Society for Science-Based Medicine

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Naturopathic "doctors" selling Mississippi a pig in a poke


Not even Sen. Josh Hawkins, the author of a bill licensing naturopathic "physicians" for the first time in Mississippi, could tell his colleagues what sort of education and training naturopaths have. (Previous naturopathic licensing attempts in the state have failed.) His colleague, Sen. Hob Bryan, admitted he didn't know what naturopathy is. Yet, Senate Bill 2511 passed unanimously out of two Senate committees.

I call that buying a pig in a poke. That's a particularly dangerous proposition when the pig is about to be licensed as primary care physician.

Had they studied the bill more thoroughly, the good Senators might be surprised to learn just how broad a scope of practice they are granting naturopaths. SB 2511 allows them to practice "primary care," call themselves "physicians," and diagnose and treat what is known as the undifferentiated patient, that is, any patient of any age, neonate to geriatric, with any disease or condition.They can prescribe drugs on a naturopathic formulary, perform minor office surgery, give injections, use intravenous therapy and deliver babies.

That's a lot when you admittedly don't know whether their education and training is up to the task. Unfortunately, instead of looking into the matter further, the committee members simply put naturopaths under the jurisdiction of the medical board and said they had to work "under the general supervision of a physician." That's a bandaid, not a cure.

I have been following naturopathic "doctors" and their licensing and practice expansion efforts for almost a decade. I do know what their education and training is and I know how they practice in states where they are licensed and states where they are not. I am happy to share that knowledge with Mississippi legislators in hopes they will see why naturopathic licensing is a mistake for Mississippi.

Naturopathic "medical" schools are small, independent schools accredited by the Council on Naturopathic Medical Education, an organization with no oversight from any person or group outside naturopathy. None of these schools are affiliated with any mainstream U.S. colleges or universities, which won't even accept credits from naturopathic school courses.There is no entrance exam to get into naturopathic school, not even the GRE.

Accredited naturopathic schools have some basic science education, but much of the naturopathic students' time is spent learning about herbs, homeopathy, dietary supplements, colonics and other unproven remedies in courses taught by other naturopaths. Unlike MDs and DOs, they don't do several years of residency after graduation. Their entire clinical training takes place at small school clinics where they see patients with minor, usually self-limited illnesses and the "worried well." If there are not sufficient real patients to get required clinical training, they practice on other students.

After graduation, they take the NPLEX exam, an exam made up by other naturopaths which no one outside of naturopathy has ever seen or evaluated for scientific accuracy. Upon passing, they can go straight into private practice.

Until recently, the insularity of naturopathic education and practice left it shrouded in mystery. Most people, like the Mississippi legislators considering this bill, knew little about it. Fortunately, a little disinfectant sunshine has recently been shined on naturopathy by Britt Hermes, who graduated from the premier U.S. naturopathic school, Bastyr University, and practiced as a naturopathic doctor. She left naturopathic practice in disgust, after seeing too many patients physically and financially harmed by their practices.

No legislator should vote on this bill without reading her blog, Naturopathic Diaries. In it she recounts, in much more detail than I have, the deficiencies in naturopathic education and training, as well as their pseudoscience-filled practices.

Mississippi legislators appear to be under the impression that naturopathy will "offer more options," as Sen. John Horhn put it, for the state's citizens. Sen. Horhn is correct. Mississippians will have "more options," just not good ones.

For starters, naturopaths are virulently anti-vaccination. They learn anti-vaccination ideology in naturopathy school and their patients are adversely affected by it. Studies show that patients of naturopaths are less likely to be vaccinated and more likely to have suffered from vaccine-preventable diseases.

Rather than preventing disease, as they claim, naturopaths have actually fabricated diseases, making otherwise healthy people think they are sick. For example, naturopaths regularly diagnose and treat non-existent diseases like Wilson's temperature syndrome, adrenal fatigue and chronic yeast overgrowth. They also use unvalidated testing to convince patients they need various nostrums, like dessicated animal glands, ozone therapy, herbs, homeopathic remedies and dietary supplements, which they sell to patients at a tidy profit

Fortunately, Ms. Hermes is not the only one to share the unvarnished truth about naturopathic practice. Discussions among actual practicing naturopaths, naturopaths who would be eligible for licensing in Mississippi, were revealed from by anonymous source and discussed on the Science-Based Medicine blog by David Gorksi, MD, a surgical oncologist who is especially qualified to critique their "supportive" cancer care. As he concluded in one post, after excoriating the treatments naturopaths themselves were describing,"

"if there's one thing this dump of tens of thousands of messages shows, on just a cursory examination . . . it's this. Contrary to the whitewash campaign of "Naturopathic Medicine Week 2014" promulgated a couple of weeks ago by credulous legislators [in Congress], naturopathy has been, is, and always will be quackery."

But what of the idea of putting naturopaths under medical physician supervision, as the latest version of SB 2511 does? It's a bad idea, that's what. In the first place, "under the general supervision of a physician" is undefined. What does that mean? How closely must they be "supervised"? Will the medical physician be liable for the naturopathic physician's actions? Will naturopathic physicians practice their "primary care" in independent offices, or must they practice only in a medical physician's office?

More importantly, medical doctors are educated and trained in, and practice, evidence-based medicine, which has as its core an accumulated body of science and respect for the scientific method. Naturopaths are educated and training in vitalism, a long discredited notion that some incorporeal force unknown to science controls bodily functioning. (Don't believe me? That's exactly what "support and stimulation of a patient's inherent self-healing processes" in the bill means – that's vitalism.) Naturopaths reject basic principles of biology and chemistry (hence their belief in, for example, homeopathy) and refuse to practice evidence-based medicine. How can two systems so diametrically opposed to one another work together? They can't.

If legislators find naturopaths vexing now, just wait until they get a practice act. The American Association of Naturopathic Physicians is gunning for full primary care scope of practice in all 50 states. Their strategy is to accept a more restricted scope as a "foot in the door" and keep coming back to the state legislators, year after year, for expanded practice. They've done this in every state where they've gained licensing and there is no reason to think they won't do it in Mississippi.

The sole reason SB 2511 has gotten this far is ignorance about naturopathic education, training and practice on the legislators' part. They are about to buy a pig in poke, a pig that's going to prove hard to get rid of should Mississippi legislators decide the whole idea was a mistake. (Idaho licensed naturopaths in the early 2000s, only to turn around and delicense them in 2015.) The citizens of Mississippi deserve better. 

Points of Interest 02/03/2017
Points of Interest 02/04/2017

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