Last week, the American Association of Naturopathic Physicians (AANP) announced that it urges government officials coordinating the national COVID-19 pandemic response to utilize all licensed healthcare professionals, including naturopathic doctors (NDs) “to support other medical professionals in changing the trajectory of this public health crisis.”
Yes, we’re facing shortages of health care workers to respond to the rising numbers of severely ill persons in need of hospital care. But government officials have good reason to doubt that NDs and the practice of naturopathic medicine (naturopathy) are needed. I’ll explain why by providing a brief description of naturopathy followed by a refutation of AANP’s argument for NDs to have a role in combating COVID-19.
What Is Naturopathy?
Naturopathic medicine is a distinct primary health care profession, emphasizing prevention, treatment, and optimal health through the use of therapeutic methods and substances that encourage individuals’ inherent self-healing process. The practice of naturopathic medicine includes modern and traditional, scientific, and empirical methods.
Naturopathy and medicine do not exist on the same playing field. They are not even comparable in a way that suggests they might be equal. One is real, validated, and continuously revised by science. The other is more of a religion that is informed by anecdotes and folklore.
She has also written:
Naturopathic education is rich in pseudoscience and fake medicine, and it is devoid of legitimate medical training. Naturopaths are not trained in the rigors of medical science, and this leads to a severe lack of competency and a huge risk of patient harm. NDs seem nice and charismatic, but they do not possess medical competency, especially to prescribe drugs.
Naturopathic practice consists of a hodgepodge of mostly unvalidated and invalidated methods to supposedly: (1) identify causes of illnesses, and (2) assist the healing power of nature known as the vis medicatrix naturae, which NDs view as based in vitalism and as an extension of creator consciousness or cosmic consciousness. As described in The Skeptic’s Dictionary:
Vitalism is the metaphysical doctrine that living organisms possess a non-physical inner force or energy that gives them the property of life.
Vitalists believe that the laws of physics and chemistry alone cannot explain life functions and processes.
Vitalism has not contributed to the progress of science, and neither has naturopathy since John Scheel, a practitioner in New York City, coined the term in 1895. Vitalism-based medicine is not science-based. I doubt that any NDs can facilitate a vitalistic healing power of nature for their patients just as I doubt that there are real Jedi knights who can use “The Force.”
Vitalism in naturopathy is most obvious in practices such as “energy medicine” methods, chakra balancing, crystal healing, homeopathy, medical intuition, and reiki, but it can also underlie herbal medicine treatments. Some naturopathic nonsense is more pseudoscientific rather than vitalistic. Many NDs make dubious diagnoses such as food allergies based on invalid tests, adrenal fatigue, chronic candidiasis, and chronic Lyme disease. Many promote irrational methods for “detoxification,” nutritional support, hormone replacement, etc.
A Healthcare Role for NDs to Combat COVID-19?
According to AANP’s COVID-19 announcement:
NDs are trained comparably to conventional doctors to diagnose and triage according to presenting symptoms, refer to the appropriate level of care, and support patients during at-home symptom management.
But the American Academy of Family Physicians found that family physicians have 15,000 more hours of training than NDs. Residencies are not even required for ND licensure. Even if ND training was to catch up quantitatively with the training of real primary care physicians, the problem would remain that naturopathy instruction, in the words of “SkepDoc” Harriet Hall, MD, “mixes good science with bad science, pseudoscience, outright errors of fact, vitalism, philosophy, ancient history, superstition, gullibility, misrepresentations, metaphysics, religion, hearsay, opinion, and anecdotes.”
AANP also claimed: “NDs practice patient-centered medicine and tailor personalized care plans.”
I’m not sure how patient centered NDs can be in practice given that they use methods of implausible value for their patients. Personalized care is desirable when it’s aligned with reality but not when its marketing outpaces the relevant science. Phony psychics provide personalized care, but that doesn’t make their services worthwhile. The personalized-care/patient-centeredness pitch is frequently used by NDs and other “alternative” practitioners seeking to differentiate themselves favorably from real physicians. But in a recent viewpoint paper, Donald M. Marcus, MD, wrote:
The biopsychosocial model of medical training and the importance of a healthy lifestyle in preventing disease have been tenets of medical education for decades. Evaluation of the humanistic attributes of students, residents, and faculty has long been required by medical schools and by accrediting agencies and medical boards.
In addition to all public health recommendations, NDs employ a toolkit of treatment approaches that can be used to support the body’s inherent immune capacity to prevent viral infections, address viral infections directly, ease symptoms in those infected, and support recovery during post-infection care.
I have trouble seeing how NDs have embraced all public health recommendations, especially considering that NDs tend not to support recommended vaccinations. We have good reasons to be wary of claims for approaches to support the immune system. The idea that NDs or any health professionals have a relevant, safe, effective toolkit to support the body’s immune capacity to fight COVID-19 has been rejected by federal agencies.
- The U.S. Food and Drug Administration (FDA) recently announced: “There are no FDA-approved therapeutics (drugs) to treat COVID-19 or other coronaviruses.”
- The FDA together with the Federal Trade Commission (FTC) recently sent warning letters to seven companies allegedly selling unapproved products that may violate federal law by making deceptive or scientifically unsupported claims about their ability to treat coronavirus (COVID-19).
- In a warning about coronavirus scams, the FTC said: “If you see ads touting prevention, treatment, or cure claims for the coronavirus, ask yourself: if there’s been a medical breakthrough, would you be hearing about it for the first time through an ad or sales pitch?”
The College of Naturopathic Physicians of BC (CNPBC) has become aware that some registrants are promoting treatment or supplements as a means to boost the immune system and may imply that this will prevent infection from the novel coronavirus (COVID-19). [Author’s note: The name of novel coronavirus is actually SARS-CoV-2. COVID-19 is the name of the disease it causes.]
Any statements by naturopathic doctors about the prevention and/or treatment of COVID-19, beyond the information made available by the public health authorities, are inappropriate, potentially harmful, and likely to violate the CNPBC’s Advertising Policy and/or Immunization Standard. When brought to the attention of the CNPBC, such statements will be forwarded to the Inquiry Committee for investigation.
The CNPBC’s Advertising Policy and Immunization Standard prohibit marketing and/or advertising that is false, inaccurate, reasonably capable of misleading the public, unverifiable, or contrary to the public interest in the practice of the profession.
Unfortunately, I have little hope for seeing similar messages from regulators of NDs practicing in the United States.
So, what does the naturopathic toolkit really offer? Pediatric hospitalist Clay Jones, MD, a contributing writer at the Science-Based Medicine blog summed it up well: “The only thing their toolkit might do is spread coronavirus.”