Talk:Naturopathy/Archive 3

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Time to split the article?

It seems to me that the article is pretty much stalled. The problem seems to be in striking the balance between a description of naturopathic practice with a reasonable amount of criticism. The root of the problem is that naturopathic medicine leads a double life. Criticism that may be appropriate for traditional naturopaths may not be relevant to the NDs and vice versa. So statements like "naturopaths have poorer education than MDs, practice widely different standards of care, do not use scientific evidence, may endanger their patients by failing to refer where necessary, don't use surgery or drugs" etc can not be applied to both groups.

Another example: As the article makes clear, NDs are primary care providers who are legally entitled to diagnose and treat disease in certain jurisdictions. Traditional naturopaths are complementary (not primary) care providers. This is also clear from the body of the article. And yet the current lead of the articles states that naturopathic medicine is a 'complementary and alternative system of healthcare'. This is confusing and misleading. NDs and traditional naturopaths may be inspired by a similar set of tenets, but the scope of their practice is a world apart. The care offered by a primary care ND who prescribes metformin and insulin for her diabetes patients is being described/criticized in the same way as the care offered by a traditional naturopath who might not even own an ophthalmoscope or have access to a lab for the necessary blood tests to monitor her patient. The former may have paid $100,000 and dedicated 7 years of her life to study before passing her board exams, and is likely to use EBM in evaluating apropriate adjunct care. The latter may have taken a weekend or a correspondence course, (or maybe not even that) and is less likely to use EBM.

It is almost impossible to come to a consensus on a singular criticism of natural medicine. Two very different phenomenon are being described and analyzed.

So how about a main article that describes the tenets of natural medicine with summary/links to an article about NDs and another summary/link to an article about traditional naturopathy? That way, criticism/discussion could be more focused and appropriate to the kind of medicine/practitioner being described. 72.0.222.218 (talk) 02:21, 21 February 2008 (UTC)

Can I briefly suggest a direction for the proposed split? *Retaining the Naturopathic medicine article and having it cover the North American profession, the 6 schools, the AANP, CNME, NPLEX, challenges and comparisons to other medical professions. *And another article titled Naturopathy discussing the philosophy, history, "traditional" naturopaths connection to nature cure, ayurveda, etc.

There's plenty of information to do this. The question would be who has the time, knowledge and interest in the subject? I'd be willing to minimally contribute, keeping in mind my COI...--travisthurston+ 03:17, 21 February 2008 (UTC)

An interesting suggestion Travis. My concern is that the NDs and the traditional naturopaths would start to war over the use of the term Naturopathic medicine. Either group would feel left out if such an article excluded them but included the other. If only the traditional naturopaths would embrace the term 'naturopathy' and the NDs would embrace the term 'naturopathhic medicine'...but sadly this isn't so. Both groups use both terms, which for better or worse are functionally synonymous. The traditional practitioners can make no claim on Naturopathic doctor or Naturopathic physician however, just as the NDs would have very little interest in what would go on in a Traditional naturopath article. Naturstud (talk) 03:39, 21 February 2008 (UTC)

It's spelled "education"

It's "education", not "eductaion". I'd fix it myself, but the page is protected. —Preceding unsigned comment added by 12.180.55.140 (talk) 23:12, 25 February 2008 (UTC)

This has been fixed. Thanks for pointing it out. Dave6 ^talk 06:16, 26 February 2008 (UTC)

Reference to Naturopathic Colleges

It is reasonable for the article to link to the list of CNME accreditied naturopathic colleges. Naturstud (talk) 02:48, 18 March 2008 (UTC)

Why is the the following being removed from the histroy section:

• "Today there are six accredited naturopathic medical schools in North America."

Without this information, the history section leads the reader to wrongly assume that the last (and only) school is NCNM that opened in 1956. This is misleading. Some editors have been deleting the history from 1956-2008 (ie the formation of six other schools) on the grounds that it is 'POV'. Would one of these editors care to comment on why they think that this is so? 206.47.252.66 (talk) 15:45, 6 April 2008 (UTC)

Naturopaths believe that they are supporting the body's innate ability to heal itself

I have introduced this concept into the lead, hopefully in an NPOV. For the longest time this article included the central tenets of naturopathy...someone keeps stripping them out, claiming that they are POV. They should be rewritten as NPOV and put back into the article, which is still falls short of describing what naturopaths believe and do. Naturstud (talk) 02:48, 18 March 2008 (UTC)

Naturopathy is more of an approach than a single model of care

I have also tried to introduce this idea in the lead. 'Naturopathy' is best described as an apporach to healthcare since it takes on so many different forms in so many different jurisdications. A naturopathis physician in Arizona may practice primary care, prescribe prescription meds, order ultrasound etc, whereas a traditional naturopath in Quebec may be limited to the 'complimentary' or 'alternative' role. The article should describe the shared philosophy and note that it can be adapted to different models of care. For example, the lead makes it seem is if all naturopaths are trained on how to order lab tests and refer to MDs... this is not true. Naturstud (talk)

Scare quotes on the word "natural"

I have removed the scare quotes around the word "natural" in the lead. If the "synthetic" meds in the same sentence can go without the quotes, then so can the "natural" substances with which they are being compared. Naturstud (talk) 03:04, 18 March 2008 (UTC)

Let me try to explain.

The word "synthetic" is not challenged here because its definition is accepted by both those who profess the fundamental validity of naturopathic claims and those who question those claims. The word synthetic, in the context of the present argument, refers to therapeutic agents which are designed and manufactured through human insight and efforts. Even though this is a limited definition, within this scope of naturopathy, it is acknowledged as a common ground.

Now here's the rub:

Without looking into the dictionary, define the word "natural" for me.

Now look in the dictionary and note the definition.

Write back with either definition, or both for that matter, and we can delve into the ambiguity of the word and why it necessitates quotations.205.217.233.25 (talk) 03:10, 26 March 2008 (UTC)P.Cogan

Better yet, why don't you just tell us why you think the quotes are justified, P. Cogan? The word 'natural' has many meanings to be sure, but in the sentence that compares natural therapies to synthetic ones, surely there is very little room for confusion or ambiguity. Are you concerned that readers are going to think we are talking about musical notes that are neither sharp nor flat? I don't get it.

If we can give the reader credit to understand that 'synthetic' refers to 'agents which are designed and (sic) manufactured through human insight and efforts', surely they will have no problem understanding 'natural' to mean agents that have not been designed and manufactured through human insight and effort.

Both words suffer the same ambiguity of scope because they could both refer to the source (manufactured vs harvested) but also the origin (intelligence vs environment) of the agents in question. Vitamin C could be considered natural and synthetic, depending on how it is manufactured - 'synthetic' is every bit as ambiguous as 'natural'.

As long as we are assigning homework to each other, please check out Scare quotes. The content could be rewritten to point out the difference between origin and source if you think it is important, but the scare quotes on 'natural' could very easily be read as POV 'sneer quotes', and should not be put back in.

207.112.94.200 (talk) 00:50, 31 March 2008 (UTC)

I have to admit, I didn't expect to get this argument as a response, but if you feel that there is any ambiguity to the word "synthetic", then by all means put it in quotes as well. I would simply like to see some indication that the claims of 'natural" vs "synthetic" are not necessarily justified. Keep in mind that Wikipedia is used as a source of information by people of all different experiences, the vast majority of whom do not have the background to appreciate how the ideas of "natural" or "synthetic" come to bear on the efficacy and safety of therapeutic options. These words are used as if the concepts are actually in contention with one another. "Synthetic" is not the opposite of "natural", in fact, there is nothing "unnatural" about "synthetic" medication, just as there is nothing inherently more "natural" about the methods of a naturopath. So yes, to answer your question, there is room for confusion. It would appear that the only real use of the word is in marketing, in the deception of the naive into believing that the offerings of the naturopath are inherently beneficial when compared to the offerings of alopathic medicine, an assertion which the ongoing debate here has shown to be unfounded.

I suggest that the quotes are reinserted, around both the word "natural" and the word "synthetic" if need be. Particularly because the word "natural" is the foundation of the entire idea of naturopathic medicine. If spurious claims of the validity of naturopathic medicine are going to be made based on a rather arbitrary and ambiguous definition of the word "natural", then I think we should do those coming here to garner information on the topic the courtesy of a full disclosure.

What is so "natural" about naturopathy?

If the hallmark of a natural process is the lack of involvement of human interference, then how do you survive? How do you eat? Even making a salad requires some synthetic input, a touch of that dreaded human creativity. Surely cooking can not be considered natural, since we mix together all sorts of ingredients and then heat it up, causing all sorts of chemical reactions.

The herbal remedies prescribed are often extracts of plans and cell lysates. How is this a natural process? Ayurvedic preparations are often "detoxified" via a process known as samskaras. This is a methodology by which the preparation is boiled successively in milk and cow's urine. Both of these substances are loaded with chemicals and boiling an herb in such a broth is expected to lead to several reactions common to organic synthesis.

One may suggest that urine and milk are natural substances, so they are O.K. So what about the reagents used in classical chemical synthesis? The bulk of organic material used in synthetic chemistry ultimately comes from one of two sources: metabolites of living organisms or petroleum reserves i.e. the natural carbon cycle. All sorts of synthetic transformations can be carried out on these source materials (like boiling them in cow's urine, for example), but the original carbon pool is all natural sources. So why are the molecules extracted from herbs (the carbon mass of which, by the way, comes from the same carbon cycle that chemists dip into) so much different than those prepared by human hands?

Another argument might rest on the toxicity of many reagents used in laboratory synthesis. Keep in mind that many Ayurvedic, herbal, and homeopathic preparations are based on mercury. arsenic, and a slew of innumerable toxic plants.

I'd suggest that the ultimate issue is one of arbitrarily defining what is natural. Why base the definition on biological sources? Is the sun not natural? Are the oceans not natural? Is the earth itself not natural? A better point of reference might be found by going a little deeper into physics. Anything which satisfies the laws of thermodynamics, the very fundamental laws of the natural world, should really be considered natural, shouldn't it? Anything which does exist obviously can exist and is, to my estimation, very much natural.

So while it might be said that the naturopathic community understands the meaning of the word natural as unambiguous, I think a lot of us on the outside here would say that definition is merely one of convenience and we would very much appreciate a little acknowledgment of that point of view. And all it will cost you is a little set of quotation marks.

205.217.249.200 (talk) 01:14, 2 April 2008 (UTC)P.Cogan

But adding the quotation marks to 'synthetic' and 'natural' makes the passage less clear, not more clear. It is a qustion of good writing more than anything else. Scare quoting these terms dosn't introduce any of the (interesting if perhaps misplaced) points that you have raised above P Cogan: it just makes the sentence clumsy and if anything increases ambiguity instead of resolving it. 72.0.222.218 (talk) 02:53, 2 April 2008 (UTC)

I'd have to agree with that. The quotes don't actually express the details of the problem. I simply wanted to make it clear that there is a controversy here. I have no intention of making any change in the article myself, I'll let someone else do the editing if they see fit. I just think the article should reflect the reasonable controversies. What is the best way to ensure that, well... I don't have the time to get into edit wars, so I'll just keep throwing in food for thought from time to time.205.217.249.200 (talk) 03:20, 2 April 2008 (UTC)P.Cogan

P Cogan raises an excellent point that the article should adress, namely the ambiguity surrounding what makes a naturopathic intervention 'natural', and the (potentially dangerous) assumption that natural=safe or natural=better. The problem once again is that naturopathy is a general aporach to healthcare, not a rigidly defined set of interventions or protocols practiced by a single group of professionals. The answer to his question 'what is natural?' is therefore elusive. I agree that this should be covered, perhaps in a larger section that deals with controversy or criticism surrounding the term 'natuopathic', which is a problematc term for this and many other reasons. However, the lead is a confusing place to put such a discussion, and the quotes make things worse not better imho. Naturstud (talk) 17:21, 4 April 2008 (UTC)

Some suggestions

Well I'm not a fan of homeopathy per se but the best way to challenge pseudoskepticism in my experience is to take the agnostic view. If someone writes that 'homeopathy does not work' do not write that 'homeopathy does work': both these statements are POV.

Focus first on making the criticism fair (NPOV), not eliminating it.

The best way to start is to rewrite critical phrase like "Homeopathy has no scientific basis" so that they are clearly atributed their source. "According to so-and-so, homeopathy has no scientific basis..." This is fair play. It isn't enough for critics to provide a citation at the end of these judgments: they may describe the fact that a certain notable source does not think homeopathy has a scientific basis. They may not report the opinion of that source as if it were itself a fact, no matter how many footnotes they add to it.

Avoid making the same mistake yourself! Don't write 'Homeopathy has been proven to work' and then provide 14 citations. Instead, report that 'Some published studies have concluded that homeopathy is effective'. No one can argue with the fact that the studies you cite have indeed reported efficacy. Stick to the facts and let the reader judge

Good luck. Naturstud (talk) 01:16, 31 March 2008 (UTC)

• This is the article for naturopathy, not homeopathy - they are different, are they not? Colonel Warden (talk) 20:18, 6 April 2008 (UTC)

Science and Naturopathy

There's a poor section at the end with this heading. The heading suggests that it's going to comment on the scientific merits of naturopathy but it doesn't. Instead it just strings some sources together in a suggestive way. This is an improper synthesis - drawing conclusions from sources which they do not suggest. Since an editor has reverted my removal, I shall try a different approach - retitling this section as "Risks" which better summarises the contents of this section. Colonel Warden (talk) 20:59, 8 April 2008 (UTC)

Is naturopathic medicine CAM?

I did a little link following today, and here's what I discovered: The CAM entry says that: "Complementary and alternative medicine (CAM) is an umbrella term for complementary medicine and alternative medicine." The complementary medicine entry says that "The term complementary medicine refers to nonconventional treatments used in addition (complementary) to conventional medicine prescribed by a physician." The alternative medicine entry says that "Alternative medicine includes practices that differ from conventional medicine. " Following the links for "conventional medicine" leads to the wikipedia entry for "medicine", which says that "Medicine is the science and art of maintaining and restoring human health through the study, diagnosis, and treatment of patients." Since naturopathic physicians are licensed to study, diagnose, and treat patients in 15 US jurisdictions, according to wikipedia they are practicing "medicine", and not "complementary and alternative medicine." I propose moving this article from the "CAM" heading to the "medicine" heading. —Preceding unsigned comment added by Lamaybe (talk • contribs) 22:18, 20 May 2008 (UTC)

Naturopathic medicine includes many forms of CAM practices and that's why it is consistently classified as CAM. Take a look at NCCAM's discussion. -- Fyslee / talk 03:33, 21 May 2008 (UTC)

I support the suggestion from above to split the article. I think we should do it following the lead of the osteopathy/osteopathic medicine articles; the first one covers the global practice of the CAM practice, osteopathy, and the second covers osteopathic physicians who are licensed to diagnose & treat patients. I think we should have an entry on "naturopathy", which is a CAM practice, and "naturopathic medicine", a form of primary care medicine in which practicioners are trained and licensed to use CAM techniques. Lamaybe (talk) 20:34, 22 May 2008 (UTC)

Please, no. Let's not separate and disorganize the encyclopedia any more. Naturopathic medicine and naturopathy are the same thing, and it is CAM. ImpIn | {talk - contribs} 23:38, 22 May 2008 (UTC)

Hi Imperfectly; I enumerated above why I think naturopathic medicine belongs in the medicine catagory, and I and others have commented above as to why we should split the article. Specifically, the bulk of comments on this page support the idea that a split would actually organize the encyclopedia more, not disorganize it. If you think it would disorganize it, and if you think naturopathic medicine is CAM and not medicine, it would help a lot if you could give specific reasons why. Thanks! Lamaybe (talk) 01:43, 25 May 2008 (UTC)

It's widely considered CAM. It doesn't claim to be able to treat all diseases, whereas the umbrella of regular medicine does. I mean, sure, it is medicine -- everything which treats illnesses is medicine. But it's best to define it precisely, which means that we should consider it CAM. It always will be CAM, at least until naturopaths figure out a way to reliably cure cancer using their methods. ImpIn | {talk - contribs} 01:44, 28 May 2008 (UTC)

It is widely considered CAM, which is perfectly appropriate, since it uses CAM modalities. But where I live, in Oregon, it's widely considered "regular medicine" too. That is to say, your family practice ND can and does prescribe the same antibiotics and antifungals, and statins and opiates that your family practice MD does. And when either one of them biopsies a lesion and diagnoses cancer, they refer their patient to an oncologist. It's generally the same practice, except the ND is trained and licensed to use modalities that aspire to support an individual's normal, healthy equilibrium, including immune function, drawing on research published in peer-reviewed journals. And at the Cancer Treatment Centers of America, licensed NDs are part of the treatment teams, so yes, their medicine is contributing to whatever rate of reliable cancer curing medicine in general has going on. Lamaybe (talk) 14:42, 28 May 2008 (UTC)

I too am opposed to any effort to qualify naturopathy as anything other than CAM. It seems that you are relying on nothing more than semantics to argue your case, Lamaybe. The wording of Wikipedia's definition of medicine is not grounds enough to include naturopathy and all of its practices under the blanket of mainstream medicine. Anyhow, it seems a most peculiar suggestion coming from you since, as you wrote above:

" I think what people are getting at when they talk about naturopathic practices boosting the body's innate defenses, is that naturopaths aim for improving health through supporting the normal and balanced functions of the individual, as opposed to improving health through attacking a pathogen, or interfering with a metabolic pathway. That basic philosophical difference is a pretty significant difference between the ways that most NDs aspire to practice and the way that most MDs aspire to practice. "

You are arguing with this earlier quote that there is an inherent difference in how naturopaths and MDs approach a disease state. In fact, you have invoked a near perfect definition of "complimentary medicine" to argue that naturopathy is unique from/complimentary to allopathic medicine, yet you are now suggesting that they are the same thing in an apparent effort to lend a sense of credibility to naturopathic practices.

I think we can circumvent the necessarily simplified wikipedia definition of medicine and acknowledge that allopathic/western/mainstream medicine can be defined as common practices subscribed to by the majority of MDs who's credentials would allow them to practice medicine anywhere in the developed world. Or, perhaps, as practices approved and recommended by recognized MD licensing boards in the developed (i.e. Western) world. Reflexology, homeopathy, and several other arts of the ND just don't meet these more practical criteria.Puddin'head Wilson (talk) 16:05, 27 May 2008 (UTC)

I think on this discussion page, we're trying to come to a consensus of what it means to communicate about medicine; the wikipedia entry on "semantics" defines it as "the study of meaning in communication." So yeah, in that sense I'm relying on semantics! I don't think the wikipedia definition of medicine is simplified, I think it's accurate, and I imagine you'd agree with that. However, you wrote something telling above, which I think points out where we disagree. You wrote: "The wording of Wikipedia's definition of medicine is not grounds enough to include naturopathy and all of its practices under the blanket of mainstream medicine." I don't want to include naturopathic medicine under the blanket of mainstream medicine, but under the blanket of medicine, which is also where mainstream medicine falls. Medicine is not the same as allopathic/western/mainstream medicine. Allopathic medicine is akind of medicine--one variety of "the science and art of maintaining and restoring human health through the study, diagnosis, and treatment of patients." Naturopathic medicine, where naturopaths are licensed, is the same thing. If, suddenly, allopathic medicine were no longer licensed in Florida, would that make allopathic medicine no longer medicine? No, it is still that same science and art. Or, if an MD uses homeopathy in her practice, as many MDs do, does that mean she is no longer practicing medicine? No, she's practicing medicine using pharmaceutical and non-pharmaceutical medicine. I still maintain that NDs and MDs aspire to approach disease states differently, but they are both practicing medicine. Lamaybe (talk) 21:03, 27 May 2008 (UTC)

I see what you're saying, but we still run into some problems.

1. From what I've read, naturopathic practices receive regular treatment in the various CAM journals which obviously consider them to be CAM. Also, when naturopathic practices are addressed in the more mainstream literature, they are generally qualified as CAM. On what grounds can a wikipedia article ignore this? 2. If we rely on the Wikipedia definition of medicine as the "science and art of maintaining and restoring human health", we run into the problem of whether or not various naturopathic practices, some of which ignore or directly contradict fundamental scientific principles, actually do anything to maintain or restore health. 3. Simply because an MD might use homeopathy in their practice does not make it part of mainstream medicine (nor does it even qualify it as medicine). I have spoken to doctors about golf while having my ears checked. Just because it happened in a doctor's office doesn't make it medicine. Many naturopathic practices are used in mainstream medicine and several others should be. However, the fact that many naturopathic practices contradict well established principles of pharmacology, toxicology, physiology, anatomy, chemistry, and physics, means that it can not, as a field, be paralleled with allopathic medicine. Yes, naturopathy is a variety of medicine. What variety? Complementary and alternative. Simply referring to it as medicine, without somehow qualifying that it is not subjected to the same regulations and standards as allopathic medicine, only serves to confuse those who don't know the difference. It ends up being deceitful (even though unintentionally) and is unwarranted, in my opinion.Puddin'head Wilson (talk) 23:06, 27 May 2008 (UTC)

I appreciate your insights, Puddin'head, you make excellent points. Tell me what you think of this perspective: whether or not pharmaceuticals, or homeopathy, or talking about golf actually help you get better, the MD or DO or ND treating you is trained and licensed to do whatever they're doing to achieve that goal. That's something that MDs, DOs, and NDs in the US have in common. There are times when your MD (or DO or ND) might prescribe an antibiotic for a viral condition, and it won't do anything, but they're still doing their best to practice the art & science of medicine. There are times when your ND might prescribe a homeopathic that does nothing (according to some, that's every time a homeopathic is prescribed :) but again, they're still doing their best to practice the art & science... I don't think the wiki article should ignore that naturopathy is generally treated as CAM. It regularly uses CAM therapies. NDs are trained & licensed to use those therapies. I agree that it would be confusing to simply refer to it as medicine, but I think it is equally misleading to just refer to it as CAM. It should qualify as both--a form of "medicine" and a "complementary and alternative medicine." Lamaybe (talk) 05:36, 28 May 2008 (UTC)

I can see your point and, yes, it is a bit of a pickle. Although both practicing elements of CAM, I will agree that a licensed ND is a lot different than someone who just sets up (for example) a reflexology, iridology, or homeopathy clinic with no real credentials. It would even seem that many NDs are, in essence, practicing allopathic medicine, but simply with a minimally invasive, level headed approach. However, the fact that many or even most of the first line approaches employed by the ND to deal with various disease states are considered CAM makes it difficult to go along with any unmitigated description of naturopathy as simply "medicine".

Also, If we look at the curricula for the accredited ND granting schools in North America, topics such as homeopathy are taught along side of the standard basic science courses. At Bridgeport, for example, pharmacology gets a 2 semester treatment while homeopathy gets 3 semesters. The one is based on solid empirical evidence and scientific observation while the other ignores and contradicts these principles. It would appear that a disregard for evidence based medicine is taught at the earliest stages of the ND's development and can, therefore, be considered as part of the very fundament of the field. Again, I can see your point, but it is a hard one to concede.

For the sake of disclosure, I should state that I am of the opinion that homeopathy should not be considered as CAM. In fact, the word "medicine" should not even be uttered in the same breath as "homeopathy". Perhaps it is simply my prejudice to this point that drives my argument here, as I am very wary of a field which embraces the "principles" of homeopathy (as well as some of the other popular CAM theories). These ideas directly contradict the science of medicine (part of the wikipedia definition) and are keeping naturopathy from enjoying the recognition which some of its other practices deserve, IMHO.Puddin'head Wilson (talk) 13:25, 28 May 2008 (UTC)

Well, I'd hate to clutter up the naturopathy talk page with chatter about homeopathy, but I'd love to hear what you base your opinion of homeopathy on. I base mine on the available randomized controlled trials and meta-analyses, and based on those I'm still on the fence, but leaning towards the idea that homeopathy is efficacious. If you'd like to rap about it off this talk page, email me using the "Email this user" link on my "talk" page. Lamaybe (talk) 14:42, 28 May 2008 (UTC)

CAM is a problematic term indeed! I am comfortable describing 'naturopathy' (the set of guiding principles) as being CAM, but not so comfortable describing 'naturopathic medicine' (as practiced by licensed NDs) as being CAM. After all, NDs will use conventional/mainstream modalities just as MDs will use complimentary/alternative ones from time to time. There has been a huge amount of cross-over hapening, esp in the past few years. The term 'CAM' could be used to describe some of an NDs practice, but not to classify it. The CAM debate makes it clear to me that 'naturopathy' and 'naturopathic medicine' would each be well served served by having their own seperate articles. The former is an (idealized and abstract) way of thinking about disease and wellness, the other is an actual practice informed (but not contained) by that ideal. Oh, as long as we are all ending our posts by discussing homeopathy, I am an ND who thinks homeopathy is complete rubish and should be taken out of the curriculum. And I know I'm not alone. Controversy exists amongst NDs as it does amongst MDs.Naturstud (talk) 01:40, 29 May 2008 (UTC)

Look, I'm sorry, but there are really good sources saying it's CAM:

• The NCCAM says: "Naturopathy is a whole medical system that has its roots in Germany. It was developed further in the late 19th and early 20th centuries in the United States, where today it is part of complementary and alternative medicine (CAM)"
• [1] and [2] from the Assosciation of Accredited Naturopathic Colleges at the least spend a lot of time connecting Naturopathic medicine to CAM.

Etc.

You can't jsut say it's not a CAM because you don't like it. If people are using it as their primary form of healthcare, then it's alternative, not complementary medicine, that still doesn't make it mainstream medicine. Shoemaker's Holiday (talk) 03:26, 29 May 2008 (UTC)

For clarity, I am not arguing against describing naturopathy as CAM, but I do have a problem with using the term CAM to classify the modern practice of naturopathic medicine. Can you name another 'CAM' whose practitioners are qualified to offer primary care, order and interpret lab tests, perform minor surgery and prescribe prescription medications? Naturopathic medicine is unique in this regard. The term 'CAM' describes many of the interventions that NDs are likely to use, but it is a problamatic and incomlete description of naturopathic medicine as a whole. The article should reflect this.... and once again, the issue would go away if the 'naturopathy' article were seperate from the 'natruopathic medicine' article. 72.0.222.218 (talk) 04:18, 29 May 2008 (UTC)

I'm sorry, but you have to provide actual sources. I'd particularly say that it is a basic requirement that you show that this power is reasonably wide-spread. The NCCAM says that only 14 states have any regulatory framework regarding naturopathy, and says that of those, "some states allow naturopathic physicians with special training to prescribe drugs, perform minor surgery, practice acupuncture, and/or assist in childbirth."

That "special training" sounds to me like even in those states, not all naturopathic physisicians use these abilities.

This is nothing like Osteopathic medicine, where the entire field is now considered a subset of mainstream medicine. We may not use the presence of special dispensations in some states for (possibly limited) prescription powers to assert that this is true of naturopathic medicine in general. I feel the need to be very clear on this: An extreme minority of naturopathic physicians have these powers, while these may rightly be discussed, and distinguished from the rest, we must be very clear that this is not normal, and cannot use this to whitewash the greater majority, that have no regulations on their practice whatsoever. It is unfortunate that the field includes both unregulated quacks and professionals with sufficient training that (in a few states) they are legally trusted with some proportion of the powers of a mainstream GP. It is particularly unfortunate that such specially-trained professionals choose to use the same name as their unregulated brethren. Nonetheless, such professionals are an extreme minority of practitioners, and to focus on them too much would have the effect of concealing the fact that in most states, naturopaths need have no training whatsoever.

It is unfortunate, and I do appreciate your views - if there was some unambiguous way of naming the trained ones, then I would support doing an article on them. However, we cannot, in good faith, say they are anything but a rare, geographically-isolated exception, and to make an article that treats them as the majority is against various Wikipedia policies. WP:NPOV/FAQ#Pseudoscience (Forgive the name of that link) and WP:UNDUE both say that we cannot treat a minority situation as a majority one. Shoemaker's Holiday (talk) 09:50, 29 May 2008 (UTC)

I feel that you have sidestepped the issue, which is the suitability of the CAM classification. Once again, I submit that this is a problematic term because it lumps a regulated, board licensed 100 year old profession in with individuals or groups who have little or no training. Naturopathic medicine is not conventional 'mainstream' medicine. Neither is psychic iridology. The problem with the term CAM is that all it can do is state (the distressingly obvious) 'this is not conventional mainstream medicine'. Do you really need me to explain why so many of my peers find this offensive? WP:UNDUE does not exist to establish or excuse hegemony. Christianity may be the dominant faith in the world, but it would not be acceptable to classify budhism, or islam (or even a lesser known 'fringe' faith) as a 'complimentary and altenative religion'. 'Mainstream medicine' may be the dominant form of medicine in the world, but if you insist on lumping everything that isn't dominant under one umbrella term like CAM, you loose the ability to distinguish between them. The article as it exists does little to distinguish between the kind of care provided by an ND and a psychic iridologist. The CAM classification without some sort of explanation adds to the confusion.

Don't take my word for it: look at Complementary_and_alternative_medicine and see just how controverisal the term is. I side with Kassirer et al. : there is no such thing as alternative medicine, only "evidence-based medicine supported by solid data or unproven medicine." As long as NDs incorporate as much evidence based medicine as they do, the term 'alternative' is a confusing half-truth. Just because I see weight loss as a superior treatment to metformin and would hate working at a hospital, that doesn't mean that I believe that you can cure diabetes by drinking lepricaun urine, and let's face it, the term 'alternative' by iteslf could suggest either scenario.

I repeat my original question: Can you name any other 'non-conventional/non-mainsteam' medical practice whose practiioners complete a min 7 years post secondary education that includes such anti-CAM offerings as anatomy, physiology, pathology, PCD, immunology, lab studies, diagnostic imaging etc? Can you name another 'CAM' that requires its students to have the same standard pre-med courses (chem, org chem, biochem) before begining their medical training? Is my stethoscope a CAM stethoscope? When I palpate an irregularly shaped prostate gland on DRE and make the apropriate referal, was that a CAM prostate, a CAM referal? Is PSA a CAM diagnostic? There is only one acceptable next step in the treatment of such a patient, and it is the same for NDs and MDs alike.

If I may ask a second question: If you accept that NDs are unique in that they combine CAM modalities with an unusal amount of conventional/mainsteam training, do you think that the aticle does a good job of describing this? I agree with you: it is unfortunate that the 'field' of naturopathy is ill defined and that depending on where you live, the title ND may not be defined to exclude any old quack who comes along. I couldn't really guess what the number of practicing NDs is when you consider the output of all of the schools. Your charactization of the professionally trained ND as a fringe minority within naturopathy is questionable however. If you are unsure, call up your insurance company and ask if they will reimburse you for a visit to see an ND: many will. With thousands of practitioners and what I assume to be millions of patient visits over the last century (the clinic where I trained sees 30,000-35,000 patient visits per year), I think it is safe to say that we are aproaching the end of the 'run-in' period for naturopathic medicine, don't you?

I keep coming back to the same point: the reason why this article has been so controversial and suffered so many edit wars is because it should actually be two different articles. The problem with the CAM tag underscores the need to distinguish between naturopathy and naturopathic medicine as practiced by NDs. As noted above, the precedent exists for osteopathy and osteopathic medicine. Naturstud (talk) 17:10, 29 May 2008 (UTC)

Reliable sources categorize it as CAM. Therefore, so do we. This talk page is not a forum for general discussion or debate about the topic. MastCell ^Talk 17:30, 29 May 2008 (UTC)

Reliable sources have also challenged the term CAM as being a meaningless one. Now what? BTW this page is exactly where we should be discussing the difficulty in categorizing both naturopathy and NDs. 206.47.252.66 (talk) 19:16, 29 May 2008 (UTC)

Let me just see if I understand the situation:

In most states and countries, the only requirement for calling yourself an N.D. is that you call yourself an N.D., because there is no licensing and no quality control. In a few, the qualifications required have been increased to such a level that it is similar to Ostepathic medicine, in being primarily mainstream, but with a little more knowledge of herbalism and other such things. Still, the maddest quack in any but the 14 states where Naturopathic medicine is regulated could call himself an N.D. and may well do, and even in the 14 states that regulate it, not all 14 hold N.D.s up to that level of training.

That's the problem, in my eyes: The respectable N.Ds are using the same designation and same name for their style of medicine as unregulated quacks in other states. So focusing on the high-end, where they're regulated and respectable, runs into the problem of that that's the minority situation, and could send people into the arms of unregulated quacks.

You have got the gist of it: the jurisdictions that do not license NDs generally have laws against anyone calling themselves any kind of 'Doctor', and so most traditional (unlicensable) practitioners simply call themselves 'naturopaths', and the professionally trained NDs are reduced to calling themselves the same thing! 206.47.252.66 (talk) 19:42, 29 May 2008 (UTC)

I don't see what we can do about this other than support efforts to get all naturopaths held to the same standards as the high-end. In this article (provided we have reliable sources that allow us to distinguish the high-end), we'll just have to try and make the distinction, and try and be fair to the highly-qualified without dignifying or lending support to the quacks operating under the same names in the unregulated states. Shoemaker's Holiday (talk) 17:41, 29 May 2008 (UTC)

Yes, Naturopathic medicine is CAM, not medicine. That is how our best sources describe it, and concluding otherwise based on another article would be either original research or at the least synthesis. To finish duplicating the discussion at Wikipedia_talk:WikiProject_Medicine#Naturopathic_medicine, there should be no problem detailing the medicine and scientific principles practiced and observed by some NDs. - Eldereft ~(s)talk~ 21:23, 29 May 2008 (UTC)

I can see nothing in the medicine article that would cause naturopathic medicine to be excluded. Naturopathic medicine is medicine; it may not be the dominant mainstream version of medicine, but it is medicine none the less. It is a mistake to take the broad term 'medicine' to mean only 'conventional medicine', something that the medicine article thankfully avoids.

206.47.252.66 (talk) 23:59, 29 May 2008 (UTC)

Eldereft, great to have your input. You make a good point that it's important to avoid synthesis while editing an article. So, to be properly encyclopedic, we need to find and share with readers the appropriate references to represent the relevant states of knowledge and perspectives on the subject. We should definitely include refs to the sources describing naturopathic medicine as CAM. We should also include references to sources describing naturopathic medicine as medicine. It's a little harder to tease out what those sources are, since you can't just google "naturopathic medicine" and "medicine" to look for references. However, as an experiment I googled "naturopathic medicine". Nine of the ten unsponsored results that came up were references to the licensed profession of naturopathic physicians, who practice medicine. And in order to support the references to licensed primary health care providers as practicing "medicine", we're just turning to the very definition of medicine. I think that's a different thing than synthesis. If there are certain classes of reference that anyone thinks it is important to see to support the idea that licensed naturopathic physicians are practicing medicine, please say so! There are references from federal and state governments, licensing boards, accreditation associations, community groups, etc.

I'm not trying to say that we should remove the "CAM" tag from the "naturopathic medicine" article, just that it desreves a "medicine" tag as well. If it feels more appropriate, we can start a different thread on this discussion page about splitting the article, and applying the "medicine" tag only to the article "naturopathic physicians" (or whatever we call it) that refers to licensed primary health care providers. Lamaybe (talk) 12:43, 30 May 2008 (UTC)

I see frequent references to reliable sources by both "sides" to this discussion, but I can't seem to find any of sufficient reliability in the article... --Relata refero (disp.) 09:44, 30 May 2008 (UTC)

I see the point of the argument but I agree that really naturopathy/naturopathic medicine should remain in the CAM field. It is certainly a type of medicine and is completely valid but the tag CAM is what the public have by and large chosen to use. Allopathic medicine (incidently a term only used in CAM circles as a method of distinguishing the "other" medicine) is what the public has chosen to term medicine. I actually think to give naturopathy the same title as medicine would devalue its many differences. As a senior lecturer in naturopathic practice I am too frustrated at the focus on being defined by natural products (certainly not the intended meaning of vis medicatrix naturae). CAM practitioners are defined by their underlying philosophies of holism and individualistic practice rather than any specific treatment tools - as opposed to the biochemical reductionist principles and philosohies of medicine. Perhaps this is all an argument over semantics? Would the term naturopathy is a "system of medicine" or "approach to healthcare" suffice as a tag (vis a vis osteopathy article)? I still think the CAM reference should stay as well. Anyone linking to the CAM article will see the controversy surrounding classificationGrubbidok (talk) 10:29, 5 June 2008 (UTC)