Columns May 14, 2009 at 4:00 am

Comments

1
You learn osteopathy at an osteopathic school. They learn naturopathic. No connections between the two I know of.
2
786

Hello there,
Thank you for your post. I have a short video (http://www.askdrkassam.com/index.php/200…) that reviews what a Naturopathic physician is and how they practice. We are trained as primary care physicians - so although we learn nature cure modalities, we also have a strong foundation of knowledge in physiology, clinical physical diagnosis, pharmacology, pathology, etc. I believe that a shift in medicine is happening and that people are beginning to become more aware of the extensive training Naturopathic physicians receive.
Take care,
Natasha
3
The placebo effect is a strange and powerful facet of human conciousness - direct control of the body through fooling the mind. It's a shame that instead of probing this more deeply, effort it being put to just making better fools. NDs are quacks. Granted, quacks with good memory for body parts, but quacks.
4
Dr. Kassam -- We can't be fooled into thinking that "degreed" NDs are the equivalent of "primary care physicians." Even if you learned the basic biological sciences, you spend years of UNLEARNING that knowledge. You come out of your "accredited" schools doing the same bogus practices that the mail-order NDs do, except that you have puffed up egos and are, therefore, more dangerous (e.g. less likely to refer patients to real physicians). Your schools' accreditation is by the Dept. of Education which ONLY looks at administrative policies, not course content. Your textbooks are woefully inadequate regarding diagnosis, so what you use to treat patients is totally irrelevant.
5
ND's are not quacks. In the states of WA and OR they are licensed primary care physicians who get the same education with the same curriculum as allopaths do PLUS botanical medicine, homeopathy, physical medicine/therapy, and nutrition. The focus of the ND is to treat the cause not just the symptoms of a condition or disease (which most allopaths/MD's do). An ND also has the ability to prescribe pharmaceuticals from an extensive formulary regulated by the state, and all requisite pharmacology courses are taught in an ND's education. Naturopathy or some form of it was the only medicine practiced for centuries until around 100 years ago when allopathy came on the scene. The science behind naturopathic medicine is published in literally hundreds of journals every year ranging from the NEJM to Botanical medicine journals. Also drugs such as Lipitor (statins in general) are in a class of drugs where the mechanism of action is derived from and based on the mechanism of action of red rice yeast--a naturally occurring yeast that has been used for centuries by practitioners of Chinese medicine to treat the same condition that Lipitor treats (elevated serum lipids). There are more examples of pharmaceuticals that are based on botanical medicines and substances that have been traditionally used for centuries, but it would be a very long comment to write it all here.
6
Dr. Kassam -- We can't be fooled into thinking that "degreed" NDs are the equivalent of "primary care physicians." Even if you learned the basic biological sciences, you spend years of UNLEARNING that knowledge. You come out of your "accredited" schools doing the same bogus practices that the mail-order NDs do, except that you have puffed up egos and are, therefore, more dangerous (e.g. less likely to refer patients to real physicians). Your schools' accreditation is by the Dept. of Education which ONLY looks at administrative policies, not course content. Your textbooks are woefully inadequate regarding diagnosis, so what you use to treat patients is totally irrelevant.
7
Completely trained physicians practice medicine and surgery. Naturopaths don't have the training, the experience, or the scope of practice I want in a family doctor. I prefer to be able to have one doctor do my Pap smear, do my college physical, remove a mole from my arm, and maybe deliver my baby. I'd never trust a naturopath to do that...it's hubris for them to say that they should be alowed to.

SMW
8
The Dept of Education-approved naturopathic accreditation organization known as CNME does look at curriculum as well as administration of the school, despite the comment that they don't.

NDs are in fact trained to do minor surgery (remove moles), do Pap smears, do general physicals, and (if they take the extra midwifery training) deliver babies. There is no hubris--look at the training, that's what we learn to do.

Before anyone starts slamming us NDs as being "quacks" or "dangerous," they must first explain how the well-trained MDs and DOs are killing over 100,000 patients per year with properly prescribed drugs every year, just in hospitals (no one knows how many die in the community), and who knows how many die from unnecessary surgery, etc. (JAMA 1998;279:1200-5). And that's data from the 1980s and 1990s--lord knows how many are killed every year now. So, who's dangerous? NDs are in fact vastly more safe just because we use fewer drugs. Giving us prescriptive authority, for which we get more hours of classroom instruction in than UW MD students (though perhaps less clinical experience, granted), for non-scheduled drugs just facilities us being primary care so that we can hopefully protect more people from excessive mainstream care.
9
"Your textbooks are woefully inadequate regarding diagnosis, so what you use to treat patients is totally irrelevant."
LindaRosaRN ND's use the same textbooks that allopathic students use, which are more complex and in depth than the books nursing students use.
10
why so much hate for the NDs? I've had plenty of extremely bad experiences with MDs too, poor unsubstantiated diagnosis, prescription of totally inappropriate damaging drugs etc. No one should take everything any kind of doctor says as the gospel truth. There are good and bad MDs, NDs, and any other kind of professional you can imagine. And even a good doctor will make mistakes sometimes. If you care about your health, be open to any and all solutions and choose the ones that make the most sense for you. The body is a big complicated thing and there is no education that can explain it all.
11
The DOE only looks at the administrative policies of CNME (Council on Naturopathic Medical Education) as well. Having CNME examine the course content of naturopathic "colleges" is like having foxes examine the hen house. There are special interests at play, and the teaching of safe and effective treatment, determined by scientific scrutiny, is not one of them.

I'm talking about THE naturopath texbook -- the one written by Joseph Pizzorno. It is pathetic. Take, for example, the section about diagnosing asthma. No wonder the naturopath killed Megan Wilson, the asthmatic teenager a few years go.

"Allopathy" and "allopath" are derogatory and insulting terms. These are 19th century terms that mean physicians' treatments have nothing to do with disease and are therefore harmful.

Maybe physicians have more fatalities because not all of their patients walk in their door like naturopaths' clients do.

12
The attempt to discredit Complementary and Alternative Medicine, and their practitioners by various well known insulting words is the last gasp of Allopathic thinking, from the medicine which set itself up IN THE LAST CENTURY, as the one true medicine. The AMA actively lobbied and used POLITICS to destroy competitors like Homeopathy but this approach, by the 1970's backfired in their faces when the Chiropractors fought back and won a major court battle against them in the U.S.

In the meanwhile, on all fronts, people are becoming familiar with the inexpensive, often impressively fast, and free of side effect ridden drugs which characterizes ND, DO, Chriopractors, Oriental Medicine Physicians, Homeopathic physicians and other modalities.

The attempt to brand the alternative system as "unscientific" or not "evidence" based is actually focusing attention on the allopaths, and their rabid supporters as people learn of the cross connections, influence peddling and outright fabrication of drug data which has been rampant for some decades and which only now is starting to be identified and reformed.

A British medical journal survey indicates that an incredible 46% of standard treatments are of unknown effectiveness while less than a third are actually beneficial - others are outright harmful or of dubious merit.
Meanwhile, patients by the millions are aghast at the "side effects" which are somehow routinely accepted without question by the anti-alternative medicine scientism-ists.

What is the proximal cause of the latest waves of innuendo, hysteria and attacks against alternative medicine? Could it be the coming reforms by President Obama and his administration which for the first time in decades will start to expose the extraordinary power and influence of the media based special interests and will slowly insitute reforms, which are already happening, spontaneously, at the state level, to address the grevious attempt to maintain near monopolism by a single medical system to the utter disregard of the health, safety and well being of men, women and children who might benefit from the allowance of other systems and other kinds of practitioners.

Freedom of choice laws have already been passed in several states and the trend is accelerating, creating fully licensed primary care physicians who are Oriental Medicine physicians, Naturopaths, Homeopaths and others. It is an inevitable and good developement which will lead to a new era of fully integrated medicine and all the invective, misrepresentation and hysteria against it will only accelerate this trend rather than forstall it.
13
The medicine which has set itself up in the last century KICKS ASS. It has out performed all the other medicines that pre-dated it. Before modern, scientific medicine there were no antibiotics, and plenty of communicable and deadly diseases you never hear of anymore.
SMALLPOX. Scientific medicine has eliminated smallpox. Nothing you can say can change that or diminish the immense value of this accomplishment.
SCIENCE WORKS BITCHES
14
There is NOT good scientific evidence for acupuncture and most acupuncturists will NOT "gladly admit the limits of their techniques". They continue to wrongly claim it is effective for a very broad range of conditions, some of them life-threatening (see wiki). There have been over 60 cases of punctured lungs caused by acupuncturists in recent years, according to Ernst & Singh in 'Trick or Treatment'.

If someone I knew was planning to throw his money (and life) away learning to be a quack I'd give them a copy of that book and any number of others that talk sense on the topic.
15
In fact, much of allopathic medicine has _never_ been put to rigorous scientific testing. Rather, it is based on tradition that was passed through main stream medical practice. Much of being a doctor is helping the body to heal itself - naturapaths can do that as well as allopaths, and sometimes better.
16
A chiropractor once told me my ADHD, nagging shoulder injury, AND my migraines were a result of a mis-aligned spine. I asked for scientific evidence. He gave me a brochure. I asked for reference to a peer reviewed study with a control group and a treatment group, and perhaps even some physiological explanation that wasn't about "fluids" (humors, anyone?) and nerves in the spine. He became quite irritated and told me that if I thought he was wrong then I shouldn't come to his office. Ah, what a response. If you don't believe my ridiculous, unexplained, unsupported theory on faith then you shouldn't be my customer. I don't know much about NDs. But Chiropractors are quacks.
17
Oh, and hey NDs, how about some LINKS to NEJM, BJM, JAMA, etc. that support your credibility? It's not that I doubt they exist, but you claim there are "many" credible article that support your treatments and profession...ok, prove it. And NOT journals reserved for natural medicine. After all, there are always internal-to-field peer reviewed journals, such as the Journal of Parapsychology, but that doesn't mean they are credible.
18
Here's the challenge with providing articles that support the credibility of naturopathic medicine: there is not a particular modality or technique that is 'naturopathic' that can be definitively tested. Rather, it is a philosophical approach to medicine, the essence of which is to maximally individualize approaches to patient care with the minimally invasive procedures and imaging. And, contrary to what Science says about it, there is no directive against or in opposition to allopathic medicine in the legal definition (or spirit, in my opinion) of naturopathic medicine.

In fact, I'm surprised people are so hung up on whether or not naturopathic doctors are well educated. That's not the issue - the education is good. It has to be in order for them to pass fairly rigorous board exams to receive their license (incidentally, to do this they have to know allopathic standards of care, and know when to refer).

The issue that I think Science and many other concerned posts on this board echo is professional oversight throughout the rest of one's career. This is the arena in which the naturopathic profession (and many other complementary healthcare professions) falls short of their allopathic counterparts.
19
I'll stick to my MD family doc. Had him for seven years now, had his mentor/partner since birth. Very happy with both of them.
20
Hold the presses here people. Nothing like a little judgment based on reading ONE book or ONE article or even ONE visit to an ND. I've been to allopathic medical school. I've been to naturopathic medical school. I've graduated from both programs, and choose to organize my practice around the naturopathic treatment models I learned as an ND. If you really think that a cold caused by a virus should be given an antibiotic, go right on in to your MD's office. If you don't see the disparity there, you should do some research before continuing your diatribe for or against either discipline. Truth: I spent more hour in both didactic and clinical educational settings as an ND. The MD education is self limiting by it's intense focus on pharmacological and surgical interventions. Check out any pharmacology text/journal and note that the answers change every six months. In fact, before you take one more step in your judgments, consider your own life. Do you bathe? Do you eat? Do you drink water? Do you exercise? Do you honestly think that these basics are miraculous discoveries of the last 100 years? If you can't figure out for yourself that pumping drugs in instead of good food is a recipe for disaster, go see your MD. I'm sure he has a pill for that.
21
I'd love to post more, but I'm too busy ordering cholesterol screens in my overweight patients, MRI in my patient with sports-related shoulder injury, and referring the patient with a rapid heartrate to a cardiologist for workup. In my spare time, I'm busy offering heart-healthy dietary advice, using stretching and massage for patients with low-back pain, and teaching my anxious patients meditation techniques. I've got limitations in my training, but I recognize them and regularly use other healthcare providers (RNs, MDs, DCs, PTs, and all the rest) to ensure my patients the best possible care. We're all trying to help improve the health of our communities, right? Last I checked, online anonymous fights never much helped with that.
22
I'm in the ND program at Bastyr. We don't use Pizzorno's textbook for diagnosis! Try: Harrison's Principles of Internal Medicine, Seller's & Ferri's for quick reference.... if you're in medicine you'll recognize those. Pizzorno's is a reference text for naturopathic treatments, with symptoms listed briefly the way they are in, oh, say, my pharmacology text ("Illness A is recognized by the following symptoms").

You people are fighting a fight that is over. Talk to the MDs who work with us and know us. Talk to our patients.
23
If anyone has a question about the qualifications of an ND graduate from Bastyr versus an MD graduate from the University of Washington, I encourage you to compare our course load and the qualifications of our faculty. The ND program at Bastyr includes as much as or in some cases more of the required basic sciences (biochemistry, anatomy, neuroscience, pathology, etc) in addition to our naturopathic training.
24
I don't live in Washington State, but I have had good experiences with complementary medicine. In my health system, the complementary medicine clinic was part of the clinic network, so people were referred back and forth from there to other clinics when necessary. They helped me with a painful back problem through chiropractic care and teaching me exercises to do on my own, and with vitamins and dietary counseling. I also had a few rounds of acupuncture that were less effective, but didn't seem to do any harm. I wouldn't make complementary medicine my only form of care, but it certainly has its place in the world of medicine.

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