Naturopathy: A Critical Appraisal

Kimball C. Atwood IV, MD

In This Article

Dissent From the White House Commission on Complementary and Alternative Medicine Policy

Two dissenting members of the recently adjourned White House Commission on Complementary and Alternative Medicine Policy warned, in a letter to Department of Health and Human Services Secretary Tommy Thompson, of the problems introduced by official endorsements of naturopaths and other "complementary and alternative medicine" (CAM) practitioners:

Vulnerable Populations
Patients will often resort to "CAM" practices, modalities and practitioners upon the diagnosis of a debilitating, chronic or terminal condition. Recent Senate hearings have documented the special vulnerability of the elderly [emphasis added] on fixed-incomes to these phenomena.

[CAM practitioners] are not positioned for equivalency with conventional primary care providers. Efforts to equate their degree of training, or the scientific basis of their practice, with that of the designated primary care specialties puts the public at risk of receiving unvalidated and non-evidence based primary care.

... "CAM" "health promotion" and "prevention practices" also include preventing disease by "balancing qi," "eliminating parasites and toxins," "cleansing the liver" and/or by "cleansing the blood" via a multitude of supplements and questionable practices. Our uncritical acceptance of "CAM" wellness and health promotion can be interpreted as an endorsement of these claims. It is absolutely unclear what role, if any, "CAM" practices play in preventing disease and to what extent patients are burdened with useless treatments and products in their pursuit of "wellness."

In sum, generic pronouncements about "CAM" neither serve the public interest nor protect the public health. It is essential to separate the effective from the ineffective, the safe from the unsafe and to contextualize these practices against conventional modalities before [emphasis added] any of them can be recommended for incorporation into the Nation's healthcare system. [38]

Even if Medicare itself successfully resists the efforts of its new advisers, their appointments are already being trumpeted to the public as evidence that the federal government considers naturopathic practices to be valid.[39,40] This will likely help naturopaths in their pursuit of universal state licensure and reimbursement by health insurers. Because licensed health care providers determine their own standards of care,[41] it would be detrimental to the public if naturopaths were successful in this pursuit.[42]