Friday, May 21, 2010

How to Identify and Avoid Phony Practitioners

How to Identify and Avoid Phony Practitioners

Seems like everyone who wants to can be a doctor these days, no schooling required. A dictionary definition of a doctoral degree is:
• any of several academic degrees of the highest rank, as the Ph.D. or Ed.D., awarded by universities and some colleges for completing advanced work in graduate school or a professional school
• an honorary degree conferring the title of doctor upon the recipient
• a degree awarded to a graduate of a school of medicine, dentistry, or veterinary science

It’s that second definition that is most troublesome, because it means that anyone can open up a virtual school and award doctoral degrees for whatever level of work – or dollars- they think sufficient.

The field of naturopathic medicine is shot through with such fraud. Only 16 states license naturopathic doctors. The licensing process requires graduation from a 4 year naturopathic school with virtually the same curriculum as that of a medical school, with natural treatments substituted for drugs and surgery.

These institutions have been accredited or are in candidate status for accreditation by one of the regional accrediting agencies approved by the US Department of Education. In addition, all of the naturopathic medicine programs of the member schools have been accredited (or are candidates for accreditation) by the Council on Naturopathic Medical Education (CNME).

On the other hand, the naturopathic schools that offer long distance education say that their courses are approved by the American Naturopathic Certification Board (ANCB). These graduates are not eligible for professional licenses. Strangely, the ANCB's website states "Due to ANCB's stringent application and certification requirements, ANCB is the certification organization preferred and recommended by the leading schools of Traditional Naturopathy, including Clayton College of Natural Health and Trinity College of Natural Health" [both are online diploma mills]. Does this seem a little incestuous?

Now naturopathy has come to veterinary medicine. One online diploma mill requires a “recognized Master's degree in a natural health field” to enter ‘doctoral’ programs offered there, but no definition of what this means. The accreditation for this school is through the American Association of Drugless Practitioners (Texas). That’s all.

We even need to worry about people making up certifications on their own. I once taught a course online on herbal medicine that was open to veterinarians and veterinary technicians. A technician, after finishing the course, granted herself a “Dip.Vet.Bot.Med” on her website, where she was offering animal health consultations. This was new to me as the instructor of the course. Presto – certified in herbal medicine after a 4 week introductory course!

So how do we judge the quality of the educational experience for practitioners of animal medicine? Let’s compare the curriculum and experience of the diploma mill to that of a veterinarian who is familiar with naturopathic principles:

Veterinary education (in the U.S.):
• Requires an undergraduate (college) degree from a university or college accredited by the US Department of Education, with a concentration on chemistry, biology and physics.
• 3 years of full time, in residence schooling that includes about 6 hours daily of didactic lectures, labs and contact with instructors who hold advanced degrees or certifications in their fields
• Required textbooks are comprehensive specialized reviews of medical science
• 1 year of full time clinical experience under direct supervision of faculty who are specialists in their fields
• Regular competency exams culminating in national and state board examinations that must be passed in order to obtain a license to practice.
• Further education on herbal medicine, acupuncture, homeopathy and other natural modalities requires well over 100 hours of study for certification each. A recent survey of 300 veterinarians who practice natural or integrative medicine revealed that 61% of veterinarians with at least 6 years of integrative practice experience have accumulated at least 250 classroom hours in integrative medicine. Of these practitioners, more than 30% have taken more than 500 hours of class room training.

Diploma mill doctoral degree:
• 200-300 hours (claimed) of self study
• Faculty - just a few of the school’s own graduates - available by phone or email
• Required textbooks are simple compilations for pet owners, typically available at your local book store
• Final exam is 3-5 questions, open book

Graduates holding a “VND” or “Doctor of Veterinary Naturopathy” degree have been taught that it is illegal for them to diagnose or prescribe in order to treat animal disease, so they position themselves as educators. Of course, the fact that they suggest treatment recommendations after learning symptoms, and the fact that they often sell just the natural remedies needed certainly could not be viewed as prescriptions (please know that I have on my most ironic smile right now). In addition, they make these recommendations without seeing the animal, which could vitally change the prescriber’s overall assessment. Yes, some veterinarians also do this, but most have medical records or direct communications from a veterinarian who has seen the animal, which solves that problem.

Any veterinarian understands the pet owner’s desire for second opinions and to have a team behind their pet’s medical care. But you can do better by your pet if you stock that team with professionals who have received comprehensive and well rounded veterinary and natural medicine education. Look for the initials below:

Veterinary degree: VMD, DVM, BVSc, MVB, VetMB or BVetMed, BVM&S or BVMS, Dr.Med.Vet
Natural medicine certifications (post graduate training offered only to veterinarians):
Acupuncture: CVA, FAAVA
Herbal Medicine: CVCH (Chinese herbal medicine), CVHM (Western herbal medicine)
Homeopathy: CVH, VetMFHom, CertIAVH
Chiropractic: cAVCA, IVCA, CVSMT
Physical therapy/rehabilitation: CCRT, CCRP
Chinese massage (tui na): CVTP

Nonveterinarians holding the “VND degree” and those who follow them may well wonder why we can’t all just get along. The argument would be that they offer only information that is complementary to that of veterinarians, and that they are only educating pet owners on how to better care for their pets. The situation feels to me much like medical practice in the US in the early 1900s. There were many private medical schools and many different educational experiences, and people had many different types of practitioners to choose from.

In the course of determining which type of practice and schools should be the recipient of grant money, the Rockefeller Foundation hired Abraham Flexner to thoroughly investigate all medical schools in the country for the first time. The report is eye-opening. Most of the naturopathic and homeopathic schools presented their students with very poor experiences – most did not require a college degree; none of the faculty was full time, and few of the students had access to actual patients in a mentoring atmosphere. Some of the schools were described as filthy, with libraries of only a few old books. By contrast, the schools that offered the best education required college degrees and 4 years of didactic and bedside education. If your mother developed a serious medical condition in the 1920’s, which type of graduate would you have wanted to see her?

These are not complementary veterinary professions. And I can already hear the defense - 'those veterinarians are just worried about competition'. No we're not. We're worried about what happens to sick pets whose owners don't know the difference between in-depth veterinary and natural medicine knowledge and a fake. If they know the difference and choose a "VND", the pet still suffers, but the owner is making an informed choice. The trouble is - most owners don't. So if that internet expert with a Dr. in front of her name offers consultations and sells supplements, it's a good idea to look for those letters, then make your decision.


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    1. Have you even looked into the amount of work students of the VND program have to do. Especially compared to online diploma mills? The text books we use are not just books for pet owners, they are text books written by veterinarians.
      Compared to the amount of holistic modalities most veterinarians learn, the VND program far outweighs that. As a Homeopath and Herbalist for people, I know what kind of training is required to properly use these modalities and the training available to veterinarians is not enough to allow them to properly utilize them. There is no reason why an individual can take their pet to a veterinarian for a diagnosis and then see a veterinary naturopath for holistic modalities. We don't learn diagnosis and we wouldn't want to. That is the veterinarians job. But we do learn how to use holistic modalities for different animals and different situations.
      Perhaps if some veterinarians weren't so afraid of losing money to natural remedies because they rely on constant exams and unnecessary constant vaccines and food that is not species appropriate. They would actually work with veterinary naturopaths to utilize both systems of healing to offer what is really in the best interest of the animals.
      Having worked in an allopathic veterinary clinic and seeing how many we're there simply for the money. Now having spoken to many who are using holistic modalities for animals, I can see who is there for the money and who is there for the love of animals.

    2. Yes, I have looked into the curriculum of the VND program, and its appalling that a "doctorate" is awarded for that level of work. I don't blame you for not knowing - if you have never been through a true doctoral program, you have no prior experience by which to compare. I've completed one doctorate, started (and didn't finish) another, and had doctoral level training in a residency program, and I'm telling you that the VND is falsely leading people to believe they are consulting a doctor.

      There is not a single veterinarian on the faculty. I know of some who were interested and backed away because of the deficiencies in this program. Since veterinarians are the only professionals thoroughly schooled in the physiologic differences between the species, the VND program is lacking in a vital safety aspect.

      Veterinarians are professionals and don't recommend exams because it's a way to make money. Exams are absolutely critical to monitor changes in condition. If you can't look at the gums, see the look on the pet's face, listen to the heart, check hydration, palpate the abdomen and the pulse - then you are not monitoring the progress of the pet. We see many patients who have been working with long distance homeopaths and mail order diploma "doctors" who have become worse over time because of a lack of these exams.

      Most veterinarians would not object to working closely with a well trained natural practitioner who stays in touch about treatment recommendations and knows when to send a patient back to the vet. The VND training is not adequate to know when it's time to send the patient back to the vet. I'm sorry, you are too uneducated to know what you don't know.

      Your attitude that veterinarians are money-grubbers speaks to your lack of experience working with veterinarians.

    3. Actually there are two veterinarians on the faculty.
      Yes, exams are necessary, but when I have been to a veterinarian, they recommend processed, unnatural foods that animals can't properly digest. Why would doctors recommend people to eat foods they can properly digest, yet it would be totally different for animals?
      Sorry, but the VND program is very extensive. We do also have the opportunity to do clinical externships. And how can you say that the program is not as extensive as other doctorate programs are. Have you done any of the work to this program? Most universities now offer their degrees online and online takes more dedication to complete the work then siting in a classroom listen to the teacher.
      If there are veterinarians out there that are happy to work with natural health practitioners, that would be great. I am a homeopath and herbalist for people first and trust me, I have done alot of education, someone who hasn't studied these modalities extensively can't utilize them properly. I enjoy what I am learning and it has been more work then I have ever had to do. After speaking with my cousin today who did an engineering degree in a university, she did as much work as I am doing. So it is a very extensive program. Again, not to diagnose, but to educate owners in nutrition and natural therapies and how to bring balance to the body. VND's don't diagnose, they don't treat disease. That is what the veterinarian should do. That's why instead of veterinarians bashing VND's they should work together.

    4. And sorry. But seeing how one expects animals to continually get vaccines when after the body has been introduced to a substance is unnecessary. It is like an allergy. Once the body has been introduced to the illness, the body recognizes it and can fight it off later if the body is strong. Any further vaccine would be cancelled out by the antibodies the body already produces. Sorry. After working in a veterinary hospital as a veterinary assistant, I saw how many were still there for a love of animals and who didn't care about animals and were only there for the money. I've seen it first hand. It's not a lack of working with veterinarians. As a homeopath and herbalist and past veterinary assistant and pharmacy technician, I am not like some natural health practitioners, I know there is a time and place for both natural modalities and a time and place for pharmaceuticals. I would never recommend that one stop their meds nor not see their conventional practitioner. I just feel there are many cases (as I do with my own family) use natural modalities first but in serious cases or when natural is not working, conventional is the way to go. But that is the problem, most conventional practitioners do not understand what natural practitioner teach. And then there are some natural practitioners are silly and only want people to use natural modalities. There is a time and place for both and they can work really well together. So it's not my lack or understanding or education. It is a lack of wanting to understand on some conventional practitioners part and some natural practitioners part.
      Maybe if you are open to working with well trained natural practitioners, speak with some VND's and see what they have to offer. They don't want take the place of veterinarians but want to help.

    5. I will simply repeat what you cannot know without actually experiencing real doctorate training - this program does not offer the same depth of information and experience that real, accredited PhD, DVM, and MD programs do. It isn't your fault that you haven't the experience to compare. And yes, I can compare because I looked at the published curriculum and text books for your program.

      And while it's nice that you have been a veterinary assistant, I think it should be obvious that this position, which requires no training and results in real world experience at holding animals and observing doctors at work, isn't adequate to evaluate doctoral level training.

      I completely agree with you that veterinary training isn't adequate to become competent in designing herbal, homeopathic or other complex natural treatment regimens. That's not the point, as many, many veterinarians have obtained that training and ARE competent in these areas. The point is that "VND" training does not provide adequate anatomy, physiology, biochemistry, nutrition and clinical training to prescribe ANYTHING for animals.

      I'm very happy to hear that there are now 2 veterinarians on the faculty - that wasn't true when I wrote the original blog posting. I hope these two doctors will begin to improve the program and educate the graduates on the difference between these different areas of training.

      I believe it is absolutely possible for "VND"s and veterinarians to work together, but unfortunately, many VNDs that you find on line in fact consult independently of veterinarians, directly with pet owners. Despite the party line that they aren't prescribing anything, the state practice acts still call this illegal. As long as you have these rogue VNDs, it's hard to think of VNDs as desiring to work *with* veterinarians who haven't had their own training but are open-minded about including natural medicine in their practices.

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  4. seems like some big time chaos! Such ridiculous practices will just destroy education standards and also affect the level of ethics mentained in medical and veterinary colleges and universities.
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