Monday, February 22, 2016

What naturopaths say to each other when they think no one’s listening, part 2

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When last I visited this topic, I started out by making a simple observation, namely by quoting John Wooden’s famous adage, “The true test of a man’s character is what he does when no one is watching.” What I was referring to was a private discussion forum for naturopaths known as Naturopathic Chat, or NatChat for short and how a leak from the group had revealed the sort of pure quackery that naturopaths talk about when they are among themselves and think that no one else is listening. Basically, NatChat revealed just how quacky naturopaths are, based on the advice they gave each other about patients and their general discussions of what passes for “naturopathic medicine.” I found examples of naturopaths recommending intravenous peroxide, homeopathic drainage therapy, black salve (for a huge protruding breast cancer), and even ozone to treat a postsurgical J-pouch abscess that clearly required the attention of a colorectal surgeon. After naturopaths on NatChat became widely aware that someone on the list had revealed discussions on the list, apparently the moderators, instead of moving to another platform, stayed on Yahoo! Groups.

None of what I’ve described in this brief recap of my first post about NatChat should be surprising to regular readers of this blog. As I mentioned the first time, regular readers might have gathered from reading this blog that we are not particularly fond of naturopaths, even the nice ones, who might be perfectly fine as people. Of course, it is naturopathy we don’t like, mainly because it is, as I like to describe it, a cornucopia of quackery based on prescientific vitalism mixed with a Chinese restaurant menu “one from column A, two from column B” approach to picking quackery and pseudoscience to apply to patients. Indeed, whenever the topic of naturopathy comes up, I like to refer readers to Scott Gavura’s excellent recurring series “Naturopathy vs. Science,” which has included editions such as the Facts Edition, Prenatal Vitamins, Vaccination Edition, Allergy Edition, diabetes edition, autism edition, fake diseases, and, of course, the Infertility Edition. We’ve also described just what happens when a naturopath tries to treat a real disease like whooping cough. The results are, to put it very kindly, not pretty.

Of course, as I’ve pointed out, any “discipline” that counts homeopathy as an integral part of it, as naturopathy does to the point of requiring many hours of homeopathy instruction in naturopathy school and including it as part of its licensing examination, cannot ever be considered to be science-based, and this blog is, after all, Science-based Medicine. Not surprisingly, we oppose any licensing or expansion of the scope of practice of naturopaths, because, as we’ve explained time and time again, naturopathy is pseudoscience and quackery.

Interestingly, what led the aforementioned NaturoWhat to give me the heads up as to what’s going on in NatChat again is an incident on the discussion board involving a naturopath who featured in the previous edition of my coverage of NatChat, Eric Yarnell. I realize He’s a naturopath who tried to point out to his fellow naturopaths how black salve is a really nasty treatment because of the way it fries normal tissue just as badly as it fries abnormal tissue. He also appears to be one of those rarest of beasts, a seemingly pro-vaccine naturopath. I say “seemingly,” because whenever I encounter a naturopath billing herself as pro-vaccine (e.g., Erika Krumbeck), a closer examination of her views almost always reveals she believes in at least some antivaccine misinformation. Surprisingly, Yarnell is the naturopath who comes closest to actually being pro-vaccine that I’ve seen.

That being said, it must be noted that questioning naturopathic dogma about vaccines, in which the risks are inflated and the benefits downplayed, is what got Yarnell in hot water over at NatChat. Basically, his story taught me two things. First, there do exist occasional naturopaths who are not as antivaccine as the vast majority of naturopaths. Second, all you have to do as a naturopath to be shunned by your peers is to cite approvingly anything on this blog or other “quackbusting” blogs or to be written about in less than a derogatory fashion by “quackbusters.” That alone is enough for you to fall under dire suspicion by your fellow quacks to the point of being temporarily banned from a discussion forum like NatChat.

Naturopathic apostasy, or: How dare a naturopath say vaccines are safe?

NaturoWhat was kind enough to provide me with a link to a Pastebin containing more recent posts on NatChat. The most relevant conversations occur in these files, spanning discussions going back a couple of weeks:

The fun began on February 17, when a naturopath named Laura Flanagan noted that Yarnell had been “booted off NatChat“:

I am very disappointed in the decision to kick Dr Yarnell off of NatChat. He is a dedicated ND who has given more to our profession than just about anyone I can think of. I appreciate his wisdom and always read his posts ( except for this week because because I am really tired of the vaccine bickering) with extra care. He has great knowledge that he shares generously. He is not a traitor to our profession and I think the accusation was a mean spirited, uncalled-for attack.

I hope that his banning will be recinded soon.

So I’ll give Flanagan credit in that, although she notes that most of the naturopaths on NatChat disagree with pro-vaccine viewpoints such as those espoused by Yarnell, she at least thought it was unfair that Yarnell had been booted from the group. I’ll also give several other naturopaths credit that they, too, were very upset about Yarnell being removed from the group, some, like Joshua Goldenberg and Ron Mariotti, so much so that they told Morstein point blank that if Yarnell’s removal from the group stood they’d be leaving the group too. On the other hand, certain naturopaths defended the moderator of NatChat, Mona Morstein, for her actions. The whole kerfuffle lasted a few days and provided an impetus for naturopaths to show exactly why they are not science-based.

We learn a little later from a naturopath named Shiva Barton that, allegedly anyways, it wasn’t Yarnell’s pro-vaccine views that got him booted but this:

According to Eric he was not removed for his pro-vaccine views. He was temporarily removed because Mona thought he might be the Britt mole because evidently he cited some research from her group. De-listing him is misguided – McCarthyism at its finest. Now, I can see banning Eric because he is really pale (we should be tanning him, not banning him) or because has a bad sense of humor, but the guilt by association thing is a little scary. I know that Mona deeply cares about NatChat and it bugs her no end that there is a mole. However, it is not a logical conclusion that citing that research equates with moledom. So, Mona, please let the dude back in so I can continue to skip over all this back and forth vaccine stuff and steal Eric’s clinical pearls when he responds to other posts with his continued very useful information.

Barton is correct. It is not a logical conclusion, but given how antivaccine most naturopaths are it is not in the least bit surprising that, in a situation where there is a suspected mole, suspicion would fall first on the member of the group espousing viewpoints that do not jibe with the prevailing views of the group.

Now here’s where things get interesting. Morstein, obviously stung by the criticism, tries to explain why she banned Yarnell:

I always wish to have NatChat be transparent. It is true I have temporarily removed Dr. Yarnell, but not due to his innate views on vaccines, food allergy testing or whatever. NatChat welcomes all views on topics. However, without going into details, behind the scenes (and yes, also due to his using Gorski as a reference) some concerns have risen about Dr. Yarnell. This is a test removal. If the flow of information to Britt is not stopped by Dr. Yarnell’s removal, I will offer a very sincere, heartfelt public apology to him and Natchat. However, I feel it is my responsibility to try to do whatever I can with whatever clues come my way to staunch the flow of information to Britt Hermes.

I do not wish for this to cause people to be upset or resentful. We need to keep our profession together since many outside people are against us. Please trust me that I do not do anything willy-nilly and needed to accumulate information before taking this step.

So let’s see. Yarnell used me as a reference, and suddenly he’s suspected of being the NatChat mole! I never realized I (or SBM or my not-so-secret other blog) wielded so much power or struck so much fear into the heart of naturopaths, or that citing me approvingly must mean that you would betray your fellow naturopaths by leaking their secrets! Seriously, I highly doubt that Yarnell particularly approves of me, even if he was willing to cite me in a discussion about vaccines. In fact, I know that, in spite of the fact that he appears to be much closer to science on vaccines than his fellow naturopaths, even Yarnell doesn’t much like science-based medicine and “quackbusters”:

I am sorry, but I don’t keep a map on my wall of all the opponents of naturopathic medicine. I don’t look up the history of every source I cite. No one does this. And if I am to be banned and accused of being a traitor or a mole because of citing a source you or anyone doesn’t like, then this list definitely needs to be shut down.

And:

No, I don’t like, support, or agree with the quackbusters on issues of our profession. They are biased and uneducated about this. I don’t know what Orac or some other specific people have said against our profession, but I know their ilk. But I do know that the specific post Orac made regarding immunization that I cited has useful information in it and it supported how I came to my position about immunization. I both stand by the citation and my right to use it without buying in to the anti-naturopathic pap from the same source.

So what happened? Basically, here’s where he committed the offense that got him banned. In response to questions about William Thompson, the CDC scientist who became the “CDC whistleblower,” Yarnell cited two posts, The William Thompson Documents. There’s no whistle to blow on Left Brain, Right Brain, and this post about William Thompson having apparently gone all antivaccine. In response, the reaction was—shall we say?—not positive, not positive at all. Apparently, it went beyond just complaints on NatChat to private e-mails to Morstein accusing him of being the mole.

Paranoia, much?

Quote naturopath Michael Uzick: SBM is criminal!

If there’s one thing I’ve learned from this latest dump from NaturoWhat, it’s that naturopaths, really, really hate us here at SBM. Frequent were the references to us as “quackbusters” (they say that as though it were a bad thing) and complaints about us being biased. Of course, I am biased—biased towards science, which is exactly why I have such a big problem with naturopathy as a profession. To some, it goes beyond this. At least one naturopath, Michael Uzick, appears to think we are criminals:

I also agree with all of the great things mentioned about Dr. Yarnell . However, citing a “Science based medicine” criminals, who are actively trying to destroy our profession is shocking to me. This same group are using posts from this forum to damage individual naturopaths and our profession. To essentially post as evidence to support vaccination something Britt Hermes or her boss has written definitely begs the question of whether Eric is the mole?

Anyone want to bet whether it was Uzick who complained to Morstein about Yarnell and accused him of being the “mole”? There’s no way of ever knowing unless one of them reveals what happened, but my money’s on Uzick. That’s not a particularly difficult guess to make, though, given that at one point Uzick explicitly asks, “Eric Yarnell, are you the mole?

Whether I’m right or wrong about this guess, at this point I didn’t know whether Uzick was referring to me as Britt Hermes’ boss (because she has provided us with guest posts for the blog) or Yarnell (Britt informs me that he was her former teacher). Certainly, I am not Britt’s boss in any sense of the word. She has provided us a few posts for SBM, and I admire her courage in having realized how full of pseudoscience naturopathy is and, above all, for having the courage to make a very difficult mid-course career change after having spent so much money and effort to become a naturopath. I admire her speaking out on her blog, Naturopathic Diaries. It should also be noted that Uzick isn’t exactly a reputable character. A Google search on his name quickly revealed this RationalWiki entry on him, which tells me that he is another “naturopathic oncologist” who is also an HIV/AIDS denialist and imported and administered an illegal cancer drug called ukrain to his patients. This led to him being disciplined by the Arizona naturopathic board with a letter of reprimand, which is pretty damned bad. Given how pathetically inadequate the regulation of naturopathy is in states that license naturopaths, any sort of formal reprimand of a naturopath is very damning indeed. Yet Uzick remains a respected member of the naturopathic community.

And here’s another little tidbit, pointed out by a naturopath named Lisa Chavez:

I have to say, respectfully so, that Dr Uzick it is really ironic that you of all people would name Dr Yarnell, (one who I know to be as genuine a nerd and naturopathic patriot as you can possibly find which I say that with fond respect) as a potential mole when you run the clinic that Britt Hermes worked at in Arizona, no?

Dr Uzick, it would really be insightful to hear your take on Miss Herpes tales, I don’t recall ever hearing your side of the story- like have you filed suit for defamation, etc??

Interesting. So Uzick was Britt Hermes’ boss.

I will give Yarnell proper credit, though. He is quoted twice as having said, “I continue to say to those who don’t support the CDC schedule to present evidence of something better.” Truly, he apparently is a rare beast, indeed. Whenever he’s quoted saying this it causes a backlash of antivaccine pseudoscience, such as this bit from a naturopathic oncologist named Colleen Huber who lists herself as the President of the Naturopathic Cancer Society:

Abundant evidence exists that the CDC schedule, and that most vaccines used in the United States, are both dangerous and ineffective.

Over 400 studies in fact, that have been published in the medical literature, including in journals such as: Pediatrics, Lancet, BMJ, JAMA, Infection, Neurodegeneration, showing the risks and failures of vaccines.  Many of these studies are referenced in Neil Z. Miller, Critical Vaccine Studies.  This book would be a good place for you to start.

If you are interested in learning about the history of vaccines, the most comprehensive and objective book that I have read is Suzanne Humphries, MD, Dissolving Illusions.

It is impossible for you to read either of these and be willing to give even one more vaccine, having learned of the damage already done, the evidence that the vaccinated suffer so much more than the unvaccinated, both from infectious diseases and vaccine side effects.  First Do No Harm requires that naturopathic physicians not administer vaccines, at least not in their present form.  If a much safer, more effective vaccine is developed in the future, I will keep an open mind, but will not administer it until proven safe and effective in credible, uncorrupted double-blind studies.  Those studies have not happened with current vaccines.

First Michael Uzick and his unscientific “medicine,” which includes high dose intravenous vitamin C, mistletoe extract, homeopathy, detoxification, and hydrotherapy (among others) as therapies for cancer. Now Colleen Huber citing Suzanne Humphries and Neil Z. Miller as authorities on vaccination? And naturopaths wonder why I consider “naturopathic oncology” to be 99% quackery! Suzanne Humphries? Seriously? We’ve met Humphries before. She is antivaccine to the core, refers to vaccines as “disease matter,” and routinely uses among the most ridiculous antivaccine arguments there are out there. And Neil Z. Miller? He’s at least as bad! He fancies himself an epidemiologist and vaccine researcher. Perhaps the most hilariously bad example of his “work” (if you can call it that) was his truly risibly incompetent attempt to negatively correlate vaccination schedules of various countries with their infant mortality rates. I deconstructed his pathetic attempt at science when it was first published. Basically, he used typical antivaccine tricks to artificially inflate the number of vaccines American children receive and appears to have cherry picked the countries used. It doesn’t get much worse than Miller’s work. He also wrote a book with Mayer Eisenstein, who was pretty damned antivaccine himself, purporting to provide a “balanced” view of vaccine but citing Andrew Wakefield and the like. Harriet Hall tore it apart with facts and science.

This is the sort of “evidence” Huber considers so compelling, Suzanne Humphries, Neil Z. Miller, and a bunch of crappy studies that antivaccinationists occasionally manage to get published in real peer-reviewed journal, rather like how antivaccinationists managed to get a dubious article claiming to link Gardasil with behavioral issues published in Vaccine, of all journals; that is, at least until editor-in-chief Gregory Poland found out about it and got it removed for further review. It happens. The overwhelming bulk of the science of vaccines indicates that they are safe and effective and do not cause all the harm that antivaccine naturopaths (but I repeat myself) like Huber seem to think they do.

Later in the thread, Uzick compares advocates of science-based medicine to a number of bad things. Specifically, he likens citing our writings to citing Nazi eugenics, the terrorist group ISIS, and tobacco company denialist science, a trifecta of poisoning the well:

Simply, these people have one intention, to destroy naturopathic medicine. I’m a naturopath and thus I’m offended by them and anyone who would use as credible the blogs of the most biased, unscientific and vicious opponents of naturopathic medicine.

There have been a lot of erroneous assumptions put forth today. Perhaps the most important is my assumption that you were aware of who the science based medicine/quackbusters are and Britt’s connection with them. In addition, her long list of activities fighting against our legislative efforts, regularly slandering our profession in articles and blogs, attacking individual doctors and engaging in the exact same tactics the quackbusters have always used.

Of course you are free to cite who ever you like. But if you cite in a professional medical forum, tobacco industry “research”, Nazi eugenicists blogs, ISIS medical hypothesis or the quackbusters that slander you and our profession and who are bent on its destruction, you might expect a provocative response in return.

Gee, Uzick says that as though he thinks that were a bad thing! And of course, we’re just like ISIS. Note our supporting beheadings of apostates. Don’t forget the Nazi eugenicists and how we advocate forced sterilization and the euthanasia of the severely handicapped. Oh, wait. We’ve never supported or advocated anything like that!

I will make no bones about our stance that naturopathy is quackery and therefore not a legitimate medical specialty, however. There is simply no other way to put it, given that one of its “core competencies,” if you will, is homeopathy. As long as that is true, naturopathy can never claim to be science-based, never claim to be anything more than quackery. Uzick and his naturopath colleagues, however, seem to have an apocalyptic view of their opponents’ efforts against them, as you will see.

Criticism on the Internet ≠ Terrorism

As you have seen, based on the existence of a mole on their discussion forum, the denizens fo NatChat recently devolved into borderline paranoia and mutual accusations over who might be the mole. Although it got heated and then Michael Uzick seemed to back down and apologize, it was clear that there was a lot of suspicion and hostility. Of course, this is not surprising, given that Uzick seems to view our activities at SBM, Britt’s activities on her blog, and the activities of other supporters of science-based medicine who oppose increasing the scope of naturopathic practice as terrorism, as he tries to explain why Morestein might have banned him:

Mona and our profession are being terrorized. She was thinking of the greater good and has been through a lot. You may not have understood that Britt is working for them and who they are, but Mona does know and cares about this profession.

I’m sincerely sorry for the degree of upset you appear to have over my question to you. It’s not about you Eric. It’s about our enemies. We are on the same side and there has been confusion, assumptions and hurt feelings that are obscuring the truth.

Uzick is not alone. Elsewhere, Colleen Huber notes that they might not have a mole, that maybe it’s a hacker getting their information through leaky e-mail servers. She mentions “core naturopathic principles, and our comprehensive medical education, and our board exams that no MD has EVER passed (without also going through ND education), even though our clinical questions on NPLEX are indistinguishable from those on USMLE,” which gave me a hearty chuckle because no MD would really want to pass the NPLEX. Also, I dare Huber to show me the USMLE questions on homeopathy that the NPLEX has, given that homeopathy is a key component of naturopathic education and featured prominently on the NPLEX. I highly doubt that there are questions like the NPLEX homeopathy questions on the USMLE. But, in reality, what Huber really, really hates are quackbusters in general and Britt Hermes in particular:

Letting the disgraced Hermes silence us, in any way, is letting the terrorist win. She does have control over the Wikipedia page, but intelligent laypeople can see past the desire to label any evidence that is inconvenient as “pseudoscience.” Wikipedia can tell you how many kangaroos in Australia, or how long the Mississippi River is, but it is notoriously untrustworthy and inadmissible as reference in universities and even now in some high schools. Intelligent laypeople I think are mostly on our side whenever they go to any effort to see what we are all about. We know that the average naturopathic patient has a higher level of education than the average American; they can see through nonsense.

Letting an ex-naturopath turned advocate of science-based medicine silence Huber is akin to “letting the terrorist win”? Seriously? I admire Britt, her ability to admit a massive error and make a painful choice to correct it, and her advocacy of science-based medicine since then as much as anyone else here, but come on! No one, not Britt Hermes, not Steve Novella, not Kimball Atwood (until recently the real nemesis of naturopathy), nor any of us at SBM or on other “quackbuster” sites has the power that Huber seems to think we do. Would that we did! But we don’t. After all, if we did, naturopathy would not be licensed in any state, much less seventeen! There would not be a provision in the Affordable Care Act that requires that any health care professional licensed in any state, naturopaths included, be reimbursed by health insurance programs offered in the exchanges. Naturopaths wouldn’t be expanding their scope of practice so that they can be considered primary care doctors, even though their training and pseudoscientific practice (e.g., as they have in Hawaii) render them grossly unqualified for such a role.

Terrorism. I do not think it means what naturopaths think it means. Certainly, it doesn’t mean writing snarky critical posts on blogs and magazines, trying to make sure that Wikipedia stays science-based, or using our Constitutional rights to oppose their efforts to expand their scope of practice to ply their quackery as primary care providers. (Mark Crislip’s description on Friday of their latest efforts in Oregon to be able to allow naturopaths to provide release to return to playing sports for school athletes who have suffered a concussion is truly scary.) Seriously, I’d really like to hear from Mr. Uzick and Ms. Huber specific examples of this “terrorism” that they’ve experienced. Nasty blog posts do not qualify. These claims of “terrorism” are even more risible in light of the overwhelming superiority in finances and numbers naturopaths have over those of us who advocate science-based medicine. They have so many advantages, in terms of influence, that it’s demoralizing at times. What keeps us going is that we have the one advantage that matters: Science is on our side.

Aftermath, or: What have we learned?

I’m grateful to NaturoWhat for having sent me this link. It was most illuminating and provided information that built on what I already knew about naturopathy. The first thing I know that was reinforced about naturopathy is that naturopaths, other than a tiny minority, tend to be very much antivaccine. Naturopaths are so antivaccine that they will cite antivaccine pseudoscientists like Suzanne Humphries, Neil Miller, and Andrew wakefield as convincing evidence of the evils and dangers of vaccines. Moreover, merely voicing pro-vaccine viewpoints will immediately land a naturopath in hot water with the majority of his colleagues and even lead some of his colleagues to suspect him of betraying them to the evil naturopathic apostate Britt Hermes and her SBM paymasters.

Speaking of Britt Hermes and us, the second thing I learned is that naturopaths really hate us. They really do. They hate us so much that it’s warped their perspective beyond anything having to do with reality, leading them deep into the heart of conspiracy land.. Of course, it is not surprising that naturopaths would be prone to conspiracy theories. They are, after all, naturopaths and therefore already divorced from science, their futile efforts to declare themselves pro-science notwithstanding. Indeed, in their conspiratorial thinking, they ascribe to us far more power than we actually have, which, sadly, is not very much. Would that our power and influence to make medicine science-based were as much as naturopaths apparently seem to think it is! In the end, though, Britt, as influential as she has become, is still an ex-naturopath with a blog, and we are supporters of science-based medicine with a blog. We have an organization that you should all support, the Society for Science-Based Medicine, but it is not (yet, I hope) nearly as wealthy or influential as the main naturopath “professional group,” the American Association of Naturopathic Physicians.

Still, they really really hate Britt, especially Gary Piscopo:

I monitor both the medicine and medical student subreddits. Hating on chiropractors, homeopaths, naturopaths, Dr. Oz, etc. is a religion. Britt Marie Hermes is in the pantheon of deities. The current “re-examination” that Reddit is going through, sadly, is not going to touch this in the slightest because there is nothing hateful, sexist, racist, or bigoted about these opinions. In fact, for many, it is simple common sense.

I wonder if Britt knows she is a deity on Reddit.

In any case, it turns out that, chastened by the criticism of her fellow naturopaths, Mona Morstein did ultimately reinstate Eric Yarnell on NatChat. That there was enough backlash to Morstein’s ban to force her to bring him back is a good thing. Maybe there is hope for some of the naturopaths on NatChat after all, but as long as naturopathy as a profession is a cesspit of quackery and pseudoscience, I doubt it.

In any case, from what I can tell, the crisis appears to have passed, at least for the moment. Eric Yarnell is calling for distributing power from just Mona Morstein and threatening to form his own discussion forum if it doesn’t happen. I expect that some changes will likely be made, or NatChat will splinter into more than one group, and life will go on for naturopaths. They’ll be able to get back to doing what they do best, like using quackery like chelation for heart disease, denying the seriousness of the Disneyland measles outbreak and claiming that naturopathic medicine could have saved the 500 children a year who used to die of the measles before the vaccine existed, asking for advice on purchasing an ozone generator, or spreading misinformation about vaccination.

It’s the sort of quackery naturopaths do best.



from Science-Based Medicine http://ift.tt/1PRpbOP

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