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How so? I expect patients to be deceived but not my education to be lies.
NDs lecturing at DO schools?
Started by cn2604
It's one thing to learn about why patients may use CAM and how it may affect their health or interact with their other medications. It's an entirely different thing to have a peddler of woo come to present their pseudoscientific garbage as having some shred of legitimacy.
The difference being you might actually learn something useful from hearing the oncologist speak.
Are you guys so insecure that you cannot handle listening to a CAM provider speak about their profession? Geez guys. I never said we had to believe what they say but I'll sit there and listen to it (1 time) and write it off, but at least I'll know exactly where they are coming from BEFORE I come to that opinion.
if it weren't for Naturopathic bullcrap, Steve Jobs would probably still be alive.
I don't give a damn how it would affect my grade, I wouldn't show up to such a lecture in protest. NDs are not colleagues, they are not physicians, and they do not deserve our respect and time. I really hate quackery. Homeopathy is one of the most popular things pushed by NDs, and it is truly quackery at its finest. Anyone who uses it as a primary treatment modality should literally be laughed out of a lecture hall immediately following their description of how serial dilution works.
Maybe I'm just still a bit upset at the few cases I've come across of people going to CAM practitioners with diseases that were initially easily treatable but either suffered severe complications or went terminal because they took too long seeking traditional medical care. That pisses me off- people should go to prison for that sort of "care," not speak at medical schools.
the luckiest guy ever, he spots the treatable pancreatic cancer at an early enough stage that it only required a Whipple....but no, he didn't want his body invaded, he wanted to try special fruit juices, vegan diets, and psychics that he was sure was going to save him. amazing how someone so smart could be so incredibly stupid
1) You're assuming I'm unfamiliar with the modalities. False. I've spent several years trying to suss out truth from fiction with respect to CAM and I found the lack of solid evidence (poorly designed trials, frank misrepresentation of findings, etc) galling. While others may still be unaware, I know what I'm dismissing when I say the lecture was a perfect waste of OP's time and tuition dollars.
2) It's not a matter of insecurity. Medical school is about time management, and allocating that precious resource prudently is a life skill. Forcing students to attend a biased lecture on a b.s. topic when there are so many other more pressing potential subjects shows a severe lack of foresight or know-how on the part of the medical school's administration.
Exactly, I don't need to have a lecture from every crazy alternative medicine person just so i can be prepared for my uninformed patients who believe in every crazy thing under the sun. if that was the case then I would have to get a lecture from someone who does cupping treatments, and another from someone who does hot stone/crystal treatments, and a lecture from a psychic, and a lecture from Uri Geller. This is medical school, we don't have the time to go through and listen to every quack's ideas
Who's insecure? Are physicists "insecure" because they don't want to give a flat-earther time to speak about their beliefs in a physics course? Are biologists "insecure" because they don't want to give a creationist time to speak about their beliefs in a biology course?
Giving a homeopath or a naturopath ANY stage to speak in a medical school gives them the illusion of legitimacy. Of course they will not be critical of their own fields, so what are you actually going to learn from them? The homeopath isn't going to tell you that their pills are just water and don't do anything but fleece the patient out money. The naturopath isn't going to tell you that giving herculean doses of water-soluble vitamins just ends up making the patient literally piss away their money.
I agree completely that exposure to it is important, you are right.....BUT, I can expose myself to it by looking online and using my own medical knowledge to develop A MEDICALLY EDUCATED OPINION ON IT. I don't need an ND (especially one referring to himself as a physician) to come in and lecture me on it, because he doesn't have the medical background. It doesn't belong in a medical school curriculum, unless taught by someone who is giving you a perspective that you may encounter these things. To have an ND come in and preach about it is too much
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Plus, can you imagine the amount of legitimacy he now gets when he goes to his patients and tells them: I lecture at medical schools all the time so that makes me a legitimate doctor who teaches and trains future doctors. that is a terrifying thought. I pray to the gods that he doesn't give a guest lecture at my school and then name drop that he guest lectures there on his advertisements and websites. that would be a horrifying loss of legitimacy of my school to the public
This thread depresses me...
Has this type of thing ever happened at your school?
Nope. At least not that I am aware of.
I see a bunch of hurt sensibilities in this thread. C'mon guys your schools are not promoting anything. They have a guest speaker so you canlearn about what you WILL see out there, your school can't control how that speaker presents himself and his modality of practice (speech). However, you can choose to sit down and listen to this person in front of you, learn what some of your patients are being treated with and use this information to your and the patient's advantage...or choose to get mad and cry about it.
so if my medical school has a mandatory lecture with someone who teaches us about the flat-earth theories, you're saying I should expect the reputation of my education not to be sullied? nope, I don't think so. naturopathic medicine is pseudoscience, just like creation "science", intelligent design, and flat earth theories. if alternative medicine worked it would be called medicine. no school should ever force me to listen to these lectures
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Uhh... yes a school can control what people say. You really think you can just walk through a door and say whatever it is you want? At the least a professor should have stood up and called it quackery like it is.
Which does unfortunately happen. I remember at least one site where a woo-peddler wrote down that he was a lecturer at some medical schools when, in reality, he only gave guest lectures.
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lol
first and foremost there are two types of NDs, ones who get a 2 year online correspondence degree and another group who attend a 4 year program set up similar to the traditional medical school model (2 years of didactics, 2 years of clinicals) Actually, if you look at the historical background the first 4 year "medical school" in the United States was a Naturopathic School.
The NDs who attend 4 years of education can also proceed into a one year internship. It is this group of NDs who by law in 17 states are classified as primary care physicians, can prescribe medications, order labs, diagnose and in some states bill insurance.
Its a confusing issue and doesnt make sense, but its important to know who you're bashing and who you're calling "not a physician" - since state and government law actually dictates otherwise in many circumstances. They technically are your colleagues (this was the same issue between MDs and DOs in the 40s-50s until the vietnam war era bridged the gap between the two)
There are quite a few CAM therapies that are much more proven and scientifically based than many of the procedures/medications I use on a consistent basis in the hospital (probiotics come to mind) not to mention that OMM has some of the poorest research (show me good research on fascia release, lymphatic drainage, cranial manipualtion, counterstrain, etc) yet its the foundation of our profession. I'm sure you as medical students are just too busy to actually really read the good research out there. Which is a sad state. You should in reality be more up to date than your attendings/professors as to the new research on multiple modalities. As a resident I am consistently discussing new treatments and modalities to my attendings, and often they change their stance and make adjustments (just recently the use of tranexamic acid has become standard with our attendings due to our group of residents pushing for its use because new research was pointing to its benefit, plus we got tired of the bloody post op dressings and pulling drains). Oh we use dakins solutions all the time in orthopedics (wasnt that a CAM therapy a previous poster bashed on???? broaden the mind)
Yes I think it should be required to learn about CAM therapy, its positive and negative effects (as was discussed in a previous post about the metastatic breast cancer). Often times what was once thought was CAM is now the preferred treament with supportable data, AND we need to be understanding to our patients who are misinformed in many situations. Calling them stupid (as one premed poster did about steve jobs - have you ever seen a whipple?) won't win them over. We need to respect their choice, inform them out of compassion of their mistakes and give better recommendations, often meeting them in the middle.
Lastly - as an informed medical student that you all seem to be, throwing the word qwackery and qwack around probably isnt the best use of vernacular. The word quack was applied in the early 1900s to the physicians who used quicksilver (ie mercury) for their treatments. These were the founding fathers of pharmacology and modern medicine. Quite ironic.
All teaching is biased, relax, its not the end of the world. There are more things to be upset about in medical school - like rising tuition prices - than a 2 hour lecture from an ND. Bring the hate.
The NDs who attend 4 years of education can also proceed into a one year internship. It is this group of NDs who by law in 17 states are classified as primary care physicians, can prescribe medications, order labs, diagnose and in some states bill insurance.
Its a confusing issue and doesnt make sense, but its important to know who you're bashing and who you're calling "not a physician" - since state and government law actually dictates otherwise in many circumstances. They technically are your colleagues (this was the same issue between MDs and DOs in the 40s-50s until the vietnam war era bridged the gap between the two)
There are quite a few CAM therapies that are much more proven and scientifically based than many of the procedures/medications I use on a consistent basis in the hospital (probiotics come to mind) not to mention that OMM has some of the poorest research (show me good research on fascia release, lymphatic drainage, cranial manipualtion, counterstrain, etc) yet its the foundation of our profession. I'm sure you as medical students are just too busy to actually really read the good research out there. Which is a sad state. You should in reality be more up to date than your attendings/professors as to the new research on multiple modalities. As a resident I am consistently discussing new treatments and modalities to my attendings, and often they change their stance and make adjustments (just recently the use of tranexamic acid has become standard with our attendings due to our group of residents pushing for its use because new research was pointing to its benefit, plus we got tired of the bloody post op dressings and pulling drains). Oh we use dakins solutions all the time in orthopedics (wasnt that a CAM therapy a previous poster bashed on???? broaden the mind)
Yes I think it should be required to learn about CAM therapy, its positive and negative effects (as was discussed in a previous post about the metastatic breast cancer). Often times what was once thought was CAM is now the preferred treament with supportable data, AND we need to be understanding to our patients who are misinformed in many situations. Calling them stupid (as one premed poster did about steve jobs - have you ever seen a whipple?) won't win them over. We need to respect their choice, inform them out of compassion of their mistakes and give better recommendations, often meeting them in the middle.
Lastly - as an informed medical student that you all seem to be, throwing the word qwackery and qwack around probably isnt the best use of vernacular. The word quack was applied in the early 1900s to the physicians who used quicksilver (ie mercury) for their treatments. These were the founding fathers of pharmacology and modern medicine. Quite ironic.
All teaching is biased, relax, its not the end of the world. There are more things to be upset about in medical school - like rising tuition prices - than a 2 hour lecture from an ND. Bring the hate.
Yeah, but...dude it's not like they're screaming obscenities or threatening anyone. Silencing them like that would be kinda fascist.
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No, it's not. It's not at all. These are schools of higher learning where we're paying several thousands of dollars for a scientific based education. If someone came in talking about opening holes into skulls to let evil spirits out that cause mental health, I bet you that person would be kicked out. It's simply insulting for a school to let someone like that go unchecked. Besides, you don't have the freedom of speech to go talk wherever you want.
Its like I just got scolded by dad..., but he brings up a good point
Is this thread really full of pre-meds telling us what is or isn't relevant to the study of medicine and being a physician? I just want to make sure I'm not imagining things.
Actually, I did know about the differences between the two NDs, but thank you for assuming my ignorance on the subject. I also know the distinction is functionally meaningless when you review the core curriculum of the 4 year degree programs (emphasis mine):
"In the world of real medicine, we have two kinds of primary care physicians: internists and family practitioners. They have four years of medical school and then a three year residency, taking care of patients under the guidance of senior physicians, to learn the basics of their job before going into practice. Most naturopaths do not have to have a residency going straight to patient care from school.
The training requirements in pharmacy, per the naturopathic board, is minimal: “ Naturopathic physicians are required to take 72 hours of pharmaceutical training as a part of their doctoral degree. Additionally, they must also have 1,500 hours of clinical training. Naturopathic physicians are required to take 25 hours of continuing education course work annually, five of which must be in pharmacology.”
Nine days of pharmacy training in school in school. 1500 hours is 35 forty hour weeks. A little over half a year of clinical experience. That is the background of naturopaths who will give medications. For comparison, in med school we spent 4 hours a day for the three months of the second year in pharmacology and I had five years of clinical experience just for internal medicine.
At our local natuopathic school they get 72 hours of pharmacology education, and twice (144 hours) as much training in homeopathy. The have the opportunity to do electives to broaden their knowledge: 144 hours in homeopathy, 36 hours in qi gong, 26 hours in Aruyveda, 24 hours in energy work and 12 hours in colonics. But no electives in pharmacology. A good foundation upon which to prescribe medications." Source
Even if NDs in all 17 states had to complete a 1 year fellowship, do you think so little of your PCP colleagues and their extensive training as to consider the two equivalent? Furthermore, *how do you feel about the frankly adversarial stance NDs have on vaccination, or the evidence that low vaccine uptake is correlated with naturopathic care?
NCCAM has been pushing that line for ages, but the fact of the matter is if medicine works, it stands the test of scientific rigor and is gradually incorporated into treatment protocols, subject of course to amendment when new data and therapies emerge. That’s medical science. How has homeopathy, acupuncture, humoral medicine and ayurveda evolved in response to findings in the literature, particularly the negative results found in well designed, properly powered clinical trials?
Also, I wouldn’t hang your hat on probiotics just yet; beyond treating diarrhea the jury is still out and much of the evidence is extremely poor for the manipulation of microbiota as a therapy for anything else.
Can’t fault you there, but why is the appropriate response to finding a marginal evidence base for one modality to pay credence to any other whackaloon modality out there? Shall we arrange a lecture by a reiki master or a light therapist next?
I admit that as a pre-med, my familiarity with the medical literature is not as UpToDate as I would hope, but I do read voraciously about CAM. Consequently I am also aware of the horrendous spin that permeates CAM literature (though spin is by no means exclusive to alt med research), meaning I am reading beyond the abstracts and discussion sections of the articles you might cite in support of these allegedly efficacious naturopathic remedies to find horrendously designed, underpowered trials that are over-interpreted. Case in point, the recent TACT trial was appallingly negative, finding no benefit to chelation therapy on any of the hard, cardiac end points and only one marginal statistically significant effect after p-hacking the data to death. But to read the publications off that data set, you’d think the world of alternative medicine had just given us a therapeutic boon. But I mean, what do I know?
You’re very clever for pointing out that bleach is used in surgery. Now please justify its use in treating autism or for scouring breast-masses as a “natural” therapy, since these are both things your esteemed colleagues do to patients in exchange for money.
And yet, you ridicule your colleague’s disdain for the use of CAM under the guidance of an ND by trying to minimize the audacity of any health care provider using bleach to treat cancer. How much time should be spent outlining the positive aspects of CAM, and how much time should go to the victims of CAM?
Again, please show me where CAM has changed its course in the face of new evidence, as medicine is wont to do. While we can respect the choices of patients, we students are allowed to and should be encouraged to question dubious practices by the institutions allegedly preparing us to think critically, assess evidence and provide the best guidance to our patients. Listening to a mandatory lecture on magic by a true believer will not help this process in anyway.
And to be completely fair, there isn’t much evidence that Steve Jobs would have been better served by conventional medicine either. The difference being most honest physicians won’t lie about the limitations of their practice, where a naturopath will attempt to bilk you as long as you live by recommending a variety of made up nutritional aids and bizarre diets, electrotherapy, homeopathy, colonics, and positive thinking. If you don’t believe in empirical evidence, what’s the harm in trying everything you “know” to “save” someone?
OED says…
1. a.A person who dishonestly claims to have medical or surgical skill, or who advertises false or fake remedies; a medical impostor. Cf.charlatann.2.
1638 F. Quarles Hieroglyphikesiv. 17 Quack, leave thy trade; Thy Dealings are not right, Thou tak'st our weighty gold, to give us light.
No, I’d say we’re using the word perfectly correctly, and its use to denote frauds predates your estimation substantially. Physicians of yore who could not benefit from the advances of modern science were very much quacks. The difference, of course, being that modern physicians stopped using quicksilver as a first line therapy, where NDs are still cooking toxic tinctures or diluting substances to nothing according to recipes unchanged for centuries. All I can say is thank god for the Flexner Report.
Do you think naturopathy is relevant to the study of medicine?
You're not. We're just here preaching the Truth. You should really know your betters.
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You sir are taking things too radical. Dude, first, if anyone INVITED by the school to talk and has really NOT insulted anyone, insults you with their beliefs simply by expressing them, you are the one with the problem, not the dude in front of you. You just can't go silencing people you don't agree with, even more so in this professional environment. You are not in undergrad anymore. If you don';t like the dude or whatever he is saying don't go to his presentation, if its mandatory, suck it up your school is telling you to listen. If you feel entitled to dictate the curriculum because you are paying, then it can be argued knowledge of CAM is education (of some sort I guess). As far as I know they are not testing you over it and it only requires an hour of your time..in that case you just have to put up with it brah. No big deal. There are really worse things than that in life. jeessss....
EDIT: I'm not in favor of these guys, but instead of sitting down all pissed off in my chgair listening to the guy, open you mind and try to take advantage of the situation. Peace my friend.
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Pretty much this.
I can't speak for her, but I think it could be relevant to the clinical practice of medicine, when it comes to dealing with some patients.
I suggest you type "acupuncture pm&r" into google - you might be amazed ! That is unless all those medical schools are quacks too? 😉
If you read the papers that came back closely, you'd see you haven't made much of a point.
Then should an ND be teaching the lecture? or a physician *who is familiar with naturopathy and will present the topic in an honest light?
I've seen it work where someone opened a hole into a skull of a person with mental illness. He released the evil spirit "meningioma" from the patient's brain.
The ND. You should not be listening to learn th practice of ND, you are listening to him and what he says to patients, and the "logic" of his practice
Because being a pre-med precludes you from knowing homeopathy is bull****, right? You're like a little kid that got into med school and now you think you are important. We'll all be attendings soon, and some of us don't forget the arrogance of others.
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Good old suck it up. The way we must all maintain the status quo. Forgive me if I believe that authority should be challenged and change comes from those that speak.
I'm all for learning what a quack says to his patients, but if the school doesn't even make an attempt to balance it with scientific evidence, you tacitly endorse it.
I see the logic behind that stance, but you run the risk of the ND abusing the legitimacy of your institution to further his cause. You can alse get at what they're saying to their patients by reading their white papers, perusing their websites, paging through their textbooks and listening to the interviews they give on television and the radio. For a super fun endeavor, you can dig up the original essays by Lust himself and learn exactly what he think naturopathy is and what it does and then delight at how modern naturopaths are torturing his words to get perscription privileges.
If this is too much work for you, you can also just check skepticism-based sources like this, http://www.sciencebasedmedicine.org/naturopathy-vs-science-vaccination-edition/
or dozens of other blogs dedicated to assessing health claims from CAM providers (and convential providers who didn't take their Hippocratic oaths very seriously). Again, I can see the attractiveness of getting the philosophy "straight from the horse's mouth," but the possibility for propogating misinformation and lending the auspices of medical authority to those have not earned it need to be considered first.
Well dang. I guess you can tell UPMC, rusk, UNC, and UVA that they're practicing quackery.
Let's see, what's more arrogant. Asking to be sure that there are pre-meds lecturing about medical education or a pre-med exploding with fake outrage over something he knows nothing about? Yes, we will all be attendings and some of us will remember the arrogance of the kids who thought they knew all before ever setting foot in a lecture hall. And speaking of similarities -- you remind me of the 12-year-old who lectures all the adults at Thanksgiving about how the world works.
You're certainly preaching, but it isn't the truth.
As a matter of fact, yes, and when you actually LEARN medicine, you will too. Naturopathy isn't just about Chinese herbs that supposedly "cure" cancer. That stuff is obviously bogus. Much of naturopathy is about natural foods that prevent illness. Fruits and veggies a big part of your diet -- that's naturopathy. Vitamin D supplements, that's naturopathy. Vitamin B12 an important part of neurologic health -- that's naturopathy. Yes, you will learn it in med school, whether it's from a naturopath or not shouldn't matter so long as the information is evidence-based and a lot of naturopathy IS evidence-based.
Much like it's difficult to assert "all MDs and DOs are against the use of medical cannabis"*, it's hard to say that all NDs are all for the herb. I know they are petitioning for the right to prescribe MJ in legal states.
Rochester University, Mayo and the Cleveland Clinic as well. Again, don't trust that the institution imparts legitimacy to the research. Read the papers yourself, familiarize yourself with the bevy of placebo effects and try again.
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The cheap knock off trying to use my words against me trick. Pretty boring and predictable. I don't need to be in Medical school to know homeopathy is bull****, so there's nothing arrogant about speaking of things I know. Don't assume me to be your typical 21 year old pre-med. My trajectory has been long, and you are simply wrong on this. I would report back next year, but you seem the type that has circular arguments to excuse yourself into being right.
Naturopaths reject empirical evidence as the means for justifying treatments. They reject germ theory, vaccines, and prescribe water and think magical energy fields can be manipulated by thought. This is explicitly stated in their educational materials, which you might want to leaf through before defending them. Why should I trust the dietary advice of a practitioner who thinks diluting medicine makes it stronger, that disease comes from within and can only be purged by detoxification and frankly denies basic scientific findings that disagree with their clinical opinion? Beyond eating less red meat and increasing my vegetable intake, what else can these professionals teach me about nutrition? And what about their ubiquitous endorsement of supplements? The burgeoning consensus is that healthy, functioning people don't need supplementation, but the backbone of naturopath is prescribing a hodgepodge of homeopathic remedies and unregulated supplements and herbal remedies.
Maybe you should get your nose out of papers and go seek real pts. I suggest visiting a va or pain clinic. Perhaps talking with a physiatrist. You are lacking in the humanistic approach. Pts are more than numbers.
This is the definition of arrogance, in case there was any doubt.
Patients are indeed more than numbers, and I would never take a patient to task for using CAM modalities unless they were at serious risk of direct harms. The discussion, however, is not about what patients think or do but what happens in medical education. The plural of anecdote is not data, and placebo effects can lead patients to believe they're getting better when they're actually getting worse. Pain medicine is incredibly complex and we have an incredibly limited tool set with which to address the needs of chronic pain patients, but that doesn't mean we should turn to modalities that are comparable in efficacy to twirling a toothpick on the skin. Perhaps you might want to peruse the Cochrane database and get a handle on how poor the evidence base is for the efficacy of acupuncture in managing pain in the long term. While the reviews are frequently charitable in their conclusions about the efficacy of acupuncture in pain management for a variety of disorders, they are also frequently accompanied by the caveat that the studies to date are of insufficient quality to make hard recommendations.
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