"Dear naturopaths ..."
While the salutation may have been cordial enough, what followed in a Canadian doctor's series of tweets about naturopathy held nothing back. Vancouver family physician Jon Hislop's tweets about the "trouble" with naturopaths struck a chord with many people in the medical community, while placing supporters of the practice on the defensive.
"You seem to have no idea how much trouble you cause for patients, MDs, and society in general. This trouble is getting worse, and it has to STOP. Since you seem to have no insight into these issues, here are some of the (many) problems you create for us all ..." Hislop wrote on Twitter on Friday.
"Naturopaths, turn your attention inwards, and ask yourselves a tough question: Doctors have been teaching ourselves, and our trainees ad nauseum "DO NO HARM"!! Do you really think you can you say the same ... ?"
1/n— Jon Hislop, MD, PhD (@HislopMD) February 2, 2018
You seem to have no idea how much trouble you cause for patients, MDs, & society in general. This trouble is getting worse, & it has to STOP. Since you seem to have no insight into these issues, here are some of the (many) problems you create for us all...
The rise of alternative medicine in Canada
Canadians spent about $8.8 billion dollars on complementary and alternative medicine (CAM) in 2015-2016, up from $6.3 billion in 1996-1997, according to a recent report from The Fraser Institute.
More than three-quarters of Canadians had tried at least one kind of complementary or alternative medicine in their lifetime, The Fraser Institute noted. Massage was the most popular, followed by chiropractic care, yoga, relaxation techniques, and acupuncture.
Naturopathy was one of the most rapidly expanding therapies over the last two decades, the institute said in its 2017 report.
The Ottawa Hospital Research Institute, the University of Alberta, McGill University and the University of Toronto have all partnered with natural health practitioners to study the efficacy of alternative treatments, CBC previously reported.
Naturopathy in Canada
Naturopathic medicine "blends modern scientific knowledge with traditional and natural forms of medicine," according to the Canadian Association of Naturopathic Doctors (CAND). Therapies include diet and lifestyle changes, botanical medicine, clinical nutrition, hydrotherapy, homeopathy, naturopathic manipulation and traditional Chinese medicine or acupuncture, CAND explains on its website.
"The naturopathic philosophy is to stimulate the healing power of the body and treat the underlying cause of disease," CAND said.
"Symptoms of disease are seen as warning signals of improper functioning of the body, and unfavourable lifestyle habits. Naturopathic medicine emphasizes disease as a process rather than as an entity."
There are more than 2,400 naturopathic doctors practicing across Canada, CAND noted. British Columbia, Alberta, Saskatchewan, Manitoba and Ontario all regulate the practice.
"Weird, non-evidence based treatments"
In his tweets, Hislop urged naturopaths to stop making patients think they need tests from their doctors, adding that when doctors disagree with a naturopath's recommendations, it compromises their relationships with their patients.
3/n— Jon Hislop, MD, PhD (@HislopMD) February 2, 2018
It takes a LOT of time for MDs to explain why MANY (nearly all) of the tests naturopaths are often demanding SHOULD'NT be done! This re-education, takes AWAY time spent effectively on that #patients actual health issues. This isn't helping their care! This COMPROMISES it!!
Hislop also asserted that naturopaths give their patients "a fantasy" that meets their own needs instead of the needs of the patients.
"The many WEIRD, non-evidence based treatments naturopaths often seem to RECOMMEND compromise patient care! Creating an expectation in patients that an unfounded treatment will work, distracts them from focusing their efforts on TRUE balance and healing in their lives!" Hislop wrote.
5/n— Jon Hislop, MD, PhD (@HislopMD) February 2, 2018
Naturopaths, giving patients hope can be helpful to their well-being. Giving them a FANATASY about some random MADE-UP 'therapy', especially when it replaces a proven one, is NOT being fair to THEM. It meets YOUR NEEDS NOT THEIRS!!!
6/n— Jon Hislop, MD, PhD (@HislopMD) February 2, 2018
Every minute MDs spend reassuring patients that they don't need to have tests & treatments their naturopath told them to have, leaves LESS time for other patients. Naturopaths are REDUCING access to care for everyone!! This is a hidden cost of naturopathy that AFFECTS US ALL!
Hislop urged that naturopaths be held accountable to their patients and to society for their actions.
10/n— Jon Hislop, MD, PhD (@HislopMD) February 2, 2018
Society needs to start insisting that naturopaths are ACCOUNTABLE to patients & society for the costs & consequences of their actions, just like the rest of us are. This #bignatura industry needs a massive overhaul, a 'reset', or possibly a 'DELETE'.
11/n— Jon Hislop, MD, PhD (@HislopMD) February 2, 2018
Naturopaths, turn your attention inwards, & ask yourselves a tough question: Doctors have been teaching ourselves, & our trainees ad nauseum "DO NO HARM"!! Do you really think you can you say the same...?
12/12— Jon Hislop, MD, PhD (@HislopMD) February 2, 2018
PS naturopaths - the odds that every single patient you see has either: a 'hormone problem', 'undetectable celiac disease', 'sugar sensitivity', or 'adrenal fatigue' (seriously, these things don't go to sleep), is EXACTLY ZERO!!
"There's nothing wrong with people having choices"
Many in the medical community applauded Hislop's thread, and provided their own examples.
"If naturopaths would quit telling my patients with bipolar disorder (diagnosed with standardized diagnostic instruments, symptoms satisfying DSM criteria) they actually have adrenal fatigue and can stop mood stabilizers I'd be most grateful," one doctor wrote in response.
Another doctor said that, after his "healthy but poor" patient visited a naturopath, his patient was out of pocket for thousands of dollars.
A patient of mine went for initial evaluation $75 with naturopath included iris analysis, saliva & hair test. Left his office w a Rx of $298.57 of natural pills & tumoral regeneration and energy tx for $2,040. He is healthy but poor. Sent me the evidence for my opinion no refunds pic.twitter.com/FLbkp951Kp— Victor Manuel (@chinomalon) February 3, 2018
And please stop telling patients to have their amalgam fillings replaced. They will spend thousands ++ of unnecessary dollars and lose more teeth - guaranteed.— Susan Sutherland (@DrSSutherland1) February 4, 2018
But others, such as a North Dakota MD, said "there's nothing wrong with people having choices."
There's nothing wrong with people having choices. Even if we think those choices are wrong.— Country-fiedMD (@Country_fiedMD) February 4, 2018
And some doctors do not keep up to date on nutrition and exercise, kinesiology professor Lora Giangregorio tweeted.
i agree w sentiments in this thread. But there R docs that do not keep up to date on nutrition, exercise & promote inaccurate info, or R quick to prescribe drugs rather than counsel or refer to dietitian or exercise physiologist or counseling. We all need to improve our practice.— Lora Giangregorio (@l_giangregorio) February 4, 2018
"We all need to improve our practice," she wrote.
"That said. I went to a naturopath once to see what they had to say. Was not impressed by the unnecessary tests they wanted me to pay for," she wrote in a follow-up tweet.
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