It’s Difficult to Say Nice Things About NDs

May 27th, 2009 | By | Category: Dear Science Column, Response to Critique

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.

ebpdModern 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.

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