Naturopathic medicine

[PeterG]

Recently I have read that in the United States people, particularly the well educated, are turning away from conventional medicine and towards alternative treatment (naturopathy, homeopathy, etc). Could anybody explain why this is so?

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[cyclohexanol]

Recently I have read that in the United States people, particularly the well educated, are turning away from conventional medicine and towards alternative treatment (naturopathy, homeopathy, etc). Could anybody explain why this is so?

Because of growing distrust of traditional western medicine, sensationalized by the media. You turn on the news any given day and they are reporting on some new study that shooting yourself in the foot is bad for you, but the next day shooting yourself in the foot cures cancer. The media also tends to highlight when something goes wrong, like a surgical tool gets left in a patient, etc... people are just increasingly aware of all of that due to the bombardment of media channels (tv, paper, internet, etc...)

Some people may be getting impatient with conventional medicine, and its apparent lack of "cures" for things which are ailing people. So when their neighbor down the street who has no training whatsoever suggests they eat this and that to cure yourself of <insert terrible ailment here>, they do. And maybe by placebo effect, they begin to feel better, or maybe there is a genuine curative property that hasn't been clearly identified yet.. who knows.

People may also be turned off to western medicine by the apparent conspiracy portrayed upon the american people by the "industry". People like Peter Duesberg and Kary Mullis are running around telling people that the pharmas are the true cause of AIDS, not HIV, creating general sense of distrust and panic in some people (not I). People listen to them because Kary Mullis won the Nobel for inventing PCR, and Duesberg is/was a professor at Berkeley, great.. so they are name droppers and may have had some coherent and/or brilliant ideas at one point, that doesn't mean everything that comes out of their mouth is gold.

So, there seem to be many reasons why people are distrustful of western medicine and are looking for alternatives.

On the flip side, there also seems to be a "melding of the minds" so to speak in the health sciences community, wherein tradionalists are adopting interdisciplinary training programs. Georgetown offers a graduate degree in complementary and alternative medicine, for example. I'm sure there are many other programs adopting methods which are more on the alternative side of medicine as well, that one I just knew off the top of my head.

Whether or not those alternatives are valid, scientifically proven methods is up for debate. I don't think these trends or alternative studies are necessarily bad. Any discipline which aims to investigate treatments and improve the health of people should be respected, as long as those programs adhere to accepted scientific methods of research, testing, and treatment. Naturopathy should not be seen as a problem, or a diversion from accepted methods, but rather as a possible extension. The problems start to occur when you have people like Kevin Trudeau (with no training) convicing thousands(?) of people that if you have alkaline blood, you don't get cancer and other such complete nonsense...



(not meant to be an attack on alternative methods, or naturopathy)

 

[Sundarban1]

I'm not convinced the "well educated" people you speak of are well educated at all. I'd be happy to be wrong if you could provide results of a controlled study that show well educated people (say college level or some advanced degree) are more likely to seek alternative routes to healthcare other than standard care. My opinion is that you are simply making a blanket statement based on anecdotal evidence. Thanks for trying, though.

 

[Lindyhopper]

I'm not convinced the "well educated" people you speak of are well educated at all. I'd be happy to be wrong if you could provide results of a controlled study . . .

There also seems to be a divide between people educated in the sciences & people educated in arts & language, who can often be scientificly naive. Just an observation & generalization.

 

[THP]

I sort of agree with cyclohexanol. It seems wise to look at what alternative medicines are offering (most specifically naturopaths) and determine if they can stand up to EBM.

This sort of thing doesn't worry me because if it is more effective then they should go to the alternative medicine sources. If those don't work they will come to us. When you have crushing chest pain and pain radiating down your left arm 99% of people know where to go.

 

[OSUdoc08]

Recently I have read that in the United States people, particularly the well educated, are turning away from conventional medicine and towards alternative treatment (naturopathy, homeopathy, etc). Could anybody explain why this is so?

Drugs are bad!

Surgery is too!

Take herbs!

 

[bananaface]

Just to clarify something - if state law allows, naturopaths can use drugs in their therapeutic regimens. They tend to do it sparingly and aren't supposed to use synthetic ones. For example, in my state, a naturopath here could prescribe Armour Thyroid (made from actual thyroids and smells awful) but not a synthetic levothyroxine.

Just because they are naturopaths we shouldn't assume they don't use EBM within their own field.

 

[NonTradMed]

I agree with most that was said here.

I've seen college educated people who turn toward alternative health care, and I've seen noncollege educated people who do so....I think unless someone is trained in the sciences, it's not education which compells someone to turn to alternative health care, but their overall view of the healthcare system. Some people are just suspicious of the 'healthcare industry' and jump at the chance to do alternative care because it's like sticking your finger to the industry. Others may feel scared because of prices and think alternative health care is a cheaper way to get the same level of care. Almost no one goes running to their herbalist when something really serious is up, but for healthcare preventions, for small ailments, hospitals and clinics may not be where alot of people want to end up in.

Education doesn't deter people from jumping to alternative healthcare systems, because as someone upthread pointed out, there are people with advanced liberal arts degrees that may also utilize it because they are ignorant of medical science. But I think less educated people are more easily convinced of alternative healthcare because they may not understand how placebos work, or how clincal trials are conducted etc.

 

[FoughtFyr]

Do not overlook the "never say die" attitude of the "sCAM" provider. There are many ailments for which either traditional mediicne would be "overkill" (for instance, LBP, which studies have shown - in the absence of serious pathology, resolves on its own as fast as it does with treatment) or where "nothing can be done" (for example, fibromyalgia). Now, you will never hear a "sCAM" provider say "I'm sorry, but there really is nothing effective I can do for you". Nor do they advise lifestyle changes alone (altough they may be needed). Nope - they have a "cure" and they are willing to sell it to you, even if actual medical scientists can't help. A tragic recent example of this is the death of Coretta Scott King who checked into a chiropractic/naturopathic clinic in Mexico to recieve "treatment" for terminal cancer.

- H

 

[McDoctor]

I'm not convinced the "well educated" people you speak of are well educated at all. I'd be happy to be wrong if you could provide results of a controlled study that show well educated people (say college level or some advanced degree) are more likely to seek alternative routes to healthcare other than standard care. My opinion is that you are simply making a blanket statement based on anecdotal evidence. Thanks for trying, though.

I disagree.

Since most insurance carriers will not cover unproven treatment modalities, the majority of alternative therapies require payment out of pocket by the patient themselves. Clearly, college educated people on a whole have more disposable income and are more likely to pay out of pocket for alternative medicine than less educated individuals.

I think there is much more skepticism regarding traditional medicine (some of it deserved) in light of recent controversy surrounding Vioxx, Celebrex,etc...
We probably could do a better job providing education to our patients to make well-informed decisions regarding their treatment options and in most instances, the well informed person will opt for the proven therapy that is the standard in traditional western medicine.

 

[PeterG]

I'm not convinced the "well educated" people you speak of are well educated at all. I'd be happy to be wrong if you could provide results of a controlled study that show well educated people (say college level or some advanced degree) are more likely to seek alternative routes to healthcare other than standard care. My opinion is that you are simply making a blanket statement based on anecdotal evidence. Thanks for trying, though.

If you want to read the article check the New York Times over the last couple of weeks.

 

[PeterG]

Scientifically naive? David Healy? Marcia Angell? There is just so much evidence that the practice of medicine is in crisis in North America that only a naive scientifically illiterate person would give much credence to the word of a single medical practitioner. You simply have to check things out for yourself, investigate your problems through the internet, talk with others who are suffering and find the few practitioners who are truly competent.

As for naturopathic medicine it is only intelligent to avoid problems by following a proper diet and keeping healthy. If a few sticks of celery will keep your blood pressure in line why would you spend 200$ at the pharmacy?

 

[Sundarban1]

If you want to read the article check the New York Times over the last couple of weeks.

Hmm. Right, just as I thought.

Let me guess, the atricle starts out like "more and more educated americans are turning their backs to standard medical care..."

Written by A.B Nautropath

 

[Sundarban1]

OK..edit. Viewing the OP's post history now I see where he/she is coming from and want my 5 seconds of life back for thinking you actually had a valid question, not a loaded question. Carry on..

 

[PeterG]

Hmm. Right, just as I thought.

Let me guess, the atricle starts out like "more and more educated americans are turning their backs to standard medical care..."

Written by A.B Nautropath

The simple fact is that Americans are becoming increasingly fedup with their health care system. Given no leadership by the governement they are increasingly turning to alternative means to deal with their problems. Medical professionals can keep their heads in the sand if they wish, but we'll all suffer because of that.

 

[Sundarban1]

Great. Disagree if you like. Bottom line is that unless you can show some evidence of what you are stating as fact, your posts equate to nothing short of whining.

 

[PeterG]

Great. Disagree if you like. Bottom line is that unless you can show some evidence of what you are stating as fact, your posts equate to nothing short of whining.

You weren't even willing to scan the NY times for an article over the past couple of weeks. The article's in there take a look if you like.

 

[scpod]

Recently I have read that in the United States people, particularly the well educated, are turning away from conventional medicine and towards alternative treatment (naturopathy, homeopathy, etc). Could anybody explain why this is so?

Same argument that been seen over and over on SDN. I haven't changed my mind since my last post on the topic, and probably never will.

 

[Sundarban1]

You weren't even willing to scan the NY times for an article over the past couple of weeks. The article's in there take a look if you like.

I have scanned the NY times and see nothing supporting what you claim in your post. Perhaps you can post the link if it exists.

 

[Beau Geste]

I've noticed the OP tends to use the NYT as his source for starting threads of controversy. Not very good evidence.

 

[DragonWell]

David Eisenberg, MD has been studying usage of CAM for at least the last 15+ years - mostly publishing his findings in JAMA.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9820257&dopt=Citation

It's interesting how polarized folks seem to be on this issue. To see allopathic medicine as "evidence based" is ridiculous. Just like "alternative medicine", the majority of allopathic medicine is based on anecdotal evidence, and as such is often revealed to be ineffective or even harmful when rigorously scutinized. Just look at HRT for an example. For 20+ years, it was accepted gospel that HRT reduced the risk of a host of illnesses, all of which made great sense, except when it was finally studied turned out to be completely untrue. In fact, it raised the risk of most of those illnesses. Likewise, Echinacea, one of the most popular, widely used and studied (in vitro) herbs in naturopathic medicine, has proved solidly disappointing is well designed studies. So what's my point? Only this...a little humility and an open mind go a long way - maybe we shouldn't be so quick to jump to one side or another...Oh wait, I forgot..this is SDN. My bad... Flame away!

 

[oldManDO2009]

Just compare the studies;

In "traditional" medicine - medication is developed, used in trials and eventually deemed safe for human use along with a daunting list of side-effect. Bottom line - medication has to prescribed based on its approved usage. Otherwise you are opening yourself up to the mighty machinery of litigation

Herbs - what studies? There may be a few here and there but nowhere near the rigorous approach taken for every medication prescribed here in the US. Bottom line - ND can "prescribe" the medication for whatever he or she deems best - not very scientific.

As for HRT - it is called progress. Many treatments 20 years ago where deemed appropriate and because we continually study treatments we generate new outcomes. It does not make the treatment 20 years ago inappropriate just improve outcomes. It is still prescribed for certain conditions and does not imply that western medicine is a sham and EBM is ridiculous.

Just my 2 cents

 

[PeterG]

David Eisenberg, MD has been studying usage of CAM for at least the last 15+ years - mostly publishing his findings in JAMA.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9820257&dopt=Citation

It's interesting how polarized folks seem to be on this issue. To see allopathic medicine as "evidence based" is ridiculous. Just like "alternative medicine", the majority of allopathic medicine is based on anecdotal evidence, and as such is often revealed to be ineffective or even harmful when rigorously scutinized. Just look at HRT for an example. For 20+ years, it was accepted gospel that HRT reduced the risk of a host of illnesses, all of which made great sense, except when it was finally studied turned out to be completely untrue. In fact, it raised the risk of most of those illnesses. Likewise, Echinacea, one of the most popular, widely used and studied (in vitro) herbs in naturopathic medicine, has proved solidly disappointing is well designed studies. So what's my point? Only this...a little humility and an open mind go a long way - maybe we shouldn't be so quick to jump to one side or another...Oh wait, I forgot..this is SDN. My bad... Flame away!

This is the most reasonable post I've read on SDN by far. Thank you.

 

[PeterG]

David Eisenberg, MD has been studying usage of CAM for at least the last 15+ years - mostly publishing his findings in JAMA.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9820257&dopt=Citation

It's interesting how polarized folks seem to be on this issue. To see allopathic medicine as "evidence based" is ridiculous. Just like "alternative medicine", the majority of allopathic medicine is based on anecdotal evidence, and as such is often revealed to be ineffective or even harmful when rigorously scutinized. Just look at HRT for an example. For 20+ years, it was accepted gospel that HRT reduced the risk of a host of illnesses, all of which made great sense, except when it was finally studied turned out to be completely untrue. In fact, it raised the risk of most of those illnesses. Likewise, Echinacea, one of the most popular, widely used and studied (in vitro) herbs in naturopathic medicine, has proved solidly disappointing is well designed studies. So what's my point? Only this...a little humility and an open mind go a long way - maybe we shouldn't be so quick to jump to one side or another...Oh wait, I forgot..this is SDN. My bad... Flame away!

This is the most reasonable post I've read on SDN. Thank you.

 

[JakeHarley]

Oops, tried to post the article but it didn't all fit.

 

[Sundarban1]

This is the most reasonable post I've read on SDN by far. Thank you.

This is because it inaccurately supports your dubious agenda. That study is almost 10 years old.

The most recent data published in Altern Ther Health Med. 2005 Jan-Feb;11(1):42-9., from the same author concludes, and I quote:

"CONCLUSIONS: The prevalence of CAM use has remained stable from 1997 to 2002."

Neither study makes any mention of significance between use of CAM and educational background. Which leaves us where we began, a blanket statement with no scientific support.

Yes, you're welcome.

 

[DragonWell]

This is because it inaccurately supports your dubious agenda. That study is almost 10 years old.

The most recent data published in Altern Ther Health Med. 2005 Jan-Feb;11(1):42-9., from the same author concludes, and I quote:

"CONCLUSIONS: The prevalence of CAM use has remained stable from 1997 to 2002."



Yes, you're welcome.

I don't support anybody's agenda except my own, which as I stated above is simply that a little humility and an open mind go a long way.

Neither study makes any mention of significance between use of CAM and educational background. Which leaves us where we began, a blanket statement with no scientific support.

Actually, Eisenberg's study found a significant correlation between education and income and CAM use - to quote from the abstract of that study: "The frequency of use of unconventional therapy varied somewhat among sociodemographic groups, with the highest use reported by nonblack persons from 25 to 49 years of age who had relatively more education and higher incomes."

A little more detail: "[The use of unconventional medicine] was significantly more common among persons with some college education (44 percent) than among those with no college education (27 percent; P<0.05) and significantly more common among people with annual incomes above $35,000 (39 percent) than among those with lower incomes (31 percent; P<0.05). Use was also significantly more common among those living in the West (44 percent) than among those living in the rest of the country (31 percent; P<0.05)."

 

[cg2a93]

Do not overlook the "never say die" attitude of the "sCAM" provider. There are many ailments for which either traditional mediicne would be "overkill" (for instance, LBP, which studies have shown - in the absence of serious pathology, resolves on its own as fast as it does with treatment) or where "nothing can be done" (for example, fibromyalgia). Now, you will never hear a "sCAM" provider say "I'm sorry, but there really is nothing effective I can do for you". Nor do they advise lifestyle changes alone (altough they may be needed). Nope - they have a "cure" and they are willing to sell it to you, even if actual medical scientists can't help. A tragic recent example of this is the death of Loretta Scott King who checked into a chiropractic/naturopathic clinic in Mexico to recieve "treatment" for terminal cancer.

- H

The clinic CORETTA SCOTT KING went to in mexico had Medical Doctors as well as alternative health providers. During the eulogy which her daughter so eloquently gave she admonished the media for spouting that tabloid drivel.

 

[FoughtFyr]

The clinic CORETTA SCOTT KING went to in mexico had Medical Doctors as well as alternative health providers. During the eulogy which her daughter so eloquently gave she admonished the media for spouting that tabloid drivel.

Well, their website lists one MD as the "owner" of the clinic, but a "Dr." Kurt W. Donsbach (whose credentials are in question) is listed as "developer" of the therapies the clinic provides. According to their website "There are five doctors (M.D.'s), a radiologist, pharmacist, lab technician, the physiotherapy staff, nurses and nurses-aids, as well as, an extensive kitchen staff, cleaning personnel, laundry crew and the maintenance department" on staff at the "hospital", but every description of therapy or treatment begins with "Dr. Donsbach believes..." or "Dr. Donsbach has developed" or has been created "As a result of the pioneering research of Dr. Donsbach".

In short, while he may have MDs on the payroll (none of whoms' credentials are listed), they are certainly not directing care.

As for "Dr." Donsbach, read this from Dr. Stephen Barrett, a well known "skeptic" who says "I have never met Donsbach personally, but I have examined more than a hundred of his publications as well as depositions, videotaped interviews, and miscellaneous other materials. I know of nobody who has engaged in a greater number and variety of health-related schemes and scams."

I know that it may hurt families to believe they have been scammed. Many continue to defend these quacks because the cognitive dissonace created by the realization of the scam is simply too much to bear. So I put little stock in the substance (with regard to the clinic) of the beautiful eulogy given to Mrs. King.

BTW - The Mexican Government shut the clinic down after Mrs. King's death. Now plenty of celebrities have died at "real" hospitals in Mexico, yet none of them were shut down as a result. If this one was so legitimate, why was it ordered closed?

- H

 

[fang]

I don't support anybody's agenda except my own, which as I stated above is simply that a little humility and an open mind go a long way.




Actually, Eisenberg's study found a significant correlation between education and income and CAM use - to quote from the abstract of that study: "The frequency of use of unconventional therapy varied somewhat among sociodemographic groups, with the highest use reported by nonblack persons from 25 to 49 years of age who had relatively more education and higher incomes."

A little more detail: "[The use of unconventional medicine] was significantly more common among persons with some college education (44 percent) than among those with no college education (27 percent; P<0.05) and significantly more common among people with annual incomes above $35,000 (39 percent) than among those with lower incomes (31 percent; P<0.05). Use was also significantly more common among those living in the West (44 percent) than among those living in the rest of the country (31 percent; P<0.05)."

There is a simple explanation for this and it has nothing to do with more education leading people to choose alternative medicine: it's called "medicaid".

Even if you could prove that the availability of low-cost or free medical services was similar in conventional and alternative medical clinics, it takes some degree of planning and sophistication to seek out CAM places instead of coming to the local ER, which is going to select for higher-income individuals. (this is not meant to be disparaging-- I'd imagine that people who are trying to figure out how to pay rent and eat every month wouldn't be spending much time researching their healthcare alternatives.)

 

[Neunuebel]

http://www.nytimes.com/2006/02/03/health/03patient.html?ex=1141621200&en=0fc4206bc7782b92&ei=5070

Link to the NYT article. You would have to register (free) to view it. This series "being a patient" is excellent, especially the last article on immigrants (both legal and illegal) struggling to recieve medical care.

 

[neuroscan20]

Recently I have read that in the United States people, particularly the well educated, are turning away from conventional medicine and towards alternative treatment (naturopathy, homeopathy, etc). Could anybody explain why this is so?

i think it has more to do with thinking "outside the box." For instance, more and more practicioners are expressing optimism for acupuncture, and more specifically, electro-acupuncture.

here is a link to a couple articles i wrote on this form of "alternative medicine."
"Acupuncture in the Brain"

Updated: "Electroacupuncture"

 

[Josh L.Ac.]

Do not overlook the "never say die" attitude of the "sCAM" provider. There are many ailments for which either traditional mediicne would be "overkill" (for instance, LBP, which studies have shown - in the absence of serious pathology, resolves on its own as fast as it does with treatment) or where "nothing can be done" (for example, fibromyalgia). Now, you will never hear a "sCAM" provider say "I'm sorry, but there really is nothing effective I can do for you". Nor do they advise lifestyle changes alone (altough they may be needed). Nope - they have a "cure" and they are willing to sell it to you, even if actual medical scientists can't help.

- H

How interesting. I'm a sCAM provider that has told patients that I probably couldn't treat them. But you say that sCAM providers never say that...

The topic of the thread is naturopathic medicine, but instead of focusing on the problems with naturopathic medicine (which I discussed on a different thread of this nature), you make a logical fallacy about CAM in general. How delightful.


BTW, there are studies that demonstrate the effectiveness of using sCAM therapies like acupuncture for lower back pain and fibromyalgia. Some fail to demonstrate an effect, but the majority are positive.




My comment about naturopathic medicine (in terms of the amount of training they recieve):

http://forums.studentdoctor.net/showpost.php?p=3473729&postcount=53

I went to acupuncture school at Bastyr University, which some claim is the top ND school. I knew many of the ND students and some of them were in my acupuncture classes (dual degree). In addition, I served on student council for the first two years of school (until I couldn't deal with the whinning anymore) and I heard many of the complaints that the ND students had.

If I had to come up with one major flaw of the ND education it would be lack of a patient contacts. To complete my acupuncture degree, I had to complete 400 primary patient contacts (I do the interview, come up with the diagnosis, design a treatment, perform the treatment, monitor outcomes) which were supervised by a licensed acupuncturist, most of which were OMDs from China with 20+ years of clinical experience.

The NDs had to perform the same number of primary patient contacts. Yeah, that's right. To be a primary care physician in a few states, they had to see 400 patients. To make matters worse, a portion of patients were fellow students that were being treated to facilitate reaching the required number of contacts. Plus, few of the supervisors came close to having as much clinical experience as the acupuncture supervisors.

Acupuncture is done (for the most part) in the context of the patient having a PCP. Most of us don't pretend to be anything more than a mid-level provider to patients with an established PCP. Plus, the chances of having a negative outcome from an acupuncture treatment is almost nil. This is why 400 patient primary patient contacts isn't too much of a concern - although it is one of the reasons why I went to China was to see 30 patients a day.

But NDs seeing patients after 400 primary contacts? It doesn't make sense.


I do feel they provide a useful service, but unless they do a "voluntary residency" or are lucky enough to get one of the few residencies, I don't understand how they can legitmately call themselves PCPs.

 

[DragonWell]

I do feel they provide a useful service, but unless they do a "voluntary residency" or are lucky enough to get one of the few residencies, I don't understand how they can legitmately call themselves PCPs.

Nicely put...That's a large part of the reason I pulled out of Bastyr and am now going DO. The other factor is: how can you call yourself a PCP but not utilize the pharmaceuticals that many patients absolutely need to manage their chronic health conditions like hypertension, diabetes, hyperlipidemia? There is no "natural" treatment that substitues for insulin.

I agree with you that NDs can play a useful role, but the role seems quite limited. Also the debt/income ratio is even more insane than MD/DO. This leads to some questionable ethical practices like NDs selling supplements in their office for profit. Now I see my old classmates advertising "free consultations" and cringe...

 

[Josh L.Ac.]

Nicely put...That's a large part of the reason I pulled out of Bastyr and am now going DO. The other factor is: how can you call yourself a PCP but not utilize the pharmaceuticals that many patients absolutely need to manage their chronic health conditions like hypertension, diabetes, hyperlipidemia? There is no "natural" treatment that substitues for insulin.

I agree with you that NDs can play a useful role, but the role seems quite limited. Also the debt/income ratio is even more insane than MD/DO. This leads to some questionable ethical practices like NDs selling supplements in their office for profit. Now I see my old classmates advertising "free consultations" and cringe...

Wow, if you were at Bastyr during the time I was there (2001-2005) then you might know who I am...I sort of stick out - bodybuilder guy, short red hair and freckles, black-framed glasses. Anyway...

I spoke with some of my ND/AOM friends about the 200% supplement markup. Most were willing to admit it was a problem, "...but you know, with all the loans to pay back, I have to make money somehow".

Reminds me of a great line from a boring movie: "Your principles mean nothing until they cost you something."

I will have a granular Chinese herbal dispensary in clinic in a few months. It is unlikely that anyone in Kansas City will have access to Chinese herbal granules, so I'll need to sell them from my practice. Actually, even if there is a Chinese herbal shop in KC, I would still be a little concerned - most stores offer "free" consultations and then sell you the most expensive herbs they have.

But back on topic. Chinese herbs are cheap, even if they are purchased from a reputable American company that tests the herbs they import. As a result, many acupuncturists sell their herbs at a 200-300% markup and the consumer doesn't complain...which still doesn't make it right. I understand factoring in all of the overhead costs that are caused by buying, storing, and selling the herbs. But 200-300%?

It is odd that the reason that many give for going into CAM - the exploitation of America by corporations and pharmaceutical companies blind with greed - doesn't register when they legitimize making their own profits. Don't get me wrong, I understand the function of a business it to make money...but come on. How is it such a travesty that pharmaceutical companies (and then the pharmacists) mark up the products 200-300% but not when the lowly ND does?

 

[Beau Geste]

Wow, if you were at Bastyr during the time I was there (2001-2005) then you might know who I am...I sort of stick out - bodybuilder guy, short red hair and freckles, black-framed glasses. Anyway...

I spoke with some of my ND/AOM friends about the 200% supplement markup. Most were willing to admit it was a problem, "...but you know, with all the loans to pay back, I have to make money somehow".

Reminds me of a great line from a boring movie: "Your principles mean nothing until they cost you something."

I will have a granular Chinese herbal dispensary in clinic in a few months. It is unlikely that anyone in Kansas City will have access to Chinese herbal granules, so I'll need to sell them from my practice. Actually, even if there is a Chinese herbal shop in KC, I would still be a little concerned - most stores offer "free" consultations and then sell you the most expensive herbs they have.

But back on topic. Chinese herbs are cheap, even if they are purchased from a reputable American company that tests the herbs they import. As a result, many acupuncturists sell their herbs at a 200-300% markup and the consumer doesn't complain...which still doesn't make it right. I understand factoring in all of the overhead costs that are caused by buying, storing, and selling the herbs. But 200-300%?

It is odd that the reason that many give for going into CAM - the exploitation of America by corporations and pharmaceutical companies blind with greed - doesn't register when they legitimize making their own profits. Don't get me wrong, I understand the function of a business it to make money...but come on. How is it such a travesty that pharmaceutical companies (and then the pharmacists) mark up the products 200-300% but not when the lowly ND does?

It is a travesty that Pharmaceutical companies mark up their drugs for huge profit. I don't care if they make a profit, but the consumer shouldn't have to sell a kidney to afford them.

However, this thread is not about the Pharmaceutical companies. It's about Naturopathic medicine. I want to hear a better excuse for markup than "they do it, so I can too".

 

[Josh L.Ac.]

It is a travesty that Pharmaceutical companies mark up their drugs for huge profit. I don't care if they make a profit, but the consumer shouldn't have to sell a kidney to afford them.

However, this thread is not about the Pharmaceutical companies. It's about Naturopathic medicine. I want to hear a better excuse for markup than "they do it, so I can too".

Uh...are you asking me? I just said that the ND/acupuncturists I went to school justified it by saying they needed to pay off their loans. I'm not a ND so I can't tell you what "those people think".



But I do remember another reason that went something like "...well, all other NDs mark their products up from wholesale to the suggested retail price as suggested by the manufacturer. If I sale my products for cheaper, then it will cause friction between me and the other providers in my area." It went something like that.

 

[Beau Geste]

Uh...are you asking me? Reread my post. I just said that the ND/acupuncturists I went to school justified it by saying they needed to pay off their loans. I'm not a ND so I can't tell you what "those people think".

Just think about the overhead the pharmaceutical companies have to pay. Fleecing consumers is wrong no matter how you spell it out.

But I do remember another reason that went something like "...well, all other NDs mark their products up from wholesale to the suggested retail price as suggested by the manufacturer. If I sale my products for cheaper, then it will cause friction between me and the other providers in my area." It went something like that.

When you get specific reasons, get back to us. "Something like that" is not basis for a good argument.

If you sell your products cheaper than anyone else, so what if there is friction? You'll have better business and a better income in the long run.

 

[DragonWell]

I want to hear a better excuse for markup than "they do it, so I can too".

I will have a granular Chinese herbal dispensary in clinic in a few months. It is unlikely that anyone in Kansas City will have access to Chinese herbal granules, so I'll need to sell them from my practice. Actually, even if there is a Chinese herbal shop in KC, I would still be a little concerned - most stores offer "free" consultations and then sell you the most expensive herbs they have.

I was actually at Bastyr in the mid-90's. I think the justification most folks give for retaling is similar to what Josh said - the products they sell are higher quality or not available in health food stores, or if they are available elsewhere and the ND tells the patient to get it themselves, the sales staff of the health food store will "upsell" them a more expensive or different product. Justification for the 200% markup comes into play from the fact that carrying your own stock incurs costs for inventorying, overhead cost of space for storing stock, etc which must be covered in the price of the supplement. It comes down to the personal ethics of the practitioner not to abuse the power differential of the doctor-patient relationship just to move product. I felt one ND I worked for did abuse it - every patient was prescribed "CoQ10 for low energy" and ended up walking out with over 100 dollars in supplements, while other docs work more with diet and lifestyle and "prescribe" much more conservatively.

 

[Josh L.Ac.]

Just think about the overhead the pharmaceutical companies have to pay. Fleecing consumers is wrong no matter how you spell it out.

I don't consider the amount of student loans a person took out in medical school as "overhead" for their medical practice, nor do I think that the amount of overhead that the pharmaceutical companies justifies the prices they charge. But this is off-topic, and I think you believed that I thought this was a legitimate excuse for NDs to overcharge - I don't.

When you get specific reasons, get back to us. "Something like that" is not basis for a good argument.

I'm not really on a mission to determine why NDs mark up their products. I'll offer my experience and provide the details of the conversations I've had with the NDs that I know, but I'm not about to go to my old school and hand out questionaires.

If you sell your products cheaper than anyone else, so what if there is friction? You'll have better business and a better income in the long run.

Agreed. Suggesting that your peers will be upset if you run your business according to your morals is a proper reason for to maintain the status quo isn't the type of argument that puts a smile on my face.






I wasn't attempting to portray this information as some sort of research study by any stretch of the imagination. It's just what I saw when I was at "...the Heart of Natural Medicine".

 

[Josh L.Ac.]

I was actually at Bastyr in the mid-90's. I think the justification most folks give for retaling is similar to what Josh said - the products they sell are higher quality or not available in health food stores, or if they are available elsewhere and the ND tells the patient to get it themselves, the sales staff of the health food store will "upsell" them a more expensive or different product. Justification for the 200% markup comes into play from the fact that carrying your own stock incurs costs for inventorying, overhead cost of space for storing stock, etc which must be covered in the price of the supplement. It comes down to the personal ethics of the practitioner not to abuse the power differential of the doctor-patient relationship just to move product. I felt one ND I worked for did abuse it - every patient was prescribed "CoQ10 for low energy" and ended up walking out with over 100 dollars in supplements, while other docs work more with diet and lifestyle and "prescribe" much more conservatively.

Another example I heard about was "everyone gets a B-12 shot" for low energy.

I think part of it is the desire to try out new treatments. Another part is the "...I need to at least give the patient something for coming in". And of course, part of it is about the extra income.

If I really had the spare time and the desire to recieve hate messages, I would send an email out to all the Bastyr ND students about this practice and how they justify it....hmm...

Hey megboo, in my post where I wasn't interested in handing out questionaires...uh...I might change my mind. We'll see.

 

[Beau Geste]

I definitely consider a medical school loan to be part of overhead, whether it be for private practice or for personal debt. It's an investment into the career and an expense (liability) just like paying wages, mortgage/rent for office, supplies, etc.

But that's not important in this thread.

Anyway, I was just responding to something in you other post that rubbed me the wrong way.

Carry on.

 

[DragonWell]

In fairness to NDs and other licensed CAM providers the scale of potential ethical abuses from selling supplements is probably laughably miniscule compared to the widespread practice of pharmaceutical companies "educating" doctors about their latest and greatest drugs...over a $100 meal, or while on a golf course in Acupaulco. The courting of doctors by pharmaceutical companies is so incidious and widespread it almost seems normal, yet although the nostrums being peddled are different, the end result is much the same - a personal reward is recieved in return for a particular prescription.

 

[Vox Animo]

Recently I have read that in the United States people, particularly the well educated, are turning away from conventional medicine and towards alternative treatment (naturopathy, homeopathy, etc). Could anybody explain why this is so?

Because people are stupid. That's why everyone does anything, cause they are stupid.

 

[eleventh]

Some homepathic medicines worked for me just fine and didn't produce any side effects either (ear medicine) and some weren't worth a penny. One time... The vile told me two things. It will help clean the cause of my symptoms not just supress them, hence a "cure." And if I take in a lot of caffine it wouldn't do a thing. I'm addicted to caffine, which doesn't help me out a lot, so I didn't see anything tangible from the "meds" for the first month. I took it again and only had black tea every other day for a week, instead of my usual two coffees and a mocha a day. It helped. Something helped. I stopped all caffine for the next month and took my life energized pills of nothing. Did the homeopath work? Not really. It was the fact that I wasn't running on caffine that made the difference in my book.

Am I convinced that homeopathic medications can't work? No, that's not the case here, but my experiences speak for themselves, to myself anyway. However, I don't think "alternative medicine" was always alternative. It's probably worked in the past for many ages. In fact, I personally know a lady who treated her breast cancer with ONLY acupuncture, magnet ummm therapy and some other natural product that I forgot the name to. Her cancer has been gone for years. I have also heard (don't quote me on it though) that the English Royal family only uses homeopathics... if true, that's quite something really. One would think such money would buy only the best in scientifically designed drugs.

My theory? Our minds and thoughts have great strength. Our faith in those thoughts are the most powerful. They can cure and make sick. This is why allopathic drugs work best for me and most people for most problems IMHO. I KNOW that they do the job they're supposed to do because the evidence that's there. That is where my faith in them comes from. That is why they work.

With that said I think we still have way too much drugs in us as a civilization.

 

[thedman888]

interesting article on ND

http://www.livescience.com/humanbiology/naturopathy_license_041118.html

 

[Josh L.Ac.]

interesting article on ND

http://www.livescience.com/humanbiology/naturopathy_license_041118.html

I have mixed emotions about that article. Yes, naturopathic doctors should not be considered PCPs until their clinical education improves by leaps and bounds. But licensing them as a mid-level provider working via referral might be a better plan.

One of the arguments for licensing NDs is that it allows the state to set a minimum level of education required for a person to call themselves a ND. Many on this site probably doubt the level of training at the ND schools in the nation, but hey, we probably could all agree that they are better than mail-order degrees. That's right, you can become a ND via correspondence courses (in some states). But if a state licenses NDs, that usually excludes the mail-order folks...I think the trial of the ND that killed his patient in Colorado was a mail-order ND.

As far as the NDs ignoring modern biomedical research, that is a mixed pattern; some do, some don't.

I will have to go into this more later since my son just woke up.

 

[Microbiology_zombie94]

Okay I am only a high school graduate who flunked out of a (crappy) college though I plan to enroll in a medical assistant program through Penn Foster but anyways I did extensive research into medical education. Honestly I think that before someone can be allowed to enter an ND program they should have a Masters of Physician Assistant Studies (or any PA program) and be licensed so they have the actual education of mainstream medicine.

 

[GH253]

While I don't want anyone to mistake me for a fan of naturopathy, the most plausible reason for its increasing popularity is widespread dissilusionment with mainstream medicine.

 

[Instatewaiter]

I would like to draw attention that someone necrobumped a 10 year old thread. Seriously people. Stop doing these things.