How is your practice Science-Based / Evidence-Based?

As a member of a medical profession, I believe that the naturopathic principles which give the naturopathic profession its identity must be tempered by scientific evidence.  I hold the position that it is ultimately part of my Naturopathic Physician’s Oath (“I dedicate myself to the service of humanity as a practitioner of the art and science of Naturopathic medicine”) that I must subject my clinical decisions to the test of science when and where possible.

There are some in the naturopathic, chiropractic, and acupuncture profession who believe that evidence-based-medicine is a product of a mechanistic world view, which is using an overly narrow/restrictive view of science, deliberately designed to place such professions distinctively on the outside of the circle of science.  As an integrative physician, Dr. Barnett does not participate in this interprofessional debate, which he believes is based more in economics and turf-war politics than what is in the best interest of patients and the public.  As a doctor with one foot in alternative medicine and one foot in conventional medicine, he often finds himself in unfriendly waters by one or the other group.  Many fellow naturopaths or other “alternative” practitioners, for example, do not like his positive embrace of CDC immunization guidelines.  Some patients are taken aback by his lack of enthusiasm about some aspects of alternative medicine that they may they favor.  Endocrinologists may shake their head at his preference for glandular medications over Synthroid or its generic. But in almost every case, despite which side is critical, his positions are based on evidence and safety concerns for his patients and public health.  He has come to the conclusion, for example, that the American Association of Clinical Endocrinologists pro-Synthroid / anti-glandular position is not based on an updated version of the scientific evidence. My experience in working in research has provided strong evidence that the very bias that science is supposed to minimize is very active against anything that is not mainstream, and much more difficult to eliminate than proponents of “science-based medicine” suggest, especially when it comes to the effects of powerful professional interests or high-powered industry.  For example, meta analysis of a treatment will eliminate studies for bias if they were funded by a company that sells it, yet will not apply this same filter to conventional drug studies that were funded in the same way. They will throw out a multitude of studies in favor of therapy for the latest negative study. They refuse to entertain the idea that while a sham treatment may blind the patient, it may also have an effect that is not just placebo.  And there is also publication bias, where medical journals refuse to publish positive studies, while anything unfavorable gets accepted by top medical journals.

I will write more in this section later.