During my time in Arizona, I realized that my profession had severely misled me. Based on my educational and professional experience as an accomplished member of the naturopathic community, I can say that naturopathic medicine might be a distinct form of something, but it is not any form of primary health care. I am saddened to report that not only was I misled, but so were hundreds of legislators, thousands of students, and tens of thousands of patients.
Historical image of a patient undergoing hydrotherapy treatment. Given my journey through naturopathic medical school, I can provide strong evidence and testimony of the quality and quantity of training at Bastyr University. It should come as no surprise to readers of ScienceBasedMedicine. The issue of this deceit boils down to the education and clinical training of naturopaths.
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The naturopathic profession perpetuates a series of false assertions to justify its advancement, which unfold in a closed-loop system that eschews external criticism. Two examples of this dynamic show that naturopaths are the sole regulators of naturopathic medicine. For more information see Melnick Department of Education. This accreditation does not apply to what naturopaths were taught in school. It actually means that the CNME meets administrative criteria and conducts its own internal evaluation process of naturopathic programs which it approves.
This evaluation is not reviewed or shared outside of the naturopathic community. Department of Education accredited school. I might even write a third post explaining how my clinical sciences coursework at Bastyr cannot possibly prepare a student to practice as a primary care physician. For now, the take home message is that naturopathic education exists in a bubble without critical oversight. A proximal consequence of this insulated community is that naturopathic education remains mysterious to outside observers, and is falsely presented to the public as being on-par with MDs or DOs and capable of training primary care physicians.
The ultimate consequence is that pseudoscience becomes legalized as medicine through political maneuvering. Bastyr University promotes itself as a leader in natural health care. Bastyr states in its promotional material that the naturopathic medical doctorate is a nationally-recognized degree and that its curricula conveys international prestige as an evidence-based, rigorous, and comprehensive program. The language for their programs is all in striking parallel with how the American Association of Naturopathic Medicine AANP presents the profession publicly. The AANP is the professional association of licensed naturopaths.
It issues position papers on various topics, maintains the naturopathic code of ethics, organizes an annual conference, and spearheads legislative efforts. Naturopathic medical students and doctors from all over the country gather annually in Washington D. When meeting with congressional aides, our success depended on us having succinct information about our naturopathic training. One of the most disseminated documents was a chart produced by the AANP that compared our educational hours to the educational hours of a student of medicine MD and a student of osteopathic medicine DO.
It is very popular among naturopaths to use such an educational chart in an attempt to justify that naturopaths are well qualified healthcare providers. The charts are often featured on practice websites and on the websites of organizations that promote naturopathic medicine. Different versions of the chart can be found all over the internet. When I practiced as a naturopath, I never thought to fact check any of these educational comparison charts.
I accepted this information as truth and was thrilled that someone else had done the tedious work for me. They are all a bit different in how hours are categorized for comparison, which tipped me off that there was some manipulation of the data.
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Some charts simply break down hours into two categories: didactic and clinical; while there is usually an accompanying table describing a further break down into other categories. Other charts attempt a more seemingly-detailed accounting of hours, but issues remain. As Orac and Jann Bellamy have already shown, this wiggle room gives ND training a false upper or equivalent hand because dubious coursework is inappropriately lumped into other legitimate categories. Here are some of these charts: 1 , 2 , 3 , and 4. Yet, what good are such charts and their unknown data inputs when I can show what it took for me to earn my ND degree?
Furthermore, what does a credit hour mean for comparative purposes when pseudoscience or experimental therapies are being taught in a supposed clinical science course? I recently scrutinized my transcript , course syllabi, and student clinician handbook. Here is a table detailing my coursework into more readable categories based on my transcript; credits were translated to hours based on all of my courses syllabi.
I graduated with 1, After breaking down the clinical training hours and assessing the quality of the medical training, I believe the quantity and quality of the training provided by Bastyr University is scant, lacks the application of medical standards of care, and includes pseudoscientific diagnostic methods and treatments of real and fake diseases. Sometimes temporary community clinics are set-up throughout Seattle for additional training. A clinic rotation is scheduled in 4 hour shifts, once per week, for an week quarter.
To provide a picture of what naturopaths mean when they claim to be primary care physicians, I think a description of a typical patient appointment and how training is structurally organized at the Bastyr teaching clinic is telling. On a clinic shift, one faculty member a licensed naturopath supervised several naturopathic students. The terms primary and secondary refer to how many quarters the student has spent in the teaching clinic.
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By definition, a secondary student has spent less than four quarters in the clinic and is a novice clinician. A primary student has spent more than four quarters in the clinic and is considered advanced. This amount of time does not equate with clinical skill.
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I knew many incompetent primary student clinicians. Each clinic shift had a specific structure that included three elements: shift preview, patient appointments, and shift review. Shift preview and review took place in the first 30 minutes and final 30 minutes of shift.
During these periods, primary students roundtabled their patients. Patient cases were presented in a standardized S. The supervisor usually asked students about differential diagnoses and treatment protocols. Medical standards of care were almost never discussed on my clinic shifts, with notable exceptions for one or two of my supervisors who insisted on it, to the dismay of many students. Actual patient care accounted for three hours of a clinic shift. Patient care visits were typically attended by two students, a secondary and a primary. Appointments lasted anywhere from one to two hours.
This charting included a typical medical intake, such as the seven attributes of the medical complaint, a review of systems, past medical history, medications and supplements taken, family history, social history, dietary patterns, and so on.
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Vital signs, like blood pressure and temperature, were usually taken by a student. The patient intake also included information thought relevant to naturopathic diagnoses, like toxin and heavy metal exposure, use of plasticware in cooking and eating, birth history, pesticide exposure through eating non-organic foods, food intolerances, religious affiliations, and a host of subjective assessments relevant for energy therapies homeopathy, flower essences, UNDA numbers, etc.
The diagnosis process in naturopathic medicine is an interesting one. For example, the complaint of heartburn could have included a differential diagnosis of gastroesophageal reflux, H. Lab testing and imaging was also considered during this discussion. Treatment then encompassed recommendations for the medical and the naturopathic diagnoses as a singular, interwoven diagnostic report. The patient care treatment plan is a mainstay of naturopathic medicine. The options seemed endless. A patient might have received any treatment recommendation! Many supervisors would limit the number of recommendations in an attempt to rein in plans that seemed to run wild.
Other supervisors would have certain requirements to consider, such as if a homeopathic remedy were offered, another therapy must also be included. To the best of my memory, I was rarely asked about the medical standard of care for a diagnosis and treatment plan. The treatments offered to patients were usually abundant and seemed like a toss-up. My clinical training included such a small amount of pharmacological experience that it hardly seems worth mentioning. I spent far more time learning how to write a prescription for botanical medicines than how to prescribe appropriate pharmaceutical medications.
Once I was in practice, I specifically befriended a pharmacist at a local pharmacy in Seattle so I could ask questions about drugs, dosages, interactions, and protocols. I still am very thankful for her help. The herb Cheladonium, the source of an infamous alternative cancer treatment.
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