Woo-woo, Voo-doo, Quackery and Snake Oil?

Almost 2 decades ago when I first started practicing naturopathic medicine, I was at times referred to as a witch doctor.  Sometimes the sentiment was given in fondness and in jest, and at other times it was given pejoratively. I see that there are new pejorative words that have taken the place of witch doctor and snake oil to describe practitioners of alternative medicine and the medicines that they use.  My favourite is woo-woo because it sounds like a cute child's toy.  Voo-doo medicine and snake oil are dated terms.  Wikipedia says that quack medicine and quackery apparently come from the archaic word 'quacksalver', which in the olden days meant "hawker of salves".  Quack meant "shouting", so in the Middle Ages, quack-salvers would go around shouting about the salves they had for sale.  Pseudo-medicine (i.e. anything not SBM) is a relatively new term.  Pseudo-science medicine cult (as in alternative, integrative, complementary medical practitioners and their patients) is probably the most pejorative term since it displays a great lack of respect for patients who choose types of healthcare other than (or along with) the drugs and surgery conventional medicine offers them.

A few years back, I remember attending an ACLS (advanced cardiac life support) course at the hospital in my home town with about 10 MDs and a few RNs.  Being in a small town, most (if not all) of the MDs had heard of me even if they didn't know what I looked like.  One MD who knew of me but had never seen me before, after a polite handshake, said:  "I didn't expect you to look like that!!"  I asked him:  "What did you expect?  A bone through my nose?"  (Not that I have anything against bones through noses, it just isn't my style).

I guess this fellow was expecting something other than a regular person dressed in the boring attire of shirt, jeans and hiking boots.  I didn't even have crazy Kramer-like hair.

In an article written by Dr. David Gorski entitled "Defining what a physician is", he writes:

"Meanwhile, a couple of miles away from where I practice, across the border, Canadian naturopaths keep trying to get the right to be able to prescribe real medications, either as an admission that their woo is mostly useless or because they want to be considered “primary care physicians.” Maybe a little of both."

Since this article was written in November 2011, it seems that Dr. Gorski was not aware that there are a few hundred naturopathic physicians in British Columbia who gained the right to legally prescribe most (not all) pharmaceutical medications in September of 2010.  As he stated, one reason Dr. Gorski believed that NDs wanted prescribing rights, is because NDs believed that the natural treatments they offered were bogus as compared to the effective pharmaceutical drugs routinely used in conventional medicine that they could now prescribe.  Sure they believed that.  NDs all across British Columbia had a collective brainstorm:  Let's trade in our woo for the big guns, because the big guns work!

Not quite.

One of the most important reasons that NDs have been fighting for decades with regards to prescribing rights in Canada, is so that as medical practitioners, we can legally wean or discontinue medications taken by patients that are harmful to them.  Yes, medical doctors are trained to do this, but it doesn't always happen where a specialist or a GP will remove a drug that is causing a patient harm.  It is difficult.  There is no blame here, only the working together of all types of professions in the best interest of the patient.  Not in the best interest of SBM, EBP or Traditional Medicine, but in the best interest of the patient.

I will use the following case study to illustrate my point.

Not long ago, I saw a 55 year old woman, obese, a smoker, had Raynaud's disease, and hypertension that was well-controlled with 3 different meds.  She had seen a nephrologist who told her that she was in early stage renal failure and would eventually lose the function of her kidneys and eventually need to be on lifelong renal dialysis.  When she came to me, her creatinine levels were 178 mmol/L, she was on Levothyroxine, Fenofibrate, Felodipine, Ramipril, HCT and Zopiclone.  I immediately took her off of the useless drug Fenofibrate (a cholesterol lowering drug that is not a statin) that has marginal (and probably zero) efficacy for the primary prevention of heart attacks and death due to coronary disease in women.  Fenofibrates are known to cause increase creatinine levels in some people, and must be used with caution in people with kidney disease.  I found it odd that the urine dipstick I did in office showed no microscopic blood nor protein in a patient who was told she was about to lose her kidneys.  For the first 2 months she altered her diet minimally, took the botanical and homeopathic medicines prescribed by me, and her creatinine levels started to decline moderately to 138 mmol/L.  She was unable to stop smoking and lost a minimal 6.5 lbs from 241 lbs over 2.5 months.  I knew from her own admission that her history of hypertension included systolic readings of well over 200, and I knew that for some patients, Ramipril (an anti-hypertensive medication) could compromise kidney function;  so too for HCT (but to a much lesser degree).  Her history of hypertension was a serious matter as was her early stage renal failure.  I left her on her Felodipine (another anti-hypertensive drug) along with her Levothyroxine (thyroid med) and Zopiclone (med for sleeping), and I discontinued her Ramipril and HCT.  I used botanical and homeopathic medicines to help support normal blood pressure function and had her monitor her blood pressure at home daily.  In one month her creatine level was normal at 90 mmol/L and her blood pressure remained unchanged at 112/72 on average.  She now has greatly improved kidney function and continues to have normal blood pressure regulation, while still experiencing obesity and a smoking habit.  At present, this woman continues to work on smoking cessation, weight loss and general health with woo-woo medicine, woo-woo nutritional advice, and a few 'real' medicines (pharmaceuticals).

There are other drugs that are also ineffective and can have dangerous side effects.

That's why naturopathic physicians have prescribing rights; because as medical professionals, we can't be all things to all people all of the time.

Voo-doo?  I think not.

Woo-woo?  I think woo-hoo! is more appropriate.