Holistic Doctors, and medicine

JAMA writes:Of the 74 quantitative studies, 23 were clearly unsupportive. Eight reported no statistically significant results,16, 58, 98-103 3 admitted to having inadequate samples,22, 56, 104 2 were inconclusive,11, 105 and 6 had negative findings.106-111 Four attempted independent replications but failed to support the original findings.112-115 To our knowledge, no attempt to conduct experiments to reconcile any of these unsupportive findings has been reported.

Guess we'll have to wait and see.

Naturopaths are licensed as independent practitioners in 13 states (Alaska, Arizona, California, Connecticut, Hawaii, Kansas, Maine, Montana, New Hampshire, Oregon, Utah, Vermont, and Washington) and the District of Columbia, and can legally practice in a few others [14]. ...however, naturopathic licensing boards have done little or nothing to protect the public from naturopathy's widespread quackery.

A "doctor of naturopathy" (N.D.) has two years of basic science courses and two years of clinical work.

In 1987, the U.S. Secretary of Education approved the Council on Naturopathic Medical Education (CNME) as an accrediting agency for the full-time schools. As with acupuncture and chiropractic schools, this recognition was not based upon the scientific validity of what is taught but on such factors as record-keeping, physical assets, financial status, makeup of the governing body, catalog characteristics, nondiscrimination policy, and self-evaluation system.

In 1968, the U.S. Department of Health, Education, and Welfare (HEW) recommended against Medicare coverage of naturopathy. HEW's report concluded:Naturopathic theory and practice are not based upon the body of basic knowledge related to health, disease, and health care which has been widely accepted by the scientific community. Moreover, irrespective of its theory, the scope and quality of naturopathic education do not prepare the practitioner to make an adequate diagnosis and provide appropriate treatment.

In 1968, the U.S. Department of Health, Education, and Welfare (HEW) recommended against Medicare coverage of naturopathy. HEW's report concluded:...

Nutrition is accepted by science.

Acupuncture at Johns Hopkins

American Specialty Health, Inc. (ASH) has published detailed clinical practice guidelines for 81 "complementary" techniques and procedures, most of which are used mainly by chiropractors. The documents indicate: 68 of these methods would not be covered under the plan because they are considered unsubstantiated, unsafe, or both.67 of the methods are classified as experimental or investigational because credible scientific evidence is inadequate to support their claimed applications.48 of the methods are scientifically implausible because they require the existence of forces, mechanisms, or biological processes that are not known to exist within the existing framework of scientific knowledge. 11 of the methods are considered unsafe, either directly or indirectly. The potential harm can be:Direct: Injury caused by a physical or psychodynamic property of a procedure.Indirect: caused by substituting a procedure of unknown safety, unknown effectiveness, or known significant risk for one of known safety or effectiveness.Non-specific: caused by the transmittal of misleading information that can cause emotional harm, cause a false sense of security, or create beliefs about one's health that are manifestly untrue.53 of the methods would render the practitioner ineligible to participate in the network.

ASH administers benefit programs for 12.1 million members and affinity discount programs for over 80 million members. Its practitioner network includes more than 28,000 acupuncturists, chiropractors, dietitians, massage therapists, and naturopaths. ... the (reports) are remarkable because (a) many of the implausible practices”most notably applied kinesiology”are widely used, (b) chiropractic organizations almost never criticize them, and (c) managed care companies almost never use implausible practices as a criterion for excluding providers.

purple writes:Homeopathic popularity faded in the 1940's ...

WHEREAS homeopathy has been an integral part of naturopathic medicine since its inception and is a recognized specialty for which the naturopathic profession has created a distinct specialty organization, the Homeopathic Academy of Naturopathic Physicians,WHEREAS homeopathy has been recognized, through rigorous testing and experimentation, as having significant scientific evidence supporting its efficacy and safety.WHEREAS homeopathic products are being subjected to intensified federal regulations and restrictions,WHEREAS products are being promoted and marketed as "homeopathic" for a variety of uses ranging from weight-loss aids to immunizations. Many of these preparations are not homeopathic and many have not been satisfactorily proven to be efficacious,THEREFORE, LET IT BE RESOLVED that it is the position of the American Association of Naturopathic Physicians that:I. Homeopathy is taught in the Naturopathic Colleges and its practice should be included in the naturopathic licensing laws. Naturopathic physicians recognize other licensed practitioners of the healing arts who are properly trained in homeopathy.II. The naturopathic profession initiate more clinical trials and provings to further evaluate the effectiveness of homeopathy.III. Naturopathic physicians be authorized to prescribe and dispense all products included in the Homeopathic Pharmacopoeia of the United States (HPUS).IV. Homeopathic products be subject to strict labeling requirements. Preparations which are not prepared in accord with the manufacturing principles in the HPUS should not use the term "homeopathic.". If parents choose homeopathic preparations for their children or their wards for the prophylaxis of infectious disease as an alternative to conventional vaccines, the physician should clearly state that they are unproven and that they are not legal substitutes for the state-mandated requirements.V. Homeopathic prescriptions should be made with careful evaluation of their effect on the entire organism.-- Adopted at the 1993 Annual Convention of American Association of Naturopathic Physicians. Principal Authors: Michael Traub, Lauri Aesoph, Peggy Rollo, Bruce Dickson, Brent Mathieu, Judyth Reichenberg-Ullman, Stephen King, Julian Winston, Louise Edwards, Prudence Broadwell.

Government funding for medical research is not expected to increase in coming years and could decline. Medical schools will be more reliant on private, for-profit industry for funding.

Today, within the United States, a "doctor of naturopathy" (N.D.) or "doctor of naturopathic medicine" (N.M.D.) credential is available from four full-time schools of naturopathy and at least eight nonaccredited correspondence schools, of which seven maintain Web sites. One correspondence school, the Progressive Universal Life Church, offers a "Ph.D. in Naturopathy" for $250 plus "life experience with no coursework. Another nonaccredited school offers a "Naturopathic Practitioner" diploma to eligible individuals who complete a 15-month program of home-study plus a dozen weekend seminars.

In a group as diverse as the members of this Commission and a field as diverse as CAM, it is not surprising that areas of significant disagreement, particularly about tone and emphasis, remained to the end. In particular, several Commissioners were concerned that the report needs to state even more clearly than it already does that most CAM interventions have not yet been scientifically studied and found to be either safe or effective.

Many of the commissioners agree with the editors of The New England Journal of Medicine who stated in 1998: "There cannot be two kinds of medicine--conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted."

Chiro is bunk.

In 1992, researchers at the Stanford Stroke Center asked 486 California members of the American Academy of Neurology how many patients they had seen during the previous two years who had suffered a stroke within 24 hours of neck manipulation by a chiropractor. The survey was sponsored by the American Heart Association. A total of 177 neurologists reported treating 56 such patients, all of whom were between the ages of 21 and 60. One patient had died, and 48 were left with permanent neurologic deficits such as slurred speech, inability to arrange words properly, and vertigo (dizziness). The usual cause of the strokes was thought to be a tear between the inner and outer walls of the vertebral arteries, which caused the arterial walls to balloon and block the flow of blood to the brain. Three of the strokes involved tears of the carotid arteries [3]. In 1991, according to circulation figures from Dynamic Chiropractic, California had about 19% of the chiropractors practicing in the United States, which suggests that about 147 cases of stroke each year were seen by neurologists nationwide. Of course, additional cases could have been seen by other doctors who did not respond to the survey.

Applied kinesiology (AK), for example, is based on the notion that every organ dysfunction is accompanied by a specific muscle weakness, which enables health problems to be diagnosed through muscle-testing procedures. Testing is typically carried out by pulling on the patient's outstretched arm after placing the test substance (such as a vitamin or food extract) in the patient's mouth until salivation occurs. However, some practitioners place the test material in the patient's hand or touch it to other parts of the body. If a weak muscle becomes stronger when a nutrient (or a food high in the nutrient) is tested, that supposedly indicates "a deficiency normally associated with that muscle." "Treatment" may include special diets, food supplements, acupressure, and spinal manipulation.

Contact Reflex Analysis (CRA) proponents claim that over a thousand health problems can be diagnosed with a muscle test during which the chiropractor's finger or hand is placed on one of 75 "reflex points" on the patient's body. If the patient's arm can be pulled downward, a condition corresponding to the "reflex" is considered present, and dietary supplements (typically made from freeze-dried vegetables or animal organs) are prescribed. CRA's chief proponent teaches that 80% of disease is due to allergy, the two main causes of disease are gallbladder disease and staph infections, and obesity is commonly caused by parasites.

It is now generally accepted that spinal manipulation can relieve some types of back pain. Most chiropractors claim to do more than just treat back pain, however.

The Chiropractic college here spent rather more time on running the business.

Success promoters who give seminars to train chiropractors in psychological patient manipulation are a notorious problem within chiropractic. I study a wide variety of health pseudosciences, but I know of no other guild that has formalized the education of practitioners in patient deception.