For Britt Marie Hermes, it all started with a trip to the dermatologist. She was 16 years old, suffering from psoriasis, and she wanted to ask her doctor about the root causes of the painful skin condition — was it genetic, environmental, affected by diet? Her dermatologist shut the conversation down.
"I remember him saying, 'Medication is your only option, this is it, you're going to have psoriasis the rest of your life, so you'd better get used to it,'" says Hermes, now in her 30s. "And that was that."
Hurt and confused, Hermes started exploring natural psoriasis remedies. Her curiosity for natural and holistic medicine grew, leading to dietary and lifestyle changes, vitamins and herbal supplements, and Chinese medicine. Graduating from college, she decided to follow her passion for natural health and enroll in a naturopathic medicine program at Bastyr University in Seattle, Washington.
Naturopathic medicine, as defined by the American Association of Naturopathic Physicians (AANP), is "a distinct primary health care profession, emphasizing prevention, treatment, and optimal health through the use of therapeutic methods and substances that encourage individuals' inherent self-healing process. The practice of naturopathic medicine includes modern and traditional, scientific, and empirical methods."
There are seven colleges and universities in the United States and Canada accredited to train doctors of naturopathic medicine. And 25 states and Canadian provinces have passed laws that officially license or register naturopathic physicians. According to information provided by AANP, there are roughly 6,000 practicing naturopathic physicians in the U.S., and those numbers are rising every year.
Hermes' story is common among naturopathic physicians and their patients. They had a chronic and painful condition that was either dismissed by doctors or overmedicated. Searching for relief, or even just someone who would listen, they looked beyond conventional Western medicine. What they found was a world where their undiagnosed maladies had a name — chronic Lyme disease, adrenal fatigue — and a way to cure them, naturally, with lifestyle changes, herbal supplements, acupuncture, physical manipulations and homeopathic elixirs.
But Hermes' story took an unexpected turn. After graduating from Bastyr and practicing as a naturopathic doctor for three years, she had a "pretty gnarly experience." She discovered that her boss and mentor was treating cancer patients with a non-Food and Drug Administration-approved natural chemotherapy drug called Ukrain. Compounded with growing fears that her naturopathic training hadn't prepared her to diagnose or treat truly sick people, she quit.
"I couldn't go to work every day and introduce myself as a naturopath and be part of this profession and continue to feel good about myself," says Hermes.
From Naturopath to Whistleblower
Now living in Germany, where she's pursuing a Ph.D. in evolutionary microbiology, Hermes has become one of the most outspoken critics of naturopathy (notice the name; she won't call it medicine). Her blog, Naturopathic Diaries, offers a methodical takedown of everything she thinks is wrong with her former profession, from the pseudoscience of detoxes to the dangerous shortcomings of naturopathic education.
Needless to say, she's not making many friends in naturopathy circles. In fact, one of her recent posts calling out an Arizona naturopath for making dubious claims of curing various forms of cancer with intravenous injections of baking soda and vitamin C has landed Hermes in hot water. The naturopath, Colleen Huber, is suing Hermes for defamation.
Hermes believes that 99 percent of naturopaths are well-meaning people who truly want to help their patients. And she says that there's real value in naturopathy for patients who finally have someone who will listen to them, acknowledge their problems and propose solutions.
But even that supportive role doesn't mean that naturopathy isn't dangerous. Hermes says there's a slippery slope once a patient opens her mind to alternative therapies and starts making spurious connections between unscientific treatments and emotional or physical improvements.
"It may start as fairly innocuous therapies, like simple diet changes, and then lead to pretty invasive and dangerous therapies that could seriously harm or even kill the patient, like intravenous injections of non-FDA approved drugs or bizarre products like baking soda," she says.
Hermes launched an online petition to block the expansion of licensure and insurance coverage, including Medicare and Medicaid, for naturopathic physicians in the U.S. "Naturopaths are not doctors," states the petition, "and they should not be treated as such."
What the AANP Says
Jaclyn Chasse is a licensed and practicing naturopathic fertility doctor in New Hampshire and the outgoing president of the American Association of Naturopathic Physicians (AANP). Her organization has been lobbying hard to win nationwide licensure for naturopathic physicians, a move that she says will safeguard patients and make it easier for conventional and alternative practitioners to work together, which Chasse feels is the ideal health care model.
"Western medicine is incredibly good at acute care and handling the needs of a critically ill patient. That's really their sweet spot," says Chasse. "Where naturopathic physicians excel is management of chronic disease. They can exist in really complementary way for patients. Conventional medicine can handle the acute risk through the use of medication. At the same time, the naturopathic doctors focus on how to transform the patient's behaviors so they don't need the medication indefinitely."
When asked about naturopaths like Huber who counsel patients to replace conventional cancer therapies like chemotherapy with intravenous vitamins and baking soda, Chasse says that such methods go against everything she was taught in naturopathic medical school about treating cancer. Naturopathic methods are never to be used alone with cancer, she says, but as supports that make conventional chemotherapy more effective and less toxic to the patient. She dismissed Huber's example as an "outlier."
"A lot of the skepticism that comes out about naturopathic physicians focuses on outlier cases," says Chasse, "and ignores all the things that naturopathic physicians do that are very much aligned and in partnership with conventional Western medicine today."
Hermes disagrees, saying that unscientific and unethical practices are rampant in the profession, although she admits that Huber is somewhat of a "polarizing figure," taking strong positions against vaccines and chemotherapy that most naturopaths wouldn't say publicly.
What really disturbs Hermes is treating children, especially sick children, using naturopathy. Hermes completed a year-long clinical fellowship in pediatric naturopathic medicine and says that she's technically qualified to sit for board certification in naturopathic pediatrics.
"And I guarantee you that I'm not qualified to treat children," says Hermes. "The problem is that the extra training that I received was focused on alternatives to medicine. When babies had fevers, I was recommending homeopathic products. When babies were sick with what looked like a viral infection, I was recommending herbs."
When Hermes heard about a child dying from viral meningitis when his parents and their naturopathic doctor chose to treat him with echinacea instead of taking him to the hospital, her heart broke. Not just for the innocent child, but for the naturopath.
"I could see how any of my colleagues could have been in her situation," says Hermes. "It wasn't her failure as much as the entire naturopathic profession and the education system to adequately prepare their graduates to be competent practitioners."
Chasse defends the pediatric training that naturopathic doctors receive at accredited universities — "That was part of our training, to identify those emergency situations." — and contends that pediatrics is a "great place for naturopathic medicine."
Health Insurance for Naturopathic Medicine
Naturopathic medicine is at a critical juncture in the United States. Groups like the AANP not only want more state legislatures to license and regulate naturopathic doctors, but they want more insurance plans, including Medicare and Medicaid, to pay for alternative treatments.
According to information provided by the AANP, only 15 states currently offer any kind of insurance coverage for procedures at a naturopathic doctor's office. Oregon, Vermont and Washington State have the most progressive policies, with naturopathic doctors reimbursed by Medicaid as primary care physicians.
Hermes and other critics of naturopathy argue that expanding licensure and insurance coverage for naturopathic doctors will only expose more sick adults and children to dangerously unscientific and unproven practices.