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Naturopathic Medicine Week: Much to celebrate (if you're not a naturopath)

Naturopathic Medicine Week starts tomorrow. This year's celebration will be minus a U.S. Senate Resolution declaring Naturopathic Medicine Week, a legally meaningless but much-touted event sponsored in 2013 and 2014 by Sen. Barbara Mikulski (D-Maryland), who is retiring from the Senate at the end of this term. Similar resolutions went nowhere in the House, and no resolutions were even introduced in 2015 or 2016. Perhaps Sen. Mikulski figured out that naturopathic "medicine" isn't as "safe, effective, and affordable" as it was cracked up to be.

In fact, 2016 has been full of minuses for naturopathic "doctors" and "physicians," as they like to think of themselves. In the past few years, two small states, neither of which confer primary care physician status, passed registration (Colorado, 2013) or licensing (Maryland, 2014) bills. However, despite numerous attempts, no state has passed a naturopathic licensing bill since. In the 2015-16 legislative sessions, Illinois, Indiana, Iowa, Massachusetts, Mississippi (twice), Nevada, New York, North Carolina and Rhode Island have all rejected naturopathic licensing attempts. Idaho actually delicensed naturopaths last year. 

Licensing bills remain pending in Pennsylvania (session ends Nov. 30th), where a bill passed in the House, and in Michigan (session ends Dec. 31st). A legislative report notes opposition from Michigan's health insurers, among others, and opponents' concern that naturopathic "methods of diagnosis and treatment are 'unscientific in concept, biologically improbable and clinically unproven.'" Naturopaths, on the other hand, continue to insist, falsely, that their training is "comparable to standard medical curriculum." In New Jersey, a licensing bill was rejected last year; this year, a new licensing bill will carry over into the 2017 session.  Yet, in Nevada, Sen. Pat Spearman has already filed a bill draft request for a bill that "revises provisions relating to naturopathic medicine." Although not yet available, this is almost certainly a new licensing bill. On it goes. 

Just a few weeks ago, California, the only state of any population size licensing naturopaths, handed them a stunning defeat when the legislature rejected an attempt to get out from under physician supervision over their prescribing. Washington state also rejected a substantial expansion of naturopathic prescribing privileges, as did North Dakota, Montana and Hawaii last year. Both California and Oregon refused to pass legislation allowing naturopaths to return student athletes to play after a concussion this year. Oregon did pass a bill forcing insurers to allow patients a choice between an MD/DO and a naturopath as their PCP. What remains to be seen, however, is how many actually choose an ND. This falls far short of the prediction made a few years ago by an American Association of Naturopathic Physicians Board member that Obamacare would mean "immediate" coverage of naturopathic services. And, despite substantial efforts, naturopaths are still not covered by Medicare, nor are they allowed to practice at the VA.

Two 2016 news stories depicted naturopathy in an unfavorable light, and deservedly so. The involvement of a Canadian naturopath in the death of toddler Ezekiel Stephan generated a number of news reports scrutinizing naturopathic practices. Globe and Mail reporter Carly Weeks looked at the websites of roughly 300 naturopathic doctors, finding

"nearly half appear to be in breach of the college's [College of Naturopaths of Ontario] rules based on claims made online. The promises are wide-ranging, from naturopaths describing their services as 'cutting edge,' to those claiming they can reverse the course of dementia, to others who make blanket statements that naturopathy can help anyone with any ailment fully restore his or her health."

Weeks also wrote an op-ed piece criticizing the government for legitimizing "health professionals who promote unproven, ineffective treatments."

In a Chicago Tribune story on Ezekiel's death, noted bioethicist Arthur Caplan called naturopathy "useless hokum." This tragedy also led to a public appeal by 43 physicians to the College of Naturopathic Doctors of Alberta to investigate, raising questions about naturopathic competency and ethics in the process.

In another unflattering media report, a naturopathic PR stunt that backfired terribly, online health news service STAT revealed that dietary supplement companies and labs offering unvalidated tests favored  by naturopaths are funding naturopathic lobbying. A PR flak hired by naturopaths had contacted the reporter to tout their legislative efforts. The headline says it all:

"Naturopaths, often derided as quacks, push to go mainstream – with help from vitamin companies"

Probably not the result they were looking for when they hired the flak.

Likely the worst thing ever to happen to organized naturopathy's attempt to legitimize its quack practices is Britt Hermes, the former naturopath who quit in disgust. While she started her blog, Naturopathic Diaries, in 2015, she's really hit her stride this year. Hermes has expanded her horizons beyond her own blog, early posts on Science-Based Medicine and a feature in Vox last year, to being a regular media source for information on naturopathy and writing for other outlets. Despite vicious attacks by naturopaths, her insider's knowledge of naturopathic education, training (such as it is) and practices has done much to counter the naturopathic narrative. In 2016, Britt was everywhere: CBC Radio, STAT, Daily Beast, The National Post, KevinMD, Forbes, Science 2.0 (also here), Quality Cancer Care – A Website for Patients and Edzard Ernst's blog, among others. She also started a change.org petition: "Naturopaths are not doctors: Stop legitimizing pseudoscience," which has passed the 7,500 signature mark, and has her own Wikipedia entry.

Sample quotes from her media appearances:

"I walked away from my practice because my boss [an ND] was committing a federal crime by importing and administering a non-FDA approved medication to his cancer patients. I decided to leave naturopathic medicine for good after a former president of the American Association of Naturopathic Physicians urged me not to report my boss's criminal activity to the authorities."

"Naturopathic clinical sciences, like pediatrics, contained material that would never be taught in medical school. We read Dr. Bob Sears's Vaccine Book and were lectured on flawed reasons why vaccines should be avoided or delayed. We learned to put sliced onions over a child's ear for an infection and other folk remedies, like wearing wet socks at night to 'boost the immune system.'"

Not the sort of information you want legislators reading when you have a naturopathic licensing bill pending.

Britt Hermes is not the only one to give the rest of us an inside look at naturopathic practice in 2016. Naturopaths themselves have drawn back the curtain, only they did it unintentionally, when a mysterious benefactor leaked their online conversations. David Gorski and our friend Orac combed through their chats and published discussions of unfortunate patients and their conditions and treatments on Science-Based Medicine and Respectful Insolence. While the first posts were published in 2014, this year we've been treated to a total of six posts on "What naturopaths say to each other when they think no one's listening," or, as Orac more colorfully titles his posts, "Sh*t Naturopaths Say."

The posts are a revelation. It's like the difference between reading news stories about Trump's treatment of women and watching the recently released video while listening to the disgusting comments from the man's own mouth. You can read Scott Gavura's excellent posts on Naturopathy vs. Science and think: Are naturopaths really that loony? And, in reading the Sh*t Naturopaths Say series, you find out, yes, they really are that loony!

We "hear," for example, naturopaths nattering on about topical saffron for erectile dysfunction, thymus gland for vaginitis, homeopathy for bipolar disorder, homeopathy and ozone therapy for a staph infection of the hand, and, of course, their anti-vaccine ideology, such as this absolute fabrication from "naturopathic oncologist" Colleen Huber

"Abundant evidence exists that the CDC schedule, and that most vaccines used in the United States, are both dangerous and ineffective."

Legislative defeats, insider revelations, bad press, no Senate declaration. Naturopaths don't have much to celebrate during Naturopathic Medicine Week. Party on, science-based medicine!

Points of Interest 10/09/2016
Points of Interest 10/08/2016

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