Naturopathy

Naturopathy

(Author's note: This page is still under construction)

The following is a letter written to a Michigan state representative in June, 2016. Michigan is (was) facing House Bill 4531 which would allow for state licensing of naturopaths (NDs or "Doctors of Naturopathy") their recognition as primary care providers. This of course would make NDs eligible for state funding through Medicaid.  

At the time of this writing (July 2016), the bill has not yet been brought to a vote..

If you live in Michigan, or live in a state facing similar bills, feel free to use this letter as a template to write to your own congressman. A copy of this letter can be downloaded from the document file at the bottom of the page.
(or click here - copy of Letter re HB 4531)

So as not to present a long, intimidating letter that would likely be set aside, the endnotes can be found in a separate document file also at the bottom of this page.


Letter to State Representative





Dear (Representative, Senator, Governor),

Thank you for your time and service to our community.

I am a concerned citizen and doctor. I am very concerned about HB 4531, a bill that would allow for licensing of “naturopathic physicians” as primary care practitioners in Michigan (1).

I realize that you have a great deal of mail to read every day, so this letter will be (somewhat) brief. However, I cannot make statements without backing them up. The accompanying Word document has endnotes and will provide you with details if you wish to read further.

As you are well aware, science demands that we follow evidence, discard disproven ideas, and tentatively hold on to ideas properly vetted by the scientific method. Science demands coherence of our observations, hypotheses, facts and theories (2). As an elected official,
you have an interest in protecting the public against frauds and scams. We are on the same page in this regard.

 “Naturopathy” is the field professed by “NDs”, or doctors of naturopathy. There are currently four institutions in the U.S. designed to train NDs (3). Naturopathy as a field of study is not offered by reputable universities in this country (4). There are reasons for this.
Naturopathy is not a science. It is a belief system (5).

It is also an organized lobby fighting to gain false legitimacy through legislation.

Today (as of June, 2016), 17 states license naturopaths (6) and they receive state Medicaid money. But naturopaths have not earned this privilege through scientific merits. I’m sure most of their proponents are sincere, hard-working and mean well. However, even if inadvertently, naturopaths have become one of the country’s largest group of snake oil salesmen. Their lobby is directly funded by the supplement industry (7). Americans spend about $30,000,000,000 a year on supplements (8), most of which has no proven benefit and is wasted money. It could soon become wasted Michigan money.

Naturopathy uses scientific lingo and the trappings of actual medicine to appear legitimate in the eyes of the unsuspecting lay person. But it is really a pseudoscience. It has magical and quasi-religious roots that appeal to “Nature” as if it were a mystical, guiding force (“vitalism”). It is based on unsubstantiated and implausible ideas of disease and health. (9)

Not only are many of their core beliefs incoherent with what we have learned about the world and biology, but they are incoherent with each other. Naturopathy is a hodge-podge of conflicting pseudosciences with dash of lip-service to actual science.

Naturopathic physicians apparently are taught biochemistry, physiology and anatomy. They claim to focus on prevention and “wellness” by offering advice on healthy lifestyle such as exercise and nutrition (10). This is all well and good, but their ideas about nutrition are often based on unwarranted claims and focus heavily on selling supplements -- usually out of their own offices and at high prices (11).
However, they also spend a great deal of time learning pseudoscientific notions such as homeopathy (12), “therapeutic touch” (13), “acupuncture” (14), applied kinesiology (15), iridology (16), and the list goes on (17).

The Bastyr Center for Natural Health even claims to offer treatments for HIV (18) using implausible treatments that rely on the placebo effects (19).  Because they believe in homeopathy, many naturopaths sell homeopathic malaria vaccines for those traveling into endemic areas (20). “Homeopathic” products are placebo sugar pills with no active ingredients!  Naturopaths are notoriously against real vaccines (21). Such practices endanger our children and the community at large (22).

Naturopaths frequently warn against proven medical and surgical treatments for cardiovascular diseases but instead promote unproven, disproven and even dangerous treatments such as herbs and the infusion of chelating agents. (23)  These practices are irresponsible, dangerous and unethical. (24)

Our government (through the National Center for Complementary and Alternative Medicine, or NCCAM – now called NCCIM) spent a great deal of money investigating many alternative treatments. They found no evidence for any of them. None. (25)

There is no limit to the amount of ideas and products that naturopaths can sell to the public (and the State of Michigan) because they are not limited by the boundaries of reality that govern legitimate medical practice. There isn't even a set standard of care within the framework of their own belief system. Legitimate medicine changes with our understanding of nature. Naturopathic “medicine” does not change with new information. It holds onto its own belief system despite evidence. This is a hallmark of pseudoscience.

Mainstream medicine has its problems, to be sure. Doctors are people too. We waste money through inappropriate testing. We spend too little time with our patients. We make mistakes that are costly. However, we spend a great deal of time developing evidence-based recommendations that should inform doctors’ practices. We need more medical doctors to cover the increasing demands of the population. We need to develop better ways of connecting with our patients on a personal level. We need to streamline beurocratic processes to make medical care more efficient. We have our problems (26).

That does not mean, however, that Naturopathy should be falsely legitimized by the state. Such false legitimacy has been called “legislative alchemy” (27) in that it takes scientifically incoherent ideas and legislates them into apparent legitimacy. Scientific legitimacy is based on merit and due diligence. It is not achieved with the wave of a legislative wand.

Thank you again for reading this. When it comes time to vote on HB4531, please remember that science matters. It is not about two competing, legitimate institutions. It is really about science and fantasy.

We Michiganders have limited dollars to spend. Let’s not waste it on quackery (28).

Once again, thank you for your time.


Sincerely,





Endnotes


1. Michigan House Bill 4531

If Michigan HB 4531 is passed, it..."would give naturopaths one of the broadest scopes of practice in the U.S., essentially equaling that of a family practice MD or DO. The bill made it through all the necessary House committees and is now before the House for an initial vote determining whether it will proceed further in that body. If it passes there, it will move to the Senate and its committee process.”


2. Coherence in science is essential.

An empiric or mathematical proposition cannot be simultaneously true and not-true at the same time. This violates the Law of Noncontradiction, the second of the three classical “laws of thought”. Science must run on the assumption that the world is a certain way. All branches should be coherent with each other. Biology must be coherent with Chemistry, which in turn must be coherent with Physics. Otherwise it all falls apart. Although coherence by itself may not be enough to justify a system of knowledge, it is necessary.


3. "Accredited" Naturopathic Schools


 “The leading accredited school, Bastyr University, in Seattle, Washington, was founded in 1978. Besides its N.D. program, Bastyr offers a B.S. degree program in Natural Health Sciences with majors in nutrition and Oriental medicine; a B.S. program in psychology; B.S. and M.A. programs in applied behavioral sciences; M.S. programs in nutrition and acupuncture/oriental medicine; and a certificate in midwifery. Bastyr has also provided health-food retailers and their employees with home-study programs that promote "natural" approaches for the gamut of disease. Students in the naturopathic degree program are required to take three courses in homeopathy and can elect to take three more. The Southwest College of Naturopathic Medicine and Health Sciences in Scottsdale, Arizona, was founded in 1992. The University of Bridgeport College of Natural Medicine in Bridgeport, Connecticut, began classes in 1997. The National University of Health Sciences, located near Chicago, which has offered chiropractic degrees since 1966, got its doctor of naturopathy program approved in 2006.
Naturopathy schools receive much of their financial support from companies that market dietary supplements, homeopathic products, and/or herbal remedies
.”



4. Not Accredited for Academic Merit

In 1987, the U.S. Secretary of Education approved the Council on Naturopathic Medical Education (CNME) as an accrediting agency for the full-time schools. As with acupuncture and chiropractic schools, this recognition was not based upon the scientific validity of what is taught but on such factors as record-keeping, physical assets, financial status, makeup of the governing body, catalog characteristics, nondiscrimination policy, and self-evaluation system. NCNM, Bastyr, and Southwest became accredited.”



5. Naturopathy is a Belief System

For proponents of naturopathy, "natural laws" are not generalizations from observation and experimentation, but seem to be the moralistic dictates of an anthropomorphic "Nature" -- usually capitalized to emphasize its purposeful, theistic properties. They also postulate that health is awarded or withdrawn in accordance with one's ability to maintain harmony and balance with the animistic, vital forces of the universe. In committing itself to vitalism, naturopathy puts bodily functions outside the realm of physics, chemistry, and physiology. This is apparent in the following excerpt from the writings of Harvey Diamond, an advocate of the "Natural Hygiene" movement: "The true cause of impaired health lies in our failure to comply with the laws and requirements of life. All health problems arise from the abuse of natural laws. Living healthfully is not an art that we must learn, it is an instinctive way of life to which we must return!"
http://www.naturowatch.org/general/beyerstein.html

Raso J. "Alternative" Healthcare: A Comprehensive Guide. Amherst, NY: Prometheus Books; 1994




6. States Licensing Naturopathy as of 7/16

States currently offering licensure to naturopathic physicians include: Alaska, Arizona, California, Colorado, Connecticut, District of Columbia, Hawaii, Kansas, Maine, Maryland, Minnesota. Montana, New Hampshire, North Dakota. Oregon, Utah, Vermont. Washington, U.S. Territories: Puerto Rico and U.S. Virgin Islands

7. Funding by the Supplement Industry

As a political lobby, Naturopathy gets funding from many corporations that provide expensive, dubious laboratory tests, make supplements and questionable gadgets.

Corporate partners, many of them dietary supplement makers, have collectively contributed more than $270,000 to fund the AANP’s work this year. One of the AANP’s top contributors: Emerson Ecologics, which distributes nutritional supplements and vitamins and gave $50,000 to the group. Emerson’s ties to naturopath advocacy run deep. The New Hampshire-based company employs AANP President Jaclyn Chasse as an executive overseeing scientific and regulatory affairs. "



8. Supplement Industry Revenue

One of the fastest growing industries in the world is the nutritional supplement group, or more broadly known as Vitamins, Minerals and Supplements, or VMS. Producing about $32 billion in revenue for just nutritional supplements alone in 2012, it is projected to double that by topping $60 billion in 2021 according to the Nutritional Business Journal.”


9. Implausible Ideas of Human Biology

As mentioned above, the core of the Naturopathy belief system is a form of Vitalism. Naturopathy rejects much of what is actually known about biomedicine, although it pays lip service to it by requiring students have prerequisite courses in such as Chemistry and by offering classes in basic sciences such as Anatomy. However, students are then told to believe in notions such as water memory, mysterious energy flows like Qi, undetectable energy pathways like meridians, undefined “toxins” and the mysterious mappings of internal anatomy on the iris. Students are schooled in the ancient and refuted notions of the “four body humors”. They are asked to somehow reconcile these notions with the fact that they are refuted by what is known about Physics, Chemistry, Biology, Neuroanatomy and Immunology.



10. Curriculum

On first glance, the curriculum at a naturopathic school looks sort-of like that of a medical school. http://www.bastyr.edu/sites/default/files/images/pdfs/curriculum/15-16%20ND%20Curriculum.pdf

However the courses are laced with the underlying vitalistic belief system without coherent standards based on medical science.

Ex-naturopath, Britt Marie Hermes, states,

There are no naturopathic standards of care. Students and residents at Bastyr University have compiled documents explaining the diagnosis and treatments for a variety of diseases, which are available to students and faculty on the university’s online portal. A review of these documents reveals a large degree of untamed variability that is reflected in naturopathic medicine.

For example, the entry on angina includes a variety of treatment options: nutrient therapy with selenium, CoQ10, magnesium, and niacin; limiting fat intake; removing sucrose, alcohol and caffeine from the diet; botanical medicine in the form of doses of ginger, ginkgo biloba, aconite, and bromelain; at home exercises; recommendations to address a type A personality; a detoxification diet; colon hydrotherapy (i.e. enemas); castor oil packs; food allergy elimination; juice fasts; hormone replacement therapy; lifestyle changes; and monitoring of uric acid levels. Of the documents I’ve reviewed, all fail to mention any standard of care, which for some conditions, at a minimum should include an immediate referral to the emergency room or medical specialist. I know it sounds cynical, but naturopathic medical care is like picking treatments out of a magical hat.”


11. Selling Supplements

It is common practice for naturopaths to sell supplements out of their office. Not only are most “supplements” unproven or worse, they are usually sold directly to the patient at a decent mark-up in price. While it is unfortunately true that some “mainstream” doctors are getting in on this game too, the AMA and policy makers strongly warn medical doctors to not engage in the sale of supplements (or any other health product) as it is a massive conflict of interest.



12. Homeopathy

Homeopathy was made up by Samuel Hahnemann in the 1700’s. It is based on the idea that whatever causes the symptoms of your disease will also cure it (Law of Similars). However, one cannot simply give a sick patient something that will make him worse. So, Hahnemann came up with the idea of diluting the substance over and over (and over and over) until the solution is so dilute that one cannot detect the substance (Law of Infinitesimals). He also stressed the importance of a ritual when diluting the substance (succussion). Drops of the ultra-dilute substance is then administered on the tongue of the patient.

Most homeopathic “remedies” today have absolutely no molecules of the original substance. They are just water. Homeopaths rationalize this by claiming that the water contains the ‘memory’ or ‘vibration’ of the original substance. This water may be given directly or sprayed onto sugar pills for distribution to the public.

There is absolutely no reason for this to work. It is completely irrational in light of common sense. It is placebo medicine at its ‘finest’. Not surprisingly, to date no proper study has ever demonstrated any effect of homeopathy.

Homeopathy is incoherent with the prerequisites courses in  chemistry that students of Naturopathy are supposed to take.

Most people are completely unaware of the nonsensical nature of homeopathic practice. Yet it is taught as part of the core curriculum in schools of Naturopathy.



13. Therapeutic Touch

Therapeutic Touch is another vitalistic belief system. Practically indistinguishable from ‘Reiki’, it involves the practitioners placing their hands over the patient in a ritualistic fashion in an attempt to redirect the patient’s vitalistic ‘energy’ (or balance it with the universes energy, or something…whatever).

This concept has been devastatingly debunked by Emily Rosa, who was only 9 at the time. Her ingenious study was objective and tested the ability of Reiki and Therapeutic Touch practitioners’ ability to detect her energy field when blinded behind a screen. They scored slightly less than what chance would predict. To date, no controlled study has shown any efficacy. Like Homeopathy, Therapeutic Touch flies in the face of all that is known In physics and biology. It is another incoherent practice that is part of the naturopath’s grab bag of incoherent practices.


14. Acupuncture

Acupuncture is another belief system that is very popular. It depends on the claim that the body’s undetectable vitalistic energy (Qi) must flow freely through “meridians” which have no known  neuroanatomical correlates in reality. The modern practice is claimed to have originated thousands of years ago in Asia. However, it is doubtful that the practice that most recognize today as acupuncture is actually the practice of antiquity. It involves placing needles at designated points in the skin to help redirect the flow of Qi.

There are many conflicting practices of acupuncture, with different maps of these “meridians”. Again, like Homeopathy and Therapeutic Touch, there is no evidence that acupuncture can actually treat disease. Patients get the same subjective results with fake acupuncture as with ‘real’ acupuncture. Studies show the same result when the needles are placed at random, rather than in the supposedly important ‘meridians’. The same results can be found with fake needles that retract into their handles rather than penetrate the skin. Patients cannot tell the difference even between toothpicks being twirled at random points on the skin and ‘real’ acupuncture.

Acupuncture, like Homeopathy and Therapeutic Touch, to be an elaborate (an expensive if covered by the State) placebo.



15. Applied Kinesiology

Applied Kinesiology is the implausible, yet widely practiced, belief that a practitioner can detect disease or demonstrate the efficacy of a treatment by testing the muscle strength or the balance of a patient during exposure to a suspected offending substance (such as an allergen) or after the application of a dubious treatment.

The Wikipedia article on Applied Kinesiology states, “Applied kinesiology (AK) is a technique in alternative medicine claimed to be able to diagnose illness or choose treatment by testing muscles for strength and weakness.  Applied kinesiologists are often chiropractors, but they may also be naturopathic physicians, physicians, nurses, physical therapists, or veterinarians. According to their guidelines on allergy diagnostic testing, the American College of Allergy, Asthma and Immunology stated there is “no evidence of diagnostic validity” of applied kinesiology,  and another study has shown that as an evaluative method, AK "is no more useful than random guessing, and the American Cancer Society has said that "scientific evidence does not support the claim that applied kinesiology can diagnose or treat cancer or other illness".

“Applied kinesiology, as described above, should not be confused with kinesiology, which is the scientific study of human movement.”

Applied kinesiology cannot pass a randomized controlled trial. Its techniques are akin to carnival tricks. Whether the practitioner is actually aware of the subtle subterfuge or is actively deceiving the patient/mark, is unclear in many cases. Recently, the tricks have been used to make fraudulent claims about rubber bracelets with a holographic sticker. The Power Balance company was found guilty of fraud in Australia and elsewhere by giving demonstrations of these parlor tricks to sell their bracelets. They claimed that the magic holograms balanced peoples’ energy (or something).

The ideas here are completely implausible and incoherent with what is known about human physiology and physics. Yet, naturopaths don’t seem to have a problem with it.

Here are some fun and interesting videos that demolish the so-called effects of applied kinesiology.



16. Iridology

Iridology is the practice of supposedly detecting disease in a given part of the body by examining the iris of the patient. Proponents claim that the iris is a map of the body. Apparently, the iris must have to change as disease develops in order for examiners to diagnose. The idea originated with Ignaz von Peczely, a 19th-century Hungarian physician.

The most common story is that he got the idea for this diagnostic tool after seeing similar streaks in the eyes of a man he was treating for a broken leg and the eyes of an owl whose leg von Peczely had broken many years before.” https://en.wikipedia.org/wiki/Iridology#cite_note-Irydolog-10

The notion is completely inconsistent with the known anatomy of the iris and the body. The structure of the iris is extremely stable over time and does not change with disease. The technology of the iris scanner would not work otherwise.

A thorough review of the available literature by Edzard Ernst found no evidence that iridology is useful in detecting disease. He did point out that it is potentially very harmful by delaying actual diagnoses or leading one to believe in a false diagnosis. “As iridology has the potential for causing personal and economic harm, patients and therapists should be discouraged from using it.”



17. Other Naturopathic Offerings

The Wikipedia entry on Naturopathy lists the following services offered by naturopaths. Many of these services are pseudosciences. Those that are not necessarily pseudoscience -- such as diet and exercise -- are not unique to Naturopathy. However, since Naturopaths are informed by their incoherent beliefs and other pseudosciences, advice in these areas should be approached with caution. The information comes from a 2004 paper, Practice patterns of naturopathic physicians: results from a random survey of licensed practitioners in two US States.

A 2004 survey determined the most commonly prescribed naturopathic therapeutics in Washington State and Connecticut were botanical medicines, vitamins, minerals, homeopathy, and allergy treatments.

The particular modalities used by a naturopath vary with training and scope of practice. These may include herbalism, homeopathy, acupuncture, nature cures, physical medicine, applied kinesiology, colonic enemas, chelation therapy, color therapy, cranial osteopathy, hair analysis, iridology, live blood analysis, ozone therapy, psychotherapy, public health measures and hygiene, reflexology, rolfing, massage therapy, and traditional Chinese medicine. Nature cures include a range of therapies based on exposure to natural elements such as sunshine, fresh air, or heat or cold, as well as nutrition advice such as following a vegetarian and whole food diet, fasting, or abstention from alcohol and sugar, Physical medicine includes naturopathic, osseous, or soft tissue manipulative therapy, sports medicine, exercise, and hydrotherapy. Psychological counseling includes meditation, relaxation, and other methods of stress management
.”


Please note that many of the items listed here are not “alternative”. Massage therapy, hygiene, nutrition, exercise, psychotherapy and ‘stress management’ are not services unique to Naturopaths. We already have an infrastructure that can provide these services if warranted. It should also be noted that naturopaths are informed by the vitalism and incoherent premises of their belief system. It should not be expected that -- with such an underlying belief system-- they would adjust their advice in areas such as nutrition as the actual evidence-based guidelines change.

Dr. Harriet Hall points out that, “What naturopaths do that is good is no different from what
MDs do, and what they do that is different is not good, and is potentially dangerous.”


It should be noted that in our current health care environment, access to good nutritional and psychological counselling is limited under our current reimbursement environment. What would it be like if naturopaths are licensed and begin billing the state for these services?


18. Naturopathy and AIDS

Dr. Kimball Atwood states in his article, "Naturopathy, A Critical Review" (Medscape 2003),
“(There are) Recommendations, by the Bastyr University AIDS Research Center, for treatment of HIV-positive patients with St. John's wort and garlic (both of which have been shown to reduce blood levels of highly active antiretroviral therapy agents), "acupuncture detoxification auricular program," whole-body hyperthermia, "adrenal glandular," homeopathy, "cranioelectrical stimulation," digestive enzymes, colloidal silver, and nearly 100 other dubious methods.”

Standish LJ, Ruhland JF, DiDomenico B, Gmeiner K. HIV/AIDS: naturopathic medical principles and practice. In: Pizzorno JE, Murray MT, eds. Textbook of Natural Medicine. 2nd ed. London, England: Churchill Livingstone; 1999:1277-1302.


19. Placebo Effects

Since 1945, pills that contain no active drug have come to be known as "placebos". Specifically, the American Medical Association uses the definition:

"A placebo is a substance provided to a patient that the physician believes has no specific pharmacological effect upon the condition being treated." They are usually made of sugar, thus the term 'sugar pill' has become synonymous with 'placebo'. Ideally, a medical researcher wants to control for all factors that patients experience in a research study, including the act of taking a pill. By using a fake drug - without the patient's full knowledge - in the control group, the effects of the actual drug in the treatment group can be measured."

Placebos are properly used in research. Placebos do not have to be pills. They can be inert injections made to appear like true injectable medications. They can be fake procedures, such as a superficial incision with stitches placed under anesthesia to mimic a surgery. Recently, placebo needles have been devised to simulate the actual placement of acupuncture needles. In short, placebos are fake treatments used to research the effectiveness of 'actual' treatments.




20. Homeopathic Malaria Treatments

Naturopathy schools and practitioners endorse the pseudoscience of Homeopathy (see above). In the United States, homeopathy is often prescribed or recommended by naturopaths. In the U.K., so-called doctors of homeopathy are the main source of this brand of pseudoscience. Since naturopaths embrace homeopathy (which has zero plausibility and zero evidence), we need to be cautious.

An informal study conducted by British journalist Simon Singh and Alice Tuft from the U.K. charity Sense About Science investigated homeopaths' recommendations for a traveler to an area endemic for malaria.

"Tuff found a variety of homeopaths by searching on the internet, just as any young student might do. She then visited or phoned ten of them, mainly based in and around London. In each case, Tuff secretly recorded the conversations in order to document the consultation. The results were shocking. Seven out of the ten homeopaths failed to ask about the patient's medical background and also failed to offer any general advice about bite prevention. Worse still, ten out of ten homeopaths were willing to advise homeopathic protection against malaria instead of conventional treatment, which would have put our pretend traveler's life at risk."


The CDC offers a cautionary anecdote about pseudoscientific malaria treatments as well.




21. Antivaccine

The field of naturopathy has demonstrated a continuous pattern of opposition to immunizations. Some naturopaths who write about the subject are completely negative. Those who present both positive and negative ideas invariably emphasize the negative. Its leaders realize that opposition to immunization could damage their credibility when they lobby for passage of licensing laws or other legislative recognition. Those who say they advocate "parental choice" fail to mention the extent to which they and their colleagues portray immunization as unnecessary and dangerous. To be credible, any assertion that naturopaths favor immunization would require a formal change in the AANP position paper and a dramatic shift in the literature emanating from the field. Unless that happens, any such assertion should be considered a dishonest attempt to curry favor with legislators.”




22. Vaccines are Safe and Save Lives

The routine vaccination schedule is based on years of research across the world.  Safety is always a top priority in this research.   As a result of this research, many of yesterday’s terrible diseases have become very rare.  Immunizations have saved billions of lives around the world. Modern culture feels no need to fear the devastating effects of infections such as measles, rubella, whooping cough, Haemophilus meningitis, tetanus, or polio. Vaccines have been so successful that we have forgotten what these horrors look like. These (deadly) infections still exist.  In fact, there have been resurgences of preventable illnesses due to anti-vaccine propaganda. As an example, in 2011, the W.H.O. reported over 30,000 cases of measles in Europe, mainly stemming a dramatic decline in vaccination. Of these cases, there were 27 cases of encephalitis and 8 deaths. This trend has spread to the United States due to international travel. In 2011, the C.D.C. reported 220 cases (nearly a quadrupling of usual cases).”


For a more up to date list from the CDC on the rates of vaccine-preventable illness and deaths,



23. Profiting From Selling Supplements

Naturopathic treatments include colonic irrigation (enemas) and fasting for "detoxification," hydrotherapy (wrapping part or all of the body in wet towels), homeopathy, acupuncture, chiropractic manipulation, aromatherapy, arduous dietary regimens, intravenous vitamin C, hydrogen peroxide and ozone, whole enzyme pills, herbs, desiccated animal organs, and other "natural remedies." Naturopaths sell these preparations to their clients at a profit, a practice that is both formally approved and joined by the AANP.”

See also: Pizzorno JE, Murray MT, eds. Textbook of Natural Medicine. 2nd ed. London, England: Churchill Livingstone, 1999:1078-1082
.


Here is an excerpt from a press release touting the partnership between a large publicly traded supplement manufacturer and the AANP : 

“CONCORD FARMS, MA (January 6, 2000) – MotherNature.com (Nasdaq: MTHR), a leading online information source and e-tailer of vitamins, supplements, minerals, and other natural and healthy living products, today announced partnerships with two leading alternative care health organizations to provide natural health products and information to their members. The agreements with Landmark Healthcare and the American Association of Naturopathic Physicians (AANP) will promote MotherNature.com to millions of patients and healthcare practitioners of the two organizations.”





24. Ethics in Medical Care

From the AMA Code of Ethics

E-3.01 Nonscientific Practitioners. It is unethical to engage in or to aid and abet in treatment which has no scientific basis and is dangerous, is calculated to deceive the patient by giving false hope, or which may cause the patient to delay in seeking proper care.

E-3.04 Referral of Patients. A physician should not so refer a patient unless the physician is confident that the services provided on referral will be performed competently and in accordance with accepted scientific standards...

E-8.20 Invalid Medical Treatment.
(1) Treatments which have no medical indication and offer no possible benefit to the patient should not be used (Opinion 2.035).
(2) Treatments which have been determined scientifically to be invalid should not be used (Opinion 3.01).

E-9.132 Health Care Fraud and Abuse. "
and

"The following guidelines encourage physicians to play a key role in identifying and preventing fraud:

-  Physicians must renew their commitment to Section II of the AMA's Principles of Medical Ethics which states that "a physician shall deal honestly with patients and colleagues, and strive to expose those physicians deficient in character, competence, or who engage in fraud or deception."
-- A physician shall continue to study, apply and advance scientific knowledge, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated."




25. No Evidence for Alternative Medicine

CAM = Complementary and Alternative Medicine
NCCAM = National Center for Complementary and Alternative Medicine
(NCCAM is now called 'NCCIH' or National Center for Complementary and Integrative Health)

But do alternative treatments work? That depends on what one means by 'work'. Do people feel good about the care they received? In many cases they do. Are their medical conditions actually treated beyond subjective feelings and beyond the natural history of disease?
The evidence says, "No".

 In the NCCAM's first 10 years, over $2.5 billion tax dollars have been spent on controlled trials to study alternative treatments. To NCCAM’s credit, they adhere to the scientific methodology of evidence based medicine, much to the chagrin of NCCAM's political support.
‘One of the purposes of this center was to investigate and validate alternative approaches. Quite frankly, I must say publicly that it has fallen short. I think quite frankly that in this center and in the office previously before it, most of its focus has been on disproving things rather than seeking out and approving.’  (Senator Tom Harkin (D-IA) in a 2009 Senate hearing)

Scientific studies are not meant to confirm pet theories. One of the main reasons to do proper scientific studies is to eliminate biases such as the 'confirmation bias'. Statements such as Sen. Harkin's reveal deep and fundamental misunderstandings of how science works.

** To date, no significant findings have been made in favor of CAM.



26. Mainstream Medicine Has Its Problems

Medicine has its problems too. Many medical practices including some pharmaceuticals and surgical procedures are lacking in evidence. An incomplete list of examples can be found here: https://sites.google.com/site/skepticalmedicine/medical-practices-unsupported-by-science

Our system spends more on healthcare per capita than any other nation. Much of it is found to be wasteful due to over-testing, processing claims, noncompliance, ineffective use of technology, hospital readmissions, medical errors, unnecessary ER visits, and hospital-acquired infections.


To the patient, mainstream medicine can feel sterile, beurocratic and impersonal. Physicians have little time to spend with patients due to patient volume. Even if all goes well and appropriate treatments are prescribed, the needed care may not be covered. Many patients cannot afford coverage at all. The list of problems with medicine goes on.

However, these problems are potentially solvable by careful study and changing practices with respect to evidence and innovation. Having problems of our own does not justify governmental recognition and funding of systems such as Naturopathy which only pay lip-service to science and evidence. This would dramatically increase the problem of waste in American healthcare.


27. Legislative Alchemy

Via the magic of “legislative alchemy,” state legislatures transform implausible and unproven diagnostic methods and treatments into perfectly legal health care practices. Without the benefit of legislative alchemy, chiropractors, naturopaths, homeopaths, acupuncturists and other assorted putative healers would be vulnerable to charges of practicing medicine without a license and consumer fraud. Thus, they must seek either their own licensing system or exemption from licensing altogether.

Licensing bestows an undeserved air of legitimacy on “alternative” practitioners. Because a state’s authority to regulate health care lies in its inherent power to protect the public health, safety and welfare, the public understandably assumes licensing actually accomplishes this purpose. In fact, the opposite occurs. Any attempt to impose a science-based standard of health care becomes impossible when vitalism and similarly debunked notions of human functioning are enshrined into law
.”



28. Quackery

Stephen Barrett, MD is the founder of Quackwatch.com. On “quackery”, Dr. Barrett states, “All things considered, I find it most useful to define quackery as the promotion of unsubstantiated methods that lack a scientifically plausible rationale. Promotion usually involves a profit motive. Unsubstantiated means either unproven or disproven. Implausible means that it either clashes with well-established facts or makes so little sense that it is not worth testing.






Copies of Letter and Endnotes

ĉ
John Byrne,
Jul 12, 2016, 4:38 PM
ĉ
John Byrne,
Jul 12, 2016, 4:38 PM