptions. Evidence is something that resist logical scrutiny. That’s the keyword, logical. Therefore something is either correct, plain wrong or lacking in enough evidence to make a judgement in absence of more solid data.
      Again, you’re also wrong about ‘western’ medicine not considering psychological influences on any disease. But a real doctor would realise that if you have clinical signs and symptoms plus laboratory work that indicate you are having a serious infection, then that the patient is unhappy with his/her marriage is not a priority and can be dealt with later. Just because you have met some doctors that are not completely thorough to advise you to also look into your marriage situation after you recover from the infection, that doesn’t invalidate the whole of ‘western’ medicine.
      You also lack a correct understanding of what research is. Research is not just doing a Google search. Neither it is reading with reverence anything just because is ‘thousands of years old’. If the person who wrote that in the first place in ancient times got it wrong, then you’re revering a ‘thousand years old’ blunder that may have been the best they had back then for their level of development. But it is not the case any more.
      Last one, how could the Amazonian find 2 plants that work together and cancel the emesis? Well that’s not any magical reason as you seem to believe. It’s exactly the same process that have followed every human population through History as well as any animal species on this planet: Trial-and-Error. Some die in the process, of course; but then the ones that survived learned the lesson and passed it on to their descendants.
      Finally, you mention that your father is a PhD in Organic Chemistry and, surprisingly for you, he remains a skeptic. Why do you think that is? Maybe because in Grad School he was trained to think logically to separate the wheat from the chaff? He has knowledge you don’t, is that simple. But there’s good news, you can learn it too! Just enrol in any real science based program.
      Hope you ‘listen’ what I explained here as it’s intended to be. For you to understand it, instead of just for replying to it. Because that’s the biggest communication problem in the world right now.
      Cheers.

      • Avishek Saha

        “Again, you’re also wrong about ‘western’ medicine not considering
        psychological influences on any disease. But a real doctor would realise
        that if you have clinical signs and symptoms plus laboratory work that
        indicate you are having a serious infection, then that the patient is
        unhappy with his/her marriage is not a priority and can be dealt with
        later. Just because you have met some doctors that are not completely
        thorough to advise you to also look into your marriage situation after
        you recover from the infection, that doesn’t invalidate the whole of
        ‘western’ medicine.”

        What are you talking about?

        I know you’re not inebriated or high (maybe you are), but you’ve basically described a dream that you conjured in your head where you seem to know exactly how I think based on my one comment and can predict how I will treat a patient.

        You’re human, and because you are, I’d like to point out that it’s human nature to perform behavior like this where you imagine situations that aren’t real but are very easy for you to tackle and feel like a total champ for doing so.

        But now that I am showing you reality, just realize you talked about a whole lotta nothing. I used diabetes as an example of a disease with multifactorial causes that lends well to the idea of treating root causes when feasible.

        As far as ayahuasca, I did not mean to imply that they figured it all out by talking to plants. That is simply a very interesting idea that you’d encounter from doing some research on shamans. And thank you I know what research is.

        • Gone_Walkabout

          What I wrote is a standard literary figure of paraphrasing your own arguments from before and presenting them in a new form, one that is less comfortable for you. You should know that. So if you didn’t understand it, I’d recommend to go back to school instead of assuming I need to get ‘high’ or inebriated to write. Maybe you will think I was under the allucinations of Ayahuasca? (Just in case you didn’t understand again, that was another literary figure known as ‘sarcasm’)
          Do you realise how conveniently you try to steer the conversation to a more complex disease like Diabetes that, as you said yourself, it ‘lends well to treating root causes’ i.e. that means that it lends well to make it favourable to your naturopathic argument, which you seem to believe real medicine doesn’t take into account. Only that medicine actually does. Just go to any hospital and ask for the Diabetes information sheets and make an appointment with a Diabetologist. Yes there are professionals that specialise in managing the myriad of effects of Diabetes in the body.
          I didn’t even mentioned the talking with the plants part. What I said is that there are no mathematical analysis involved of ‘very small chances’ to calculate because there’s a big elephant in the room that you decided to not see. That is Trial-and-error methodology. That’s how the world works very frequently. As I said before, some will die in the experiment and some will live to tell the story.
          And again, you don’t understand what Science, Research, Scientific method, and evidence is. Research is not just reading about something, Science is not just a body of knowledge, and the Scientific method is the best tool that Humanity has ever invented because it allows us to differentiate what may be an interesting finding from just background noise. If you want to believe that to understand naturopathy you have to measure it by its own invented subjective parameters instead of real objective parameters then you are asking to not be tested at all. Because by definition subjective is anything that depends on individual perception, which is variable (e.g is that flower blue or green? Ask that question to a colour-blind people and see how the answers compare!). On the contrary, objective data is immutable and amenable to be measured.
          Cheers.

    • mikerbiker

      Why do so many naturopaths believe in homeopathy when, as you seem to acknowledge, it doesn’t work?

      And I’ve read the cochrane reviews for acupuncture- they always conclude that the studies are weak and more research is needed.

      If we know that there are ineffective treatments that people will falsely believe are effective, how do we determine what is effective? See also this excellent video about fake medicine by Derren Brown. https://www.youtube.com/watch?v=hfDlfhHVvTY

      • Avishek Saha

        Homeopathy works undoubtedly. I simply said there isn’t much published evidence on it.

        • http://www.taylorhermes.com Taylor

          Have you read the numerous systematic reviews of the hundreds of studies on homeopathy? The conclusion is that it is no better than placebo. So why no just have your patient balance on one leg for 5 minutes every day?

          • Avishek Saha

            That would be a waste of time. Spend your time instead interviewing homeopaths to try to understand how it works and pick up some free classes if possible. Studies on homeopathy, like studies on acupuncture, fail to study the modality.

            Homeopathy is prescribed in two ways. One way is easy to understand: you look at the person’s symptoms and give them the corresponding remedy as it’s termed. These symptoms however differ vastly from what’s found in the Merck Manual or pathology textbooks. Many of the symptoms are emotional and highly subjective. This adds a nice psychological component to homeopathy. Things like being unable to procure tears despite immense grief, or coughing after sneezing, or having to uncover your feet from the bedsheets at night due to heat are some of the symptoms that homeopaths look it. This type of description also pertains to the patient very well and doesn’t require any type of objective testing. When the right remedy is chosen, the symptoms can disappear within minutes.

            The other way is constitutionally. This is based on the idea that people have constitutions or personalities essentially. The remedy must be matched to the constitution.

            Now have you read a systematic review or paper that uses homeopathy properly? Probably not because there are none, and that’s why homeopathy has never been studied by someone who knows homeopathy. Although I’d have to look at the research myself to confirm that statement.

            • R3d

              Because interviewing true believing homeopaths about whether their treatment works is a much better way of removing bias than meta-analyses. Of course, as confirmation bias is just something made up by big pharma and their paid shills right? Damn man, you sound like a complete loon going on like that.

              • Avishek Saha

                It’s not perfect, but it’s a step for the unbiased scientist who wants to investigate. Obviously, that’s not your gig. You’d rather go on without understanding what homeopathy is and how to even design a proper study to investigate it, or see why people think it works. That would be too difficult for you because you’d rather hold on to your belief system. Please stop deluding yourself into thinking you are scientific by any standard. At least some people here have asked me some intelligent questions. All done here.

              • Avishek Saha

                It’s not perfect, but it’s a step for the unbiased scientist who wants to investigate. Obviously, that’s not your gig. You’d rather go on without understanding what homeopathy is and how to even design a proper study to investigate it, or see why people think it works. That would be too difficult for you because you’d rather hold on to your belief system. Please stop deluding yourself into thinking you are scientific by any standard. At least some people here have asked me some intelligent questions. All done here.

        • JGC

          In other words “It works! I just know it works! I’ve seen it work! There just isn’t any evidence that it works I can show you….”

        • Aariq

          there is SOOOOO much published evidence. I posted this link before, but this is a review of reviews. 17 review articles, each of them reviewing many studies. The conclusion was that magic water doesn’t work any better than regular water.
          http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1874503/

      • Avishek Saha

        To answer your question, we determine what’s effective because it should work and be reproducible. Ineffective treatments that the patient believes work don’t magically work via the placebo effect. That type of rhetoric forms the belief system for which CAM naysayers adhere to and is ill-conceived.

    • http://www.taylorhermes.com Taylor

      Talking to plants? You know very well that’s not an adequate explanation to discover useful information about nature. Why don’t you just talk to your patients’ beta cells?

      Chances are Amazonians were able to figure out ayahuasca likely because they paid attention to what they consumed and the effects that ensued. This process is far more scientific than what you are proposing. You also seem to grossly misunderstand ayahuasca. A good recipe does not mediate the vomiting. The vomiting is actually desired. A good recipe is the correct amount of harmala-derived MAO inhibitors mixed with DMT. Do you know what happens otherwise?

      • Avishek Saha

        My instructor on a trip to Peru told us about how she talked to a plant while on ayahuasca and went out into the forest and found it. This plant had no medicinal value but for some reason was beckoning to her. I believe it.

        Yes they probably did pay attention to what they consumed and the effects that were consumed, as did chinese medicine doctors and ayurveda docs.

        You are correct and I forgot the details of ayahuasca. I didn’t have time to brush up before posting–the point is that the chances of them finding this combo are really really small when you do the math. I don’t have the exact numbers but I could find a calculation from a colleague who has done them. This simply illustrates that without science we are not fools as homo sapiens, and thus traditional medicinal systems deserve some credit for their discoveries.

        But you bring up a broader point which I made in my response to JGC. When researchers understand the occult, it is accepted as fact. When it is not understood, it is dismissed as pseudoscience. Ayahuasca should sound like a bunch of pseudoscience. They take some random vines and leaves and boil it in a pot for 8+ hours and then drink the tea as part of some healing ceremony under the Amazonian stars. Now that we know that the potent combo of plants with MAOis and DMT produce such an incredible experience, we can understand it. Naturopathic medical doctors may believe in therapies that have a dearth of published evidence. But just the amazonian shaman’s confidence in ayahuasca’s ability to make you trip (that’s not at all the purpose of ayahuasca it is not seen as a drug), naturopaths and herbalists confide in the ability of plant medicine to heal specific illnesses. Although there is a dearth of published evidence on many of these therapies, there is evidence. The same type of evidence that the shaman in the amazon uses to be the adept herbal medicine practitioner he is.

        As a true scientist, the experiences of herbalists and other practitioners must be investigated. It’s pretty ironic how some people who read quackwatch and sciencebasedmedicine are quick to claim that herbal medicine, acupuncture, homeopathy, and pretty much anything classified as CAM doesn’t work. Their dismissal is unscientific by all standards and these types of people simply don’t have the acumen to be doctors and usually aren’t.

        • R3d

          Please, I’m interested in the math. Please show me your calculations for the really small chance. Include all your assumptions, and I’ll show you how they are ridiculous.

        • http://www.taylorhermes.com Taylor

          No one is saying that medical interventions labeled as CAM don’t work a priori. The issue is that they have mostly all been examined and found to not work or to be too far outside the realm of plausibly working. Reiki and homeopathy are solid examples of systems that have been tested despite them being outside the realm of prior plausibility, and as shown, they are placebo. It is important for you to understand that tradition does not mean that something is good.

          On your point about the probability of figuring out ayahuasca. We have no idea how long this formulation took to develop, and it doesn’t strike me as that unusual for people to find interesting ways to manipulate their minds, bodies, and environments. Prehistoric people have developed many kinds of complex processes to augment their existence: psychedelics, metallurgy, food, agriculture, etc. These can all be understood in the context of empirical inquiry and scientific reason. The trick is figuring out when you are just fooling yourself.

        • David

          Nothing makes our blood boid more than when naturopaths, homeopaths and chiropractors call themselves scientists and that they practice evidence based medicine. Sorry sir you are far from “a true scientist”

        • Aariq

          I know this is getting very off-topic, but why do you assume Amazonians didn’t use the scientific method? You seem to think the only two possibilities for coming up with ayahuasca is 1) mix and match random plants until you get it right, or 2) ask the spirits.

      • Avishek Saha

        My instructor on a trip to Peru told us about how she talked to a plant while on ayahuasca and went out into the forest and found it. This plant had no medicinal value but for some reason was beckoning to her. I believe it.

        Yes they probably did pay attention to what they consumed and the effects that were consumed, as did chinese medicine doctors and ayurveda docs.

        You are correct and I forgot the details of ayahuasca. I didn’t have time to brush up before posting–the point is that the chances of them finding this combo are really really small when you do the math. I don’t have the exact numbers but I could find a calculation from a colleague who has done them. This simply illustrates that without science we are not fools as homo sapiens, and thus traditional medicinal systems deserve some credit for their discoveries.

        But you bring up a broader point which I made in my response to JGC. When researchers understand the occult, it is accepted as fact. When it is not understood, it is dismissed as pseudoscience. Ayahuasca should sound like a bunch of pseudoscience. They take some random vines and leaves and boil it in a pot for 8+ hours and then drink the tea as part of some healing ceremony under the Amazonian stars. Now that we know that the potent combo of plants with MAOis and DMT produce such an incredible experience, we can understand it. Naturopathic medical doctors may believe in therapies that have a dearth of published evidence. But just the amazonian shaman’s confidence in ayahuasca’s ability to make you trip (that’s not at all the purpose of ayahuasca it is not seen as a drug), naturopaths and herbalists confide in the ability of plant medicine to heal specific illnesses. Although there is a dearth of published evidence on many of these therapies, there is evidence. The same type of evidence that the shaman in the amazon uses to be the adept herbal medicine practitioner he is.

        As a true scientist, the experiences of herbalists and other practitioners must be investigated. It’s pretty ironic how some people who read quackwatch and sciencebasedmedicine are quick to claim that herbal medicine, acupuncture, homeopathy, and pretty much anything classified as CAM doesn’t work. Their dismissal is unscientific by all standards and these types of people simply don’t have the acumen to be doctors and usually aren’t.

    • JGC

      Avishek, I’m not interested in which beliefs acupuncture is based on: I’m interested in what evidence exists which demonstrates it’s more effective as a treatment for non-self-limiting injuries and illnesses than placebo or sham acupuncture treatments.

      “How did two independent systems of traditional medicine come up with such similar theories?”

      The insertion points for acupuncture are based on the human circulatory system–traditionally acupuncture was a form of bloodletting using lancets. It wasn’t until China’s cultural revolution that the thin needle acupuncture we’re now familiar with arose, at which time the meridian points were actually moved slightly so that they would no longer correspond to the circulatory system in order to reduce the likelihood of bleeding. I wouldn’t be surprised if the Ayurvedic points also arose as a function of our understanding of human circulatory system.

      “The chances that they would be able to find the right plants to prevent vomiting by the hallucinogenic plant is extraordinarily small.”

      How small? show your math–that is, if this is anything other than an argument from incredulity.

      Before that question is answered, “works” must be defined”

      No problem: produces clinically significant better outcomes as a treatment for non-self-limiting injuries and illnesses than placebo or sham acupuncture.

      “The main point is: treat the patient, not the disease.”

      This is hardly unique to naturopathy but is a core component of evidence based medicine–by what rational argument is prescribing antibiotics to a patient with an infection, or providing anti-inflammatories for a patient with RA, represent treating the disease rather than the patient?

      “This is VASTLY different from what happens at an appointment with an MD who would just look through some lab work and prescribe some drug he gets kickbacks from.”
      Ad hominem duly noted. What is your opinion on naturopaths profiting from the sales of the supplements and homeopathic remedies they prescribe for their patients (a common practice in that field)?

      • Avishek Saha

        After an acupuncture appt, the acupuncturist or chinese medicine doc evaluates outcomes which are not studied in Western medicine or in published research. You’d need to understand basic chinese medicine theory to comprehend what I’m speaking of, but they look at the pulse, abdomen, and forearm. They are looking at changes in the organ systems off which they based their rationale for which points they will use. A study of acupuncture that fails to recognize this is not studying acupuncture for what it is, and that basically is 100% of anything published in the US on acupuncture.

        When a treatment is prescribed with a conflict of interest, it’s potentially a bad thing. I believe this is much more prevalent among MDs. Thankfully, you can look them all up to see which drug companies they receive kickbacks from. Furthermore, if a naturopath prescribes a supplement, he/she is addressing a more root cause of the pathology unlike an MD who is trained to focus on specific symptoms. Although you are correct that in theory treating the patient rather than the disease is part of evidence based medicine, conventional docs don’t, and arguable cannot follow this advice for institutional reasons. If I have an acute infection and go to an MD, I will be prescribed some sort of useless NSAID. If I go to a naturopath, I will get echinacea most likely and maybe some natural cough syrups. The latter treatment does more good for the body.

        We could go through example after example but ultimately you’ll have to talk to more naturopaths to see how we think. You clearly have no idea, as you called what we do “naturopathy.”

        I do not learn naturopathy. I would argue that naturopathy isn’t even an entity. I learn medicine. I embrace what works and believe in treating the root cause when possible as do my peers. We happen to have some views that are different than MDs but it’s not pseudoscience. One of the big ones is that we do not believe in suppressing fevers in children because they resolve naturally. MDs however will prescribe tylenol. Pretty dangerous idea imo but I have yet to see this clinically. For now, i take their word for it.

        As far as acupuncture points, the whole idea is that there are electrical conductance points on the body that correspond with various organs. There are points for the gallbladder, liver, heart, small intestine, stomach, etc. In Ayurveda it’s the same–it’s believed to be an electrical thing. That’s another discussion I don’t have time for but if you are curious look into it. You probabaly won’t find much, but you may see that acupuncture does work after all when defined appropriately in the context of culturally relevant chinese medicine outcomes (such as exacerbation in qi among various meridian channels). If someone studied acupuncture’s effect on qi, heat, dampness, or any other variable practitioners seek to balance with treatment, and then showed there was no effect, they’d have a point. until then they’re not studying acupuncture. I’ve even discussed this with some researchers and it’s amazing how they never thought of this.

        Which brings me to your bottom line. When mechanisms that fit the biochemical basis of the human body are discovered for explaining the effects of diet, exercise, yoga, meditation, herbs, or any other CAM concept on any marker of disease, these therapies are readily accepted into the treatment toolbox of modern medicine. So you might want to acknowledge that there are several handfuls of ideas which naturopaths have preached for a while (how about fiber and probiotics) that are now gaining credence. Treatments with mechanisms that do NOT fit biochemistry or cellular physiology as we know it are simply shunned.

        If it were obvious like taking ayahuasca that something were happening, modern medicine would accept it. Homeopathy and acupuncture don’t work that obviously all the time (homeopathy does actually). But there are plenty of rational and sane people that see it working in front of their eyes and that is something that cannot be ignored or simply labeled as the placebo effect when reproduced. A clinician bases his or her philosophy on what he sees as well as published evidence. If he were to only rely on published evidence, he would be a sordidly incompetent doctor.

        • JGC

          Avishek, you do realize your entire first paragraph can bereduced to “there is no such evidence because acupuncturists don’t bother to systematically collect and evidence or attempt to evaluate efficacy”?

          “I embrace what works and believe in treating the root cause when possible as do my peers.”

          How do you distinguish between interventions that actually do work and interventions that only appear to work due to confounders like confirmation bias, placebo effects, regression to the mean, etc.?

          “Homeopathy and acupuncture don’t work that obviously all the time (homeopathy does actually)”

          Homeopathy never works–homeopathic remedies are simply water or whatever other vehicle is used to succuss the starting material. If you have evidence to the contrary, n the form of well designed, adequately blinded and sufficiently powered studies demonstrating that homeopathic treatments perform better than placebos as treatments for nonself limiting illnesses or injuries, I’b be very interested in considering it.

          “But there are plenty of rational and sane people that see it working in front of their eyes and that is something that cannot be ignored or simply labeled as the placebo effect when reproduced.”
          The plural of ‘anecdote’ is not ‘evidence’.

          • Avishek Saha

            That’s really the great debate. Anecdotes DO EQUAL evidence. Just not strong evidence. It’s the weakest evidence possible. When someone tells you they tried something and it worked, of course this needs to be further investigated. Now that’s a very different anecdote from a doctor who thoroughly examines the patient by performing the necessary physical exams, looking in the ear, eye, nose, throat, mouth, examining the lungs, heart, abdomen, genitals, etc, and then taking further labs if necessary, and seeing a CHANGE after a treatment. That’s what doctors do. And those are still anecdotes, but they are certainly much more credible than what someone subjectively has to say about a treatment because their memories may have jumbled up information. This is common sense, but I am explaining it to you because you’ve clearly lost that sense. Many turning points in medicine have been made from these “anecdotes” (like DES). Once published this anecdotes turn into case studies. But they are just observations at the end of the day.

            Therefore I argue that a plural of anecdotes should certainly count for something. This hasn’t been measured and I’m not sure why people think that thousands of anecdotes for homeopathy, even carefully controlled single blind studies (as are done for all homeopathic treatments in what are called ‘provings’) should count for nothing. It just goes to show that these people aren’t skeptics, they just choose to hold onto their viewpoint more than the rigor and unbiasedness required for performing honest science.

            From a philosophical standpoint, has any research been done to show that having multiple anecdotes with quantifiable variables doesn’t count as evidence because it fails to approximate the truth?

            Obviously, this isn’t necessary so of course not. It’s also impossible to study because it assumes a singular truth which may be debatable for whatever is being studied.

            When you don’t have published research to work off of, you will try to form the most logical conclusion possible from observations, case reports, case studies, and the work of your colleagues. That’s what doctors do. That’s what TCM doctors did. That’s what shamans in South America likely did. That’s what Ayurveda doctors did. And obviously, they came up with some things that worked. Please go ask a clinician how they make decisions. Ask them if they think they aren’t being evidence based when they decide to go off of what they’ve seen in practice.

            How do you distinguish between interventions that actually do work and interventions that only appear to work due to confounders?

            By measuring baseline and post-treatment outcomes specific for the predicted effects of that treatment. With homeopathy, treatments have very specific effects that are unique to the treatment. If the wrong treatment is prescribed, or if the patient starts taking random homeopathic supplements because they started to see it work and want more, the patient’s condition will likely regress and the symptoms produced by whatever they’re taking may manifest. Often homeopathy does do absolutely nothing…that’s when the remedy doesn’t match the patient’s symptom state.

            With acupuncture, the same thing. Specific points have specific effects. With herbs, you could look at more objective outcomes I suppose, but then you’d certainly run into the placebo question and double blind trials are necessary imo. However, as I said, people have figured out a lot about herbs without modern scientific methods. They feel different when ingested, so that’s how you know. Sure the placebo effect is an important point but few people seem to talk about how there are millions of different placebo effects, each for various mechanisms in our physiology. If herbs and CAM simply worked via the placebo effect, you wouldn’t expect the diverse qualitative aspects of non-conventional modalities. For example, I said herbs feel different. This is a qualitative thing. I feel it in my stomach. That’s qualitative. Breathing is easier. Etc. Qualitative research sits on the bench in scientific discussion but this would help people see that treatments have many effects on us apart from primary outcomes. For drugs it’s called side effects. One problem with this is that the effects would vary and it’d be tough to understand what to make of it. However, some herbs have affinities for certain organs, like Osha for the lungs.

            Surely you will admit that people have figured out a lot in the CAM world without published evidence. And maybe you’ll realize that no one is immune to making claims before there is sufficient evidence, as drug companies do this all the time.

            Homeopathy definitely works. If you simply want to believe it doesn’t, go ahead. I’m afraid you are simply missing the truth. I’m sure you’d agree that you want to find the truth. And I’m sure you’d agree, since it’s quite reasonable, that the singular objective truth cannot always be explained by the published available evidence, for reasons including lack of plausible mechanism resulting in faulty methodology, lack of interest, and lack of ability to generate adequate sample size (much of CAM is highly individualized). There is an overwhelming amount of evidence that homeopathy works.

            Cows with mastitis can be treated with homeopathy successfully. Mastitis is a side effect of antibiotics (which the cows don’t need anyway). There is no placebo there. Look around and you’ll find some great documentaries on youtube. Sure, it’s not published evidence. It’s just tapping into your common sense which you have deep down. Cheers, I’m all done here.

            • JGC

              “Anecdotes DO EQUAL evidence”

              A couple simple questions, to which I’d appreciate a yes or no answer:

              Do you consider the anecdotal accounts by people who believe they’ve been abducted by aliens represents evidence that extraterrestrial flying faster than light saucer-shaped vehicles are systematically abducting US and European citizens and conducting medical examinations upon them (all of which seem to include sigmoidoscopy of some sort)?

              Do you consider that the anecdotal accounts from individuals claiming to have been victims of or to having witnessed the physical and sexual abuse of children and adults by Satanists constitutes evidence that Satanists were in fact kidnapping, abusing and sacrificing infants on a large scale in the 1980’s?

              Do you consider the anecdotal accounts offered by a large number of parents who are absolutely convinced their children developed autism as a consequence of routine childhood vaccination to be evidence demonstrating the existence of a causal association between vaccines and ASD’s?

              if the answer to any of these is “No’, could you explain exactly how you pick and choose which bodies of anecdotal accounts constitute evidence, and which do not?

              “When someone tells you they tried something and it worked, of course this needs to be further investigated.”

              Because after all, maybe wearing my lucky team jersey inside out on game day really does improve the performance of the NFL team I root for.

              “When you don’t have published research to work off of, you will try to form the most logical conclusion possible from observations, case reports, case studies, and the work of your colleagues.”
              With respect to acupuncture, however, recall that we do have published research to work off of, which includes a large number of well designed, appropriately blinded and properly controlled trials all of which indicate acupuncture is nothing more than a theatrical placebo.

              “Cows with mastitis can be treated with homeopathy successfully.”
              Citations needed.

              • Avishek Saha

                Your questions are disrespectful. I’d answer the same as you. What I’d like you to see is that different anecdotes carry different weight. THIS HAS NEVER BEEN QUANTIFIED. NOT ALL “ANECDOTES” ARE THE SAME!

                That is obvious.

                When a homeopath talks to a patient for 45 minutes and comes up with a constitutional prescription for the patient and it resolves every diverse symptom the patient had, it’s not simply a wide-acting placebo nor is it the same caliber of anecdotes as people who believe they’ve been abducted be aliens. This is because for whatever remedy was prescribed, a countless number of other homeopaths have prescribed the same remedy in the same situation. That is called reproducibility. I hold steadfast that homeopathy has followed the rigor of the scientific method.

                I cannot fathom how hundreds of people around the world, all homeopathy experts who see results in their practice, would be deluded. I cannot fathom how the books that they use (they are called repertories and they list suggested remedies for each symptom the patient may have–these are really different symptoms than the type found in the Merck Manual. They include things like losing thoughts, babbling, being startled easily to noise or music, basically they speak the patient’s language, yea I know it sounds like pseudoscience but if it works then that needs to be investigated rather than dismissed due to a lack of biological plasubility) which are as big as the Merck Manual are made up of just fluff.

                How is it possible to come up with VOLUMES of pure bullshit? I don’t know. But that is what you are all saying about homeopathy or acupuncture, or Ayurveda, or Chinese Medicine. That for thousands of years people simply made stuff up.

                Well they did. So some of that might be true I’ll give you that. But just maybe it can work. This brings back the point I made to someone else. You all like to cite the lack of published evidence as the reason why these treatments cannot work (pretty much any CAM treatment it seems which is obviously false). But you do not seem to investigate very deeply how patients may see these practitioners and be rid of their symptoms when conventional medicine doesn’t work. Hell there are many patients for which nothing works until they receive the right homeopathic remedy.

                Most naturopaths don’t practice true homeopathy but that is another discussion. They use it more for symptoms rather than doing a full homeopathic intake and then prescribing a constitutional remedy. Anyway, the point is, skeptics like to say that it is ALWAYS the placebo effect. Yet they have no evidence to show that. It’s just the plausibility based off the research.

                And that is not the correct way to be evidence-based. It is not correct to say that the tree did not make a sound in the forest because no one was there to record it. But that is essentially what the argument boils down to.

                If you saw the types of things we see with homeopathy, I doubt you’d be as skeptical.

                • JGC

                  Respect is earned, Avishek,, and while you u may find my questions uncomfortable to address I fail to see how they’re disrespectful.

                  “What I’d like you to see is that different anecdotes carry different weight.”

                  I understand that you want me to accept the validity of this claim, which is why I provided the examples I did and asked you to explain how exactly how you pick and choose which bodies of anecdotal accounts constitute evidence, and which do not–i.e., how can one distinguish which anecdotes should ‘carry more weight’ from those that should not.

                  By what rational argument is a homeopath’s anecdotes “not of the same caliber” as someone relating an alien abduction?

                  “This is because for whatever remedy was prescribed, a countless number of other homeopaths have prescribed the same remedy in the same situation.”

                  Just as there are “countless” other abductees who will have described abductions with similar or identical features. You’re not helping yourself here.

                  “I hold steadfast that homeopathy has followed the rigor of the scientific method.”

                  And you’re wrong when you do so.

                  “I cannot fathom how hundreds of people around the world, all homeopathy experts who see results in their practice, would be deluded.”

                  Logical fallacy alone: your argument from incredulity is noted.

                  “I know it sounds like pseudoscience but if it works then that needs to be investigated rather than dismissed due to a lack of biological plasubility)”

                  But it has been investigated, Avishek–extensively–and those investigations have demonstrated that homeopathy does not generate outcomes that are distinguishable from placebo treatments. Furthermore, they demonstrate that the observations of apparent efficacy homeopath’s claim are a function of confounders such as confirmation bias, regression to the mean, etc.

                  “How is it possible to come up with VOLUMES of pure bullshit?”

                  All that’s necessary is that those authoring those volumes believe their own bullshit, much as you admitted in another post regarding demonstrating qi exists “it’s not really necessary in my point of view because I believe it works and research is not requisite to show that something works”

                  “But just maybe it can work.”

                  In which case it should be possible to demonstrate it works. We do so for all other medical interventions–indeed, establishing efficacy is a requirement before FDA approval of a new drug entity or medical device. Why should CAM treatments be held to a lesser standard of evidence?

                  “You all like to cite the lack of published evidence as the reason why these treatments cannot work (pretty much any CAM treatment it seems which is obviously false).”

                  Not only the lack of published evidence suggesting they work but also the much larger bodies of evidence demonstrating they don’t work

                  “Hell there are many patients for which nothing works until they receive the right homeopathic remedy.”

                  But we don’t know that, do we? we know only that some patients claimed symptomatic relief after receiving homeopathic interventions. We don’t know the intervention is the cause of their relief–the claim it was is just logical fallacy again (post hoc ergo propter hoc).

                  “Yet they have no evidence to show that.”

                  Other than all those inconvenient properly blinded and controlled studies that demonstrate results generated by homeopathy and placebos are indistinguishable, you mean.

                  “If you saw the types of things we see with homeopathy, I doubt you’d be as skeptical.”

                  I’d be just as skeptical or more so. Recall Richard Feynman’s warning:
                  Science is a way of trying not to fool yourself. The first principle is that you must not fool yourself, and you are the easiest person to fool.

                • Thomas Mohr

                  “How is it possible to come up with VOLUMES of pure bullshit? I don’t
                  know. But that is what you are all saying about homeopathy or
                  acupuncture, or Ayurveda, or Chinese Medicine. That for thousands of
                  years people simply made stuff up.”

                  With regard to homeopathy this is very simple. During their drug trials homeopaths record every little irrelevancy. The art of science is to discern the relevant from noise, which is not done in the repetitories. If you tos of bullshit and write it down you get volumes of bullshit. BTW, my favorite symptom was that one could not stand the babbling of his mother in law who constantly lost the thread of the stories she told. The second one was that one had to gasp after drinking beer too fast. These are symptoms out of homeopathic repetitories.

            • David

              You are ignoring time! you are ignoring the natural waxing and waning of chronic disease. You may give acupuncture for example an arthritic patient, and the next time they come in by all your parameters they are doing better and by all your “objective” measures they are doing better. However, is this due to your acupuncture or would they have improved anyways!!!
              This is the whole point of scientific studies that can tease this out and can definitely be applied to homeopathy and acupuncture. It is a complete cop out to try and pretend that these modalities can not be tested in this manner.

              • Avishek Saha

                No I’m not. I’m well aware of that. However, when patients have had chronic conditions for a long time, and have visited every type of practitioner, and them something magically works, calling that a placebo isn’t based on any sound reasoning. Why wasn’t anything else they tried a placebo? And why does this happen all the time to the doctors I learn from and admire? Maybe because what they’re doing actually works. Just maybe.

        • Marcel

          “Furthermore, if a naturopath prescribes a supplement, he/she is
          addressing a more root cause of the pathology unlike an MD who is
          trained to focus on specific symptoms.” That is one of the greatest fallacies ever propagated by the naturopathic community. Take homeopathy. What did Hahnemann base his treatments on? Symptoms produced by the substances in undiluted form; not the underlying cause of a disease.

          “If it were obvious like taking ayahuasca that something were happening, modern medicine would accept it.” Any treatment would take a lot more than the obvious effects of ayahuasca in order to be validated as effective against a given disease or condition. When the the basis for the psychotropic effects of ayahuasca were determined, the scientist who performed the work didn’t announce that the medical practices of shaman who use the plant mixture were valid or effective. I would know because I was there when it happened.

    • Anonymous Acupuncturist

      I am the Acupuncturist from this post. I was very hesitant about getting involved in the comments, but this particular one enticed me. Perhaps it is because your wording and logic reminds me a bit of myself when I was just starting out as a TCM student.

      First, I am going to address one of your comments. Your criticism of me reading Cochrane Reviews instead of re-reading the Materia Medica and studying thousands of cases tells me that you do not know what the Cochrane Collaboration and Materia Medica are. The Cochrane Collaboration is an independent and non-profit organization that conducts systematic reviews of randomized controlled trials. When you read a Chocrane review, you are reading an analysis of dozens of studies with hundreds, sometimes even thousands, of patient participants. Second, the Materia Medica is a guide to traditional Chinese herbalism. Unless I am mistaken, this conversation is about Acupuncture. If you must knock my integrity as a former student, do try to pick a textbook that is relevant.

      I think many people in alternative medicine embrace something that could be called “optimistic relativism”. They are attracted to the idea that truth and reality are perception-based and malleable. That there are simple solutions to complicated problems, such as illness and physical debilitation and that these simple solutions have already been discovered and utilized by people who came before us.

      When you talk about thinking holistically, people with diabetes simply getting better with stress reduction, and shamans talking to plants, I can’t help but think that you are using this belief system. Optimism is a coping mechanism, and it is comforting to think that there is still some magic tucked away in the corners of this planet that can rescue us from the ridged confines of “reductionist thinking”. As a personal philosophy, I do no think there is a problem with optimistic relativism. When it is used to usurp authority over scientific rationale, however, it creates real-world problems.

      Take for example studies that show that patients who get CAM for cancer die sooner and have more complications than patients who stick with mainstream medicine:
      http://www.ncbi.nlm.nih.gov/pubmed/12565991
      http://www.ncbi.nlm.nih.gov/pubmed/21225354
      http://www.ncbi.nlm.nih.gov/pubmed/22734852

      To address your earlier statement, I do not think a diligent student is one who strictly adheres to the texts on their subject. A diligent student is one who thinks critically and searches for evidenced-based answers, even if they contradict their personal beliefs.

      • Avishek Saha

        I am nothing like you were when you were a student, because I am very aware of the role belief systems play in our lives and actively work on not having them. I’m not the type of person who believes hyped-up claims you can find on the internet. I’d say the same for most of my peers.

        I simply believe acupuncture works and citing Cochrane is a ridiculous way to go about saying it does not work. You should have studied the theory of classical and traditional chinese medicine and evaluated it within that context, because that context is completely removed in the “scientific” (in quotes because it’s much less scientific than chinese medicine) study of acupuncture.

        These are the types of questions I’d be asking if I were studying acupuncture.
        1. When I stimulate the points of organ X in a patient with a deficiency of qi, or some other variable (that can be measured via pulse, tongue, forearm, or abdomen examination), can changes be observed on examinations post treatment?
        2. Does consistent acupuncture treatment cause emotional change in the patient that correlates the specified organ system from where the dysfunction arose? Can these emotional changes be tracked with changes on physical examination (including tongue and pulse).
        3. For less specific treatments, can I measure changes in the patient specific to that point? For example if I stimulate point X and expect result Y, will I achieve that result even if the patient isn’t aware of the effect stimulation of point X should have?

        Now THOSE are some real specific in depth questions that create a framework from which any point or organ system/pathology could be studied. Why is this such a big deal? Because it’s these imbalances that are ultimately believed to cause a disease that one may find in the Merck manual, such as ulcerative colitis, or some type of cancer. The etiologies for these diseases may involves different organ systems in different people. As you may know there are constitutions–earth, fire, water, etc. The way they manifest the same disease is different. As far as I know, the most specific acupuncture trials operated on the flawed belief that certain points are good for certain diseases.

        As you can see, that’s a joke. Perhaps diligent isn’t the right word. I’ll take that back. You are simply born into an era where people are taught to think a certain way and extremely complex theories like chinese medicine are very difficult to understand and study in a research setting.

        This is in contrast to your idea that many alternative practitioners think that there are simple solutions to complex illnesses. I have the belief that what we do is more complicated and intelligent than the cookie-cutter medicine that people who follow this blog may espouse. Of course, modern medicine isn’t cookie cutter all the time. MDs do acknowledge that diseases can be caused in many ways but when we become too reliant on “evidence” (because relying on expensive drug trials as your evidence doesn’t make you a very scientific thinker) we can become very cookie cutter because we will simply ignore treatments without enough evidence that may have a long use…like acupuncture.

        • R3d

          After reading your two comments, I have no choice but to believe that you flat out have no idea what that word ‘science’ you use so often actually means. You mind has seemingly been filled with so many pseudoscientific buzzwords and concepts that I think your probably beyond saving. What a shame, as you may have been otherwise capable of intelligent thought.

          • Vic Nurcombe

            Couldn’t agree more….your co-respondent seems to have very little idea of what Science actually is. And how it seeks to rise ABOVE “perceptions” and “beliefs”, to actual reality. As a working scientists I REALLY object to the idea that this magical “qi” is some sort of “energy”. If qi is an energy….show me where exactly on the electromagnetic spectrum its wavelength can be measured. Is it infra-red, or ultraviolet? If it’s an energy, it can be measured. If you can’t measure it objectively, you have no right to call it an “energy”. Call it by its real name…..magic. We tested several acupuncturists against each other in Melbourne many years ago……they couldn’t even come up with consistent reinforcing diagnoses, let alone treatments….they were all different. Even when we spiked the test with patients suffering from well defined conditions, easily identified by real doctors….liver cancer, bulbar palsy, psoriasis….not any of the 10 “practitioners” came close to identifying the real pathology.
            One wonders why the TCM fraternity don’t keep accurate statistics on how often they are right, and how often they are wrong, and plotted progress, improved health, against time.
            I suspect its because they can’t.

            • Avishek Saha

              It’s mechanism has already been investigated. A distinction should be made between people who say there is no available research and people who simply aren’t interested in finding research on the subject because they purposely choose to be ignorant or hold onto their point of view, like people who read this blog and sciencebasedmedicine, and fall for the type of bogus on quackwatch.

              Please read Dr. O’Becker’s “The Body Electric.” Then, get back to me on some type of studies that should be done to investigate the possible electromagnetic mechanisms of acupuncture. If you guys had some respect for science you’d be thinking about these types of questions instead of holding onto the false belief that there is no evidence.

              You are right though that research has shown that there is variability in the diagnoses and treatments among acupuncturists. I don’t know how it works in AUS but in the US there are various levels of acupuncture credentialing. I work with people who train at the highest level and require the most hours of practice. They have to learn proper diagnosis as far as I know. And in the clinic, you would expect to see similar treatments and diagnoses based on TCM’s physiological view of the body.

              • Vic Nurcombe

                You do understand you talk something approaching gobbledegook? I’m a Professor of Medicine, with a BSc+Honours in Physiology, an MSc in Medical Statistics, a PhD in Medical Biochemistry. I have over 160 peer-reviewed papers in medical research. Therapies I’ve developed have passed double-blinded, placebo-controlled, multi-centre trails (the toughest, and only true trials in medical science) and are currently in patients now. After 40 years in both labs and hospitals, I can’t understand a word you are saying. You seem to have no conception of even basic physiology, anatomy or biochemistry. There are NO “electromagnetic mechanisms of acupuncture”…..in even asserting there are, you have revealed that you don’t even know what the electromagnetic spectrum is……which is rather startling ignorance. Why do “sham” needles in “acupuncture” work even better the real needles? Cochran notes this effect has been seen in 37 separate, carefully controlled trials. It demonstrates that acupuncture is pure placebo. In other words, it worked no better than chewing on a Mars Bar. It isn’t reproducible medicine……placebo is induced just by being in a therapeutic situation. Exhaustive testing conducted by the University Of Shanghai has shown the ridiculous levels of variability, both diagnosis and remedy, by practitioners, both easter and western. The Dean pointed out to me that acupuncture was invented by Chairman Mao in the 1940s-50s to cover up the fact the Communists had no way to deliver effective health care to a huge population, because they had no money.
                Where exactly are all these anatomical “channels” for the magical “qi” to flow? I’ve been looking down microscopes for decades, and I’ve yet to see a “channel” fill of “qi”. Where are they? Show me a micrograph? Indicate a measurement to me, with error limits, which shows “qi” flowing ANYWHERE. How is it measured? Of what does it consist? if this “therapy” has been around for “thousands of years”……demonstrate the channels to me. Tell me how I can measure the “energy” too. I used to run a Dept of Anatomy, I’ve done autopsies……I’ve seen channels of lymph….I’ve seen nerves….I’ve seen blood vessels…..I’ve seen ligaments, tendons, sinusoids……where are the channels of qi???????

                • Avishek Saha

                  I speak calmly, without bias, unlike you. Judging by how quickly you respond and how quick you are to verbally attempt to insult my posts (which doesn’t do anything for science but show that you are closed minded), you are clearly coming from an emotional place and are likely unfit to have a rational discussion.

                  That’s great you have those degrees, but you do not possess the acumen I would expect of a researcher. I take that back. I do expect you to behave this way because you are simply human.

                  Now please, go back to my comment and re-read what I wrote. Perhaps take a deep breath. Science has shown that it works. I simply said it is a possible mechanism. The author of this work was a Columbia trained doctor who regrew bone in salamanders using microcurrent. Some chiropractors and physical therapists use microcurrent today. He wrote in the book that acupuncture may work in a similar fashion. Don’t remember the other details.

                  And yes I agree with the variability. That’s a problem. Here at school however we don’t seem to have that. It would be an interesting study but the docs and residents come up with similar diagnoses without talking to each other.

                  What do you mean where are the channels? Why do they have to be visible under a microscope? They are not in the epidermis that’s for sure. Don’t ask me, ask some acupuncture experts and investigate it thoroughly which you haven’t done!

                  Sham does NOT work better than placebo. Furthermore there is variability in how sham is done. Next, as i’ve said in my response to anonymous acupuncturist’s comment, acupuncture isn’t studied in it’s traditional context. I proposed several research questions that would do acupuncture justice in how it’s studied. The way they view disease is non-Western. If it works in that system, it must be studied. And as I’ve asked other people to do, why don’t you propose a good research design for an acupuncture/homeopathy study? Well probably because you have absolutely no idea what you’re talking about when it comes to understanding how they work, due to a desire to refute that it works rather than seriously investigate the subject like the scientist you clearly are.

                  • Vic Nurcombe

                    Insult? Really? “but you do not possess the acumen I would expect of a researcher”. And that, of course, is not an insult. I smile at the irony. Microcurrents and salamanders have everything to do with the developing nervous system, and potassium and calcium currents. The mechanisms have been demonstrated, and are no longer remarkable. They are not therapeutically useful. They have NOTHING to do with your “qi” energy. “He wrote in the book that acupuncture may work in a similar fashion”. This is not convincing. I’m simply asking for some simple explanations. If this “qi” has been around for thousands of years…….why hasn’t its “essence” been throughly explored, thoroughly explained? Unlike you, I have ACTUALLY tested the acupuncture effect…..or rather, lack of effect. The chinese themselves have dropped acupuncture astonishingly quickly, as western anaesthetics have become available. Unlike you, I have actually done quite a bit of study in this area, so that, unlike you, I actually have some idea of what I’m talking about. Sham works better than placebo, and the studies prove it…..as you have little working knowledge of the human body, here is a simple discussion, with references attached….http://scienceblogs.com/insolence/2008/04/03/sham-acupuncture-is-better-than-true-acu/
                    You say “The way they view disease is non-Western”….is more nonsense. Medicine is medicine. Something works in a double-blind trial or it doesn’t. It doesn’t matter what modality….it passes, or it fails. IF TCM actually worked…..then explain the catastrophic health statistics of China. Why in 5000 years of Chinese civilisation did the average life expectancy not improve AT ALL? We have had scientific medicine in the West for about 150 years….and in that time life expectancy has almost TRIPLED. How could that be, if “traditional” medicine actually worked? Part of the reason is that in 5000 years, astonishingly, the Chinese NEVER twigged to the idea that there were micro-organisms…..they adhered to imported ancient greek ideas, via India, of “earth”, “wind”, “fire” and “water”……a catastrophe. Dysentery and cholera are not caused by an excess of “wind”, or unbalancing of “qi”….they are caused by bacteria and amoeba. TCM is so backward, they actually think that off they kill an (increasingly rare) tiger….and boil its bones….and drink it….that they will become more like a tiger. This is the tradition you are trying to defend.
                    Homeopathy has never….NEVER….passed a proper clinical trial. EVER. And it has been subjected to 100s of trials. The fact that if homeopathic principles were actually correct, then instantly ALL chemistry and physics are completely wrong……is neither here, nor there. Except that chemistry and physics isn’t wrong. They consistently predict actual events. Water has a “memory”?? I rather think not.
                    Assessed here….https://www.sciencebasedmedicine.org/homeopathy-failing-randomized-controlled-trials-since-1835/
                    I notice you refuse to answer the question……where are these qi channels? Why have I never seen them? How can I measure qi too? Where do I aim my microscope? I’ve asked over 30 acupuncture “masters”, and not one has been able to show me one. How can anyone say there are channels…….but not to be able to demonstrate them?
                    Unless of course….they didn’t actually exist.
                    You seem to think I’m angry……I’m decidedly not. But I am addicted to evidence. So show me, so that I can learn, test, and verify. Otherwise……its just gobbledegook.

                  • Vic Nurcombe

                    “I speak calmly, without bias, unlike you”. That you could even make that statement was the biggest smile of my day. So….you have no biases, eh? You’d be the first human in the history of existence who didn’t then!!

                  • JGC

                    Citations needed.Science has shown that it works.”
                    Citations needed.

                  • David

                    homeopathy study would be easy to study in your context.
                    Randomize distilled water as control versus homeopathic treatments in a blinded fashion and see what your conclusions are with regards to effect. Obviously this is not an ideal study because we would like harder outcome measures. I can pretty well guarantee you will not be able to tell who got placebo versus treatment and that is a good enough study for me.

                  • David

                    homeopathy study would be easy to study in your context.
                    Randomize distilled water as control versus homeopathic treatments in a blinded fashion and see what your conclusions are with regards to effect. Obviously this is not an ideal study because we would like harder outcome measures. I can pretty well guarantee you will not be able to tell who got placebo versus treatment and that is a good enough study for me.

              • Vic Nurcombe

                You do understand you talk something approaching gobbledegook? I’m a Professor of Medicine, with a BSc+Honours in Physiology, an MSc in Medical Statistics, a PhD in Medical Biochemistry. I have over 160 peer-reviewed papers in medical research. Therapies I’ve developed have passed double-blinded, placebo-controlled, multi-centre trails (the toughest, and only true trials in medical science) and are currently in patients now. After 40 years in both labs and hospitals, I can’t understand a word you are saying. You seem to have no conception of even basic physiology, anatomy or biochemistry. There are NO “electromagnetic mechanisms of acupuncture”…..in even asserting there are, you have revealed that you don’t even know what the electromagnetic spectrum is……which is rather startling ignorance. Why do “sham” needles in “acupuncture” work even better the real needles? Cochran notes this effect has been seen in 37 separate, carefully controlled trials. It demonstrates that acupuncture is pure placebo. In other words, it worked no better than chewing on a Mars Bar. It isn’t reproducible medicine……placebo is induced just by being in a therapeutic situation. Exhaustive testing conducted by the University Of Shanghai has shown the ridiculous levels of variability, both diagnosis and remedy, by practitioners, both easter and western. The Dean pointed out to me that acupuncture was invented by Chairman Mao in the 1940s-50s to cover up the fact the Communists had no way to deliver effective health care to a huge population, because they had no money.
                Where exactly are all these anatomical “channels” for the magical “qi” to flow? I’ve been looking down microscopes for decades, and I’ve yet to see a “channel” fill of “qi”. Where are they? Show me a micrograph? Indicate a measurement to me, with error limits, which shows “qi” flowing ANYWHERE. How is it measured? Of what does it consist? if this “therapy” has been around for “thousands of years”……demonstrate the channels to me. Tell me how I can measure the “energy” too. I used to run a Dept of Anatomy, I’ve done autopsies……I’ve seen channels of lymph….I’ve seen nerves….I’ve seen blood vessels…..I’ve seen ligaments, tendons, sinusoids……where are the channels of qi???????

              • JGC

                “Please read Dr. O’Becker’s “The Body Electric.”
                I’ll happily read anything Dr. O’Becker has published in first or second tier peer-reviewed scientific journals–that is after all the forum in which working scientist publish their results and defend the conclusions they derive from them. Can you suggest any such articles that might support your claims regarding acupuncture (hopefully one’s published more recently than 1985)?

          • Avishek Saha

            Looks like my analysis was a bit too complex for your level of comprehension? Like I have hinted…this is complex stuff and due diligence is required for a serious study of it. In response to your other comments, just re-read the comment you are replying to in order to get a better idea of how homeopathy and acupuncture should be studied in a scientific setting.

            If you had any useful thoughts maybe you’d share a legitimate study design for acupuncture, as I did. Instead you got nada. Pc

            • R3d

              What on earth are you going on about? I never said I didn’t comprehend your analysis, I said you clearly don’t understand the meaning of many of the words you use in your so called ‘analysis’ (which is itself hilarious), the example being science. If you think interviewing homeopaths about how homeopathy works, in order to gain an understanding of the (purported) mechanisms underpinning homeopathy is better science than that carried out by Cochrane et al., then you clearly don’t understand the careful, systematic processes by which all scientists go about studying their field.

              It is evident from your comments that a school that teaches you naturopathy and ayurvedia is not the best place to be learning about science. This conversation with you is kind of like arguing with a petulant pre-teen about what it means to be an adult. You can sort of see the rough outlines, and you think therefore you know something about it, but in fact you lack any sort of meaningful understanding.

              • Avishek Saha

                It doesn’t matter what you say, because you don’t know what you are talking about. If you understood the complex analysis, you’d probably ask questions. You are just ignoring it because you don’t understand that speak. I don’t blame you, it’s complex, but you must investigate it if you want to find out if/how it works. Also my school doesn’t teach naturopathy or ayurveda. I do not study naturopathy. I study medicine and take research classes for my masters to accompany my doctorate. Please refer to my reply to JGC to get a better understanding of what you think is “science.” Homeopathy DOES work, and I didn’t say it is science. It is science in the fact that it is logical. It certainly isn’t the narrow-minded large sample size depersonalized medical science that you seem to be enamored by. Again, why don’t you attempt to understand homeopathy, and then come up with a valid research design?

                Because you haven’t looked into it, which is why you didn’t comprehend my robust rebuttal of anonymous dropout acupuncurist’s empty post. I want to help you understand but this is my last comment to you because you clearly aren’t taking the time to digest what I have to say. Pc.

                • R3d

                  Look, you seem to have a problem making simple things more complex then they need to be, so you can then sound really smart insisting that only you have a sufficient understanding of the complexity needed to properly understand it. It’s actually really simple. Homeopathy can’t possibly work, as it violates fundamental principles of chemistry and physics. There are no more molecules of active substance in a ‘100c’ (10E100 fold dilution). 1 mole of a substance contains around 10E23 molecules. If there are no molecules left, then how can it work? water memory? This would entail water retaining a memory of every single solute that it has ever dissolved, millions of years ago. Where / how is this information stored / encoded? Why is there no evidence of such a profound effect? Why can’t it be isolated and studied? A much, much, muuuuuuuch simpler explanation, that is consistent with all the observable phenomena, is that homeopathy doesn’t work.

                  • Gone_Walkabout

                    And let us all be grateful that that water selectively decided to forget those times it were down a toilet or even was in a diarrhoeic Dinosaur! ^_^

                • http://www.taylorhermes.com Taylor

                  I thought you were a student of “naturopathic medicine” at NCNM. Is this not correct? Based on what you have been talking about here, you are not being taught medicine. You are being taught doublespeak and fairy tales.

                • Aariq

                  Actually, homeopathy doesn’t work and a LOT of people have studied it. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1874503/

                  “Similarly, there was no homeopathic remedy that was demonstrated to yield clinical effects that are convincingly different from placebo”

                • Thomas Mohr

                  Avishek, in natural science there are two types of hypotheses. Those that can be used to describe the environment because they work and those that can not be used to describe the environment b/c they do NOT work. Homeopathy belongs to the latter. Being logical does NOT suffice.

                • Thomas Mohr

                  Avishek, in natural science there are two types of hypotheses. Those that can be used to describe the environment because they work and those that can not be used to describe the environment b/c they do NOT work. Homeopathy belongs to the latter. Being logical does NOT suffice.

            • http://www.taylorhermes.com Taylor

              The only way to reliably evaluate any medical intervention is to do a double-blind, placebo controlled trial. Many of these have been done for acupuncture, but I don’t have confidence that you can design one for us.

        • ali monk

          I am a

        • ali monk

          Apologies- I had trouble posting my previous post.

          I’m a medical student (in Canada). I have a few random thoughts to share, if you’d be so kind as to read them.

          We do not get kickbacks from drug companies, and neither do our preceptors. We study evidence-based health, including psychosocial aspects of health care, every single day.

          We incorporate systems such as recommending meditation, yoga, etc. for our patients. I regularly tell many of my patients that much of the modern medicine we have was originally from plants. Sometimes, chemists come into the mix and make plant medicines safer to use.

          We don’t talk poorly about CAM practitioners to our patients. I will not recommend something like homeopathy because yes, it can be harmful when someone thinks they are taking a remedy for a condition that truly needs medication. It also hurts the wallets of my most vulnerable patients.

          I would ask that you do the same for us. It hurts all of our patients when you tell them that we get kickbacks from drug companies when we don’t, or that we are not critically reviewing evidence on the medications we prescribe (I’m presenting evidence for/against TPA for stroke tomorrow in class). We look at NNT, ORs, sensitivity and specificity of all the available evidence. When a drug company does have a new medicine, we critically review it. Maybe it will be different when we are a few years in parctice but many of us are critical thinkers open to changing our views and even my preceptors have listened when I’ve been critical of medications.

          There are simply amazing medical technologies coming up all the time. Monoclonal antibody-based drugs are new-ish and they are actually revolutionizing the way we treat many diseases such as arthritis and cancer. You will not have access to prescribe these unless you become an MD (and even then you might not), but you need to make sure you know when to refer your patients to an MD.

          Lastly, it might be different in the US (I’m assuming that’s where you are) but your patient population will NOT be the same as mine. You will likely have patients who, when you tell them that herbs, yoga, and acupuncture can help with their diabetes, will enthusiastically incorporate those modalities because they can afford it and they have the social supports to incorporate them. I’m the one who has to work with a single mom on income assistance to manage her diabetes. “Go to yoga classes” cannot be implemented in all cases. If I do family med I may very well teach mindfulness techniques but even those are not sustainable for many.

          Thanks for your attention.

          • Anonymous Acupuncturist

            Well said, thank you for your insight!

        • Joshua Gustin Grant

          There is no “believing” that something works. It works with a testable percentage and level of efficacy beyond placebo or it doesn’t.

          • Avishek Saha

            I know. Homeopathy works. Acupuncture works. Outcomes: reduction in symptoms and whatever the patient came in for. Homeopathy is miraculous.

            • Lawrence McNamara

              No, it doesn’t & it is only “miraculous” because there is no way that it could work, without violating numerous physical laws.

        • JGC

          “When I stimulate the points of organ X in a patient with a deficiency of qi, or some other variable (that can be measured via pulse, tongue, forearm, or abdomen examination), can changes be observed on examinations post treatment?”

          You’ve done less than half the work here, Avishek: where’s the blinding, and where are your controls?

          The question isn’t whether changes can be observed on examinations post treatment by the person who knows they administered the treatment, but whether any changes observed post treatment are significantly different from changes observed in patients who think they have received treatments by someone who does not know whether or not the patient actually received treatment.

          BTW, can you describe how one can objectively and reliably measure someone’s amount of qi to determine whether or not they are deficient, what the normal range of circulating qi in adults is, and indicate what units qi is expressed in (foot-candles per newton squared, perhaps)?

          • Avishek Saha

            Have you heard of a pilot study? You are stating the obvious.

            I don’t know how to measure qi objectively. I’d love to know. We should find out. But no one is interested because people have opinions that are a bit too strong. Furthermore, it’s not really necessary in my point of view because I believe it works and research is not requisite to show that something works. That is a fact.

            I kick a tree and some bark scrapes off…no research required to see the immediate cause and effect. Surely with acupuncture and homeopathy it’s not that straightforward, but a careful process of observation, hypothesis formation, testing, and reproducibility of this testing has taken place for numerous “CAM” treatments including botanicals, homeopathy, and acupuncture. Maybe I’ll design a trial like this someday, but I like emphasizing to people to realize that it really isn’t necessary: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359147/

            And as you all know, you can’t rely on evidence all the time. It is illogical. Sometimes the drug an oncologist might want to prescribe because it may work better for a patient has less evidence behind it. He/she is using his clinical expertise in that situation. Acupuncturists and homeopaths, and many naturopaths rely more extensively on this type of clinical experience, which trumps using published available evidence in many situations.

            What you guys won’t realize and won’t accept is that there is plenty of evidence for homeopathy and acupuncture. it’s all anecdotes. Until it’s published like this: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359147/. But really it’s the same exact thing from my view. This is an epistemological issue that we won’t agree on.

            • JGC

              Yes , I’ve heard of pilot studies. Are you claiming to be conducting one? If so, can you describe its methodology, the
              criteria for subject enrollment, how many subjects you have calculated you’ll need to enroll in order for the study to be powered sufficiently to generate statistically significant results?

              You admit you don’t know how to measure qi objectively but do at least you know how to objectivity detect it? You assert it’s a form of energy so surely there must be instruments that can detect it just as there are devices that can detect other forms of energy (EMF meters, for example).

              “Furthermore, it’s not really necessary in my point of view
              because I believe it works and research is not requisite to show that something works.”

              So your point of view is that superstitious belief is enough?

              “Surely with acupuncture and homeopathy it’s not that
              straightforward, but a careful process of observation, hypothesis formation, testing, and reproducibility of this testing has taken place for numerous “CAM” treatments including botanicals, homeopathy, and acupuncture.”

              And what has that process demonstrated? Pharmacognosy–the identification of active compounds from natural sources such as plants–is of great utility but neither homeopathy
              nor acupuncture can be shown to produce better outcomes than placebo controls.

              “And as you all know, you can’t rely on evidence all the
              time. It is illogical.”

              What do you suggest we rely on instead of evidence—the fact it would be really, really cool if some unlikely idea worked?

              “Sometimes the drug an oncologist might want to prescribe
              because it may work better for a patient has less evidence behind it.”
              In which case–if he really is a qualified oncologist–he will either not prescribe it and stick to standard of care or he will prescribe it in combination with standard of care therapy in the context of an IRB approved clinical study. He won’t simply abandon use of the treatments that have more evidence behind it to instead provide a treatment which either has little or no evidence suggesting efficacy or (to mirror the evidence
              supporting acupuncture and homeopathy) has a lot of evidence behind which demonstrates it does not work.

              “What you guys won’t realize and won’t accept is that there
              is plenty of evidence for homeopathy and acupuncture. it’s all [something that isn’t evidence].”
              FTFY

            • Thomas Mohr

              Avishek, apparently you do not know what natural science is and how it works. Example: “I kick a tree and some bark scrapes off…no research required”. This statement is wrong. Every one of us has done this research, but does not remember is b/c usually this is done at the age of 3 or 4. The basic principle, impact -> damage is actually a core subject in material science. Quote: “And as you all know, you can’t rely on evidence all the time”. Wrong. Evidence is the *only* thing you can rely on and that goes that far that even intuition is based on evidence. Do you know how intuition in science works ? It is being confronted with data to the point that they enter the subconciousness from which they reemerge as intutions.

        • Anonymous Acupuncturist

          Avishek, before I dig into your response, there is something I can’t help but find both interesting and ironic about this continued conversation. Although you are very
          thorough with your responses, your arguments typically come down to one of two arguments:

          “Acupuncture and Homeopathy are just too complex to understand
          from a scientific perspective”

          and

          “Research that contradicts me is irrelevant because it is “close
          minded”, unlike me”.

          The reason why I find this ironic is because you are a student.
          You are not a naturopath, a homeopath, an acupuncturist, or a
          doctor, yet here you are on a post by someone with an extensive history in acupuncture on a blog site by someone with an extensive history in naturopathy arguing with people with extensive backgrounds in bio-medical research among other things, and yet you are trying to tell us how
          complex and difficult to understand your arguments are.

          I can tell you with confidence, acupuncture is not a “deeply
          complex system that is difficult to understand”. It may seem
          complicated to you because you are a student and your knowledge is not yet very extensive. Seeming complex, however, does not make something non-falsifiable. The same goes for homeopathy. There is a distinct difference between being “open minded” and being willfully ignorant of scientific consensus.

        • Anonymous Acupuncturist

          Now I see you have brought up the classics. Much better than the Matria Medicina! Good for you. I do not take my comment back about the Matria Medicina being irrelevant to the conversation because the conversation is, again, about acupuncture. Whether herbal medicine is used in junction with acupuncture or not is irrelevant because it is herbalism. Not acupuncture. I am sure you understand the distinction. Also, I could not help but be amused by your comment “so it may not be required reading, but you’d get an idea of how things are prescribed constitutionally as acupuncture when it is done right”. Does having studied the entire text front to back
          several times count as “getting an idea of how things are
          prescribed”? You can argue with me about the scientific validity
          of my field, but please don’t try to tell me the contents of my own education. It makes you sound very arrogant and deluded.

          Now, lets move onto your questions. I think JGC already made a good point about the flaws of the rationale used, but I’ll still
          answer.

          1. Observable changes are not so straightforward. You may be
          treating a patient for presumed “qi deficiency”, but you are
          also having that patient lay quietly and relax. As you can suspect, regardless of what points you use, the patient’s blood pressure may go down, causing their pulse to feel different, and they may fall asleep. Many patients will report feeling relaxed and rejuvenated after a treatment. Is that because of the acupuncture or because of the rest? This is why scientific validation is important.

          2. In short, no. The diagnostic system is very intricate in
          TCM, as you like pointing out, and takes into account a lot of
          variables including pulse, face color, tongue color, sweat, urine
          consistency, and so on. What’s interesting about these things,
          however, is that the interpretation can vary very much from
          practitioner to practitioner. For one acupuncturist, a tongue may
          seem red, to another it may seem to have a purplish hue. For one acupuncturist a pulse may feel “wiry”, to another “thin”. A
          patient can be seeing several master practitioners for a course of several months, and they still may not agree what condition they were suffering from in the first place. Likewise, a patient can continue to see one practitioner who will interpret their symptoms as improving while the condition stays the same, or interpret the condition as getting much worse when it is actually getting better. This can be explained by simple human error and bias. It’s a flawed system.

          3. Certainly no. In fact, the opposite is quite
          possible. If you put a needle somewhere irreverent that is not an acupuncture point and tell the patient that they will
          experience a specific effect, there is a good chance that they will. There are studies that confirm this, and I personally witnessed it myself. I would link you to these studies if you are interested, but I suspect you would not bother reading them.

          Though you are incorrect about many of the statements you have made regarding tcm and research, you are correct about the basic concept behind TCM. It’s goal is to look at the body as a larger system and correct imbalances in the system so that the body heals itself. It’s a wonderful concept, in fact it was part of what drew me to TCM in the first place. The only problem, however, is it is just a concept. The practice falls short of its goal.

          Also your claim that acupuncture trials are only done by using a
          specific set of points for a specific disease is inaccurate. In the
          literal thousands of trials that have been conducted for acupuncture, there are trials that use tcm diagnostics, trials that use specific points, and trials that use points that are not traditional at all. The research still continues to disappoint.

        • Vic Nurcombe

          If nothing else, our intrepid correspondent has stimulated me to look at some “ancient” chinese texts…..not that they are easy to follow. I have serious doubts that simply looking at tongues, and feeling pulses, tells you a huge amount. But in wading through, and looking at the responses of TCM “experts”, I came across this illuminating discussion between practitioners…between Subhuti Dharmananda (Director, Institute for Traditional Medicine, Portland, Oregon) and an inquisitor…..he writes…..”The changing setting in which Chinese medicine is practiced in modern versus ancient times, especially with the advent of advanced technological medical diagnostics, has raised questions as to the value of pulse diagnosis. Should its use be limited to confirming a diagnosis reached by other means? Or, does the pulse information add critical information that can greatly alter the treatment strategy? Training in pulse diagnosis is often quite limited; further, the requisites for carrying out a traditional style diagnosis are sometimes absent from the clinical setting, making the results of the pulse taking less certain. How does one get the desired information under such circumstances?
          Several years ago, an acupuncturist in the U.S. wrote to me saying: “I’ve been practicing for over twenty-five years now and have a busy practice; but, I’m totally disheartened about my abilities. The biggest difficulties are diagnostic. I graduated school as one of the best students in my class, yet neither I nor any of my classmates had any clear sense of tongue or pulse diagnosis. I’ve gone to endless seminars over the decades, but theory isn’t doing it for me. All the theory is useless if you’re unsure of your diagnosis. What I need is an experienced practitioner to work with who can and will tell me if what I’m seeing on the tongue and feeling in the pulse is correct. Otherwise, I feel as if I’m fantasizing all the time. Is that what Chinese medicine is all about?”……..he replies…….”This practitioner has recognized something that many others, who feel more confident despite limited training, may ignore: there is a great potential to simply “fantasize” the diagnostic signs, that is, to read into it something that is not really present.”
          So, a KOP in his field, TCM, is discussing the large amount of diagnostic fantasising that characterises his field. Which is what I observed when we ran double-blind trials on acupuncturists in Melbourne……that amongst 5 “experts” there was absolutely no consensus as to either diagnosis or appropriate treatment.
          This has placebo written all over it. And may I wish anybody who chooses to read the Huangdi Neijing of the Han dynasty for “enlightenment”, the best of luck. I attempted to read this, and had a native chinese speaker reading the original for comparison. a sample…..”A yin pulse that shows no stomach qi is called the pulse of zhenzang [decaying pulse] and the prognosis is usually death. Why? Because a yin pulse reflects absence of yang and thus absence of life activity. If you can distinguish the presence or absence of the stomach pulse, you can know where the disease is located and give the prognosis for life or death, and even know when death might occur….When yang pulses are absent in a patient, the yin or the decaying pulse of the liver is like a thin thread on the verge of breaking, or like a tightly wound wire about to snap. The patient will die within eighteen days. If the decaying pulse of the heart is like a thin fragile thread, the patient will surely die within nine days. If this pulse is found in the lung pulse, the patient will not survive longer than twelve days. If it is found in the kidney pulse, the patient will die in seven days. If it is found in the spleen pulse, the patient will die in four days.”
          No mention of statistics anywhere!!!!

      • Xerxes Croes

        “I think many people in alternative medicine embrace something that could be called “optimistic relativism”.” – You’re being too kind, I think most people like Avishek Saha suffer from Contrived Enlightenment – To me, he is like Sarah Palin, just spouting gibberish, and word salads….

  • David Grant

    I am glad that the author has exposed the pseudoscience beyond acupuncture and other forms of CAM. Part of me wants to believe the claims of these disciplines, but the rational side of brain simply will not let me accept it. While people love to criticize science-based or Western medicine, there is not a single person when they become ill won’t visit a CAM practitioner. They all get remedies based on science based medicine. The simple truth is that while we can do a lot to take better care of ourselves, the fact is that sometimes do need pharmaceutical drugs and surgery to deal with illnesses and other things affect our health. I think another reason that because these traditions originated outside of the West, then it must be good. Not every cultural tradition or practice should be accepted. I think we need to become a bit more discerning in this regard.

    • knotfreak

      Whenever I hear “ancient chinese practice…”, I ask the person if he or she is also considering foot binding.

  • Rob Legroulx

    Actually acupuncture I believe works and If not that what then? nothing else Is usually the better treatment than If anything I even seen In local paper that they did a study on this and found It had some benefits. I can’t believe what I’m seeing on this site coming from my experience myself yet MD’s always continue to fail us with chemo or other big pharma drugs that only mange the cause and not fix the problem. So If not ND’s who then will help us? since after all It was the rockefellers that made MD’s king.

    • JGC

      ” yet MD’s always continue to fail us with chemo or other big pharma drugs that only mange the cause and not fix the problem.”
      Yup–that’s why 5 year survival statistics for testicular cancers, lymphomas, leukemias, etc. are all unchanged from the 1950’s.

      Oh, wait…

      Well, it’s why statin drugs doen’t actualy lower high cholesterol, they only manage the symptoms of having high cholesterol.

      Oh, wait again…

      Well, antibiotics don’t actually eliminate bacterial infections, right? They do? What about antifungals? Those too?

      Hmmm…

    • PrimaryCareDoc

      Huh. That’s weird. Not one hour ago I saw a patient who, 10 years ago, was hospitalized with acute myelolastic leukemia. She was about an inch from death. She got chemo and a stem cell transplant, and is alive and well today.

      I wonder how that happened?

    • mikerbiker

      If only there was some sort of method to determine whether your beliefs reflect reality.

    • mikerbiker

      If only there was some sort of method to determine whether your beliefs reflect reality. Here’s a good lesson from Ms. Frizzle.

    • http://stephenmeansme.blogspot.com/ StephenMeansMe

      > since after all It was the rockefellers that made MD’s king.

      Gotta love the “nefarious globalists” conspiracy theorizing.

    • Vic Nurcombe

      You say….”MD’s always continue to fail us with chemo or other big pharma drugs that only mange the cause and not fix the problem”. This is badly thought out indeed. True medicine doesn’t pretend to be perfect…..but it has made spectacular and steady progress over the last 150 years, to the extent that, almost miraculously, the life expectancy of a person in advanced countries has almost TRIPLED. Thousands of years of “traditional/alternative/complementary medicine did NOTHING for life expectancy……suggesting strongly that it just doesn’t work. The life expectancy in China, for example, didn’t change for 5000 years……not until they got antibiotics, anaesthetics and all the other advances of Western medicine. How could that be? Your somewhat incoherent sentence “MDs always continue to fail us….” is simply nonsense. The latest attack on the cancers through the immunotherapeutic manipulation of T cells is yet another example of spectacular progress for some of the worst cancers that we know. More than 90% of kids with leukaemia will escape death, whereas it was 100% morbidity just 20 years ago. “Big pharma drugs”……I suspect you know very little about pharmaceutical history. Pharma, which absolutely has problems associated with it, has actually given us……penicillin (and I note that complementary medicine, for 5000 years didn’t even twig to the essential idea that there were microbes, for heaven’s sake!!!!……backwardness and superstition and “tradition”), insulin, smallpox and polio vaccines, ether and the other anaesthetics, morphine, aspirin, salvarsan, the essential antipsychotics, birth control, a series of cardiac drugs, L-dopa, the steroids, the antimalarials, cyclosporine, the HIV drugs, heparin…….and on, and on, and on……you can look up the lists at WHO. Total lives saved/extended/improved???? Verifiable, recorded billions and billions. Give me one major change to world medicine, at this sort of scale, given by homeopathy? acupuncture? chiropractic? reflexology? “herbs”? drinking the blood of snakes? rubbing your “chakra” points? It’s just embarrassing. Personally, I think CAM is a failed set of modalities, and in 40 years of scientific medicine, they have not impacted on me even one whit. Which is strange, because if something ACTUALLY works – and I don’t care what that is…..I’ll want to test it, because it might help people.

  • Nube

    I’m tying to understand why this page if filled with hate and pain. It just demonstrate the lack of love for yourself and others. I clearly can see and understand that in Naturopathic Medicine and TCM the the spectrum is not just black and white, it include many colors. I’ve seen many positive outcomes in both modalities. I’ve also seen many cases where patients did not received the appropriate care, in the same way that many MD’s have made terrible mistakes. My point is that all this professions have a specific role to play in this broken health system. Is sad that many people here are very wounded and are broken but instead of just painting all their life with darkness and blaming a profession for the unhappiness and emptiness that you feel, you should just try to find a way to heal. And if we go deep to the principles of both professions the power is in using food as medicine (Gu Qi in Chinese Medicine), the sun, water, air and love. Here is where the NDs/LAc can really shine because we all know that MD’s usually don’t have the time to support the patient to address the main cause of a problem or to support them through life style changes.

    Dr.Britt Hermes and followers I really hope that you all understand the negativity that you all are putting in the world by not appreciating or seeing both sides of the coin, because many people is also alive because an ND,LAc existed to offer the right treatment.
    May the goodness in you can overcome the darkness.

    • http://www.taylorhermes.com Taylor

      many people is also alive because an ND,LAc existed to offer the right treatment.

      I don’t think so.

    • JGC

      “I’ve seen many positive outcomes in both modalities.”

      Were the positive outcomes you observed resulting from naturopathy due to interventions unique to naturopathy, or were they due to treatments that are integral parts of evidence based medicine–diet, exercise, nutrition, lifestyle counseling, etc.? Always helps to remember the adage “What is good about naturopathy isn’t different and what is different about naturopathy isn’t good”.

      “And if we go deep to the principles of both professions the power is in using food as medicine (Gu Qi in Chinese Medicine), the sun, water, air and love.”

      The evidence demonstrating that the naturopathic treatments that use food as medicine, the sun, water, etc., are actually effective as treatments for non-self-limiting illnesses and injuries can be found where, Nube?

      “Here is where the NDs/LAc can really shine because we all know that MD’s usually don’t have the time to support the patient to address the main cause of a problem or to support them through life style changes.”

      Which is an argument that we change the way in which medical care is delivered by MD’s so that medical practices can remain financially viable while dedicating more time to fewer patients, and not an argument in support of naturopathy’s efficacy–agreed?

      • Shawn Morris

        “or were they due to treatments that are integral parts of evidence based medicine–diet, exercise, nutrition, lifestyle counseling, etc”
        These modalities, plus botanical medicine, are what NDs practice. There is evidence base for many therapies within these modalities and NDs are the ones who will implement gentler modalities in a safe, routine way. The reality is that MDs do not often use nutrition, botanicals, and lifestyle interventions, even though many believe they work. They are too busy, they wish they had more time, but they do not.

        “Which is an argument that we change the way in which medical care is delivered by MD’s so that medical practices can remain financially viable while dedicating more time to fewer patients, and not an argument in support of naturopathy’s efficacy–agreed?” Clearly, the medical care of MDs should change to allow longer patient visits, as many MDs desire, and this would be a great and difficult long term health care goal. It also does speak to naturopathic medicine’s efficacy, because NDs have the time for more accurate diagnostics and to tailor treatment programs to the patients using extensive training in diagnosis, pathology, botanicals, nutrition, pharmacology and yes, standards of care (which are taught in a very straight forward way at my school: Bastyr, maybe this was not your experience?). There are positive changes taking place in the allopathic community, like the integrative programs at med school teaching gentler modalities. I guess the allopathic medical community is gleaning some things from naturopathic practice. Naturopathic medicine, in turn, owes a lot to MDs as far as diagnostic thinking, health sciences, understanding red flags for safe practice, etc. Even nutrition, hydrotherapy, and botanical medicine is interwoven in the history of allopathic medicine.

        Food for thought: Why is it so difficult to take a nuanced view on seemingly divisive issues, why do humans constantly attempt to make things black and white? In the ND community I often hear people degrading allopathic practice, and vice versa. I think a wise person would say that any system of thought will have its strengths and weaknesses. Nuance is more difficult, right? If your efforts arise from a genuine desire to protect patient safety, then I commend you for extending your compassion to the wellbeing of others.

        • David

          naturopaths are simply not trained to do what you claim they can do. How can they diagnose diseases properly when they only read about these diseases in a book and are taught by other naturopaths. Do you have an ophthalmologist showing you how to do eye exams and show you the thousands of possible ocular disease manifestations. Do you have a cardiologist teach you how to do a proper cardiac exam and teach you to how to read ecg, echo, angio etc? A lot of medicine is pattern recognition and if you have never seen it before how can you diagnose it

          So maybe a naturopath has a role as a glorified nutritionist and lifestyle counsellor but they should not be practicing as a primary care professional nor solo in any way.

          • Shawn Morris

            Hi David,

            In fact, I was taught cardiology by an MD cardiologist at Bastyr, and yes he taught me how to read an EKG, and Echo, Angio, as well as MRI, CT, PET, SPECT, and every other form of diagnostic imaging. He also taught me triage, diagnostic algorithms, standards of care, and lab diagnosis in extensive detail. For every system class (rheumatology, pulmonology, etc) standards of care have been reinforced and tested repeatedly. I was taught immunology by a PHD who formerly taught at Yale School of Medicine. I was taught neurology by an MD neurologist. Pathology was taught by an MD and PhD in pathology. Many of my teachers have been MDs. My anatomy professor previously taught at the University of Washington School of Medicine in the MD program for twenty years. Since being on my clinic shifts I have seen heart failure, aortic aneurysms, all matter of mental illness, CAD, diabetes, autoimmune disease, atherosclerosis, HTN, hyperlipidemia, sprains and strains, etc etc multiple times. Every one of these patients has been managed safely and effectively and referred appropriately with correct diagnostic workup. Believe me, the ND program is hard…in fact I wish it was a little easier like people on this website seem to perceive. I really did not know I was going to be put through the ringer like an MD student, obviously it’s a good thing. I’m not sure where the misinformation comes from…I think its because the ND profession has evolved so fast that things are really different than what it looked like five or ten years ago. Thank you for writing, it’s interesting to see what the perception is. Personally, when I’m done I want to be a “glorified nutritionist,” lifestyle and mental health counselor, and use herbs safely then refer out with a strong ability to recognize red flags. I think the training is adequate for this, and people can benefit. The concerns on this website are valid, I do believe they are being addressed by my medical education. It is most important to practice safe medicine and know when to escalate and refer, that is crucial.

            • David

              Could you supply the name of this cardiologist. So he took you on the wards so that you could examine patients with all these ailments? Also you realize I am describing second year medical school training. By the third and fourth year medical school you should be able to be the front line seeing these patients, diagnosing them, and then coming up with s treatment plan. In most medicos schools there would be about a 100 cardiologists sharing the training of med students so that they can have adequate exposure. Even by chance, if you have a couple of MD, they would have to be spread very thin amongst all your students. I looked at the faculty of Bastyr, and the only md I saw were ones who obviously cannot get a license to practice in USA and therefore were forced to work at a naturopath School to make ends meet. For comparison sake do you know that Harvard has a medical faculty of about 9000 md?

              • Shawn

                Hey again,

                I do diagnose and create treatment plans as a third year student under the supervision of licenced NDs and MDs. I was taking about 2nd and 3rd year. Maybe a communication error. 2nd year my diagnostics, pathology, and pharmacology coursework was taught by MD/PHD, while complementary approaches and phlebotomy skills (herbs, nutrition, lifestyle, etc) were taught by NDs. Imaging is taught by a DO.

                Here is my immunology professor (I studied first year at NCNM) professor https://ncnm.edu/faculty/heather-zwickey-phd/

                Pathology:
                http://www.bastyr.edu/people/faculty-researcher/jing-meng-md-phd

                Neurology:
                http://www.bastyr.edu/people/faculty-researcher/katherine-raymer-md-nd

                Cardiology (co-professor)
                http://www.westernwashingtoncardiology.org/wwc/chepuri.asp

                Family practice: Robert Anderson, MD
                http://www.drstevemorris.com/randerson.html

                Obviously there will be more MDs at an allopathic school, and let’s face it these are two different professions. I want to be mostly taught by family practice NDs…this is what my career will be in. This is why NDs need to be trained to recognize red flags, know when to refer appropriately, and know when higher force interventions are required. In Seattle area, NDs and MDs do successfully practice integrative medicine and patients are mostly treated safely and effectively. It would be great to export this model around the country. NDs are trained extensively to practice at the family practice level, and we see the conditions that family practice docs encounter over and over on shifts and in grand rounds. Clearly we are not ER docs, or really meant to work in a hospital. What we can do: family medicine, that is basically what the whole program is geared towards. And honestly, not many MDs want to do family medicine anyways because it’s too boring and does not pay enough as hospital work and specializations.

                Also it is incorrect (not to mention rude) to say these people only teach at Bastyr because they could not get another job. The MDs who have been part of my training are passionate about what they do, and from my research there is no reason to believe they could not have successful careers elsewhere.

                For your interest: UW medicine premed advising page discussing different career options, with a write up on naturopathic medicine as one option: https://www.washington.edu/uaa/advising/at-the-uw/pre-health-advising/fields/medicine/. I think this page does a good job of comparing contrasting MDs, NDs, and DOs is a short summary while respecting the strengths and differences of each.

                • David

                  i think med students should be allowed to practice family medicine in Washington without a residency then as well. We both can agree, I hope, that a medical student is better trained in cardiology etc. So why do they need a 3 year residency to do what you can do without.

                  • Shawn

                    It is a problem I agree. They would require us to do residency, but opportunities are limited. The school tries to compensate by requiring 120 hours of preceptorship with experienced NDs and MDs. Also our program is tailored 100% to family practice, so we have a bit more classroom and clinical time to focus on this. I think if MD students had a similar requirement for family practice in preceptorship plus more time in med school focused on family practice then they should be allowed to practice after graduation. Still, I hear you. This problem is at the forefront of what bastyr is trying to change…I think in five years all NDs will be doing residency, at least in Washington. They are trying to open a residency center in Seattle that will offer around 100 residency positions to new ND grads. I will be doing a residency in family practice for three years after graduating with Dr. Robert Anderson, MD and his partner, an ND in family practice for 30 years. But I am one of the fortunate students to have this opportunity.

                  • Thomas Mohr

                    quote 1: “Honestly, I also hope Bastyr cuts down on the homeopathy coursework”.

                    Quote 2: “I have seen sufficient scientific research, and my professors are honest when the research does not back up an anecdotal treatment, which is infrequent.”

                    Are you aware you are contradicting yourself ? Bastyr does not only NOT acknowledge lack of scientific backup, they teach *entire specialities* that lack scientific support.

                  • Shawn

                    Hey Thomas, If you go back and read I am not contradicting myself. My homeopathy teachers are straight forward about the lack of research, and they leave it up to the students to decide if they want to practice anecdotal homeopathic medicine. Many of us do not, and will not go on to use homeopathy. Also, many MDs do practice and study homeopathy, actually more than NDs…but that is a digression.
                    Read my comment again. What I said is there is plenty of research for the other modalities taught, which is the vast majority of the curriculum (nutrition, botanical medicine, lifestyle counseling) to justify the routine use of these therapies in medicine. And NDs get way more training in these areas along with pharmacology. Even if MDs are interested in these things, which many are, it is not common for them to implement nutritional and botanical therapies. My botanical medicine teachers are forthcoming about current botanical research for every herb and condition studied, and they provide links to studies and we are trained to think critically about the literature and not just accept a study because it supports a natural approach. Anecdotal botanical treatments are discussed as anecdotal treatments, and make up about 5% of treatments taught. All my nutrition information is supported by research, and the professor goes to great lengths to link multiple studies, and disregards therapies that are supported by only weak evidence. If you have the chance you should sit in on some classes at Bastyr to get a better idea of how research evidence is used to inform instruction. I think a lot of views here reflect the naturopathic profession ten years ago….

                  • Thomas Mohr

                    Shawn, recently a large metastudy encompassing over 200 studies and 1800 papers was published re hmeopathy. That is NOT lack of research.

                    Re botanical medicine, we agree that plants are a very valuable source of drugs. However, there are also large metastudies in the field covering 1000 medically used herbs. The conclusion was that for half of them research exists (mostly in vitro), for about 150 there are some sort of clinical studies showing pharmacologically relevant results for 8. Te problem with plants is that whatever pharmacological substances they contain, the effect of these substances is diluted by other ingredients. Why do you think we use aspirin and not willow bark tea ? The probem is that many adjuncts of botanical medicine think that nature made plants to cure diseases. Nature doesn’t care about humans. Not one little bit. The reason why plants are a source of pharmaceuticals is simply that they are incredibly diverse chemical factories producing substances that – by coincidence are effective in human diseases. However, they are not designed for this purpose and therefore suboptimal.

                  • Shawn

                    Regarding homeopathy: yes, lots of research, from what I can find most of it shows about same efficacy as placebo or ineffective. This is what I meant by “no” research= little to no positive research. I think there are some studies by Dr. Iris Bell, MD, that show positive results, but that’s all I’ve come across.

                    Regarding botanicals: We learn to use about 175 herbs, the ones with the best clinical results. And we follow the doses used in these studies. With consistent dosing, the idea is that many herbs will have the effects with less side effects. In these studies and clinical practice, this has been shown to be true. Coincidence or not, those compounds are in the botanical products, which is why we get positive studies. In this way, NDs do practice allopathic medicine, using the compounds against the disease, while usually laying down therapies that build the immune system. Searching WebMDs classification of herbal medicines with efficacy, side effects, interactions, closely resembles my coursework. Here’s an example with Echinacea: http://www.webmd.com/vitamins-supplements/ingredientmono-981-echinacea.aspx?activeingredientid=981&activeingredientname=echinacea
                    Even the language WebMD uses, “possible effective” “insufficient evidence” etc, that’s how the herbs are talked about in class. If a trial of a particular herb yields no benefit, than a good MD will step it up to a pharmaceutical. And if the case is severe/emergent, we’re going straight to standards of care. In certain conditions we learn when to start with pharmaceuticals and skip the botanicals, or use them as adjuncts.

                  • Shawn

                    Regarding homeopathy: yes, lots of research, from what I can find most of it shows about same efficacy as placebo or ineffective. This is what I meant by “no” research= little to no positive research. I think there are some studies by Dr. Iris Bell, MD, that show positive results, but that’s all I’ve come across.

                    Regarding botanicals: We learn to use about 175 herbs, the ones with the best clinical results. And we follow the doses used in these studies. With consistent dosing, the idea is that many herbs will have the effects with less side effects. In these studies and clinical practice, this has been shown to be true. Coincidence or not, those compounds are in the botanical products, which is why we get positive studies. In this way, NDs do practice allopathic medicine, using the compounds against the disease, while usually laying down therapies that build the immune system. Searching WebMDs classification of herbal medicines with efficacy, side effects, interactions, closely resembles my coursework. Here’s an example with Echinacea: http://www.webmd.com/vitamins-supplements/ingredientmono-981-echinacea.aspx?activeingredientid=981&activeingredientname=echinacea
                    Even the language WebMD uses, “possible effective” “insufficient evidence” etc, that’s how the herbs are talked about in class. If a trial of a particular herb yields no benefit, than a good MD will step it up to a pharmaceutical. And if the case is severe/emergent, we’re going straight to standards of care. In certain conditions we learn when to start with pharmaceuticals and skip the botanicals, or use them as adjuncts.

                  • Shawn

                    Just writing to say I have to sign off the discussion board for now…getting too wrapped up in it for now and need to focus on wrapping up my graduation requirements. I think this was a productive dialogue, I have learned quite a bit. I plan to sign on again next year. Thank you for taking the time to engage with these issues and do the back and forth. Take care, Shawn

                  • Marcel

                    Too bad. Can anyone think of 175 herbs with sufficient clinical evidence to support their efficacy, let alone their safety? After 35 or so years in the filed of natural products research, I can’t. As for WebMD, I would hardly call it a reliable source of information about herbal medicines; nor is Memorial Sloan Kettering for plants used against cancer, or Natural Standard for any botanical you care to mention.

                  • JGC

                    When I think of traditional herbal remedies, the first thing that leaps to mind is aristolochia…

                  • JGC

                    When I think of traditional herbal remedies, the first thing that leaps to mind is aristolochia…

                  • Marcel

                    Too bad. Can anyone think of 175 herbs with sufficient clinical evidence to support their efficacy, let alone their safety? After 35 or so years in the filed of natural products research, I can’t. As for WebMD, I would hardly call it a reliable source of information about herbal medicines; nor is Memorial Sloan Kettering for plants used against cancer, or Natural Standard for any botanical you care to mention.

                  • Avishek Saha

                    Homeopathy works. I wonder what type of arguments the “skeptics” who fail to present a proper methodology for studying homeopathy would have to say about this paper: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359147/

                    It doesn’t tell us anything we don’t know. it’s not placebo medicine. There is really not much more to be said. You can either see it work time and time again and not believe it, or see it work time and time again, every time when the correct remedy is prescribed, and still not believe it.

                  • Thomas Mohr

                    First, in a psychological setting it is difficult to distinguish between drug and treatment. Second, this study has severe shortcomings, namely
                    1) They test a score (a discrete number) with a t-test based ANOVA. THat does not fly.
                    2) They use a one-way ANOVA for independent samples in a repeated measurements seting. That does not fly either. They should have used a mixed model two-way ANOVA utilizing a test designed for discrete variables.

                    The study design is very nice, a pity they ruined it by kitchen stats.

                  • Thomas Mohr

                    First, in a psychological setting it is difficult to distinguish between drug and treatment. Second, this study has severe shortcomings, namely
                    1) They test a score (a discrete number) with a t-test based ANOVA. THat does not fly.
                    2) They use a one-way ANOVA for independent samples in a repeated measurements seting. That does not fly either. They should have used a mixed model two-way ANOVA utilizing a test designed for discrete variables.

                    The study design is very nice, a pity they ruined it by kitchen stats.

                  • Avishek Saha

                    Why don’t you post those studies? They won’t be of much use to me but I’d love to dissect them.

                  • Thomas Mohr

                    I have posted them on this board previously and I will NOT repeat myself.

                  • Avishek Saha

                    *applause* wow you should receive an award for your great deeds.

                  • Avishek Saha

                    *applause* wow you should receive an award for your great deeds.

                  • Thomas Mohr

                    “Many of us do not go […] into homeopathy” You might be interested in Caulfield et. al., Allergy, Asthma and Clinical Immunology 2011 7:14 who checked exactly this statement by reviewing websites of naturopathic clinics in two Canadian Provinces. The top three modalities offered where Homeopathy, Clnical Nutrition and Botanical Medicine. About 50% of the top ten modalities (Detox, IV Therapies and others) offered where either bogus or not tested.

                  • Shawn

                    This study is interesting. I think it varies from area to area, here (my subjective sense) Bastyr grads focus on the latter two: botanicals, nutrition, and add counseling, phys med, and pharmacology. I know many CAM people are into homeopathy. It is a small part of my training though, and yes I wish it was smaller. And I was talking about my peers, just a subjective gauge…I don’t know anybody who is planning to practice homeopathy in my class apart from one or two friends. I think this is another change in the profession that will play out over the next decade even though Bastyr and other schools are holding onto it for now. Still even though I don’t buy into homeopathy, I hope practitioners can find a way to keep afloat. I mean, should we take away the livelihood of an MD because they practice homeopathy? I think malpractice should be the metric we use to evaluate practitioners…are they harming patients or taking advantage financially? I know we can say,”they’re harming by not using appropriate EBM, and exploiting by charging a lot for unsupported treatments” but I think this needs to be evaluated in a case by case basis by an institutional board before stripping someone of their livelihood. Or is the answer to regulate more (that’s my vote). My sense is people here think, let’s take away these people jobs.

                  • David

                    120 hours is a bit of a joke. I remember in my internship I worked a few 120 hour weeks!

                  • Thomas Mohr

                    Until very recently, Austrian MD residents even worked once to twice a month 48 hours – during weekend duty – Saturday 8AM till Monday 8AM. The 120 hours mentioned would have been worked off during less than three weekend duties.

                  • Shawn

                    Yes, the 120 hours is not enough. Still I can’t see how more hours can be added during the training, I have maybe 1-2 free hours left per day. They could up the hours, but what is really needed is greater residency programs after school so we do get the pattern recognition you described down. I have a lot of respect for MDs who have gone through the traditional system. MDs training is degraded too often by people in the alternative communities. The reality is that it is way more competitive to get into medical school, like the top 2 % of qualified applicants. The work load is intense, and the residency demands as well. There is no question it is more difficult than the ND program, and requires strength of character and incredible intelligence and work ethic to succeed. The ND program is no walk in the park, but it’s a different animal. For me personally I know I need residency to get to the level of competency I feel comfortable with. I do think Bastyr is being as proactive as possible preparing students to recognize red flags and know standards of care. On this site that has been disputed, but a lot of these changes are more recent, like the strong emphasis on standards of care in every class, taught before complementary modalities.

                  • David

                    It seems like there is incredible variability in naturopathic schools. another naturopath that was taking part in these discussions went to a naturopathy school that had a faculty of 16. I think this was in Arizona. She has very outlandish ideAs

                  • Shawn

                    There is a wide variability…was that one of the accredited schools? Sounds like one of the smaller 2 year/online programs to become a naturopath, not a ‘naturopathic doctor’. Definitely not SCNM in Arizona, that has a large faculty. Curriculum is fairly uniform across the accredited schools, though Bastyr has the reputation as the most rigorous and evidence based.

                  • David

                    I looked it up. It was SCNM with a faculty of 19.

                  • Shawn

                    Wow that is small…I didn’t know, I just assumed because it’s an accredited school…sorry about saying that without knowing. They may have more people in the clinic, but I don’t know. The curriculum still should be the same, I have never looked into it. just did my research into Bastyr.

                  • Shawn

                    FYI: there’s a newly accredited school in Puerto Rico: http://ut.suagm.edu/en/salud/naturopathic-medicine. Just interesting there is a school out there.

                  • knotfreak

                    If you read up at SBM, you will find that self-accreditation means very little.

                  • JGC

                    “I can’t see how more hours can be added during the training”

                    Perhaps they could stop wasting hours teaching things like homeopathy and acupuncture, to make more time to study modalities that have been shown to actually be effective?

                  • PrimaryCareDoc

                    You make the training longer. Duh. You don’t cut out training because there isn’t enough time, shrug your shoulders, and say, “eh, I guess that’s good enough.”

                    This is MEDICINE, for fuck’s sake. People’s health and lives are on the line.

                  • PrimaryCareDoc

                    You make the training longer. Duh. You don’t cut out training because there isn’t enough time, shrug your shoulders, and say, “eh, I guess that’s good enough.”

                    This is MEDICINE, for fuck’s sake. People’s health and lives are on the line.

                  • David

                    Anyways, i guess we can agree to disagree about naturopaths practicing as first line primary care givers. At least, you seem more grounded in reality compared to the other naturopaths who have commented on this board

                  • Shawn

                    Yes agree to disagree, though I don’t fully disagree. I think we should have less of a scope than primary care to reflect the lesser training. I do think there should be an attitude of respect towards medical doctors. Thank you for sharing your criticisms, I’ve learned quite a bit. I think the residency issue is major, I hope to work towards greater residency opportunities for NDs so we can get the experience we need to be competent. I wish I could be exposed to more of the rarer diseases in person more frequently, and it’s another valid criticism. It does happen but not frequently enough. Some NDs at Bastyr are able to go on grand rounds at UW school of medicine, I think this is one potential way to strengthen this part of the training.

                  • David

                    Naturopathy seems incredibly market driven in a bad way. MD seem to practice quite uniformly around the world.
                    Naturopaths practices seem to be tailored to what they are allowed to do. So admittedly, in Washington where they have more prescribing rights and the ability to act as PCPs, they seem to practice something closer to MD and less woo. The less rights they have the crazier the offerings
                    In a non scientific manner, I looked up naturopathic clinics in Washington state versus Canada versus Florida and this seems true.
                    So is a more evidence based naturopath just a poorly trained MD trying to practice as a PCP—is this even more dangerous than a crazy woo offering naturopath who parts believers from their money. That I cannot answer.

                  • Shawn

                    I guess in some ways this is true, are training is less, and we are given the right to practice as a PCP but with less of a scope than an MD. I can see how that is frustrating for MDs who have to complete residency for a similar level of licensure. As far as how dangerous that is…from my research that is a difficult question to answer. A lot depends on doing residency after doing ND school, and many ND graduates who stay in Washington have to do a residency to stay competitive. Our scope is less in Washington with a vigilant malpractice system, and NDs are not allowed to treat complex diseases like cancer without co-management with an MD. From my research ND malpractice in Washington is not too common. It is a complementary system, where we work with MDs. Most patients in Washington come to an ND with chronic diseases with established diagnoses to try other approaches, often recommended by their MDs. It’s true, the less regulation/licensure the more out there it gets…and the more malpractice which is why it should be regulated. And NDs should be held accountable for accurate diagnosis and treatment efficacy.

                  • JGC

                    The problem is less that naturopathic practices vary with respect to what they’re allowed to do in different states than it is that there exists no real standard of care for naturopaths. Within the same state different naturopaths are free to prescribe different treatments for the same illnesses or injuries, with no attempt to actually determine relative efficacy. Similarly, naturopaths are free to determine for themselves what indications are serious enough to require referral to licensed physicians (so you can wind up with people suffering an acute asthma attack being treated by acupuncture or aromatherapy rather than being sent to the nearest ER, with no consequence for the naturopath).

                    An evidence based naturopath would be one who only offered treatments that had been shown to be safe and effective–i.e., they would be naturopaths who didn’t offer anything that was unique to naturopathy.

                  • David

                    That is the problem…if you tease out all the treatments for which there is no evidence..all you are left with is a very poorly trained person trying to work like an md.

                  • JGC

                    The problem is less that naturopathic practices vary with respect to what they’re allowed to do in different states than it is that there exists no real standard of care for naturopaths. Within the same state different naturopaths are free to prescribe different treatments for the same illnesses or injuries, with no attempt to actually determine relative efficacy. Similarly, naturopaths are free to determine for themselves what indications are serious enough to require referral to licensed physicians (so you can wind up with people suffering an acute asthma attack being treated by acupuncture or aromatherapy rather than being sent to the nearest ER, with no consequence for the naturopath).

                    An evidence based naturopath would be one who only offered treatments that had been shown to be safe and effective–i.e., they would be naturopaths who didn’t offer anything that was unique to naturopathy.

                  • David

                    I think one of the problems that MD have with naturopaths, chiropractors and even optometrists is a very distinct different approach to training Medical doctors are exposed to s myriad of different diseases over and over again, that they may never see again in their careers. This gives an MD the ability to recognize the rarer diseases when they do arise and I would argue gives an MD a better ability to see the patient as a whole (stealing that from naturopathic rhetoric). All the other health professionals are drastically under trained and only read about most diseases in a book.

                  • knotfreak

                    Again, four years at the price of Bastyr is an expensive path to a career of referring patients to real doctors.

                  • PrimaryCareDoc

                    wow. A whole 120 hours! That’s like…a week and a half of residency.

                    Pathetic.

                • Thomas Mohr

                  Your immunology teacher is a prime example why Bastyr’s faculty is in no way competitive to the faculty of a real Medical School. Zwickey’s publication list prior to joining NCNM as a director of research (!!!) in 2002 encompasses two (!) papers. At my university she would probably have difficulties qualifying as a senior postdoc.

                  When she became Dean of Research her publication list was a whopping 13 papers, none in a top journal.

                  As a comparison, my best friend is a dermatologist on her way to becoming an associate professor. She has 17 papers, some of which in top journals. In fact, having published in top journals is a requirement to enter the pathway to professorship.

                  • Shawn

                    No question medical school is vastly more competitive and requires more from professors for qualifications. Still, Dr. Meng was doing pathology research before coming to Bastyr. Also, Dr. Zwickey goes around the country teaching medical school professors how to teach medicine at top universities. She is invited by Harvard, Columbia, Yale, OHSU, among others to consult for their curriculum delivery. She is a great teacher, one of the best. Maybe they were looking at her teaching skills more strongly when they hired her. Most of my basic science professors have published well over ten research papers, and come from mainstream universities.

                  • Thomas Mohr

                    Shawn, you do not get the point. Zwickey did not teach you how to teach medicine, but immunology.. She may be great at lecturing about how to teach medicine, but that is not what she taught you. Concluded from her papers in immunology her expertise in immunology is not that great.

                    Re Jing Meng the point is not doing some pathology research, but being trained as a pathologist – from her CV it is clear she never worked in a pathology department looking through all the histology slides. I sometimes repair the wiring at home and had some courses at university in that topic, but that does not make me an electrician, much less someone competent to teach the trade.

                    Finally, 10 papers for a professor is nothing. Normally professors in Zwickeys position have five to ten times as many publications.

                  • Shawn

                    Ok. Still other professors came directly from University of Washington School of Medicine, a well respected medical school where they were core clinical faculty. They are also the ones that served on the hiring board for Dr. Meng. I get that it’s less than medical schools, I still think I touched on the same competencies sufficiently. When reviewing for boards I used the USMLE step 1 study guide, and these professors had taught everything and beyond in USMLE and boards…In the end the knowledge is still comparable (Not saying I’m the same as an MD, but I have had to learn this stuff).

                • Thomas Mohr

                  Another example is Jing Meng, the pathology professor. If you take a look at her Linkedin Profile you will see that the word Pathology appears under “Jing also knows”. If you read her summary in the link you gave, you will notice that her teaching experience is that of an internist with an oncology streak. In order to become a professor for pathology at a real medical school, one has to take an at least three years specialty training as *pathologist* and do scientific research in that area.

            • David

              I just looked again at the 100 odd faculty at Bastyr and I did not see a single practicing md Why would they hide these cardiologists and neurologists that are teaching you?

            • David

              I just looked again at the 100 odd faculty at Bastyr and I did not see a single practicing md Why would they hide these cardiologists and neurologists that are teaching you?

            • Vic Nurcombe

              So if you are studying all these medical modalities….why aren’t you doing medicine???? Instead of wasting your time in modalities that do little but offer placebos? Come into the trenches with us and fight the real battles!!! We need cures for cancers, infectious diseases, inherited disorders, musculoskeletal degeneration and mental conditions URGENTLY……and you want to spend your time prescribing rose-hip tea to whining members of the middle classes??? Come and join us in the REAL battles!!! We need help from engaged intellects who ACTUALLY reverse and repair SERIOUS conditions. I’ve yet to see homeopathy or acupuncture reverse stage 4 overian cancer. of the 37 major cancers, we are getting very good at knocking off 11 of them. there are 26 to go. Come and fight where the battle is hottest.

              • Shawn

                I was on the fence between med school and ND school. I think I might have been accepted to medical school, I did graduate cum laude from University of Washington in pre med biology. The reason I went ND is because in Washington I can take medicare so I can see low income people, and I want to focus on diabetes and cardiovascular disease in my practice and have longer patient visits. I volunteered in an ND clinic that serves a low income community in Seattle, and the providers were doing so much for the community and patients with very limited resources were getting better. It’s not just “hibiscus tea”–it’s doing comprehensive treatments and having the time to be with patients for effective counseling, set up their referral networks, work with them to find housing, employment, be an advocate. Clearly, lifestyle and nutrition are a big part of cardiovascular disease and diabetes. In other areas where ND is cash only, there is elitism to it…in Washington things are different, so that’s my reason. It is medicine, and it is effective. This care may not be as fast paced, but when the regulation is strong and state insurance will pay for it, there is meaningful work to do.

                • Vic Nurcombe

                  Good answer. I’m absolutely in accord with the idea that the strong are here to protect the weak. A reason why my medic father left the US to go back to home country australia, where health is a right – for everybody – not a privilege.

            • Vic Nurcombe

              So if you are studying all these medical modalities….why aren’t you doing medicine???? Instead of wasting your time in modalities that do little but offer placebos? Come into the trenches with us and fight the real battles!!! We need cures for cancers, infectious diseases, inherited disorders, musculoskeletal degeneration and mental conditions URGENTLY……and you want to spend your time prescribing rose-hip tea to whining members of the middle classes??? Come and join us in the REAL battles!!! We need help from engaged intellects who ACTUALLY reverse and repair SERIOUS conditions. I’ve yet to see homeopathy or acupuncture reverse stage 4 overian cancer. of the 37 major cancers, we are getting very good at knocking off 11 of them. there are 26 to go. Come and fight where the battle is hottest.

            • knotfreak

              It totally scares me that you graduated cum laude and can’t see the difference between MD and ND. There are so many other ways you can serve low income communities than by becoming a quack.

          • knotfreak

            What is the point of so much training just to see red flags and refer to real doctors?

          • Avishek Saha

            Are you a doctor? Are you a researcher? Either way, it’s clear you’re not asking questions. You have an opinion, and would rather stick to it than know the truth.

            So here’s how we know how to diagnose diseases.

            OUR CURRICULUM COMES FROM THE SAME TEXTBOOKS AS ALL OTHER MED SCHOOLS. THE MERCK MANUAL. ROBBINS AND COLTRAN. THE NEWEST PATHOLOGY TEXTBOOKS. OUR LIBRARIES HAVE ALL OF THESE BOOKS. OUR COURSE NOTES COME FROM THESE BOOKS. OUR PROFESSORS AREN’T ALL NDS. MANY ARE MDS AND PHDS WHO DON’T ACTUALLY KNOW MUCH ABOUT NATUROPATHIC MEDICINE, BUT SIMPLY HAVE COME TO REALIZE THAT THERE WERE MORE ANSWERS TO THEIR PATIENT’S QUERIES THAN THE ONES THEY WERE TAUGHT AT ALLOPATHIC MED SCHOOL. WE PRACTICE PRIMARY CARE AND YOU CAN GET OVER IT NOW.

            Ignorance, be gone.

          • Avishek Saha

            Here’s how, ignoramus. I shouldn’t even bother responding because you’re not asking questions, You have a preformed opinion.

            My professors aren’t NDs, they are MDs, PhDs, and NDs. Our curriculum comes from the same textbooks as any med students and our libraries have the latest editions of all these textbooks as they should.

            Yes we learn how to do proper cardiac exams, whatever you mean by proper.

            What is the point of trying to put us down? Why don’t you talk to patients who have received naturopathic care and ask them why they choose it? Clearly you guys think we aren’t capable of anything which is a minority opinion.

            • http://www.taylorhermes.com Taylor

              You might find this FTC video insightful about your “medical” training: https://www.youtube.com/watch?v=B0_Z7VsD9GI&feature=youtu.be

              • Avishek Saha

                I didn’t find it useful. It’s important as we are very skeptical of cancer cures too.

                It’s clear you aren’t interested in learning about my education since you just posted a cancer scam video. I assumed a while ago that you sir in your white t-shirt in your profile picture aren’t capable of scientific discourse. You’re not professional.

                Your choice to be ignorant is the antithesis to scientific thinking. Why don’t you ask me for a course curriculum? Because I don’t care to answer someone who isn’t worth my time so I probably wouldn’t tell you. And you’d have no understanding of it anyway because you don’t seem to possess a medical background?

              • Avishek Saha

                I didn’t find it useful. It’s important as we are very skeptical of cancer cures too.

                It’s clear you aren’t interested in learning about my education since you just posted a cancer scam video. I assumed a while ago that you sir in your white t-shirt in your profile picture aren’t capable of scientific discourse. You’re not professional.

                Your choice to be ignorant is the antithesis to scientific thinking. Why don’t you ask me for a course curriculum? Because I don’t care to answer someone who isn’t worth my time so I probably wouldn’t tell you. And you’d have no understanding of it anyway because you don’t seem to possess a medical background?

            • Thomas Mohr

              You’re from that Portland college are you not ? A lot of NDs plus a handfull MDs and a few PhDs, all with an abysmal research record, and that includes deans and stuff. None of your deans would qualify for even a PhD program in a real university in Europe, much less for a professorship. Why do you think Britt had to restart on BSc level ? Zwickey f.i. has experience in how to teach medicine but lectures immunology. This is the blind learning from the one-eyed. This is the problem.

        • David

          And please explain the more accurate diagnostics that a naturopath can do.

          • Shawn Morris

            Hey David,
            I was drawing attention to the benefit of having more time, and NDs have training in the same physical examinations, diagnostic algorithms, and red flag recognition that MDs use. That was a poor choice of words…more accurate..which is purely speculative. Sorry about that. I do think having more time with a less busy schedule helps arrive at the correct diagnosis if the training is adequate, which is why many MDs are advocating for greater patient time.

            • David

              you are taught by ND and by non specialist MD (who do not have a license to practice) on patients who are essentially healthy. A medical student is taught by renowned academic specialists on hospitalized patients who have every disease that you only read about in books. You simply do no know what you do not know ( which is a lot)

              • Avishek Saha

                Yes, we simply do not know what we do not know. What a succinct yet redundant way of spelling out the obvious.

                It’s so pathetic that people like you who love to slam CAM treatments fail to take adequate time to investigate what they are criticizing. It’s a human nature thing…because if you actually investigated it deeply enough, you’d see that your opinion would have to be altered a bit to reflect reality. And that is very hard to do because of a thing called the ego.

                That being said, I’ll have you know that my professors aren’t NDs and non-specialist MD who do not have a license to practice. They are microbiologists, pathologists, and ER docs who have seen crazy shit. Please accept the fact that you do not know what you do not know (which is a lot).

    • mikerbiker

      I think it’s important to emphasize that Britt is a refugee from a dangerous cult. She speaks out so that others are not ensnared.

    • mikerbiker

      I think it’s important to emphasize that Britt is a refugee from a dangerous cult. She speaks out so that others are not ensnared.

    • Anesia

      The pressure to avoid negativity at all costs, to “find the silver lining,” and to be “open-minded” is typical of the brainwashing that often occurs in CAM communities. I am very proud to have the courage to face reality: I was part of something that I regret. It was wrong and bad. I can still redeem myself by continuing my new career in an established field. The science in my new field isn’t perfect, since counseling psychology and neuroscience have a long way to go in understanding how best to address mental health problems. But I can live with myself at the end of the day. It will take time to come to terms with the 14+ years I spent in Naturopathic Medicine. No one has the right to tell me how I should heal. The only people who have any right to comment on my experience are those who have actually been there, and we are few at the moment.