Friday, May 25, 2012

Vermont Bill S.209 - Rosemary Jacobs


Rosemary Jacobs
Oral Testimony Before
Vermont House Health Care Committee 
Hearing On Bill S.209
April 11, 2012


When I arrived at the hearing, Ben from the Vermont Medicine Show blog, was already there video taping the event. Hinda Miller had spoken and left. Lorilee Schoenbeck, ND, representing the Vermont naturopaths (NDs), Madeleine Mongan of the Vermont Medical Society and Craig Jones, MD from the Vermont Blueprint for Health were about to speak.

I got the feeling that although the committee members all smiled at me that they were hostile, annoyed that they had to listen to my talk when they wanted to be somewhere else and that their minds were already made up. Ben felt the same. In fact, they wouldn’t even let him speak even after he told them that he had emailed the committee clerk a few times asking to be put on the agenda without ever getting a reply adding that he had made a 150 mile roundtrip in order to attend the hearing and requested that they give him five minutes to address them. They refused. 

The state has spam filters that are hard to get passed so Ben definitely should have phoned and asked to be on the agenda when he didn’t get a response to his email requests, but IMO, it was really rude of the committee to refuse to hear him and it showed that they had already decided how they would vote before the hearing commenced.

Representative Fisher, the Committee Chair, and Representative Pearson left as I was about to speak and returned after I had finished. Neither heard a word of what I said about aluminum, uh, sorry, silver. (A sarcastic reference to Fisher’s question to Lorilee, http://rosemary-jacobs.blogspot.com/2012/05/lorilee-schoenbeck-me.html.) 

I didn’t stick to my outline responding instead to specific things previous speakers had said. Although I hadn’t been there to hear Miller, listening to the tape showed that she had said all that I expected she would. My talk did ramble a little and I wasn’t clear in places. I’ve tried not to edit it for clarity so that you can hear what the committee heard with all its warts although I have added a few clarifications inside parenthesis in a few places.

This is a summary of my oral testimony. It is available from the Legislative Council, tel. 802-828-2424, recorded on CD 164,  House Committee On Health Care, April 11, 2012. The CD costs $1.

I was hit in the face by some of the things that I heard here today. This is not about freedom of choice. Vermonters who want to already do see naturopaths. It is about entitlement, about being given rights not earned. 

Naturopaths can spend lots of time with patients because, unlike MDs, they have so few of them. They are actively seeking patients. 

When I had cancer, the most valuable thing I had was time. If I had gone to an ND, like one in Vermont who says she offers “science-based” cancer therapy, and then found out that her treatments were not scientific or evidence-based, that she had wasted my time, I would have been furious. 

Health care delivery today is robotic and impersonal because third party payers won’t pay for the services of psychologists and sociologists (I meant social workers. My comment was meant for Mr. Pearson who has a BA in psychology and, I believe, brought up the need to include NDs in the Blueprint because of these kinds of holistic services which they offer. I cannot hear Mr. Pearson on the CD, but believe that that is what he had said before leaving.) NDs want to get in the backdoor. They claim that they have the training to treat your mind, body, spirit, that they are shrinks, healers and preachers. These are three different disciplines. NDs don’t want to be held to the same standards as those other professions. They want everyone to take their word for it when they say that they are qualified to practice all those different things. That is deceptive and that is what bothers me. 

Madeleine Mongan mentioned an analysis done in Colorado of the exam given to NDs by their schools which found it wanting. In Colorado the bill to license NDs has been repeatedly defeated because of the efforts of traditional naturopaths who say that if it passes they, the traditionalists, will lose the freedom they have now of seeing patients and the patients who want to see them will lose the right to do so. The traditional NDs proudly call themselves drugless healers insisting that they are not MDs and that NDs never have been medical doctors. They are not trained to use pharmaceuticals. Like me, the traditional NDs don’t believe that the education naturopaths get in their 4 year schools is equivalent to that of medical doctors or that NDs who have graduated from those schools deserve the privileges MDs have. 

At this point the Vice Chair, Sarah Copeland-Hanzas, who was conducting the meeting, stopped me and told me that I was off topic and that I should stick to the merits of the bill. (After listening to the CDs, I think that I was sticking to the topic. I was addressing the very points others had made like freedom of choice, the need to have a system that takes the emotional needs of people into account, the claim that Vermonters need the bill passed in order to have access to NDs. The difference, of course, was that unlike the others who had raised those points, I wasn’t advocating for NDs. I also noticed that when Senator Miller’s phone rang while she was speaking no one had chided her.)

I complained about Hanzas’s admonition saying that I was doing what the committee had permitted the NDs and their advocates to do and that I wanted equal time. “If they can do it, I can do it.” The members smiled more broadly then before. (I’ve been discriminated against most of my life by people who don’t like the way that I look, and I don’t take it lying down.)

I noted that if third party payers are forced to reimburse for NDs services, more patients will be endangered and a ton of money will be wasted. I believed this based on my experience with NDs and silver. I told the representatives that I had submitted written testimony electronically and hoped that they had seen it, but I did have hardcopy of two copyrighted articles that were unavailable electronically. 

VT NDs have a formulary that includes silver for IV use and colloidal silver for use in the eyes. They are now saying that they don’t use silver, but why is it in their formulary then?

The other thing that really bothers me is their attitude. I was given silver in nose drops when I was a child by an MD. If he had read his medical journals instead of the fraudulent ads from drug companies he never would have prescribed the drug that disfigured me. Silver was used before the advent of antibiotics; it didn’t work although it discolored many people. 

As an experiment, I was dermabraded in 1978. In medicine we don’t assume. We test. (I meant that it was only by testing, not speculating or assuming, that we could learn what effect dermabrasion or anything else would have on argyria.)

In Oct. 2010 Arline and I went to an alt med conference sponsored by Senator Bernie Sanders that many NDs attended. We asked them why silver was in their formulary. Didn’t they understand “this is what it does”? (Pointing at our faces. The relevant link with Arline's photo was included in the material I had previously emailed the committee. http://rosemaryjacobs.com/naturopaths.html.)

Silver is not in the pharmacology books. It is in the toxicology books. MDs haven’t used it internally for over 50 years. Many MDs & NPs (nurse practitioners) have apologized to me over the years for what someone in their profession had done to me. Some tried to find a lawyer to sue the MD who had disfigured me. When I told them that that MD had been a nice caring person who had made mistake they replied that that wasn’t true that he had been an incompetent doctor and that at that point in time (the 1950s) he should have known better then to have used silver internally. 

NDs, on the other hand responded, “No. We don’t do that,” and they wouldn’t talk to me. Not 1 or 2 NDs but many. I’ve had a webpage for over 15 years. People write all the time to say an ND told them to use silver. I had always assumed that the NDs they were referring to weren’t the ones who had gone to ND schools. I didn’t think that the naturopaths who ran those 4 year schools could be ignorant enough to use dangerous snake oil. I found it very hard to believe that NDs didn’t use silver and that many of them didn’t believe it was a “natural remedy”. After finding it in the VT Naturopathic Formulary, I asked the next person who said an ND told her to use it if the ND had gone to a 4 year ND school since she was in a state that doesn’t license NDs. She said that she had said that she had and that she wouldn’t have gone to her otherwise.

If NDs want to be considered the equals of MDs, they have to practice evidence-based medicine, EBM. If they don’t want to do that, it is their right and privilege, but they have to be honest and tell people there is evidence MDs tell them about showing that some things work and some don’t and that some are dangerous but that they disagree, that that is not their belief. Then they have to ask patients if they want to see why they believe things those who practice scientific medicine don’t believe. They have to either show people their evidence or admit that they have none, that their medicine is belief based, not evidence based. Only then will patients be able to make informed decisions. 

I added that the thing that bothers me the most is the NDs’ lack of honesty. I’ve heard so often “our education is the same as that of an MD”. In that case how do they fill in all those hours with all the other stuff they study too? (What I had meant was if they studied all the things that MDs study and if they took approximately the same hours of classes that MDs took, how were they able to fit in so many hours of courses in subjects that MDs don’t take like homeopathy, botanical medicine, hydrotherapy, etc.)

Continuing I added that I can’t believe anyone who has learned pharmacology would not know that silver is a natural toxin and not a natural remedy. Anyone who had the most fundamental knowledge of pharmacology would know to check the substances they wanted included in their formulary in pharmacology and toxicology textbooks and in the journals indexed in PubMed. If they had done so, they would have discovered that there is nothing indicating taking silver internally offers benefits and a lot showing that it causes harm. 

In conclusion I noted that people who have gotten argyria recently from silver supplements are being treated with laser therapy. I’ve corresponded with a dermatologist abroad, where as with all the industrialized countries in the world except the US, there is a national health care system. Since the doctor has a patient with argyria, I told him about laser therapy. He responded that his patient couldn’t afford it and the government system will not pay for it. IMO, that is the way all the national systems work. However,  in the US people are getting insurance companies to pick up the tab. I believe it is a cultural thing. Americans today expect 3rd parties to pick up the tab for everything they want. This is entitlement, not freedom, not equality. 

There were no questions. My talk was 16 minutes long.

Vermont House Health Care Committee; naturopaths; Michael Fisher; Christopher Pearson







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Thursday, May 24, 2012

Vermont Bill S.209 - Hinda Miller


Hinda Miller
Oral Testimony Before The
Vermont House Health Care Committee
Hearing On Bill S.209
April 11, 2012

The Senator’s testimony is recorded on a CD which can be purchased for $1 from the Legislative Council, tel. 802-828-2231. It is CD # 163, House Committee On Health Care, Wednesday, April 11, 2012.

Unfortunately, I was not able to arrive in time for the start of the hearing which began at 8:30 AM so that I didn’t hear the oral testimony presented by Senator Hinda Miller, one of the bill’s two sponsors, although when I listened to it on the CD, she said exactly what I had expected her to say. The points she made, the same as those that NDs and their advocates always make, were the ones that I had addressed in my written testimony, http://rosemary-jacobs.blogspot.com/2012/05/vermont-bill-s209-introduction.html. 

Based on the things Miller has posted on the Internet and what the media has reported about her, Hinda sounds like a very interesting character and a very lucky woman. She has been called a myth by some in Burlington, Vermont having become a multi-millionaire at  the age of forty after developing the “jogbra” along with two other women, one of whom stopped speaking with her many years ago and is one of her many vocal critics today. 

Hinda was born into a Jewish family in 1950 in Montreal, Canada where her father was a businessman. Her grandparents were immigrants. She got degrees in fine art in NYC and came to Burlington in 1977 where she worked for as a costume designer for a theatrical production which is where and when she met Lisa Lindahl. As joggers Miller and Lindahl came up with the idea of a jogging bra which Polly Smith, also a costume designer, made the prototype for. Miller’s father lent her the money to start a business manufacturing the garment. The company was purchased by Playtex in 1990. Around 2001 Miller became a US citizen. She was elected to the Vermont Senate in 2002 then ran unsuccessfully for Mayor of Burlington in 2006.

In addition to being a jogger, Hinda is a vegetarian and a yoga instructor. Her husband Joel is a psychologist and business consultant who owns many rental properties. 

Sources for the above.

In her testimony Senator Miller said that naturopaths deal with diet, nutrition, lifestyle, exercise, supplements and herbs as well as with the more “traditional allopathic” practices. 

She said that Bill S.209 was needed to clarify a bill passed in 2007 that recognized NDs as primary care physicians, “PCPs”. Bill S.209 wouldn’t expand their scope of practice but rather enable them to be included in the Blueprint For Health, http://healthvermont.gov/admin/legislature/documents/blueprint_leg_report.pdf, subsequent to their being scored by NCQA, http://www.ncqa.org/, an agency chosen by the state to accredit health care practitioners. 

Miller noted that VT has a shortage of PCPs and that there are 40-50 NDs in the state but that many can’t take on new patients. (It is unclear to me why the senator doesn’t think they can take on new patients. I will try to contact her and ask her to explain and to comment here.) 

The reason that I fail to understand this is because Lorilee Schoenbeck, ND who gave oral testimony after Miller left said and passed out a handout stating that 95% of the NDs practicing as PCPs in Vermont are taking new patients. Many of those NDs have more than one office; some have offices in MA and NY, states that don’t license NDs, http://www.vanp.org/member_directory.php. I know of one VT ND who gives nutrition advice in a natural products store, another who teaches and two who give telephone consultations. Many are presently advertising for patients and most claim to spend lots of time with them, usually at least half an hour for a repeat visit and longer for an initial visit.

That doesn’t sound to me as if VT NDs can’t take on new patients or as if Vermonters need more naturopaths. It sounds to me as if naturopaths need more Vermonters, more business, and that they are hoping that getting all the privileges MDs have will get them the customers they need to stay in business.

Hinda added that many people in Vermont want to use naturopathic care to enter the health care system but she didn’t present any evidence substantiating it. 

When one of the representatives asked Miller if the Senate committee that had first considered Bill S.209 had established criteria indicating that NDs should be included in the system as PCPs just as MDs and DOs were and that the other alt. med. professions that want the same privilege should be excluded, she said that they had but didn’t elaborate. 

The Senator added that Bill S.209 would give people choices but that the medical society opposed that because medical doctors feel that “their way is the only way”. She said that NDs like Lorilee Schoenbeck would explain that NDs have all the training that MDs have. Concluding with the assertion that there is always tension between “those of us who feel nutrition, diet and all those things can help us maintain our health and it is our responsibility to do that. We need help.” I assume that meant that people who feel like she does need help from NDs to keep them doing the things they believe keep them well. 

She finished with, “We are very happy about surgery and drugs,” meaning, I assume, that she and her ND buddies approve of MDs offering those treatments, the latest mantra to come from the lips of alt medders. Not long ago they ranted about the injuries and deaths MDs caused with such therapies. Perhaps, like me, you remember their repeated shouts about MDs burning, slashing and poisoning cancer patients. As a person who they burned and slashed in 1984 when I had breast cancer, I was and still am damn glad that they did that to me and doubt I’d be alive today if they hadn’t. 

I have frequently shouted back at alt med practitioners who used those scare tactics to try to convince vulnerable sick people that medical treatment backed by solid evidence was evil and lethal and that their alternatives were safe and effective in spite of all the evidence to the contrary. I guess one of the reasons they are toning it down now is because there are so many people like me who have been successfully treated by the “burn/slash/poison” crowd who realize how wrong alts are when they accuse those who practice evidence-based medicine of all kinds of brutality. I bet their marketing professionals have told them, “Ya gotta stop saying that stuff even though you believe it. Other people don’t. It makes you look bad. It is bad for business. Turns customers away. We’ve entered the next phase. Integrated is the new word. Remember that! Integrated medicine, Complementary. Not Alternative anymore. Ya got it?”

Comment:

I don’t know Senator Hinda Miller. My impressions of her come from what she said and what I’ve read about her. Based on that, I conclude that like many affluent, wealthy, articulate Westerners well educated in the arts she truly believes in alternative medicine. 

According to one reporter, http://www.7dvt.com/2006/miller-time, Miller said that she was the kind of person “who runs off a cliff head-first”. Her former business partner, Lisa Lindahl, who hadn’t spoken to her in 15 years, agreed saying that she, Lindahl, would say, 'Well, OK, if we jump off that cliff, where are we going to land and what is it likely going to cost us?” "Hinda's management style was to get it done, cross it off her list and deal with the consequences later."

Like most visionaries, it sounds as if Hinda follows her hunches and moves swiftly without investigating first, without thinking before she leaps. The difference is that in the fields were so many of these people have recently succeeded so well through trial and error, following hunches works because the results become apparent quickly and are easily observable by the naked eye. For the tenacious and lucky who have been in the right place at the right time, found the partners and investors they needed when they needed them, the material rewards were huge. The only risks posed by failure in their chosen endeavors, by following the wrong hunches, were bruised egos and financial losses. But that is not true in medicine where mistakes and bad bets kill and debilitate human beings. 

Steve Jobs was probably the greatest and most successful visionary of our times. Like Miller he believed in the value of nutrition. His wife even started a nutrition company. He also believed in alt. med. and only abandoned it when it became woefully apparent that it was not saving his life. 
http://www.nytimes.com/2011/10/21/technology/book-offers-new-details-of-jobs-cancer-fight.html?_r=2&hp=&pagewanted=all#. 
Whether or not his delay in seeking evidence-based medical treatment for his cancer resulted in his premature death is something that may never be known unless perhaps the medical doctors who treated him in the end are someday given permission to speak out and to publish his medical records. http://www.quora.com/Steve-Jobs/Why-did-Steve-Jobs-choose-not-to-effectively-treat-his-cancer. 

I think Jobs’s case illustrates how the skills that bring huge success in one area can bring disaster in another. It shows why it is so important to know the skills and liabilities we bring to different tasks, to know our strengths and weaknesses and to know our limits.

Playing with your own life is your right, but you have no right to play with the lives of others which is exactly what people like Miller and her colleagues in the legislature do when they pass laws that put an unreasonable risk on the lives and health of others by granting privileges to practitioners who don’t deserve. http://rosemary-jacobs.blogspot.com/2012/04/naturopaths-terrify-me-nds-do-not.html,  http://rosemary-jacobs.blogspot.com/2012/05/deadly-folk-medicine.html, 

Miller claimed that unless NDs are given all the same privileges that MDs have that people would not have access to their services. Does she really think that Vermonters don’t already have access to NDs as well as to nutritionists, coaches, herbalists, supplement salesmen, all kinds of exercise instructors including yoga teachers even though none of them has MD privileges now or is licensed as a PCP? Does she think that all of those professions should be licensed as PCPs and given prescription privileges? Or does she think that the only alts who deserve MD privileges and PCP status are her ND buddies? 

While I’m not the least surprised that an artist would believe that NDs have the same education as MDs do, I am amazed that so many other legislators would take the NDs' word for it without verifying it independently. I’m surprised they’d jump off the cliff with Hinda.

I respect Miller for what seems to me to be her sincerity, and I respect her right to her beliefs about health care, but I don’t think that beliefs should set government policies in this day and age. I think that Hinda is acting on hunches, not facts, hunches about people having far more personal control over their health and longevity than the objective evidence suggests. I think Miller’s head is buried deep in the sand and that she is refusing to even consider the fact that the treatments NDs routinely offer could harm or kill her rather than help her. Here are my reasons in case you’ve missed them.
http://rosemary-jacobs.blogspot.com/2012/05/deadly-folk-medicine.html 
http://rosemary-jacobs.blogspot.com/2012/04/naturopaths-terrify-me-nds-do-not.html 

I wonder whether or not the House Health Care Committee members share Miller’s  beliefs. All but Porier and Till voted in favor of Bill S.209. Morissey was absent. Did they vote in favor because they are true believers like Miller apparently is or did they do it for political reasons? 

Hinda Miller, Vermont, Bill S.209, House Health Care Committee, Vermont House of Representatives, naturopaths, NDs, dangerous medicine

  
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Vermont Bill S.209 - Introduction


On April 11, 2012 the Vermont House Health Care Committed held a hearing on Bill S.209, http://www.leg.state.vt.us/docs/2012/bills/Passed/S-209.pdf,  which would “require health insurers to include naturopathic physicians as primary care providers, include naturopathic physicians as medical homes under the Blueprint for Health, specify that naturopathic physicians may practice independently and without supervision, and allow naturopathic physicians to apply for loans and grants from the state’s health information technology fund to enable them to purchase electronic health record programs.”

The primary purpose of the bill was to make sure that NDs would be included along with MDs and DOs who can practice independently as primary care physicians and be reimbursed for their services. 

Because of another bill that would have eliminated the philosophical exemption as a reason for letting parents opt out of vaccinating their children while still permitting them to attend school the legislators, and especially those on this committee, had been extremely busy. That bill brought out strong emotions pro and con with many people speaking out and lobbying for and against its passage making the 2012 legislative session pretty hectic for all while Bill S.209 and H.524 went unnoticed. I myself only stumbled upon them accidentally when it was already late in the game. 

These were the 2012 committee members on the House Health Care Committee considering Bill S.209:

Rep. Michael Fisher, Chair
Rep. Sarah Copeland-Hanzas, Vice Chair
Rep. Paul N. Poirier, Ranking Member
Rep. Leigh Dakin, Clerk
Rep. Jim Eckhardt
Rep. Patti Komline
Rep. Mary A. Morrissey
Rep. Christopher Pearson
Rep. Kristy Spengler
Rep. George W. Till
Rep. Mark Woodward

I submitted the following written testimony to the committee:

Testimony Before Vermont House Health Committee on Bill S.209
April 11, 2012
From:
Rosemary Jacobs
Derby, VT 05829

I oppose Bill S.209.
I believe that naturopaths, NDs, acting as primary care physicians pose an unreasonable risk to Vermonters, offer substandard care and greatly increase health care costs for everyone, even those who do not make use of their services.
Unreasonable Risk - Substandard Care
NDs have a state sanctioned formulary http://www.vtprofessionals.org/opr1/naturopaths/info/Naturopathic Physician Formulary 20091211.pdf that includes “silver” for IV use (p.5) and “colloidal silver” for use in the eyes (p.1). When I told them of the danger and illegality of this, they ignored me. http://rosemaryjacobs.com/naturopaths.html
When I asked the source of their IV drugs and colloidal silver, they refused to tell me which makes me believe that they have illegally been using “dietary supplements” as drugs.
Until I spoke with the Director of the Office of Professional Regulation and the Health Commissioner who I was only able to reach through the efforts of Rep. Michael Marcotte who serves with me on the Board of Directors of the Orleans/Essex VNA, I don’t think that the NDs or their regulators knew that the FDA had posted a rule in the Federal Register in 1999 stating that silver cannot be used as a drug because there is no evidence that it offers any benefits and that there is a lot of evidence that it causes harm. https://www.federalregister.gov/articles/1999/08/17/99-21253/over-the-counter-drug-products-containing-colloidal-silver-ingredients-or-silver-salts  (Click on PDF)
Silver can discolor the skin. The condition is called argyria. I have had argyria for over 50 years.
Silver was used by desperate doctors and patients before the advent of antibiotics. It didn’t work and caused many cases of argyria. While there are many uses for silver in medicine, including approved topical drugs, medical doctors who practice evidence-based medicine have not used silver internally for over 50 years.
I think that NDs either didn’t know or didn’t care that while it is legal to sell silver as a “dietary supplement” which is often called “colloidal silver” or “CS”, that it is illegal to make drug claims for supplements and that supplements have to be taken by mouth, not put in the eye or administered IV. http://toxsci.oxfordjournals.org/content/123/2/333.long
“Dietary supplements” are legally classified as “food” under present law and unlike drugs their safety and efficacy is not evaluated by the FDA or anyone else before they are sold. http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/05/10/FDCQ1788VE.DTL
While legally anyone who follows good manufacturing practices can make a supplement, I think the NDs either didn’t know or didn’t care that only a licensed drug manufacturer or compounding pharmacist can manufacture a drug and that even they are limited as to which substances they can use and which drugs they can make.
Until I brought it up, I don’t think that NDs realized the reasons why, unlike with supplements, only authorized people can manufacture drugs, or the necessity for IV drugs to be sterile. Here is a tragic example of the danger of injecting a unsterile substance into a person - a Canadian ND charged with manslaughter after her patient died subsequent to her injecting him with a contaminated substance. http://montreal.ctv.ca/servlet/an/local/CTVNews/20120222/mtl_naturo_120222/20120222/?hub=MontrealHome
According to the article, the substance was magnesium, one of the “minerals” listed on p. 5 along with silver in the VT ND formulary that VT NDs may use intravenously.
As specific dietary supplements have become popular, scientists have started to study them. They are finding that many, even those which initially had looked promising and were previously assumed to be safe, may in fact be harmful. http://www.forbes.com/sites/stevensalzberg/2011/10/16/a-bad-week-for-the-nutritional-supplements-industry/ http://www.medpagetoday.com/Columns/At-Large/31494                                                                          http://www.health.harvard.edu/blog/fda-needs-stronger-rules-to-ensure-the-safety-of-dietary-supplements-201202024182
My greatest fear is that there is something totally useless out there that is as lethal as cigarettes and that by the time that is discovered it will be too late to save many from premature deaths.
Useless Therapies
NDs have traditionally called themselves “drugless healers” who avoided pharmaceuticals using and promoting “natural remedies” instead. In 1994 with the passage of the Dietary Supplement Health and Education Act, DSHEA, pronounced duh shay, natural remedies were classified as “dietary supplements”. NDs, even those in states which have recently granted them prescription privileges, still make extensive use of supplements, products which are not evaluated for safety or efficacy before they are sold. Yet most if not all NDs believe in, promote and sell supplements directly to the patients they treat in spite of the fact that there is no objective, much less scientific, evidence of their value.
Naturopaths believe in, study and use classical homeopathy, the biggest scam to ever come down the pike.
Classical homeopathic products are almost always devoid of active ingredients. They are just inert substances like sugar and water which NDs believe have healing powers.
The James Randi Foundation offered a $1 million prize quite some time ago to anyone who could demonstrate that a homeopathic remedy works. No one has won it yet. He repeats the offer here where he also shows how pharmacies are using a belief-based system of medicine espoused and promoted by NDs to rip off customers and rob them of their health care dollars:
A Philosophy-Based System of Medicine
NDs also practice anthroposophical medicine, http://www.vtprofessionals.org/opr1/naturopaths/info/Naturopathic Physician Formulary 20091211.pdf  p.4 The only listing for that on the NCCAM, National Center for Complementary and Alternative Medicine, site http://nccam.nih.gov/news/2007/051407.htm simple states that a MD on their staff studied the modality in Germany. This is what wiki says about that obscure practice NDs call “medicine”,
http://en.wikipedia.org/wiki/Anthroposophical_medicine
Utter nonsense
IV Tin for baldness, a treatment that would be so easy to test especially on some of the bald NDs I’ve seen:
Scroll down to # 12

The Warming Sock Treatment from a VT licensed ND who practices in VT & MA, where NDs are not licensed. VT residents can be reimbursed for some of her services by insurance, but not MA residents:                                       http://www.valleynaturopathicfamilymedicine.com/links-and-resources

Unnecessary Costs
When NDs, their treatments and the products they promote harm people, the cures or attempted cures can be costly. Most people who have gotten argyria recently from sliver supplements are being treated with laser therapy by dermatologists. Both the patients and doctors have so far been very pleased with the results. The cost of treating an entire face is about $7,000, but no one is satisfied with just a face. They move on to ears, throats, hands, etc. The estimated cost of treating an entire body is $100,000. The treatment isn’t permanent and has to be repeated and no one knows if there will be side effects later on. Insurance has been picking up the tab and I can’t believe that the insurance companies aren’t passing the costs on to all their customers. Actually, I don’t know how they could stay in business if they didn’t.
Preventive Medicine
Without presenting any evidence to substantiate the claim, NDs say that they save us all money by keeping patients well and preventing disease. They say that they get their patients to eat healthy diets and follow healthy lifestyles often erroneously stating that no one else, especially MDs, addresses those things or succeeds like they do.
If NDs have found techniques that get the majority of people to eat balanced diets, maintain a normal weight, refrain from smoking and excessive alcohol and to exercise in moderation, they should share it with the rest of us. However, I suspect that they haven’t found any such techniques. If in fact it is true that their patients follow healthier lifestyles than the majority of the population, I suspect that is because the people presently attracted to NDs are obsessed with health and would do the same without ever speaking to an ND.
Conclusion
NDs practice a belief-based system of medicine that holds that nature and natural products heal even when, as with silver, there is overwhelming evidence showing that the opposite is true. NDs use dangerous and useless therapies that didn’t work for our grandparents and were for that reason discarded by those who practice scientific or evidence-based medicine decades ago.
While I believe that people who want to should be able to use their services as they can now, I don’t believe that third party payers should be forced to pick up the tab. Forcing them to will waste health care money and erroneously give the general public, the ones who are not true believers in alternative medicine, the impression that NDs are the same as MDs and that their drugs and therapies are supported by objective evidence of safety and efficacy when that isn’t true.
While I believe that adults should be able to do whatever they want as long as they don’t hurt anyone else, even ingest silver, I don’t believe they should be able to force anyone else to pay if they decide to use remedies or therapies for which there is no good evidence of safety and efficacy or to force others to pay for cures if they injure themselves with such things.
I also believe that naturopaths should be honest with themselves and everyone else and admit that their system of medicine is a belief-based one, not an evidence-based one, so that people can make informed decisions about whether or not they want to use their services.
naturopaths, vermont, Blueprint for Health, Michael Fisher, Sarah Copeland-Hanzas, Paul N. Poirier, Leigh Dakin, Jim Eckhardt, Patti Komline, Mary A. Morrissey, Christopher Pearson, Kristy Spengler, George W. Till, Mark Woodward, Vermont House Health Care Committee

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Tuesday, May 22, 2012

Deadly Folk Medicine



Aristolochic acid, AA, is found in a number of herbs that have been used medicinally since antiquity, including many still used today in Traditional Chinese Medicine (TCM) and Ayuvedic medicines of India. 

Because AA was believed to have anti-inflammatory properties the German pharmaceutical industry used it to develop drugs in the 1960’s and 70’s. This effort ended in the early 1980s, when researchers discovered that AA was a powerful carcinogen in rats. 

Scientists now know that AA is a potent human nephrotoxin (kidney poison) and human carcinogen, causing chronic kidney disease (CKD) and cancers of the upper urinary tract (UUC). 

The dual toxicities of AA were highlighted in the 1990’s when operators of a high end spa in Belgium incorporated traditional Chinese herbal remedies into their weight-loss program. Over 100 otherwise healthy women developed CKD, requiring lifelong hemodialysis or kidney transplantation. Several of the women died. 

Similar cases appeared in other countries throughout the world including the US.

Alerted by this development, scientists investigated. 

Endemic (Balkan) nephropathy (EN) caught their eye, an illness that initially presents with mild symptoms, advancing progressively to chronic renal failure. Upper urinary tract cancer is also strongly associated with EN. 

EN occurs only in farming villages in the Balkan countries of Bosnia, Bulgaria, Croatia, Romania and Serbia located near the tributaries of the Danube River. It was first noticed in the late 1950s. Although it often occurs in members of the same family, it is not inherited. Those who develop EN do so after living for a period of time in one of the villages where it is endemic. Scientists searched unsuccessfully for its cause for 50 years. When they noticed the marked similarities between it and aristolochic acid nephropathy (AAN), they hypothesized that aristolochic acid might be the causative agent of EN. 

Investigating further, they discovered that Aristolochia clematitis, a plant native to the area where people suffered from EN, grew in local wheat fields and that the seeds were commingled with wheat grain used by local residents to bake bread, a staple of their diet. Being scientists they conducted experiments which showed that AA is a major factor in the development of EN and the associated urothelial cancer.

Knowing that Aristolochia had been used as herbal medicines for centuries throughout the world, the scientists wondered whether or not AA had in the past and was still causing chronic kidney disease and upper urinary tract cancer in individuals who routinely use TCM.

To explore this possibility, the scientists turned to Taiwan which has the highest incidence of UUC of anywhere in the world and where Aristolochia remedies are extensively used. By conducting a molecular epidemiologic study, they concluded that AA “contributes significantly to the incidence of UUC in Taiwan, a finding with significant implications for global public health”.

There was an excellent review of the journal article in Science Daily, much better than mine. If you want to read it, go here: http://www.sciencedaily.com/releases/2012/04/120409164305.htmScience.
Then search for “aristolochic acid”, “April 9, 2012”, “Study Links Toxic Component in Herbal Remedies To Kidney Failure And Cancer”.

Two quotes from Science Daily,
“We believe our latest research highlights the importance of a long-overlooked disease that affects many individuals in Taiwan, and, by extension, in China and other countries worldwide, where Aristolochia herbal remedies traditionally have been used for medicinal purposes,” stated Arthur Grollman, MD of Stony Brook University in NY.

“Marc De Broe, University of Antwerp, an investigator not associated with the study says, ‘From a group of fewer than 200 patients in Belgium, and a geographically confined rural population in the Balkans, the circle of cancer risk due to AA exposure has now grown to potentially global proportions.’”

What other herbal medicines and other “natural remedies” that have been used for centuries have and continue to cause debilitating and potentially fatal diseases? Since very few if any have ever been tested for safety and, in the US, the Dietary Supplement and Health Act (DSHEA) makes such testing unnecessary, we won’t know unless or until something dramatic catches the attention of scientists again.

That is the heart of the matter, the difference between evidence-based medicine and the alternative or folkloric kind. The former investigates and does its best to get the facts. It objectively tests its beliefs, hypotheses, to see if they are correct. The latter believes and assumes, evidence be damned. 

While you very definitely can be injured and killed by approved drugs and practitioners of evidence-based medicine and while there definitely may be folk remedies out there that offer major benefits that outweigh the risks they pose even though they have yet to be scientifically shown to be safe and beneficial for specific indications, the only way to substantially increase the odds, the risk/benefit ratio, in your favor is to use evidence-based medicine and avoid the alternatives or folkloric kinds like the plague unless you have nothing left to lose. 

As a person who was injured early in life by an incompetent MD who didn’t know enough to look at the evidence, maybe now you can see why alternative medicine and its practitioners terrify me, especially those like NDs who are lobbying hard and successfully to convince the public and politicians that they practice evidence-based medicine when that isn’t true. Maybe now you understand why my fear that they are using “remedies” as lethal as cigarettes that will cause many premature deaths before anyone realizes it are justified. Maybe now you will understand why I put such a high value on evidence-based medicine although I respect the right of adults to use belief-based systems of medicine as long as they are honest and don’t insist that they are evidence-based when they are not. Maybe now you will understand why I am so upset by NDs who insist that they have the equivalent educations of MDs who believe in and practice evidence-based medicine while NDs routinely use folk medicine, remedies and “dietary supplements” before they are ever objectively, much less scientifically, evaluated for safety and efficacy. Maybe now you will understand why I think they are playing Russian roulette with the health and lives of their patients.

There are presently 7 accredited naturopathic schools in North America, 5 in the US and 2 in Canada, whose degrees permit people to be licensed as “primary care physicians” in several states and provinces. 

Some of those schools also offer degrees in Chinese Medicine.

Many NDs incorporate it and Ayuvedic medicine into their practices. They also study “botanical medicine” in their schools and use it in their practices even though little of it has ever been scientifically evaluated for safety and efficacy.

NDs believe that a long history of use demonstrates safety and that practitioners over the centuries have learned by experience and observations which remedies work and are safe whereas scientists have learned through extensive investigations and testing that the only accurate way to evaluate the safety and efficacy of a drug or therapy is through the use of objective, scientific tests. What they just discovered about AA in Taiwan is one more example of the things that have led them to this conclusion over the years. 

As one ND so elegantly puts it, “Naturopathic Medicine is a distinct approach to wellness which integrates modern science-based knowledge with traditional Western and Eastern diagnostic and treatment methods.”   http://www.drhaff.com/Naturopathic-Medicine.html. 

What she and her colleagues don’t understand is that when they choose to routinely practice medicine that is supported by solid evidence along side of that which is not, they are not practicing scientific or evidence-based medicine. They are simply choosing what they like, what fits into their philosophy or system of belief and using it on unsuspecting people. What they seem to like the most in scientific medicine is the technology, the image, the white coats, stethoscopes, needles, diagnostic equipment. Well, that is the impression I’ve gotten from listening to them and reading their websites. They’ve missed the heart of the matter, the need to objectively test their beliefs about the safety and efficacy of drugs and therapies to see if they are correct before using them. And that is what terrifies me. 

aristolochic acid, Chinese Traditional Medicine, Ayuvedic, alternative medicine, naturopaths, folk medicine, oriental medicine, NDs, deadly medicine

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Saturday, May 5, 2012

Letters To The Editor About Naturopaths


The Barton Chronicle is a small weekly newspaper in my community 
http://www.bartonchronicle.com/. On March 28, 2012 it published the following letter from me which can be accessed on Chronicle site by subscribers.

To the Editor:

An Open Letter To: Harry Chen, MD, VT Commissioner of Health; and, Chris Winters, Director of the VT Office of Professional Regulation.

If passed as written, Bill H.524 will grant naturopaths, NDs, licensed in VT who pass a pharmacology exam the right to prescribe all the drugs that MDs prescribe.  

Representative Mike Marcotte tells me that you are assuring legislators that the exam that NDs will be required to pass will be sufficiently rigorous to demonstrate that they are competent to prescribe drugs.

Can you tell me specifically: what qualifications the person who draws up the test will be required to have; what the test will cover; who will decide what it covers; how it will be administered; will it be an open book test taken anywhere the candidate chooses over a period of days or a supervised exam over a period of hours, etc.? 

Can you tell me how you can guarantee that any of the answers you give to the above will in fact be carried out? Even if you were to have the authority, time, knowledge and resources to ensure that specific conditions were met what guarantee would there be that another administration would also meet them when not legally required to do so by law?

Why are you pushing to have a bill passed that will give VT NDs more prescription privileges than they already have knowing that you were unaware that their IV use of silver was dangerous and illegal until I brought it to your attention and since the NDs ignored me when I alerted them to their error? http://rosemaryjacobs.com/naturopaths.html How can you trust their judgment or the state's ability to supervise them? 

Why are you pushing to give NDs all the same prescription privileges that primary care physicians have rather than  letting them continue to practice under a limited license as they do now? To put it another way, since you were unable to protect the public before, how will you protect it after you give NDs more privileges?

Who drew up the test that the author of the Vermont Medicine Show blog passed? http://vermontmedicineshow.blogspot.com/2012/02/i-have-no-scientific-or-medical.html? What privileges were those who passed that test awarded or going to be awarded? 

Rosemary Jacobs

On April 4, 2012 The Chronicle published a letter in reply to mine, but did not print my response the following week since it generally waits a few months after a person’s letter has been published to print another one from him. For that reason, I decided to post these letters here.

The other author, however, said she didn’t want me to post her letter even though she understood that anyone who subscribed to The Chronicle could access it on their site. When I told her that in that case I would paraphrase it, she said that she had no objection to that. When I asked if she wanted me to use her name, she said that she did not. For that reason I am using a pseudonym. I’ll call her Jane.

Jane said that she used the money she collected from disability to pay for care from alt. med. practitioners adding that while she didn’t dislike medical doctors they hadn’t helped her and alts, including naturopaths, had.

Jane said that she knew about “the use of silver in healing” although she’d never heard about it being used intravenously. Mentioning me by name, she said that she felt sorry for me. She also said that she had heard of a member of Congress who had discolored himself using silver for a long time. (She had to be referring to Stan Jones, a Libertarian from Montana, who ran for the senate and lost.) 

Jane was in favor of the state granting NDs prescription privileges because she had found that they rarely recommended commonly prescribed drugs, but she believed that the real reason for giving NDs prescription privileges was so that third parties would reimburse patients for their services, something she was all in favor of because when it happened, she would be able to use her disability checks to buy food instead of having to choose between eating and seeking medical treatment. 

This is the letter I sent The Chronicle in reply to Jane’s, the one which it didn’t print.

To the Editor:

Regarding Bill H.524 that will give naturopaths, NDs, the right to prescribe all the same drugs that MDs do, Jane wrote, "The key to wanting naturopaths to have these rights is who pays the bill." I totally agree. Naturopaths who have traditionally called themselves "drugless healers" and avoided pharmaceuticals want all the same privileges that MDs have so that third parties will be legally forced to treat them as equals and reimburse patients for their services. 

I am all for third parties paying for the services of health care practitioners who can consistently present objective evidence showing that the services they provide offer major benefits that outweigh the risks they pose, but I believe that a profession that includes silver in its state sanctioned formulary for IV use is demonstrating that the services it provides are at best useless and at worst dangerous. Either way they waste money in a day and age when our government is struggling to find a way to provide all its citizens with basic safe, effective, efficient, affordable health care. 

Since Jane knows so very little about silver and the VT Naturopathic Formulary, I'd suggest she check my blog http://rosemary-jacobs.blogspot.com and website. http://rosemaryjacobs.com/naturopaths.html . While she may have missed Paul Karason, the Blue Man of Oprah fame, my friend Arline who visited here and was stared at in a local restaurant, and all the other people who have recently been severely disfigured by silver without obtaining any benefits whatsoever from consuming it, she will find a few of them on my sites because unfortunately, as I predicted in 1995 when I learned that silver was being sold as a "dietary supplement", there are now many recent cases of argyria, skin discolored by silver.

Many of these alternative medicine victims are having dermatologists treat them with laser therapy which costs about $7,000 for an entire face. No one is satisfied with just a face. They move on to ears, throats, hands, etc. Plus the procedure has to be repeated and no one knows if there will be side effects down the road. To my horror, insurance companies rather than the responsible parties, have been picking up the tab! And oh yes, an entire body treatment has been estimated to cost $100,000, costs third parties pass on to all their customers. Perhaps that explains why this is not a simple matter of individual choice or entitlement but rather something that has a profound affect on all of us, something that increases the health care costs of everyone including naturopaths' satisfied customers.  

But it gets worse. As I told the NDs who have repeatedly ignored me, I have been in the position of speaking with a teenage girl who turned gray when her mother forced her to take a silver supplement. She was speaking about killing herself as she drove along a highway a few thousand miles away when we lost the connection. I couldn't even send a sheriff to find her. Luckily, she didn't commit suicide that time. That is so tragic and so unnecessary and please don't tell me that NDs know how much silver can be safely consumed because it isn't true. If you look at the references on my sites you will see that no one has ever done the toxicology studies required to determine that, which brings us to the major difference between NDs and MDs. MDs have traditionally used drugs that have been well studied before they were used while NDs have traditionally used "remedies" and "supplements" that have never been scientifically tested or even objectively tested with the result that no one knows if they are safe, useless or dangerous. NDs could be using something totally useless that is far worse than silver, and they certainly haven't earned the privilege of prescribing all the drugs MDs do. 

Rosemary Jacobs

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