Dear Science,

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?

Sadly, there isn't a good way of telling someone his life and beliefs are completely full of shit. Fortunately, not all of naturopathic medicine is bunk. (It's the dietary-supplement makers that deserve to be called out on their total sociopathic thievery. If you have any Hydroxycut products around your house, throw them away now.)

Let's take a moment to talk about how an MD is trained. Medical schools teach a curriculum that is mostly based on rigorous scientific research in physiology, biochemistry, pathology, pharmacology, and microbiology. The aim is to use the scientific method—in which ideas and concepts are tested and refined by experiment—to continually improve the care given to patients. This attempt to integrate scientific knowledge and techniques with the clinic really took off at Johns Hopkins University with its efforts against the 1918 influenza outbreak.

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. There aren't multiple realities—there is one. If one cannot demonstrate a benefit from treatment (say, an ointment containing vastly diluted toxins), there probably is no benefit. It might be worth mentioning to your friend that smaller, primary-care-focused medical schools are warmly embracing the parts of naturopathic medicine proven by science. One might be a good match for him.

Refiningly Yours,

Science

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