NDs get medical licenses in CA

[DD214_DOC]

http://www.auburnjournal.com/articles/2004/12/23/news/lifestyle/01health.txt

Thought some of you may be interested in this.

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[Doctor Bagel]

i think it's a good think. we have licensed naturopaths in oregon, and i don't think it's had negative health consequences here. the big plus is that if you're seeking alternative treatment, you know you're getting it from someone who can be licensed and who attended a four-year graduate program. there are all these bs naturopathic programs that grant certificates online after a few months of study, and in states without licensing, customers don't have an easy way to distinguish between practitioners. so, overall, while it grants nd's more rights, it can protect patients by helping them distinguish between well-educated practitioners and people who got a degree by filling out an ad in the back of rolling stone.

here's one of those sleazy online programs that i talked about above.

http://www.ccnh.edu/healthy/tradnaturopathy.asp?adclfr=GGnaturopathy

 

[Doctor Bagel]

now, compare that sleazy clayton college program with bastyr university, arguably the best naturopathic school in the country.

http://www.bastyr.edu/academic/naturopath/curriculum.asp?track=4

yeah, you can guess who i'd want to see if i sought treatment from an nd.

 

[DragonWell]

Before I decided to go DO, I completed a year of the ND program at Bastyr and can vouch for the quality of instruction - many of our professors were current or former University of Washington med school faculty.

The only hesitation I have about NDs or DCs being considered primary care providers is the lack of residencies. At least when I was in school, there were only 2 (yes two) residency positions available at Bastyr's Clinic for a class of 100+ students. Students practiced in the clinic during third and fourth year, but it doesn't seem comparable to the experience MDs/DOs gain during a residency.

I think NDs provide a valuable service to patients, but what changed my mind about going in that direction is that I began to see how limited the practice really was. Like it or not, pharmaceuticals, surgery and other allopathic methods save and extend many people's lives in ways that no other therapy does.

I also found that while the curriculum is strong in basic sciences, dogma often seemed to trump science when it came to treatments. Although many of the treatments have eloquent theories to back them, good studies are hard to find. All you folks that have problems with cranial, imagine being required to study homeopathy for a year!

In the long run, I question how economically viable it will be to have a primary care provider whose role is so limited...right now consumer demand is high for anything "alternative" and as long as consumers are willing to pay out of pocket for it, they will probably get it. However, as our finite health care resources shrink, if NDs want to keep carving out a piece of the pie, I think they will need to prove the worth of their care much more conclusively, especially as more MDs/DOs start to practice "holistically".

Just my .02! So happy I found Osteopathic Medicine!

 

[hokte]

Before I decided to go DO, I completed a year of the ND program at Bastyr and can vouch for the quality of instruction - many of our professors were current or former University of Washington med school faculty.

The only hesitation I have about NDs or DCs being considered primary care providers is the lack of residencies. At least when I was in school, there were only 2 (yes two) residency positions available at Bastyr's Clinic for a class of 100+ students. Students practiced in the clinic during third and fourth year, but it doesn't seem comparable to the experience MDs/DOs gain during a residency.

I think NDs provide a valuable service to patients, but what changed my mind about going in that direction is that I began to see how limited the practice really was. Like it or not, pharmaceuticals, surgery and other allopathic methods save and extend many people's lives in ways that no other therapy does.

I also found that while the curriculum is strong in basic sciences, dogma often seemed to trump science when it came to treatments. Although many of the treatments have eloquent theories to back them, good studies are hard to find. All you folks that have problems with cranial, imagine being required to study homeopathy for a year!

In the long run, I question how economically viable it will be to have a primary care provider whose role is so limited...right now consumer demand is high for anything "alternative" and as long as consumers are willing to pay out of pocket for it, they will probably get it. However, as our finite health care resources shrink, if NDs want to keep carving out a piece of the pie, I think they will need to prove the worth of their care much more conclusively, especially as more MDs/DOs start to practice "holistically".

Just my .02! So happy I found Osteopathic Medicine!

Your story sounds similar to mine, except I went to chiropractic school. My main gripe about the education was also a lack of a residency. After learning about pathophys. and diagnosis, there was never a chance to actually apply the knowledge. This is because the last year of internship was based in clinic dealing with mostly musculoskeletal complaints. Occasionally something other than that wondered in, and they were referred, but we really needed to see more. I'm happy about my alternative background, but I'm glad to be involved in the program I'm currently in.

Do you think you'll study more naturopathic after DO school?

 

[DragonWell]

I definitely remain very interested in all approaches to healing. I want to study what works and causes the least amount of strain to our resources. I think that might include parts of naturopathy, parts of Osteopathic Medicine, surgery,etc. By the time school and residency is over, If I have any room left in my brain, I would definitely consider studying with some "alternative" providers.

I remember a conversation I had once with a very well respected ND who had written several books. He talked about how he had treated a seriously infected wound with mega doses of Goldenseal, far beyond what would normally be used. This was presented as great evidence for the "healing power of nature", and at the time, with my ideals firmly in place, I totally agreed. Now goldenseal is overharvested to the point of being an endangered species and the antibiotic pills which would have served the same function are as cheap as ever.

I guess I've learned to serve patients, not principles.

So, having experience with Chiropractic school, do you feel DCs are qualified to dx and tx problems outside the musculoskeletal realm? In my limited experience (I'm a massage therapist), some DCs seem to focus on rehab and muscluoskeletal probs and others take a much wider view of what they treat. I've always wondered why they seemed to be so split over their scope.

 

[cfdavid]

I'm perplexed at how popular "natural remedies" are with people today. It seems that everyone I talk too is jumping on the naturopathic bandwagon. Seriously. I know so many people that subscribe to all of these naturopathic-like newsletters that promote all kinds of, what seem to me as questionable, very alternative (albeit, admittedly used for centuries in parts of the world) remedies.

Now don't get me wrong, I'm sure that some such remedies work very well. But, is it really better to take several tablespoons of willow bark ("natural"), or a fricken aspirin for god's sake? After all, whatever chemical in some dried up flower petal is working, is working at the biochemical level. And without rigorous clinical studies (regardless of the "Big Pharma keeping the natural remedies "down" arguement), how is one to be sure that the side-effect profile is safe? What quantities are truly efficacious?

My dad was on a flight not long ago, and he was sitting next to an MD surgeon. The surgeon was bitching about his profession (remuneration), and how it's changed etc. etc..... He said he was quiting surgery and would be getting certified in some "natural" or alternative medicine course, cause "that's where the money is these days". WTF?

Again, I'm sure there are some very effective, cost advantageous, "alternative" or natural remedies out there. But, from what I've heard and read, it seems a bit over the top.

Am I missing something?

 

[scpod]

Am I missing something?

I think that part of the problem stems from people's misconceptions of what medical science can do. People expect perfection these days. Few remember that it wasn't a long time ago that everyone died of cancer, and even childbirth was gamble as to whether or not mother and child would live. People have grown to expect that doctors can perform miracles. So........when they can't perform miracles, the rumors begin to spread like wildfire. Everyone has a story of some friend, relative, or aquaintance who went to a doctor and whose life was "ruined" because the doctor was unable to do anything. How many times have you heard, "The doctor should have known that. Didn't they teach him that at medical school?" Thus......they begin looking for treatments anywhere they can find them. People want to believe that there is some "magic" that is inherent in the world that can instantly heal them. Since doctors don't have that "magic", then they look for other sources. Look at all the fantasy fiction that people read today. In every novel those worlds are filled with people who can magically cure the sick with a potion, a few herbs, and a nod. People simply want to believe that that can happen in the real world as well.

 

[kahoo99]

DCs are in no way prepared to be primary docs. As preperation for medical school I'd been working for an orthopedic surgeon for a little over a year and every once in a while we'd get someone who had been referred to us by her "doctor." These doctors filled the patients heads with absolute crap. In fact it lead to a long office discussion about who should be referred to as doctor.

 

[Doctor Bagel]

I definitely remain very interested in all approaches to healing. I want to study what works and causes the least amount of strain to our resources. I think that might include parts of naturopathy, parts of Osteopathic Medicine, surgery,etc. By the time school and residency is over, If I have any room left in my brain, I would definitely consider studying with some "alternative" providers.

I remember a conversation I had once with a very well respected ND who had written several books. He talked about how he had treated a seriously infected wound with mega doses of Goldenseal, far beyond what would normally be used. This was presented as great evidence for the "healing power of nature", and at the time, with my ideals firmly in place, I totally agreed. Now goldenseal is overharvested to the point of being an endangered species and the antibiotic pills which would have served the same function are as cheap as ever.

I guess I've learned to serve patients, not principles.

interesting points. the goldenseal story is fascinating and does show limitations of seeing an nd instead of an md or do. i agree that a more integrative approach is best instead of ignoring all modern remedies.

also, i do think people who sell herbal, vitamin and homeopathic supplements are a bit questionable. i've got down that path before, and you wind up spending a fortune buying all these supplements. if you take the advice of even andrew weil, you'll probably spend $100s or even $1000s a month in supplements. just check out the supplement section of your local natural foods store to see how costly that stuff is.

 

[hokte]

We have to remember that what is termed alternative in our country, is accepted as mainstream in many other countries. People have been using herbs and other remedies for centuries with success. The problem is that the layperson hears that someone who had cancer took some herb and is now in remission. This is now claimed to be a cure all for cancer, without regard to the cancer cell type, grade, or innate healing capabilty that individuals body might posses. I'm happy that there are alternative means to health care for those who want it. Just because a person maybe doesn't want to take an asprin for a headache, or don't want to try chemotherapy for cancer, doesn't mean that they can't find help somewhere. People should have a choice.

I know many DC's who have had great success with people who didn't get results by the more mainstream approach. This of course is mostly with chronic conditions. I still think that the DC cirriculum should include some type of residency to interact more with the conditions taught in school. As it stands, during internship you would only come in contact with this if your patient with a musculoskeletal complaint, also had another ailment. The schools make a point to say that youre only treating musculoskeletal and nothing else. I think as long as the patient is totally aware of the care you are providing, it should be their choice. And I don't think DC's, herbalists, DO's or MD's should say, "I can cure XYZ disease....." I guess that is unless they really can. Oh yeah, and have some proof..

 

[hokte]

DCs are in no way prepared to be primary docs. As preperation for medical school I'd been working for an orthopedic surgeon for a little over a year and every once in a while we'd get someone who had been referred to us by her "doctor." These doctors filled the patients heads with absolute crap. In fact it lead to a long office discussion about who should be referred to as doctor.

DC's may not be qualified to treat a number a conditions, but are more than qualified to recognize a problem and send them to the proper provider.

 

[DragonWell]

also, i do think people who sell herbal, vitamin and homeopathic supplements are a bit questionable. i've got down that path before, and you wind up spending a fortune buying all these supplements. if you take the advice of even andrew weil, you'll probably spend $100s or even $1000s a month in supplements. just check out the supplement section of your local natural foods store to see how costly that stuff is.

Although allopathic medicine is hardly in the ivory tower when it comes to ethics, I do think the fact that many alternative providers directly sell patients supplements is a little questionable. I worked in two NDs offices, one very busy and the other very slow, and it definitely seemed like the slower office depended a lot on sales of supplements to pay the bills. I think patients might have been surprised to learn the suppplements were marked up 50%, same as retail, especially since they often ended up costing more than the office visit.

In contrast, I'm sure an MD/DO woould never prescribe a particular drug because of the perks or stock options they get from a drug company,especially when drug companies have so many "objective" studies to prove safety and efficiacy...

 

[cfdavid]

I think that part of the problem stems from people's misconceptions of what medical science can do. People expect perfection these days. Few remember that it wasn't a long time ago that everyone died of cancer, and even childbirth was gamble as to whether or not mother and child would live. People have grown to expect that doctors can perform miracles. So........when they can't perform miracles, the rumors begin to spread like wildfire. Everyone has a story of some friend, relative, or aquaintance who went to a doctor and whose life was "ruined" because the doctor was unable to do anything. How many times have you heard, "The doctor should have known that. Didn't they teach him that at medical school?" Thus......they begin looking for treatments anywhere they can find them. People want to believe that there is some "magic" that is inherent in the world that can instantly heal them. Since doctors don't have that "magic", then they look for other sources. Look at all the fantasy fiction that people read today. In every novel those worlds are filled with people who can magically cure the sick with a potion, a few herbs, and a nod. People simply want to believe that that can happen in the real world as well.

Well stated. And that's kind of my point. SOME of the naturopathic newsletters (NOTE: I'm not harping on ND's, but also MD's and DO's that practice in herbs and "natural" remedies) that I've read seem somewhat predatory. Like playing on the all too popular agrument against big pharma, and traditional docs "that just want to push pills". As if there's some grand conspiracy or something. Again, it seems like somewhat of an easy way out and predatory in terms of addressing the real problem which may be a false perception (like you said) of what modern medicine can actually do for people.

Also, most people by nature prefer "natural" over "synthetic". Synthetic drugs seem so "chemical" in nature. And there is a normal human adversion to want to put "chemicals" into our bodies. But, again, it's an ignorant public that assumes that "natural" herbs are somehow not acting chemically.

We all know that many of the modern drugs that have been discovered have been isolated from some natural herb, leaf, root, or whatever. But the difference is that they've been extracted, purified actually, tested for correct dosages and efficacy, and whose side effect profiles have been studied. Not to mention a lot of the drugs that are available in sustained release form, which prevents "spiking", and allows for more of a "sustained" baseline concentration of a substance in our bodies. And that's a good thing. "Natural" remedies don't seem to offer this.

 

[Doctor Bagel]

In contrast, I'm sure an MD/DO woould never prescribe a particular drug because of the perks or stock options they get from a drug company,especially when drug companies have so many "objective" studies to prove safety and efficiacy...

of course not.