Thread by @DocMCohen

Misinformation like this is becoming ubiquitous on Canadian naturopathic clinic websites.

Mostly it's a repetition of the same few ideas, so I'm going to break these down and show why they're false.

Long thread alert!

1) Universally, when describing their education, NDs include undergrad. It's a trick to artificially inflate the number of yrs of training, but your bachelor's degree is not part of your training as a health care provider. This is sneaky and deceptive.

2) Despite the emphasis on undergrad training, NDs are surprisingly quiet on what MDs do AFTER med school. Family doctors can't practice without minimum 2 yrs of residency training. Other doctors commonly do 4+ yrs.

Residency is NEVER mentioned in these ND to MD comparisons. 🤔

3) Trained like MDs but with extra "natural" training is a common theme. This is tricky and misleading framing. Essentially, because SOME of the components of ND and MD training overlap, they feel justified in saying the training is basically equivalent.

4) And when ND and MD education is framed as similar, all the things MDs don't study (ie, homeopathy) are presented as "additional", as though they're specialized extras.

Meanwhile the large number of things MDs learn that NDs don't are conveniently ignored.

5) So what are the similarities and differences? Yes, there are basic sciences and clinical skills that NDs learn. But so do ALL health care providers.

Dental students learn anatomy and diagnosis too. But when was the last time a dentist said they went to medical school?

6) More importantly, NDs spend a LOT of time studying non-scientific fields, like herbalism, homeopathy, hydrotherapy and more.

This is not ON TOP of a standard, science-based medical curriculum, it's INSTEAD of it.

7) Next to the non-scientific curriculum, clinical experience is the biggest difference between ND and MD education.

NDs train primarily in office settings whereas MDs train mostly in hospitals. This means that medical students gain exposure to much more serious illnesses.

8) Hospitals are where students scrub into surgeries, catch babies being born, learn to resuscitate unstable patients in the middle of the night and see complex and serious illnesses again and again and again. The volume of work is huge because there is SO MUCH TO LEARN.

9) Which brings me to hrs. NDs claim 1,500 hrs of clinical experience. MDs accumulate at least 4,000 hrs.

But those 4,000 hrs DON'T include residency. This is the critical point that ND misinformation skips past.

Even after 4,000 hrs, MD grads CAN'T practice independently.

10) After medical school, I spent another 6,000 hrs in my family medicine residency. Only THEN was I allowed by my regulatory college to call myself a family doctor.

11) So let's break this down:

1,500 hrs vs. 10,000 hrs.

That is the difference in clinical training volume between me and a naturopath who calls themselves a family doctor on their website.

12) And that's JUST the difference in quantity. The quality is also vastly different.

ND students see a generally healthier patient population and work in primarily one type of setting. Family medicine residents see a huge range of patients in a wide range of settings.

13) So these ubiquitous statements about the "key difference" between NDs and MDs being the philosophy and approach? False and self-serving misinformation.

The quality and quantity of training are VASTLY different.

14) Let me put it like this:

There is no way I would have felt prepared to be a family doctor the day after I graduated med school.

Every new MD grad about to start a family medicine residency feels the same. There is SO MUCH have to be able to do before we can practice.

15) That a newly graduated ND feels totally comfortable setting up a clinic website telling the public that they are a family doctor is unsettling to say the least.

Dunning-Kruger is in effect.

16) Lest you think family medicine is the only medical specialty affected, NDs also commonly claim specializations in pediatrics, oncology, geriatrics and more.

16) My regulatory college wouldn't look kindly on me calling myself a pediatric specialist since I haven't done a 4+ yr pediatrics residency.

Even though I see plenty of kids in my family practice, I'm still not allowed to imply that I'm a pediatrician. Because I'm not.

17) By the way that "chose to specialise in Pediatrics" screenshot isn't from a clinic website, it's an ND profile on the @OANDorg website. The provincial advocacy group for Ontario NDs.

Imagine if @OntariosDoctors allowed MDs to post misleading profiles on the OMA website.

18) So why are NDs allowed to claim specializations without having done specialty training? Actually they're not, at least in Ontario.

But regulations need to be enforced to have meaning, and this is where we seem to have the biggest problem.

20) A lot of the misleading language I'm breaking down comes from a few specific sources, namely representative orgs such as @AANMC.

NDs setting up practices use this language for their websites and advertisements.

21) From @naturopathicdrs, the national ND advocacy group in Canada.

22) From @OANDorg. I could post examples like these all day.

The various provincial and federal regulatory authorities seem content to look the other way on this misleading information. So nothing changes.

23) Misrepresentation is an informed consent issue. There's nothing wrong with making an informed choice to see an ND, but if that choice is even partly influenced by the false idea that ND training is similar to MD training, then it's NOT fully informed.

24) Any practitioner who misrepresents their education has questionable ethics.

To some degree NDs are themselves misled by their orgs, so that's where our focus needs to be to.

Our medical regulators need to stand up for informed consent and stop ignoring this issue.

FIN