MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

vaccination

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We have recently heard much about spinal manipulations for kids. It might therefore be relevant to learn about an international taskforce of clinician-scientists formed by specialty groups of World Physiotherapy – International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) & International Organisation of Physiotherapists in Paediatrics (IOPTP) – to develop evidence-based practice position statements directing physiotherapists clinical reasoning for the safe and effective use of spinal manipulation and mobilisation for paediatric populations (<18 years) with varied musculoskeletal or non-musculoskeletal conditions.

A three-stage guideline process using validated methodology was completed: 1. Literature review stage (one scoping review, two reviews exploring psychometric properties); 2. Delphi stage (one 3-Round expert Delphi survey); and 3. Refinement stage (evidence-to-decision summative analysis, position statement development, evidence gap map analyses, and multilayer review processes).

Evidence-based practice position statements were developed to guide the appropriate use of spinal manipulation and mobilisation for paediatric populations. All were predicated on clinicians using biopsychosocial clinical reasoning to determine when the intervention is appropriate.

1. It is not recommended to perform:

• Spinal manipulation and mobilisation on infants.

• Cervical and lumbar spine manipulation on children.

•Spinal manipulation and mobilisation on infants, children, and adolescents for non-musculoskeletal paediatric conditions including asthma, attention deficit hyperactivity disorder, autism spectrum disorder, breastfeeding difficulties, cerebral palsy, infantile colic, nocturnal enuresis, and otitis media.

2. It may be appropriate to treat musculoskeletal conditions including spinal mobility impairments associated with neck-back pain and neck pain with headache utilising:

• Spinal mobilisation and manipulation on adolescents;

• Spinal mobilisation on children; or

• Thoracic manipulation on children for neck-back pain only.

3. No high certainty evidence to recommend these interventions was available.

Reports of mild to severe harms exist; however, risk rates could not be determined.

It was concluded that specific directives to guide physiotherapists’ clinical reasoning on the appropriate use of spinal manipulation or mobilisation were identified. Future research should focus on trials for priority conditions (neck-back pain) in children and adolescents, psychometric properties of key outcome measures, knowledge translation, and harms.

Whether one agrees with these directions or not (and I am not sure I fully do), I have always thought that people who, despite the largely lacking or flimsy evidence for spinal manipulations, insist on having manual therapy should consult a physiotherapist, rather than a chiropractor or osteopath.

Why?

Because, in my experience, physiotherapist:

  • display less cult-dependent behaviours,
  • do not follow the gospel of charlatans, like Palmer and Still,
  • do not believe in the fiction of subluxation,
  • are not so money-minded,
  • less prone to use un- or disproven methods, like applied kinesiology, homeopathy, cranial osteopathy, etc.,
  • unlikely to try to sell you useless dietary supplements,
  • tend to judge better their limits of professional competence,
  • are far less likely to try to persuade you of BS related to anti-vax, anti-drug, anti-science, anti-EBM, etc.

Although the vaccine has many individual and social benefits, ‘Vaccine Hesitancy’ has led to an increase in the number of vaccine-preventable diseases.

The aim of this study is to determine the effect of ideas that cause vaccine hesitancy to comply with traditional medicine practices and drugs and to determine the ratio of parents’ preference for so-called alternative medicine (SCAM).

This study was performed on the parents who refused vaccination in their children under the age of 8 between the years 2017-2022. Parents of the vaccinated children who were matched for age and gender were determined as the control group. Demographic characteristics of families, education levels, compliance ratios for well-child follow-up and pregnancy follow-up, preference ratios for traditional medicine and/or SCAM applications were compared.

A total of 123 families, 61 of whom were vaccine refusal and 62 of the control group, were included in the study. It was determined that the ratio of parents who refuse vaccination have increased in the last five years. The education level was found to be higher in the SCAM group (p=0.019). The most common reasons for vaccine refusal were distrust of the vaccine content (72.1%) and noncompliance with religious beliefs (49.1%). It was also found that the ratios of prophylactic vitamin use and tetanus vaccination of mothers during pregnancy were lower in the SCAM group. While the rate of compliance with vitamin D and iron prophylaxis for infants was lower in the vaccine refusal group, the ratio of preference for SCAM was higher.

The authors conclused that vaccine hesitancy is a complex issue that affects public health, in which many individual, religious, political and sociological factors play a role. As with recent studies, this research shows that the most important reason for vaccine rejection is “lack of trust”. The higher education level in the vaccine refusal group may also be a sign of this distrust. Not only the rejection of the vaccine, but also the lack of use of vitamin drugs seems to be related to lack of trust. This may also cause SCAM methods to be preferred more. These results show that providing trust in vaccination is the biggest step in the fight against vaccine hesitancy.

We have discussed the link between SCAM and vaccination hesitancy many times before, e.g.:

This new study seems to imply that the common denominator of both SCAM use and vaccination hesitancy is distrust, distrust in vaccinations and distrust in conventional medicine. That makes sense at first glance but not when you think about it for only a minute.

I can see why people distrust conventional medicine (to some extend, I do it myself). But why should distrust motivate some people to put their trust into SCAM which is even less trustworthy than conventional medicine. The rational thing for a distrusting person would be to critically assess the evidence and go where the evidence leads him/her. This path cannot possibly lead to SCAM but would lead to the best available evidence-based therapies.

If we consider this carefully, we arrive at the conclusion that not distrust but a degree of irrationality is more likely be the common denominator between SCAM use and vaccination hesitancy.

What do you think?

It had been reported that five infants under three months of age have died from whooping cough this year, as cases continue to spread across the country.

The UK Health Security Agency (UKHSA) has reported 1,319 cases of whooping cough in England in March, up from 900 in February and bringing the total for 2024 so far to 2,800.

But there is help!

The “Leading Holistic Health Portal” (LHHP) informs us as follows:

As far as therapeutic medication is concerned, several remedies are available to treat whooping cough that can be selected on the basis of cause, sensations and modalities of the complaints.  For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are following remedies which are helpful in the treatment of whooping cough:

  • Cuprum met – in whooping cough accompanied with convulsions, or when the paroxysms are long and interrupted…
  • Coccus cacti – this remedy has paroxysms of cough with vomiting of clear, ropy mucus, extending in thick, long strings even to the floor…
  • Belladonna – in sudden violent paroxysms of whooping cough, without any expectoration, and the symptoms of cerebral congestion…
  • Spongia Tosta – excellent remedy for whooping cough; dryness of all passages; cough dry, barking croupy like a saw driven through a pine board…
  • Corallium Rubrum – violent spasmodic cough, whooping cough; a very rapid cough, the attacks follows so closely as to almost run in to each other…
  • Aconite – clear ringing whistling whooping cough, excited by burning sticking in larynx and trachea…
  • Arnica Montana – paroxysms of whooping-cough excited by a creeping and soreness in trachea, bronchi or larynx, generally dry, often with expectoration of frothy blood mixed with coagula…
  • Hyoscyamus – shattering spasmodic cough, with frequent, rapidly succeeding cough, excited by ticking, as from adherent mucus…
  • Hepar Sulph – hoarse croupy night cough; deep, dull, whistling cough, in the evening without, in the morning with expectoration of masses of mucus…
  • Drosera – Drosera is one of the remedies praised by Hahnemann; indeed, he once said thatDrosera 30th sufficed to cure nearly every case of whooping cough, a statement which clinical experience has not verified. Drosera, however, will benefit a large number of the cases, if the following indications be present: a barking cough in such frequent paroxysms as to prevent the catching of the breath…
  • Mephitis – Mephitis is useful in a cough with a well marked laryngeal spasm, a whoop…
  • Ipecac – Convulsive cough, where the child stiffness out and becomes blue or pale and loses its breath…
  • Antimonium tartaricum – With this remedy the child is worse when excited or angry, or when eating; the cough culminates in vomiting of mucus and food…
  • Cina –This is not always a worm remedy. It is a most excellent remedy in whooping cough. It has the same rigidity as Ipecac, the child stiffness out and there is a clucking sound in the oesophagus when the little one comes out of the paroxysm…
  • Magnesia phosphorica – This is the prominent Schuesslerian remedy for whooping cough, which begins as does common cold. The attacks are convulsive and nervous, ending in a whoop…

So, why do we have so many cases of whooping cough?

The reason is, of course, the currently very low vaccination rates.

And why are they so low?

Could one reason be that some healthcare practitioners advise us wrongly?

What the LHHP does not tell us is the fact that homeopaths (and other SCAM practitioners) often advise against vaccinating children against whooping cough (and other infections). Take, for instance, this section from an article entitled: “The Homeopathic Option for Whooping Cough“:

In my medical opinion, this overemphasis upon a preventative vaccination strategy is largely due to conventional medicine’s inability to treat whooping cough once it is diagnosed. Physicians understand that antibiotics are likely to have minimal if any effect upon the course of the illness once the cough has set in, and the same applies to cough suppressants. Antibiotic treatment is believed to reduce transmission to others if prescribed at the onset of the illness, but the odds of diagnosing whooping cough at this very early stage are highly unlikely.

Clinical experience indicates that homeopathic medicine is a viable option for pertussis. However, mainstream medicine’s general unwillingness to consider any therapy that is not manufactured by PhRMA tends to blind it to potentially new and/or unexplored treatments. And in the case of homeopathy, there is a long-standing undeniable bias that assumes that it is just not possible that it can work because it defies conventional medical beliefs about the nature of illness and how it can be treated.

Really, a long-standing undeniable bias?

And I thought it was called evidence!

In conclusion, I urge everyone to follow the official recommendations:

The whooping cough vaccine protects babies and children from getting whooping cough. That’s why it’s important to have all the routine NHS vaccinations. The whooping cough vaccine is routinely given as part of the:

If you’re pregnant you should also have the whooping cough vaccine – ideally between 16 and 32 weeks.

To this I might add: beware of the advice by homeopaths and other SCAM-practitioners who recommend against vaccinations.

Conspiracy theories, as often discussed here, plague the realm of so-called alternative medicine (SCAM), e.g.:

In fact, I did recently suggest that so-called alternative medicine is a conspiracy theory in disguise. Previous research has found that individuals who struggle with emotion regulation are more prone to believing in conspiracy theories. Emotional granularity – the ability to differentiate between nuanced emotional states – is a key component of effective emotion regulation, yet its relationship with conspiracy beliefs has not been explored thoroughly.

Psychologists from the Uni Graz in Austria conducted an experience-sampling study (165 participants, mean age = 26.3 years) including measures of emotion regulation and differentiation. The study started with an online survey that assessed participants’ sociodemographic (age, sex, and education) and trait measures. Following this, participants were asked to install an in-house developed app on their smartphones to obtain the emotional granularity specificity index. The app displayed two notifications each day for over a week (14 max.). Notifications were randomly displayed between 08:00 am and 10:00 pm with a minimum of at least 5 h between two notifications. Participants, on average, answered 57% of the notifications.

The findings revealed that individuals who endorse conspiracy theories engage in repetitive thinking about the causes and consequences of events and exhibit a reduced ability to distinguish between negative emotions. This effect, however, was observed only in the performance-based measure of emotion differentiation, not in the self-report measures.

The authors conclused that this suggests that enhancing emotional granularity may help individuals in regulating their emotions more effectively, thereby reducing their vulnerability to adopt conspiracy beliefs.

To reduce belief in conspiracy theories, one might, according to the authors, consider a training program to enhance emotion regulation and differentiation. A combination of cognitive control training on emotion regulation, which has been shown to reduce overthinking, as well as reflecting on and diversifying emotional experiences, could provide simple tools for assessing and regulating emotional experiences. This, in turn, may lead to decreased endorsement of conspiracy theories in the long run.

Perhaps we should recommend this to the chaps who recularly comment on this blog bursting with conspiracy theories?

Many fans of so-called alternative medicine have, as discussed ad nauseam on this blog, an irrational attitude towards vaccinations. They frequently claim that they do more harm than good. I wonder whether the data from a very large study might convince them other wise.

The WHO launched the ‘Expanded Programme on Immunization’ (EPI) in 1974 to make life-saving vaccines available to all globally. To mark the 50-year anniversary of EPI, this analysis sought to quantify the public health impact of vaccination globally since the programme’s inception.

his modelling study used a suite of mathematical and statistical models to estimate the global and regional public health impact of 50 years of vaccination against 14 pathogens in EPI. For the modelled pathogens, we considered coverage of all routine and supplementary vaccines delivered since 1974 and estimated the mortality and morbidity averted for each age cohort relative to a hypothetical scenario of no historical vaccination. These modelled outcomes were then used to estimate the contribution of vaccination to globally declining infant and child mortality rates over this period.

Since 1974, vaccination has averted 154 million deaths, including 146 million among children younger than 5 years of whom 101 million were infants younger than 1 year. For every death averted, 66 years of full health were gained on average, translating to 10·2 billion years of full health gained. Vaccination has thus accounted for 40% of the observed decline in global infant mortality, 52% in the African region. In 2024, a child younger than 10 years is 40% more likely to survive to their next birthday relative to a hypothetical scenario of no historical vaccination. Increased survival probability is observed even well into late adulthood.

The authors concluded that since 1974 substantial gains in childhood survival have occurred in every global region. We estimate that EPI has provided the single greatest contribution to improved infant survival over the past 50 years. In the context of strengthening primary health care, our results show that equitable universal access to immunisation remains crucial to sustain health gains and continue to save future lives from preventable infectious mortality.

>So, will this excellent and compelling analysis concince many irrational anti-vaxers? Somehow, I have my doubts.

In the previous 3 parts of this series (see here, here and here), we have discussed 9 fake diagnoses of so-called alternative medicine (SCAM):

  • adrenal fatigue,
  • candidiasis hypersensitivity,
  • chronic intoxications,
  • chronic Lyme disease,
  • electromagnetic hypersensitivity,
  • homosexuality,
  • leaky gut syndrome,
  • multiple chemical sensitivity,
  • neurasthenia.

Today I will briefly discuss three further fake diagnoses and list the treatments that SCAM practitioners might recommend for them.

Vaccine overload

Vaccine overload is a term for the notion that giving many vaccines at once may overwhelm or weaken a patient’s immune system which, in turn, is alleged to lead to adverse effects. Because children have an immature immune system, they are claimed to be afflicted most frequently.

There is no evidence that vaccine overload exists nor that it can lead to illness. This does not stop SCAM practitioners to apply or recommend all sorts of SCAMs for the imagined condition. Particular favourites are all sorts of detox diets, homeopathy and a wide range of dietary supplements. Such diets and supplements can be tricky for younger children. In this case, SCAM practitioners recommend, amongst many other things, smoothies or adding turmeric, ginger, and small amounts of Shillington’s adult supplements to the child’s food.

None of these recommendations are supported by anything resembling sound evidence, of course.

Vertebral subluxation

On this blog, we have discussed vertebral subluxations more often than I care to remember. Chiropractors claim that these figments of their imagination impair the flow of innate which, in turn, makes us ill. Straight chiros, those who adhere to the gospel of their guru DD Palmer, diagnose subluxations in 100% of their patients. They are undeterred by the fact that vertebral subluxations do not exist.

I can understand why! If they did aknowledge that the diagnosis is fake, they would have no reason to treat patients with spinal manipulations, and they would quickly go out of business.

Yin/Yang imbalance

According to the assumptions of practitioners of Traditional Chinese Medicine (TCM), all health problems arise from an imbalaance of the two life forces , yin and yang. To restore the balance, they employ a range of therapies such as acupuncture, herbal mixtures, massages, etc.

But these life forces do not exist. Thus they cannot be out of balance, and consequently the imbalance cannot cause illness. TCM practitioners don’t want to hear any of this. Why not? You guessed it: if they aknowledged these facts, they would need to stop practising.

____________________

Fake diagnoses are the life-line of many SCAM practitioners:

  • they tell you that something is wrong with you (despite the fact that you are entirely healthy);
  • they make sure that this is a reason for serious concern;
  • they claim they can put the alleged abnormality right again;
  • they administer a lengthy series of treatments and/or sell you plenty of remedies;
  • when they have earned enough money treating you, they give you the good news: you are back to narmal;
  • gullible consumers are impressed by the unfailing competence of the SCAM practitioners.

My conclusion:

there is nothing easier and more profitably to heal that a condition that did not exist  in the first place.

 

An interesting and fully referenced (205 references) article caught my attention; it seems highly relevant to the discussions we are having on this blog. Let me show you the abstract:

Medical misinformation has always existed, but it has recently become more frequent due to the development of the internet and social media. Medical misinformation can cover a wide variety of topics, and studies show that some groups are more likely to be affected by medical misinformation than others, like those with less trust in health care, less health literacy, and a more positive attitude toward alternative medicines. Aspects of the internet, like echo chambers and algorithms, have contributed to the rise of medical misinformation, along with belief in anecdotal evidence and alternative remedies that are not backed by science. Some personal beliefs and a lack of media literacy skills are also contributing to medical misinformation. Medical misinformation causes higher rates of death and negative health outcomes, a lack of trust in medical professionals, and more racism and hate crimes. One possible way to combat the spread of misinformation is education surrounding media literacy. Still, there are gaps in this practice that must be addressed like a lack of high-quality research about different educational programs.

The author also offers the following key points:

  • Medical misinformation is becoming an urgent issue for United States citizens—leading to increased deaths,
    a lack of trust in health professionals, and hate crimes and racism.
  • Although this is a worldwide issue, the United States has the second highest rate of misinformation of any
    country, behind India.
  • One piece of misinformation during the COVID-19 pandemic stated that highly concentrated alcohol could
    disinfect the body and kill the virus. Studies show that 800 people died, 5,876 were hospitalized, and 60
    became completely blind from drinking methanol, thinking it would cure coronavirus.
  • Studies estimate that only 14% of the United States population has proficient health literacy, which makes it difficult to recognize medical misinformation.
  • Media literacy education is being pursued in order to combat the spread of misinformation, but more research is needed in order to understand the long-term effects of this education and what programs are best.

__________________

I would like to stress, as indeeed the author does as well, that medical misinformation is a phenomenon that is by no means confined to the US. Like most information, misinformation has become a global issue. Its dangers cannot be under-estimated. My blog offers an abundance of reports where misinformation in the realm of so-called alternative medicine (SCAM) has caused harm and even death. The author advocates media literacy as a remedy for the problem. I would argue that even more important would be to teach CRITICAL THINKING, a task that has to start at school and must continue well into adult life.

This conclusion is so very obvious that it begs an important question: WHY HAS IT NOT BEEN DONE YEARS AGO? The answer, I fear, is simple: for reasons that are self-evident, governments have little interst in the public being able to think critically. On the contrary, governments across the world foremost want to be re-elected, and critical thinking would be a major obstacle to this aim.

 

In spite of the safety and efficiency of the COVID-19 vaccines and the many promotion efforts of political and expert authorities, a fair portion of the population remained hesitant if not opposed to vaccination. Public debate and the available literature point to the possible role of people’s attitudes towards medical institutions as well as their preference for so-called alternative medicine (SCAM) on their motivations and intentions to be vaccinated. Other potential ideological factors are beliefs about environmental laissez-faire and divine providence insofar as they encourage people to let the pandemic unfold without human interference.

In three cross-sectional samples (total N = 8214), collected at successive moments during the Belgian vaccination campaign, the present research examines the distal role of these psychological and ideological factors on vaccination intentions via motivational processes.

  • Study 1 gauges the relation between trust in medical institutions and preference for SCAM on intentions to get vaccinated via motivations.
  • Study 2 examines the role of beliefs in the desirability of letting nature take its course (‘environmental laissez-faire beliefs’) on vaccination intention via motivations.
  • Study 3 tests whether people’s adherence to environmental laissez-faire and beliefs about divine providence are linked to their motivations for vaccination via trust in the medical institutions and SCAM.

The results show that adherence to SCAM has a deleterious effect on vaccination intentions, whereas trust in medical institutions has a positive effect. Both ideological factors pertaining to external control are only moderately related, with environmental laissez-faire beliefs having stronger effects on SCAM, medical trust and vaccination motivations.

The evidence of an association between SCAM and willingness to get vaccinated is undeniable. On this blog, we have discussed it repeatedly, e.g.:

But what exactly is the nature of this association?

  • Does SCAM-use predispose to vaccination hesitancy?
  • Does Vaccination hesitancy predispose to SCAM use?
  • Is both true?

After reading all this research that has emerged on the subject, I get the impression that we are mostly dealing here with a cross-correlation where a certain mind-set of being

  • prone to conspiracy theories,
  • anti-establishment,
  • anti-science,
  • irrational,
  • of low intelligence,
  • unable of critical thinking,
  • etc., etc,

determines both the SCAM-use and the vaccination hesitancy.

 

An article about chiropractic caught my attention. Let me show you its final section which, I think, is relevant to what we often discuss on this blog:

If chiropractic treatment is unscientific, then why do I feel better? Because lots of things alleviate pain. Massage, analgesia and heat – but also a provider who listens, empathises and bothers to examine a patient. Then there is the placebo effect. For centuries, doctors have recognised that different interventions with unclear pathways result in clinical improvement. Among the benefits patients attributed to placebo 100 years ago: “I sleep better; my appetite is improved; my breathing is better; I can walk further without pain in my chest; my nerves are steadier.” Nothing has changed. Pain is a universal assignment; no one has a monopoly on its relief.

The chiropractic industry owes its existence to a ghost. Its founder, David Palmer, wrote in his memoir The Chiropractor that the principles of spinal manipulation were passed on to him during a séance by a doctor who had been dead for half a century. Before this, Palmer was a “magnetic healer”.

Today, chiropractors preside over a multibillion-dollar regulated industry that draws patients for various reasons. Some can’t find or afford a doctor, feel dismissed, or worse, mistreated. Others mistrust the medical establishment and big pharma. Still others want natural healing. But none of these reasons justifies conflating a chiropractor with a doctor. The conflation feels especially hazardous in an environment of health illiteracy, where the mere title of doctor confers upon its bearer strong legitimacy.

Chiropractors don’t have the same training as doctors. They cannot issue prescriptions or order advanced imaging. They do not undergo lifelong peer review or open themselves to monthly morbidity audits.

I know that doctors could do with a dose of humility, but I can’t find any evidence (or the need) for the assertion on one website that chiropractors are “academic overachievers”. Or the ambit claim that most health professionals have no idea how complicated the brain is, but chiropractors do.

Forget doctors, patients deserve more respect.

My friend’s back feels better for now. When it flares, I wonder if she will seek my advice – and I am prepared to hear no. Everyone is entitled to see a chiropractor. But no patient should visit a chiropractor thinking that they are seeing a doctor.

______________________

I would put it more bluntly:

  • chiropractors are poorly trained; in particular, they do not learn to question their own, often ridiculous beliefs;
  • they are poorly regulated; in the UK, the GCC seems to protect the chiros rather than the public;
  • chiropractors regularly disregard essential rules of medical ethics, e.g. informed consent;
  • many try to mislead us by pretending they are physicians;
  • their hallmark intervention, spinal manipulation, can cause considerable harm;
  • it generates hardly any demonstrable benefit for any condition;
  • chiropractors also cause considerable harm, e.g. by interfering with real medicine, e.g. vaccinations;
  • thus, in general, chiropractors do more harm than good;
  • yes, everyone is entitled to see a chiropractor, but before they do, reliable information should be mandatory.

The Amercian Medical Association (AMA) recently published a lengthy article on naturopathy in the US. Here are some excerpts:

There are three types of health professionals who offer naturopathic treatment:

  • Naturopathic doctors. These nonphysicians graduate from a four-year, professional-level program at an accredited naturopathic medical school, earning either the doctor of naturopathy (ND) degree or the doctor of naturopathic medicine (NMD) degree.
  • Traditional naturopaths, who have obtained education through some combination of a mentorship program with another professional or at an alternative clinic, distance-learning program or classroom schooling on natural health, or other holistic studies.
  • Other health professionals such as chiropractors, massage therapists, dentists, nurses, nutritionists, or physicians who practice under a professional license but include some naturopathic methods in their practice and who may have studied on their own or taken courses on naturopathic methods.

At least 24 states and the District of Columbia regulate the practice of naturopathy. In order to be licensed, naturopaths in these states must earn an ND or NMD from an accredited naturopathic program and pass the Naturopathic Physicians Licensing Exam. Three states—Florida, South Carolina and Tennessee—prohibit the practice of naturopathy. In states that neither license nor prohibit the practice of naturopathy, traditional naturopaths and NDs alike may practice without being subject to state regulation.

Postgraduate training is neither common nor required of graduates of naturopathic schools, except in Utah … less than 10% of naturopaths participate in an approved residency, and such residencies last only a year and lack a high degree of standardization.

… naturopaths are required to get at least 1,200 hours of direct patient contact, physicians get 12,000–16,000 hours of clinical training…

ND programs emphasize naturopathic principes—for example, the healing power of nature—and naturopathic therapeutics such as botanical medicine, homeopoathy and hydrotherapy. Coursework in naturopathic therapeutics is combined with, and taught alongside, coursework in sciences. But there are no specifications around the number of hours required in each area … naturopathic students may lack exposure to key clinical scenarios in the course of their training … naturopathic students’ clinical experience is typically gained through outpatient health care clinics, as naturopathic medical schools typically do not have significant hospital affiliation. This means there is no guarantee that a naturopathic student completing a clinical rotation will see patients who are actually sick or hospitalized, and they may not be exposed to infants, children, adolescents or the elderly. It has been said that naturopaths tend to treat the “worried well.”

… Naturopaths claim they are trained as primary care providers and, as such, are educated and trained to diagnose, manage and treat many conditions, including bloodstream infections, heart disease and autoimmune disorders. Yet their education and training falls several years and thousands of hours short of what physicians get.

…The AMA believes it is the responsibility of policymakers to ensure that naturopaths’ claims that they can treat a broad range of conditions are backed by facts—facts that include the specific education and training necessary to ensure patient safety.

________________

The AMA is clearly cautious here. A less polite statement might simply stress that naturopaths are taught a lot of nonsense which they later tend to administer to their unsuspecting patients. On this blog, we have repeatedly discussed the danger naturopaths present to public health in the US and elsewhere, e.g.:

Claims that naturopaths are a viable alternative to evidence-based medicine are wrong, irresponsible and dangerous. Regulators must be reminded that they have the duty to protect the public from charlatans and should therefore ensure that no false therapeutic or diagnostic claims can be made by naturopaths.

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