© Eric Yarnell, ND, RH(AHG) August, 2005. This article may be reprinted in any non-commercial forum as long as it is not altered in any way.
I have recently heard a few students questioning their education at Bastyr University and other naturopathic medical schools. Some are concerned by the fact that not every one who graduates ends up in a successful, full-time practice. Some are concerned by the power imbalances with mainstream medicine. Some appear to just be carping as we are wont to do on occasion.
While naturopathic education is not perfect at any institution, and while the profession still has a long way to go on its journey, I believe this profession is absolutely incredible. Anyone interested in a natural medicine profession should seriously consider naturopathic medicine. I believe it offers the greatest breadth and depth of any natural medicine profession. I would not change my decision to attend Bastyr University or become a naturopathic physician for anything.
Naturopathic physicians don't have all the money, or the power, or the prestige. But we do have a truly patient-centered philosophy that can really help everyone. We can't cure everyone, but we can help them. And we are truly committed to looking for and eliminating the causes of disease, not just relieving symptoms (though that can be necessary and we have ways of doing that too).
Despite the fact that the mainstream medical complex has got basically all the money, power, and prestige, they still couldn't wipe out naturopathic medicine or natural medicine in general. This is because people very often get treated poorly in mainstream medicine, or else they have nothing to offer patients. Drugs _prescribed properly_ and surgical complications are major causes of death. Thus inevitably people look for alternatives, and realize they exist.
Naturopathic medicine is to my mind the most powerful medical system. We are able to flexibly take in the best parts of all sorts of medical systems and apply them to the individual patient's case with great effectiveness. If nothing else, at least we are willing to take the time and _listen_, really listen.
No naturopathic medical school can hand its students a perfect practice on a silver platter. While every medical doctor in the US gets a state-funded residency, we are not allowed into this monopoly. We get a pittance of research dollars compared to mainstream providers. Insurance plans, the federal government health care plans, hospitals, and many other institutions discriminate against us, either completing blocking access, refusing to acknowledge our existence, or by throwing up huge barriers to entry. Yet despite all these political roadblocks, naturopathic medicine continues to grow and thrive and get stronger. So while naturopathic students have to work harder to succeed, in the end their success is all the greater for it in my opinion.
Every naturopathic medical school is struggling against unbelievable odds. Even in states with long-established licensing like Washington, there are threats to our licensure from various political trends. Even well-established naturopathic schools do not get the incredible largess heaped on mainstream medical schools by local, state, and federal government agencies, not to mention private donors. Add to this the fact that various people are taking weekend courses and daring to compare themselves to us, and it just gets harder. What is miraculous is that the schools stay open at all given these circumstances. Yet they continue to grow and get stronger.
So I say to those people who are considering naturopathic medical school and it feels right, go with it. No, you won't graduate knowing for certain you'll "make it." You won't get a government-funded residency in all likelihood. You'll have to struggle and keeping learning as you go. But you will still be in the best medical profession of all, and will help a lot of people. To those who complain, I say look at the cold, hard facts and you will see a different picture. Be proud, be strong, and together we will do our part to heal the world.
© Eric Yarnell, ND, RH(AHG) July, 2005. This article may be reprinted in any non-commercial forum as long as it is not altered in any way.
The founding editor of this publication, Wallace Simpson, has long opposed natural medicine in any form, without actually evaluating the evidence involved. In fact, he has said, “When we began the journal, we did so simply because no one else was doing it. By definition, we have to start with the premise that alternative medicine claims are all unproven or false” (CSICOP 1999). To start with the assumption that all claims are false is not scientific and in fact reveals incredible bias. If you start off with the answer (“no matter what the evidence, the outcome will be that the premise is false”) you cannot conduct an objective or scientific review of anything. This journal is simply another way for a group of staunch opponents of natural medicine to attack it without actually neutrally evaluating anything.
According to SRAM’s webpage, SRAM “will simply seek justified answers to two questions: “Is it true?” and “Does this treatment work?” (SRAM 2005) In fact, the majority of the articles in this journal appear to do far more than this—they go to great lengths to discredit and humiliate practitioners and practices of natural medicine. They seem to select the least supported or supportable elements of natural medicine and use these worst-case scenarios to discredit all of natural medicine.
The same critical approach could be taken with conventional medicine. The Scientific Review of Conventional Medicine could pick only those therapies and practitioners within conventional medicine that have been shown to be fraudulent, corrupt, scientifically discredited, etc. and rant against them. For example, empirical use of antibiotics in children with serous otitis media has repeatedly and undeniably been shown to be useless or of extremely marginal benefit (worse than useless if one adds in the expense and adverse effects from taking useless or extremely marginally useful drugs) (Glaziou, et al. 2004; Del Mar, et al. 1997; Kozyrskyj, et al. 1998; Cantekin 1994). Some studies even show that use of antibiotics increases the likelihood of recurrence of serous otitis media compared to placebo and that they increase the likelihood of new infections with antibiotic-resistant bacteria (Mandel, et al. 1991; Cantekin, McGuire & Griffith 1991; Hofman, et al. 1995). Nevertheless, the large majority of physicians continue to use empirical antibiotics as their first line approach to patients with serous otitis media (McIsaac and To 2004; Metlay, et al. 1998; McHaig and Hughes 1995). Does this prove that conventional medicine “claims are all unproven or false”? No, though it does show that there is a double standard that SRAM is ignoring. Conventional medicine should clean up its own house before it casts aspersions on others.
Nevertheless, SRAM is correct in its assessments that some people and practices in natural medicine are fraudulent and false, and are rightly criticized. This is not generalizable to all of natural medicine though, as they seem to think.
In the most recent issue of SRAM (Fall/Winter 2004-5, volume 8, number 2), we find the following articles:
EDITORIAL
Scientific Reviews of Medical Journals Wallace Sampson
Original Articles
An Investigation of PharmacistsÕ and Health Food Store Employees’ Knowledge about and Attitudes toward Kava Ian C. Webb, Jennifer E. Chatterton, and Barry L. Beyerstein
Doctors’ Impressions of Vaccine Information from CAM Providers, Lloyd B. Oppel, Richard G. Mathias, and Morley C. Sutter
Analysis
A Review of King HH and Lay EM, “Osteopathy in the Cranial Field,Ó” in Foundations for Osteopathic Medicine, 2nd ed. Steve E. Hartman and James M. Norton
The P6 Acupuncture Point and Postoperative Nausea and Vomiting Kimball C. Atwood IV
Inherent Dangers of Faith-Healing Studies Bruce L. Flamm
Sellers of “Natural” Products: A Review of Consumer Protection Barry L. Beyerstein, Ian C. Webb, and Jennifer E. Chatterton
Commentary
Alternative History of Medicine Plinio Prioreschi
Reviews
Naturopathy: A Monograph, Part II Kimball C. Atwood IV
Labyrinths and “Alternative” Medicine Benjamin Radford
This set of articles does not seem to go out of its way to follow the supposed purpose of SRAM, “Is it true?” and “Does this treatment work?” How does an article about the attitudes of health food store employees help determine whether the herbal medicine Piper methysticum (kava) is “true” (whatever that means) and whether it is effective? How does an article about doctors’ views about vaccination recommendations by other practitioners say anything about truth or therapeutic efficacy? These articles are intended to attack and discredit natural medicine. Could we not turn around again and criticize those same doctors surveyed about vaccination for their use of antibiotics in children with serous otitis media despite the massive, overwhelming evidence this doesn’t work and can even be harmful? Does that discredit all of conventional medicine? Could we ascertain the level of information provided by conventional providers about antibiotics for serous otitis media and thus prove this therapy doesn’t work and isn’t true?
The one article in this issue that actually dispassionately evaluated a therapy was the article about P6 acupuncture. The article evaluates a meta-analysis of this approach and points out numerous problems with it. This does appear to live up to the SRAM goal of determining whether a treatment is “true” and effective. The other analytic, commentary, and review articles are all attacks and do not attempt to assess veracity or efficacy of any natural therapies, instead they only attack. Thus SRAM is only barely trying to assess the science of natural medicine, but instead focuses on discrediting it by rather dubious means. While earlier issues of SRAM had more articles that actually evaluated natural therapies as they claim to be about (albeit never, ever choosing therapies that are supported by the majority or all studies), they quickly devolved into mostly negative attack articles.
In conclusion, SRAM should simply be ignored as an ongoing diatribe against all of natural medicine by a group that, by their own admission, starts with a set conclusion and basically ignores the full breadth of evidence available on the subject.
References
Cantekin EI (1994) "Antibiotics to prevent acute otitis media and to treat otitis media with effusion" JAMA 272:203-4
Center for the Scientific Investigation of Claims of the Paranormal (CSICOP) (1999) ÒScientists and Physicians Gather in Philadelphia for "Science Meets Alternative Medicine" www.csicop.org/articles/19990226-altmed/ (accessed 16 April 2005)
Del Mar C, Glasziou P, Hayem M (1997) "Are antibiotics indicated as initial treatment for children with acute otitis media? A meta-analysis" BMJ 314:1526 9
Glasziou PP, Del Mar CB, Sanders SL, Hayem M (2004) ÒAntibiotics for acute otitis media in childrenÓ Cochrane Database Syst Rev 2004;(1):CD000219.
Hofmann J, Cetron MS, et al. (1995) "The prevalence of drug resistant Streptococcus pnuemoniae in Atlanta" N Engl J Med 333:481-6
Kozyrskyj AL, Hildes-Ripstein GE, Longstaffe SE, et al. (1998) "Treatment of acute otitis media with a shortened course of antibiotics: A meta-analysis" JAMA 279:1736-42
Mandel EN, Rockette HE, et al. (1991) "Comparative efficacy of erythromycin-sulfisoxazole, cefaclor, amoxicillin or placebo for otitis media with effusion in children" Ped Infect Dis J 10:899-906
McHaig LF, Hughes JM (1995) "Trends in antimicrobial drug prescribing among office-based physicians in the United States" JAMA 273:214-9
McIsaac WJ, To T. Antibiotics for lower respiratory tract infections. Still too frequently prescribed? Can Fam Physician 2004;50:569-75.
Metlay JP, Stafford RS, Singer DE. National trends in the use of antibiotics by primary care physicians for adult patients with cough. Arch Intern Med 1998;158(16):1813-8
Scientific Review of Alternative Medicine (SRAM) webpage (2005) www.sram.org (accessed 16 April 2005)
© Dr. Eric Yarnell, February 1, 2005. This article may be reprinted in any non-commercial forum as long as it is not altered in any way
For decades now the prostate specific antigen (PSA) blood test has been considered the best way to determine if a man has prostate cancer. There has long been concerned voiced about the overly simplistic idea that more PSA automatically meant dangerous forms of prostate cancer were present. A series of large clinical trials has now confirmed that in white men at least, a PSA less than 10 essentially cannot tell one anything about whether dangerous prostate cancer is present or not.1
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“For white men these observations constitute confirmatory evidence that serum PSA between 2.5 and 10 ng/ml is unrelated to prostate cancer and is most surely caused by benign prostatic hyperplasia (BPH).” Thomas Stamey, MD2 |
The reasons for this are twofold. First, non-dangerous prostate cancer (it won’t kill you) is extremely common, with 8% of men in their twenties already having it and 83% by age 70!3 Second, enlargement of the prostate (benign prostate hyperplasia or BPH) is also very common, and as the prostate gets larger, more PSA is always made. Also we must realize that prostate cancer is not a single disease but a spectrum of conditions, and that most men with prostate cancer have a mild form that will never be a problem for them.
Therefore without knowing the size of the prostate, there is no way to interpret a PSA below 10, at least in white men (not enough research has been done on men of other races but there are at least hints this is the case with Hispanic men). Only a transrectal ultrasound can reliably document prostate volume. A man with a small prostate and a high PSA may actually have an aggressive tumor and should undergo a biopsy. A man with an enlarged prostate and a PSA below 10 should not have a biopsy and certainly shouldnÕt have his prostate removed unless a biopsy shows very aggressive cancer.
Therefore, as I do, it is imperative to look at multiple factors to determine if a man has an aggressive prostate cancer that requires surgery or other invasive therapies. Come in for a holistic evaluation and honest discussion of all your treatment options, be they natural supportive measures or radiation or surgery.
1. Stamey TA, Caldwell M, McNeal JE, et al. (2004) “The prostate specific antigen era in the United States is over for prostate cancer: What happened in the last 20 years?” J Urol 172:1297-301
2. Stamey TA (2002) “Limitations of serum PSA below 10 to 12 ng./ml” AUA News 7:31.
3. Stamey TA (2003) “Editorial: More information on prostate specific antigen and prostate cancer” J Urol 170, 457Ð458, August 2003
© Dr. Eric Yarnell, October 1, 2004.This article may be reprinted in any non-commercial forum as long as it is not altered in any way
Merck's voluntary removal of Vioxx (rofecoxib) reveals the serious problems with the pharmaceutical model of medicine and highlights the safety of natural medicines.
This "wonder drug" for arthritis has since 2000 been strongly suspected
of increasing the risk of heart attacks and strokes, now confirmed by a large
study conducted by Merck (see www.vioxx.com
for more information).
However, it was never shown to be more effective than older drugs, and now clearly the idea that it would be safer has been proven false. Compare this to herbs or nutritional supplements used for similar indications, such as osteoarthritis, including ginger, willow, devil's claw, glucosamine sulfate, and vitamin E. These all have incredibly good safety records and work with the body, not against it.
The drug industry tries to hide the fact that its products, taken as directed, are one of the leading causes of death in the US.1 Natural products, though taken by enormous numbers of people, cause very few deaths every year.
The time has come for things to change. Every drug trial funded by the government should be required to have a natural product comparison arm to see if the drug is better or safer than natural alternatives. Drug company employees should never be allowed to work for the FDA or make decisions on approval of drugs. Every clinical trial should be registered before patients are entered so that negative studies can't be hidden or suppressed. And FDA should require longer duration studies to look at the safety of drugs before they are approved. And drugs should be more often reserved for those patients who don't respond to safer, cheatper, natural alternatives and not the first line of treatment.
The next time you see a drug ad on tv, remember, let the buyer beware.
1. Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: A meta-analysis of prospective studies. JAMA 1998;279(15):1200-5.
Disclaimer: Medicine is a rapidly evolving area. Every effort has been made to provide accurate, complete information at the time of publication. However, new information may become available leading to changes. Patients should always consult with their health care practitioner before making changes in their treatment programs because often their are complexities involved that no single source of information could explain sufficiently. Additionally, every individual is unique and applying general information without the informed opinion of multiple sources of information is unwise. Eric Yarnell, ND, RH, PS is not responsible for the inappropriate application of any information on this website.
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