A recent column of mine responded to a question/rant about naturopathic medicine:

A dear friend of mine is about to enter a prestigious program of naturopathic medicine. There—in exchange for hundreds of thousands of dollars and five years of his life—he will study homeopathy, osteopathy, water therapy, etc. Apparently, after gaining his ND credential, he will not only be allowed to practice medicine in Washington, but also to prescribe drugs. Why does state law allow these practitioners to dole out the pills? Can this possibly be safe?

Incredulous Friend

P.S. Is there a polite way to tell someone that everything he passionately believes in is bunk and that he’s throwing his life away?

I disagreed with the questioner; a lot of alternative medicine is worthwhile, and increasingly demonstrated to be so by the scientific method.

Fortunately, not all of naturopathic medicine is bunk….The less a branch of naturopathic medicine defines itself as being in opposition to “allopathic medicine” (i.e., scientific medicine), the more useful it seems to be for patients. Most massage therapists or acupuncturists will gladly admit the limits of their techniques, and the benefits from receiving treatment from either can be scientifically demonstrated. For things like chronic back pain, arguably these practitioners will be of more use to a patient than a doctor armed with pills and surgery. Training in osteopathy is becoming ever closer to the curriculum one would find in a medical school; Science would trust an osteopath as a primary caregiver as much as an MD.

Only when the naturopathic fields refuse to have their claims tested by experimentation does Science find them to be silly or even fraudulent.

This position—that an ND curriculum based upon science is as valid as one taught at a traditional medical school—is a bit out there, a more generous stance in favor than typical for naturopathic medicine.

The response from the local ND community? Emails like these:

First problem: it is an opinion dressed in an article called ‘Science.’ That is shitty science. It is also crappy journalism to advance opinion as fact. Some simple searches on PubMed would have improved the entire article, or maybe call a few people with credentials like Dan Savage does.

Bigger problem: Bastyr University pays the Stranger for ad space. Obviously, you print what you think is important and everybody is better off because censorship creates fear and drones. However, I think taking money from a University for ad space and bashing them in an opinion-laden article passed as Science is low. It is one thing to take ads for cigarettes and then criticize, but Naturopathy is not cigarettes, it leads to health not health problems.

You paper shapes peoples opinions. Do you really want to suggest that current medical practices are ideal? Do you want to discredit the ND’s who heal while not partaking in the fraud that is our current healthcare system and medical practice? I would like you to publish articles on ‘iatrogenic’ disease. There is a story.

Ugh.

EBPD.jpgModern medicine works because of a long legacy of scientific inquiry to human health—from peer-reviewed, double-blind, randomized and controlled trials to simple correlations of observations to disease states. After pulling out the horrors of our employer-based private insurance system, for-profit hospitals and other aggravations, this body of knowledge— continually expanded, pruned and refined—is the basis for the dramatic successes of a deeply flawed health care system.

Take Evidenced-Based Physical Diagnosis, written by a Seattle VA doctor Steven McGee, as an exemplar example. Any caregiver (MD, ND, DO, whatever) with this book, or similar, in their mind is skittering on top of a vast and precise body of knowledge that has taken centuries to accumulate. This collection of carefully curated information, that some of my ND readers are ready to call fraudulent, is beautiful and scientific in the deepest sense of the word. To the extent that alternative caregivers are contributing to it—using differing philosophies and point of view to open whole new areas to observation—they deserve a warm embrace. To the extent they are furiously, blindly and stupidly lashing out at it, they are the enemies of health.

Jonathan Golob is an actual doctor.

62 replies on “It’s Difficult to Say Nice Things About NDs”

  1. I suppose you could TRY to prove naturopathic medicine with the scientific method, but it probably/most likely will not work.
    The biomedical system (the one that hands out pills like candy) is what spawned out of the scientific method.

  2. If Chinese medicine is so good, how come their life expectancy ALWAYS lagged behind the West until the introduction of Western medicine?

    “My MD couldn’t figure it out, the gastro specialist thought it was all in my head. Then I decided to try an ND and voile”

    He figured out it was in your head. Like it is for most of you for ND lovers.

    Ever notice how most of the people who swear by ND have problems with their colons and assholes?

  5. i was just saying yesterday that i have long thought it takes a special arrogance to declare yourself a doctor. an expert in such a huge body of knowledge that can declare the ailment and course of treatment. i was specifically talking about acupuncturists, which i think is very difficult to do well. a good one is amazing.
    there are good and bad of everything- nd’s, chiropractors, massage practitioners. i’m sure most people have seen the differences among their own general practitioners.
    your own personal experience doesn’t prove any rule. millions of people being helped by something sorta does. knowing this is anecdotal is fine.
    you gravitate towards the best delivery of information. i’m sure you could find evidence in any direction. the fine art of interpreting scientific data is lost on most people. others will spit fire in defense of what is only truth until disproven.

  6. I know this sounds condescending, but having spent quite a bit of time in Chinese hospitals, I think I can fairly qualify most of the talk on this subject here as bullshit. It is inaccurate to depict the medicine practiced in China today as anything approaching Traditional Chinese Medicine (TCM). Therefore, it is also specious to cite China’s health problems as a fault of TCM. In China, TCM is rarely if ever practiced in the hospital, which is where you go in China if you have a cold, the flu, a yeast infection, etc. Doctors in China practice Western Medicine. If you want something different, you go to a massage or acupuncture or tui na clinic where they do body work and also prescribe herbs and tinctures. Alternatively, there are shops everywhere selling dried bits of exotic animals for “medicinal” use. Virtually none of the people involved in these industries are doctors or authentically trained TCM practitioners. While it is true that there are numerous TCM learning centers in China, the vast majority of them are bullshit that have little or nor basis in the enormous written record of TCM that stretches back thousands of years. Most people agree that the best TCM schools in the world are outside mainland China, in places like Taiwan, Germany, and the U.S.

  8. Homeopathy is right up there with phrenology and astrology in my Big Book O’ Crap For the Credulous, but don’t be hatin’ on osteopaths. Their training is relatively traditional, very rigorous, and has a better clinical success rate than most of the rest of the stuff lumped in as ND/complementary/alternative medicine. I’m not convinced osteopathy belongs in the Humbug bucket with the rest of the charlatans.

  9. Homeopathy rocks. I’m going to throw an aspirin into Puget Sound and cure everybody in town of headaches!

    Every time I see my MD, he advises me about prevention, lifestyle changes, and nutrition. And I got cured of long-term stomach pain, too – goodbye gallbladder, see you in hell!

  10. This allopathic vs naturopathic medicine debate gets so old: insurance companies have been covering “alternative” treatments for some time now. In fact, people should not consider acupuncture, biofeedback and massage therapy alternative. Jonathon and others might be interested to know that most (but not all) residents at the University of Washington use Uniform Medical Plan as their medical insurance (nice cheap group rate, and I have no association with them fyi), which pays 90% for 16 acupuncture treatments/year, biofeedback, 16 massages/year, AND naturopathic practioners. This is not new. It does take some time for naturopathic or alternative therapies to become accepted/covered by insurance companies, but, as Jonathon said, when these treatments are subjected to the scientific method those that work will be embraced

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