Today, for reasons that will become apparent in a moment, we begin with a look at the website of Rosanne Lindsay, a Wisconsin naturopath who uses the initials “N.D.” (Naturopathic Doctor) after her name even though she graduated from the Trinity College of Natural Health. Trinity is an unaccredited (by any agency recognized by the U.S. Department of Education) online school where one can become a “Certified Traditional Naturopath” after a 16-week course. The clinical component of the course, also conducted online, involves the evaluation of two (yes, two) patients of one’s choice. The only requirements for entry into the naturopathic program are a high school diploma and completion of two prerequisite Trinity programs totaling 76 hours. (To give you a flavor of the quality of Trinity’s programs, Trinity also offers certifications in quack practices like homeopathy and iridology.)
So, for far less than the number of hours the average medical student would spend in class or a clinical setting in a few weeks of education and training, one can complete the entire Trinity naturopathic program, including prerequisites, without the pesky college degree, MCAT, 4 years of medical school, multi-year residency, U.S. Medical Licensing Exam, and other such requirements designed to ensure that those who diagnose and treat people are competent to do so.
Despite this modest, and highly questionable, education, Lindsay, who also advertises herself as a herbalist, apparently feels qualified to diagnose and treat thyroid disease. She has even authored a book that claims one can “reverse thyroid disease naturally”. She advises that
You don’t have to take a hormone for the rest of your life. Synthetic hormones block communication between all the glands of the endocrine system. Simply come back into balance and your thyroid come [sic] back online to make its own.
uses Applied Kinesiology to access information to identify nutrient deficiencies and toxicities, and to create custom herbal tinctures as part of a custom 8-week protocol. In addition to replenishing lost minerals, healing foods and medicinal teas are recommended to help cleanse and support the liver, kidneys, colon, and lymph. Yoga and meditation or other energy healing modalities may be suggested to enhance your plan to bring you back into balance.
Applied kinesiology is rank quackery and this is dangerous advice for anyone actually suffering from thyroid disease, who should be under the care of, at the least, a primary care physician and in some cases a specialist, such as an endocrinologist. Naturopaths should not try to treat endocrine disorders.
Lindsay’s nonsense about thyroid disease is bad enough, but where she really excels in scientific gobbledygook is in her rants about COVID which, she claims “is not a true virus, nor is it infectious”. Masks are therefore unnecessary and are really “a test to see who follows orders for the new Global Reset“, a truly bizarre conspiracy theory involving the UN and “world governments” whose agenda is “to remove inherent rights if the people consent to immoral dictates”, which include, in her mind, public health measures designed to control the spread of COVID.
She appears to believe (it’s hard to follow) that the introduction of radios in the early 1900s was the real cause of the 1918 influenza pandemic (which was actually healed with homeopathy, according to her) and the rollout of 5G is just déjà vu, with the powers-that-be pretending that a new virus is the cause of illness, when it is actually “radiation poisoning”. Also, there are nanobots in COVID vaccines which can be deployed for nefarious purposes. And so on.
You would think that the good folks elected to the Wisconsin Legislature would be appalled by such threats to the public’s health and doing all they could to protect Wisconsonites from practitioners such as Lindsay.
But, no, they are not. Unfortunately, since I last wrote about the topic in April, bills in Wisconsin (and Massachusetts, as you’ll read below) have advanced and the Wisconsin Legislature appears dangerously close to passing a new law that protects “complementary and alternative health care practitioners” like Lindsay and leaves them free to treat thyroid disease and other serious conditions.
Lindsay is, in fact, the president of the National Health Freedom Coalition which, along with its sister organization, National Health Freedom Action, advocates for the passage of so-called “health freedom” laws or, as I prefer to call them, Quack Protection Acts, because what they really do is protect quacks from prosecution for the unlicensed practice of medicine and other regulated health care professions, like psychotherapy and midwifery. Her COVID diatribes are no surprise, given that these organizations are rabidly anti-vaccination and heavily promote bills designed to handicap public health officials in fighting infectious diseases like COVID.
The quack bills
Wisconsin defines the practice of medicine as
examin[ing] into the fact, condition or cause of human health or disease, or to treat, operate, prescribe or advise for the same, by any means or instrumentality.
Practicing medicine without a license can result in a fine of up to $10,000 and imprisonment of up to 9 months. The state can also issue a cease-and-desist order to halt unlicensed practice. This gives you some idea of the seriousness with which the state of Wisconsin regards unlicensed practice, at least until now.
Lindsay’s unconventional (to put it nicely) advice regarding the cause of, and her treatments for, thyroid disease fall within the definition of the practice of medicine, potentially subjecting her to a cease-and-desist order, a substantial fine, and jail time. But if Wisconsin Assembly Bill (AB) 86 passes, that will no longer be the case (as long as she follows a few easily-met requirements) and the state will be powerless to stop her and others like her.
The great irony here is that, should a medical doctor diagnose and treat thyroid disease like Lindsay does, he or she would be subject to discipline for falling below the standard of care, especially if the patient was harmed.
AB 86 is the Assembly’s version of Senate Bill (SB 98), which already passed the Senate, leaving the Assembly’s vote the last stop before the Governor’s desk. A public hearing before the Assembly Committee on Health was held in July but the Committee has yet to vote on the bill, which has many co-sponsors. There’s plenty of time left, however, as the AB 86 will carry over to the 2022 legislative session.
Sadly, only the Wisconsin Association of Marriage and Family Therapists actually showed up to testify in person against the bill, although the National Association of Social Workers filed written testimony opposing it and the Wisconsin Council on Mental Health suggested amendments to protect mental health patients. The Wisconsin Nurses Association registered its opposition but did not provide testimony. Otherwise, the medical community was AWOL, at least as far as the Legislature’s website shows.
Lindsay herself testified in favor of AB 86, where she told the Committee that
As a group, we naturopaths and other holistic practitioners, remain unlicensed simply because we do not cause harm in what we offer.
That is patently untrue. Naturopaths and “holistic practitioners” can, and do, cause plenty of harm, a subject we’ve covered many times here on SBM. Unfortunately, this false premise ran through much of the supporting testimony: that complementary and alternative practitioners use only “safe” and “gentle” treatments, which are somehow also tremendously effective.
Typical of other “health freedom” bills, AB 86 offers unlicensed “complementary and alternative” health care practitioners a “safe harbor” from prosecution for violating any licensing law (such as engaging in unlicensed practice) as long as the practitioner follows certain procedures and does not engage in prohibited activities, most of which, like taking x-rays, they aren’t interested in anyway. In this, the bill essentially allows an unlicensed practitioner to practice as if he or she were actually a licensed health care professional if they stay within these parameters, the details of which we’ll get to in a moment.
Considering that “alternative medicine” is, by definition, used as an alternative to “conventional” medicine, the bill specifically contemplates that the public will see these unlicensed practitioners to treat their medical problems, no matter how serious, without the benefit of competent medical advice. In fact, the bill nowhere requires that the unlicensed practitioner recommend that his “client” (which is what the practitioner’s patients are called) seek medical advice, no matter how dire her condition, and a suggestion that the bill be amended to add a referral requirement was shot down by the “health freedom” crowd and failed to make it into the final version.
In addition to medicine, the bill covers, among others, nursing, dentistry, midwifery, respiratory therapy, pharmacy, speech pathology, all mental health professions (including psychotherapy and marriage and family therapy), and optometry. Thus, as I read the bill, not only could complementary and alternative practitioners treat disease, they could also deliver babies, dispense drugs (in the form of herbs), fix your teeth, examine your eyes, and treat even the most difficult mental disorders, as long as they are otherwise in compliance with the proposed legislation.
A “complementary and alternative health care practitioner” is defined in the bill as an unlicensed practitioner who offers “complementary and alternative health care services”, that is, any “health care practice or method of healing therapy or modality” not prohibited by the bill. Prohibited acts include surgery, setting fractures, skin punctures “except by pricking a finger for purposed of blood screening”(for which no education or training is specified), x-rays, prescribing drugs, chiropractic adjustments, recommending that a client discontinue medical treatment and making “a diagnosis of a medical disease other than a general assessment regarding normal structure or function in humans”.
[A proposed amendment changes this to “make a diagnosis of a medical disease or mental disorder” but “does not prohibit a complementary and alternative health care practitioner from responding generally to a client’s expressed concerns”. I cannot tell whether the Committee voted to include this change in the bill.]
It is not clear that the prohibition against making a diagnosis of a “medical disease” would include quack diagnoses like adrenal fatigue and leaky gut. Curiously, if not for diagnosis of a disease, why does the bill permit “blood screening”? In any event, how hard could it be for the unlicensed practitioner to shoehorn his “diagnosis” into the catchall “general assessment regarding normal structure or function”. (Just look at what dietary supplement companies have done with their limitation to “structure and function” claims.)
Luckily for the unlicensed practitioner, if a diagnosis has already been made by an actual medical professional, he is free to treat the disease or condition without limitation, including cancer, severe mental illness, neurological diseases like MS and ALS, allergies, asthma – you name it – with no prohibitions on the age or medical condition of the patient.
The bill specifically permits obviously fraudulent practices like craniosacral therapy, “detoxification“, healing touch, homeopathy, polarity therapy, and reflexology. Also allowed are potentially dangerous practices like Ayurveda, traditional naturopathy, and “healing practices” using food, supplements, and nutrients, as well as herbalism. These are listed by way of example only, the sole limitation being the imagination of a charlatan and whatever nostrums he or she might cook up.
There are a few other low-bar prohibitions, like taking kickbacks and sexual contact with a client. And, just to show how committed to public safety the Legislature is, anyone who is convicted of a felony, but has not completed his sentence, is prohibited from being a complementary and alternative health care provider. Anyone who is convicted of a felony “relat(ing) to providing health care” is barred altogether. So, if you’ve committed, I presume, felony Medicare fraud, you’re barred, but not if you are a convicted of, for example, sexual assault, wire fraud, child endangerment, or, for that matter, homicide, as long as you’ve completed your sentence.
There is one prohibition that could potentially prove problematic for unlicensed practitioners. They cannot
falsely advertise or provide false information about the complementary and alternative health care practitioner’s degree, training, experience, or other qualification or about a complementary and alternative health care service.
It appears impossible to practice complementary and alternative health care without providing false information. And the provision seems totally incongruous when the bill specifically allows practices, like craniosacral therapy and homeopathy, that are based on falsehoods, leaving me wondering how it would be enforced.
Finally, the bill requires disclosures to clients of information like the fact that the unlicensed provider is, well, unlicensed, as well as fees and any degrees, training, experience, or qualifications he holds, no matter how pathetically inadequate they are. (No education or training is actually required, it’s just that you have to disclose it if you have them.)
The practitioner is not required to record the client’s complaint, diagnosis, prognosis, treatment plan, or results. Although the client is entitled to
complete and current information concerning the . . . practitioner’s assessment of the client and the recommended complementary and alternative health care service that is to be provided, included the expected duration of the service and access to the client’s records and written information in the client’s records
This information doesn’t have to be in writing or recorded in the client’s records; only “the nature of the . . . service to be provided” must be written.
There are penalties for violations. The state can “request” that the unlicensed provider “correct” the violation. For other than failure to follow the disclosure requirements, the state can issue a cease and desist order and assess a fine of up to $10,000.
While better than nothing, this falls far short. Why? Well, remember, per this bill:
- Any charlatan (convicted felons included), with no medical education or training whatsoever (or, education and training that does more harm than good) is allowed to treat any disease or condition, no matter how serious, in any patient of any age, with supplements, herbs, “energy” therapies, homeopathy, and whatever other quack remedies he or she can dream up.
- Mentally, physically, or financially harming clients, even repeatedly, is not itself a violation and not subject to enforcement.
- There is no requirement that practitioners suggest the client seek medical attention or refer cases to a competent practitioner.
Within these liberal parameters, far too much harm can be done and the state will be powerless to stop it.
A similar Quack Protection Act is pending in the Massachusetts General Court (the state’s legislature) only these bills provide even fewer guardrails than Wisconsin bill. (Because of these similarities, I won’t discuss the bills in detail.) House Bill 2343 and the companion Senate Bill 1380 allow the practice of “complementary and alternative health care”, defined as anything that is not prohibited in the bill, which is not much: surgery, using radiation and fluoroscopy, prescribing drugs, providing a medical diagnosis or chiropractic adjustment or massage therapy, or pretending to be a licensed health care provider. That’s it. Other than these, apparently anything goes, again limited only by a charlatan’s imagination.
The Massachusetts bills also have similar disclosure requirements, only fewer of them. For example, no disclosure about fees is necessary. There are no prohibitions against sexual misconduct or the like, and (like Wisconsin, but worse) any felon (apparently even while serving his or her sentence) can set him/herself up as a practitioner. There is no enforcement mechanism and apparently the state can do nothing to curb quackery if these bills pass, no matter what physical, mental, or financial harm occurs.
A hearing before a joint Senate-House Committee was held on October 15th, along with several dozen other bills. It does not appear that the Committee has voted but, again, there is plenty of time left.
In my view, no one who is not properly educated and trained should be allowed to “assess” or treat anyone in need of medical care at all, ever, and certainly the state should not have any part in facilitating obviously fraudulent health care practices.
In what other profession or industry is this tolerated? None, to my knowledge. We do not permit unregulated banks run by people who have no education or training in finance to hold deposits, make loans, operate without audits, and so on, based on the fiction that they are providing “complementary and alternative” banking services. We do not permit unlicensed lawyers who didn’t go to law school or pass the bar to give legal advice, represent clients in court, and draft contracts and estate plans, based on the fiction that they are providing “complementary and alternative” legal services. We do not permit unregulated utility companies run by people untrained in the safe provision of these public services to offer electricity, gas, sewage treatment, and water to the public based on the fiction that they are providing “complementary and alternative” utilities. Ironically, we only allow this harmful nonsense in the one area that people value most: their health.