Naturopathic Medicine: Legitimate medical therapy or quackery?

1
(No Transcript)
2
Allopaths, Naturopaths, Osteopaths,Oh My!

• NUTR 547 - Nutrition Update
• Summer 2006
• David L. Gee, PhD
• Central Washington University

3
Naturopathic Medicine
4
Two views of naturopathy

• Bastyr University (web page, 2006)
• Naturopathic medicine is a distinct profession
  of primary health care, emphasizing prevention,
  treatment and the promotion of optimal health
  through the use of therapeutic methods and
  modalities, which encourage the self-healing
  process

5
Bastyr University (web page, 2006)

• The scope of practice includes all aspects of
  family and primary care, from pediatrics to
  geriatrics, and all natural medicine modalities.

6
Two views of naturopathy

• Quackwatch.org
• A Close Look at Naturopathy, S Barrett, MD
• Naturopathy, sometimes referred to as "natural
  medicine," is a largely pseudoscientific approach
• a close look will show that naturopathy's
  philosophy is simplistic and that its practices
  are riddled with quackery.

7
Quackwatch.orgA Close Look at Naturopathy, S
Barrett, MD

• the average naturopath is a muddlehead who
  combines commonsense health and nutrition
  measures and rational use of a few herbs with a
  huge variety of unscientific practices and
  anti-medical double-talk.

8
Definition of naturopathyPractices to improve
health and treat disease by assisting the bodys
natural healing process

• herbology
• homeopathy
• massage
• hydrotherapy
• Chinese medicine

• Ayurvedic medicine
• accupuncture
• pharmacology
• minor surgery
• obstetrics

9
History of Naturopathy

• Earliest medical therapy used naturopathic
  methods
• Hippocrates
• nature is the healer of all diseases
• Greek root of physician is nature
• American use of naturopathy
• very popular until 1920s
• advent of modern medicines (antibiotics,
  corticosteroids, vaccines)

10
The Principles of Naturopathic MedicineAmer.
Assoc. of Naturopathic PhysiciansPhysicians Oath

• Do no harm
• symptoms of disease part of healing avoid
  suppression of symptoms
• Act in the cooperation with the healing powers of
  nature
• physician facilitates this natural process
• Address the fundamental causes of disease
• physician identifies and treat root causes
• physical, mental, spiritual, emotional

11
The Principles of Naturopathic MedicineAmer.
Assoc. of Naturopathic PhysiciansPhysicians Oath

• Heal the whole person through individualized
  treatment
• health goes beyond treating the symptoms
• Teach the principles of healthy living and
  preventive medicine.
• Building health, not fighting illness

12
Naturopathy vs Naturopathic MedicineControversy
within CAM

• Naturopathic physicians
• formalized course of study
• 4 year graduate course of study
• professional board exams
• may prescribe some drugs, minor surgery,
  obstetrics
• ND degree
• American Association of Naturopathic Physicians
  (AANP)
• promote state licensure
• values standardization improvement of practice
  (research)

13
Naturopathy vs Naturopathic MedicineControversy
within CAM

• Traditional Naturopaths
• holistic approach to health
• drugs, surgery, and other invasive techniques
  outside scope of traditional naturopathy
• training from correspondence school or from
  practitioners
• no programs accredited by US Dept. Ed.
• some grants ND

14
Legal Status of Naturopathic Medicine

• 13 states with licensure (WA)
• Scope of practice prohibits major surgery and
  prescribing controlled substances
• 1 state with registration
• 2 states with legal basis for practice
• 2 states prohibit practice (SC, TN)

15
Legal Status of Naturopathic Medicine

• American Association of Naturopathic Physicians
• represents NDs
• goal have licensure in 50 state
• American Naturopathic Medical Association
• represents traditional naturopaths
• Opposes licensure

16
Medicare/Medicaid/Insurance and Naturopathic
Medicine

• Currently not covered by Medicare
• 2003 two ND (from Bastyr) appointed to US
  Medicare Advisory Committee
• In Washington state, an "every category of
  provider" law requires private insurers to
  reimburse naturopaths.

17
Quackwatch National Council Against Health
FraudConcerns about Naturopathic Medicine

• Allopathic medicine
• Based on measurable causative factors
• Treatment proven using scientific methods
• Naturopathic medicine
• Based on glib generalities
• Simplistic theories
• May contradict science based knowledge
• Assumes safety

18
Cited examples of Naturopathic QuackeryK.
Atwood, Medscape General Medicine,
2003http//www.medscape.com/viewarticle/465994_1

• The repudiation of standard treatments of asthma,
  offering instead, for example, a hydrogen
  peroxide bath to "bring extra oxygen to the
  entire surface of the skin, thus making the lungs
  somewhat less oxygen hungry" or "gems and
  minerals ... worn as jewelry, or placed around
  the home in special places."
• This quotation is from "Articles written by
  Naturopathic Physicians for the general public"
  (on the AANP Web site). The author is listed as a
  "senior editor of the Journal of Naturopathic
  Medicine, the official publication of the AANP."

19
Cited examples of Naturopathic Quackery

• The insertion of endonasal balloons, followed by
  their inflation in the nasopharynx, to "release
  tensions stored in the connective tissue and
  return the body to its original design," thus
  curing learning disorders and a host of other
  problems.

20
Cited examples of Naturopathic Quackery

• Treatment of the acute stroke patient for at
  least 20 minutes with an "ice-cold compress ...
  over the carotid arteries under the jaw bone on
  the neck" (which "may even abort the stroke") and
  subtle energy medicine.
• The author of these recommendations is listed as
  a "senior editor of the Journal of Naturopathic
  Medicine, the official publication of the
  American Association of Naturopathic Physicians."

21
Osteopathic Medicine
22
Osteopathic MedicineFeatures

• Whole person approach
• not only treating specific symptoms
• Focus preventive health care
• Extra training musculoskeletal system
• 2/3 rd of total body mass
• Osteopathic manipulative treatment (OMT)
• use hands to diagnose and encourage bodys
  natural tendency to heal itself

23
Osteopathic MedicineScope of Practice Current
Status

• Doctor of Osteopathic Medicine (DO)
• fully trained and licensed to prescribe
  medication and perform surgery
• Separate but equal branches of medicine
• DOs full active members of AMA
• 65 of DOs in primary care
• family practice, pediatrics, internal medicine,
  OB/GYN

24
Osteopathic MedicineA brief history

• Late 19th Century
• Andrew T. Still, MD, OD
• over prescription of medications
• origins of disease in dysfunctional
  musculoskeletal system
• rational medical therapy includes manipulation
  and limited use of medications
• osteo - pathos

25
Osteopathic MedicineA brief history

• Early 20th century
• DOs adopt use of medicines and surgery
• Chiropractors limit to manipulation
• 1960s AMA lobbies to end practice of osteopathy
  in CA
• referendum passed to end osteopathy
• ODs become MDs
• College of Osteopathic Physicians Surgeons
  absorbed in UC system (Irvine)

26
Osteopathic MedicineA brief history

• 1974
• CA Supreme Court overrules referendum
• Professional equivalency for ODs
• 1960 incorporation of ODs into MDs
• US Army allows ODs as physicians

27
Comparative training for MDs, DOs
NDsPre-requisites
2 yrs of chemistry
1 yr of biology
1 yr of physics
28
Comparative training for MDs, DOs
NDsMedical Schools
29
Curriculum

• Kirksville College of Osteopathic Medicine
• http//www.kcom.edu/
• Bastyr University
• http//www.bastyr.edu/academic/naturopath/curricul
  um.asp?track4
• UW School of Medicine
• http//apps.medical.washington.edu/somoc/index.asp

30
Comparative training for MDs, DOs
NDsPost-Graduate Education

• MDs
• Residency Program (3-7 yrs, depending on
  specialty)
• Fellowships (1-3 yrs, subspecializations,
  optional)
• License to practice (examination)
• Board Certification (optional)
• DOs
• Internship (1 year)
• Residency (2-6 years, optional)
• NDs
• Residency Program (Bastyr 2 yr, optional)

31
Conclusions

• Who should patients turn to for nutrition
  information and counseling?
• MDs, DOs, or NDs??
• How about RDs !!