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Regrets of a Naturopath

I enjoyed this article at Stat, about former naturopath Britt Hermes. She graduated from a well-known program in the field and was in practice for several years before it began to dawn on her that (1) she didn’t really know that much about medicine and human disease, and (2) naturopathy was often a load of crap. Her web site, Naturopathic Diaries, is getting a lot of traffic, and a lot of hostility from the field’s other practitioners. This sort of thing would explain the latter:

Naturopathic medicine is not what I was led to believe. I discovered that the profession functions as a system of indoctrination based on discredited ideas about health and medicine, full of anti-science rhetoric with many ineffective and dangerous practices.

I left the profession of naturopathic medicine to pursue an education in biomedical research. Since my departure, I have been working to understand my former biases within naturopathic medicine. I am now exploring the ethics and evidence, or lack thereof, of naturopathic education and practice. I hope I can convey the message that naturopathy must be highly scrutinized, as its proponents have a seemingly on-going history of deceit, exploitation, and medical fraud.

You don’t run into that many people who completely fall out of this sort of belief system. In my experience, when someone starts to have doubts about one of these fields, they tend to sort of slide over into yet another fuzzy set of unproven/unprovable stuff, sometimes with the rationalization that it’s all the same thing, anyway, when you get right down to it, tapping into the natural energy of the universe and fighting the toxins, etc. So you see these practitioners who seem fine, simultaneously, with six or eight rather different belief systems (well, different if they were examined closely and taken to their conclusions).

For example, one of the things that seems to have caused Britt Hermes to throw her hands up and leave (rightly so) was that her former boss was importing and prescribing an unapproved drug for cancer patients. This stuff, known as Ukrain, has apparently been kicking around the cancer-cure underground for a while. That scene never really changes, as a look at Ron Rosenbaum’s article from the 1970s will show you (it’s in the excellent collection The Secret Parts of Fortune). The definition of “naturopath” is apparently elastic enough to bring in something like this, probably because it’s supposedly a derivative of a natural product mixture from the celandine plant. But it’s semisynthetic, if it’s what it says on the label, altered in a lab, and what’s natural about that?

The unifying principle seems to be that it’s “alternative”, something the Evil Medical Establishment doesn’t recognize. That gives you a very wide field to operate in. Hermes has said that her curriculum while getting her degree included things like putting sliced onions over a child’s ear to deal with an ear infection, and wearing wet socks at night to “boost the immune system”. Those are indeed pretty alternative, but one problem with them is that they don’t cost much. From a business standpoint, something like Ukrain that you can’t get from actual doctors and hospitals will be, by definition, desirable for some desperate patients. As a side note, it’s also something that no insurance will pay for, so your own payments come directly from those patients with no one else pressuring you on the price or taking a cut, which must be attractive, too. If you think drug companies have too much pricing power, wait until you see what the fakes charge.

Naturopaths are the source of a lot of nonsense about vaccines, cancer treatments, and much else, so I’m glad to see someone giving them a good shaking. I hope it does some good – hearing from someone who used to be in the field has got to be more effective than hearing from an Evil Pharma guy like me, that’s for sure.

49 comments on “Regrets of a Naturopath”

  1. Me says:

    I remember reading her columns on Science based medicine blog a while back: talking about her college debts vs her earning potential, and what they would have been had she studied medicine instead. Poor girl was screwed out of tens of thousands of $$$ for her education in quackery.

  2. Passerby says:

    It partly depends on how you define “naturopathy”. If it involves nonsense of the kind the author talks about then of course it’s completely fraudulent. But if it involves extracting active principles from plants and animals then it’s closer to what we call natural products chemistry. Defined that way naturopathy has given us many useful drugs like taxol and artemisinin (which was recognized by the Nobel Prize last year).

    1. Druid says:

      Nice try but that’s crap too. To get just one dose of taxol requires 600g tree bark with all the other ineffective but toxic components in there, AND it has to be given iv! I recall when the clinical trials on taxol were being held up because there was not enough pacific yew in the world. And that is not unique among natural product medicines. Quite apart from the fact that naturopaths knew nothing about it anyway, the heroes are the process chemists who achieve affordable (and patentable) synthetic routes to natural products.

      1. Passerby says:

        Epic fail in trying to understand what I was saying, which was simply that there is value in isolating drugs from plant sources: If you define naturopathy that way then the term should be uncontroversial. Sadly that’s not how the so-called naturopaths themselves define it. Also, it’s interesting how you credit process chemists and call them “heroes” but neatly avoid giving credit to Holton and Wender who made major inroads into the practical synthesis of taxol. I know that there’s been some total synthesis bashing on this blog (and some of it for good reasons) but let’s give credit where it’s due.

        1. anon the II says:

          I hate to pile on to Mr. Passerby, but it wasn’t really the process chemists were the heroes. Nor was it Holten or KC. How did Wender get into this conversation? If I remember right, the challenge was raw material and that was mostly solved by some gene jock biology types at a little company in Ithaca, NY who figured out how to make an advanced intermediate in culture. Of course Wall and Wani deserve a little credit also.

        2. Peter S. Shenkin says:

          Naturopathic medicine has nothing to do with the search for pharmaceutically active compounds in plants and animals. Rather, naturopathic medicine partakes of the myth that there is sort of an élan vital in chemicals actually extracted from plants and animals that gives them a power absent from exactly the same chemicals created synthetically. That idea and the like are at the heart of the folly. It’s true that a plant extract may contain beneficial (or harmful) impurities that youwdon’t get if you take the pure major product, but that’s about the extent of the “truth” in it.

          Aside from the manifest nonsense in this underlying idea, the naturopaths miss that even those petroleum-based chemicals are derived from aged dinosaur carcasses. You could argue that the élan vital, carefully sealed underground for eons, must have been preserved and still must be present. You’ll be more convincing if you use the term “hermetically sealed,” because of its accompanying alchemical echo.

          Beyond that, they miss that we and what we do are part of nature. To paraphrase Bucky Fuller, “If it weren’t natural, it wouldn’t exist.”

          1. Isidore says:

            That’s rather Hegelian, isn’t it? “What is natural is real, and what is real is natural”.

          2. thirtyone84 says:

            “sort of an élan vital in chemicals actually extracted from plants and animals that gives them a power absent from exactly the same chemicals created synthetically”

            In fact a lot of plant/marine sponge/fungal extracts do show in vitro biological activity that disappears when the individual purportedly active components are isolated / re-synthesized. It’s a commonly observed synergistic effect of natural product extracts, so there is something in the statement that extracts can show biological activity that the pure isolated compounds don’t. Of course, it’s not reliable and that kind of thing can’t be dosed or properly tested since there’s potentially multiple pharmacological targets.

    2. KevinH says:

      The problem with defining “naturopathy” that way (aside from not being the way that the word is generally used) is that it overlaps large parts of “conventional medicine”. The principal distinction is that naturally-derived products used in conventional medicine have to actually demonstrate efficacy in clinical trials.

      Vast swaths of the modern pharmacopoeia – including a bunch of the essentials on the WHO Model List – are direct copies or close derivatives of naturally-occurring compounds. Aspirin. Chemotherapeutics from bleomycin to vincristine. Warfarin and digoxin. Amphotericin B. Hydrocortisone. Opioids. Too many antibiotics to list.

      If one chooses to define “naturopathy” so broadly, then the principal distinction with conventional medicine becomes simply that naturally-derived products used in conventional medicine have to actually demonstrate efficacy in clinical trials.

      (Now if I really wanted to abuse the definitions of “natural products” and derivatives, then I’d start an argument about how monoclonal antibodies ought to fall into the category too.)

      1. Passerby says:

        Fair enough, and your thoughts overlap with mine. I think the word has been hijacked by fraudulent hucksters. if you actually break it down it simply means medicines from nature. If that’s how it’s used I see no problem with it.

        1. MTK says:

          At best what you’re advocating is a retro-hijacking of the word.

          The word is meant to convey an alternative to “conventional medicine” or what some may call science-based medicine. To now and try to claw back a portion of science-based medicine is dishonest to both science-based medicine and naturopathy. The whole point of naturopathic medicine is that cures and treatments don’t require any synthetic means or at least a minimum of human processing and that conventional medicine doesn’t recognize the power of natural medicines which of course is false, since it’s not that it denies natural remedies, but rather that any treatment, natural, synthetic, murine, terrestrial, extraterresttial, or whatever requires scientific validation.

          What you’re trying to do is the opposite of guilt by association. Validation by association. Not buying it. Let’s be real here and call naturopathy for what it is. A belief system and not much more.

          1. Passerby says:

            Indeed, that’s what I am advocating. I hate that these people have hijacked a word which, based on its etymology, should legitimately belong in the lexicon of bonafide scientists and doctors. These people calling themselves ‘naturopaths’ is very Orwellian, involving as it does a nefarious use of language to control public perception.

          2. Mike says:

            Scientology anyone?

    3. Daniel Barkalow says:

      Better example would probably be St John’s Wort, which works about as well as synthetic antidepressants whenever people bother to run studies. Of course, there was no reason to believe it was more effective at its traditional purpose than onions for ear infections until after Prozac was available, and getting a reliable dose of Prozac is easier now.

      The fundamental problem with naturopathy isn’t that the treatments don’t work; it’s that the epistemology doesn’t determine whether the treatments work or not.

      1. Derek Lowe says:

        As I understand it, though, studies funded here by the NIMH and the NIH’s complementary medicine institute did not show an effect for St. John’s wort versus placebo. The positive results were from a meta-analysis of 29 studies in Europe, I think.

        1. MTK says:

          I believe you’re right, Derek.

          My favorite chuckle with respect to alt-med and science came from Tom Harkin, the Senate’s patron saint of NCCAM, who said this at a hearing:

          “One of the purposes of this center[NCCAM] was to investigate and validate alternative approaches. Quite frankly, I must say publicly that it has fallen short. I think quite frankly that in this center and in the office previously before it, most of its focus has been on disproving things rather than seeking out and approving.”

          1. anon says:

            OMG! Thanks for posting that quote; I had not seen it before.

          2. loupgarous says:

            Not the first dumb thing Harkin has said, and it indicates he doesn’t “get” science. Perhaps someone can E-mail him the Royal Society’s seal, with “nullius in verba” enscrolled at the bottom.

            But if Harkin doesn’t understand how experimental science works (“disproving things” being the hurdle all hypotheses must leap to become accepted knowledge), his Latin may be unreliable, too. “Nothing in words” might not enlighten him further, but we hit the issue of his attention span if we explain further.

    4. Scandriel says:

      If we define “astrology” as “studying stars” then it is a vital field of study for understanding physics at large scales. If we define “homeopathy” as “staying at home for a few days” (because hey, it has ‘home’ right in the name!) then it’s a good idea to take some homeopathy when you have the flu.

      1. johnnyboy says:

        lol, spot on !

  3. biotech says:

    Good for her! Coming to these sort of realizations is actually quite hard if you are brought up in a given viewpoint/field. Even in ‘hard’ sciences, there are plenty of labs which do science very poorly. I remember I had to come to the realization that the lab I was doing my graduate work in was actually terrible at science and was systematically finding data to support hypotheses rather than test hypotheses.

  4. Chad Irby says:

    The sad part is how many people keep falling for the same old frauds, decade after decade, due to the “naturopaths” merely changing the names of their old failures.

    I had someone try to educate me on the anti-cancer benefits of “Vitamin B17,” until I told her about what it really was. Chemists call it amygdalin. Most people know it from its modified version: Laetrile.

    The same goes for a lot of other things: the people selling this crap just put new labels on the old poisons, and keep on killing people.

  5. anon says:

    Sounds like she REALLY HAS done a “cleanse” and washed away the toxins, Or at least the stupidity.

  6. Lane Simonian says:

    The lack of progress in using natural products or synthetic medicines from natural products may reflect a variety or problems with some of the products themselves, but it may also be a result of dismissing these products as a means of treating some diseases before adequate investigation. Here is a good, non-biased review of the topic.

    Natural Products as Sources of New Drugs over the 30 Years from 1981 to 2010

    From Samuel Danishefsky quoted in this review: “In summary, we have presented several happy experiences in the course of our program directed toward bringing to bear nature’s treasures of small molecule natural products on the momentous challenge of human neurodegenerative diseases. While biological results are now being accumulated for systematic disclosure, it is already clear that there is considerable potential in compounds obtained through plowing in the landscape of natural products.”

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3721181/

    And I will add this one because the people who did the science got a major part of it right.

    https://www.marijuanatimes.org/how-cannabis-can-relieve-debilitating-alzheimers-symptoms/

    1. Peter S. Shenkin says:

      @Lane, they sure as hell got this part wrong: “It is prudent for all of us to understand that all of the proven medicinal benefits of cannabis are attributed to naturally-occurring marijuana and its derivatives, such as cannabis oil, but NOT for synthetic, marijuana-like compounds, which are actually harmful.”

      I accept your main point, which I take to be that “naturally” occurring compounds can have beneficial pharmaceutical effects. It may indeed be the case, as you propose, that insufficient effort is put into clinical testing of such compounds. My own gloss is that this is not scientific blindness or arrogance, but simply because it’s hard to make money on something you didn’t patent, and maybe impossible if you have to pay for full clinical testing and approval.

      1. Lane Simonian says:

        They did indeed get that part wrong. The interesting part is that the cannabinoid receptors which can lead to memory and behavioral problems in “normal” people are damaged in Alzheimer’s disease, so the effects of THC are often more positive than negative. Both natural and synthetic THC have shown some benefits in regards to improving behavioral problems in people with Alzheimer’s disease maybe due to its antioxidant properties.

        Still several people have noted that CBD oil high in cannabidiol and low in THC seems to improve memory and functions of daily living in those with Alzheimer’s disease the most.

        I think there are several layers of resistance to using natural products approach to treat neurodegenerative disease: first is the idea that it is all garbage and all the studies indicating otherwise are crap, second that if it indeed worked we would all know it by now, third as you note the cost and lack of remuneration for undertaking a clinical trial to try to determine efficacy. The quotes that I have received for doing a small placebo controlled randomized double-blinded six month trial using heat processed ginseng and aromatherapy to treat Alzheimer’s disease range from $120,000 to $200,000. That type of money is not easy to come by.

        Thank you for a very constructive comment.

        1. loupgarous says:

          And from what I know about the costs of clinical research, Lane, you were offered an extremely good quote – or the CRO you asked is trying to keep staff busy who weren’t doing much at the time you spoke with them.

        2. Peter S. Shenkin says:

          I wonder if THC would cure my own behavioral problems, which my third-grade teacher so outspokenly complained about. When asked for examples of mammals, I waved my hand frantically and, when called upon, politely (or so I thought) said, “Human beings are mammals.” Miss O’Connell, shocked, called my parents in and told them, “He knows too much.” They returned home giggling.

          Actually, having tried the THC cure, I can confidently say that it made my behavioral problems worse.

          You probably know that at the Scopes trial, William Jennings Bryan, when cross-examined by the defense, claimed on the stand that human beings are not mammals. He dropped dead just a few days later, having been nailed to the cross of evolution by Clarence Darrow. He now seems to be undergoing a somewhat delayed resurrection.

  7. Here’s the thing. Naturopathy, with-doctoring, whatever, it all basically *works* a lot of the time.

    Got a cold? Got the flu? Take this plant extract. Sleep outside. Drink swamp water. Do basically any goddamned thing that doesn’t actually kill you, and in a week or so you will be cured. Astonishing!

    And the hell of it is that for a lot of this stuff, naturopathy is by golly *better* than an MD. The MD is expensive, the facility isn’t that cozy, maybe the MD has a terrible bedside manner. The Naturopath suggests a change in diet to something less horrible than you’re eating, so you do that, because it’s “part of the cure” for your flu.

    When you’re “curing” flu or any number of common things that basically go away by themselves, it’s easy to get the idea that you’re pretty good at this, and that MDs are not. The leap to cancer follows kind of naturally, although it doesn’t work as well.

    Even there you get a surprising number of victories, though. And isn’t “occasional positive reinforcement” the most powerful training tool of all?

    The point here is that you actually have to engage is science of the hard kind, the kind that is complicated, difficult to even get right, and always difficult to understand, to even know that naturopathy and all its friends “don’t work” (which, for the record, they don’t, but even defining what that *means* is pretty complicated to laypeople).

    1. tangent says:

      Yeah, people mostly don’t realize how hard it is to be a good empiricist. Naive empiricism doesn’t cut it. Observing your own patients is not enough information to evaluate most things.

      MDs rely all the time, and with the same self-satisfaction, on the same bad epistemology that naturopathic practitioners are using. They just happened to be trained up with better tools to wave around smugly.

  8. Janex says:

    Naturopathy has its place as an “addition to” therapy. As practiced currently, it tends to do a great job of producing placebo effects and as we all know there are a number of conditions for which a placebo works well. The listening, the paying attention to the symptoms can be very important for some types of illnesses, especially with insurance companies forcing real doctors to spend less and less time with patients.

    It also has some potential of being a source of natural product leads, but frankly the low hanging fruit in that area has been picked. The best source of that type of information was never the pseudo-science of naturopathy but great grandma’s herbal recipes and the herbal recipes of traditional healers. Those sources have been deeply mined by the early pharmaceutical industry. There simply isn’t as much to find now.

    1. anon says:

      “As practiced currently, it tends to do a great job of producing placebo effects and as we all know there are a number of conditions for which a placebo works well.”

      The problem with this thinking is that it assumes the placebo actually does something positive instead of merely allowing for the “get better anyway” effect to occur.

  9. Anonymous says:

    The reason why naturopathy has any attention is the same as why people would vote Trump. It is so much easier to believe in a simple made up explanation for complex problems than to take reality as boring as it might be.
    With the whole self-centered trend we’re going through with smartphones and “social” bullshit apps taking any remaining brain cell down the toilet, I doubt we’re going anywhere but into a science batching era.
    That one person actually woke up is great but it is by no mean a trend for the millions of idiots promoting that kind of senseless bullshit.
    Onions? Wtf

  10. Isidore says:

    This whole business shows how words can be appropriated and misused. “Naturopathy” has nothing to do with healing and everything to do with letting Nature take its course. I mean, what can be more natural than becoming ill and possibly dying from an infection by a non-GMO organism, like E. coli or Y. pestis. And don’t get me started on “organic”, the appropriation of which I find especially egregious.

    1. David says:

      I wonder if some people will see me at some point as an alternative, hipster scientist, when I tell them I do Organic Chemistry.

      1. Phil says:

        I’ve already gotten the response “organic chemistry, aren’t those things opposites?”

  11. another guy says:

    How about “homeopathic dilution” that involves taking a solution of water and whatever “active ingredient” you may choose, and then performing a series of successive dilutions (say one-hundredfold dilutions, thirty times in a row) to the point where there is almost no chance there is even a single molecule of “active ingredient” left in the water. The naturopaths claim there is the “essence” or “water-memory” of the drug still in the water and that is the basis of the “cure”. Now there’s a business model for you, selling tap water priced as if it were on the same level as a cancer treatment.

  12. Dopamine says:

    Recent studies are showing why the placebo effect and ancient cultures “medicine men” seem to have their positive effect…. stimulation of dopamine release and “natural opioids”.

    It’s logical that people who sometimes find benefits from homeopathy are experiencing the same thing.

    Lets look at it for what it really is though, 100% reliance on it, or using uncharacteristized materials as “medicines” is dangerous, no doubt.

    It’s exciting that medicine is learning more about how to use these effects to our advantage!

  13. steve says:

    Here is the definition of naturopathy from the American Association of Naturopathic Physicians http://www.naturopathic.org/content.asp?contentid=59. Good to read before pontificating on what the definition is. The problem, as Derek pointed out, is that it is so broad as to be basically meaningless. It’s great to have an open mind but it shouldn’t be so open that your brain falls out. There is simply no such thing as “alternative” medicine. Something either works or it doesn’t. The appeal of naturopaths and the like comes from the fact that modern medicine became a bunch of pill pushers who believed the sales and marketing folk from large pharma. Too many people are on too many drugs. In some cases these are miracles but in others they cause side effects that are harmful to many. There was therefore a backlash with people wanting to take more charge of their health and have physicians who are like-minded. All well and good but another industry popped up that also is just about making money and preying on people’s sickness without regard to evidence or concern about side effects. Hopefully one day pharma will learn its lesson and be less concerned about maximizing profits by selling drugs at any cost.

    1. steve says:

      By the way, I admit that I’m a pig for saying this and don’t want to cast myself in the same mold as Donald Trump, but looking at Britt Hermes’ website, if that’s what naturopaths look like then sign me up.

      1. Not Impressed says:

        If you don’t want to cast yourself in Trump’s mold, can I suggest not acting like him?

        1. loupgarous says:

          Let’s be bi-partisan, though.

          For Steve to “act like Donald Trump” he’d have to have said “then I’d like to grab her… “. while for him to “act like Hillary Clinton” he’d have to kill her pet cat and slash the tires on her car for complaining after Bill Clinton had actually groped her (by amazing coincidence, what happened to a White House staffer incautious enough to complain after the President had attempted to palpate her curves).

          1. steve says:

            NI – get a sense of humor, lg – get a sense of reality. Thanks.

    2. loupgarous says:

      Steve, there are two things involved in the economics of bringing drugs to market: proving the safety and efficacy of a new drug to the FDA’s and EU’s satisfaction can cost about a billion dollars. If the people of those nations, through their governments, want cheaper drugs, they must make it less expensive to prove safety and efficacy so that there’s more competition to develop and manufacture new drugs.

      I suggest that Congress (and whatever does Congress’ job over the Atlantic) redouble its efforts on new ways of testing, but ultimately, the existing phases of human research – healthy volunteer, subclinical safety in patient, and safety/efficacy in patient – are necessary and expensive hurdles.

      If you think processing Clinical Research Forms and using those data to compile New Drug Applications is cheap, let me enlighten you. Just ordinary clinical programmers with mid-range skills in coding in SAS probably draw in the $80.000 – $120,000/year range. The product teams I’ve seen in Big Pharma employ eight to ten of them per compound.

      And we haven’t even considered the salaries of statisticians, medical experts, team leaders, and product group leaders, nor payments to local investigators.

      That last compensates the MDs who supervise local tests in multi-center trials and their staffs. An RN is usually detailed to be “statistician” in that she assumes responsibility for correctly completing Clinical Research Forms at site. This is a job so exacting that I’ve seen delays in processing NDAs until the data could be “cleaned” by drug company visits to local study sites in which seeming implausibilities in study results could either be affirmed by examination of patient charts or cleared-up by new CRFs reflecting the patients’ actual circumstances – usually dosage of the study drug, intercurrent illnesses, patient habitus, etc.

      Add to that the expense of a pilot plant to make the study drug, analytical chemists to make sure the drug as produced conforms to the specifications of the drug as designed by the drug development chemists, all of the support staff, packaging plants (though the expense of having Marketing design four-color separation boxes for drugs that haven’t yet passed NDA is questionable, I suppose it gets the stuff out on time right after approval. adminstrators’ salaries, and the company’s law firms’ billable hours for representation before FDA and other regulatory agencies.

      Making sure a new drug returns at least the billion dollars it takes to gain approval is not a trivial matter, nor does it speak to greed. Expecting drug companies to “eat” expenses for, say, a Crohn’s Disease drug because they make nice profits on synthetic insulins is no more moral than the mugger who sticks a gun in your face and takes your wallet because, after all, you can go to work the next day, cancel your credit cards, and earn more money to replace the cash you lost.

      We can (and should) cover drug companies with vitriol for arbitrarily increasing the cost of medications to patients “because”. The price of opiates for pain relief has skyrocketed, as have prices for synthetic insulins (the only kind sold here in the United States, now). I think at the prices diabetic patients and their insurance companies are obliged to pay, that it doesn’t take long to pay off development of these new variant insulins (every big player in the market has a pilot plant, and no changes are necessary to make a new insulin at these plants other than re-sequencing the DNA of the E.coli cultivar needed to make the insulin, as far as I know).

      But if we just accuse the entire drug industry of greed rather than criticizing specific bad behavior (to our representatives in Congress, not to the drug companies themselves), then it’s just noise which Big Pharma and Congress are so used to hearing they just tune it out.

      Big Pharma, warts and all, is a quantum leap ahead of naturopathy, Homeopathic Pharma, Peach Pit Pharma and all the rest specifically because it’s regulated in a way that requires scientific testing of its claims for its products.

      1. steve says:

        This site has well documented the pricing abuses of large pharma; just compare the costs of drugs in the US versus the rest of the world. Bottom line is that the current system is unsustainable. There is simply no way we can continue to pay these prices as the baby boomer population ages and more people require medications while the working population shrinks. Demographics will prove the undoing of the large pharma model.

        1. Vader says:

          “This site has well documented the pricing abuses of large pharma; just compare the costs of drugs in the US versus the rest of the world.”

          The last is a red herring. The rest of the world has government-controlled markets where a single player (the government) can deny you access to the entire market if you don’t offer the drug at a price that gives you a bare profit. And by “bare profit” I mean you get to ch arge just a little more than the cost of production and distribution.

          The problem is that that does not let you recover any of your research and development costs.

          You still play along, because you can amortize your research and development with the high prices charged in the U.S. and you still make a (bare) profit on the foreign sales. It’s the rational choice even if it sticks in your craw. (It would stick in mine.)

          The bottom line being, the whole world gets the drug but only the U.S. customers are paying for the expensive research and development to market the drug in the first place. Because foreigh governments are happy to bully you into dumping all the R&D costs on the U.S.

          This, too, has been well documented at this site. You must have missed it.

  14. pete says:

    “getting her degree included things like putting sliced onions over a child’s ear to deal with an ear infection”

    That’s more of a preventive, actually. It’ll keep out houseflies.

    1. Vader says:

      It may also reduce contact with human disease carriers. Though garlic probably works better.

  15. Wallace Grommet says:

    The problem with too many naturopathic providers is how they must run to the head of the latest fashions in woo, and then capitalize on them. Plus, the outright apathy and hostility towards the current vaccination protocols is hugely troublesome,as in thier typical customer will become a non-customer unless the ND can perform balletic rhetorical contortions around the issue. Lastly, they are a closed sytem of self certification, and have already achieved primary care staus under law in Oregon. Their agressive lobbying at state capitol legislatures knows no shame. They want prescriptive privileges on par with an MD! Talk about geting fed by the hand you’re biting!

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