Naturopathy: A Critical Appraisal

Kimball C. Atwood IV, MD

In This Article

Implications for Medicare

In an interview for the Seattle Times, one of the new MCAC appointees offered examples of how he might affect the process of selecting therapies for Medicare coverage:

[The new appointee] said he plans to push for more emphasis on prevention and health promotion. He also wants well-proven and cost-effective alternative techniques to be covered by Medicare.

Examples could include natural ear-infection treatments for infants and acupuncture treatments for those suffering sports injuries or drug addiction, he said. [1]

Naturopathic literature suggests that by prevention and health promotion this Medicare adviser is referring to "detoxification," "cleansing programs" for "food allergies" and "candidiasis," enemas, "constitutional" homeopathic preparations, and so forth. "Natural ear-infection treatments for infants" are not only unproved but are implausible and dangerous. Acupuncture treatments for sports injuries are unlikely and unproven, and acupuncture for drug addiction has been convincingly disproved.[31]

Elsewhere, the same appointee recommends a flower pollen extract for benign prostatic hypertrophy,[32] an "intranasal douche with hydrastis tea" for bacterial sinusitis,[33] a "general bowel detoxification diet" for autism,[34] and oral bromelain (a protein extracted from pineapples) for the "lumpy skin around varicose veins."[35] For cervical dysplasia and pelvic inflammatory disease, he recommends "vaginal depletion packs," 1 by 3-inch cotton tampons containing a tar-like mixture of botanical oils, left in place for 24 hours at a time and repeated weekly.[36]

Formal criteria require that appointees to the MCAC be "from among authorities in clinical and administrative medicine, biologic and physical sciences, public health administration, health care data and information management and analysis, the economics of health care, medical ethics, and other related professions."[37] How were the 2 naturopaths selected? On February 18, 2003, I sent a letter to Thomas A. Scully, the Administrator of the Centers for Medicare & Medicaid Services, making points similar to those in this article and implicitly asking that question. There were 30 cosignatories.* Mr. Scully had not replied as of December.


*Lee S. Anderson, Marcia Angell, Seth Asser, Robert Baratz, R. Christopher Barden, Stephen Barrett, Heather Brock, Carl E. Bartecchi, Henry N. Claman, E. Patrick Curry, John E. Dodes, Bruce L. Flamm, Laura J. Fochtmann, Timothy Gorski, Saul Green, Arthur P. Grollman, James J. Kenney, Jeffrey M. Lohr, Janice Lyons, Peter Madras, Frederick L. Merian, Steven Novella, Arnold Relman, John A. Robinson, Barbara Rockett, Francis X. Rockett, Linda Rosa, Wallace Sampson, Sally Satel, Gerald Weissmann