I was not going to write about the recent “Naturopathic Chat” forum leak. But then, while having dinner tonight, I had a dark thought: What if my hypothetical naturopath (or real doctor) were talking about me, my medical history, family, and other personally identifiable information in a web forum with a readership of 3,300 members? And what if this so-called private venue had a known spy–someone who was lurking, reading, and sharing these posts with others across the Internet?
If you are a naturopathic patient, the likelihood that your naturopath is chatting about you online is high. You are at risk of being a victim of a HIPAA violation.
The patients of real doctors, that is medical doctors, do not need to worry as much, if at all, about this kind of regular breach of privacy because chatting online about patients is considered highly unethical and is vehemently discouraged by any legitimate medical profession. For naturopaths, however, who have little sense of what is ethical, let alone legal, online forums are places where they engage in melees of transgression and ineptitude.
A brief background: the online behavior of naturopaths
A few online venues exist exclusively for licensed naturopaths. I used to be a member of three Internet groups: two on Facebook (largest one here) and one on Yahoo! groups called Naturopathic Chat, or “NatChat” for short. All three require proof of being a naturopath who graduated from one of the CNME-accredited programs in order to join. Membership requires one to show some combination of a state license number, date of graduation, and name of alma matter. These groups serve as places of “safe haven” to share clinical pearls (meaning, knowledge about treatments gained through experience) and to pose questions about anything related to naturopathic medicine.
When I decided to leave the naturopathic profession, I removed myself from these groups. No one asked me to leave, as I had not yet publicly debuted my blog or my new and improved views on naturopathic education and practice. None of my former friends and colleagues knew I was planning to start a blog. (It was a rather spontaneous decision.) I removed myself from these groups as a professional courtesy. I did not take any information with me when I left. I never even thought to do so. At the time, I knew having such information would be tempting to use against the naturopathic profession in political efforts (like seeking loan forgiveness), and I chose not to tempt myself. I remember thinking that I had enough fuel for the fire.
The thing is, there is a “spy” in the NatChat Yahoo! group. I become aware of this sometime at the end of 2014, when I read a post by David Gorski on ScienceBasedMedicine.org where he discussed information that was leaked on Reddit. (This was about six months before I started this blog.) After reading Gorski’s post, I immediately thought that I would soon be accused of being the spy. Sure enough, I am the number one suspect.
I don’t care about this so much. It’s rather silly. Even sillier, they accuse me of being employed by ScienceBasedMedicine.org because I have written guest posts there. Sorry NDs, ScienceBasedMedicine.org is just a popular blog run by a group of welcoming and accomplished professionals, whom I am glad to consider my supporters in advocating for better medicine through science. Such flimsy allegations demonstrate the inability to exercise even the most basic deductive reasoning. The chronology of the leaks and me voluntarily removing myself from NatChat and the Facebook groups just do not make a compelling case to indict me.
Having said that, what bothers me the most about the NatChat leaks is that naturopaths display an utter disregard for preserving patient anonymity. Now that I am aware of how other medical professionals conduct themselves, naturopaths seem entirely in violation of health privacy laws. The naturopaths in this online forum know, for certain, that someone is sharing their messages. And yet, they continue to ask questions with inappropriate details that can lead to compromising the identity of those under their care.
Take for example, Daniel Smith, ND from Medford, Oregon. He writes in NatChat:
46 year old woman presents to clinic with fatigue, adrenal exhaustion and hypothyroidism. We have worked extensively to support her digestion and immune system and adrenal glands. These are now well supported. She is quite happy with the change. She has been helped the most with adrenal supplements, and these along with Thornes thyrocsin have helped her make strides. She now is able to function at her high stress triple A job without utter exhaustion. She is still “wiped out” at 9 pm, but at least not at 4 pm anymore.
He goes on to provide all of her lab results, imaging results, a detailed family and personal history, and current list of medications.
Not surprisingly, the first treatment recommendations given by his fellow NatChatters include a gluten-free diet, a “blood-type diet,” and IgG food allergy testing. Because when in doubt, any good ND must recommend dubious diets and hope for the best, right? Not to mention, he thinks she has adrenal fatigue, which is a fake disease commonly diagnosed by NDs to tirelessly sell bogus nutritional supplements. If there is one saving grace about the NatChat leaks, it is showing the world how grossly deficient naturopathic medical training really is.
Generally, a high-degree of incompetency
I am often accused of throwing the baby out with the bathwater because I have allegedly taken a few bad experiences and mischaracterized the entire ND community. Supposedly, there are some “good” naturopaths out there.
Yet, I believe I have been understating the level of incompetency of naturopathic “doctors”. Here is a zinger. Emily Longwill, ND from Ventura, California asks the NatChat group:
I have a patient who I am concerned has leukemia. I have never made this diagnosis before and am looking for guidance. This patient is un-insured and not interested in seeing a MD unless absolutely necessary.
WHAT? This makes me so angry! I cannot even be tactful here. WTF, Emily? You are concerned and not sure what to do!? Guidance needed!? Is the suspicion of cancer not considered “absolutely necessary” to refer out!?
After “Dr.” Longwill reports she had previously treated the patient using chelation therapy for lead, mercury, or thallium, she goes on:
I am considering ordering flow cytometry/immunophenotyping versus going straight to bone marrow biopsy. Any suggestions for other tests or things to rule out?
The answer is “welcome to not being a real doctor, Emily”.
Thankfully, Mona Morstein, ND (the moderator of NatChat) picked up on this irresponsibility:
I would call a hemotologist [sic] for case discussion and possible referral. I’m not sure why it’s come about that NDs feel they have to [sic] everything with patients, especially when the situation is new to them, and not seek helpful discussions with MD specialists in that field.
But Mona, why is this a case for a possible referral? Nice try.
Beside the obvious incompetence, I selected this leak in particular for one other reason. I am from Ventura County, California. I have friends and family there, some of whom might consider visiting a naturopath for medical advice, as much as this makes me want to cringe. This is a serious, potentially life-saving warning to my loved ones back home (and anyone, anywhere): Never see a naturopath. Especially one named Emily Longwill.
Too much sharing, not enough caring
It has been pointed out to me that no other professional group–medical doctors, psychologists, nutritionists, etc.–runs secret social media chat rooms that encourage the discussion of their patients. This is for good reason. It is breach of privacy, and it is unethical. Shame on naturopaths for putting their patients’ privacy at risk.
Now, tragically, this information is public, available on pastebin for all to see because NDs setup an unsecured venue which made the leak possible in the first place.
If you are a naturopathic patient, be warned, your naturopath has probably talked about you on the Internet. Maybe she has even discussed some of the most intimate aspects of your body, like Melanie Whittaker, ND from Stanwood, Washington who got her ND from Bastyr in 1992:
Did a routine pap recently on a new patient. There was a really excessive amount of mucus/exudate that I thought was coming from the cervix. Cultured and checked for all diseases and it came back normal vaginal flora. Patient is now HPV hi risk positive-she says no one has told her this before. She gets paps yearly usually and she is in her 50s.
Patient only has noticed sometimes a different odor. The discharge had no odor. I figure with that much discharge she could easily have odor sometimes.
I don’t know what to do about helping decrease this discharge and I really think that needs to happen.
The patient does not seem bothered by this “symptom.” Only Melanie, who clearly has not done enough paps to understand the variation possible in the amount of vaginal mucus. So she decided to talk about it on the Internet. It is also unclear why Melanie decided her patient was now considered to be high-risk for HPV, to the dismay of her patient. This is yet another demonstration of how naturopaths are dismally trained leading them unable to perform common primary care procedures. This is shameful.
Dear medical doctors, don’t be a naturopathic puppet
Naturopaths often use medical doctors to order labs or write prescriptions for their patients. This needs to stop. It is happening frequently, and it is dangerous. In fact, just today, the Royal Australian College of General Practitioners advised that doctors deny patient requests for unnecessary tests suggested by their naturopaths. (Sorry, the link is behind a paywall, but Google cache still has it available.) I could not agree more with the RACGP warning.
Medical doctors need to know that they can play right into the hands of under-trained pseudo-doctors, who do not even know what to do with the information that is ordered on their behalf. It is a waste of time and money, and, in some cases, might be practicing medicine without a license. This is how naturopaths can skirt around medical practice acts that are meant to prevent under qualified individuals from causing harm.
Dear real doctors, Please stop helping naturopaths break the rules and contributing to increased health care costs and greater patient harm.
Here is a great example of the pure malfeasance of one such naturopath. Mychael Seubert, ND, from the unlicensed state of New York shared how easily it is to get medical doctors to help him avoid the problem of not actually being licensed to practice medicine in his state:
This is my first posting for help on a case and appreciate and help you can provide. I had a complicated case on Friday and this is a long posting. I am in an unlicensed state (NY), but have an MD that will run pretty much whatever labs I recommend in this case.
Seubert goes on for another 1200 words, detailing anything you could really ever want to know about his patient. He starts off with
A 52 yo Caucasian Male (Greek) presented with a CC of Chronic Kidney Disease (Stage 4 Polycystic Kidney Disease) and his main symptoms he suffers from are fatigue, light twinges in his lower back, and erectile dysfunction/low testosterone. Kidney dysfunction was first discovered about 8 – 9 years ago. He states he has also been diagnosed with bipolar disorder since 1979.
Someone should report this jerk to the New York state medical board.
Helping others break the law
Besides the egregious violation of patient privacy, there is another terrible thing about this Internet forum. Naturopaths seem to be using it to help each other break the law, not just dance around state licensing technicalities.
Regarding Iscador, a beloved naturopathic cancer “treatment” derived from the herb mistletoe, Kristen McElveen, ND says in one NatChat post,
I really miss it [Iscador] now that we can’t get it (legally) here in the states. I had a great response with a stage IIIb melanoma patient who is still cancer free after 3 yrs, with only 1 yr of Iscador before the FDA stopped shipment in the US. He did no other conventional treatment other than his initial surgery of the lesion and 4 lymph nodes, so hard to say if they just got it all, or if it was a combo. Still, I loved using it.
Not legal? No problem? Hana Roberts, ND asks,
Where are people getting it now that it is illegal in the US? I would like to start using it.
Yes. You read that correctly. She is asking how to obtain an illegal medication to use in her practice.
McElveen responds,
I was told to call a Canadian pharmacy and have them unofficially send me some, or find an ND willing to send it to me.
Fortunately, McElveen has a wee-bit of a moral compass and states that she is uncomfortable going through with this process. But we know very well that other naturopaths seem to have no moral qualms about importing non-FDA cancer medications and administering them to terminally ill cancer patients.
NDs, you are your own mole
Dear naturopaths, I am not your mole. But frankly, I don’t care if you continue to suspect me. While you are worrying about me, your patients will still suffer as you insist that you are capable of doing things that are just not possible given your training and belief in the ridiculous philosophy that is naturopathic medicine. The truth about naturopaths is beginning to sink in.
As long as naturopaths continue to share information in online forums, there will be spies and leaks. NDs have already shown the public that they should not be trusted nor counted on to act as legitimate doctors. Except to a small proportion of diehard patients who will choose nothing but alternative medicine and, sadly, a number of legislatures who readily buy naturopathic talking points that they “treat the root cause of disease,” naturopaths are on a path to discredit themselves. The naturopathy leaks perfectly reinforce the fact that NDs are not medically qualified and are only poised to cause more harm than good.
My job just got a little bit easier. Thanks!
Oh, now they really are going to love you! Interesting, that AMA HIPPA document. Looks as if state attorney generals can enforce the law? Also “The DHHS Office of Civil Rights (OCR) enforces the privacy standards” ? So that would be the federal agency to get the attention of on this issue? Sadly, I see HIPPA creates no right of private action. I think those who have had their privacy violated (as well as receiving poor care) should not have to rely on some agency getting motivated.
They’re not just discussing patients in private forums but all over social media. I’m connected to a TCM/acupuncturist on FB who maintains personal and business accounts with little separation between the two. His personal account ‘friends’ include friends, relatives, fellow practitioners and clients and he regularly posts clinical vignettes where it often isn’t too difficult to work out who he is discussing. He, and fellow pracs, routinely dispense advice to friends and followers via FB too.
I think there’s also a separate but related issue concerning the ethics of treating friends and family. For this guy, a significant portion of his client base is socially connected to him and it’s not unusual in his scene. I recall him recently completing NLP training and scouting for friends and family to ‘practice’ on! Aside from NLP being widely discredited, I wondered about the ethics of a newly minted, unsupervised ‘counsellor’ delving into the psyche of potentially very troubled people he also has a real-life relationship with. Most CAMmers I’ve encountered, whether part of a ‘regulated’ modality or not, seem to have very blurred boundaries and very little awareness of or concern about these issues.
Yup- it’s essentially a cult.
Incredible. An example how privacy is guarded within the medical world. The Cancer Genome Atlas is a repository of samples from patients with various cancers, it is in fact THE best repository of this sort and very important for research. In order to get for instance rawdata dealing with somatic mutations one has to fill out an application detailing how the data will be used, for which purpose, etc. and most of all. NOT TO PASS THEM ALONG TO *ANYBODY*. The reason is that based on the mutation pattern the patient could theoretically traced down. If I would do such a thing with a customer (I run a company doing computational biology (putting -omics data into biologic context) and development of in vitro tests) the customer would ask me Thomas, are you gone completely mad ?
Given the essential character of naturopathy as a practice of zealots – right down to the unethical lowliness of importing banned drugs with no established efficacy – none of this is surprising. Believing their own bullshit, naturopaths are a danger to the public and those who would knowingly or unwittingly become involved in their deviousness. A number of physicians have told me that they refuse to authorize any and all tests requested by naturopaths in order to avoid what could easily amount to collusion in both the mistreatment and misdiagnosis of patients. When one comes to understand the ineptitude of naturopaths, it becomes apparent that physicians are not refusing out of a battle of egos, but to first do no harm.
Given the essential character of naturopathy as a practice of zealots – right down to the unethical lowliness of importing banned drugs with no established efficacy – none of this is surprising. Believing their own bullshit, naturopaths are a danger to the public and those who would knowingly or unwittingly become involved in their deviousness. A number of physicians have told me that they refuse to authorize any and all tests requested by naturopaths in order to avoid what could easily amount to collusion in both the mistreatment and misdiagnosis of patients. When one comes to understand the ineptitude of naturopaths, it becomes apparent that physicians are not refusing out of a battle of egos, but to first do no harm.
Thought just occurred to me that HIPPA might not apply to some of these wanna be doctors. It applies to the medical profession, right? I wonder what the threshold is, given a lot of sCAM flies below the radar, where people are unlicensed, outside of the real medical system.
I’m pretty sure that in any state where an ND is licensed, they are legally bound to adhere to HPPA standards. Getting their regulatory boards to notice means filing a complaint and its not hard to do. I wonder if any of the boards would follow through and investigate.
I’m pretty sure that in any state where an ND is licensed, they are legally bound to adhere to HPPA standards. Getting their regulatory boards to notice means filing a complaint and its not hard to do. I wonder if any of the boards would follow through and investigate.
Unfortunately, while a ton of lip-service is paid to HIPPA, sanctions for violating it are extremely rare & never seem to be more than a “slap on the wrist.”
The real shit show is the ‘private’ Facebook page. Pt photos, demographics, mthfr/sibo worship. natchat is so myspace compared this page.
Are you the mole??? 😉
no. whomever the mole is, i haven’t seen much impact on the ‘profession’ or awareness to the underlying concerns, mostly yarnell and well you bashing. i was a couple years ahead of you; but you know the vibe and type of people in this group, accept every idea except the ones criticizing your own. i wish that more state DOH and more specifically insurance agency paying attention to what is being done in these offices and outside these offices in order to really into action ways to stop it. speaking with some 1st/2nd yr students about options other than ND your name gets mentioned more than pizzorno/hibbs/jones/bastyr…so maybe it is starting to shake that ‘foundation’ at st. ed’s.
no. whomever the mole is, i haven’t seen much impact on the ‘profession’ or awareness to the underlying concerns, mostly yarnell and well you bashing. i was a couple years ahead of you; but you know the vibe and type of people in this group, accept every idea except the ones criticizing your own. i wish that more state DOH and more specifically insurance agency paying attention to what is being done in these offices and outside these offices in order to really into action ways to stop it. speaking with some 1st/2nd yr students about options other than ND your name gets mentioned more than pizzorno/hibbs/jones/bastyr…so maybe it is starting to shake that ‘foundation’ at st. ed’s.
OMG. That leukemia one. It reminds me of when an unlicensed midwife crowdsourced how to manage a post-dates pregnancy with an amniotic fluid of 0 on Facebook. The baby ended up dying. The whole sordid tale is here: http://www.skepticalob.com/2014/02/jan-tritten-crowd-sources-a-life-or-death-decision-and-the-baby-ends-up-dead.html
That sounds horrific.
It was horrific. It was terrible. He was one of far too many babies that have died at the hands of the uneducated midwives whose religious-esque beliefs around birth end up precluding education lest they somehow circumvent the innate intelligence of the birthing process or some bullshit. Reading about the deaths is rage inducing. Terrible. Anything other than CM or CNM is dangerous and even then since home birth isn’t integrated into the hospital system in any way, home birth in general is more dangerous than it needs to be. And on top of that lack of oversight and malpractice insurance means even CNM/CM and sometimes even MD end up letting women who have no business doing so deliver at home. Basically anything other than lowest of low risk, including premips and hbac, is high risk in this environment.
keyword: unlicensed.
Does it actually matter? Both do not get a real medical training.
Actually some do. http://www.amcbmidwife.org/amcb-certification/why-amcb-certification-
Opps, I thought the issue was unlicensed v. licensed NDs!
Everyone makes mistakes. 🙂
I don’t know what exactly in those midwives certification programs so I am not the best to make a judgement on them so if you would like to know more you will have to ask an expert.
I’ve been learning a lot more about direct-entry midwives, since their regulation is up for renewal here. I just wrote a whole long post and then realized you can probably find a decent wikipedia article that’s as good of, or better source than I am.
Like NDs, I’m afraid they don’t know what they don’t know, and inflate the value of the experience they have.
Well, a lot of us don’t know what we don’t know, but thankfully, my ignorance doesn’t put someone else’s life at risk.
Bastyr recently bought up a low-quality Seattle midwifery school.
So direct-entry midwives are crap.
“A direct entry-midwife can also become what is known as Certified Professional Midwife (CPM), although, in my view, the use of the term “professional” is misleading here. Their education and training can be minimal.” (https://www.sciencebasedmedicine.org/oregon-health-plan-will-cover-only-low-risk-births-planned-for-home-and-birth-centers/#more-39922)
So it appears only the Certified Midwives and Certified Nurse Midwives are safe.
Where is that post? Link plz.
They said “unlicensed”, no need to say it again to defend midwives.
Nothing wrong with defending real midwives–as in CNMs.
keyword: unlicensed.
Respectfully, Britt, I recommend that you avoid using the term “naturopathic medicine” and simply call it naturopathy. It isn’t medicine.
And, while I’m in “critical mode,” I’d also call naturopathic practitioners “naturopaths” since they aren’t doctors of anything.
Just sayin…
Tag her @britthermes or email
That’s not the right tag, FYI.
Geez, how am I being continually surprised with just how bad naturopathic training and ethics are??
I just read that case where the 18yr old had a fever of 104 for a week.
Further down in the chat, Ian Bier says
“Fevers are an essential part of the immune response and are perfectly safe up to about 106. ”
106?? ! I’m not a medical person–can’t you get brain damage or go into a coma when a fever gets that high?
This is one of those ‘grain of truth’ situations that are so prevalent in CAM. Fever is a part of our defences and there is a real question as to whether pyrexia per se is a valid target for treatment. There are some really good posts at ScienceBasedMedicine on the topic. But really high body temperatures can indeed be damaging. And here is the problem. If you commit yourself or your child to the care of someone who is inflexibly committed to letting disease follow its natural course then you cannot hope that they will intervene or seek competent medical care for you when things go wrong.
Much of what CAMsters treat is trivial and/or self-limiting, which allows them to think they are practising effective medicine. But, the wheels come off if they are faced with serious disease. They are incompetent to recognise it and predisposed to persist in their useless interventions, which risks disease progression to a point where outcome is seriously compromised.
HIPAA privacy rule: “The Privacy Rule protects all “individually identifiable health information” held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral. The Privacy Rule calls this information “protected health information (PHI).”12
“Individually identifiable health information” is information, including demographic data, that relates to:
the individual’s past, present or future physical or mental health or condition,
the provision of health care to the individual, or
the past, present, or future payment for the provision of health care to the individual,
and that identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual.13 Individually identifiable health information includes many common identifiers (e.g., name, address, birth date, Social Security Number). ”
Discussing patient cases without identifiers for the purpose of treatment and education fits within the rule. If you are concerned with patient safety, I wonder why publishing the case information on your blog on this sponsored link is helpful?
Talia, this ND gives the complete medical record including age, smoking habits down to the brand this patients prefers (which is completely unrelated to the case) It would be very easy to identify this patient, therefore this is a clear violation of HIPAA.
Read the damn post.
‘If you are concerned with patient safety, I wonder why publishing the case information on your blog on this sponsored link is helpful?’ Why are you saying that to @badlyshavedmonkey? Message that via email to the author of the article.
HIPAA privacy rule: “The Privacy Rule protects all “individually identifiable health information” held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral. The Privacy Rule calls this information “protected health information (PHI).”12
“Individually identifiable health information” is information, including demographic data, that relates to:
the individual’s past, present or future physical or mental health or condition,
the provision of health care to the individual, or
the past, present, or future payment for the provision of health care to the individual,
and that identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual.13 Individually identifiable health information includes many common identifiers (e.g., name, address, birth date, Social Security Number). ”
Discussing patient cases without identifiers for the purpose of treatment and education fits within the rule. If you are concerned with patient safety, I wonder why publishing the case information on your blog on this sponsored link is helpful?
I think slight to medium fever is not a valid target for treatement per se since it very likely activates the immune system. Normally fever does not exceed 40.6°C (105F) and Brain damage may occur from 42°C (107.6F) onward. The problem with fever approaching 105, 106F is treatment options begin to narrow and the therapeutic margin becomes thin. aside that, having fever that high for a week points to some serious illness.
I think slight to medium fever is not a valid target for treatement per se since it very likely activates the immune system. Normally fever does not exceed 40.6°C (105F) and Brain damage may occur from 42°C (107.6F) onward. The problem with fever approaching 105, 106F is treatment options begin to narrow and the therapeutic margin becomes thin. aside that, having fever that high for a week points to some serious illness.
Then
Hmm…let’s think about that for about a nanosecond to decide whether the extensive surgery was solely responsible for an extended remission or whether mistletoe made any contribution.
“I had a great response”.
That, folks, shows the essential flaw in the approach to evidence of all CAM.
I can guess why.
It the comments were posted on someone’s personal page, I would agree that it would be concerning. However, these comments were posted on closed groups set up for the purpose of discussing cases, and where the group rules state that the material is not shared outside the group. Additionally, they do not violate HIPAA as posted. MDs, DOs, ARNPs also have these groups and discuss cases in a similar fashion, which I happen to know from personal experience. Finally, if you truly had cause to believe that these excerpts violated HIPAA, then you should not be posting them either.
I taught Clinical Ethics modules to naturopathic students. Whether I was qualified to do this is questionable, but I had a basic knowledge from my Master’s program. I studied hard and managed to convey essential concepts, current/relevant issues, and a framework for ethical decision-making which strongly advocated for consultation. We covered confidentiality/HIPAA in some depth (yes, in licensed states HIPPA applies to ND’s). I assigned recent articles discussing patient privacy issues related to social media and other electronic communication. Maybe I prevented a handful of those students from joining these online forums. I now regret deeply that my course wasn’t focused on how inherently unethical most naturopathic “diagnostics,” treatments, and practices are. I recall touching on this issue when discussing informed consent. I explained to students that when you describe a test or treatment option to a patient, you must let them know whether the test or treatment has been proven (or to what degree it has been studied). Unfortunately, we never took the time to examine how if this level of informed consent were actually done, as it should be, the whole of the naturopathic practice would disintegrate. I believe MDs/DOs/NPs etc and mental health professionals like myself can do better in this aspect of informed consent as well. But if we do better at this, we will probably just have more informed patients/clients, and maybe better outcomes. If ND’s do better at this, their whole sham falls apart. Except that some patients will not care about the science at all, because they are glamoured by magical tradition, which is a terrible tragedy.
What was your impression of ND students from your experiences? Do you think they are qualified to be physicians?
I should add the obvious: offering treatments not backed by any science is called “experimenting.” It requires IRB approval, not an ND license.
Or… the ND who suspected leukemia in an uninsured patient and then sought consult among colleagues was able to refer this person for treatment in time, who, we can only speculate, would not have otherwise gone to a doctor.
Or… the ND who suspected leukemia in an uninsured patient and then sought consult among colleagues was able to refer this person for treatment in time, who, we can only speculate, would not have otherwise gone to a doctor.
Have you read the entire post ? Apparently not. The patient clearly has massive health problems for a longer time and has been treated by chelation therapy (another therapy of highly dubious value) instead of being referred to a real doctor.
Suspicion of leukemia clearly requires immediate referral for diagnostic confirmation and treatment. However, it’s not even clear to me (as an MD, but one who does not treat leukemia) that the symptoms described point to a likely leukemia diagnosis. The patient is described as gaining weight, not losing weight as I would expect. Fever, pallor of skin or eyes, or lymph nodes enlargement visually or on palpation are not described. The scattered lipomas (assuming they actually are lipomas) don’t fit with a leukemia picture either, although someone with, say, neurofibromatosis causing scattered lipomas could certainly develop leukemia as well.
Second, the blood work does not really look very abnormal. At my center, the lower limit of the normal range for platelet count is 150 and for Hb is 14.0 — this patient is barely below this range. WBC of 13.9 with 79% neutrophils is higher than normal, but well within what could be expected for someone with a simple infection (respirator, urinary, or otherwise) or taking steroid or other types of medication
Now, I have not assessed this patient, so there may be other clinical signs that point toward a possible leukemia diagnosis. And I do not know what this patient’s baseline blood work looks like. And any suspicion, textbook or otherwise, requires further workup by a competent professional and referral for treatment decisions.
However, I don’t think this is even a slam-dunk leukemia diagnosis, to begin with. Which would be another factor against this ND’s ability to manage patients in a primary care setting.
“Possible referral” POSSIBLE
not
OMG get that person to a MD.
If these are your words, Talia, http://www.taliand.com/2012/01/12/what-is-homeopathy/ then you are already showing a very poor start to any debate concerning medicine, ethics, or science. Homeopathy is a scoundrel in all of these topics.
Ok. This is a reply to a certain student of naturopathy called cam who comments here. Feel free to copy and paste this comment to her/him/ them when they show up.
Naturopathy is the study of crystal healing and only crystal healing. I do not care about references. I don’t need any references because I’m cam and naturopathy is what I define it as. Who cares about what the governments(https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/naturopathy)(http://www.health.gov.au/internet/main/publishing.nsf/content/0E9129B3574FCA53CA257BF0001ACD11/$File/Natural%20Therapies%20Overview%20Report%20Final%20with%20copyright%2011%20March.pdf [page 111]), associations of naturopaths say (http://www.anpa.asn.au/index.php?option=com_content&view=article&id=110&Itemid=298) and universities say (http://handbook.westernsydney.edu.au/hbook/course.aspx?course=4597.2). I AM CAM AND WHAT I SAY IS TRUE BECAUSE I WAS TAUGHT THAT IT WAS TRUE.
Ok, enough with the sarcasm because I made my point.
Listen here Hermes actually graduated from her course of naturopathy so naturally she knows more about naturopathy than you.
Firstly the denial of pseudoscience in naturopathy seems common among naturopaths. See (http://skepdic.com/comments/natpathcom.html) As you can see naturopaths are good at claiming that they practice science-based medicine but they don’t all. Only some,
That some does not include you, cam. You are not science-based. I have seen your pseudoscience comments on how you will treat patients. Less pseudoscience than homeopathy but still pseudoscience like boosting the immune system. (http://www.abc.net.au/health/features/stories/2015/07/22/4277927.htm) Seriously stop boosting the immune system. Now you must renounce most of the herbal supplements you were probably taught to boost the immune system. I’m waiting.
First on becoming science-based, admit that naturopathy and naturopaths are full of pseudoscience. Come on Sam Homola managed to admit that most chiropractors and chiropractic itself is riddled with pseudoscience.
Second, doubt everything you have been taught. Like listen to the commenters here.
P.S: ” Naturopaths can use conventional medicine as part of their practice, but this tends to occur only when its use aligns with the naturopathic belief system.” (https://www.sciencebasedmedicine.org/australian-review-finds-no-benefit-to-17-natural-therapies/)
“Having reviewed the approaches advertised by naturopaths, I looked to the literature: Is there any published evidence naturopathy offers anything beneficial? There is some published evidence, but the results are disappointing. Some studies try to evaluate “naturopathic” counselling.What’s not clear is if there’s anything uniquely naturopathic to this advice. Diabetes treatment guidelines emphasize that care must include multiple professionals and be patient-centred. Moreover, counseling on diet and exercise is hardly naturopathic – it’s core advice in conventional treatment guidelines. Whether naturopathic management of diabetes has any beneficial effects remains unclear.”
(https://www.sciencebasedmedicine.org/naturopathy-vs-science-diabetes-edition/)
The issue of naturopathy is that it is a mix of conventional medicine and alternative medicine. Which is why using the conventional medicine side of naturopathy to prove naturopathy science-ness is not going to convince anyone that naturopathy is science-based till pseudoscience is eliminated from naturopathy.
Face it your course is full of woo.
NOTE TO THE MOLE: if you are reading this then you should have leaked the information to an news agency via at least HTTPS not spread patients’ sensitive across the internet.
e.g Vox
http://www.vox.com/contact or just a specific journalist that would most likely be interested like http://www.vox.com/authors/julia-belluz
e.g The Guardian
https://www.theguardian.com/info/1999/nov/22/contributors-guide-and-contacts
http://www.theguardian.com/profile/melissa-davey or http://www.theguardian.com/profile/michael-marshall
They still can! Go mole, go!
I love love love the picture at the head of this article! Such a perfect fit!
Britt-
I cannot commend you enough for this blog! Keep up the good work!
I’d love for you to please write about all the naturopaths (not just the so-called “doctors”) who acquire online “degrees”, then set up specialized nutritional counseling websites and sell their own lines of unregulated supplements. This has become a real problem in the US and I’m not sure how it can be stopped. These people have no backgrounds in the medical sciences. They’re making stuff up and people are buying it…so sad!
Have you read “Trick or Treatment” by Simon Singh and Edzard Ernst? A great read! You should write a book like this.
NDs dont get online degrees. Check your facts before you rant.
Who’s ranting? I’m stating what is happening in the real world. Two people that I know obtained online “naturopath degrees” (from the now defunct Clayton College and the Institute for Integrative Nutrition) in less than a year with no bio-med backgrounds. Do you really think that they should be giving nutritional advice on their websites and selling their brands of supplements? They never even took a biology 101 class! They themselves have been horribly mislead by this unscrupulous industry. Sad.
Hi J
Yes, Trick or Treatment basically changed my life. I have a whole post about it. NDs who get online degrees are not licensed. There is a big political rift between the two types of NDs. Licensed NDs call the internet naturopaths Un-Dies. I am also not sure how it can be stopped, other than with stricter regulations on homeopathics, supplements, etc. Since the Un-dies dont want to be licensed, and specifically do not consider themselves doctors, they exist in a weird grey zone. That is basically all I know about them. But, the post I wrote about the naturopath who let her children suffer from whooping cough for about a year is an Un-die. Her website description sounds an awful lot like licensed NDs, and she uses much of the same BS to treat her “patients.”
The political agenda of NDs, on the other hand, is clear. They want to be licensed in all 50 states as PCPs and be eligible for federal loan repayment programs. In my opinion, this is easier to tackle, as I have direct evidence of the poor education and training of NDs. Thanks for reading/ commenting!
http://www.cbc.ca/radio/thecurrent/the-current-for-february-29-2016-1.3468749/homeopaths-and-skeptics-battle-new-health-canada-labeling-policy-1.3468895
Canada is taking a lead position that USA and rest of the world should follow.
David, Canada is not taking a lead position in that case. Within the EU labeling of homeopathic remedies is already that strict, since years. Basically it works as follows: Either you register a homeopathic remedy, but then you are prohibited to *any* health related claims on the label or you seek approval as a drug, in this the company seeking approval has to present studies proving efficacy. In fact in Germany the label has to say that this is homeopathic drug, registered only and therefore no health claim can be made.
I stand corrected. That is good to hear. I made an assumption…based on the apparent popularity and widespread use of homeopathy in places like france and germany, i just assumed the public was being duped with false claims.