Naturopathy invades the heartland

Many are the times I’ve referred to homeopathy as The One Quackery To Rule Them All. Because homeopathic remedies diluted greater than 12 C (12 serial hundred-fold dilutions) have been diluted more than Avagadro’s number, they are incredibly unlikely to have even a single molecule of starting compound in them. That makes them water. Given that the vast majority of homeopathic remedies are, in fact, only water, they are the perfect quackery, and any effects due to homeopathy are nonspecific and placebo effects. More recently, I’ve pointed out that, because you can’t have naturopathy without homeopathy, naturopathy is the grab bag quackery for which no quackery is too quacky to be included in the grab bag. I, of course, respond to homeopaths and naturopaths, “Get into the f-ing sack.”

Personally, I like to use acceptance of homeopathy as a litmus test for credulity, knowing that anyone who believes in homeopathy–even understanding what it is–has a serious credulity problem. Naturopathy has a serious credulity problem. Even so, naturopathy seems to be making inroads in a lot of places, being the “respectable” form of quackery. Heck, its practitioners even give themselves the title of “doctor,” and the “ND” after their names is really close to the “MD” after the names of real doctors. Maybe that’s why naturopathy is among the most successful alt-med “disciplines” at insinuating its way into academic medical centers, “integrating” itself with science-based medicine. Of course, I never could figure out how “integrating” quackery with science-based medicine does anything other than taint SBM with pseudoscience.

Be that as it may, the other day I saw more evidence of just how prevalent the infiltration of pseudoscience has become. Normally, naturopathy and other forms of “alternative medicine” are associated with large population centers full of people who, because they live in large population centers yearn for the “natural” and earnestly believe that, just because it’s natural it must be better. Now, it’s infiltrating places like rural Montana:

Patients battling cancer now have a new option in their arsenal, which may include multiple cups of green tea or a prescription for ginger supplements.

Lynn Troy, a naturopathic doctor, works one day a week treating cancer patients at Kalispell Regional Medical Center’s Northwest Oncology and Hematology office. She began there in January, joining a small population of integrated cancer care naturopaths employed by hospitals in Montana.

“It had a slow start, but now it’s really busy,” Troy said.

Billings Clinic also offers naturopathic services for its integrated cancer care program, but the idea has yet to catch on throughout most of the state.

Unfortunately, I have no doubt that the naturopaths are working to try to make sure that the idea catches on in the rest of the state. And they’ll do it by doing what Troy does in this interview, co-opting science-based medicine and woo-ifying them. First, there’s the false appeal to “wholism,” in which only the naturopath “takes care of the whole patient.” Then add to that the claim of being a nutritionist:

A big part of her job is to assess the diet and nutrition of the patient, and to prescribe herbs and supplements to complement the array of traditional medicines they are already taking.

Troy said her prescriptions range within the botanical, herbal and homeopathic medicines, depending on what she is treating – whether it’s a side effect of current therapies or a general symptom.

This could mean suggesting supplemental melatonin, coenzyme-Q10 or five cups of green tea, she said, as well as various herbs. Her patients are motivated to make a change, Troy said, and their diet is a good place to start.

Of course it is, but making a change just for change’s sake is rather pointless. In medicine, suggestions for “making a change” should be based on sound evidence and science. Naturopaths, as we’ve seen time and time again, are experts in taking preliminary results of scientific investigation and investing far too much confidence into them to the point of using them in people whether they sufficiently evidence-based enough for that or not.

And let’s not forget the “empowerment” angle. Not surprisingly, it’s in this article too. Troy’s naturopathy is described as giving patients the power to take control, with naturopathy described as teaching patients “how they can change their lifestyle to improve their health”–as if conventional medicine doesn’t try to do that every time physicians try to persuade their patients to lose weight, excercise, stop smoking, and make other lifestyle interventions in order to improve their health does not. Apparently, woo makes the medicine of hard truth about what it takes to improve one’s health easier to take. Or, alternatively, taking supplements flows from the same impulse that taking a pill does: It’s way easier to take a pill or a supplement than to commit to long term changes in lifestyle that can be unpleasant and, more importantly, require a daily effort to follow. In this, naturopathy and supplement hawking are no different than medicine. Where they are different is that SBM requires valid scientific evidence before it recommends a pill or other treatment; naturopathy bases its recommendations on a philosophy rather than science. It also convinces the patient that it’s “empowering” him or her. The problem is, true empowerment can never derive from being fed information that is at odds with reality.

But it’s not just naturopathy. If you want to have an idea when something’s gone “mainstream,” just look at the course catalog of your local community college, a community college like Northern Virginia Community College:

Newcomers to this concept [of homeopathy] can gain a wider understanding of this alternative medicine at Johnson’s “Intro to Homeopathy” class at the Alexandria campus of Northern Virginia Community College this spring.

The Basics: Three two-hour sessions are spread out over three weeks and students need to purchase a copy of Timothy Dooley’s “Homeopathy: Beyond Flat Earth Medicine” ($11, Timing Publications). The first class is an overview of homeopathy and an examination of how it’s used today. According to the World Health Organization, it’s the second most widely used form of medicine in the world (bested only by herbal medicine) and it’s most popular in Asia, South America and Europe.

Another naturopath. Why does it always have to be a naturopath? Maybe it’s because naturopathy is a cornucopia of quackery, a hodge-podge of virtually any quackery that can fit into the “natural” belief system underlying naturopathy, be it traditional Chinese medicine, Ayurveda, homeopathy, various forms of supplements, or “energy healing.” He’s also recruiting:

Students who complete the class will not be certified to practice homeopathy, but they will have with a stronger understanding of the discipline. Johnson hopes that the class helps participants decide whether they would like to continue on to naturopathic school to get an ND themselves.

I must admit, I often have a hard time stifling a laugh when I hear the term “certified to practice homeopathy.” Give me a couple of measuring implements, some vials to shake up the remedies between each dilution step, and a lobotomy, and I could be “certified to practice homeopathy” right now. (You don’t even have to give me a Bible to smack the remedy against at each succussion step, the way Samuel Hahnemann himself did it!) Needless to say (but I’ll say it anyway), I’ll pass.

Be that as it may, this course at the community college is clearly meant as a “gateway” to homeopathy. It serves two purposes. First, it serves as propaganda to make believers out of members of the general public. True, these are self-selected members of the general public, given that they’re willing to pay $129 for three classes on homeopathy, but after the class they have the potential to become at the very least evangelists for pseudoscience and at the very worst potential new homeopaths themselves.

And so it goes.

Unfortunately, the longer I’m at this, the more of this sort of thing I see. I tend to attribute the increasing infiltration of quackery into places where you’d never see it before, such as northwest Montana and community colleges in Virginia, to quackademic medicine. The reason is due to an effect that I like to call the “Harvard effect,” as in, “Harvard’s doing it.” And Harvard is doing it to. So is Stanford, UCSF, the University of Michigan, Yale, Memorial Sloan-Kettering Cancer Center, the M.D. Anderson Cancer Center, and many academic hospitals. They provide the patina of respectability to pseudoscience, giving smaller hospitals out in the sticks, whose physicians tend to want to emulate academia anyway, because that’s where the cutting edge therapies are. By associating with academia, quackademic medicine takes on the aura of being “cutting edge” itself. Worse, unlike high tech new cutting edge therapies at university hospitals, which are quite expensive and demand specialized skills unlikely to be available in rural areas, modalities like naturopathy are relatively cheap and can be done anywhere.

Is it any wonder that small community hospitals in Montana (or Missouri or Ohio or Kansas or anywhere else with lots of rural hospitals) would want a piece of that?