There is an equally serious concern with health care providers who learn via distance education as well as schools like Bastyr. Bastyr and probably the other NP schools have a course or two in ethics. I would like to think that professionals teaching prospective doctors imbue a certain amount of ethical training that follows the student into the real world. My NP broke nearly every ethical rule in the Medical and Psych board's book. The most serious violation, that pertains to NPs, is that he didn't refer me out to a medical doctor but claimed that my symptoms were normal and to be expected with the kinds of things were we discussing (he was attempting to treat me for post traumatic stress disorder as the "mind" part of the mind-body medicine model). We had a dual relationship as I worked for him, as part of therapy, promoting his lectures (I would get to hear him speak for free on issues I wasn't getting in therapy). He was definitely a wolf in sheep's clothing. He identified my blind spots and used them. The ethical issues many times are overlooked as the focus is on the degree programs' quality of science and clinical skills classes. The therapist I saw to clean up the mess is seeing more and more clients who have been duped by eclectic health care providers who have a little bit of knowledge, but are lacking in wisdom.
Hello Hope - I'd like to comment on your posting without seeming to minimize your complaint, which sounds quite valid and serious. Every month I get my copy of the NASW (National Assoc. of Social Workers) national newsletter. Typically there is a small section in which 20-30 names are listed, Social Workers from around the country that have had their licenses suspended or revoked due to some unethical professional behavior. My point is simply this: there is nothing about sitting in a classroom that creates ethical behavior and there is nothing about DL that creates unethical behavior. There are thousands of healthcare professionals who have violated ethical codes of conduct and most of them went to very good, brick and mortar schools. The person who took advantage of you may be an unethical practitioner, they may be a crook, and perhaps they shouldn't be allowed to practice, but please don't blame it on DL. Sorry for your troubles, Jack
Hi Jack, Point well taken, but I wasn't blaming DL in general. I did mention also schools like Bastyr, that are relatively easy to get into. I've seen much debate about the quality of the science classes, but not much about ethics training. Now I'm hearing about boundary violations between eclectic practitioners and their clients\patients. Hope
And if you continue to pay attention to this issue then you'll continue to hear stories about such things as sexual misconduct, therapists borrowing or stealing money from patients, etc. etc. In my experience, practitioners typically learn their ethics from their supervisors during internships and later, in their early professional careers. The problem (IMHO) is that some people just don't give a damn, or, if we want to be more charitable, they go astray. It's true with MD's, lawyers, businesspeople straight across the board. Bastyr may be easy to get into (is it?) but what school did those guys from Enron go to? How about the guys from Worldcom? How about Buddy Cianci? You can force someone to sit in a classroom and listen to hours of lectures on ethics but that's not going to make them behave in an ethical manner. Should healthcare programs teach ethics? You bet! But there will always be people willing to bend/break the rules (unfortunately). Jack
I am a healthcare risk management consultant in Seattle, which is also home to Bastyr. For those who may not know Bastyr, it is one of the largest training programs for naturopaths in the United States, and I believe that they also train some other types of alternative health care providers. I am a non-paid guest lecturer there from time to time on malpractice. I am also an assistant clinical instructor on risk management at several other allopathic medical, nursing and other clinical schools. Without going into the merits of DL, Bastyr or alternative health care providers in general, boundary violations, unethical behavior or sexual contact between patient and clinician is by no means limited to any one class or type of health care provider. Ethical violations by any type of provider are to be sanctioned and deplored, but I doubt that ethics classes make much of a difference either way. One is either an honest and ethical person innately or one is not. Regards, Michael Lloyd Mill Creek, Washington USA
Your situation sounds very unpleasant and you have my sympathies. Your wrath about Bastyr and ethics seem woefully misplaced, especially in a distance learning context. First, Bastyr is very much a residential university. They do not grant distance degrees to naturopaths or acupuncturists. Now, licensed degree-holding NDs and L.Acs may earn some distance learning continuing education credits, but the qualifying subjects do not require clinical experience. This is common for many licensed health professionals. In Washington state, naturopathic physicians are subject to the same ethical requirements as other licensed health professionals, and also abide by the same standard disciplinary process. In Washington, licensed naturopaths seem to have a very low proportion of discipline actions when compared to other licensed health occupations. Each month Washington state publishes disciplinary charges and actions on their website. Very very few involve NDs or L.Acs. Finally you state that getting into Bastyr is relatively easy. Please back that up with facts. It is unfortunate that your lousy experience happened in an unlicensed state where your legal options are limited. This is why licensing for professional naturopaths is good for consumers. But licensing or any kind of degree does not ensure the wisdom for which you pine.
From my original post... "The ethical issues many times are overlooked as the focus is on the degree programs' quality of science and clinical skills classes. " I am aware that there are unethical folks in all walks of life, and I'm not saying that DL graduates unethical doctors and on-sites do not. I've spoken with students at on-site ND schools and DL programs who have said not much attention is paid to ethics, which is a concern of mine. I included Bastyr in my post (which did offer DL programs up until 1998 or 99) so as not to imply only DL programs need to address this, but all eclectic health programs (eclectic is the word Robert Epstein uses in his Psych textbook, Keeping Boundaries). Licensing, of course, will not make a difference as to whether one breaks ethics codes. There were only a few NDs in my state and half had been investigated for not referring out and for diagnosing and treating. Especially in alt med, which tkes a mind-body approach, it is essential that practitioners know where to draw the line before they start practicing psychology without skill. There are ethics that must be emphasized and not merely presented in a book or seminar regarding boundary violations. As horrific as sexual misconduct and stealing are, there are more insidious ones, like nurturing dependence, inappropriate discharge, bringing personal beliefs into the therapeutic program (my ND used Landmark Forum technology without using their terminology). As far as Bastyr admission requirements - a bachelors degree is preferred, not required, and no particular program of study is required. Basic sciences and psych credits can be up to 7 years old, not 3 as with standard medical schools. There is no admissions test for the ND program, whereas standard med schools have the MCAT.
