Spit Take

This was on the Oregonian website: Naturopathic clinic designated as top tier primary care facility. Good thing I was not drinking when I read the headline.

The article has, by the way, my favorite picture of acupuncture technique, because not only are there no gloves on the hands of the acupuncturist as her fingers are next to the needle, there is a box of (unused) gloves behind her on the shelves. I use this photo in every acupuncture talk and the audience always responds with disgusted laughter.

But how could a naturopathic clinic be a top tier primary care facility?

Remember, in Oregon, naturopaths are designated in the statues as primary care providers. This is like designating pi as equal to 3.14, but it is the law of the land here in Magic Kingdom of Cascadia. It does not matter that naturopathic education and training in real medicine are about the equivalent buying a Fisher-Price Medical Kit Playset and declaring yourself trained as a doctor. According to the state, playing doctor is enough to make you a doctor.

So what then is the requirements to become a top tier clinic?

Core Attributes

– Access to care: Patients get the care they need, when they need it.
– Accountability: Recognized clinics are responsible for making sure patients receive the best possible care.
– Comprehensive: Clinics provide patients all the care, information and services they need.
– Continuity: Clinics work with patients and their community to improve patient and population health over time.
– Coordination and integration: Clinics help patients navigate the system to meet their needs in a safe and timely way.
– Patient and family-centered: Clinics recognize that patients are the most important members of the health care team and that they are ultimately responsible for their overall health and wellness.

There is almost nothing in the core attributes concerning the actual appropriate diagnosis and treatment of diseases. It is all about service and coordination of care, the infrastucture for providing care, not the actual medical care itself.   This is something that medicine has not always been all that good at in the past. 

If you go through the standards, there is almost nothing about adhering to science-based medical care and standards.  Use homeopathy, acupuncture, energy and water therapy and other fantastical interventions?  Not even relevant to the designation.  And so not only can the naturopathic college get a designation, so can A Natural Path, an ND clinic in Seaside Oregon.

No good deed ever goes unpunished. Just as evidence-based medicine can be misused to make pseudo-medicines appear effective, the goal to provide better medical care can be misused by those with no medical training at all.

As I read the standard, for something as fundamental as childhood vaccinations, a clinic does not actually have to give vaccines, they just need to

offer(s) or coordinate(s) recommended age and gender appropriate preventive services based on best available evidence.

Not actually give the vaccine, just offer and coordinate. Although they do have metrics for meeting minimal vaccination standards for children and adults. I will have to investigate this further as well and am trying to see if I can access the submission forms of the ND clinics.  I have not heard back from the state as I write this.

As far as the designation as a top tier primary care facility it does not matter in the least, as in the case of naturopaths, that the providers have no education or training in real medicine and that their entire paradigm of medical care is rooted in pseudo-science and fantasy. It is almost all about the service provided, not the quality of medicine practiced.

The designation is like restaurant sanitation grades. It offers important information about the infrastructure of facility but says nothing about the quality of the cooking. And in the case of an ND clinic, it is like getting the Just Like Home Dinner Play Food.