Wednesday, June 20, 2012

Science, a TNM Partial Review, ND Partovi and Me

here, I cite from and comment upon a recent exchange [see 002., below] I had with a California naturopath regarding my partial review of a naturopathy textbook that is blatantly pseudoscientific [see 001., below; my comments are in unquoted bold]:

001. blatant pseudoscience excerpts and my partial review:

001.a. the pseudoscience of the Textbook of Natural Medicine [TNM; in part]:

001.a1. oh, there is just so much pseudoscience at the HEART of AANP-AANMC-FNPLA-CNME naturopathy!

Editors Murray, M.T. (ND Bastyr 1985) & Pizzorno, J.E. (ND NCNM 1975) have a chapter in "Textbook of Natural Medicine" (3rd ed., 2006; ISBN 978-0-443-07300-7) by ND Bradley titled "Philosophy of Naturopathic Medicine" which states such gems as:

"the foundations of naturopathic medical philosophy are found in vitalism [...] naturopathic medicine has always identified the Latin expression vis medicatrix naturae (the healing power of nature) as its philosophical linchpin [...] to survive and thrive in this new environment, naturopathic medicine must keep its vitalistic roots [...] the philosophy of vitalism is based on the concept that life is too well organized to be explained simply as a complex assemblage of chemical and physical reactions [...] the third general argument in favor of a vitalistic view of life is evolution [...] the point is only that vitalism is a medical philosophy based on observable scientific phenomena. Unfortunately, a definitive definition of this quality (in the old literature called the 'vital force,' defense mechanism,
or simply 'nature') will have to wait for more research."

So, there's their HNP vitalism thing claimed as scientific though, quite unscientifically, not only science-ejected but admitted to be as scientifically observed as the Easter Bunny.  It gets better. In the chapter "A Hierarchy of Healing: The Therapeutic Order: The Unifying Theory of Naturopathic Medicine" NDs Zeff, Snider, and Myers state:

"an entire physiologic system [includes] (immune, cardiovascular, detoxification, life force, endocrine, etc.) [...] many naturopathic modalities can be used to stimulate the overall vital force [...and] harmonize with your life force [...] as disturbing factors are reduced in the system, the natural tendency of the system to improve and optimize its function directs the system back toward normalcy. This is the removal of the obstacles to cure, which allows the action of the vis medicatrix naturae, the vital force, the healing power of nature."

the icing on it all is to label his science-ejected vitalistic nonsense, "science-based natural

this is, truly, 'science that ain't science.'

001.b. my partial review of that TNM, "This is Scientific Medicine?" (posted 2006-05-20) whereby I give the tome "1.0 out of 5 stars", wherein "14 of 106 people found the following review helpful" (as of 2012-06-17), states:

"I recently viewed the new chapter concerning 'naturopathic philosophy' [in the 3rd edition, 2005] within this text at the University of Bridgeport's library, as there's a naturopathic school there that I attended. The chapter discusses the premises of 'the naturopathic.' Do you really want to be treated by a physician who conflates (blends) supernatural, nonscientific, scientifically discarded, idealistic, metaphysical, religious and scientific information -- and presents the whole thing as [supposedly] scientific? [a misrepresentation: Kitzmiller et al. v. Dover Area School District anyone?]. Check out "The Epistemic Conflation of a School of Thought Claiming to be Scientific" and "Why I Dropped Out of Naturopathy School" online per me, Rob Cullen. [THIS is future healthcare? I disagree, these prophets are truly 'facing backward']. I'm highly ethically disturbed by this text and naturopathy, still. I'll just make one point about this book's contention that complexity, self-regulation, and evolution indicate that life defies the laws of natural science {and is therefore supernatural} -- particularly the second law of thermodynamics, per physics, in terms of life as supposedly being antientropic as indicated by life's evolving complexity [p.081-082] -- therefore justifying, particularly, vitalism and its handmaiden teleology-finalism. [Beliefs essential to 'the naturopathic'; explanations no longer within science at all; rejected-knowledge in terms of the scientific].[Yes, evolution! Even though evolution is actually the culmination of 'methodological naturalism,' which is HOW science approaches phenomena, that is: SCIENCE DOES NOT INVOKE THE SUPERNATURAL {which includes ideas like naturopathy's vitalism, spiritism and kind}, science determines its contents based upon EMPIRICAL EVIDENCE, and exceptionally LEAN explanatory approaches {per parsimony: as in 'do not multiply entities needlessly'; that is, if not ascribed by the evidence, IT ISN'T A SCIENTIFIC EXPLANATION}]. Ah, HUGE problem. The second law deals with closed systems and life's context is within an open system, in terms of thermodynamics. [For the compliance of the 'living' with thermodynamic law, see Atwater & Rosa's work in 1897 which specifically speaks in terms of the first law {the Kinesiology Dept. of Rice University has a nice web page on biological thermodynamics}; and see 'Biological Thermodynamics' ISBN 0521795494 {p.321 specifically speaks in terms of the second law}]. UB says NDs practice "scientific medicine" and naturopathy is "health science." Hmmm, what kind of [supposed] science text gets something so simple WRONG? Naturopathy is a 'self-labeled science-based' area that won't let go of what has not been considered scientific [the supernatural, the metaphysical, the idealistic, the scientifically-refuted and -discarded -- and kind; i.e., the tenets of their doctrines] for several decades PLUS. This text reflects naturopathic 'epistemic mislabeling nonsense' [e.g. naturopathy's vitalism ("life force"), spiritism ("personal spiritual development; body, mind, spirit"), autoentheism ("god-power within"), teleology-finalism ('life force' as "intelligent, purposeful, goal-directed") and 'whatever else idealism'/ woo-woo AREN'T science-based (or even empirical phenomena, as in therefore 'not scienceable') -- but are falsely labeled as scientific by naturopathy anyway]. In reality, minimally, a mandatory, manipulatable, spiritual, 'underlying' {metaphysical, supernatural, idealistic and what-not} 'life force' {of many aliases} immediately responsible for states of health and disease is INSTEAD AN ARTICLE OF FAITH {aka a 'sectarian medicine' belief set}. Hmmm: "the most thoroughly researched and carefully referenced text on natural medicine has been revised to include the most up-to-date information...." It has been a couple of months since I read that chapter, and I'm still, honestly, LAUGHING OUT LOUD. Naturopathy is, essentially, a 'supernatural science' (an oxymoron; particularly, vital-force-spirit, spiritism, autoentheism, and teleology-finalism as "science-based" are arrived at through a radical unlimiting of the boundaries of 'the scientific'); while evidence from science doesn't support the supernatural / theistic, the metaphysical, or the idealistic; and vitalism and spiritism, in terms of physiological agency, are refuted biological hypotheses. -rc."

Note: I stand by this partial review, to this day, and I wrote it 6 years and one month ago.

002. Partovi, R.D. (ND SCNM) chimes in:

[page 02, page 03; these reviews are not locked, by the way, so comments written by others can be altered by them in the future, therein, I've video screen captured these and will talk of them as of 2012-06-13]

i. Posted on May 31, 2012 12:26:18 AM PDT Ryan Darius Partovi says:

"Hey Rob, Send me an email. I tried emailing you recently, but your old email address didn't work. Anyway, just wanted to let you know that our new textbook, Fundamentals of Generative Medicine has a great chapter at the beginning explaining how what we perceive as 'vitalism' is actually an emergent property of what we perceive as 'mechanism.' It's pretty fascinating stuff, brought to you by the mind of Peter J. D'Adamo (and edited by yours truly). :-) Best wishes, Ryan."

Note: he has me confused with someone else. I do look forward to the D'Adamo book, if I can get it cheaply.  What ND Partovi doesn't understand is that if what he says is true regarding their approach to vitalism, then the book is a radical departure from the central defining doctrine of naturopathy.  In refuting vitalism, if true, they are stating that the human body conforms to the general model of modern human biology which, ultimately, is materialistic, reductionistic, mechanistic, scientific, evidence-based, parsimonious and the like.  Therein, life force and vital force is EJECTED.  This could be an interesting schism within the naturopathic fold.

ii. In reply to an earlier post on May 31, 2012 4:51:31 AM PDT Robert J. Cullen says:

"Great, a new 'category' of so-called complementary and alternative medicine [sCAM] -- trade-marked, I'm sure! I guess the products run through their respective revenue cycles, and a new model must be fabricated and marketed: blood type diet --> genotype diet --> generative medicine. A suggestion is that you get a comp. of that textbook into the hands of the senior editors at Science Based Medicine [Gorski, Novella; and I suggest Atwood and Hall too] for review. As a JD yourself, you may find the posts there by Jann Bellamy interesting. Is this the same ND D'Adamo that Time Magazine reviewer Sachs wrote about in 2008: 'if there's anything scientifically sound about any of this [the Genotype Diet], we haven't seen the signs'? Briefly, regarding 'how what we perceive as vitalism is actually an emergent property of what we perceive as mechanism', I'd have to see what operational definitions are being employed and in what contexts. Perhaps, you are admitting that a delineation is possible between what is grossly science and what is grossly science-exterior, in a basic sense. I notice that your bio. up at D'Adamo speaks of 'preventive, evidence-based, integrated medicine.' Rich. I take it, then, therein, if we truly are delineating science from nonscience, that you'd disagree with the NPLEX/ NABNE claim on ND /NMD boards that homeopathy is a clinical science? If we're talking about rigorous professional standards, evidence, and scientific analysis, that is, wouldn't you agree that something as bogus as homeopathy shouldn't be falsely labeled as science? Ah, having flashbacks of my UB days: wherein a few classes in homeopathy nonsense were required to graduate [which I kept dropping], and so many scores and scores of hours in clinic employing homeopathy were required in order to graduate [yet, I sat around doing nothing, overseen by the homeopathy instructors whose repugnant classes I kept dropping, and who couldn't look me in the eye]. So, I dumped the program [it would have taken 15 years of tuition to graduate, based upon the patient contact hours they were exposing me to]. I find homeopathy ethically repugnant, and why be part of an apparatus like North American naturopathy wherein nonsense and sense, science and unicorn tears, are irrationally all considered the same 'good stuff'. I'm looking forward to the forth edition of the TNM too, which likely gets released this fall. And then there's also the future Foundations textbook. -r.c."

Note: I'm not sure what the idea is of a new product called "generative medicine."  There is medicine that science supports and then there is crap, basically.  UB: what crooks.

iii. In reply to an earlier post on May 31, 2012 2:33:38 PM PDT Ryan Darius Partovi says:

"Hey Ron, I don't know if you recall, but you and I had an email discussion some years ago back in October of 2010 when you still had the email address I'm sorry that I dropped off the dialogue-got busy with school, as I'm sure you can imagine. I'm glad to reconnect with you, although I'm sorry to hear that you were unwilling to finish the program at UB. As the former resident at UB the last year, I can tell you that despite the challenges that school faces, it was an immensely edifying and rewarding experience for me working with the students there. I happened upon our conversation some months ago and sent you a reply, only to find out that your email address was no longer good. I would like to enroll you into continuing our dialogue via email if you would like. Mine is I will copy and paste the last part of our conversation below. You last message read: Your explanation of the dilution method continues to make a lot of sense, but as I read that article you sent me it strikes me as odd that, at once point the author would attempt to address the 'is homeopathy the placebo effect' by making the overwhelming bulk of her response to that question be a thorough and impassioned defense of the very real physiological chemistry behind the placebo effect -- namely, dopamine effects, if I recall -- and then spent only the last sentence or two saying that, in fact, homeopathy has been concluded in several studies to have an effect beyond the placebo effect. Why go to such lengths to defend and validate the placebo effect if homeopathy isn't the placebo effect, after all? My response: Hey Ron, So, this is a little ironic. I was searching for an old email completely unrelated to yours, only to happen upon yours regardless. I'm wondering how you're doing! I never heard from you, although my phone number is still the same. I hope you're doing well. I just started my first year of residency at the Center for Personalized Medicine and D'Adamo Personalized Nutrition in Wilton, CT, as well as the University of Bridgeport College of Naturopathic Medicine. Peter and I are working hard on the creation of a Center for Excellence in what we hope will become a new specialty/modality within naturopathic medicine called "Generative Medicine" here at UB. You can read about that here: I'm still not a fan of homeopathy. In fact, it was the one section of my clinical boards that I didn't score > 75%. That said, they've recently re-done the way the boards are scored such that all naturopathic modalities are averaged into one score, which makes up 33% of your board result, the other 67% being made up of clinical diagnosis and "other interventions" (pharmacology and emergency medicine). Thus, my high scores on the other modalities more than made up for my low homeopathy score, hahahah. Anyway, I hope you managed to tough it out at NCNM or at least to transfer somewhere that was a better fit for you! Please let me know how and what you're doing, where you are now, and I'm sure Peter would join me in giving his regards. Sorry for the severely delayed response! -R "

Note: what kind of language is "I would like to enroll you"? Ah, naturopathy, a truly remarkable reversal of values, wherein science is nonscience, and excellence is equated with "generative medicine."

iv. In reply to an earlier post on Jun 3, 2012 12:53:09 PM PDT Last edited by the author on Jun 3, 2012 12:54:23 PM PDT Robert J. Cullen says:

"Surreal: if the above post is directed at me, Rob, well basically I'm not Ron and never used that name or that email. I don't see a Ron in these comments, actually, either. So, you've mixed up or dare I say INTEGRATED recipients, I think. The conversation you've detailed is, therein, not one I was a party to. Your mentioning of the NPLEX though is a reminder to me not to trust naturopaths: the last thing homeopathy is is a legitimate 'clinical science' as those board exams falsely posture [and this textbook]. Doesn't it ethically bother you that naturopathy poses as a 'science-based profession' yet what profession is based upon false labels like 'the clinical science that is homeopathy'? I don't' think the dentistry boards have a section on the Tooth Fairy. I don't think the veterinary boards have a section on the Loch Ness Monster. Yet naturopathy has a section on homeopathic magic beans and unicorn tears falsely labeled science. I don't consider being a part of such a racket 'edifying and rewarding.' To get back to the book these comments are based upon, ND Bradley [when, apparently he] states in his chapter, through a mannerism of similar false labeling: '[regarding] vitalism [...] there is no conflict with the findings of biomedical science.' Vitalism is science-ejected, period. I recommend the work of evolutionary biologist Ernst Mayr: if we are TRULY talking about vitalism and not weasel-wording the concept through a patina of naturalistic-language-obscurantism. -r.c."

Note: Mayr used to be up at the New York Academy of Sciences debunking vitalism.  They took it down, for what I'll guess are political reasons, though it is archived.

v. In reply to an earlier post on Jun 3, 2012 11:48:28 PM PDT Ryan Darius Partovi says:

"Hmmm, Sorry Rob, it appears that I mistook you for someone else. Regarding your concerns about the empirical basis of homeopathy, I would refer you to the following peer-reviewed journal articles:

which contains the following quote that I find helpful: "...we hope that the debate will finally move from the question, `Does homeopathy work?' to the more pressing questions of `How does homeopathy work?' and `What conditions can homeopathy treat effectively and cost-efficiently?'" In sum: just because you don't understand how something works doesn't change the fact that it works. :-) Put another way: "Once you eliminate the impossible, whatever remains, no matter how improbable, must be the truth." - Sir Arthur Conan Doyle Regarding vitalism, I find it ironic that you cite Ernst Mayr in defense of your premise that vitalism is "science-ejected," because it was Mayr himself (cited by D'Adamo in his work on epigenetics) who said, "The genetic basis of characters could be modified either by direct induction by the environment, or by use and disuse, or by an intrinsic failure of constancy, and that this modified genotype was then transmitted to the next generation." This inherently Lamarckian biological perspective was roundly despised for nearly 2 centuries by the biological mainstream. It's only been within the last 10 years that the environmental regulation of genetic expression has begun to be fully appreciated by most biologists. I'm confident that Mayr would appreciate and concur with D'Adamo's most recent conception of vitalism (i.e., the vis medicatrix naturae) as an emergent property of systems biology. I would enroll you into reading at least the first few sections of the academic textbook, Fundamentals of Generative Medicine to better understand the concept, which is far too complex to fully explore in the scope of a book review. You can acquire a copy here: Dr. D'Adamo also provides copies to current UBCNM students if you decide to continue your studies there based upon your newfound appreciation of the empirical basis of naturopathic medicine."

Note: it's easy to cherry-pick.  Quotes from famous people are not science.  When I quote a famous scientist summarizing something, it is not the same as some famous non-scientist lauding nonsense. But, ND Partovi is also a lawyer, and law is argumentation and sophistry, not scientifically rigorous engagement.  Again, who asks someone "I would like to enroll you into reading"?  I like the end leading sentence, whereby I'm asked when I stopped beating my wife...though I am not married.  Similarly, I do not have an appreciation for naturopathy's "empirical basis" for the empirically vacuous.  And by the way, science is a subset of empiricism.  It is not enough to be empirical to be scientific.  It is a necessary condition but there are other aspects to scientific rigor besides empiricism.

vi. In reply to an earlier post on Jun 4, 2012 11:55:11 AM PDT Robert J. Cullen says:

"This is like arguing with a creationist about evolution, or the age of the earth. Actually, rigorous science has shown us that homeopathy is indistinguishable from placebo. Cherry-picking weak studies that have been superseded is in fact a hallmark of pathological science. I believe, if homeopathy had actually been shown to work regardless of how it works, the Nobels would have been already awarded, the scientific model of the the world would have been remodeled to include magic unicorn tears [quite a revolution!], and homeopathy wouldn't be facing defunding in the UK's NHS based on rigorous scientific consensus. Your argumentation reminds me just how muddled, absurd, and retrograde naturopathy is, epistemically. You use biochemical complexity / genetics to support a dualistic idea that historically is a position claiming 'the physical composition and context of the organism is not enough to explain life' / vitalism [and teleology]. You know, when Jim Sensenig taught VMN to me as "god power within you" in 1998, I don't think he meant 'your genes, your phenotype.' What you are defining is then not the vitalism of "life force" / lebenskraft / vis medicatrix naturae / chi / prana / orgone / 'god power within' etc. Either your category has an operational definition that is discrete and therein a baseline for discussion, or you are merely recontextualizing the category at whim and therein continually moving the goal posts during a discussion. I look forward to the future nonimpact of 'generative medicine', scientifically speaking. The blood type diet and genotype diet are quite laughed at in terms of their supporting data, their claims, and their thought methodology in terms of rigorous science. Don't you think they'd have transformed the world by now if they were the breakthroughs claimed? Your homeopathy example reminds me that one can cherry pick oneself into some of the most absurd positions. I much prefer , whereby, in terms of rigorous thought and not junk thought, Shelton explains why homeopathy's empty-pills are indistinguishable from placebo. What's funny about that book is that the only reviewer, who gushes about homeopathy, obviously didn't read the book because he thinks it is a book supporting the use of homeopathy. As for the University of Bridgeport claiming "health science" and including homeopathy [and kindred delusions], I AM ETHICALLY REPULSED. -r.c."

Note: yup.

vii. In reply to an earlier post on Jun 4, 2012 12:05:38 PM PDT Ryan Darius Partovi says:

"Rob, If you are so very convinced that the weight of scientific evidence supports allopathic medicine as the only effective paradigm, why did you ever pursue a doctorate in naturopathic medicine in the first place? Why not just go to allopathic medical school? In my mind, both allopathic and naturopathic medicine have their roles to play in the health care system as it stands. The allopathic approach focuses on the management of symptoms and treatment of disease using drugs and surgery as interventions to create the minimum impact on a person's lifestyle and productivity. The strengths of the allopathic approach are the increased freedom that it allows patients with regard to their diet, lifestyle choices, etc. The allopathic paradigm looks to science for a greater understanding of disease processes in an effort to circumvent or counteract those processes using standardized interventions, which are often subjected to large clinical trials prior to use, to minimize the impact of diseases on the lives of their patients. This paradigm is superb in the realms of emergency and other urgent care scenarios and has a mixed level of success in the arenas of prevention and chronic disease. The naturopathic approach focuses on the understanding of the laws of nature for the purpose of helping patients move from a diseased state toward an ultimate goal of optimal wellness by changing their diet, lifestyle, etc. to be more in line with those natural laws. The naturopathic paradigm uses science to better understand what is necessary to further optimum wellness in each particular patient. Therefore, the naturopathic approach favours reserving drugs and surgery for only those scenarios in which the patient's condition is so severe that an increased level of intervention is necessary to preserve their health. The strengths of this approach are that it has a high level of success with chronic diseases (so-called "lifestyle diseases"), can help patients who may lack a clearly-defined clinical disease state but who fall short of feeling fully empowered in their lives, and has excellent success with the prevention of many diseases. The weaknesses of the naturopathic approach are that it does require considerable changes to diet and lifestyle on behalf of the patient, which may frustrate some patients, and as it has historically lacked a set of standardized interventions (as a profession and a company, we are working to change that), there is a lower level of evidence available, with most studies being smaller or circumstantial rather than interventional, to support the use of any one particular treatment. Thus, it's most productive, in my view, to view the two paradigms as relatively orthogonal (independent relative to one another, non-redundant, and non-overlapping). They are simply two different paradigms for two different types of people, which have two different underlying objectives, and which work differently toward different results. The allopathic paradigm works toward minimizing the effects of disease on a patient's life and lifestyle, while the naturopathic paradigm works directly to change the patient's life and lifestyle to bring it more in line with the laws of nature. Both approaches have benefits for different types of patients at different times in their lives, and neither is inherently "better" or more or less "valuable" than the other. They each have their place in the healthcare system, and neither is a threat to the other because of these differing paradigms and the different market needs that they therefore serve. With regard to the evidence basis of naturopathic medicine, I will refer you to the Naturopathic Physicians Research Institute (NPRI - for further information."

Note: I consider it quite an error to label modern medicine "allopathic."  It's a nonsense distraction, really. Naturopathic laws contain the science-ejected falsely labeled science.  What kind of law is TOTALLY WRONG?  An 'unjust law', so to speak.

viii. In reply to an earlier post on Jun 4, 2012 8:28:38 PM PDT Robert J. Cullen says:

"You are falsely positioning me: e.g. "if you are so very convinced that the weight of scientific evidence supports allopathic medicine" [I am criticizing naturopathy from the point of view of scientific skepticism not as it compares to modern medicine, and the use of the term allopathic is quite wrong in terms of modern medicine. We don't call modern chemistry alchemy and we don't call modern astronomy astrology. Similarly, allopathic is quite an inappropriate label. That may have been the medicine of Hahnemann's time, but it is an archaicism]; "why did you ever pursue a doctorate in naturopathic medicine in the first place?" [because they labeled it and continue to label it something it overall is not, in terms of the essentially naturopathic: science]. Notes on some of your assertions: "the naturopathic approach focuses on the understanding of the laws of nature" [when people are telling me things like Hering's Law of Cure is a scientific fact, as a law of nature, yeah right, that's a 'law'. Science dynamically discovers the laws of nature, while static sectarian nonsense like homeopathy's ADIO is in the dustbin]; "the naturopathic paradigm uses science" [then why is the vitalistic, supernatural, teleological and kind within naturopathy when those things are science-exterior but they fundamentally define naturopathy, because for naturopathy the illogic is science subset nonscience]; "neither is inherently 'better' or more or less 'valuable' than the other" [well isn't that convenient, except for this very obvious fact: naturopathy abuses the public trust by labeling the patently nonscientific science-based and then engaged in clinical and education commerce under such false postures aka licensed falsehood; for me, labeling as a scientific fact that which exterior to what science supports is in no way valuable, it is miseducation. And NCNM's explanation of naturopathy's principles are quite the primary source regarding that. As I've said many times, naturopathy is a great example of the reversal of values: the science-ejected is termed science-based, the supernatural is termed natural, the absurd sectarian is termed a law of nature, deception is termed professional etc.]. But, thanks for engaging in this discourse. Very few of your colleagues do engage. My future plans regarding the naturopathic are to continue to independently watch, analyze, compile and critique, and also to directly engage with State's consumer protection departments and the like in both licensed and unlicensed states. I think it's a damn shame that a whole generation is being miseducated, and I'm speaking of this globally in terms of naturopathy [listed here in part]: that iridology and homeopathy are science [Australia], that EAV is a powerful diagnostic tool [Canada], that craniosacral therapy is doing what they say it does and we are all riddled with toxins that we need colonics to rid us of [US]. Oh, it goes on and on. -r.c."

Note: yep.

ix. In reply to an earlier post on Jun 5, 2012 9:50:21 AM PDT Ryan Darius Partovi says:

"I'm convinced that the fundamental disparity between our positions is the definition of the term "science-based." In the law (I also have a law degree), there is a concept called "burden of proof," of which there are several levels. You can find a full review of each level here: I find it useful when engaging with allopathic (antipathic, if you prefer-hardly controversial, as even the Kyoto Encyclopedia of Genes and Genomes (KEGG) defines diseases as perturbed states of the molecular system, and drugs as perturbants to the molecular system - colleagues to go to this burden of proof concept to describe some of our fundamental differences with regard to our approach to treatment. My use of the term "treatment" only was intentional, as diagnostics in the naturopathic world are completely derivative from conventional medicine. While the culture of allopathic/antipathic medicine requires randomized, placebo-controlled, double-blinded clinical trials to show efficacy of high-powered, high-risk, single interventions (the primary modality of conventional intervention because of their total reliance on drugs and surgery for treatment); the naturopathic medical model looks to outcomes-based research to evaluate the outcome of a complete protocol that includes a cluster of low to moderate-power, low-risk interventions (e.g., nutrition, herbal medicines, food-derived medicines, hydrotherapy, exercise, meditation, etc.), which have either a theoretical (e.g., the blood type diet) or empirical (e.g., homeopathy) basis in the scientific literature. Now, back to that term "scientific basis," because I see that as the crux of our disagreement (let me know whether or not you agree). As naturopathic physicians, because we are using a cluster of interventions, it doesn't really matter whether or not one or two of their effects turns out upon further study to be mostly or even wholly placebo (although, the possibility remains the the effects of certain single interventions are only synergistic-and this too should be studied, e.g. does homeopathy increase the efficacy of an otherwise identical protocol?) as long as the weight of all of the interventions is efficacious. When you look at the outcomes-based research, the answer is clear-naturopathic medicine works (at least in the studied areas)! (See: for examples.) Having established that naturopathic physicians need not always utilize the highest-proof single interventions because of the holistic, broad nature of our approach; it makes sense that we apply a "preponderance of the evidence" standard when deciding upon single interventions, i.e., that an intervention is more likely to be efficacious than not efficacious. Effectively, the standard is satisfied if there is greater than 50 percent chance that the intervention is efficacious. Put simply, if 49% of the studies are negative and 51% of them are positive, the naturopathic physician may include it into her protocol. In the allopathic world, because of the reliance on high-powered, high-risk, single interventions (i.e., drugs and surgery), it is necessary to apply a higher burden of proof with regard to the science-basis of the interventions. Typically, I find that in those cases where there is a rigorous science-basis for conventional interventions (A 2001 review of 160 Cochrane systematic reviews (excluding complementary treatments) in the 1998 database revealed that 41.3% concluded positive or possibly positive effect, 20% concluded evidence of no effect, 8.1% concluded net harmful effects, and 21.3% of the reviews concluded insufficient evidence. The reviewers concluded that, "the number of reviews indicating that the modern biomedical interventions show either no effect or insufficient evidence is surprisingly high." -, the level applied is the higher "clear and convincing evidence" standard that requires that the evidence for the intervention be "highly and substantially more probable to be effective than not" and the clinician must have "a firm belief or conviction in its efficacy." That higher burden of proof is appropriate in a practice of medicine that relies upon high-powered, high-risk single interventions. In sum, I would like enroll you into considering that both naturopathic and conventional medicine have varying burdens of proof for the use of their interventions, each of which is appropriate to the nature of their practice. I appreciate your analysis and critique, and should you be made aware of any physician who does harm to their patients, then I would encourage you to report them to their state's consumer protection authorities. As my mentor once quoted to me, 'A good doctor is better than a bad doctor, but no better than none at all.'"

Note: again, that weirdness of "I would like to enroll you."  I'm not sure I understand the last quote.  A good doctor is better than a bad doctor but no doctor is better than both, is what I take out of it. "Diagnostics in the naturopathic world are completely derivative from conventional medicine" is bullshit.  The Naturocrit post before this has a naturopath claiming that with iridology she can see in that patient's eye the health of the past three generation of that patient.  And regarding "it doesn't really matter whether or not one or two of their effects turns out upon further study to be mostly or even wholly placebo", now we're at the core of naturopathy.  "Science" as a marketing tool but NDs [and the racket in general] don't care if it's true.  Instead, as this last ND Partovi entry indicates, they lazily move the goal posts during the game.  Science's parameters are quite defined, and I think ND Partovi has done a very good job of explaining just how non-rigorous naturopathy's knowledge process is.

and regarding "should you be made aware of any physician who does harm to their patients", what I am quite aware of are schools that train supposed physicians that are BOGUS SCHOOLS and therefore in terms of false commerce, HARMFUL.
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