The death of Jade Erick: Why state licensure doesn't protect patients from naturopathic quackery

Ever since I first realized that naturopathy is a cornucopia of quackery administered by naturopaths in a "One from Column A, Two from Column B"-style of practice, I've opposed the licensure of naturopaths. Not surprisingly, naturopaths crave state licensure because it puts the imprimatur of the state on their pseudomedical profession. More importantly, it makes it more likely that health insurance companies will actually pay for their services. Unfortunately, thus far, 19 states, five Canadian provinces, the District of Columbia, Puerto Rico, and the US Virgin Islands have all passed laws licensing naturopaths, and naturopaths always want more. Whenever they fail to get a licensure bill passed, they always come back again. Eventually, they usually get what they want. That's what happened earlier this year in Massachusetts. Meanwhile, supplement companies are supporting the efforts of naturopaths to win over state legislatures with propaganda portraying naturopaths as perfectly acceptable primary care providers who emphasize lifestyle and prevention over those evil pharmaceuticals. They're nothing of the sort, of course, but it's effective political propaganda to win licensure.

The Association of Accredited Naturopathic Medical Colleges (AANMC) cites these alleged "benefits" of naturopathic licensure:

  • Allows for better patient healthcare.
  • Creates public safety in relation to alternative therapies.
  • Reduces healthcare costs via prevention.
  • Ultimately has a positive effect on the entire medical community.

Here in my own state, the Michigan Association of Naturopathic Physicians argue for licensure (which, fortunately, they don't have yet) with these talking points:

  • Licensure would allow Naturopathic Physicians to practice under the full scope of medicine for which they were trained.
  • Local communities would enjoy an increase in safe and natural healthcare options and highly individualized medial care.
  • Naturopathic Physicians would help ease a stressed and overburdened medical system by filling the much-needed role for primary care medicine in the State of Michigan.
  • Licensure would make it more feasible for patients to get insurance coverage for Naturopathic Medical Care.
  • Patients would not have to travel outside Michigan to see licensed Naturopathic Physicians.
  • Licensure would help increase jobs by encouraging more Naturopathic Physicians to move to Michigan communities and relieve rural areas without availability of health care.

These are familiar talking points. They're also all a load of fetid dingos' kidneys. Let me translate. Naturopaths are saying that "licensed" naturopaths from "accredited" naturopathy schools are not like "those" naturopaths, who are the real quacks. No, say the naturopaths, we're real doctors ma-an. Basically, they try to convince legislatures that (1) naturopathy is science-based (it's not, other than the actual science-based modalities naturopaths have co-opted, such as diet and exercise, and corrupted with woo); (2) naturopathic medicine has value (it doesn't); and (3) naturopaths can regulate themselves.

Quack AttackThere are many examples that put the lie to this last talking point. Most recently, in the state of California, a licensed naturopath killed a patient with what was reported in the press to be intravenous turmeric but was probably intravenous curcumin. The victim was a young woman named Jade Erick, and the naturopath was Kim Kelly, who operated in Encinitas, CA. He was treating her for eczema, and she was only 30 when she rapidly went into cardiopulmonary arrest as the infusion started.

As I documented, licensure didn't stop Kelly from advertising and administering to his patients all manner of utter quackery. For example, Kelly offers he offers biopuncture, naturopathic detoxing, hormonal balance treatment, IV nutrition, and “wellness programs.” Biopuncture, I note, is an unholy combination of acupuncture and homeopathy so quacky as to defy belief. On Kelly’s blog, I found—surprise! surprise!—more quackery, such as (of course) more biopuncture and more “detoxification,” along with other quackery such as adrenal fatigue treatment, intravenous vitamin C, and a dangerous modality like intravenous peroxide for chronic infections.

So more than a month later, the question, of course, is: What's going to happen? At the time, I predicted that likely nothing would happen, as I caught David Field, the chair of the Naturopathic Medical Committee of California, which is the body that is responsible for overseeing naturopathic practice, looking for dirt on conventional medicine. His fellow naturopaths were happy to give it to him, citing all manner of "death by medicine" studies that blame hundreds of thousands of deaths on iatrogenesis. every year. At the time, I thought he was tipping his hand in any investigation of Kim Kelly, but a commenter reminded me that he was scheduled to testify soon in front of the legislature because the law licensing naturopaths expires at the end of 2017 and needs to be renewed, lest it sunset and leave the status of naturopaths in California uncertain again. Truly, 2017 was a bad year for a high profile case like Kelly's to hit the local and national media, leading naturopaths to go into damage control mode and circle the wagons, rather than ask what went wrong in the case of Jade Erick and why Kim Kelly was using intravenous curcumin to treat eczema when there is basically no good evidence to justify such a practice. When a fatality is involved, such an investigation is critical.

Ex-naturopath who saw the light, Britt Hermes, has reported more on this case, pointing out that California has a serious problem regulating its naturopaths. It turns out that the complaint over the death of Jade Erick was not the first complaint against Kim Kelly:

Almost a year before Erick’s death, a complaint was submitted against Kim Kelly for subjecting patients to treatments using ozone, a toxic gas without therapeutic value. The complaint included 33 other naturopathic doctors licensed in California who were also using or advertising so-called “ozone therapies.” According to complaint documents, Kelly was doing procedures called “prolozone,” in which ozone is injected into joints allegedly to promote healing. But he was also doing ozone insufflations, in which a catheter is used to insert the gas into a patient’s rectum or vagina. The complaint highlights the fact that California naturopathic doctors are not permitted to use ozone gas and that the U.S. Food and that Drug Administration prohibits ozone generators from being sold for medical purposes.

I've heard of ozone therapy, even intravenous ozone therapy, before. It's pure quackery based upon the apparent naturopathic belief that more oxygen is always better. Damn, though, if Britt didn't show me that, even this far into my blogging career, I still find new forms of quackery that I had never heard of before. Most commonly, these treatments come from naturopaths. "Prolozone"? Injecting ozone into joints to "promote healing"? That's pretty bad. At the best all that happens is that the gas will be absorbed into the bloodstream. At the worst, the highly oxidative gas could do the exact opposite of "promoting healing" and provoke an inflammatory reaction that makes the arthritis worse. As for insufflating ozone into the rectum or vagina? The same issues apply. Ozone at high concentrations can damage tissue. It's a toxic gas.

Naturopaths, as is their wont, advertise ozone (prolozone) as the cure for practically everything that ails you. For instance:

Prolozone® is a homeopathic/oxygen injection technique developed and pioneered by Dr. Shallenberger. It is excellent for all forms of musculo-skeletal and joint pain including chronic neck and back pain, rotator cuff injuries, degenerative and arthritic hips and knees, degenerated discs, and shoulder and elbow pain. The good thing about Prolozone is that because it actually corrects the pathology of the disorder, there is a 75% chance for the chronic pain sufferer to becoming permanently pain free.

But what on earth do naturopaths claim that shooting ozone up a woman's vagina can do? Well, there's this:

Many women have reported relief from yeast infections and various sexually transmitted diseases including herpes. Many women also use this method as an alternative to rectal insufflation as it is theorized that the ozone not only affects the pelvic region, but also enters the general circulation causing a body wide effect. (We believe vaginal and rectal insufflation are equally effective for system effect.)

Good to know.

Then there's this:

What conditions benefit from Vaginal Ozone?

  • Yeast, bacterial and viral vaginal infections
  • Unexplained pain in or around the vagina
  • Labia pain
  • Pain with intercourse
  • Pelvic Pain

You can even find videos telling you how to set up ozone generators to shoot ozone up your vagina or rectum:

In it, we learn that rectal and vaginal ozone insufflation are "excellent treatments for killing off pathogenic bacteria, fungi and yeast associated with the inflammation pathway that causes addictive biochemistry, auto immune disease, weight issues and many other epidemic metabolic disorders and diseases today."

So it's not just Kim Kelly in California subjecting patients to potentially harmful treatments. Lots of naturopaths are doing it, and there are numerous complaints. Rebecca Mitchell, the executive director of the California Naturopathic Medicine Committee, the body charged with protecting the public through the regulation of the state’s naturopathic doctors, wouldn't comment on the status of the complaints, but the source of the original complaint confirmed to Britt Hermes that Mitchell told the complainant that the proceedings to investigate a complaint against a naturopath in California can take several months to a few years and "uses the same process and expert reviewers as the Medical Board and Osteopathic Medical Board."

Hermes notes:

Mitchell's description seems inconsistent with the fact that for its cases, the Naturopathic Medicine Committee relies upon naturopathic doctors as expert reviewers, who examine complaints covering deviations from the standard of practice. But since there is no "naturopathic standard of care," a point that the committee acknowledged in 2009 and that critics of the regulation of naturopathy have noticed too, naturopathic expert reviewers must make ad hoc determinations that are likely to deviate from the medical consensus and fail to establish lasting precedent. For some influential naturopathic doctors, the standard of care includes anything taught in naturopathic school or done by two or more practitioners.

She also has observed that the Naturopathic Medicine Committee is very, very slow to investigate complaints against naturopaths compared to other regulatory boards, noting that the Committee took an average of 797 days to complete an intake and investigation. In comparison, it took the Medical Board took 230 days, and the Osteopathic Medical Board took 170 days. Astoundingly, it took the Naturopathic Medical Board an average of 134 days even to assign an investigator, compared to 15 days and 32 days, respectively, for the Medical Board and Osteopathic Medical Board, respectively, concluding:

No other health profession, from veterinary medicine to chiropractors, took as long as the naturopathic committee to initiate and complete investigations of its licensees. (Mitchell was unable to comment on these processing times.)

And noting:

By March 10, 2017, when Jade Erick received the curcumin IV, 294 days had passed since the Naturopathic Medicine Committee received the complaint that Kelly was operating outside his scope of practice with a dangerous substance.

Imagine how embarrassing it must be to be doing worse than chiropractors. No, don't. Besides, it certainly doesn't seem to bother naturopaths that it takes so long for the Naturopathic Medical Committee to do anything. That's just the way they like it. Fortunately, the law that established the licensing of naturopaths in California expires at the end of 2017. Unfortunately, there is a new bill (SB 796) that was introduced by Jerry Hill (D-San Mateo) that would extend naturopathic licensure to 2022. It is a bill that needs to fail.

As I pointed out at the beginning of this post and in more previous posts than I can remember, naturopaths love to portray themselves as the equivalent of primary care doctors, able to take care of patients safely and effectively using "natural" treatments. It's their main talking point when seeking licensure laws. Basically, organized naturopathy promotes naturopathic licensure as a PR strategy to win legitimacy for their pseudoscientific medicine and, not coincidentally, as a strategy for turf protection against “those” naturopaths they deem as less "qualified" (whatever that means in the case of naturopaths). Their key argument is that licensure will provide a level of regulation that will maintain a minimum level of competence and benefit the public. Yet, as the case of Jade Erick and the naturopath whose treatment killed her, Kim Kelly, demonstrates, those claims are simply not true. Also, contrary to these talking points, the committees and boards set up to enforce a standard of care can't do that because there is no naturopathic standard of care and are painfully, unconscionably slow in what they do do. Basically, naturopathic licensure does nothing to protect the public. It does, however, legitimize quackery.

If Jade Erick's death shines a light on the quackery that is naturopathy and the ineffectiveness of any sort of state licensure of the "profession," although it will be cold comfort to her family, at least her death will have helped to prevent further cases like hers.

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I think I’ll stick to blowing toxic gas OUT my rectum, thank you.

By darwinslapdog (not verified) on 25 Apr 2017 #permalink

Dose & Poison? Really? The woman died so the dose was high enough I guess. Licensure for naturopaths is a bad idea.

@MJD: Ozone is an extremely reactive oxidizer, because (as I understand things; someone will correct me) it releases that third oxygen atom as a free radical, and even then there's still a plain vanilla oxygen molecule hanging around looking for something to oxidize. Because of this, ozone has essentially no specificity, and as such will attack any cells in the vicinity: host, pathogen, or commensal flora.

Bleach also kills germs, but that doesn't mean I want some hypothetical gaseous form of it used in my body, in any dosage. And that other potent oxidizer, hydrogen peroxide, is no longer recommended as a routine topical anti-infective precisely because of its indiscriminate tissue damage.

@MJD: Maybe. But the article you cite doesn't show any current accepted medical use for ozone. Everything is investigational, at best. It's not an excuse for quacks to go running off and using this on people. It is not ethical to experiment on people.

The possibility of usefulness does not justify use by people who have no flipping idea what they are doing.

MikeMa - You are conflating two different stories. The person that died was administered curcumin, not ozone.

madder@4: You are basically correct. It is energetically favorable for an ozone molecule to release that third oxygen atom, leaving it free to combine with whatever else may be around. It's OK in trace concentrations, where the thing that odd oxygen atom is most likely to combine with is another odd oxygen atom, but the treatments described above do not involve trace concentrations (which is why calling them "homeopathic" is a misnomer). The idea is as out there as a bleach enema. As for the claimed "75% chance for the chronic pain sufferer to becoming permanently pain free," I'll note that a patient who dies is guaranteed to be permanently pain free, but of course that is not a desirable outcome, either.

As for the wider point of licensing, one of the complaints many people have about SBM is that the profession has trouble regulating itself. There is a fair amount of merit to that claim in many states (I'm looking at you, Texas). But naturopaths turn out to be even worse at regulating themselves than medical doctors. Part of it is the inevitable result of there being effectively no standard of care: it becomes hard to prove that someone has violated standards that don't exist. Even so, taking more than four months just to assign an investigator to a complaint is inexcusable. Furthermore, what are the standards? My opinion on the four claimed benefits of licensing naturopaths (the first quoted material in the OP): 1. No. 2. No. 3. Maybe, but there are more effective ways to achieve this goal. 4. Hell no.

By Eric Lund (not verified) on 25 Apr 2017 #permalink

I was under the impression that the woo-peddlers thought antioxidants cured everything. Now it's superoxidants? As long as "oxi-" is in there it's magic? My head hurts.

By The Very Rever… (not verified) on 25 Apr 2017 #permalink

This sounds fun though: adrenal fatigue treatment. I imagine the cheaper "clinics" do jump scares while the more expensive prescribe a daily pass for the local amusement park. 'You must ride 3 coasters a week for the next 4 months. If that doesn't work we'll try bungie jumping treatment."

I always wonder why people can hear "this magical treatment will kill bacteria, fungus, and parasites on contact!" without for a second asking how it will know not to kill bits of the patient as well.

Eric Lund:

The idea is as out there as a bleach enema.

Considering that ozone can be used as a bleach, that's so good an analogy it might not be an analogy anymore but just straight-up truth.

Of course, the defenders will say "but it's not bleach!" because they think that's chlorine, just like they do about MMS, but I have to ask them: so what do you think OxiClean is? It's basically a powder that releases hydrogen peroxide when you get it wet. Oxygen turns out to be a great bleaching agent, especially when it's in those special compounds that make it extra aggressive.

By Calli Arcale (not verified) on 25 Apr 2017 #permalink

@ Calli Arcale:

These are probably the same people who were screaming their heads off 30 years ago about coffee filters being bleached with chlorine bleach (industrial chlorine bleach--probably MMS, exactly), so unbleached filters became very popular.

Now I notice since they've switched to oxygen bleach (Oxi-Clean, like you said), bleached filters are in the majority again.

I missed the transition because I used a gold filter for years, till they started grinding coffee so fine that too much sludge was getting through.

By The Very Rever… (not verified) on 25 Apr 2017 #permalink

These are probably the same people who were screaming their heads off 30 years ago about coffee filters being bleached with chlorine bleach (industrial chlorine bleach–probably MMS, exactly), so unbleached filters became very popular.

In order to make white paper, you have to treat it with some kind of bleaching compound at some point during the manufacturing process, hence the use of industrial-grade bleach. There were alternatives, but at the time they either were more expensive or didn't produce white paper.

The main problem with industrial-grade chlorine-based bleaches is that you run the risk of producing organochlorine compounds in your waste. Most such compounds are toxic enough to qualify as hazardous waste. That's expensive to get rid of, so Oxi-Clean and similar bleaches are now much more cost effective. This is better for most people, but it's been economically disastrous for a number of former paper mill towns, including Berlin, NH, and a bunch of towns in upcountry Maine. (Nearly half of Maine is owned by paper companies, who allow recreational use of the land, sometimes for a fee.)

Although not producing organochlorine waste is a significant advantage of peroxide bleaches, that's about where the advantages end. The stuff is still toxic to human beings in the amounts and concentrations needed to run a paper mill.

By Eric Lund (not verified) on 25 Apr 2017 #permalink

"I was under the impression that the woo-peddlers thought antioxidants cured everything. Now it’s superoxidants? As long as “oxi-” is in there it’s magic? My head hurts."

Remember, the more oxygen, the better. Antioxidants cure the diseases caused by bad things that cause us to oxidize. Oxygen is good. This is why hydrogen peroxide is a great thing to drink.

I'm not sure why you're confused about this.

By Dangerous Bacon (not verified) on 25 Apr 2017 #permalink

"Oxygen is good."

If it's so good why do their curative herbs and plants expel it as a waste product? Good thing that animals like us came along to scrub the atmosphere of their harmful waste.

Fornax: ‘You must ride 3 coasters a week for the next 4 months.'

I've heard of rollercoasters as a treatment for gallstones, but not adrenal fatigue. (Is adrenal fatigue even a medical problem? It sounds made up.)

By Politicalguineapig (not verified) on 25 Apr 2017 #permalink

Ozone up the vagina to cure herpes?! Good grief.
Can you imagine how that conversation would go with the health officer?
"Where do you think you may have gotten herpes?"
"Well, there was this one gal. She said she'd cured it with ozone so it was OK. Can I cure mine with ozone too?"
Health officer beats head against table.

By JustaTech (not verified) on 25 Apr 2017 #permalink

PGP @16: Was it gallstones or kidney stones?
I'm sure that there are real diseases of the adrenal glands, but based on how often I see "adrenal fatigue" associated with "one weird trick" on internet ads, I'm highly dubious.

By JustaTech (not verified) on 25 Apr 2017 #permalink

Are you fatigued from too much adrenaline all the time, or are your adrenal glands fatigued from producing so much adrenaline? Seems the treatment could go either way...which is handy.

By The Very Rever… (not verified) on 25 Apr 2017 #permalink

PGP and JustaTech: Adrenal fatigue is a made up problem. It's an excuse to peddle woo to people with vague symptoms doctors can't diagnose. The claim is it's a step below actual Addison's because all labs come back normal.

Adrenal insufficiency, better known as Addison's Disease, is another matter. That's a real disease of the adrenal gland that we can diagnose by checking hormone levels, and routine electrolytes. JFK had Addison's Disease.

In order to make white paper, you have to treat it with some kind of bleaching compound

Don't be silly. Anybody can make white paper (PDF).

Recently, my Primary Care Physician referred me to a urologist, who found and removed a bladder cancer. My PCP is a real doctor, an MD. He knew when to refer me, and what specialty to refer me to: it was part of his education.

If a Not-a-Doctor were licensed as a PCP, would his education have taught him when to refer a 'patient' (customer) to a real doctor, and what kind of doctor to refer the 'patient' to?

By Se Habla Espol (not verified) on 25 Apr 2017 #permalink

Kelly was doing procedures called “prolozone,”

I could have sworn that was a variety of cheese.

At the worst, the highly oxidative gas could do the exact opposite of “promoting healing” and provoke an inflammatory reaction that makes the arthritis worse.

At least it's not harsh or unnatural or damaging like methotrexate.

Prolozone® is a homeopathic/oxygen injection technique

Homeopathic ozone is a thing (needless to say), but this "prolozone" scam appears slightly different, presented as real cargo medicine with needles and white lab-coats and machines that go ping... "homeopathy" is not used here in any honest sense, but rather to adorn the grift with an aura of harmlessness and benevolence.

By herr doktor bimler (not verified) on 25 Apr 2017 #permalink

An ND would not refer you to anyone, they'd just make up the treatment on the spot and charge you whatever they thought you could pay.

@JustaTech #18, one year, my unit was in the field training. Another unit was across the road from us and called our medical personnel over for help, as their unit had no medics in it.
28 year old female service member, unresponsive. No pulse or respiration. Shortly before collapsing, she had complained of a tearing pain in her back. CPR was ineffective, indeed, chest compressions were not inducing palpable pulses in her carotid arteries.
The patient was evacuated to the hospital and after a half hour of ineffective treatment, pronounced dead.
Autopsy revealed that she had expired from a dissected aorta. She had begun treatment for severe hypertension just the week prior to her deployment for training. Further findings at autopsy, an benign adrenal tumor, which was producing large amounts of adrenaline.

That's a really, really rare form of tumor of the adrenal gland. When our battalion surgeon had mentioned the finding and asked us what we thought it was, I said, it was a pheochromocytoma.
His jaw dropped.

I could have sworn that [prolozone] was a variety of cheese.

No bimler, prolozone is a species of oxygen (·O₄) originally discovered by Ernest Roquefort.

By Ms. Rondles (not verified) on 25 Apr 2017 #permalink

“Oxygen is good.”

If it’s so good why do their curative herbs and plants expel it as a waste product?

Obligatory link: Love Is Like Oxygen.

By Eric Lund (not verified) on 26 Apr 2017 #permalink

Meanwhile, at the FDA, the battle against illegal cancer cures continues:

"Illegal Cancer Treatments: FDA Warning - Fraudulent Claims of Diagnosis, Treatment, Prevention or Cure

[Posted 04/25/2017]

AUDIENCE: Oncology, Patient, Consumer

ISSUE: FDA issued warning letters addressed to 14 U.S.-based companies illegally selling more than 65 products that fraudulently claim to prevent, diagnose, treat or cure cancer.

It is a violation of the Federal Food, Drug and Cosmetic Act to market and sell products that claim to prevent, diagnose, treat, mitigate or cure diseases without first demonstrating to the FDA that they are safe and effective for their labeled uses. The illegally sold products cited in the warning letters include a variety of product types, such as pills, topical creams, ointments, oils, drops, syrups, teas and diagnostics (such as thermography devices). They include products marketed for use by humans or pets that make illegal, unproven claims regarding preventing, reversing or curing cancer, killing/inhibiting cancer cells or tumors, or other similar anti-cancer claims. See the list of illegally sold cancer treatments.

BACKGROUND: The products are marketed and sold without FDA approval, most commonly on websites and social media platforms.

RECOMMENDATION: Consumers should not use these or similar unproven products because they may be unsafe and could prevent a person from seeking an appropriate and potentially life-saving cancer diagnosis or treatment. Avoid purchasing products marketed to treat cancer without any proof they will work. Patients should consult with their health care professional about proper prevention, diagnosis and treatment of cancer.

Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:

Complete and submit the report Online: www.fda.gov/MedWatch/report

Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178"

https://www.fda.gov/ForConsumers/ProtectYourself/HealthFraud/ucm533465…

"Illegally Sold Cancer Treatments

The FDA has issued 14 warning letters and four online advisory letters to companies illegally selling more than 65 products that claim to prevent, diagnose, treat, mitigate or cure cancer. The products are marketed and sold without FDA approval, most commonly on websites or social media platforms. They have not been reviewed by FDA for safety and efficacy, and can be dangerous to both people and pets."

https://www.fda.gov/ForConsumers/ProtectYourself/HealthFraud/ucm533465…

By Lighthorse (not verified) on 26 Apr 2017 #permalink

Yeah. I was aware of this yesterday morning, but something else caught my attention. I am Dug the Dog.

OT ( but I didn't want to f@ck up today's post)

Some bad news...

It appears that Null is back on the air on WBAI despite a programme page that says he isn't ( WBAI.com). I heard him yesterday and today.

I'm not sure what happened but he has friends in high places as well as in scummy foetid marshes in woo-ville ( I always used *swamp* but with Trumpo abusing the term I need to distance myself. Maybe I'll say *biofilm*)

By Denice Walter (not verified) on 26 Apr 2017 #permalink
I could have sworn that [prolozone] was a variety of cheese.

No bimler, prolozone is a species of oxygen (·O₄) originally discovered by Ernest Roquefort.

No, Fucklesworth.

one of the complaints many people have about SBM is that the profession has trouble regulating itself.

To be fair, Eric, 'convenmtional medicine' ≠ SBM, and I think the SBM folk like Orac would be all for some change to MD regulation that would have more teeth in dealing with the Burzinskis etc. As far as I know, there are no going proposals for change, though, just rather futile hopes that the self-regulatory MD boards will 'wake up' and show some cojones in protecting the public. That should change.

In any event that not-SBM medical mainstream has to take a lot of blame for the naturopath-licensing mess. Who can blame the NDs for following the 'conventional' model. If MD licenses came with regulation that had real teeth and actually worked, then it would indeed be positive-on-the-whole for NDs to be licensed and regulated on similar lines.

As it is, you could rewrite the OP replacing the ND and her wacky treatments with any number of 'maverick' MDs and their wacky treatments, concluding that MD licensure is a bad idea, as it too often legitimates quackery and does next to nothing to protect the public from quacks who acquired a 'legitimate;' medical degree.

For all we know, Kim Kelly may be as much an outlier as Burzinski, in terms of the degree of risk to which she exposed Ms. Erick. More typical NDs may just offer treatments that are dubious but not dangerous to a similar degree. There is more than enough evidence from the Naturochat leaks and other sources that common ND practices don't deserve legitimation.When science advocates advance the sort of very un-scientific argument against naturopathy represented by dramatic emotion-stirring individual cases they poison the well for the reason they claim to stand for, and the principles of evidence they hope will triumph in the end.

For all we know, Kim Kelly may be as much an outlier as Burzinski, in terms of the degree of risk to which she exposed Ms. Erick. More typical NDs may just offer treatments that are dubious but not dangerous to a similar degree.

Wrong, wrong, wrong, wrong. For all we know, Kim Kelly is well within the mainstream of naturopaths. This is beyond question based on what naturopaths do, say, publish, and advocate.

Sadmar: California naturopath Kim Darrell Kelly is a man.

By cloudskimmer (not verified) on 27 Apr 2017 #permalink

Justatech: It was kidney stones, my bad.

Panacea: Thanks for the clarification. I knew about adrenal insufficiency, not sure where I picked it up,

Wzrd1: Yowza. What a nightmare for everyone concerned.

By Politicalguineapig (not verified) on 27 Apr 2017 #permalink

And now my post at Michalski Chiropractic and a lot of others that were just a wee bit critical have been scrubbed and comments closed

MJD @37: So, you eschew all tropical fruits, right? Because of the risk of cross-reactivity? No pineapple, kiwi, mango, etc?

Dude, let go. It is an ex-hypothesis. If you weren't here hammering into irrelevant conversations it would be pushing up the daisies.

By JustaTech (not verified) on 27 Apr 2017 #permalink

Justatech: MJD can't let it go, it's all he's got since the divorce.

By Politicalguineapig (not verified) on 27 Apr 2017 #permalink

"divorce"

Was his spouse's name Reality?

For all we know, Kim Kelly is well within the mainstream of naturopaths.

Well, my point is we don't know. Mr. (sorry) Kelly may indeed be within the ND mainstream in some ways, but it's not like there's a massive trail of corpses from crazy IV injections of whatever, is there? If NDs produce harm, there ought to be some way to compile systematic data on that, rather than rely on single cases of outrage. And I doubt wrongful death would be a particularly useful metric, as any quack with half-common-sense would stay away from risky treatments with at-risk patients – unlike MDs who actually are tasked to help folks who are seriously ill or injured.

I would assume NDs are subject to malpractice lawsuits, yes? I wonder if some systematic data could be derived from court records. I know someone will protest that quackery depends on patients whose belief in magical thinking is so strong that practitioners are never considered at fault, but that wouldn't hold with NDs if they are indeed capable of passing themselves off as 'real doctors' capable of being PCPs. Even so, any simple counting wouldn't do for comparison to MDs, a study would need to be more qualitative to take into account the vast differences between what NDs and MDs do.

But, but, but... these are quibbles really. The significant question is "what is to be done" to protect the public from quackery. Licensing of NDs under any existing or proposed scheme is obviously bad regardless of whether the Erick case is typical of anything or not. However, unlicensed naturopathy, in which pretty much anyone can hang out a shingle and call themselves a naturopath is hardly any better. And what of all the many other varieties of quacks, including those with conventional medical degrees? It's not like Burzinski's the only one.

What would effective regulation of medical services look like, and how would we get there? If sbm can't speak to this, who will? if we admit there are problems with all 'self-regulation', who should guard the hen house? Singling out NDs smacks of hypocricy and runs the risk of failing politically along the lines of the AMA's long ago attempt to quash chiropractic – which left the major forces of conventional medicine so burned they've been shrugging at quackery for decades. It seems obvious to me that the politically prudent and ultimately best for the public approach would be for MDs to demand rigorous regulation with some real penalties for quackery for everyone, including themselves...

Well, my point is we don’t know.

That's nice. And my point is that we do know. Other than the IV turmeric/curcumin, nothing I could find on Kim Kelly's website or in my reading about him is in any way outside the mainstream of naturopathy. Other than the IV curcumin, he neither advocates nor offers any treatments that hundreds of naturopaths don't also do, and I can point to a lot of naturopaths that offer treatments even more far out. I'm not relying on a "single case of outrage." Take away the IV curcumin, and Kim Kelly is just another naturopath. If Jade Erick hadn't been so unlucky (what we know about IV curcumin would not have predicted death to be likely), he would have kept practicing as a respected member of the Southern California community of naturopaths for who knows how long...

I would assume NDs are subject to malpractice lawsuits, yes?

Yes, they are, but suits are seldom brought against them because most of them don't carry malpractice insurance. Also, successful malpractice suit must prove that the practitioner (1) caused injury and (2) his management of the patient didn't live up to the standard of care. Since naturopathy in essence has no defined standard of care, proving malpractice in naturopathy is exceedingly difficult, and, given that most naturopaths don't have malpractice insurance, there isn't a deep pockets to go after.

@sadmar: Naturopaths are very difficult to sue. To prove malpractice, you have to show that the naturopath performed a negligent or grossly negligent act, or malpractice and that the act caused harm. A reasonable person should know that the act or lack of act would cause harm in a same or similar situation.

Malpractice suits often rest on the standard of care. Since naturopaths have no standard of care, it is very difficult to prove they should know or reasonably know that their act or omission would cause harm in a same or similar situation.

Because naturopathy is a belief system, its victims are rarely inclined to sue. If it kills someone, the family might or might not be inclined to sue, but they have to have some place to start. I'm sure it'll happen eventually, just like some quacks have been locked up, but it's like sweeping back the ocean with a broom.

Justa Tech (#40) writes,

It is an ex-hypothesis.

MJD says,

To my knowledge, ex-hypothesis is not a word that has ever been used in the science community.

@ Orac's minions,

Is ex-hypothesis an abbreviation for extraordinary hypothesis?

Please advise...

By Michael J. Dochniak (not verified) on 27 Apr 2017 #permalink

@MJD:

Is ex-hypothesis an abbreviation for extraordinary hypothesis?

Please advise…

It's a reference to the Monty Python Dead Parrot sketch, specifically the end, where the irate customer (played by John Cleese) shouts "THIS...IS AN EX PARROT!"
What JustaTech is saying is that your hypothesis has been properly investigated and found to be wrong. So it's an ex-hypothesis, just like the dead parrot was an ex-parrot.

By Julian Frost (not verified) on 27 Apr 2017 #permalink

@Julian Frost #47, thanks. I forgot about that reference and accepted at face value, due to the source. :)
It rang a bell, just barely.

Note to self, watch that film again...
It's ripped onto one of the HD's around here in my sock drawer.

By Wzrd1 (not verified) on 27 Apr 2017 #permalink

In reply to by Julian Frost (not verified)

@ rs:

Ha ha.
He's not the only one divorced form *her*.

By Denice Walter (not verified) on 28 Apr 2017 #permalink

Maybe you can ask the Goldwater Institute to oppose naturopathic licensing.

By Joseph Hertzlinger (not verified) on 29 Apr 2017 #permalink

Speaking as a nursing professional, I do
Believe as nurses there are "standards of care"
That we must meet/follow or else how could
we be deemed competent/incompetent. It
baffles me that the state would allow this
However I'm not a statist(that's a topic of conversation
for another day). There is risk in every choice
You/I make in life even though "fresh tumeric"
Is known to be a potent anti-inflammatory NOT
Manufactured tumeric/curcumin. My point, Be aware of
of a natural product in its highest concentration. This
Incident reminds me of banning of ephedra by the Feds that
was being used for weight loss however it was
Causing dangerous side effects that were cardiac
Related. Ephedra is derived from the Chinese herb
Ma Huang which has been used therapeutically in
smaller doses to achieve desirable results. My point is
"Ignorance" can lead to more harm than good. Also
How many patient deaths have been
Pharmaceutically- related? I know two wrongs
Don't make a right but I'm sure it's no comparison
Vs deaths caused by natural IV infusions.

By Outdoorsy (not verified) on 29 Apr 2017 #permalink

Joseph: wouldn't that be interesting. An organization opposed to regulation in pretty much any form opposing licensure for naturopaths on the basis of free choice.

Yeah that pretty much sounds like a disaster in the making. The enemy of my enemy is not always my friend. Sometimes they're just another enemy and you find yourself fighting on three fronts.

Outdoorsy, your post is somewhat confusing.

As a fellow RN (and a nursing instructor to boot), let me point out that there is no belief about this but immutable fact: there ARE standards of nursing care and they are spelled out in the Nurse Practice Act of your state, in the ANA Standards of Care, and in the standards of care of your specialty if you have one. Fail to uphold them, and you will not be able to defend your practice if you ever wind up named in a malpractice lawsuit.

The purpose of the NPA and these standards is to protect the public, which I know for a fact you were taught in nursing school.

I'm not sure what you mean by "fresh" turmeric. I have to assume you mean freshly ground. Certainly there's some data to suggest it may have anti-inflammatory properties, but you must realize it's a long way from seeing that in a petri dish to knowing it actually has any benefit as an anti-inflammatory in humans whether it is fresh (however you mean the term), professionally prepared (be it by the supplement industry or Big Pharma), or its active ingredient isolated and commercially prepared by Big Pharma.

Ephedra was banned because people were going into SVT and having heart attacks (I saw these several times in my ER days when it was still legal). There's an old saying: the poison makes the dose. Ephedra, whether you call it Ma Huang or what ever, is essentially ephedrine, a stimulant. It increases heart rate, blood pressure, can depress the appitite, and cause urinary retention.

The supplement industry does not regulate the purity of its products. There is an old saying, "the dose makes the poison." When you can't guarantee the dose, then you can't plausibly say that smaller doses achieve desirable results (which you don't specify), and you also have no basis for say what dose achieves what desirable result in the first place, making your whole claim completely unsupported by anything resembling evidence.

No one says that real medication is 100% safe, but those medications have been studied, and the risks are usually well known. When unexpected risks pop, like they did for Vioxx, the drug is withdrawn from the market (like Ephedra was), or a black box warning is issued.

Way back in the early days of modern medicine, physicians got the idea that lost fluid volume could be replaced intraveneously, and lost blood as well. They tried infusing water into depleted patients and they all died because water is not isotonic. They tried infusing dogs blood into people; they died because it is not compatible with human blood.

Those physicians were wise enough to STOP what they were doing until they figured out how to make it work safely.

"Natural" woo quacks don't stop. They continue to use unproven practices and charge big bucks for them. This is why I don't like quacks, mistrust "natural", and wish they could be banned out of existence. They don't know what they don't know and worse, they don't care. So the public is at risk.

@ Orac (and anyone else who'd care to comment)

What are your thoughts on “what is to be done” to protect the public from quackery? If sbm-ers restrict themselves to the bully pulpit of warnings and debunking, that acts as a sort of tacit endorsement of laissez faire. I'm looking for some kind of policy proposals – if not 'finished products' then some rough ideas for discussion on developing some.

"Don't license naturopathy" may keep things from getting worse (or not), but it's not going to make anything better.

Part of the problem with singling out this CAM practice or that, like these anti-naturopathy posts, is that you wind up with these weak, unscientific claims about harms as justification. Your response in #44 borks the argument of the OP. If Kelly is a typical ND, IV tumeric shouldn't have been fatal, Ms. Erick's fatality was just bad luck, and all those other NDs who are are very much like Kelley are not creating corpses or causing serious injury to their patient's health, where's the problem?

On the other hand, if we take 'quackery' in general as the domain, there's no real problem with a shortage of harms. It also becomes clear that things like disciplinary labels and form of credentials – ND, DC, MD, MG [mission from God :-) ] – don't in any way parse out to categories of 'safe' and 'not-safe'. How then do we rope off the 'not-safe' and establish consequences for 'not-safe' practices that apply to all presenting themselves as health practitioners?

Julian Frost (#47) writes,

What JustaTech is saying is that your hypothesis has been properly investigated and found to be wrong.

MJD,

Please cite references....

By Michael J. Dochniak (not verified) on 30 Apr 2017 #permalink

sadmar, part of the problem is naturopaths really don't understand how the immune system works, and are poorly equipped to handle the consequences of a severe anaphylactic reaction. If they stock epinephrine, which is the first line treatment in severe cases, they're admitting modern medicine can do more than their quackery can do. If they don't stock it, they could lose the patient.

I'll bet "Dr." Kelly didn't have any EpiPens on hand. But even if he did, I don't think he'd recognize anaphylaxis when he saw it. There's more to it than hives and shortness of breath.

That's why we shouldn't license naturopaths. They have no standard of care and they don't know WTF they are doing when they try to appropriate and tweak actual technologies for their own purposes.

How do we differentiate between safe and not safe. Well for starters, we give the FDA their teeth back. We press for Governors to appoint people to BOM's who will clamp down on people who practice medicine without a license, and physicians who violate the standard of care.

We press for Congress to regulate the supplement industry.