Osteopathic vs Naturopathic medicine?

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daveyboy said:
I meant that they are not physicians in the sense that they are not eligible for a license to practice medicine in the culture that I live in.
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NDs are licensed to practice medicine (naturopathic) within 13 states and two territories of the US-I don't know if one of these states is your home, or not. http://www.naturopathic.org/naturopathic_medicine/whatis.html

You would have been correct if you had said they are not licensed to practice osteopathic or allopathic medicine within the US...but no one ever said they were 🙄

Your general attitude seems to be that naturopathic medicine is not a 'real' or 'valid' form of medicine-and once again-I feel the urge to point out to you that this is an ethnocentric viewpoint. Naturopathic medicine is a real form of medicine to many people in the US-and it has borrowed from systems of medicine that are currently employed by millions in the world (and which have been around thousands of years longer than western medicine-ie. Chinese, Ayurvedic).

The question I posed was "Is it correct, or is it incorrect and (indirectly) ethnocentric to assert that NDs are not medical physicians?" Of course, it could also just be an innocent matter of semantics-and not actually reflect any negative attitude against naturopathic medicine and NDs. In my opinion, the naturopathic, osteopathic, and allopathic all refer to the type of medicine the physician practices. If medicine isn't medical, I don't know what is! :laugh:

In an attempt to answer this question- I looked up the definitions for 'medical' and 'physician'. I found nothing in their description which would preclude anyone from correctly referring to NDs as medical physicians.
 
OzDDS said:
I don't see how your argument is any different than an MD's viewpoint in the 1960's. "allowing the body to heal itself".. isn't this what Osteopathic med is all about. How hard would it be for ND schools to just incorporate 2 years of MD equivalent medical science and then claim to be equivalent. That is what DOs did basically right? With ND schools promoting a more general physician type curriculum, then saying they will practice in rural and underserved areas, to get approval for MD res training... then many of them then proceeding to apply for non gp related training programs.. Soon you'll have to decide which Plastic surgeon you want to visit between an MD, DO, ND, Dr of Oriental medicine, etc. when does it stop? I don't think we should be allowing such things in the name of medical anthropology or political correctness. 👎
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Well, I don't know about allowing such things in the name of medical anthropology or political correctness...And I don't see whats wrong with giving the public a choice between doctors. The truth is that there isn't really much of a difference between DOs and MDs in practice-so its not providing the public much of an option-so you're right that this doesn't make much sense.

However, in China, people go to see western doctors, as well as Chinese doctors - and the two types of doctors work together to treat the patient. Similarly, I know many in america who see both NDs and MDs/DOs. The two systems are not mutually exclusive of each other - unless each views the other as a threat to its own existence.

However, I doubt NDs are going to evolve to become entirely like MDs/DOs. If anything, I think DOs and MDs are going to evolve to incorporate more of the treatments that NDs use-such as preventative medicine, acupuncture... as these modalities become more in demand by the american public and are 'proven' in scientific studies. Yes, I know MDs and DOs alike are trying to focus on preventative medicine already. 🙂
 
OzDDS said:
I don't see how your argument is any different than an MD's viewpoint in the 1960's. "allowing the body to heal itself".. isn't this what Osteopathic med is all about. How hard would it be for ND schools to just incorporate 2 years of MD equivalent medical science and then claim to be equivalent. That is what DOs did basically right? With ND schools promoting a more general physician type curriculum, then saying they will practice in rural and underserved areas, to get approval for MD res training... then many of them then proceeding to apply for non gp related training programs.. Soon you'll have to decide which Plastic surgeon you want to visit between an MD, DO, ND, Dr of Oriental medicine, etc. when does it stop? I don't think we should be allowing such things in the name of medical anthropology or political correctness. 👎
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For the most part I think you are correct. However, I don't think that the same niche exists today for the ND profession like that did in the early 1900's for the DO's. Also, a large number of physicians are integrating CAM into their practice, as well as an increasing number of fellowships and residencies that are offering formal training in it. With the pharmacology training has already, practicing herbal medicine is just a matter of becoming familiar with a new set of drugs.

If ND's were to get full practice rights they would have to prove to a legislature that they offer a unique service, and can perform this service better than anyone else. They would need to show a compelling need for a new type of physician. This would be pretty hard to do with a lobby of board certified Integrative Medicine specialists, the AMA, and the AOA(unless they are in LA filming a TV show) arguing that NDs do not. It is much more likely that NDs will practice in the way an NP does, which is not anything to sneer at if you are considering the profession.

Bottom line, guys like Andrew Weil have made too much money off hippy medicine to let some other group come in and take their sweet gig. And it is a sweet gig, the ultimate in boutique medicine. You can get healthy people to come to the doctor, and there is always another herb to take to get even healthier. BRILLIANT!
 
dancote said:
I will confess, I am very interested in Naturopathic medicine. The reason I didn't go that route is 1) I was concerned that I would not see enough pathology 2) that licensing would not be available in my area for some time. My plan now is to get my D.O. degree and then do the N.D. degree (something like 15% of Naturopathic students already have a medical degree). I did spend a lot of time speaking to N.D. students to learn about the current programs. It was interesting to learn that they all do the basic science courses the first 2 years. These include gross anatomy, Bio. Chem., etc. They do clinical type work the 3rd and 4th years. The southwestern school in Arizona has an excellent program and they now offer a residency after graduation.
There are something like 13 states that were N.D.s are licensed as primary care doctors. In several states (Arizona and Utah,?) they are able to prescribe. I believe that NY is attempting to put a law through for N.D. licensing. The District of Columbia is the most recent to be licensed as also was CA.
My love and devotion to osteopathic medicine does not limit my interest in other forms of healing. I hope to be a family doctor someday with the open mind to look at various (researched backed) methods of healing.
N.D. doctors are here to stay. I hear good and bad from people who have worked with them, but that is also true of other types of doctors. The important thing is that all doctors (including the N.D.) depend on sound research and properly conducted studies in their practice. We will be seeing a lot more research in herbal and chinese medicine in the future as this is what a large percent of the population wants.

-dan
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Dan, that is really cool-we need to keep in touch 😀
 
yposhelley said:
Well, I don't know about allowing such things in the name of medical anthropology or political correctness...And I don't see whats wrong with giving the public a choice between doctors. The truth is that there isn't really much of a difference between DOs and MDs in practice-so its not providing the public much of an option-so you're right that this doesn't make much sense.

However, in China, people go to see western doctors, as well as Chinese doctors - and the two types of doctors work together to treat the patient. Similarly, I know many in america who see both NDs and MDs/DOs. The two systems are not mutually exclusive of each other - unless each views the other as a threat to its own existence.

However, I doubt NDs are going to evolve to become entirely like MDs/DOs. If anything, I think DOs and MDs are going to evolve to incorporate more of the treatments that NDs use-such as preventative medicine, acupuncture... as these modalities become more in demand by the american public and are 'proven' in scientific studies. Yes, I know MDs and DOs alike are trying to focus on preventative medicine already. 🙂
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Smurf, this ain't easy to say, but I agree with you.
 
daveyboy said:
Smurf, this ain't easy to say, but I agree with you.
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😀
 
yposhelley said:
NDs are licensed to practice medicine (naturopathic) within 13 states and two territories of the US-I don't know if one of these states is your home, or not. http://www.naturopathic.org/naturopathic_medicine/whatis.html

You would have been correct if you had said they are not licensed to practice osteopathic or allopathic medicine within the US...but no one ever said they were 🙄

Your general attitude seems to be that naturopathic medicine is not a 'real' or 'valid' form of medicine-and once again-I feel the urge to point out to you that this is an ethnocentric viewpoint. Naturopathic medicine is a real form of medicine to many people in the US-and it has borrowed from systems of medicine that are currently employed by millions in the world (and which have been around thousands of years longer than western medicine-ie. Chinese, Ayurvedic).

The question I posed was "Is it correct, or is it incorrect and (indirectly) ethnocentric to assert that NDs are not medical physicians?" Of course, it could also just be an innocent matter of semantics-and not actually reflect any negative attitude against naturopathic medicine and NDs. In my opinion, the naturopathic, osteopathic, and allopathic all refer to the type of medicine the physician practices. If medicine isn't medical, I don't know what is! :laugh:

In an attempt to answer this question- I looked up the definitions for 'medical' and 'physician'. I found nothing in their description which would preclude anyone from correctly referring to NDs as medical physicians.
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I don't think I have a negative attitiude towards NDs. I have actually been very impressed with what I have seen from their national organization.

We have been using different definitions for medicine and physicians, so that disagreement is a semantic one. I can work with your definition of medicine, but it would help to let me know when your definition of a term is somewhat unconventional. This isn't an implication that I immediatedly think your point is wrong or weird, but more a result of the fact that I rarely interact with people of your academic background these days.

You strike me as somebody who has been involved in debate. Is that true?
 
daveyboy said:
I don't think I have a negative attitiude towards NDs. I have actually been very impressed with what I have seen from their national organization.

We have been using different definitions for medicine and physicians, so that disagreement is a semantic one. I can work with your definition of medicine, but it would help to let me know when your definition of a term is somewhat unconventional. This isn't an implication that I immediatedly think your point is wrong or weird, but more a result of the fact that I rarely interact with people of your academic background these days.

You strike me as somebody who has been involved in debate. Is that true?
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:laugh:
Haha, no...no background in debate. -actually I majored in Biology and only minored in Anthropology...

I'm not sure which of my definitions you found unconventional? If you look at one of my earlier posts in this thread-you will find the exact definitions I am referring to, as I posted them there. Ethnocentricism was certainly defined correctly, and my definition of physician was from an English dictionary. Assuming we agree that the word 'medical' pertains to medicine -here is a definition of medicine from an English dictionary...

"med?i?cine ( P ) Pronunciation Key (md-sn)
n.

1. The science of diagnosing, treating, or preventing disease and other damage to the body or mind.
2. The branch of this science encompassing treatment by drugs, diet, exercise, and other nonsurgical means.
3. The practice of medicine.
4. An agent, such as a drug, used to treat disease or injury.
5. Something that serves as a remedy or corrective: medicine for rebuilding the economy; measures that were harsh medicine.

6. Shamanistic practices or beliefs, especially among Native Americans.
Something, such as a ritual practice or sacred object, believed to control natural or supernatural powers or serve as a preventive or remedy."

As you can see, this definition encompasses the role of an ND. I have no idea which of these is the conventional use of the word (I would think your opinion of a conventional use for the word would be #4)

I'm glad to hear you don't have a negative opinion of NDs-its my hope they can learn from us and we from them...its good to keep an open mind.
This is just my little pet peeve---I think NDs should be treated with as much respect as DOs and MDs-they are different than MDs or DOs, yes, but try just as hard to help people heal-and undergo four years of schooling-two years of which would be considered "science-based" by the most conventional of people.

I thought that saying they aren't medical physicians was a subtle way of putting them down-but if it doesn't bother NDs (I have no idea if it does or doesn't)-then it shouldn't matter. As I said in my last post, it could just be a question of how we choose to define the term "medical physicians".
 
Yposhelley, my tolerance for long post is zero to NONE.
On top of that you are using really big words... I mean really big.

Davebody and Yposhelley... if this really important to figure out, start a poll.
The beauty of a Poll is that majority wins.

Lets see you are wasting your energy debating about NDs... channel that energy and go out and spread the world of DOs. Write letters, emails.. hand out flyier in the streets... do everything you can DO!
 
yposhelley said:
:laugh:
I'm glad to hear you don't have a negative opinion of NDs-its my hope they can learn from us and we from them...its good to keep an open mind.
This is just my little pet peeve---I think NDs should be treated with as much respect as DOs and MDs-they are different than MDs or DOs, yes, but try just as hard to help people heal-and undergo four years of schooling-two years of which would be considered "science-based" by the most conventional of people.

I thought that saying they aren't medical physicians was a subtle way of putting them down-but if it doesn't bother NDs (I have no idea if it does or doesn't)-then it shouldn't matter. As I said in my last post, it could just be a question of how we choose to define the term "medical physicians".
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I think the reason for the tension between the two groups is that often western medicine is dismissed by NDs and there is a perception among the MD/DO community that patients of NDs are kept from seeing a MD/DO when it is necessary. There are a lot of people who are distrustful of physicians in general, and when they have a person with the title of Doctor who tells them that they don't need to see a MD/DO for their problem, they want to trust the credentials. I am all for alternative medicine, when traditional medicine has failed, but in order to treat our patients fairly we need to foster a community of trust amongst our medical counterparts. You can also repeat what I just said replacing ND with DC as these exact same problems exist with chiropractors.

There needs to be a lot more education on the different options that a patient has in all of the professional schools. Recently I met a chiropractic student who was amazed when I told him that we learn musculoskeletal manipulations in osteopathic medical school. He asked me when they started teaching chiropractic techniques in medical schools. I told him that osteopathic medicine pre-dates chiropractic and he didn't believe me. Last year, the complementary medicine club on campus had an ND speaker and he had very little knowledge of our education standards. Conversely, we are taught nothing of NDs even though they are licensed as primary treating physicians in 13 states.
 
WannabeDO, I see your point...but that hasn't been my experience with NDs-I haven't come across anti-allopathic attitudes amongst NDs.
The NDs I have known have always been very aware of the limit of their abilities. They recieve diagnostic training in their schools, as well as training in the sciences - they wouldn't mess around treating cancer with chinese herbs unless the patient was terminally ill and had already tried chemo/surgery...they would immediately recommend them to an MD/DO.
 
I have worked with a nMD before while I was in med school in AZ. They have full rx rights and dea number. That means they have access to any drug that an MD/DO can rx.

Here is the problem. After the 4 year nMD, no internship/residency required to practice "Medicine." They can hang up their sign and advertise as a GP. Others are doing home deliveries because they can't get into the local hospitals. An MS4 student in their program couldn't recognize pneumonia on a cxr and described lung sounds as "wet." My impression of their clinical skills was very low and I wouldn't recommend them to anyone, other than for a second opinion on a previously diagnosed dz.

My wife had to treat an nMD after she initially refused conventional medicine and returned 6 months later with a necrotic breast. Great survival outcome on that one.
 
r90t said:
I have worked with a nMD before while I was in med school in AZ. They have full rx rights and dea number. That means they have access to any drug that an MD/DO can rx.

Here is the problem. After the 4 year nMD, no internship/residency required to practice "Medicine." They can hang up their sign and advertise as a GP. Others are doing home deliveries because they can't get into the local hospitals. An MS4 student in their program couldn't recognize pneumonia on a cxr and described lung sounds as "wet." My impression of their clinical skills was very low and I wouldn't recommend them to anyone, other than for a second opinion on a previously diagnosed dz.

My wife had to treat an nMD after she initially refused conventional medicine and returned 6 months later with a necrotic breast. Great survival outcome on that one.
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What is an nMD??? I know it ain't an ND because they don't have full rx rights and a DEA #....

Just found this guy's website, but he can't prescribe meds from what I can tell http://www.drstallone.com

Check this out too http://www.drhooker.net/faq.htm#antibiotics
 
OnMyWayThere said:
What is an nMD??? I know it ain't an ND because they don't have full rx rights and a DEA #....

Just found this guy's website, but he can't prescribe meds from what I can tell http://www.drstallone.com

Check this out too http://www.drhooker.net/faq.htm#antibiotics
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That person is mistaken. the only people in the US with full practice rights are MD's and DO's, and the only one's with DEA numbers are the former plus PA's and NP's
 
medic170 said:
MD's and DO's, and the only one's with DEA numbers are the former plus PA's and NP's
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and Dentists
 
yposhelley said:
NDs are licensed to practice medicine (naturopathic) within 13 states and two territories of the US-I don't know if one of these states is your home, or not. http://www.naturopathic.org/naturopathic_medicine/whatis.html

You would have been correct if you had said they are not licensed to practice osteopathic or allopathic medicine within the US...but no one ever said they were 🙄

Your general attitude seems to be that naturopathic medicine is not a 'real' or 'valid' form of medicine-and once again-I feel the urge to point out to you that this is an ethnocentric viewpoint. Naturopathic medicine is a real form of medicine to many people in the US-and it has borrowed from systems of medicine that are currently employed by millions in the world (and which have been around thousands of years longer than western medicine-ie. Chinese, Ayurvedic).

The question I posed was "Is it correct, or is it incorrect and (indirectly) ethnocentric to assert that NDs are not medical physicians?" Of course, it could also just be an innocent matter of semantics-and not actually reflect any negative attitude against naturopathic medicine and NDs. In my opinion, the naturopathic, osteopathic, and allopathic all refer to the type of medicine the physician practices. If medicine isn't medical, I don't know what is! :laugh:

In an attempt to answer this question- I looked up the definitions for 'medical' and 'physician'. I found nothing in their description which would preclude anyone from correctly referring to NDs as medical physicians.
Click to expand...


Physician = Licensed in Performing Surgery (of all types) and administering medications (of all types) in all states as well as other various procedures. This also requires that the practitioner can have full practice privileges and rights at any hospital, which is not true of anyone other than M.D.'s or D.O.'s.

The word physician applies to an Allopathic or an Osteopathic Physician.

There are some Doctors with a limited scope of practice, including D.C.'s, N.D.'s, etc. There doctors have some skills, but are not qualified to practice all skills. In addition, they do not have surgical and pharmacologic privileges or physician privileges at medical hospitals.
 
So if the osteopathic profession remained OMM and not incorporated allopathic medicine, would they presently be called physicians. The answer to that is NO. Diploma of Osteopathy given arround the world, are not recognized as Physicians. If you wish to call a N.D. and D.C. Physician than do feel free to do so. Of course legally it depends on state regulations.
 
There is more than one definition of physician, including (and this is my favorite one- "one upon whom we set our hopes when ill and our dogs when well" but here are a couple others
"any duly licensed practitioner of the healing arts within the scope of his or her license",
"a licensed medical practitioner"
www.phs.org/intel/glossary.htm
www.mmcbenefits.com/medical/comprehensive/definitions_main.html


If anyone chooses to recognize only their definition of physician (ahem, be closeminded), well then, that is their prerogative. It is true that under the definition stated by OSUDoc08, NDs would not be able to be called physicians. Those with the power often make the rules that states follow, but NDs are working to get more recognized, and they do provide some valuable services. I recognize they are not licensed to perform the same scope of procedures as an MD or a DO. NONETHELESS, they do call themselves naturopathic physicians, whether one likes it or not. The difference between a DO/MD and a ND physician is degree of licensing and scope of practice, but since NDs stay within their scope of practice, I don't see why they can't be called physicians, using the definitions I posted above.

I hope we can at least agree that there is more than one definition of physician. Docbill, I don't think any lawyers are going to be coming after any NDs for calling themselves 'physicians', as long as they are not claiming to be capable of performing surgery, which they shouldn't be. BTW- I have no idea what that ND is doing calling himself an NMD. What the heck is an NMD?

Well, if we can't at least agree there is more than one definition for physician, then at least recognize that no one is going to change my mind on this issue. In this case, call me stubborn (which I readily admit) and lets just let this particular discussion die, 'kay? 😉

Or, on the other hand, we could continue to flog this dead horse, just for fun. :laugh:
 
Although I am by no means an expert on this subject, nor a licensed ND, I did attend a year of the ND program at Bastyr University (www.bastyr.edu) and I think I can shed a bit of insight into some of the issues raised in this thread.

At least here in WA state, NDs, DOs, and MDs are all considered primary care providers, and thus their services must be covered by insurance plans operating within the state. (My PCP under Blue Cross is an ND.)

Again, at least in WA, NDs are licensed to prescribe pharmaceuticals, although the list of drugs for which they have prescriptive authority is limited to ~100. Just the essentials of a basic general practice pharmacy - synthroid, "the pill", some antibiotics, etc.

NDs learn and can practice minor surgery under the state law (I believe the law limits them to a very shallow depth of tissue penetration) probably enough to excise a mole, etc.

They can draw blood, give injections, do paps - essentially everything most PCPs do. Perhaps most importantly, at least in my experience, they maintain strong relationships with the conventional medical community and are very comfortable referring patients and "co-managing" with other providers if and when the need arises.

Please don't confuse ND graduates of four year universities like Bastyr with the "NDs" who get their degrees from mail order schools (like the Clayton School advertised above). IMHO, the lobbying efforts and miseducation from ND diploma mills is the most serious impediment to more widespread understanding and acceptance of Naturopathic Medicine. Good NDs can help a lot of people, and possibly provide a model of very cost effective front line health care - something our society appears in desperate need of.

As discussed above, the definition of a physican may be somewhat subjective. Therefore, I defer to the ultimate authority - the Yellow pages, which under "Physician" lists NDs, DOs, MDs and DPMs. QwestDex has spoken!
 
bodymechanic said:
At least here in WA state, NDs, DOs, and MDs are all considered primary care providers, and thus their services must be covered by insurance plans operating within the state. (My PCP under Blue Cross is an ND.)

Again, at least in WA, NDs are licensed to prescribe pharmaceuticals

NDs learn and can practice minor surgery under the state law

They can draw blood, give injections, do paps - essentially everything most PCPs do. As discussed above, the definition of a physican may be somewhat subjective. Therefore, I defer to the ultimate authority - the Yellow pages, which under "Physician" lists NDs, DOs, MDs and DPMs. QwestDex has spoken!
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So what is keeping ND groups from pushing the AMA to allow them to be eligible for MD "allopathic" residency training programs like DOs have done?



..If as you are infering.. that NDs are primary care physcians and that they are equal to a GP-MD or GP-DO.
 
OzDDS said:
So what is keeping ND groups from pushing the AMA to allow them to be eligible for MD "allopathic" residency training programs like DOs have done?
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I would like to see a link showing ND coursework. Do they have sufficient background in pharm/path/phys? Do they take biochem? If the answer is no, then i have to to say that your question answers itself.
*edit- not to mention having clinical skills coursework and rotations with current physicians...

Seriously, i have no idea what their courseload looks like. My idea is people sitting around in an apothecary poking each other with needles.
 
Sorry about that link, Oz. I got it from a google search on this site-you'll see the definition listed-http://www.google.com/search?hl=en&lr=&oi=defmore&q=define:physician

Dr. Nick-Since you don't know, you probably shouldn't go by what you imagine. I'm sure there are many who have the idea that osteopathic doctors sit around all day trying to cure cancer with manipulations. Anyways, for your benefit-here is the four year curriculum for Bastyr University found at this site, http://www.bastyr.edu/academic/naturopath/curriculum.asp?track=4. If anyone puruses their site, please note they do refer to themselves as "naturopathic physicians."

The four year curriculum does include biochemsistry, physiology, and human pathology (a comparable amount to MD/DO schools). Here are the first three years, although I recommend looking at the website since its cleaner there-
Four-Year Track: Year I

Quarter Cat. No. Course Title Credits Lec. L/C Total
Fall BC5104 Biochemistry 1 4 4 0 44
BC5107 Human Physiology 1 Lec/Lab 5.5 4 3 77
BC5110 Histology1 5 4 2 66
BC5122 Gross Human Anatomy 1 4.5 4 1 55
BC5122L Gross Human Anatomy 1 Lab 2 0 2 22
NM5131 Naturopathic Clinical Theory 1 2 1 2 33
NM5804 Clinic Entry 1 1 0 2 22
Quarterly Total: 23 17 12 319

--------------------------------------------------------------------------------

Winter BC5105 Biochemistry 2 4 4 0 44
BC5108 Human Physiology 2 Lec/Lab 5.5 4 3 77
BC5112 Embryology 3 3 0 33
BC5123 Gross Human Anatomy 2 4.5 4 1 55
BC5123L Gross Human Anatomy 2 Lab 1 0 2 22
BC5141 Research Methods & Design1 2 2 0 22
NM5135 The Determinants of Health 1.5 1.5 0 16.5
OM5120 Fundamental Principles of TCM1 3 3 0 33
PM5300 Massage 1.5 0 3 33
PM5301 Hydrotherapy/ Physiotherapy Lecture 2 2 0 22
Quarterly Total: 28 23.5 9 357.5

--------------------------------------------------------------------------------

Spring AV5100 Fundamentals of Ayurvedic Medicine1 2 2 0 22
BC5106 Biochemistry 3 4 4 0 44
BC5109 Human Physiology 3 3 3 0 33
BC5124 Gross Human Anatomy 3 4.5 4 1 55
BC5124L Gross Human Anatomy 3 Lab 1 0 2 22
BC5129 Neuroscience 5.5 4 3 77
BO5301 Botanical Medicine 1 Lec/Lab 2 1.5 12 26.5
NM5136 The Vis Medicatrix Naturae 1.5 1.5 0 16.5
PM5305 Hydrotherapy/Physiotherapy Lab1 1 0 2 22
PS5103 Physician Heal Thyself1 2 2 0 22
Quarterly Total: 26.5 22 9 340
1AV5100, BC5110, BC5141, OM5120, PM5305 and PS5103: Usually also offered in summer
2Two hours every other week times five weeks


Four-Year Track: Year II

Quarter Cat. No. Course Title Credits Lec. L/C Total
Fall BC6200 Human Pathology 1 4 4 0 44
BC6204 Immunology1 4 4 0 44
BO6301 Botanical Medicine 2 2 2 0 22
HO6300 Homeopathy 1 2 2 0 22
NM6210 Clinical Lab Diagnosis 1 3.5 2 3 55
NM6221 Physical/Clinical Diagnosis 1 Lecture 2 2 0 22
NM6221L Physical/Clinical Diagnosis 1 Lab 2 1 2 33
PS6305 Naturopathic Counseling 1 3 3 0 33
TR6310 Foods, Dietary Systems & Assessment 3 2 2 44
Quarterly Total: 25.5 22 7 319

--------------------------------------------------------------------------------

Winter BC6201 Human Pathology 2 4 4 0 44
BC6210 Infectious Diseases2 6.5 5 3 88
BO6302 Botanical Medicine 3 Lec/Lab 2 1.5 1 26.5
HO6301 Homeopathy 2 3 3 0 33
NM6211 Clinical Lab Diagnosis 2 3.5 2 3 55
NM6222 Physical/Clinical Diagnosis 2 Lecture 2 2 0 22
NM6222L Physical/Clinical Diagnosis 2 Lab 2 1 2 33
PS6306 Naturopathic Counseling 2 3 3 0 33
TR6311 Macro & Micronutrients 3 3 0 33
Quarterly Total: 29 24.5 9 367.5

--------------------------------------------------------------------------------

Spring BC6202 Human Pathology 3 4 4 0 44
BC6305 Pharmacology 2 5 5 0 55
BO7303 Botanical Medicine Dispensary Lab1 1 0 2 22
HO6302 Homeopathy 3 3 3 0 33
NM6212 Clinical Lab Diagnosis 3 3.5 2 3 55
NM6223 Physical/Clinical Diagnosis 3 Lecture 2 2 0 22
NM6223L Physical/Clinical Diagnosis 3 Lab 2 1 2 33
NM6804 Clinic Entry 2 1 1 0 11
NM8801 Preceptorship 1 1 0 4 44
PM6300 Naturopathic Manipulation 1 2 2 0 22
Quarterly Total: 24.5 20 11 341
1BC6204 and BO7303: Usually also offered in summer
2 BC6210 and BC6305: Offered in winter and spring quarter
Eligible to take NPLEX basic science exams
See clinic admission, page 48.


Four-Year Track: Year III

Quarter Cat. No. Course Title Credits Lec. L/C Total
Summer NM7325 Naturopathic Case Analysis & Mgmt 1 1.5 0 3 33
NM7341 Cardiology 3 3 0 33
NM7400 Minor Office Procedures1 3 3 0 33
NM7417 Medical Procedures1 3 3 0 33
Quarterly Total: 10.5 9 3 132
1-2 Clinic Shifts2 2-4 0 4-8 44-88

--------------------------------------------------------------------------------

Fall BO7300 Botanical Medicine 4 Lec/Lab 2 1.5 1 26.5
MW7320 Normal Maternity 3 3 0 33
NM7302 Gastroenterology 2 2 0 22
NM7307 EENT 2 2 0 22
PM7301 Naturopathic Manipulation 23 3 3 0 33
PM7305 Orthopedics 2 2 0 22
PS7200 Psychological Assessment 2 2 0 22
TR7411 Diet & Nutrient Therapy 1 3 3 0 33
Quarterly Total: 22 21.5 1 246.5
1-2 Clinic Shifts2 2-4 0 4-8 44-88

--------------------------------------------------------------------------------

Winter NM7101 Environmental Medicine 1.5 1.5 0 16.5
NM7102 Public Health 1.5 1.5 0 16.5
NM7115 Naturopathic Clinical Theory 2 1 1 0 11
NM7304 Dermatology 2 2 0 22
NM7306 Oncology 2 2 0 22
NM7314 Pediatrics 1 2 2 0 22
PM7302 Naturopathic Manipulation 34 3 3 0 33
PM7341 Sports Medicine/Therapeutic Exercise 2 2 0 22
PS7203 Addictions & Disorders 2 2 0 22
TR7412 Diet & Nutrient Therapy 2 3 3 0 33

--------------------------------------------------------------------------------

Spring BO7301 Botanical Medicine 5 Lec/Lab 2 1.5 1 26.5
NM7109 Practice Management 1 1.5 1.5 0 16.5
NM7305 Clinical Ecology 1 1 0 11
NM7311 Neurology 2 2 0 22
NM7315 Pediatrics 2 2 2 0 22
NM7320 Family Medicine 2 2 0 22
NM7330 The Healing Systems 3 3 0 33
PM7303 Naturopathic Manipulation 45 2 2 0 22
PS7315 Naturopathic Counseling 3
 
I'm posting the fourth year, too.

Four-Year Track: Year IV

Quarter Cat. No. Course Title Credits Lec. L/C Total
Summer NM8206 Radiographic Interpretation 1 Lecture3 3 3 0 33
NM8207 Radiographic Interpretation 1 Lab3 1 0 2 22
Quarterly Subtotal: 4 3 2 55
3-4 Clinic Shifts 6-8 0 12-16 132-176

--------------------------------------------------------------------------------

Fall NM8303 Geriatrics 2 2 0 22
NM8308 Endocrinology2 3 3 0 33
NM8312 Urology 1.5 1.5 0 16.5
NM8325 Nat. Case Analysis & Mgmt 2:
Grand Rounds3 1 0 2 22
NM8413 Adv'd Naturopathic Therapeutics 1 2 2 0 22
Quarterly Total: 9.5 8.5 2 115.5
3-4 Clinic Shifts 6-8 0 12-16 132-176

--------------------------------------------------------------------------------

Winter NM8101 Ethics4 1 1 0 11
NM8213 Diagnostic Imaging5 2 2 0 22
NM8309 Rheumatology 1.5 1.5 0 16.5
NM8414 Adv'd Naturopathic Therapeutics 2 2 2 0 22
NM8802 Preceptorship 2 1 0 4 44
Quarterly Total: 7.5 6.5 4 115.5
3-4 Clinic Shifts 6-8 0 12-16 132-176

--------------------------------------------------------------------------------

Spring NM8102 Jurisprudence 1 1 0 11
NM8109 Practice Management 2 2 2 0 22
NM8212 Radiographic Interpretation 25 3 3 0 33
NM8314 Pulmonary Medicine 1.5 1.5 0 16.5
NM8803 Preceptorship 3 1 0 4 44
NM8844 Interim Patient Care6 2 0 4 44
Quarterly Total: 8.5 7.5 4 126.5
3-4 Clinic Shifts 6-8 0 12-16 132-176
1NM8206 and NM8207: Both offered summer and fall
2NM8308: Offered fall and spring
3NM8325: Offered in fall, winter and spring
4NM8101: Offered fall and winter
5NM8212 and NM8213: Both offered winter and spring
6NM8844: Students are required to complete a total of 44 interim clinic hours. (Usually students staff the shifts they are assigned to in the quarter just ended.) Students register for and pay for this shift in their last quarter of attendance.


Summary of Clinic Requirements: Naturopathic Medicine Program
Quarter1 Cat. No. Course Title Credits Lec. L/C Total
variable NM7820-29 Patient Care 1-10 20 0 40 440
variable NM8801-3 Preceptorship 1-3 3 0 12 132
variable NM8830-36 Patient Care 11-17 14 0 28 308
variable NM8844 Interim Patient Care2 2 0 4 44
variable PM7801-2 Physical Medicine 1-2 4 0 8 88
variable PM8801-2 Physical Medicine 3-4 4 0 8 88
Clinic Totals: 47 0 100 1100
1Quarterly shift assignments are based on availability.


Elective Requirements: Naturopathic Medicine Program
Quarter Cat. No. Course Title Credits Lec. L/C Total
variable variable Elective and Special Topics 15 15 0 165
Elective Totals: 15 15 0 165
 
OzDDS said:
So what is keeping ND groups from pushing the AMA to allow them to be eligible for MD "allopathic" residency training programs like DOs have done?

..If as you are infering.. that NDs are primary care physcians and that they are equal to a GP-MD or GP-DO.
Click to expand...

I can't speak for the ND profession, but part of the answer may have to do with the fact that the ND philosophy (especially "vis medicatrix naturae" - the healing power of nature) is very much alive and well, and is still a real guiding force in most naturopathic treatments. (http://www.scnm.edu/college/philosophy.php)

Looking at the experience of Osteopathy (especially the great discussions on this board), it seems that along with the advantages of AMA acceptance, there may be some tradeoffs, especially when it comes to putting a holistic philosophy into practice.

MD + Alt. Med training definitely does not equal ND, while the MD + OMT = OD question seems at least somewhat open to debate.

Also, NDs are not equal to a GP-MD or GP-DO in one incredibly significant factor. Their licensed practice is limited to ~13 states. Although IMO, naturopaths are the experts when it comes to CAM, I think the lack of national licensure makes the future of naturopathy somewhat uncertain. If MDs, DOs and other providers continue to integrate alternative medicine, perhaps eventually even as a specialty, I wonder if the NDs will still have their slice of the health care pie.

After all, when most people think of an expert on CAM, Andrew Weil is a household name, while Joseph Pizzorno or Michael Murray (authors of the "Textbook of Natural Medicine") are relatively unknown.
 
bodymechanic said:
Also, NDs are not equal to a GP-MD or GP-DO in one incredibly significant factor. Their licensed practice is limited to ~13 states. Although IMO, naturopaths are the experts when it comes to CAM, I think the lack of national licensure makes the future of naturopathy somewhat uncertain. If MDs, DOs and other providers continue to integrate alternative medicine, perhaps eventually even as a specialty, I wonder if the NDs will still have their slice of the health care pie.

After all, when most people think of an expert on CAM, Andrew Weil is a household name, while Joseph Pizzorno or Michael Murray (authors of the "Textbook of Natural Medicine") are relatively unknown.
Click to expand...

Given that 'alternative medicine' is not a well-defined entity, but, rather, a marketing term, how could it make sense to make it a specialty? Alternative Medicine is not a well-defined entity, per se. It's just a mishmash of treatments which aren't generally accepted by mainstream medical scientists. Some of the treatments may have promise, others are almost certainly completely bogus and totally irrational. What will an 'alternative medicine specialist' practice? Homeopathy? TCM? Iridology? Colon cleansing? Or all of the aforementioned?

As I mentioned, alternative medicine is little more than a successful marketing term---- sort of makes people feel like they're in on something new and exciting, even though much of what constitues alt med is old and never demonstrated to have any efficacy. Put simply, a treatment either works to a degree, or it doesn't. It it works, it's medicine. If it doesn't work, it's not medicine. Yes, cultural factors do come into play with many forms of treatment, but that doesn't absolve the promoters of a given treatment of the responsibily of demonstrating its efficacy.

Here's a review of the Pizzorno/Murray text by a former NEJM editor:

Textbook of Natural Medicine
Arnold S. Relman, M.D.
January 9, 2001
This two-volume textbook, published in a second edition in 1999, is edited by two naturopaths -- one the president, and the other a member of the faculty of Bastyr University, which is the leading school of naturopathic medicine in the country. The textbook has over 1,600 pages and 57 contributors (most of whom practice and/or teach naturopathic medicine), and it purports to provide "well-documented standards of practice for natural medicine." I therefore take it to be an up-to-date summary of what is taught about the practice of naturopathic medicine and how its practitioners are expected to provide care for the patients who consult them.

Among the criteria we have adopted for deciding whether a complementary and alternative ("CAM") practice should be licensed by the State are: (a) evidence that the practice "confers measurable benefits" to those who use it (Criterion #2), and (b) evidence that the use of "some or all of the modalities within a practice that fall within the accepted standards of the practice may result in direct patient harm" (Criterion #5). A close reading of this textbook should provide some answers to these crucial questions about the potential benefit and harm of naturopathic practices as currently taught.

I borrowed a copy of the Textbook of Natural Medicine (the "Textbook") and studied it carefully over a period of several days in an attempt to answer these questions. My conclusion is that the licensing of naturopathic medical practitioners as independent providers of primary health care would endanger the health and safety of the public and would not result in health benefits commensurate with its risks. There is abundant evidence in the Textbook to support this conclusion, but I summarize below only a few of the most problematic examples of the deficiencies and dangers in naturopathic practices.

1) The textbook describes the diagnosis and treatment of only 70 "specific health problems," and they are simply listed in alphabetical order, without regard to the nature of the condition or the organ(s) involved. In comparison, standard textbooks of conventional medicine provide a much more rational and systematic presentation that includes hundreds of disease conditions and describes them in much greater depth and detail. The Textbook includes in its 70 chapters on specific diseases nothing about cancer, diseases of the blood (including leukemias and anemias), nothing about heart attacks or serious abnormal rhythms of the heart (such as atrial fibrillation), and virtually nothing about kidney diseases, chronic obstructive pulmonary disease, cirrhosis of the liver, or about many common and serious infections such as pulmonary tuberculosis, malaria, syphilis, meningitis, encephalitis or bacterial endocarditis. Lacking adequate education about these diseases, naturopathic practitioners might fail to diagnose them in a timely fashion or delay in referring patients for appropriate medical treatment,

2) Many of the treatments recommended in the Textbook for the 70 diseases are not likely to be effective, and treatments proven to be effective are often totally ignored. This could endanger the health and safety of patients with serious diseases who relied solely on care from a naturopathic practitioner. As explained in the Textbook, naturopathy objects to the use of pharmaceutical agents and depends instead an the use of herbal or "natural" remedies of unproven value. Here are some examples of common, serious diseases that are dangerously mistreated in the naturopathic Textbook:

A) The chapter on the treatment of anginal (coronary artery) heart disease does not even mention the use of nitrates, beta-blockers or calcium-channel blockers -- all of which are standard, effective, FDA-approved treatment for this condition. Failure to use one or more of these agents in the treatment of severe angina would probably be considered medical malpractice. There is no mention of "statin" drugs to lower cholesterol and prevent further progression of coronary heart disease. The use of angioplasty or bypass surgery for patients unresponsive to pharmacologic therapy is dismissed. "Chelation" -- a totally irrational and unproven form of treatment -- is discussed favorably. However, at the end of this chapter, it is stated that "patients with unstable angina pectoris . . . should be hospitalized", thus tacitly admitting that naturopathic methods may be ineffective and that serious cases may require medical or surgical treatment found only in hospitals.

B) The chapter on congestive heart failure recommends unproven nutritional supplements, but says nothing about the standard (and usually effective) treatment. with diuretics and ACE-inhibitors, which have been shown to give comfort to, and prolong, the lives of these patients, It does, however, admit that "In later stages, adjunct (prescription) drug therapy is Usually necessary", but gives no details,

C) The chapter on high blood pressure says nothing about the diagnostic work up that is often needed to rule out certain curable causes (such as certain diseases of the adrenal gland, or obstruction in the aorta or the renal arteries). It recommends diet lifestyle changes and the use of herbs but admits that severe cases unresponsive to these "natural" measures may require treatment with pharmaceuticals (presumably under the management of a conventional medical doctor). However, it ends with the dangerous advice that once control of high blood pressure has been achieved with drugs, the naturopathic physician should have the patient "taper off " the medications. For some such patients, a reduction in medication risks sudden resurgence of severe hypertension and the possibility of a stroke or heart attack. Most patients with severe hypertension need to remain on medication indefinitely, or for many years.

D) The chapter on diabetes says very little about the use of insulin, nothing about oral hypoglycemic drugs, and nothing about the diagnosis, prevention or treatment of diabetic acidosis-- except to warn that it is a medical emergency that will require hospitalization,

E) The chapter on epilepsy says nothing about the use of anti-epileptic drugs, without which many cases simply could not be adequately controlled. Uncontrolled epilepsy is dangerous.

F) The chapter on HIV infection and AIDS advocates various types of herbal and "natural" remedies but gives no information about conventional drug therapy. Although it is admitted that no clinical studies have yet demonstrated the effectiveness of naturopathic medical care in HIV infection when used alone, or even as a supplement to conventional medical treatment, the chapter nevertheless ends with this advice: "We urge physicians to apply the principles of naturopathic medicine in the care of their HIV positive patients." As if this neglect of the proven life-prolonging value of anti-viral pharmacotherapy were not shocking enough, the chapter also fails to recommend drug treatment of pregnant women with HIV infections, which is standard practice for the prevention of HIV transmission to the newborn. Neglect of such treatment would surely be considered malpractice in the medical profession.
 
continued:

G) The chapter on the treatment of asthma is also seriously deficient because it says nothing about the use of bronchodilator drugs, or drugs that block the allergic response in the lining of the respiratory passages, or about the short-term use of adrenal steroids for emergency cases. These are all well-established treatments for asthma; and it is difficult to imagine how serious cases could be managed without them. However, the Textbook advises naturopathic physicians to refer patients with acute asthmatic attacks to a hospital emergency room. This acknowledging that naturopathic remedies may not work and that seriously ill patients will need treatment by conventional medical methods. But this advice is also deficient in that it fails to mention that appropriate medical treatment could prevent the onset of attacks that require emergency care.

3) As already noted, naturopathic teaching (as exemplified in the Textbook) claims that "natural" herbal remedies are generally superior to pharmaceuticals in the treatment of most diseases -- despite the fact that the FDA forbids the manufacturers of herbal preparations and dietary supplements from making therapeutic claims. The textbook nevertheless devotes a large section to herbs and dietary supplements in which many such claims are made, often with little or no credible supporting evidence in the peer-reviewed scientific literature. At the same time, the Textbook omits entirely (or mentions only in passing) the use of many standard, proven pharmaceuticals that modern medicine has found useful or even essential in the treatment of serious diseases. For example:

Antibiotics are given only cursory consideration and often mentioned only as a last resort.
Nothing is said about the antibiotic treatment of syphilis tuberculosis or meningitis.
Chemotherapeutic agents for cancer are dismissed despite the fact that they are known to be effective in certain types of tumors and in leukemias.
There is no mention of the use of anticoagulants (blood-thinners) in the treatment of blood clots or their use to prevent embolic strokes in patients with atrial fibrillation. (These diseases are not even mentioned.)
There is no mention of diuretic drugs that are sometimes absolutely essential in the treatment of edema due to heart failure or kidney disease.
Perhaps most disturbing of all, there is no mention of opioid drugs in the treatment of intractable pain. Morphine and its derivatives are often essential for the relief of patients in the terminal stages of cancer. It is almost incomprehensible that nowhere in the numerous discussions of the management of pain by a great variety of "natural" methods is there a reference to the use of morphine or other analgesic drugs. Obviously, as any experienced physician knows, there are alternatives to drugs that may help -- particularly when pain is mild, moderate or only intermittent. But in advanced cancer, morphine is often the only way to afford relief, and it seems remarkable that the Textbook should omit such an essential form of treatment.

Primary care practitioners whose education does not include the use of prescription drugs simply cannot be expected to provide effective and safe care for many serious conditions they are likely to encounter. While it is true that unnecessary or inappropriate use of drugs is harmful, and that even proper usage of drugs can sometimes cause serious reactions, there can be no doubt that on balance prescription drugs have been enormously beneficial, and that drugs will be even more important in the future. The anti-pharmaceutical bias of naturopathic education (as illustrated in the Textbook) therefore poses real risks for patients who rely on naturopaths for the management of their illnesses. Without prompt and appropriate drug therapy many patients with serious diseases will die.

I recognize that there are probably large variations in philosophy and medical education among naturopathic practitioners. Some may practice more prudently than others and may use conventional medical treatments more frequently and work more closely with conventional medical practitioners. But we should make public policy decisions based on the standards of practice that are being taught, not on our opinions about individual practitioners. Judging by the standards of practice presented in the Textbook, it seems clear that the risks to many sick patients seeking care from the average naturopathic practitioner would far outweigh any possible benefits.

____________________

Dr. Relman is Emeritus Professor of Medicine and of Social Medicine, Harvard Medical School; Editor-in-Chief Emeritus of The New England Journal of Medicine; and a member of the Massachusetts Board of Registration in Medicine (BORM). He prepared this report while serving as BORM's representative to the Special Legislative Commission on Complementary and Alternative Medical Practitioners, an ad hoc group formed to provide advice to the Massachusetts legislature.
 
OzDDS said:
So what is keeping ND groups from pushing the AMA to allow them to be eligible for MD "allopathic" residency training programs like DOs have done?



..If as you are infering.. that NDs are primary care physcians and that they are equal to a GP-MD or GP-DO.
Click to expand...

because DO's are trained to do EVERYTHING that MD's do.

ND's can only do minor surgery and limited pharmacology in only a few states.

duh.
 
OSUdoc08 said:
because DO's are trained to do EVERYTHING that MD's do.

ND's can only do minor surgery and limited pharmacology in only a few states.

duh.
Click to expand...




True... But it sounds to me like NDs (among others) are attempting to move in that direction.. and are willing to change their curriculum to "meet the requirements" so that they can be equal in the eyes of the law to MDs.. and DOs.

Don't forget... Medicine is also big business, especially if you can ride the ever so popular "Alternative medicine" train. Unfortunately I think this is where we are headed. And if we ever take the road to America?s nationalized healthcare system? at least the version that Kerry/Edwards pushed for? without any prior changes to the status quo.

What is going to happen is this:

1) In the name of political correctness, everyone with a ?doctor? degree be it alternative or traditional will be equal in the eyes of the law. Each group will be eligible for insurance reimbursement and the like..
2) After this is in place and 70% of our patients are members of the hippie baby boom generation.. Guess who will be ?their? top choice doc.. probably the in vogue alternative docs.. This will mean that they will be getting more business than traditional docs as well as creating a undue risk to society. All this and on top of that.. guess who will probably still get sued more? MDs 👎
 
russellb said:
Given that 'alternative medicine' is not a well-defined entity, but, rather, a marketing term, how could it make sense to make it a specialty? Alternative Medicine is not a well-defined entity, per se. It's just a mishmash of treatments which aren't generally accepted by mainstream medical scientists.

As I mentioned, alternative medicine is little more than a successful marketing term---- sort of makes people feel like they're in on something new and exciting, even though much of what constitues alt med is old and never demonstrated to have any efficacy. Put simply, a treatment either works to a degree, or it doesn't. It it works, it's medicine. If it doesn't work, it's not medicine. Yes, cultural factors do come into play with many forms of treatment, but that doesn't absolve the promoters of a given treatment of the responsibily of demonstrating its efficacy.
Click to expand...

Alternative medicine is a term that is used to lump together all treatment modalities that are not allopathic. I agree with you that residencies in naturopathic medicine are not likely to be forthcoming any time soon, but I do see a trend where practitioners of allopathic and osteopathic medicine are beginning to be more open to it (treatments such as acupuncture, and some herbs), as well as the public demanding it. Therefore it seems possible that MDs/DOs may start to incorporate some of these treatments, or at least work in closer collaboration with NDs. In fact, many already do.

The term 'alternative medicine' covers too large a scope of treatments for anyone to be able to dismiss the efficacy of all of them across the board. To do so would be to draw a hasty conclusion. Granted, research needs to be done, but not likely to be funded unless there is a profit to be made for the people doing the funding. Also, just because some greedy people latched onto some alternative treatment modalities to make a profit and turned it into a marketing term, does not dismiss the possibility that many of these treatments can and do have some worth. Your journal article is interesting, but its not exactly coming from a neutral source. You have to realize that many western doctors look at naturopath doctors as unwanted competetion.

Whatever anyone else has to say about NDs, remember this...THEY ARE KICKING OUR ASSES WITHIN THE FIELD OF PREVENTATIVE MEDICINE. If alternative medicine is just a term that introduces people to living a more healthy lifestyle, then it is a marketing term I can live with. I wish more people went to naturopath physicians, simply because of how they emphasize taking care of your body and don't rely so heavily on pharmaceuticals. It seems to be more challenging for an MD/DO to get the same message of preventative health care across, because most of their patients expect them to prescribe something and don't want to commit to making a lifestyle change. They just want a slice of denial and a quick fix.
 
The ONLY reason that a MD/DO is in practice with a Naturopath is for 1. Marketing 2. Money making... There is no scientific validity to any of their treatments, but there is money to be made when you add the trusted "MD" moniker. Show me a single double blinded article placebo controlled article on any naturopathic remedy (besides zinc). And DON'T give me the crap "it isn't done because there isn't money to be made" line...you can publish any kind of clinical research you want. Emergency Medicine literature is filled with studies using cheap treatments from Magnesium Sulfate to simple Morphine (see "Morphine induces less nausea than meperidine when administered perenterally" J. Emerg Med, Oct 2004) treating common conditions. Simply conduct a good study and write a solid paper.
As for allowing practice encroachment...if we keep our heads in the sand, then it will happen.
 
DocWagner said:
The ONLY reason that a MD/DO is in practice with a Naturopath is for 1. Marketing 2. Money making... There is no scientific validity to any of their treatments, but there is money to be made when you add the trusted "MD" moniker.
As for allowing practice encroachment...if we keep our heads in the sand, then it will happen.
Click to expand...

If a patient chooses to see a ND in addition to a DO/MD, then the ND is part of the "health care team" and I think most people would advocate communicating with that ND so that the best decisions could be reached regarding that patients health.

Well, I can see you hold very strong views, and that there is no point in arguing with you.

But I will throw out one tidbit-acupuncture is considered alternative medicine and many NDs practice it. Guess what? It has been scientifically proven to be effective in relieving some symptoms. Hopefully that will open your mind a little. BTW-as to your strong views, keep in mind that some of your future patients may find them offensive. In certain states there are many patients who prefer to see NDs as their PCPs and only see DO/MD at their doctors advice. If you start slamming their doctor, they will be less likely to see you again, and this may affect their health negatively.
 
I am Emergency Medicine, don't really care if they want to see me again...I tell them the truth (the manipulation will likely not cure your asthma, the St. Johns Wart has not been shown to be beneficial, the accupuncture won't cure your diabetes). I don't work on referrals so I don't need to sugar coat the truth.
 
DocWagner said:
I am Emergency Medicine, don't really care if they want to see me again...I tell them the truth (the manipulation will likely not cure your asthma, the St. Johns Wart has not been shown to be beneficial, the accupuncture won't cure your diabetes). I don't work on referrals so I don't need to sugar coat the truth.
Click to expand...

And prescription drugs do cure asthma, and diabetes? 🙄

Judging from two of your above comments, it sounds like you picked the specialty best suited to your personality. Good luck, I'm sure you will be a great ER doc. :luck:
 
russellb said:
Given that 'alternative medicine' is not a well-defined entity, but, rather, a marketing term, how could it make sense to make it a specialty? Alternative Medicine is not a well-defined entity, per se. It's just a mishmash of treatments which aren't generally accepted by mainstream medical scientists. Some of the treatments may have promise, others are almost certainly completely bogus and totally irrational. What will an 'alternative medicine specialist' practice? Homeopathy? TCM? Iridology? Colon cleansing? Or all of the aforementioned?
Click to expand...

I agree that 'alternative medicine' is an ill defined catch-all term with little true meaning. By a specialty in alt med, what I meant were programs similar to what Andrew Weil has created at U of Arizona (http://integrativemedicine.arizona.edu/), which offers a two year fellowship in 'Integrative Medicine', (whatever that ill defined catch-all term means).😀 Hopefully, as alt med is integrated more into the mainstream, the grain will be seperated from the chaff, and the result will be not only better treatments for patients but also specialty programs which will focus on treatments and modalities which have proven benefits. There is defintely a lot of chaff to be discarded...

As regards the review of the Textbook of Natural Medicine, I am sure that the criticisms mentioned are quite valid from the reviewer's perspective and experience as an allopathic physician. However, it should be remembered that the purpose of the book is not to be yet another comprehensive manual for diagnosis and treatment for all diseases, but instead to present a naturopathic approach to certain diseases. It is one resource of many used by NDs, others of which include standard textbooks of medicine and pharmacology.

I think it is unfair to judge an entire profession on the basis of one book. For example, since one DO textbook, 'Foundations of Osteopathic Medicine', devotes over half its length to the subject of manual medicine, is it fair to assume that all DOs devote half their time to MM? The mission of 'Foundations' is to present what makes Osteopathy unique, not to rehash every other medical textbook.

Call it what you will, alternative, integrative, natural, woo-woo, whatever, alternative medicine is big business because a significant percentage of the public are dissatisfied with what they are currently getting for their healthcare dollars. By endeavoring to work with and support the body's natural tendency to heal itself, well trained NDs play a valuable, albeit limited role in meeting this desire for a different focus in medicine. When the body's innate healing systems are overcome by chronic disease, genetic predisposition, etc. the benefits of Naturopathy are likely more supportive than curative, and thankfully there are MDs and DOs out there who can step in with more powerful (and risky) treatments.

Anecdotally, I have heard malpractice insurance is much lower for NDs than for other licensed physicians, as very few claims have been filed against NDs.
 
DocWagner said:
Show me a single double blinded article placebo controlled article on any naturopathic remedy (besides zinc).
Click to expand...


Goel V, Lovlin R, Barton R, et al. Efficacy of a standardized echinacea preparation (Echinilin) for the treatment of the common cold: a randomized, double blind, placebo controlled trial. J Clin Pharm Ther. 2004;29:75-83


sample = 282 males and females aged 18-65
 
yposhelley said:
Whatever anyone else has to say about NDs, remember this...THEY ARE KICKING OUR ASSES WITHIN THE FIELD OF PREVENTATIVE MEDICINE. If alternative medicine is just a term that introduces people to living a more healthy lifestyle, then it is a marketing term I can live with.
Click to expand...

I don't need some "alternative doctor" to teach me how to live healthy. This is something that MDs can do already. We don't need yet another pathway to another equivlent doctoral degree in order to pick up the slack in preventative medicine. Maybe you should just rethink our approach to what we already have. Maybe we just need to educated children in schools in all year levels about how to live a healthy lifestyle. 👍
 
OzDDS said:
I don't need some "alternative doctor" to teach me how to live healthy. This is something that MDs can do already. We don't need yet another pathway to another equivlent doctoral degree in order to pick up the slack in preventative medicine. Maybe you should just rethink our approach to what we already have. Maybe we just need to educated children in schools in all year levels about how to live a healthy lifestyle. 👍
Click to expand...

or even better: This is something that DO's do already.
 
I agree with much, though not all, of what you're saying, so I'll address a few points.



Alternative medicine is a term that is used to lump together all treatment modalities that are not allopathic. I agree with you that residencies in naturopathic medicine are not likely to be forthcoming any time soon, but I do see a trend where practitioners of allopathic and osteopathic medicine are beginning to be more open to it (treatments such as acupuncture, and some herbs), as well as the public demanding it. Therefore it seems possible that MDs/DOs may start to incorporate some of these treatments, or at least work in closer collaboration with NDs. In fact, many already do




Strictly speaking, the term 'allopathic' means that which is not homeopathic, as defined by Hahnemann. I know that we use the term 'allopathic', but I find it to be both outdated and misleading. It is used in a manner which implies that it is static an unable to accomodate new knowledge. In fact, what constitutes 'allopathy' is constantly changing and evolving.

Residencies in Naturopathy don't make much sense to me. Nor does Dr. Weil's 'integrative' program. Weil's program sounds very nice, and it appeals to us at an emotional level, but anyone who has read Dr. Weil's writings will quickly realise that he's a New Age guru and relies very little on critical thought and hard evidence. Moreover, let's suppose that a 'natural ' treatment were highly effective in the management of unstable angina. Would that not become part of the Cardiologist's treatment arsenal? Why should it be separated into an 'integrative' model? A treatment is just that--- a treatment. If it works, then there will be a place for it in the relevant specialty.


The term 'alternative medicine' covers too large a scope of treatments for anyone to be able to dismiss the efficacy of all of them across the board. To do so would be to draw a hasty conclusion. Granted, research needs to be done, but not likely to be funded unless there is a profit to be made for the people doing the funding. Also, just because some greedy people latched onto some alternative treatment modalities to make a profit and turned it into a marketing term, does not dismiss the possibility that many of these treatments can and do have some worth. Your journal article is interesting, but its not exactly coming from a neutral source. You have to realize that many western doctors look at naturopath doctors as unwanted competetion.




Re: Naturopaths as competition. Despite all of the noise made about alternative medicine in recent years, they have not cut into the incomes of conventional practitioners. The notion that they are viewed as competition isn't well supported, IMHO. Many of us disagree with what some of these folks are saying, but we don't lose sleep over the notion that they will hurt us in the marketplace.

Regarding research into alternative treatments----
you're repeating the cop-out used by many alt med practitioners, i.e., there's no money to fund it. I don't work in academia anymore, but I have worked in major academic institutions in the past and have discussed this issue at length with people involved in research. The basic premise is , 'where there's a will, there's a way'. If alt med practitioners are serious about doing the research, there are are all sorts of funding avenues available, from NCCAM to private donors. My feeling is that the 'will' is, in large part, not there. Why do believe this? Well, I think that high quality research is a huge risk for the alt med world. If I were a betting man, I would bet that only a very small percentage of what constitutes alt med will show any measurable benefit when studied in a critical manner. As their treatments fail to show important benefits when compared to what's currently available, they will be left making all sorts of excuses as to why the studies are wrong, etc. in an attempt to save face.



Whatever anyone else has to say about NDs, remember this...THEY ARE KICKING OUR ASSES WITHIN THE FIELD OF PREVENTATIVE MEDICINE. If alternative medicine is just a term that introduces people to living a more healthy lifestyle, then it is a marketing term I can live with

They are kicking our asses in terms of MARKETING themselves in the world of preventative medicine. In fact, you will be hardpressed to come up with any data demonstrating that their advice prevents, well, anything. Any good nutritional advice that they give is nothing that a dietician couldn't give. And there are all sorts of bogus diets promoted by ND's (think: blood type diet). Are they any more successful at convincing patients to eat a balanced diet and exercise regularly than MD/DO's are? If so, I'd like to see some proof. I can't find any.

It seems to be more challenging for an MD/DO to get the same message of preventative health care across, because most of their patients expect them to prescribe something and don't want to commit to making a lifestyle change. They just want a slice of denial and a quick fix

As above, do you have any data to prove what you're saying? Mind you, I agree completely that patients come to us looking for a quick fix. But, I would argue that they look for the same things from an ND, but they will get an herbal concoction, a homeopathic remedy, or have their qi balanced instead of a conventional pharmaceutical.

I wish more people went to naturopath physicians, simply because of how they emphasize taking care of your body and don't rely so heavily on pharmaceuticals

Instead of pharmaceuticals, they rely on herbal meds, homeopathy, etc....Most herbals or of uncertain risk and benefit, whereas homeopathy likely has zero risk and zero benefit.
 
As regards the review of the Textbook of Natural Medicine, I am sure that the criticisms mentioned are quite valid from the reviewer's perspective and experience as an allopathic physician. However, it should be remembered that the purpose of the book is not to be yet another comprehensive manual for diagnosis and treatment for all diseases, but instead to present a naturopathic approach to certain diseases. It is one resource of many used by NDs, others of which include standard textbooks of medicine and pharmacology.

But therein lies the problem. If this is their approach to treatment, and there are all sorts of inaccuracies regarding diagnosis and management of common conditions, then what does that say about their approach? I'm a Radiologist. We have comprehensive books as well as subspecialty oriented texts. If any of our standard texts, comprehensive or not, had these sorts of glaring problems, then it would be a serious source of embarassment for Radiologists.

Call it what you will, alternative, integrative, natural, woo-woo, whatever, alternative medicine is big business because a significant percentage of the public are dissatisfied with what they are currently getting for their healthcare dollars

Correct. It's big business. Yes, people may be unsatisfied with some of the conventional care they receive. But the allure of much of alt med is not it's proven efficacy, but the fanciful claims made by many practitioners. While I agree that some alt med treatments may be of value, very little is proven. And any alt med treatment which is proven to the satisfaction of the scientific communtiy will leave the realm of altenative medicine and simply be part of medicine.
 
RusselB, first of all I'm glad you agree with some of the things I have said. Let me say that I totally agree with you that many of the alternative treatments are indeed just fads. One of my best friends (an educated woman) kept saying this chinese herb cured colds because it had anti-bacterial properties...this really turned me off. I agree there is a great deal of research to be done, but many of the treatments, if not necessarily effective, are at least harmless. The placebo effect works sometimes, kind of like the power of positive thinking.

There have been many pharmaceutical drugs that have been little more than succesful marketing campaigns, as well. You think allopathic/osteopathic medicine isn't big business? Do you know how many billions are spent on drug propaganda? The public has been duped into taking many harmful and unsafe prescription drugs that were later called off the market by our nation's great guardian of consumer safety-the FDA.

Naturopathic medicine emphasizes preventative health to a much greater degree than does allopathic medicine. I say this from first hand experience with NDs, MDs and DOs. It is in this way that I said they do better than DOs/MDs with promoting preventative medicine. Look at the ratio of commercials promoting a health lifestyle to the ratio of drug commercials and you will see where the profit-motives lie for western medicine. I think most people agree that western medicine really needs to get on the ball regarding preventative medicine, but the thing is...its just so darn profitable to keep churning out those drugs that only treat symptoms. Health care is a huge industry, you think that most of those who are making a profit want to decrease it by focusing on commercials for eating right? Where would be the profit in that?

Right, the reason so many MDs/DOs harp on practititioners of naturopath medicine is because they are deathly afraid of what those natural herbs could do to their patients??? They need to examine their own prescription drugs that have only been on the market for a few years more closely before they start worrying about herbs that have been in use for thousands of years. Pharmaceutical companies are ethical, and the FDA does not do a good job protecting us from being bombarded with unsafe pharmaceutical drugs. DesPLEX, fen-phen, HRT, Bextra...to name a few of the drugs that should have been tested more effectively before being let into the market. Not to mention marketing drugs for symptoms other than those they were tested for-"off-label prescriptions". In many cases, these drugs have been not only uneffective for treating those symptoms, but have also have caused harm to the patients who took them. !n 2003, thousands of doctors prescribed Neurontin, a supplemental epilepsy drug, for treating upwards of 20 diseases and ailments for which it had not been tested. Later testing showed that a placebo worked as well or better for treating Bipolar disease and painful diabetic neuropathy. Hmmm...just some food for thought.

Look, I'm not the one to talk to about NM. I will be attending either an osteopathic or allopathic medical school next year, because given a choice between being an ND and being a DO/MD, I chose western medicine. With all its faults, it is still better organized than NM, and is based much more on evidence-based medicine (although the evidence is often full of holes). I also find it very disconcerting when people start accepting treatments without any proof. But as far as your comment that finding funding to back research for alternative treatements isn't hard and its just a cop out. The thing is that its hard to patent herbs that have been around for centuries, its not like designing a synthetic drug. There isn't as much profit to be made there, and if what you say is true-that people are willing to believe it works without any evidence (and I agree with you there), why would any drug company go to the bother of wasting money on research when they can just start packaging the herb and selling it at walmart? If the FDA really gave a $hit or was concerned about the danger of alternative supplements, they would shut it down and require research to start it back up. but unfortunately the way they work is that the drug is innocent until proven guilty, as the history of pharmaceutical drugs has so clearly shown.
If you would like me to back up that observation, I can give you several citations and examples, but it would take up an awful lot of my time. Let me know.
 
OSUdoc08 said:
or even better: This is something that DO's do already.
Click to expand...


Seriously, they don't do it any more than MDs. 🙄 Looking at the state of health most americans are in, its cleary not enough.
 
There have been many pharmaceutical drugs that have been little more than succesful marketing campaigns, as well. You think allopathic/osteopathic medicine isn't big business? Do you know how many billions are spent on drug propaganda? The public has been duped into taking many harmful and unsafe prescription drugs that were later called off the marker by our nation's guardian of consumer safety-the FDA.

Agreed

I agree there is a great deal of research to be done, but many of the treatments, if not necessarily effective, are at least harmless. The placebo effect works sometimes, kind of like the power of positive thinking.

True, but I would argue that placebo or non-specific effects don't really justify a multi-billion dollar industry.

Naturopathic medicine emphasizes preventative health to a much greater degree than does allopathic medicine. It is in this way that I said they do better than DOs/MDs with promoting preventative medicine. Just look at the ratio of commercials promoting a health lifestyle to the ratio of drug commercials and you will see where the profit-motives lie for western medicine.

Keep in mind that many of the patients that ND's treat are the 'worried well'. It's easy to emphasise 'wellness care' when most of your patients are relatively healthy. That isn't the case for the average MD/DO

The number of drug commercials doesn't surprise me. After all, they are in business to make money. Although I'm not a fan of DTC marketing of drugs, I can't blame the pharmaceutical companies for doing it. I suppose medical associations could come out with commercials emphasising healthy living, but I doubt that they would have much effect.

Right, the reason so many MDs/DOs harp on practititioners of naturopath medicine is because they are deathly afraid of what those natural herbs could do to their patients???

No. I don't think that very many MD/DO's give much thought to NDs, actually. And the criticisms tend to be a result of the fanciful claims that they make. If you do a search, yyou won't have a hard time finding NDs touting all sorts of cures for cancer, etc.



They need to examine their own prescription drugs more closely before worrying about herbs that have been in use for thousands of years. As if pharmaceutical companies are ethical, and as if the FDA does such a good job protecting us from being bombarded from unsafe pharmaceutical drugs

Reasonable points. The FDA doesn't do a perfect job, but pharmaceuticals are much more tightly controlled than herbal products. Moreover, I've read of numerous instances of herbal products being spiked with small doses of pharmaceuticals, hence enhancing their perceived effectiveness.

The fact that many herbs have been used for centuries isn't really a good argument. All sorts of ineffective treatments were used for many years. Moreover, plenty of cultures which used herbs extensively had remarkably short life expectancy (e.g., take a look at life expectancy in China prior to the arrival of Western Medicine in the middle of the last century. It lagged well behind western life expectancy prior to that). That doesn't imply a cause/effect relationship, per se, but does imply that we might be overestimating the safety/effectiveness of many herbs.

Anyhow, the lack of data regarding the safety of herbs in concerning to me. Remember , their benefits are related to their pharmacologic effects. Why shouldn't we expect adverse consequences as well? My feeling is that if we begin to minitor the safety of herbal remedies in the same manner that we do with pharmaceuticals, we'll find all sorts of unfortunate surprises (e.g., renal, hepatic, and cardiac toxicity with long term use). Just my opinion, though.


The thing is that its hard to patent herbs that have been around for centuries, its not like designing a synthetic drug. There isn't as much profit to be made there, and if what you say is true-that people are willing to believe it works without any evidence (and I agree with you there), why would any drug company go to the bother of wasting money on research?

Correct. No manufacturer is going to pay for research on supplememnts. It isn't worth it. My point is that there are other sources of funding. For example, take a look at the research being done on glucosamine (this is of interest to me as a recreatrional weightlifter).

If the FDA really gave a $hit or was concerned about the danger of alternative supplements, they would shut it down and require research to start it back up.

Not quite. Read about the Dietary Supplement and Health Education Act
http://vm.cfsan.fda.gov/~dms/dietsupp.html


but unfortunately the way they work is that the drug is innocent until proven guilty, as the history of pharmaceutical drugs has so clearly shown.

Depends on what you mean. You're correct that it's tough to predict the long term consequences of a pharmaceutical. But those which cause serious short term risks will never get to market without proving some serious benefit. It's true that long term risks can result in a drug being pulled. There are plenty of examples of that. However, do you think it would be feasible to require 10-20 year longitudinal studies prior to drug approval? I don't, but that's just my opinion.

If you would like me to back up that observation, I can give you several citations and examples, but it would take up an awful lot of my time. Let me know.

Nah, this is just a discussion on a forum. We aren't going to change the world here 🙂
However, my guess is that I've read many of the same sources as you have. Perhaps my interpretation of them is a bit different from yours.
 
Yeah, perhaps. I agree its not worth doing a dissertation on it.

Good discussing with you, though. I like to hear different viewpoints. 👍
 
yposhelley said:
Yeah, perhaps. I agree its not worth doing a dissertation on it.

Good discussing with you, though. I like to hear different viewpoints. 👍
Click to expand...

It's important to keep an open mind, yet remain skeptical in this profession. I have used alternative treatments (e.g. acupuncture --- western-style, not traditional Chinese, admittedly) in certain situations. But I think that we have to view all treatments through a skeptical lens which allows us to filter out those which are likely a waste of time and money and keep those which may be helpful.

The nice thing for you if pursue a career as an MD or DO is that you will be in a position to use your skills to evaluate unconventional treatments which may prove helpful, since this may be an interest of yours. 🙂
 
Yeah, that was my main idea when I first started to consider pursuing a medical education. I agree the main thing is to keep an open mind. 👍
 
yposhelley said:
Seriously, they don't do it any more than MDs. 🙄 Looking at the state of health most americans are in, its cleary not enough.
Click to expand...

You've clearly not been educated at an osteopathic school, therefore you aren't the authority on that information. The 6% of physicians that are DO's don't have an impact on a majority of the patient population----yet.
 
OSUdoc08 said:
You've clearly not been educated at an osteopathic school, therefore you aren't the authority on that information. The 6% of physicians that are DO's don't have an impact on a majority of the patient population----yet.
Click to expand...

No disrespect intended...

You're what, a first year? And your 4 months of education have really shown you a lot, right? Have you even done anything clinical yet where you are working side by side with both MDs and DOs?

Talk to me in four years when you are in your residency or better yet, actually practicing, and then your opinions will carry much more weight with me. Right now you are immersed within osteopathic theory, and your opinions understandably reflect what you are being taught, but don't necessarily reflect the reality of practice. I have shadowed a lot of DOs and a lot of MDs, and haven't been able to see a significant difference in practice of medicine, aside from that DOs may touch their patients more. More importantly, I haven't seen a difference in the health of their patients and efficacy of prevention. I admire your loyalty to your profession, but there are plenty of people on these forums who would be willing to back me up on this opinion. Of course there are plenty who will back you up on yours, as well.

That being said, we can take this over to the "what makes a DO more than an MD plus OMT thread" where it would be more pertinent. The truth is I really don't care to argue this point with you. It doesn't bother me at all if you want to hold onto your opinion, just as long as you don't have a problem with me posting mine. And they are just opinions, anyway. What you are making is a prediction, and cannot be proved or disproved.
 
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