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Are they planning to replace that eagle with a duck?

On August 14, 2019, the American Association of Naturopathic Physicians (AANP) reported a success in their 5-year campaign to get the Veterans Health Administration to authorize naturopathic care for veterans. They announced, “A Naturopathic Clinic in Washington has signed what is believed to be the first ever contract with a benefits administrator of the Veterans Health Administration (VHA) to provide services to veterans.” They claim the use of naturopathic physicians will improve outcomes, reduce cost, improve disease prevention, and increase patient satisfaction. There is no evidence that naturopathy improves outcomes; in fact, there is evidence that the patients of NDs are less likely to get preventive health screenings, are less likely to get recommended vaccinations, and are more likely to be diagnosed with a vaccine-preventable disease. Critics of naturopathy have pointed out that many of the treatments offered are not evidence-based and may even be harmful. The Science-Based Medicine blog has addressed these problems repeatedly.

Britt Hermes is a former naturopathic doctor turned whistleblower. Her website, Naturopathic Diaries, exposes all the flaws of naturopathy. She explains:

The profession functions as a system of indoctrination based on discredited ideas about health and medicine, full of pseudoscientific rhetoric and loaded with ineffective and dangerous practices. Naturopaths must be highly scrutinized because they have an ongoing history of deceit and exploitation—veiled in good intention.

Their education includes homeopathy, for crying out loud! Homeopathy not only doesn’t work but is incompatible with our knowledge of science. It was debunked in 1842.

The announcement has a link to a white paper that is full of misinformation and opinion.

The AANP statement mentions two NDs who have been hired by the VA. One of them, John S. Finnell, is said to focus on clinical research. A search of PubMed for clinical studies by J Finnell yielded no hits. But his faculty page at the AOMA Graduate School of Integrative Medicine lists 8 publications. They include articles on cannabis use by patients with multiple sclerosis, the safety of fasting, the biochemical effects of 7 days low-fat vegan diet, and a method of correcting vitamin D deficiency; none of them appear to support the claim that naturopathy improves outcomes.

I was intrigued by one study on the list: Finnell is one of three authors of a safety survey of intranasal glutathione. OK, so users self-report that it’s safe to use it intranasally, but is it effective for anything? The authors say glutathione “has been hypothesized to have therapeutic potential for some conditions.” They don’t offer proof that it works; they just speculate that it could work because it is an antioxidant and produces detoxification. The patients surveyed in the study had been prescribed glutathione for multiple chemical sensitivity (MCS), allergies, sinusitis, Lyme disease, and fatigue. Glutathione is not a proven treatment for any of these conditions. Fatigue is not a diagnosis, but a subjective symptom that can occur in many different diseases and even in the absence of disease. MCS and chronic Lyme disease are controversial diagnoses not recognized by mainstream medical and scientific organizations. In short, I do not consider Finnell’s research to constitute a useful contribution to evidence-based clinical medicine. It amounts to the speculation and the let’s-throw-everything-we-can-think-of-at-it-and-see-if-anything-sticks approach that is all too common in naturopathic thinking.

Conclusion: Authorizing NDs to treat veterans is a mistake

We owe our veterans a debt of gratitude for their service in defending our country. Surely they deserve quality 21st century medical care rather than untested treatments and 19th century quackery. Naturopathy is illegal or has been abolished in six states; infiltrating the VA and giving federal approval would be a way to effectively bypass those state laws. Yes, patients appreciate extra time and attention, but are not qualified to judge the effectiveness and safety of the interventions they are offered; they have to rely on medical experts to educate them. The experts in the VA system have failed in their duty to our veterans. Allowing naturopaths to treat our veterans is a mistake. It might make some patients more satisfied with their medical care, but shouldn’t we be aiming for better objective health outcomes rather than for subjective customer satisfaction? Every charlatan, quack, and snake oil salesman has satisfied customers. Penn Jillette once said if all you really want is to feel better, why not just take heroin? Modern science-based medicine is far from perfect, but it’s the best we’ve got. Naturopathy is a step backwards that is likely to lead to substandard medical care and poorer health outcomes. I am irate that they are funding this misguided policy with my precious tax dollars.

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Posted by Harriet Hall

Harriet Hall, MD also known as The SkepDoc, is a retired family physician who writes about pseudoscience and questionable medical practices. She received her BA and MD from the University of Washington, did her internship in the Air Force (the second female ever to do so),  and was the first female graduate of the Air Force family practice residency at Eglin Air Force Base. During a long career as an Air Force physician, she held various positions from flight surgeon to DBMS (Director of Base Medical Services) and did everything from delivering babies to taking the controls of a B-52. She retired with the rank of Colonel.  In 2008 she published her memoirs, Women Aren't Supposed to Fly.