Naturopathic genetics: a new specialty?

Naturopathic genetics: a new specialty?

Naturopathy is chock-full of quackery. No doubt about it. Here at SBM and elsewhere, the seemingly limitless nonsense that can be incorporated into naturopathic practice has been documented time and again: detoxification, food “sensitivities,” anti-vaccination ideology, fake diseases (chronic yeast overgrowth, adrenal fatigue, chronic Lyme disease), bogus tests (also here), homeopathy, chelation therapy, assorted other odd-ball treatments, lack of ethical standards, and just general wackiness.

So, let’s give naturopaths licenses to practice primary care! What a good idea.

This affinity for nonsense is perfectly understandable, given their pseudoscience-filled education and foundation in vitalism. Once the scientific method is chucked in favor of “philosophy,” what’s to stop them from simply making things up? As far as I can tell, nothing. But why inflict this on the public under the guise of promoting health, safety and welfare?

To be fair, naturopaths aren’t the only ones who incorporate quackery into their practices. There are chiropractors, acupuncturists, reiki masters, doctors of Oriental Medicine, and “integrative medicine” practitioners. But what sets naturopaths apart, in my mind, is the sheer range of pseudoscience they will accommodate without the slightest hint of doubt in its efficacy or safety and their unwavering belief in their ability to diagnose and treat patients with the expertise and skill of medical doctors. “Delusional” is not too strong a word to describe their utter lack of awareness of their ignorance or the danger to patients they may pose.

We “self-proclaimed guardians of the true definition of evidence-based medicine” are not the only ones to notice this. From the Florida House Committee on Health Care Interim Project Report, January, 2004:

. . . the proposed licensure of naturopathic physicians would likely increase the risk of harm to the public . . .

The American Cancer Society:

Available scientific evidence does not support claims that naturopathic medicine is effective for most health problems.

. . .

Excessive fasting, dietary restrictions, or use of enemas [colonic irrigation], which are sometimes components of naturopathic treatment, may be dangerous. Naturopathic treatment may involve taking unregulated herbs, some of which may have harmful effects. . . .

The Immunization Action Coalition:

Naturopathy and homeopathy are totally ineffective in preventing vaccine-preventable diseases.

Even the National Center for Complementary and Integrative Medicine (although, hypocritically, NCCIM helps keep naturopathic schools afloat by giving them research funds):

. . . little scientific evidence is currently available on overall effectiveness [of naturopathy].

Some beliefs and approaches of naturopathic practitioners are not consistent with conventional medicine. . . and their safety may not be supported by scientific evidence. For example, some practitioners may not recommend childhood vaccinations. The benefits of vaccination in preventing illness and death have been repeated proven and greatly outweigh the risks.

Timothy Caulfield, Professor, Faculty of Law and the School of Public Health, University of Alberta; Comment: “Don’t legitimize the witch doctors,” National Post (Canada):

. . . many naturopathic practices are based on a semi-spiritual theory (the healing power of nature), and have no foundation in science. They reside largely in the realm of pseudoscience.

Not exactly a bunch of wild-eyed, Big Pharma-shill bloggers, are they?

So, why is it that state legislators are, once again, willing to introduce naturopathic licensing and expansion of practice bills? One reason I’ve discovered is that the “naturopathic doctors” will flat out fabricate “facts” in support of these bills, both in the form of the bills they draft (and make no mistake, it is the naturopaths who are drafting these bills) and in the information they give legislators.

(And, speaking of Big Pharma shills, naturopaths are hiring lobbyists to promote their interests in the state legislatures. In at least one Massachusetts legislative session, their state association was given $25,000 to pay for lobbying. Imagine the outcry if, say, Nurse Practitioners were given thousands of dollars by Merck to lobby for increased prescription privileges.)

For example, in (the unfortunately successful) lobbying for licensing in Maryland last year, the Maryland Association of Naturopathic Physicians (now the Maryland Naturoapthic Doctors Association, because they are prohibited from calling themselves “physicians”) represented to the legislature that:

Research confirms that naturopathic medicine is effective in reducing chronic disease, and provides important cost savings.

Where is this “research?” As far as I can tell, it doesn’t exist. In fact naturopathic care is associated with poorer outcomes.

[A] study . . . found that the addition of naturopathic care to conventional medical care reduced incidence of metabolic syndrome and the risk of a cardiovascular event (such as a stroke or heart attack) by a third.

Not true, as David Gorski demonstrated in his deconstruction of this study.

NDs complete . . . over 1,500 hours of direct clinical patient care.

Again, not true, as we know from Britt Deegan Hermes’s revelatory post. (That this is a fiction is more extensively documented on her blog, Naturopathic Diaries.)

12 states . . . have naturopathic licensure legislation pending.

No, they didn’t. And, in fact, of the states where naturopathic licensing bills were pending, all were rejected except in Maryland.

Carnegie Commission of Higher Ed: Naturopathic Medicine Programs reviewed and designated as “Doctors Degree – professional practice” [and] included in this category [are]: MD, DO, DDS, DVM.

No it doesn’t.

New fictions

I must admit, however, that even I was surprised by the “Legislative Intent” section of New York’s latest bills to license naturopaths, fresh off the presses and recently introduced in the Senate and Assembly.

Here we learn of yet another amazing (and totally fabricated) naturopathic ability: their superior understanding of human physiology allows them to anticipate, and therefore avoid, iatrogenic consequences of conventional medical care, the latter due to conventional medicine’s failure to intervene earlier and treat the human body as “a whole living system.” At least, I think that is what they are saying. Sometime their word salads are hard to follow. Take a look for yourself:

The legislature recognizes that in the practice of naturopathic medicine the healing power of nature principle is viewed as being an inherent property in a living organism to heal itself, and is an acknowledgment that synergy results from the coordination of the many chemical and physical reactions of the living system through varied and circuitous feedback pathways making the whole function as more than the sum of its parts.

Let’s pause here to contemplate that this may well be the reason naturopaths are so sure homeopathy works, while the rest of the scientific world remains convinced that it’s nonsense. Must be all that synergy and circuitous feedback pathways only they know about.

Earlier in the bill, we learn that the American healthcare system excels at triage and responding to emergent conditions, but there is an epidemic of chronic disease and “unacceptable degree” of iatrogenic disease. Thus, we must leave the medical doctors to their triage and emergent conditions, because the naturopaths have a better idea of how to handle things:

The number of reactions and resulting complexity and synergy is viewed in the profession of naturopathic medicine as being why treatment of a given physiological process may result in unforeseen nonlocal consequences, including iatrogenic disease; and is why naturopathic doctors investigate and treat the patient as a whole living system, find and remove the cause, and prefer less invasive therapies and substances with fewer side effects. It is also why the naturopathic doctor prefers to intervene early to prevent the occurrence of disease.

So, they no longer claim that they are educated and trained to practice primary care equal to that of MDs and DOs, they are actually better at it.

Maybe this is their secret:

The naturopathic doctor . . . relies on the scientific method in implementing vitalistic, functional, and evidence-based strategies for assessing and treating patients.

I hate to be the bearer of bad news, but there is no way you can rely on the scientific method to implement vitalistic strategies. The scientific method would, in fact, negate every last one of your vitalistic strategies.

As I sometimes do (and here) when blogging about state naturopathic legislation, I have a look around the internet to see what area naturopaths are up to even before they are licensed. This usually ends up looking a lot like what naturopaths in licensed states are doing, making one wonder why they want to bother with licensing in the first place. (Actually, we do know: a veneer of legitimacy and insurance reimbursement.)

In my New York-based browse, I came upon yet another surprise from naturopaths. There’s a whole new naturopathic specialty of which I was previously unaware: the naturopathic geneticist. Let’s take a look at “Dr. Doni’s” website.

Dr. Doni, a graduate of Bastyr, is a former Board member of the American Association of Naturopathic Physicians and former Executive Director and President of the New York Society of Naturopathic Physicians. In other words, she’s firmly rooted in the mainstream of naturopathic medicine. In addition to the usual naturopathic folderol (leaky gut, adrenal fatigue, the “Hampton Cleanse,” food “sensitivities”) we find that Dr. Doni purports to be an expert in genetics.

As we learn from her website:

Many conventional doctors are not looking at your genetics when you present certain symptoms. Fewer still know how to identify and address genetic mutations. Of those, even fewer will treat your condition naturopathically.

I don’t doubt that “conventional” doctors don’t normally look at your genetics when you present with certain symptoms, probably because those symptoms have nothing to do with genetic mutations. And I have even less doubt that they treat the patient “naturopathically” when genetic mutations are an issue. But Dr. Doni, of course, knows better.

Everyone is different, but most patients with MTHFR or other genetic abnormalities will exhibit with one or more of these symptoms.

And what are these symptoms?

  • Chronic/recurring headaches or migraines
  • Chronic fatigue
  • Miscarriage(s)
  • Abnormal pap smear
  • Infertility
  • Hormonal imbalances (thyroid, ovarian, adrenal, pancreatic, etc.)
  • Auto-immune issues
  • Chronic digestive issues
  • Anxiety and/or depression
  • Brain fog
  • Irritability
  • Sleep issues
  • Aches and pains (including fibromyalgia or arthritis)
  • Difficulty focusing and/or difficulty with memory

Ah, the one true cause of disease (again)! And here Mayo Medical Laboratories was thinking MTHFR testing should be reserved for patients with coronary artery disease, acute myocardial infarction, peripheral vascular artery disease, stroke, or venous thromboembolism who have increased basal homocysteine levels or an abnormal methionine-load test.

Dr. Doni is particularly focused on this MTHFR mutation. Hmmm. Where else have we heard about this from a questionable source of medical information? Oh yes, here, in Steve Novella’s post on “functional medicine” guru Dr. Mark Hyman’s “personalized medicine” for dementia. And in Orac’s take on Hyman.

Dr. Doni will, for a mere $3,000 (4 months; dietary supplements not included), shepherd you through genetic testing, help you understand your genetic mutations and formulate a “natural remedy plan” that will not only reduce or eliminate your symptoms, but also avoid “serious illness” and it’s attendant medications and surgeries. And you can do all of this without ever setting foot in her office. Yes, you can enjoy the benefits of “Dr. Doni’s MTHFR and Genetic Profiling Solutions Package” via Skype!

See what I mean: naturopaths can totally make stuff up and sell it. Of course, to be fair, so can Dr. Hyman. Then again, he’s not a former member of the AMA Board or former president of the Medical Society of the State of New York.

Now, for some good news (and bad)

Ready for some good news about naturopathy? I thought so. Not news naturopaths would consider good, but good news to those of us who take offense at the infliction of nonsense on unsuspecting patients via the licensing of faux doctors.

Idaho actually repealed licensing naturopathic doctors this year! They were licensed in Idaho in 2005, but because of difficulties with implementation, licensing never really got off the ground. A bill was introduced that not only solved that problem, but gave naturopaths an expansive scope of practice: it defined naturopathy as “primary health care,” gave them their own regulatory board and prescription privileges, and allowed their board to approve naturopathic “specialty” practices. (Genetics, perhaps?) Only “gross negligence,” as opposed to negligence (the normal standard for malpractice), could be disciplined.

The whole thing blew up in their faces. Not only did the bill fail, but another passed repealing naturopathic licensing altogether and declared all current licenses “null and void.”

Another licensing bill failed in Mississippi and it appears an Iowa licensing bill will fail as well. Bills to expand naturopathic scope of practice, including varying degrees the authority to prescribe, didn’t pass in Montana, Washington and North Dakota. The North Dakota bill looked as if it might succeed until the legislature heard from Britt Hermes, who gave them the low down on the lack of naturopathic education and training in pharmacology. In Hawaii, naturopaths were unable to get a bill passed allowing them to corner the market in colon hydrotherapy by excluding others from using it.

Unfortunately, a number of licensing bills have been introduced (again) and are still pending: Illinois (for the 6th time); Massachusetts (10 times), Nevada, New Jersey, New York (8), North Carolina (7), Pennsylvania (7), Rhode Island (5). All of these would give naturopaths a broad scope of practice similar to that of a primary care physician, although they vary in details.

For example, Pennsylvania’s bill would allow “visceral manipulation,” a term chosen perhaps to avoid the laughable “reposition body tissues and organs” used in a previous bill, although no more plausible. But it’s no laughing matter that the Pennsylvania bill actually passed in the House and has now moved to the Senate for consideration.

Colorado, a state that appears to have an endless tolerance for quackery, has increased the naturopathic scope of practice just two years after initially allowing them to register (but not become licensed) with the state. This time, naturopaths wanted to overthrow the ban on their seeing patients under two years of age. That ban has now been removed, but with supposed protections for these patients, including providing the parent with the recommended vaccination schedule, more continuing education and recommending the child have a relationship with a licensed health care provider. Naturopaths must have a collaborative agreement with a pediatrician or family practice doctor to “ensure safety” of children under two. Of course, if oversight by a real doctor is necessary for safety, the logical corollary is that naturopathic practice is unsafe. But simple logic seems to escape Colorado legislators.

After the deadline for bill introduction passed, yet another bill was introduced, this time allowing naturopaths expanded prescription privileges. This was courtesy of the Colorado legislative leadership, which has discretion to allow such things for pet legislation. So far, the bill made it to the House floor.

California is contemplating a major expansion of naturopathic prescription privileges, sponsored by Sen. Marty Block. Sen. Block is also a co-sponsor of a bill that would eliminate California’s personal belief exemption. Perhaps someone should tell Sen. Block about naturopath’s anti-vaccination ideology and their ability to grant exemptions under California law.

Connecticut “modernized” its naturopathic scope of practice this year. As they promised, they’re back trying to get prescription privileges, or at least a committee to report to the legislature on expanded privileges, an effort blessed by Dr. David Katz. (Maryland, per last year’s licensing legislation, has a similar “Formulary Workgroup,” which will issue its report to the legislature later this year.) Finally, Oregon is considering a bill allowing naturopaths to choose whether they are “primary care” or “specialty” practitioners under health insurance policies.

We don’t have thousands of dollars to oppose naturopathic bills, but we do have thousands if readers. Go to the Society for Science-Based Medicine’s “Legislative Updates,” find out what’s pending, and contact your legislators.

 

 

Posted by Jann Bellamy

Jann J. Bellamy is a Florida attorney and lives in Tallahassee. She is one of the founders and Board members of the Society for Science-Based Medicine (SfSBM) dedicated to providing accurate information about CAM and advocating for state and federal laws that incorporate a science-based standard for all health care practitioners. She tracks state and federal bills that would allow pseudoscience in health care for the SfSBM website.  Her posts are archived here.