Dammit!

[Praktica]

I don't see that those without a medical education have any choice but to trust their doctor - but that doesn't prevent you from getting a second opinion. What grounds does any unqualified person have to judge whether a treatment is effective or not?

In the case I cited the specialist is the only one of that type available in our province, as is the case for a number of other medical specialists if there even is one of the variety you require available locally. In such cases a second opinion requires travelling out of province for many NZers usually at significant cost and inconvenience so is it any wonder many are so inclined to move outside of the conventional health sector.

A patient is well placed to know whether their treatment is effective or not; your health complaint is either improving or it's not. You're very much demonstrating that you've never suffered any health issue that isn't just a 'cut and dried' treat and cure situation.

I spent some years in the medical education system in my youth, and gained a good understanding of the knowledge and experience required to become a diagnostician. You have to remember, too, that doctors are human, and can make mistakes.

[harm_less]

In the case I cited the specialist is the only one of that type available in our province, as is the case for a number of other medical specialists if there even is one of the variety you require available locally. In such cases a second opinion requires travelling out of province for many NZers usually at significant cost and inconvenience so is it any wonder many are so inclined to move outside of the conventional health sector.

A patient is well placed to know whether their treatment is effective or not; your health complaint is either improving or it's not. You're very much demonstrating that you've never suffered any health issue that isn't just a 'cut and dried' treat and cure situation.

I spent some years in the medical education system in my youth, and gained a good understanding of the knowledge and experience required to become a diagnostician. You have to remember, too, that doctors are human, and can make mistakes.

Especially so in the current climate of income focussed large GP practices and staff deficient public health systems. All the more reason to question the medical services you receive.

And the human body is an incredibly complex organism and very easy to mis-read, especially if the lines of communication between doctor and practitioner are compromised, for whatever reason. Attempt to put 'lipstick on a pig' in respect of the latest new and shiny treatment regime only complicates matters further.

[Praktica]

So if things are too complex for doctors, given their education, to manage, how is some hapless "alternative practitioner", working without a scientific basis for their training, going to manage?

[Olive]

I used to go to a meeting in premises next to a naturopath who called herself "Doctor *** " (I won't use her name). Among the many elaborate and extremely unconvincing diplomas on her wall was a school first aid certificate. That was her medical qualification. So self-deluding and dangerous.

[Praktica]

My GP has a nursing certificate on her wall - she was a nurse before training as a doctor.

[harm_less]

So if things are too complex for doctors, given their education, to manage, how is some hapless "alternative practitioner", working without a scientific basis for their training, going to manage?

Before you start denigrating alternative health practitioners you should be aware that a naturopath is required to attain an Advanced Diploma in Health Sciences (Naturopathy & Nutrition) which is a NZQF Level 7 qualification. Plenty of science involved there I can assure you as my partner tutors for a local naturopathic training facility in the capacity of a holistic nutritionist.

Considering the education your average GP receives in regard to diet, metabolic processes and lifestyle influences on health is cursory to say the least a well qualified naturopath is often better placed to interpret the nuances of our health than the GP whose standard routine is to weigh you, take your blood pressure (if you're lucky) and request blood tests, then prescribe the pharmaceutic concoction that is recommended by his or her drug manual, or refer you onto a more specialised practitioner.

I would place more credence in a practitioner that deals with their patient on a more holistic and in depth level who is more likely to advise changes in lifestyle and diet along with a course of corrective supplements if indicated. The ultimate though is an integrative health practitioner such as my own GP who has a working knowledge of both naturopathic and pharmaceutical modalities.

[Praktica]

How long does this diploma take to complete? What practical content is involved? (lab study, dissection class, clinical training). Are the holders of this diploma able to prescribe drugs?

[harm_less]

How long does this diploma take to complete? What practical content is involved? (lab study, dissection class, clinical training). Are the holders of this diploma able to prescribe drugs?

The diploma course is a 3 year course, though in the US the degree is a 4 year one that is a specialist add-on to a medical degree.

The intent of a naturopath is usually to treat chronic conditions whereas a medical doctor's treatment is usually focussed on acute or traumatic afflictions. That is where surgery and pharmaceutical approaches are more effective. Naturopaths aren't in the business of cutting people up so dissection is hardly relevant. And as per my earlier post a naturopath is not where you will be prescribed synthetic drugs, but my integrative GP fills that requirement when warranted.

Essentially naturopathy is a non-invasive method of treatment which utilises the body's own abilities to heal itself as much as it is able.

[Magoo]

i dont discount the propensity of the naturopath to obtain healthy outcomes in many cases.
nor do i doubt the power of the druid and his bag of roots and leaves or the aboriginal his pointing bone.
the chinese herbal 'chemists have their place too along with the aromatherapists, hypnotherapists and physiotherapists.

None are doctors.

[Oh_hunnihunni]

Well no. Doctors are a much later invention, but the skills are shared, if not the sophisticated knowledge.

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How long does this diploma take to complete? What practical content is involved? (lab study, dissection class, clinical training). Are the holders of this diploma able to prescribe drugs?

Don't underestimate the work involved. I have had the opportunity to help a student doing an accredited homeopathy course and I was amazed by the level of technical information she had to absorb, understand and memorise. Every area of expertise has these kinds of challenges, just because we may not share that interest doesn't mean the committment involved in furthering that knowledge isn't huge.

[Magoo]

Well no. Doctors are a much later invention, but the skills are shared, if not the sophisticated knowledge.

theres no denying the collective evidence of herbal/organic remedies well before the science broke them down into components.
the village healer was prescribing willow bark tea long before joe aspirin arrived.
thats why i dont discount it. medicine is what heals, not why it heals.
trial and error is the most brutal form of research, one learns lasing lessons quickly.

i cannot see the naturopath wrestling Covid, performing an appendectomy, or sorting prostate cancer, but theres a place in medicine for them.

[harm_less]

i cannot see the naturopath wrestling Covid, performing an appendectomy, or sorting prostate cancer, but theres a place in medicine for them.

In the COVID situation addressing or maintaining a good level of health and innate immunity goes a long way towards protecting an individual from any infective agent such as this virus. By contrast, bypassing the body's primary defence mechanism (by injection) and/or implementing pharmaceutical including hospital level care post-infection is the conventional medical approach.

[Oh_hunnihunni]

Well no. Doctors are a much later invention, but the skills are shared, if not the sophisticated knowledge.

theres no denying the collective evidence of herbal/organic remedies well before the science broke them down into components.
the village healer was prescribing willow bark tea long before joe aspirin arrived.
thats why i dont discount it. medicine is what heals, not why it heals.
trial and error is the most brutal form of research, one learns lasing lessons quickly.

i cannot see the naturopath wrestling Covid, performing an appendectomy, or sorting prostate cancer, but theres a place in medicine for them.

One of the reasons we have pandemics at all is over population. One of the causes of over population is modern medicine.
So, one could extrapolate from those facts that if we were still reliant on the old ways, including my personal favourite - hedge witchery - we might not be enduring this pandemic at all...

Oh, and just an update, with daily treatment consisting of eye drops of yoghurt whey, my nasty conjunctivitis is just about cleared. Tomorrow with luck, I will be able to use my contacts and mucking about with knives in the kitchen will be less of an adventure. 

[SueDonim]

A Level 7 (naturopathy) diploma is approximate to a bachelor's degree so is worthy of respect. Added to an existing medical degree it would be great. Standing alone, the three years aren't really comparable to the 6 years university education needed to start two years experience on the job as a junior doctor. After that they spend about 6 years gaining specialist skills and qualifications (a total of 14 years!), one of which can be choosing to become a GP. Other specialists learn a greater degree of depth in their chosen field.The GP has to be a generalist - able to recognise and deal with anything that comes their way. I have worked in the health sector and have seen first hand the hours of work, the mind-blowing depth of knowledge needed to pass the exams, and the overall pressure experienced by the young doctors. A Level 7 diploma is not comparable.

Dietetics is a separate allied health discipline, like physiotherapy, etc. I think that's where naturopathy would fit in if it was accepted, although dieticians do a degree plus a post-grad masters.

There always seems to be excessive mistrust of GPs' abilities. Obviously they are human and make mistakes, but are working much more "alone" than other specialists. Sure, they have colleagues around them, but they don't have the "group" concept that other specialists do. Even a specialist who is the only one in a region still has students under them to question and discuss what they see.

A young GP may not yet have gained the breadth of experience needed, and an older one is likely struggling to keep up with the business side of practice, not to mention the vast amount of reading just to keep up with the speed of today's increase in knowledge. Add to that the fact that a day at work is likely to be endless people coming through with the "same ole ..." so it is easy to miss the one in a thousand patient when the symptoms show something more than expected.

Just as any profession has good people and not so good people, with doctors you also have the medical knowledge v. patient communication v. the time pressure of the appointment system. So the best doctor in the world could be a poor communicator and I think this is why a lot of people feel they get more from alternative treatment providers, simply because they feel cared about and listened to. When the GP pauses to talk properly to the patient, they are instantly late for the next patient and by the end of the day patients who have waited over an hour past their appointment time are understandably getting grumpy. The doctor is then finishing their day very late, and may still have a couple of hours of paperwork to do. The appointment times are set by the practice management who needs to run it as a business. How many people are willing to book and pay for two appointments to give themselves a bit of extra time with the doctor? I do that sometimes.

Many complementary therapies have a place. Some have good evidence for efficacy and some are just placebo, with homeopathy probably the most well known. The practitioners still do courses to learn how to apply the principles, but I'm sure they are not told that there is little to no basis for the supposed benefit. There's a good readable article at https://www.mja.com.au/journal/2010/192/...ce-tell-us.

[Oh_hunnihunni]

And yet many swear by the efficacy of homeopathy, and well trained homeopaths still make a very good living in the community well served by mainstream medical services.

It is important I think to understand that while we are a clever species we do not know everything, we do not have all the answers, no matter how many degrees or years of measured and tested study we have indulged in. Sometimes old knowledge is just as true as the new versions, just like the modern drugs we use that are in fact synthetic versions of the old naturally sourced ones.

I am just grateful to have access to so many sources of healing. Without those and the people who practice them most of us would simply not be here now.

A reality some might debate as a good thing or a bad...

[SueDonim]

... Jesse Mulligan (on Radio NZ) recently recounted his reluctant doctor's visit for a collection of vague symptoms. Diagnosis: Shingles (subsequent to a COVID vaccination). Doctor's action: won't be related to the vaccination so won't report it. That attitude from our health professionals is all too common and good reason to override their actions if you see fit.

---

In 2018-19 there were 483 people hospitalised with shingles. That's more than 1 a day. About 60% are older than 60 so 40% (which is significant) must have been under 60. Those that are hospitalised are only a small proportion of those that suffer from the disease. (https://www.health.govt.nz/our-work/immu...r-shingles, see section 23.3.2).

MedSafe shows that up to 4 December 241 people reported a relationship between the Covid vaccine and Herpes zoster (https://www.medsafe.govt.nz/COVID-19/saf...ort-38.asp). Out of how many million doses?

So it seems that Jesse Mulligan's doctor thought it was likely coincidental. This doesn't stop Jesse making his own report, which then skews the data further but at least he could feel he's had his say.

---

i cannot see the naturopath wrestling Covid, performing an appendectomy, or sorting prostate cancer, but theres a place in medicine for them.

In the COVID situation addressing or maintaining a good level of health and innate immunity goes a long way towards protecting an individual from any infective agent such as this virus. By contrast, bypassing the body's primary defence mechanism (by injection) and/or implementing pharmaceutical including hospital level care post-infection is the conventional medical approach.

Maintaining a good level of health is always a good thing to do, but is not necessarily "respected" by viruses. The original SARS virus in 2002 killed the healthiest people because it turned the strength of their immune system on themselves.

In the current pandemic, it seems to have been older/more vulnerable suffering the greatest impact, so far. But that can change. The hint is there with the fact that many of the problems, including long covid, relate to an autoimmune response. Being personally very vulnerable to "autoimmune" I was at first hesitant about the vaccine, but when I looked into the evidence I found that while the vaccine has a risk of an autoimmune reaction, catching covid is a far far greater risk. So have embraced the availability of the vaccine, including getting my booster this week.

The conventional medical approach makes the best use of the current knowledge about the body and how it works, for the benefit of people who may otherwise succumb to the disease, whether by death or long term disability.

[Oh_hunnihunni]

I agree. But it also pays not to treat doctors as gods, or to expect them to perform like them. Sometimes dying is the better option than modern medicine.

As for age related covid death stats, we need to remember that the older we get the more likely we are to die. Of anything. That is the way it is supposed to be.

[Praktica]

The problem I have with homeopathy (and with most "alternative" practices) is the lack of proof of efficacy - and lack of explanation of possible modes of action. These things go back to a world where science was lacking, or very new, and knowledge was limited. Being old does make a treatment correct.

[Oh_hunnihunni]

If you rely on proof for every action you would find it hard to get up in the morning - assuming morning arrives, there being no proof it will...

We do not know why most things work, we simply accept that they do. Like magic, groceries arrive on on supermarket shelves, electronics work wirelessly (wtf?), bleach gets our sheets white, roses smell good, fantails fly sideways, helicopters hover, and deep sea whales die on our beaches.

Homeopathy works for lots of people. Modern medicine fails to work for lots of others.

That is real life.

[harm_less]

Oh, and just an update, with daily treatment consisting of eye drops of yoghurt whey, my nasty conjunctivitis is just about cleared. Tomorrow with luck, I will be able to use my contacts and mucking about with knives in the kitchen will be less of an adventure. 

Great news. My partner is very impressed by the success of your biological warfare approach.

I have used a similar approach for sinus inflammation in the past using a preservative product that is marketed to butchers to minimise spoilage of sausages. I use it in the form of a nasal flush. It contains Lactobacillus sakei which is effective in helping rebalance the flora in the nasal respiratory region which relieves sinus inflammation in my case.

---

The problem I have with homeopathy (and with most "alternative" practices) is the lack of proof of efficacy - and lack of explanation of possible modes of action. These things go back to a world where science was lacking, or very new, and knowledge was limited. Being old does make a treatment correct.

The problem with find scientific proof of 'alternative' practices is that are usually multifactorial and modern science has very much a reductionist approach. This is to eliminate all possible influencing factors but when many naturopathic treatment regimes have a number of modes of attack, often using naturally derived compounds that contain very many complex compounds the double blind method of testing tends to fall short. That's why many of these treatments are referred to as being 'traditional', they have proved themselves over the test of time not in a laboratory.