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- @growhope First, I never said Bausell was an authority. The ... - TommyKPdx
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A new law in Oregon will allow naturopathic physicians to prescribe a wider range of drugs to their patients. Up until now, naturopaths have only been able to prescribe naturally derived medicines, which includes some heavy narcotics. Naturopaths will first have to petition the Board of Naturopathic Examiners' Formulary Council in order to expand the list of drugs they are allowed to prescribe.
Medical doctors have expressed concerns about the new law. Their opposition has been characterized as a "turf battle." Naturopaths have said they hope wider prescription authority will expand their ability to serve patients as their primary care physician.
David Wall of Osteopathic Physicians and Surgeons of Oregon argues that naturopathic physicians are more likely than medical doctors to make prescribing errors because of gaps in their training. Psychiatrists raised a similar argument against legislation that would permit Oregon's psychologists to prescribe medication. That bill has been put on hold to allow a task force to come up with a compromise.
Do you see a naturopath? Will this new legislation change the way you receive medical care?
GUESTS:
- Igor Schwartzman: Naturopathic Physician
- Mitch Stargrove: Naturopathic physician, licensed acupuncturist, author of a text book called Herb, Nutrient and Drug Interactions and professor of the history of medicine at Oregon College of Oriental Medicine and National College of Natural Medicine
- David Walls: Executive director of Osteopathic Physicians and Surgeons of Oregon
Tagged as: medicine
Photo credit: nima 10+ / Flickr / Creative Commons
COMMENTS: (83 total)
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As a licensed ND, I am pleased at the change in prescriptive rights. This change enables patients who are choosing a naturopath as their primary care doctor to have all their health care needs met by one doctor. I have had many problems with coordination of care due to my inability to manage medications that my patients are taking(that have been previously prescribed by a MD). In addition, ND's work to improve the overall health of their patients, often eventually enabling patients to reduce or discontinue their medications. This benefits the patient and reduces the financial burden of long-term medication management on the health care system.
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I am a licensed naturopath, and I focus on holistic mental health. Many of my patients are on antidepressants and anxiolytics (anxiety medication). As a result of treatment, their need for these drugs often decreases or changes, and in the past they have been required to see another doctor in order to reduce their dose or taper off of these drugs. This allows for many errors in communication and coordination of care. Not being able to legally help people transition off of their meds has compromised the quality, efficiency and expense of their care. I am pleased by the expansion of our formulary, not because I'm interested in prescribing more pharmaceuticals or replacing the role of an allopath, but because I can help safely take someone off of a medication when it is medically appropriate.
Krista Tricarico, ND
OpenMind Medicine
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This looks like another step down the slippery slope which leads to anyone being allowed to call themselves a doctor, regardless of training, and prescribe nostrums of all types, whether proven safe and effective or not. We already struggle with chiropractors and naturopaths calling themselves 'doctor'. Now we have to deal with them extending the charade by prescribing actual drugs.
Blurring the line between scientific medicine and unproven therapies can never be good for patients. Allowing naturopaths to prescribe drugs which have been through rigorous testing and peer review sounds like a good idea (it sure beats the other therapies they offer - a quick look at Ms Tricarico's site shows that she practices homeopathy and chelation therapy, amongst other nonsense). But the highly unpalatable side-effect is that it is no longer clear who is an actual science-based doctor who went to medical school, and who is merely a practitioner of new-age mumbo-jumbo with nothing to back it up beyond anecdotal evidence. Which, as anyone who is familiar with the territory knows, is not evidence at all.
We are fortunate to live in a time when vaccination, sanitation, knowledge of disease epidemiology, and high quality nutrition are widespread, allowing our society to be largely healthy and disease-free, whether the naturopaths are peddling their trade or not. Just keep your fingers crossed that when people get diseases that don't get better on their own they'll go to a real doctor for treatment.
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Very well put. People need to understand that peer reviewed science is a wonderful thing.
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If your "scientific" medicine is so good, then why is the U.S. 37th in the industrialized world in all measures of healthiness (e.g., infant mortality, life expectancy, etc.)? And calling our society healthy and disease-free is a joke with our epidemics of obesity, diabetes, cancer and heart disease. If the MD is so well trained in pharmacology, then why do they mostly reach for the latest, most expensive drug that the pharmaceutical companies have bribed them to prescribe and the TV ads have told their patients to demand? It's about time that holistic physicians are given the right to help their patients wean off these dangerous chemicals and get well.
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starushka,
If naturopaths are truly concerned with helping people, then the ethically responsible choice is to become a conscientious MD who does not engage in any of the practices you describe above. We should work on improving or fine-tuning what has already been tried and tested---this will provide the greatest help, to the greatest number of people. Of course there are a zillion problems with our current health-care system, which we should work harder to fix---however, these problems in no way can be used to suggest that naturopathy is an effective course of treatment. -
@starushka
Well, it's not just "my" scientific medicine, it's yours too. You benefit from vaccination even if you don't get vaccinated, thanks to herd immunity. You benefit from proper sanitation, even if you don't believe in the germ theory. You will certainly benefit from the ER should you ever need it.
The reason the US is 37th in the the industrialized world is that there are 36 countries ahead of us, all of whom use scientific medicine as well, and most of whom have some form of socialized medicine. What is your point?
There are no doubt arguments to be made regarding the way that medical care is meted out in the US. This has absolutely no bearing at all on whether any alt med practice is valid. These modalities should stand on their own, regardless of any problems plaguing the healthcare system in this country.
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In case you haven't noticed, but you are very much in the minority here with your whole series of comments. If your concern is science-based medicine, try using PubMed, there is plenty of supportive information about natural therapeutics. My other suggestion is for you to spend some time reading about the history of medicine, it may do you some good.
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@growhope
I'm happy to be in the minority. A discussion about naturopathy in Portland is always going to be an irrational love-fest, and it's important that the scientific point of view be put forward.
I am quite familiar with both PubMed and the history of medicine, but thank you for your advice.
Meta-analyses of alternative medicine studies show that there are vanishingly few that are rigorous, properly conducted, and statistically significant (see Bausell, "Snake Oil Science", for a good overview). And anecdotally it is clear that most naturopaths reject science-based medicine, to the point of questioning vaccination, the germ theory of disease, etc. This is sheer idiocy, and it's dangerous.
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TommyKPdx,
I am not an naturopathic doctor, but do know something about science. Being a research scientist, I spend my days sifting through dozens of pages of literature. Based on the information that is published in hundreds of journals, your arguments are highly flawed and unsupported. For your information, Bausell is no authority on alternative and complementary medicine.
For having so much passion and perhaps even anger you ought to do something more productive, try a research project. Consider referencing studies published by a number of reputable sources, including research teams from Harvard, Johns Hopkins, UChicago, as well as OHSU.
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@growhope
First, I never said Bausell was an authority. The argument from authority is fallacious anyway, as you should know. Bausell is, however, capable of perusing Cochrane systematic reviews, and the results of such an analysis are clear: there are almost no high quality systematic reviews of any alternative therapy that result in support for the therapy.
Second, as you also should know as a scientist, it is up to the people making claims to produce the evidence for those claims. And when the claims are as eyebrow-raising as "natural substances are better than synthetics", or "diluting a substance makes it more potent", or "manipulating the back cures colic", the evidence had better be pretty impressive. It's not up to me to produce this evidence. Perhaps you could cite some specific references.
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Does anyone ask their MD how many hours of pharmacognosy that they had in medical school when they give an opinion on herbs? How about how many hours of biochemisty and nutrition they have had in relation to the nutritional recommendations that come from an MD? I don't think so but perhaps they should. It seems only fair here! I am a 1992 graduate of National College of Naturopathic Medicine. It took 8 years to aquire my ND degree. My pharmacology classes were taught by Gae Ryan PharmD. Dr Ryan taught our pharmacology classes at NCNM concurrently with the classes she taught at OSHU. We received the same training from exactly the same teacher! Every single year ND's are required to complete a minimun of 25 hours of continuing education with 5 of those hours being in pharmacy topics. I often attend training at OSHU, sitting in the very same room with my MD, DO and NP counterparts learning exactly what they learn! All you have to do is look at NCNM's website to see what academic rigor is reqired of today's ND students. I have been in practice for almost 20 years now and I love networking with my MD collegues who are open minded. There is no "turf" when it comes to helping a beloved patient! Not for me anyway. If I don't know something I tell my patients that I will find out who does and I stick to my word. That often means that I talk with an MD or another ND or my pharmacist. It means research on the topic at hand, just like it does for EVERY doctor who faces an unknown. Sometimes it means that I refer. I have MD's and Dentists and DO's who actually refer to me. It is called networking! We appreciate each other so much because no one has to be god! As an ND I spend time with my patients. I took an oath to do no harm, to educate, to treat the whole person, and to apply treatment plans that are in line with the healing power of nature and prevention of future disease. I will always choose a pharmaceutical agent as a last resort, rather than a first and with the greatest of respect for the risk-benefit ratio. If a synthetic is cheaper and safer than a naturally derived pharmaceutical then that is the smarter choice to make. Knowledge does not always impart wisdom. We desperately need more wisdom in todays health care picture!
Sinserely, Donna L Beck ND
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The suggestion that naturopathic physicians lack the training to prescribe medications suggests either arrogance or an alternative agenda.
The Wisconsin Naturopathic Physicians Association recently compared the competing curricula of Portland’s National College of Natural Medicine and Seattle’s Bastyr University with the Medical College of Wisconsin in Milwaukee. The instruction and training hours of the naturopathic curriculum exceeded MCOW’s program in basic and clinical sciences, was comparable in clinical instruction in basic therapeutics, and provided added instruction in naturopathic therapeutics, nutrition, and patient counseling services not offered in the allopathic curriculum. Students of naturopathic medicine receive the same training in biology, chemistry, biochemistry, anatomy, physiology, and even pharmacology. In addition, they receive academic and clinical training in nutrition, exercise, healthy lifestyles, patient counseling and psychology, and have access to training in other ‘traditional’ medicines and treatments used in other cultures with success.
Naturopathic doctors (NDs) are no less ‘doctors’ than those who are trained in allopathic medical schools and receive a MD degree. NDs emphasize and receive intensive training in the benefits of diet and natural substances to help the body defend and heal itself, they understand and value the therapeutic benefits of synthetic drugs and are trained to use them when appropriate. That NDs use synthetics less frequently than MDs does not suggest a lack of training; indeed, the objective evidence is that the opposite conclusion is more accurate.
Oregon’s legislature has recognized qualified naturopathic doctors as valuable members of the medical community who should have access to all the tools they are trained to use to the benefit of their patients. What is emerging is a welcome new health care paradigm: that modern medicine is beginning to recognize that integrating the best of traditional with the best of the modern benefits the patient, lowers total cost, and improves the overall health of our population. -
First, let's please ditch the ridiculous and intentionally pejorative term "allopathic", which is only used by alternative practitioners, and is not recognized by anyone else familiar with the English language. The correct word is "scientific".
It is stated that ND students receive the same training as medical students in all the fields that matter (biology, chemistry, etc). Yet after all this apparent training in the sciences, they emerge with an utterly non-scientific view of the world, in which placebo-controlled double-blind testing is not required and even disdained; where "natural" substances are somehow qualitatively different from, and superior to, "synthetic" substances; and, commonly (though not stated above) where vaccination is stated to be ineffective.
What this suggests is that the ND education system does not emphasize, or perhaps does not even teach, the scientific method, and that naturopathy is not, therefore, a scientific endeavour. Rather, it is a belief system. The public is entitled to believe whatever it wants, but government endorsement and enabling of these beliefs is not in the best interest of society, particularly when it conflicts with well established knowledge obtained by the scientific method.
The majority of states in the US do not regulate or license naturopaths, and the practice of naturopathy is banned in two of them. The UK does not recognize or regulate naturopaths at all. In short, naturopathy is far outside the mainstream. The suggestion above that "modern medicine is beginning to recognize that integrating the best of traditional with the best of the modern benefits the patient..." is completely unsupported, and I suspect that it will stay that way.
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The government of Oregon has passed this bill expanding our prescription rights for the simple purpose of patient accessability to health care. For a great many years we have quietly taken care of both insured and uninsured patients through our public and private practices by participation with the Community Care Coalition, breast and cervical cancer screening via the Komen Oregon Breast and Cervical Cancer program, and the VFC program (vaccine for children program). Many of us provided family health care through the Oregon Health Plan. Many of us delivered babies.
We have had prescription rights for many medications and have demonstrated that we are responsible prescribers.
This law allows me to prescribe medicine as a Family Practice physician but in an integrated setting. I understand my strengths and limitations.
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Blue8235 (or another ND, MD, DO, or whatever),
I was intrigued by your last line — "I understand my strengths and limitations." What are they, in your estimation, particularly in the realm of prescribing medicines?
Dave
David Miller — Tue June 16th 6:10a.m.
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My husband and I are 64 years old. We have not had health insurance for 7 years. We go to a Naturopathic physician. Ironically, my son is an ER physician in Calif. I would really like to see Nathuropaths and Homeopathic physicians take a more public stance on wellness, healthy living, supplements, etc. With President Obama's emphasis on healthy living, it seems a perfectly natural role for, say, The National College of Natural Medicine, in Portland. My son the ER doc says that 9 times out of 10, when someone comes into the ER, he can tell whats wrong just by looking at them and talking with them. But, because of liability issues, he is bound to run a lot of expensive and time consuming tests before treating. Obama wants to stop defensive medicine, but we need leadership, real leadership, in taking care of our bodies. Will the natural medicine schools step up???
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I am a nutritionist who has followed the advice of naturopathic doctors for years and greatly prefer them to allopathic doctors, who also have an important role to play in healthcare. My concern with this bill is that NATUROPATHIC DOCTORS WILL NO LONGER BE NATUROPATHIC DOCTORS! The distinction between natural approaches and drug approaches to healing will be totally blurred and natural medicine will take a step backwards. How can this possibly be good for professionals who profess to be practitioners of NATURAL medicine? How can it be good for patients who are seeking NATURAL approaches to healing?
Joe Emerson
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Would like to call in, but will be in a meeting, so... I wanted to just say how important this piece of legislation is to the 28 community health clinics (with 146 sites across Oregon) that I represent as the Director of Policy at the Oregon Primary Care Association. We serve the vulnerable and uninsured of Oregon with over a million visits a year, a number that is rising rapidly with the declining economy. In a gallant attempt to help ensure that these services remain available to Americans during the recession, the federal government has channeled some stimulus dollars to our health centers. While these funds are critical and WILL help expand access to care, we continue to struggle because of a lack of providers.
Nationally, there is a huge shortage of primary care doctors and nurses and the numbers leaving the field is astounding; One of our clinics and its community is facing a loss 11 physicians in this year alone. This legislation opens up a new avenue to providers at a critical time.
Several of our clinics already employ naturopaths VERY successfully. They work along side, and must meet all the same requirements as, their "Western-trained" counterparts, and many are willing to serve in areas that have less of a draw to their Western counterparts - rural and inner-city clinics.
This piece of legislation should be celebrated, and we, at the Oregon Primary Care Association, applaud our legislators for passing this critical piece of health reform in a year of monumental health reform.
Jennifer Pratt, Director of Policy, Oregon Primary Care Association
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Good discussion. I appreciate the comments from the NDs who state that their first approach is not to prescribe. I think many of us look to naturopathic doctors to help us decide what is the best approach in situations where you might not be sure if a drug, herb, or something else is the what you should do. Despite what the detractors (like TommyKpdx) say, the naturopathic doctors I know tend to be more scientific than many MDs or DOs. This really shouldn't be surprising as, it has been stated, the science training is the same then NDs study the science of nutrition, exercise, herbal medicine, mindbody medicine, etc. It is a commonly held misconception that there is no scientific basis for these things but all you have to do is look at the National Library of Medicine (like PubMed), research these things and you will see there is a treasure trove of science behind much of what NDs do. It is also a huge fallacy that modern medicine is based solely on science. Nothing could be farther from the truth. Many drugs and practices are not validated but because they are done by MDs, have the patina of science and authority.
A big missing piece in this discussion is that naturopathic doctors are expert in nutrition, herbal medicine, lifestyle modification, and prevention which if widely applied, would solve many of our society's help problems. Having NDs available in more healthcare situations is likely to reduce waste, improve prevention, decrease costs, and improve health, all of which are steps in solving our healthcare crisis.
Finally, there is clearly a turf battle for the public opinion. You hear the discussion framed in terms of education, science based vs faith based practice, and residency experience. You can already see that NDs have an incredibly extensive training program. Which philosophy would you rather be guided by? One based on fear and reflexive CYA approach for liability or one based on improving health, hope, and prevention?
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I am a naturopath and have been unable to figure out the rationale for the limited formulary we've had. A formulary based on naturally derived substances covers many of the drug classes but currently limits my ability to offer comprehensive care to my patients. In my opinion, we should either have full prescribing rights or none at all. With that said, the right to full prescribing rights should come with the demand for better education in the use of pharmaceuticals than is currently taught and continuing education and testing requirements toward that end.
Tim in Newberg
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Tim,
You note that "a formulary based on naturally derived substances covers many of the drug classes but currently limits my ability to offer comprehensive care to my patients." But how do you respond to Joe Emerson's concerns, above:
"The distinction between natural approaches and drug approaches to healing will be totally blurred and natural medicine will take a step backwards. How can this possibly be good for professionals who profess to be practitioners of NATURAL medicine? How can it be good for patients who are seeking NATURAL approaches to healing?"
Thanks,
Dave
David Miller — Tue June 16th 8:12a.m.
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Unfortunately, changing prescription laws for naturopathic physicians may do nothing to solve the amount of undue and costly influence the insurance companies have over the process. In many instances insurance companies, while keeping compensation for naturopathic doctors artificially low, drive up the cost of a patient's care.
What commonly happens is that an insurance company will refuse to compensate an ND for prescribing certain medications, or lab tests. This forces the ND to refer the patient to an MD who will be compensated by the same insurance company for prescribing the medication or labs. This simply results in additional office visit costs and other charges.
What is needed for real reform, is for people with insurance to demand from their insurance companies and/or legislators equal treatment and compensation for naturopathic doctors. This compensation should be on an equal basis with other primary care doctors.
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The primary care shortage is already a threat to the health of Oregonians in many parts of the state. This law allows NDs do their part in filling the need in rural areas where they would be the only physician for miles. NDs have already been prescribing prescription drugs without any more errors than are found in other medical professions; this law simply erases the arbitrary line of "natural" versus "synthetic."
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The debate over "science" verses "art" in medicine is far from a new subject. It can be traced back to the Caduceus itself; the Greek symbol of the two intertwining snakes. One snake represents the mechanistic and one represents vitalism. Even this is debated in some conventional medicine circles as there are those who say the medical symbol should have only one snake on the staff! But which one is the "Real" medicine? How about honoring BOTH? What a concept! The fascinating history of medicine tells us also of the "fathers of these medicines:" Nathan Smith Davis 1817-1094 is the father of the AMA. Andrew Taylor Still MD DO1828-1917 is considered the father of Osteopathy. Daniel David Palmer DC 1845-1913 is the father of Chiropractic and Benedict Lust MD DO ND, 1872-1945 is the father of Naturopathy. A biographical read on these men will show that they were on the "medical playing field" at the same time in history. Each were trained by a combination of apprenticeship and what formal education was available. The MD's of the day used bloodletting, leeches and mercuial compounds as their main modalities. There were also the "barber surgeons." The first accomplishement of science historically was to save us from these horendous modalities!The term "allopathic" verses "homeopathic" terms evolved in relation to one another because "homeo" meant "same" and "alleo" meant "different. Science serves us all, or should. If natural medicine had a fraction of the fundinng that pharmaceutical medicine has had then I can only barely imagine the benefits to the world in relation to the health of people and the planet! Today's conventional medicine does it's best work when their is a crisis. Natural medicine does it's best work in preventing a crisis and in restoring wellness after a crisis has past. Real integrative medicine is an approach to medicine in which providers from different whole medical systems, network with one another for the purpose of sharing their knowledge and skills in a way that treats disease, prevents disease and promotes healthy living in the safest and most cost efficient way for the patient. Let us unite in respect!
Donna L Beck ND
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If I understand you correctly, what you are saying is that homeopathy, chiropractic etc are better than orthodox medicine was in the 19th century. Terrific. Unfortunately since then these modalities, like all belief systems, have not moved on and learned from new information. Homeopaths still maintain that their remedies are effective, despite Avogadro's number having been determined in the meantime, utterly destroying the entire field of homeopathy. Straight chiropractors and naturopaths still base their notions on vitalism (indeed the very word was used above by Ms Beck), a thoroughly discredited and naive metaphysical concept, and eschew the germ theory of disease.
In the meantime, scientific medicine has discovered everything we know about the body and disease. Life expectancy has risen enormously and continues to rise; infant mortality has decreased and continues to decrease; once terrifying diseases have been eradicated or are easily treatable. All of the progress in medicine in the last century has been science-based. The NDs and DCs have had nothing to do with it.
And please, stop bleating about 'funding' being the reason that 'natural' medicine is a total failure. The NCCAM is enormously well funded but to date has produced nothing of significance. It is in the best interest of the alternative medicine community to learn how to perform rigorous experiments of their treatments, but judging by the lack of high quality trials in this area, the evidence suggests that they are simply not interested in doing so.
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This is a topic I can't reconcile. How many of the same people who advocate for science over religion in schools (and elsewhere) often turn to naturopathic medicine and come to its defense. It is essentially faith-based medicine, rather then evidence based.
I've been known to take many a 'natural' remedy, to give it a shot, and still do. But, I do so knowing it is a crap shoot. How anyone could make a career of this---I do not know. I certainly hope one day soon we can do rigorous scientific inquiry and study to evaluate the efficacy of individual naturopathic treatments. Certainly odds are that some treatments will prove valuable, but I think it is reasonable to say the odds are against a majority of these methods working. Because, if medicine in a natural state was so simple, why would modern medicine have ever been needed? It certainly wasn't just commerce.
It would be wonderful if every naturopathic prescription worked, then we could all see a decrease in the costs of health-care. Perhaps, there is a 'natural' substance or method out there to cure every disease. And, I hope one day we can prove there is, but currently naturopaths do not have enough evidence to make their practice worthwhile. -
Exactly, these methods and compounds need to be rigorously tested just like real medicine. I suspect many have been and there results were no better than placebo.
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I'm an ND and I am surprised by some of my colleagues' concerns about expanding our prescribing rights. As physicians we are still responsible for finding the most effective, least invasive therapies available, all the while addressing the precipitating causes of disease.
Just because I add a rototiller to my list of garden tools doesn't mean that I am going to use it every time I weed my garden. Nor does it mean that I am going to forget the usefulness of my spade or the importance of soil quality.
NDs have never been defined by the modalities they employ; NDs are defined by the philosophy that guides them.
-Marnie Loomis ND
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Thanks for adding your analogy, Marnie!
Well, this conversation has been a good one for me because up to date I hadn't had the opportunity to hear many other view points. It has broadened my opinions and my regard to the broader scope.
I am still intrigued by the question of malpractice. Now that our prescriptive rights are more inclusive, how will this affect our liability as far as 'standard of care'? All doctors have a PARQ conversation with patients regarding treatment, and now that we are legally able to prescribe a greater number of medications that are considered 'standard', will we be held to do so? Perhaps this is a moot point, since we have had the ability to prescribe standard antibiotics for quite some time now and I am unsure how often it has been an issue of liability.
Cara Clark, ND
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Thank you for such a wise analogy. I have been seeing a naturopath for the last two years for a chronic condition no allopathic doctor was able to successfully treat. They kept wanting to "weed the garden" with a backhoe and Agent Orange when what I needed was somebody willing to use a spade and a little Roundup. The half hour my naturopath spends with me everytime I go in lets us get to finding the weeds far more efficiently than the 5 minutes the allopaths gave me. And my newfound health is the result.
I have no fear that most naturopaths will use the new additions to their formulary judiciously. After having spent hours with my ND and attending seminars given by others, I have a tremendous amount of respect for their knowledge, willingness to continue learning, and their dedication to finding the least dangerous, most effective ways to treat different health issues. And, I've been most surprised by their humbleness and deep compassion.
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I guess one can ask the question: Have naturopaths finally realized the limits of their profession, realizing they need more advanced 'nature' to assist their patients in critical areas of health-care to be effective doctors? Isn't that what this law is about?
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Yes, exactly.
It seems like everyone is just dancing around the issue of how our insurance system has completely deemphasized primary care and the patient-doctor relationship.
This whole argument is a red herring. The wide variation alone in regulation, education, and practice of naturopathy leads me to believe that any success in naturopathy is either the result of the placebo effect or the fact that someone is taking the time to listen to the patient and coordinate better care with their doctor(s).
So, the argument should not be about letting naturopaths perscribe synthetic medication. It should be about reestablishing strong patient-doctor relationships and coordinating care better.
Otherwise, we are just talking in circles.
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Do you ask the same question about MDs and DOs who have now begun recommending fish oil supplements and offering Vit. D testing to their patients? Or MDs who send their patient's with hypoglycemia to a nutritionist? Or OB/GYNs who give prenatal vitamins to all their pregnant patients? Or my MD, who sent me to a chiropractor when I was having bowel problems because he rightfully concluded it had to do with one of my vertebrate being out of alignment.
There is room for many different philosophys. And let's face it, there are many illnesses for which the allopathic community has no real, effective treatments other than palliative care. They could learn much, and the open minded ones are, from naturopathy.
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I think the Naturopaths should have taken a lesson from the Osteopaths who sold their unique identity decades ago for acceptance. It looks to me like Naturopaths are on a similar trail. Soon, MDs, DOs and NDs will all be indistinguishable allopaths.
John Donovan, DC
The Dalles
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I hope and work hard toward that not happening. Ultimately, I think it more likely that MDs will learn from the models and methods of natural medicine. And, I hope more DOs discover the beauty of the osteopathic heritage.
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Don't you think every practitioner should have as many tools in their toolkit as possible. If I seek out the care of a naturopath it could be because I want pharmaceuticals as a last resort instead of as an only otion, which has been my experience with allopathic doctors. It doesn't mean I am anti-pharmaceutical, just careful.
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Nurse Practitioners and Physician Assistants are the front line primary care providers. We write a number of prescriptions and the discussion has not included us as those with whom a discussion would occur with a naturopath. The Discussion needs to increase.
Susana Serna, FNP-C
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Did I correctly understand the gentleman to say "I learn more about medicine at lunch or on the golf course than from classes or books" (not an exact quote, I had to pull off the road, find the website, and type)? If that is common thinking among NDs, I don't think it is an appropriate argument to say that MD resistance is a turf war, ESPECIALLY when the complexities of the synthetics isn't something I would expect golf buddies to converse over. Further, the folks who MIGHT talk about it on the golf course are salespersons from the pharmecutical companies... not whom I would consider the most reliable sources.
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This is certainly not "common thinking among ND's." Dr Stargrove was emphasizing the point of collaberation amongst practitioners of various disciplines." Synthetic drugs and naturally derived drugs are BOTH drugs. Drugs are strong. They have both risks and benefits when used. Training to prescribe either is exactly the same. Formal training is a MUST for all prescribers. I am a member of the Oregon Board of Naturopathic Examiners. We are required to monitor the continuing education of our licensees by state statute and by laws.
Dr Donna Beck
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what I was referring to was that books, classes and such only take you so far, the nuances of prescribing for real world individuals are refined by talking with other practitioners about their real world experiences
and, actually I don't golf, but a zoo concert with my MD friends, or a hike with my DO and Chinese medicine friends can really help enrich one's understanding and build collegial foundations that benefit patients and the broader community
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I am a veterinarian that practices western medicine. All veterinarians that practice natropathy or holistic medicine or acupuncture are veterinarians first - they have the same degree I do and then go on to further training. There are no prescibing issues. Perhaps this would be a good model for Human Natropaths that would eliminate this issue. If all Natropaths were MD trained they would have prescibing rights with their license.
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I trust my naturopath more than my MD, I find my naturopath to have a better grasp on my personal medical issues and more likely to prescribe or recommend a medicine that will work. I also find the office visit to be more personal and tailored to my personal needs, not the case with my MD who often is so overloaded(in his own words) and often spends less than two minutes interviewing me and then goes on to prescribe a potentially dangerous medicine.
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I don’t understand how anyone can take naturopaths seriously. Without peer reviewed science they can just make things up. Maybe they don’t directly hurt people but if they prevent someone from getting real treatment that could be dangerous.
I can’t believe that the reason these treatments aren’t accepted by science is because the pharmaceutical corporations are against them. It they really worked the companies would find a way to make money on them.
Real drugs are “natural”. You can’t make something from nothing.
Did you know that it was a naturopath who deliberately introduced dandelions to the Northwest? They probably would have gotten here anyway, but knowing that someone did it on purpose is frustrating.
This training these naturopaths talk about means nothing to me. I could probably find some one to train me in alchemy for 10 years but that doesn't make it real.
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You state that 'this training these naturopaths talk about means nothing to me". One of the textbooks that was required in the year-long Pharmacology course that I studied at NCNM was, "Lipincott's Illustrated Review of Pharmacology", written by 5 PhD's and is considered a standard textbook in medical schools. We study all classes of pharmaceuticals, and are subject to examinations on each class of drug.
Your comment about Dandelions is an interesting aside!
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In response to the question of whether this change in law will make ND's less "Natural" or unique, I would like to make a comparison. Currently, I feel that ND's have essentially been asked to practice primary care medicine with one hand tied behind our backs. When the best approach may require a medication that is not on our formulary, we have to either send to patient to a MD, or find the 2nd best alternative. While I do prescribe medications when warranted, I do this approximately 20 times a year. My forte is using the plethora of naturopathic therapies which work incredibly well to prompt innate healing mechanisms in the patient. This will not change when my prescriptive rights expand.
In response to the question of training, the ND program allows and encourages students to do a portion of our clinical training with MDs and DOs, therefore we do receive a wide range of clinical experience, not necessarily only with NDs.
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First, you seem to be equating "medications" with "conventional, FDA approved drugs". But a medication is any substance used to treat a disease. This then implies that you consider the non-FDA substances you prescribe to be qualitatively different from the conventional treatments. Why do they deserve this distinction?
Second, you state that "naturopathic therapies... work incredibly well to prompt innate healing mechanisms in the patient". How was this fact arrived at? What is the mechanism by which this occurs? What is the active ingredient that promotes this healing? How is it a diagnosis and appropriate course of treatment determined?
The evidence suggests that naturopaths do not have any factual basis for the assertion that their therapies promote healing mechanisms in the patient. The fact is that most patients, for most diseases, get better on their own. This is a consequence of having an immune system. Something, of course, that was discovered and understood by scientific medicine.
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Do you think these new prescribing rights for Naturopaths will help facilitate integration of Naturopaths into major medical centers like Oregon Health & Science University? There are Naturopaths already at OHSU and credentialing is an issue. IS this issue now remedied?
thank you
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Please ask the DO how much continuing education they receive on a yearly basis in the area of pharmacology?
Donna Beck ND
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Did that guy just admit that he does his medical research on the internet? RUN FOR YOUR LIVES!!
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have you tried pubmed? or MedScape? or MedPage?
all healthcare professionals use the internet to investigate the established knowledge, emerging resources, and connect with colleagues for the real-world experiences of clinical practice
I'd be more wary of a healthcare provider who didn't use the internet (unless they do primaily hands-on therapies)
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I beleive that medicine should be complementary and the ability for NDs to also prescribe will help as long all in the medical profession work together.
I work in the natural health care field for animals an hope that the practice of more integrative health care. I have found in my business that I must know pharmaceuticals, homeopathics, herbals, ect to be sure that there will not be any interaction with products. I had considered pursuing an ND degree but preferred to work with animals.
Again better sharing of knowledge and working together is the key for allopathic, osteopathic and naturapathic physicians, ect. But the bottom line is that you must look at healthcare on a very personal and individual basis.
Love your show.
Cindy Ross/MinglewoodSolutions.com
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Lots of broad generalization about NDs on here.
It appears that many people do not understand what NDs are trained and licensed to do - they are trained as primary care physicians-general practitioners.
They use evidence-based options to work with and treat patients, and discuss with patients to decide the modality. Some of the comments here are concerned that this will make NDs "less natural" and others are concerned that NDs don't use science to practice. Both of these are extreme opinions and not based on the the facts of what NDs are trained and licensed to do. Just like in all professions, there is a broad range of individuals practicing in a variety of ways.
The discussions about NDs are using lots of stereotypes and assumptions that NDs "think MDs overprescribe" or that this is a "turf war" (comments in the Oregonian).
In fact, the day to day is that most NDs work collaboratively with MDs and all other types of providers on a routine basis to provide good medical care to patients. -
What is the extent of Drug company involvement in this?
Obviously, giant Drug Corporations would benefit from more people prescribing their products. Are they spending money on lobbying and if so how much and who is getting that money?
Drug Corporations really are potentially the elephant in the room here.
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I have frequently encountered doctors who will not prescribe drugs because they don't feel comfortable with them or realize they do not know them well. Why is it assumed that it would be any different with any other doctor.
On the other side I have never been asked about additional suppliments I am taking when I get my synthetic prescription. Drug herb interaction are a very real thing, and most people take some type of suppliment. What is the Allopath/osteopath solution to this reality?
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drug-herb and drug-nutrient interactions are real and clinically important - that's why my cohorts and I spent five+ years cataloging and analyzing them
however, we need to get past the media hyope and hysteria
sure, "natural" does not inherently mean "safe" especially outside the counsel of trained and experienced professional guidance and case management
apart from some specific foods, herbs and nutrients which are almost always benign, pharmacological agents whatever their source are meant to be potent and to exert specific effects, so someone needs to be looking at how they work together
most interactions are not a problem, the majority are clinically valuable in an integrative approach
herbs and nutrients can complement drug therapies and mitigate drug adverse effects and drug-induced nutrient depletions
some interactions can be dangerous if unmanaged - frank disussion and disclosure are key and a strong, trusting therapeutic relationship is the foundation for that
ultimately an individualized and evolving strategy in which different agents (drugs, nutrients, herbs) function as tactics requires respecting patient choices and working together within collaborative relationships
good resources in the area of interactions are emerging and among the best is our text - you can learn more at www.medicineworks.com
nevertheless, as naturopathic physicians the inherent healing power of the body as a self-regulating system is our primary resource and helping patient's cultivate their vitality, self-responsibility and inner knowing is what makes our practices thrive and our patient's get better
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Is David Walls claiming that NDs don't have adequate pharmacological training? When we compare NDs training to that of nurse practitioners or physician assistants? NPs and PAs both, until recently, had more prescribing rights than NDs. A PA is trained in 26 months (a little over two years), a NP is trained in 24 months (two years), a Naturopathic physician is trained in 48 months (four years) in primary care and precribing pharmaceuticals (numbers are from the OHSU and NCNMs websites). NDs have double the training in primary care. Dr. Walls is limiting not only the whole Osteopathic profession's ability to work in a synergistic manner with NDs, he is also limiting all patients' acessibility to truly wholistic healthcare with his uninformed views.
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I am a Family medicine PA in Portland I wanted to make the argument that Nurse Practicioners and Physician Assistants work together with MDs and DO's to care for our patients. Our expedited training serves to get primary care providers out to see patients sooner - there is a concerning shortage of primary care providers. Studies show that quality of care recieved from PAs, NPs, MDs, DOs does not differ.
I do believe that NDs should be comfortable with all realms of medicine as they are caring for patients taking all types of medications for a variety of illnessess. I think its going to come down to the comfort of the individual provider with his or her knowledge. All in all health care providers want what is best for their patients!
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I believe in Naturopathic Medicine and would love to give up my MD who keeps on prescribing more and more drugs every time I see him. However, my insurance does not cover the cost of visiting a ND while to visit my MD, I have to pay only $10.00 as out of pocket expence the rest is covered by insurance.
Instead of continuing to tell patients to go talk to your giant insurance company or your employer -which is as everybody understand is easily said than done- why don't the ND's group together and pressure the mega insurance companies like Regence Blue Cross to include coverage for visiting ND's?
If the MD's and DO's could get together to make insurance companies recoganize them, so should the ND's and make it easier for us poor patients and employees to visit ND's.
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One of your guests said that MDs were much more open-minded toward naturopathy now. I haven't seen that at all here in Oregon. My biggest problem is finding a way to coordinate care between the two.
Another guest said that MDs receive much more training in pharmacology. Then why do many just reach for the latest, most expensive drug that the pharmaceutical companies have been pushing, without regard for safety, and especially without regard to the patient's whole body and mind. This is why it will be a good thing for naturopaths to be given the right to prescribe these medicines because their practice and philosophy is built on holistic care.
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I think it needs to be mentioned that the Oregon Association of Naturopathic Physicians went through a rigorous process to create legislation that passed the criticism and scrutiny of all or most medical professional groups in the State.
Further, SB327 passed the House unanimously after this process.THe legislators saw the wisdom and correctness of the bill, even after hearing the comments of the Ostopathic group, which were transparently selfserving.
ND are fully cqualified to embrace the implications of this bill.
Thank you for the show, Kevin
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natural medicines are drugs, some very active. the people need to recognize this. amounts of active ingredients are variable.
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If I understand the way our state works, such changes to a professional law (especially health care) is not taken lightly. This change was looked at closely, even before the session started.
The answers to the question of ND responsibility is answered as with any other health profession with regulatory oversight in Oregon, the doctor can only provide the service s/he is educated and trained to do within the scope of that practice.
This law was not changed with big money, but with many discussions involving legislators and professionals. The health care of Oregonians was paramount. I think we will see good things come from this.
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That is absolutely true!
Dr Donna Beck (OBNE board member)
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To TommyKPdx: If the UK does not license naturopaths, then I wonder where the Queen of England and her family get their homeopathic medicine recommendations--I guess from open-minded allopaths!
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the royal family is treated by MD homeopaths - most of the great homeopaths (histroicallY) were MDs
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From a homeopath. They may not be licensed, but they can certainly practise (at one's own risk, of course). Still, why you would bring up the royal family's healthcare choices is beyond me. Since when are they the arbiters of what works and what doesn't?
The Queen Mother, for example, had cataract surgery, a hip replacement, and a blood transfusion, among many other interventions. You can be sure that none of them involved a homeopath.
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One comment about training of physicians is that it's a very different set of skills that we are discussing when referring to the care of chronic or moderately healthy pts, which is mostly what NP's deal with. Understanding the complexity of of issues which occur in an acute care setting is a skill set NP's are not exposed to. Pts who arrive at the ER for motor vehicle accidents, have acute medical crisis such as drug overdoses, and complications from GI and other system diseases are not attended to by NP's. This is an important distiction in training and experience. Ask an ER doc if he/she's ever consulted an NP when treating a heart attack.
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An ER doc would also NOT consult a primary care MD family physician in these situations either. Only ER MDs would be adequately trained to handle these emergent situations. Even ER docs have to refer out to specialized surgeons in some cases. NPs, PAs, family physician MDs and NDs are all adequately trained in primary care management, drug prescribing and appropriate referral. Each profession has and knows its limits and abilities, and when it needs to refer out.
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The best alternative medicine is to require no medicine at all. A condition fondly referred to as health. The real divide between hard line conventional and naturopathic medicine is one of paradigms. I believe that the body has an amazing ability to heal and that my job as a physician is to assist that happening as much as possible. I don't believe that permanently medicating for symptoms is an acceptable alternative to true health, it should be a last resort. The new ND formulary law will allow me to assist my patients without one hand tied behind my back by pharmaceutical prescriptions I'm not allowed to modify nor provide. While I appreciate that my MD/DO colleagues have many more hours of apprenticeship and indoctrination than my profession can manage at this time -- the arguement that we are therefore a public safety menace is beyond unreasonable. NDs are indoctrinated to liberally refer to conventional medicine and we do. There is a place for all of us. Conventional medicine without question keeps critically ill people alive. My mission is to then help them regain health.
Jeff Clark, ND
True Health Medicine, PC, Tualatin, OR -
Using the words "indoctrination" is a brillient choice. That is IT. ND's certainly have the training to safely and sanely prescribe when a pharmaceutical agent is called for. MD's have much more indoctrination because pharmaceutical agents are their primary modality. Naturopaths have SO MANY things in their "medical bags" to choose from. Again stating that there is room for both: Crisis medicine and wellness care! Thanks Jeff!
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You don't have to "believe" the body has an amazing ability to heal. Everyone knows that. We have all gotten sick and then recovered. Your implication is that non-NDs do not understand that. I don't believe you have any basis for such an assertion.
You state "I don't believe that permanently medicating for symptoms is an acceptable alternative to true health". Skirting the meaning of "true health" (I for one have no idea what it might mean), let's be aware that the entire field of alternative medicine relies on permanent medication, or at least regular visits. Chiropractors are notorious for pushing "maintenance" sessions on their clients. Naturopaths devise complex nutritional supplement regimens that are regularly tweaked, ostensibly to "maintain health". That sounds like permanent medication to me, regardless of how you would prefer to classify your prescriptions.
Ultimately, naturopathy simply does not have a body of evidence to which it can point to support its assertion that it "helps [people] regain health". Rather, this is simply stated as an undeniable truth. Rational people would like to know where this certainty comes from. When someone is making such a definitive statement, asking for evidence is the least we can do.
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TommyK - you are being extremely dogmatic, and probably can't even recognize it in yourself. No matter how many statistics you have before starting treatment, medicine is practiced one patient anecdote at a time. There is no statistically average patient. The multivariate equation that defines that person sitting in front of you defies being resolved to a single variable. If a patient is having an adverse drug reaction it is purely anecdotal data happening right in front of you, but you had best deal with that n=1 sensibly and promptly.
Higher quality information is of course always better. But double blind clinical studies are not the only way of knowing. It is your statement of faith that only this kind of knowledge has value and that everything else is worthless. Pure dogma.
You best give up eating food to be consistent with your dogma -- there is no double blind clinical study proving artichokes or most other foods are safe to eat. All we have is lots and lots of anecdotal trial and error human experience handed down to us by generations that have gone before.
Jeff Clark, ND
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@ drjeffclark
I think we understand that medicine is practiced one person at a time. That's why I go to see my doctor when I'm sick, he examines me, and figures out what to do to help me get well. He doesn't treat all patients as 'the average patient' and prescribe the same thing regardless of what's wrong with them.
Nevertheless, if he gives me a prescription, that drug has typically been tested in trials that prove beyond a statistical point of reasonableness that it is (a) safe and (b) effective for a particular ailment. Thus, if that ailment is diagnosed in a patient, it would be appropriate to prescribe the drug to treat it. I'm assuming you don't disagree so far.
What you do disagree on is that double-blind studies are not the only way to get at the truth about whether something works. Unfortunately, the history of science suggests otherwise. There are many ways in which a remedy can appear to work, even when it has no effect. And the only way to exclude these effects that we know of is to perform double-blind, placebo-controlled trials. That's just the way it is - this is not an opinion of mine, it's been borne out time and again, and it's not going to change.
The corollary is that any medical study that is not performed with adequate blinding or placebo control (especially studies involving pills and similar remedies, which are the easiest to control) is immediately at least suspect, and probably worthless. This is not dogma, and it's not a bias against alternative medicine. We just know from experience that the results of such trials are not reliable and repeatable.
The fact is that most alt med practices, and naturopathy is definitely among them, could be investigated using sound techniques. That would involve things like formation of a hypothesis, random and representative sampling of the population, a statistically large sample size, double blinding, appropriate placebo control, statistical analysis, independent verification, peer review, and so on. It's a lot of painstaking work, but that's how scientific medical research is done, and it is the only way that we know of to be sure that the multitude of potential confounding variables are excluded from the results.
If naturopaths are not willing to do this kind of work, we have to reluctantly conclude that what they are doing is not scientific. That means that what they do may or may not work, but we will never know until someone does the science.
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It would seem that we are making moutains out of mole hills. Naturopathic Physicians became Naturopaths for a reason. They believe in the body and nature's ability to heal the body. They did not become ND's to prescribe synthetic medicine.
People seem to be concerned that ND's are going to go "crazy" with the prescriptions. Dr. Stargrove who has been in practice for 20+ years and he stated earlier that he has barely written 20 prescriptions. I have been in practice for 7 years and have maybe written 6, mainly antibiotics for severe infections that need antibiotics.
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I just want to clarify as a nurse practitioner that the Oregon requirement for Continuing Education is 100 hours every 2 years with what I believe is 30 hours in pharmacology.
My NP program required a total of 10 semester units in basic and advanced pharmacology and the total time for me to obtain my MSN and Nurse Practitioner was 36 months as opposed to the 24 months one person stated earlier. The up and coming DNP will take 3-4 years plus a 1-year residency.
Because of the shortage in primary care providers, I welcome the different disciplines represented in primary care. It gives people options for their care and as a person trained in nursing, I am happy to have the freedom to be able to integrate all modalities. There is a place for all of us.
Debi Wong, NP
Family Nurse Practitioner
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Our family of 4 has had a naturopathic doctor as our primary care physician for the past 8 years, through the birth of both of my sons.
My doctor has prescribed anitbiotics when needed, after trying the many herbs and homeopathic remedys she has under her belt. The prescription drug has been the last resort. I love the idea of people using naturopaths as their primary cary physicians because I think they have alot more tools to use to for healing than a MD can use.I think of it as a ladder with the prescription drug at the top.
I often feel frustrated at people going to an MD for the many childhood illnesses that occur and the only option given to them is antibiotics. I think this is adding to the resistance of antibiotics and all the odd infections that seem to be around these days.
Diana PDX
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First, there is no such thing as an effective homeopathic remedy. These substances are diluted to the point where typically not a single molecule of the 'active ingredient' is actually present. Scientifically implausible (to put it mildly) assertions by homeopaths about the magic of succussion and water memory aside, this means that the remedy is nothing more than sugar or lactose or whatever the pill happens to be made of. You cannot cure a bacterial infection with a placebo.
If you are using antibiotics as a 'last resort', that means that a potential bacterial infection is growing inside you or your children while you are wasting time with homeopathic placebos and unproven and untested naturopathic remedies. I cannot imagine why you would think this is desirable, or even acceptable. When applied to your children, it sounds to me like gross negligence.
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Hi
My husband and I are both naturopathic physicians and have been in practice in Oregon for 7 years. This bill for us is a huge accomplishment for our profession and specifically for our practice. We practice in a small community where getting into a primary care physician is sometimes difficult or can be timely. If we are able to maintain our patient's prescriptions for them and can handle all of their primary care concerns, then they will no longer be dependent on their previous and often unavailable primary care physicians.
Many of our patients use us as their primary care physician. Concerns arise when patients need vital prescriptions refilled such as inhalers, anti-depressants, and many other medications. It is difficult to truly practice primary care with patients who need prescriptions refilled when we can't prescribe them.
It is also important to note that all competent physicians will do research to make sure there is complete understanding before prescribing pharmaceuticals. We, as naturopathic physicians, will do the same to ensure good service and care to our patients.
Because we excel at using naturopathic medicine, our practice won't change significantly by this bill. We won't begin using significantly more pharmaceutical medicines. This law will allow us to offer more complete health care to our patients!
Thank you Oregon.
Jessica Black, N. D.
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My 2 cents as an MD:
1) I, to be honest, resent the implication that all us "docs" are interchangable. I think NDs and DCs all bring in unique skills to patient care, but I also think the training (and pre-training) to become an MD far exceeds the other doctors. I understand you sit in the same classes and have some of the same professors, but my hardest training years by far were the 3 clinical years in medical school and 3 clinical years in residency. In addition to daily office hours, we worked on-call in the hospital on average 1:3 nights. MDs bring to the outpatient setting a large skill set learned by taking care of acutely ill people at all hours of the day. How many NDs have had to pronounce a death, or had a phone call from the ICU where your answers can have an immediate life or death consequence? How many have spinal tapped a 6 month old in the ER or laid in a hospital call room going over your decisions of the day, wondering if you made any mistakes. 12 years into private practice I still take call 1:3.5 nights, being awakened at all hours to talk with and see sick adults and kids. Do the NDs plan to be available 24 hours on call? Because we MD primary call docs are. I think unless you've seen people at their worst, seen how a fever from yesterday turned into florrid sepsis today, or the neck pain turned into a cerebral dissection, that you are missing an important part of the clinical skill set that is needed even in the mundane world of outpatient medicine. If you aren't familiar with and haven't had to manage the serious outcomes of "common" problems, you don't know the whole story, and your clinical skills are worse for it. Those hours upon hours of clinic and hospital work in training teach you to recognize disease in its multi-varied presentations, and ensure that you see enough of the "exotic" presentations so that you don't miss them the next time they come up. I don't want to harp on anecdotal experiences, but a recent young male patient of mine with facial swelling was told by a local ND he had "toxin build up" and sold $80 worth of vitamins. He, in fact, had a lymphoma constricting his SVC which thankfully was diagnosed with conventional medicine.
(continued below if possible)
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Tommykpdx says there is no such thing as an effective homeopathic remedy. Many Europeans will strongly differ with you. I have used homeopathic remedies for warts, migraines, and recently a bout of dizziness. Vertigoheel is a homeopathic remedy used throughout Europe for dizziness and seasickness. I had taken a few over the counter meds the pharmacist recommended to no avail. Went to see my ND and he gave me some Vertigoheel. Worked like a charm. As to it being a placebo effect - please explain why the first two things I took - which I was assured would work - had no placebo effect but Vertigoheel did. I think you are letting your dogma get in the way of clear thinking and observation. Just because some pharmaceutical company hasn't run a study on something doesn't mean it doesn't work.
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Well, if it's popular in Europe, it must be true!
"Just because some pharmaceutical company hasn't run a study on something doesn't mean it doesn't work." You are right. What we do know, however, (and this applies to several of the posts on this page) is that there are many ways that a remedy can *appear* to work, when actually some other factor is responsible. The placebo effect and regression to the mean are two examples, but there are many others.
The point of double-blind placebo-controlled studies is to eliminate these and other confounding factors, leaving (hopefully) just the effect of the thing you are testing. This is very difficult to do properly. It requires training, dedication, the ability to detect flaws in procedure, and honesty, not to mention time and money. Nevertheless it is the *only* way we know of to eliminate the common confounding factors, and therefore the only reliable way of getting at the truth.
This much is well known, and the desire of alternative practitioners to circumvent this by asserting that therapy X is not conducive to double-blind testing, or that double-blind testing is not the only way to get at the truth, does not change the facts. By now, the need for double-blind testing in medicine is so well understood and documented that to assert that it's not necessary, or not appropriate, seems like deliberate deception.
I'm glad that Vertigoheel worked for you. That may be because it actually contains something (I see from a site selling it that it contains 210 mg of cocculus indicus, for example; I have no idea what that is, but 210 mg of the stuff sounds far above typical homeopathic levels); it may be because your condition went away on its own; it may be because of something else. I have no idea, and neither does anyone else, because it hasn't been tested. For every person like you that had good luck with it, there might be 10 for whom it does nothing other than drain their wallets. Again, no-one has any idea, because the company selling it hasn't done the research, and never will. Personally I think this is a disgraceful state of affairs - we are back to the time of roving patent medicine salesmen and caveat emptor - but you are entitled to spend your money on whatever you want.
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Hi, there. I am 58 years old, and have been under Naturopathic care for the last eight years. I am well, and take no prescription medications, finding the regimen of herbs, and vitamins prescribed by my Naturopath to be wonderfully effective for the long term.
I think of Naturopathy as the "organic" arm of medicine, with pharmaceuticals akin to chemical fertilizers. I do know from my Naturopath, however, that she will prescribe drugs with great discretion. The new prescription capability means, however, that she can legally take a patient off of a synthetic medication, something she previously could not do. Since she has the training and experience to make that call, this is the greatest benefit to her, and her patients.