BC Naturopaths imminent to be granted prescribing power/minor surgery/lab/imagi

[mrgreek]

I've read this thread with great interest. I'm not a doctor or a medical student. Just a BC resident that sees a lot of doctors. Actually, just three, a GP, a rheumatologist, and a dermatologist. I see an accupuncturist too. I was a sceptic about that, but he's been treating my wife's family for years, and I think it works for me. I do all this because I have psoriasis and psoriatic arthritis. I take a lot of medicines.

 

I went to see a naturopath yesterday. I'd never seen one before. I'd read about the proposal to expand their role in BC. I liked the idea of a holistic viewpoint, and was interested in a naturopathic perspective on nutrition and excercise. And I was also a little curious about this debate.

 

It struck me that no "end users" have contributed to this thread. Perhaps I'm not welcome here. But I did want to share an actual, current experience with a practicing naturopath right here in B.C.

 

I made an appointment to a prominent group practice I found on the internet. I picked it because it was within walking distance of my home in Vancouver. I received a five page medical history to fill out and bring to my appointment. It was mostly conventional, with a few new age touches. The first session was to be 90 minutes, and cost $180.

 

First, I got a tour from the receptionist. It reminded me of an asian spa. The clients were mostly middle-aged ladies. The massage rooms looked very nice. I walked by an elderly lady reading in an armchair in another room, in IV in her hand, and was told she was receiving chelation therapy. I was offered herbal tea.

 

Then I met with the ND. Mostly, he heard my medical history. He hadn't read the five page form. I told him about my meds, starting with Humira, a biologic that I take for arthritis. He said he'd never heard of it. I said it's one of the newer biologics, and he looked blank. I told him about my statin, my daily aspirin, and about my ED drugs.

 

He then told me that psoriasis was caused by "toxicities". That all my medications were just hiding symptoms, that they were the worst of the toxins causing my underlying disease. He singled out Humira as a classic example, even though he'd previously said he hadn't heard of it. He also said that cholesterol was not espeically relevant to heart risk.

 

He said I needed to do several tests to establish the "biochemical terrain of your body." He said I could see the receptionist to schedule them and get the pricing, but in the mean time that I would get a quick VEGA test to get the general level of my immune system and cardiovascular system.

 

I waited in reception for the clinical assistant to do the VEGA testing. Basically, it measured electrical resistance from on hand to the other. One meridian line measured the immune system, the other my heart. The clinical assistant told me that I'm going to need to discuss more heart tests with the doctor, but that my immune system was doing fine.

 

Back to reception, where I paid my $180, and was told that my next visit would be $200 for tests and $85 for the consult. I told him I'd check my calendar and get back to him.

 

I'm not going back.

 

My layperson's assesment is that the whole thing is at best pseudo-science and at worst a fraud. If I continued at this clinic, it was clear there would be pressure to stop my meds. This is despite my explanation that I was especially happy with my newest arthritis medication. Before I took this medication, there were days when I could barely walk. With this medication, I ran for 20 minutes this morning. I don't have as strong a feeling about my statin, but all my other doctors seem in favor of it, so I'm going to stick with that one too. In fact, I think I'll just keep taking everything my regular doctors prescribe.

 

I can only speak about one ND in one city, but I think this practice may be dangerous.

 

My father's experience was almost identical to yours... which is what makes me think this is a 'one person' issue, and is more systemic. Because other NDs do the same thing.

[leviathan]

What a quack. The immune system test proves *that* beyond a shadow of a doubt. If he didn't even know what Humira was, I shudder to think of what other drugs he's unfamiliar with.

 

(And those biologics are indeed amazing!)

 

How are these people even allowed to work in our country? It's a pure scam.

[UBCmed09]

I waited in reception for the clinical assistant to do the VEGA testing. Basically, it measured electrical resistance from on hand to the other. One meridian line measured the immune system, the other my heart.

 

The BBC did an interesting undercover investigation on these VEGA tests a few years back. They sent an undercover reporter in to 3 different pharmacies that provided VEGA testing (most often used for food sensitivities) and recorded the results and also noted vitamin/mineral recommendations from the staff. They did it twice to be sure. Let's just say the results were not favourable.

 

http://www.bbc.co.uk/insideout/south/series2/food_sensitivity_allergy_vega_tests.shtml

 

I guess a BC naturopath would say, yes but the tests weren't being read by a qualified ND....um, right.

[Mourning Cloak]

I've worked in a blood lab for almost 15 years, and I can tell you for certain that this particular naturopathic technique is pure snake oil:

 

Dark field microscopy aka live blood analysis etc.

 

Some very unethical people are actually selling this in Canada! But all the stuff that they claim to "see" is what people in the real world call artifacts. The difference in appearance before and after "treatment" is purposely induced by subtle changes in the handling of the slide. I can induce these very same artifacts for you on demand; any tech could.

 

Live bood analysis/dark field microscopy of the blood is a total scam.

[ploughboy]

Live bood analysis/dark field microscopy of the blood is a total scam.

 

Not a total scam. I'm pretty sure you can diagnose syphillis that way (you can see the spirochetes).

[A-Stark]

Malaria can be diagnosed by examining the RBCs too IIRC.

[Nephets]

you don't need dark field for malaria though...

[A-Stark]

Right.

 

(I should really remember this better given that I was at a "teaching session" with a resident about malaria. The head of the provincial lab explained ol' plasmodium in detail and bought us coffee. )

[Titanic]

doctors are morons.

i cant believe that nobody is standing up hard against this.

a little letter in some stupid newspaper aint gonna do sh|t. they ened to get the lawyers on those naturopathological liars. lol i just came up w that.

 

we whing alot about it but i bet nunya wrote a lteter to the PM or yoru MP or whatever. lol serves us all rite when a naturoQUACKKKK is consiedred equal to a general practioner.

 

LOL

[LotusLand]

The difference is the meds post MI actually reduce morbidity and mortality and have lots of evidence showing this. The homeopathic meds are just expensive water with NO beneficial effect beyond placebo.

 

I absolutely agree that post MI drugs are beneficial but must disagree on your second assumption that homeopathic meds are based only on placebo. If you have read the Nov 2008 Lancet article, they refuted the findings of an earlier study liking homeopathy to placebo.

 

I am not here to bash what you pro-allopathic posters are saying, I just think that this debate has ignited some aggressive and confrontational response that SOMETIMES is based on erroneous info. My desire is only to dispute some of this misinformation.

[LotusLand]

Well, they also might be things like St John's Wort - "natural" drugs that will interact with many others, with serious adverse consequences.

 

Homeopathy is a joke, though, which not only ignores but largely contradicts pharmacological principles.

 

If you were to check drug interactions of all the drugs a person is on, you will more often than not find interactions. Whether we are talking about cardiovascular drugs to anti-depressants, many prescriptions have listed interactions and are still prescribed commonly.

 

Homeopathy is NOT a drug so why do you insist that it has to follow pharmacological principles?

[LotusLand]

... I know what I'm talking about, which is why I posted.

My problem isn't with a drug you may find for 10 dollars that may have 140 pills. My problem is the drugs that cost $100+ for oregano and parsley.

 

Please let me know which drug you are talking about specifically that only contains oregano and parsley and costs $100 plus, I'm curious as I've never come across such a product. If it indeed exist, that's unacceptable, I agree.

 

To nit pit , I was referring specifically to your quote of homeopathic pills which DO cost about 10 dollars a vial, not a couple hundred. I wanted to point out that homeopathic pills are not the same as herbal supplements such as "oregano and parsley."

 

By the way, my father takes expensive cardio meds and I'm in complete support of it especially post CHF/quad bypass in his case, even though he's not so happy to be taking them.

[LotusLand]

Unfortunately, quickly looking over a course listing is not the same as actually taking the courses. If you check out the UofT med curriculum... which I'm sure many of us are familiar with - you'll see that it looks much more sparce that the naturopathic link provided above (it actually looks like we don't learn much there at all!) http://www.facmed.utoronto.ca/programs/md/curriculum/schedule.htm.

 

The point is that you can't judge a book by it's cover. In my years of experience, I have had several opportunities to work with naturopathic doctors. You would be amazed by the perspective they often have to offer. Yes -- it is different from ours -- but it very often makes sense, and actually compliments what it is we're doing. In the end, we all have to keep in mind that we are there to serve the patient. Many of our patients present with vague symptoms... fatigue, stress, etc. Assuming there isn't an underlying condition, we can't always help them. We don't have a medicine for stress. We don't have a medicine for fatigue (unless you count coffee!). For these patients, I often refer to a naturopath and I have seen wonderful results when the two types of medicine are combined. I have a friend who is an oncologist in Toronto who swears that he knows the minute a patient walks in the door if they're seeing a naturopath. "They just look healthier" is what he always says.

 

The bottom line is, put your egos aside... and open your mind to the possibility of working in cooperation with other health care providers such as naturopathic doctors. In this day and age, patients are WANTING natural approaches to health care in addition to the services we provide. At the very least, we as MDs should be recognizing that naturopaths are the most qualified out there in terms of natural medicine. And as responsible caregivers, if a patient is going to seek care from a natural health care provider, we should support them in this decision and refer them to someone who at the very least has the qualifications and education that a naturopath has. I really urge all of you to look beyond your bubble and explore the other health professionals that are out there. I know that for myself, doing so has really allowed me to form better connections with my patients and provide better care. And in the end... that's what it's all about.

 

Very eloquently put. Your patients are extremely lucky to have you, a doctor who remembers that we are all here to ultimately help the patient first. Thanks for posting and bringing some balance and additional perspective.

[LotusLand]

Wow...what a load of BS. Then again, I can hardly say I'm surprised. It's not like science has been the strong suit of the profession.

 

Here's the iridology wiki for anyone interested: http://en.wikipedia.org/wiki/Iridology

 

FYI, Iridology is NOT part of the core curriculum of ND education. In fact, there are very few NDs who use it and if they do, they didn't learn it at naturopathic school.

[LotusLand]

Alright, let's see some examples in naturopathy where health becomes REALLY Costly:

 

Fees naturopaths charge in Canada:

 

Ontario Association of Naturopathic Doctors

"Recommended Fee Guide for the Professional Services of Naturopathic Doctors"

Based on an hourly rate of $125 - $180 (This does NOT include profit from sales of natural products/supplements, procedures (labs, "Detox", colon hydrotherapy, etc))

 

initial (60-90 min): $125-$240

follow-up: (20-60 min): $45-$180

short consultation: (10-15 min): $25-$50

phone consultation: (5-20 min): $15-$65

 

Anita Bratt, ND - North Vancouver (btw, check out the Autism tab on her website)

 

 

 

Family physicians make $80-$120/hr after overhead (eg. current BC Hospitalist fees = approx $120/hr). While Naturopaths supposedly make $120-$180++/hr (or MUCH higher with all those natural supplements/add-on tests/chelation/colonic hydrotherapy), with overhead less than an MD's office. Heck, even Internal Medicine specialists make in the $130-170/hr range.

 

Where is the value in healthcare for mad prices like this for just placebo-based "medicine"?

 

Overhead costs are similar to a MD's office. They have the same instrumentation for physical exams, paps, etc.

 

With regards to testing, I don't think anyone should be making money off of testing as they are being used for diagnostic purposes (I realize that some of you may not agree that they are entirely diagnostic....). So yes, if those prices are inflated, that's not a good thing. I researched some of those fees and some of them do appear to be in line with what the lab charges, so I'm not sure how much a ND would make off doing a test...

 

I think that too many people are focusing on modalities that fall outside of the regulated scope of naturopathy (iridology, muscle testing, dark field microscopy). The largest portion of their "prescriptions" is based on nutrition and lifestyle changes which obviously do have EBM behind it and not just placebo.

[da_birdie]

With regards to testing, I don't think anyone should be making money off of testing as they are being used for diagnostic purposes (I realize that some of you may not agree that they are entirely diagnostic....). So yes, if those prices are inflated, that's not a good thing. I researched some of those fees and some of them do appear to be in line with what the lab charges, so I'm not sure how much a ND would make off doing a test...

 

I think that too many people are focusing on modalities that fall outside of the regulated scope of naturopathy (iridology, muscle testing, dark field microscopy). The largest portion of their "prescriptions" is based on nutrition and lifestyle changes which obviously do have EBM behind it and not just placebo.

 

I do not have a lot of time tonight to respond to all this.

 

But I'll just point out that the largest portion of their PROFIT is likely derived from sales of unnesessary/unproven supplements, treatments, and procedures. Just by flipping in the local newspaper, or by googling for local naturopath clinics, you will be surprised finding any that doesn't advertise re: detox / chelation therapy, etc. I cannot recall any naturopath ads that emphasize on their superior "nutrition and lifestyle counselling" alone.

By the way, I thought that's what family physicians and registered dietitians are trained to do?

 

I would be suprised if naturopaths don't keep a significant portion of the fees they charge for lab tests among the likes of "organic acid test" ($380), "IgG food allergy test" ($250), etc. Another question is, do naturopaths send those blood/urine samples to regular labs (eg Lifelabs in BC), or labs built-in to their clinic? When MDs order lab tests, they don't make/charge a cent; it is up to the lab that decides whether to charge the patient (ie. to determine whether the lab is covered by healthcare). How is it that when it comes to naturopaths ordering lab tests, the patient pays directly to the naturopath, but not to the "independent laboratory"? Isn't there a conflict of interest?

 

Let us suppose the naturopaths don't make a cent from ordering those tests, what is the justification of having the patient spending that kind of money on such "allopathically unnecessary" and "scientifically unproven" tests?

[da_birdie]

I absolutely agree that post MI drugs are beneficial but must disagree on your second assumption that homeopathic meds are based only on placebo. If you have read the Nov 2008 Lancet article, they refuted the findings of an earlier study liking homeopathy to placebo.

 

I am not here to bash what you pro-allopathic posters are saying, I just think that this debate has ignited some aggressive and confrontational response that SOMETIMES is based on erroneous info. My desire is only to dispute some of this misinformation.

 

I can't seem to find that Nov 2008 Lancet article that "refuted the findings of an earlier study liking homeopathy to placebo". Not on Pubmed, not on the Lancet website. However, by googling "lancet" and "homeopathy" I did find lots of pro-homeopathy websites criticizing that "earlier study on Lancet".

 

Please provide actual date / volume / page # of the Lancet article you quoted.

 

As far as I know, Lancet did not publish any article that suggests homeopathy is better than a placebo.

[mrgreek]

lol lotusland, sure, when I go back home, I'll find out what it's called.

 

There was one drug my dad was curious about that he was given... he asked me to find it on the internet... It wasn't found anywhere, under every given name on the bottle (and producers webpage), as well as the *different* name on the receipt he gave my father. Placebo? Who knows

[Nephets]

Please let me know which drug you are talking about specifically that only contains oregano and parsley and costs $100 plus, I'm curious as I've never come across such a product. If it indeed exist, that's unacceptable, I agree.

 

To nit pit , I was referring specifically to your quote of homeopathic pills which DO cost about 10 dollars a vial, not a couple hundred. I wanted to point out that homeopathic pills are not the same as herbal supplements such as "oregano and parsley."

 

By the way, my father takes expensive cardio meds and I'm in complete support of it especially post CHF/quad bypass in his case, even though he's not so happy to be taking them.

 

It's nitpick, not nit pit.

N.

[leviathan]

Very eloquently put. Your patients are extremely lucky to have you, a doctor who remembers that we are all here to ultimately help the patient first. Thanks for posting and bringing some balance and additional perspective.

Only some naturopaths are there to help the patient, and only some of the time. If you look at the abundance of ads in the paper for naturopathic treatments like 'chelation' and 'detoxification' therapy, you can see just how rampant their scam jobs really are in our society. You can't say naturopaths are there to help the patient when they remove them from preventative proven drugs like statins and put them on oregano and parsley, which they charge the patient for. It disgusts me.

[Mourning Cloak]

Not a total scam. I'm pretty sure you can diagnose syphillis that way (you can see the spirochetes).

 

Not from blood you can't. But it's a great test if you've got a weepy syphilic lesion and a very smart tech to read it.

 

Malaria can be diagnosed by examining the RBCs too IIRC.

 

There's a couple of papers on this from 30 years ago, but I've never been in a lab in Canada that did this. It would be crazy hard.

 

Summary:

While there are some legitimate uses for darkfield microscopy in a legitimate lab, darkfield microscopy/live blood analysis is highway robbery. If you need your blood looked at, get a CBC, diff & smear.

[NLengr]

If you have read the Nov 2008 Lancet article, they refuted the findings of an earlier study liking homeopathy to placebo.

 

Citation for said article?

 

The only one I could find is from 2005. Aijing et. al. 2005 Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy The Lancet Vol. 366 No. 9487 pp. 726-732

 

Here is the summary: "Biases are present in placebo-controlled trials of both homoeopathy and conventional medicine. When account was taken for these biases in the analysis, there was weak evidence for a specific effect of homoeopathic remedies, but strong evidence for specific effects of conventional interventions. This finding is compatible with the notion that the clinical effects of homoeopathy are placebo effects."

 

Here's a link to the abstract: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)67177-2/abstract

[ploughboy]

Not from blood you can't. But it's a great test if you've got a weepy syphilic lesion and a very smart tech to read it.

 

Ah. That'll try and teach me to try and be a smartass...

[A-Stark]

If you were to check drug interactions of all the drugs a person is on, you will more often than not find interactions. Whether we are talking about cardiovascular drugs to anti-depressants, many prescriptions have listed interactions and are still prescribed commonly.

 

Homeopathy is NOT a drug so why do you insist that it has to follow pharmacological principles?

 

So what the **** is it then? Things like dose, efficacy, and potency don't matter for homeopathic "remedies" then? How are they metabolized? Where do they act? What are the active ingredients and what are their mechanisms of action? They are either biochemically active or they're not and for all intents and purposes are "drugs".

[Mourning Cloak]

Ah. That'll try and teach me to try and be a smartass...

 

I am glad for you that you are the kind of MD who hasn't done this test. You clearly did well on CaRMS. It's a yucky specimen to collect.

 

http://www.aafp.org/afp/20030715/283.html