New York State Board of Regents Accreditation?

Discussion in 'General Distance Learning Discussions' started by chrisjm18, Sep 28, 2020.

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  1. Neuhaus

    Neuhaus Well-Known Member

    As a kid I recall people being genuinely confused as to whether a DO was a "real" doctor. Not philosophically, mind you, but in terms of whether this person was able to do the sort of things a physician can do. I can look up a license. You can look up a license. Most people can look up a license. Most, however, won't.

    Beyond that, there's actually an oddly logistical reason to get the MD. There are only so many approved post-nominals in New York (I'm sure other states too). MBBS is not one of them. Many forms, after the provider name, require you to circle the appropriate post-nominal. Those options are MD/DO/FNP/PA-C. Now, there are of course variations to license classes. A nurse midwife (CNM) can do quite a bit and a Certified Nurse Anesthetist has their own abbreviation I'm too lazy to look up. But all of those relate to licenses, not degrees. There are quite a few Physician Assistants in New York who don't even have degrees because up until 2009 (ish) it was still possible to become a Physician Assistant through a certificate program in this state. So while PA-C implies a masters, or at least a bachelors, it isn't necessarily so. The only thing PA-C really means is that you got the license according to whatever requirement was in place at the time you were licensed.

    MD/DO is a weird one. It's the opposite. It's a degree that implies a license which is not always the case.
     
  2. copper

    copper Active Member

    Actually, the "C" in PA means "certified" which is different than licensed but that's trivial minutiae. Some more trivial comments are that the MD or DO degree doesn't necessarily imply a license either. I remember reading an earlier post about Dr. Jarvix an MD that was in engineering and medical physics but never got a license to practice but invented the artificial heart: https://en.wikipedia.org/wiki/Robert_Jarvik
     
  3. Neuhaus

    Neuhaus Well-Known Member

    Indeed, then you might also be aware of the situation when Dr. Jarvik appeared in a pharmaceutical commercial and was promptly accused of practicing medicine without a license. In part, the complaint cited that he used the post-nominal "M.D." The M.D. or D.O. is, indeed, an academic degree. And, within academia people can use it without much concern. I imagine it is the same within most companies. If, however, you "market" yourself with the post-nominal M.D. you may run afoul of state regulations if you don't have a medical license.

    Writing a paper probably isn't a problem. Designing biomedical technology isn't likely a problem. But if you offer any service to the public that is even tangentially related to health and use the post-nominal "M.D." then you generally need to have a license.

    My point was that it differs from many other academic degrees. A Psy.D., for example. People trained as psychologists may be licensed in any number of ways depending upon the precise nature of their training, the scope of their practice and what their state offers. Locally I know of two psychologists with practices who aren't licensed psychologists at all, they're licensed as psychoanalysts. For the M.D., there is no other license you're qualified for (except, of course, the Homeopathic M.D./D.O. that New Mexico either did or still does which was a dumping ground for doctors who lost their licenses in other states). Even they had to use the post-nominal M.D.-H in all marketing. While you might be able to use a PsyD to become a Mental HEalth Counselor or a Marriage Therapist, you can't use an M.D. to become a Physician Assistant or, well, any other licensed profession aside from a physician.

    That's really all I was doing there.

    And yes, you're correct. PA-C is for a certified PA. The designation for one lacking certification in New York is "RPA" where the "R" stands for "registered."
     
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  4. copper

    copper Active Member

    Do you have a link to the New Mexico homeopathic license? I tried to find it but can't and it looks interesting to some of my colleagues. Thanks!

    I do see mention of it in Arizona law.
     
  5. Johann

    Johann Well-Known Member

  6. copper

    copper Active Member

    There are a lot of States that license NDs! The ND goes through a four year program and can even add midwifery scope. It's probably a good thing for the safety of the general public to have licensing introduced into New Mexico law for NDs. As far as Arizona, I really don't see the value of an already licensed MD or DO adding MD(h) to their scope. There are already MDs, DOs and even NPs that are able to operate within their scope of practice with a sub specialty of Integrative Medicine. I really don't see the need for a separate division in Arizona law unless the medical boards plain and simply don't support it?
     
    Last edited: Oct 7, 2020
  7. Neuhaus

    Neuhaus Well-Known Member

    Correct, it was Arizona, my error. And the post-nominal for it is MD(H) or DO(H).

    https://homeopath.az.gov/about

    It has indeed been disturbing on some level because it isn't a scheme for licensing NDs, it's for MDs who want to practice non-traditional medicine even though you can practice all the homeopathy you want with a standard MD/DO. So it's a license class for physicians who don't have a standard license...

    You're basically inviting the sort of abuse that came through; physicians who lost their licenses to practice in other states and got a "second chance" through this board. Some of these folks then went on to practice regular medicine rather than anything homeopathic or "integrative."

    As for NDs, I am actually opposed to the licensing of NDs and have actively lobbied my state representatives to kill the measure whenever it comes up in New York. Our state has many NDs. They practice as "wellness coaches" and try not to cross that line into practicing medicine without a license. However, a license will, in the eyes of many, legitimize the field and it will further promote pseudoscience into the healthcare scene. I don't have a problem with acupuncturists because their scope is limited and many that I've met recognize that they may be evoking nothing more than a placebo effect but, as they put it, "a placebo effect is still an effect."

    Chiropractors and NDs latch on to the ability to call themselves "physicians" whenever they are allowed to do so and often try to push traditional MDs out of a patient's care team so they can sell them overpriced vitamins and flower remedies and such.

    I don't disagree with the notion of an ND but I don't think it should be a licensed profession with PCP recognition and I certainly don't think my insurance premium should be thrown into a pool that gets wasted on such things. Pool the money for real healthcare not non-scientific woo.
     
  8. SteveFoerster

    SteveFoerster Resident Gadfly Staff Member

    Agreed on the perils of legitimizing unscientific practices. It strikes me as a license to practice astrology or tasseomancy.
     
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  9. Neuhaus

    Neuhaus Well-Known Member

    Let me also just clarify my position on chiropractic before it becomes a whole thing...

    I have been to a chiropractor for the sorts of things chiropractors are good at. My neck is stiff, I have a pain in my back and they crack it back into place. Super helpful. I once had this weird situation where my knee was clicking whenever I walked. It just started happening suddenly. I went to a chiropractor and it was fixed. No pain. No medicine. All good.

    What I object to is when your chiropractor suddenly bills themselves as a "chiropractic physician" and advertises that their methods can be used to treat things like asthma, food allergies etc. No, twisting my neck is not going to cure asthma. I object to the fact that this license class allows them to sell herbal supplements in manner that looks like a physician prescribing something complete with pharmacy lookalike dispensaries in offices that have all of the trappings of being a place of medicine. Wanna twist my neck because it hurts? Cool. Wanna hold out a claim that you can cure cancer with herbs? Not cool.

    Naturopaths, unlike chiros, don't even offer that one service that they are generally accepted as doing well and of having a benefit (even if the benefit is not as expansive as they sometimes claim). You don't need an ND to tell you to eat vegetables and exercise more. If you are REALLY wanting some homeopathy medicine you can buy all of the overpriced water you like. If you want flower remedies get yourself a Victorian era book full of debunked claims on that subject and go to a florist and stock up.

    Do what you want with your money. Spend it on tarot readings or televangelists or lottery tickets or whatever you like. But when we start adding healthcare licenses to the mix, insurance coverage is soon to follow. Now you're spending my money on that. As premiums find a new way to be spent, costs rise and premiums go up. We all pay for the woo while many others go without the basic healthcare that many in this country are privileged enough to scorn.
     
  10. copper

    copper Active Member

    I think a lot of consumers of healthcare are getting pissed off with the MD model of healthcare. You go into a physician's office he or she sees you for 2 to 3 minutes, they don't listen and they write a prescription for the symptom without addressing the root cause. It's in and out medicine and perhaps people are looking for something else?? The ND that goes through an accredited school recognized by AANMC is licensed in many States see link: https://aanmc.org/licensure/#:~:text= States currently offering licensure or registration to,21 Utah 22 Vermont 23 Washington More

    States seeking a license to protect and promote public safety as opposed to the unlicensed naturopath or homeopath in my opinion is an excellent pathway. Also, AANMC accredited schools of naturopathy have made great strides to focus on natural but evidenced based science on their treatment modalities. For example, the OBGYN using tradition instead of evidence may cut the umbilical cord upon birth but the naturopathic midwife would delay cord clamping as the evidence shows better APGAR scores and healthier outcomes. I think the real question is whether or not all ND schools are equal in their approach to evidenced based science? The answer is No! Of course the multi billion dollar pharmacy industry appreciates your business but that's another story!
     
  11. Rich Douglas

    Rich Douglas Well-Known Member

    What I would object to is calling them physicians at all. They are not.

    If I go to an ENT, that person is a medical doctor first, then a specialist in ENT. Chiropractors are not, by comparison, medical doctors first and then back specialists. They do not have the same medical training as do physicians. And I agree that going beyond that scope is real sketchy, even though it's been going on in the chiropractic field for decades.
     
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  12. copper

    copper Active Member

    One trend I see lately is that many DC and ND practices can’t stand alone so they are hiring NPs to fill the gap!
     
  13. Neuhaus

    Neuhaus Well-Known Member

    There was an MD nearby who was doing the same thing. She had a private practice. Then she had a separate private "wellness consultancy" which employed an N.D. From what I gather, it was a paper arrangement (which, by the way, I can respect. See also: how my wife completed her required clinical supervision for her LMHC). The state medical board, however, was not OK with it.

    If you look at Scandinavian countries, Naprapathy, for example, is a Masters degree. Osteopaths in some countries are the same (noting that Osteopaths in other countries are more like Chiropractors than the D.O.s in the United States). So, honestly, I think I would have a lot less of an issue with naturopaths if they didn't insist on being "doctors" with a post-nominal annoying similar sounding to physicians.
     
  14. Neuhaus

    Neuhaus Well-Known Member

    I'm sure this comment may run afoul of some rule on this forum so I will ask for forgiveness immediately following...

    Bullshit.

    This is the battle cry of every supposed "holistic" healer. Are there crappy doctors who don't address root causes and just write prescriptions willy nilly? Absolutely. I recall my wife's OB/GYN walking into the room once and, before greeting my wife, pulled out his prescription pad and wrote her a prescription for percoset and handed it to me. THEN he talked to her. We were both disgusted.

    So we went and found a better doctor. There are plenty and there are quite a few who don't suck.

    I also have to accept that I don't get to see my doctor very often. However, I am also well pleased with the office's NPs and PAs so, you know, whatever.

    I have health issues. I go to a lot of doctors. And not for anything serious (thank God) like MS or cancer. But I have stomach problems that I see a GI for. I have sleep problems I see a pulmonologist for. I have an opthamologist and haven't seen an optometrist in nearly 20 years. I see a lot of MDs. I've seen a lot of MDs in three different states and five different cities. And not for any longer than a single, unsatisfactory visit have I encountered this myth of the uncaring MD who just wants to pump me full of drugs. Any medication I am on is one I need and my doctor is cool with giving me those medications because they're medicine and have been clinically proven to be effective and safe. Anyone who acts like lipitor is the devil's poison is selling a narrative whereby only they can be trusted with their particular brand of snake oil. And, sadly, that marketing works especially in a world where highly privileged Americans can refuse vaccines that people in third world countries wish they could have because even if they get themselves sick advanced (relative to poorer nations) healthcare is often available at the nearest strip mall.




    You can't make up a pseudo-science, create an accrediting body for said pseudo-science (which, by the way, is operated by practitioners of said pseudo-science) and then say "It has to be legit, it's accredited!" Well, I guess you can since you just did and that's exactly how NDs justify their existence. It doesn't make the logic any less circular, however.

    No, they haven't. They have worked very hard to create their own "scientific" journals to publish their own "research" to make it look like what they are doing is backed by science. Despite this, anything short of basic nutritional and lifestyle counseling out of a naturopathic medical school has been soundly debunked by science, real science. I could give you many websites by actual scientists debunking ND woo, but I'll settle for this one https://www.naturopathicdiaries.com/

    It's a blog by a former naturopath who graduated from an AANMC accredited school and realized early into her career that not only was this pseudoscience but dangerous pseudoscience that put people at risk. She writes a compelling post about her criticism of the licensing exam that AANMC (or whatever affiliated body) requires all N.D.s to pass in states where they are licensed.

    It's full of flower remedies and other wildly debunked nonsense that, fine if you want to pay for it but that someone coming to you for an emergency situation (as the exam describes) would be in peril listening to.

    With the caveat that I don't know much about umbilical cords and don't really care to educate myself on the topic, so what?

    There are always different views on treatment modalities. If there is an OBGYN who clips the cord then I;m sure there are others who don't and clamp it as you've described, particularly if there is actual evidence that this is beneficial. That does not mean that a naturopath is somehow better than an OBGYN.

    Put another way, I can follow the best practice for changing my oil. You finding a mechanic who does it a less preferred way does not mean that HR Managers are better at being mechanics than mechanics.

    No, that isn't the real question. There really isn't a question. Naturopathy is pseudoscience, period. And you can write that off because anyone I present to you who is actually a scientist you'll probably just disregard as being a tool of the pharmaceutical industry.

    The thing is, we have a really good name for alternative medicine that has been proven to work; medicine and it is practiced by MDs throughout the world.
     
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  15. copper

    copper Active Member

    I'm not here to defend naturopathic medicine but I'm not going to say it is "bullshit" either! Aspirin came from willow tree bark and penicillin from mold. Don't think for one minute organic chemists from renowned organizations are not studying or discovering remedies in nature! The difference is the clinical trial process and avoiding the "magic bullet" with overdoses of herbals that did not undergo rigorous clinical trials. Even many of the pharmacological approved medicines have numerous side effects and even adverse reactions just listen to any TV commercial!

    As far as State governments licensing NDs it has been done for many years and more and more States are developing legislation. What does this accomplish? It provides a minimum standard! Would you rather have unlicensed, untrained people hanging a shingle? If you live in a State that has a bill for ND license, write your state legislators and express your opinions!
     
    Last edited: Oct 10, 2020
  16. Johann

    Johann Well-Known Member

    Aspirin? Penicillin? You bet! We'll take cures from wherever science finds 'em. Nature included, of course. There are big hopes for native rain-forest plants. Much ongoing research. Like you say, organic chemists (scientists, not charlatans) have their hands full. I don't take cures from snake-oil peddlers. We take aspirin because we know it works - and how it works. Not because Druids 2,000 years ago had patients chew willow bark (contains acetylsalicylic acid) for fever. (True. You can look it up.) "Minimum standard" by licencing = minimum standard of nonsense / BS. Worthless.

    I hope I never have to spell "acetylsalicylic" again.
     
  17. Johann

    Johann Well-Known Member

    If one of these "practitioners" gives you mold to chew - run!
     
    Last edited: Oct 10, 2020
  18. copper

    copper Active Member

    "While the plant kingdom continues to serve as an important source for chemical entities supporting drug discovery, the rich traditions of herbal medicine developed by trial and error on human subjects over thousands of years contain invaluable biomedical information just waiting to be uncovered using modern scientific approaches. " https://pubmed.ncbi.nlm.nih.gov/28758992/

    I think it is very possible naturopathic medicine has the potential to be well respected one day if the scientific approach and random clinical trials (RCT) are utilized. Just like everything in medicine, RCTs will yield varying results presented with statistical analysis. "No better than placebo", "clinically significant," etc. come through the scientific method. I believe and hope many of these modern accredited naturopathic schools are now integrating evidenced based science into the curriculum. As for the anecdotal evidence, it is overwhelming but may be dangerous, harmless or perhaps therapeutic? Certainly a lot of testimony that needs further investigation!
     
  19. Johann

    Johann Well-Known Member

    Another thing - even in some cases where the flower-cure works (somewhat) there can be trouble. E.g. St. John's Wort, which may have some effect in relieving depression -- in certain cases only. If the "practitioner" goes direct to the plant, or some amateur's extract, the dose is completely uncontrolled. Bad stuff can ensue - very bad stuff.

    I'll stick with my MD. She and her kind have kept me ticking for nearly 78 years. I trust them. I think my trust is evidence-based.

    Beginning to integrate evidence-based knowledge into ND classes is not enough. Maybe when it's thoroughly entrenched ... oh, but that would be traditional Med School.
     
    Last edited: Oct 10, 2020
  20. copper

    copper Active Member

    I don't think so! At a minimum. it filters out a lot of the charlatans! That's why these States are legislating it in the first place! Like I said, I'm not here to defend naturopaths, I have no experience ever using them but I have looked at their curriculum and it is rigorous and impressive... for a supposed "charlatan" pathway! https://www.scnm.edu/wp-content/uploads/2020/09/SCNM-ND-4-Year-Program-of-Study.pdf

    Is anyone on this forum actually qualified to comment on the ND training currently being taught and or practiced in States with licensure? An MD, DO, PhD in bioscience? It would be interesting to read your perspectives.

    This thread sure has diverted a long way from Regents of NY.
     
    Last edited: Oct 10, 2020

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