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There is a lot of confusion as to who Naturopathic Doctors are and what they do.
I’ve heard some outrageous things:
we practice voo-doo and pseudo-science
we don’t use research or evidence-based medicine
we aren’t trained licensed doctors
we are homeopaths
we are tree-hugging, crystal healing, snake oil using hippies
and the list goes on.
To be honest, I never knew what a Naturopathic doctor (ND) was until I was introduced to CCNM (the Canadian College of Naturopathic Medicine). Like so many people, I was skeptical of the type of medicine ND’s practiced and thought they were “energetic healers”.
I wasn’t interested.
About 2 years later someone I knew was attending the school and my interest was peaked. After finding out that NDs are trained in acupuncture, physical manipulation and nutrition, I thought that this would be a great combination of tools to treat patients with. And with my history of competitive gymnastics I was well versed in the benefits of these therapies.
What I didn’t realize is—being a Naturopathic doctor is so much more.
What is Naturopathic medicine?
Naturopathic medicine is the merging of Western science with Eastern traditional philosophies to promote healing of the whole person (mentally, emotionally, physically and spiritually) from the root of the issue. Naturopathic medicine supports the body to heal itself, not suppress symptoms.
The body is capable of healing itself given the right support and removing obstacles to heal. Naturopathic doctors call this the vis – the body’s innate ability to cure and maintain homeostasis (balance). The vis is the foundation for the 6 Naturopathic principles:
First to do no harm – Minimizing risks of harmful side effects and using the least force necessary to diagnose and treat while respecting the individual’s self-healing process.
Identify and treat the cause – Rather than merely eliminating or suppressing symptoms, NDs seek to identify and treat the causes of illness.
Doctor as teacher – Patients are encouraged to take responsibility for their own optimal health through knowledge and empowerment.
Treat the whole person – A person’s health status must address his or her physical, mental, emotional, genetic, environmental and social support to truly understand all contributing factors.
Emphasize prevention – Preventative health is the only sustainable health model. NDs are leaders in prevention of disease by assessing risk factors, heredity and susceptibility to illness.
Supporting the healing power of the body – Naturopathic medicine recognizes an order and intelligence to the self-healing process inherent to every living creature.
Whether or not you believe in a spirit, energy force or vis, isn’t the point.
Our bodies are complex.
Our physical, emotional and mental well-being are interconnected with our internal and external environment. We cannot compartmentalize ourselves into symptoms. We are affected by everything we consume, interact with and experience. Energy and the conversion into various forms of energy is the foundation of science.
NDs obtain a thorough intake by combining the patient’s history, experiences, symptoms and utilizing modern Western medical tests (ie. physical exams, blood work, imaging, genetics testing) to choose the most appropriate wholistic therapy to treat.
No two people are exactly alike. Individualized treatments are necessary for optimal long-term health.
On the same note, no two Naturopathic doctors are alike. You may find an ND using different treatment tools or styles of patient interaction.
But because Naturopathic doctors are licensed and board-certified across North America, this ensures the highest standards, quality of care, safety and effective clinical treatments for all our patients.
Choosing the right ND for you will be key to your long-term success, but not because of their skills or education, but the relationship you create. You can find a local ND at the end of this article.
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Naturopaths vs Naturopathic Doctors
Is there really a difference? YES.
Naturopaths are unregulated, unlicensed and have the equivalent education of a University degree.
This does not mean that all Naturopaths are unsafe, ineffective or not as smart as Naturopathic doctors. I know Naturopaths who have studied in Europe, Australia, and New Zealand and are phenomenal practitioners, but these are rare gems.
For the general public, they may not know the difference. They may not be able to differentiate solid education from an outspoken, confident “script”, and this is an issue.
There are some Naturopaths who are giving the Naturopathic medical profession a bad name. This is where titles such as “quacks”, “pseudoscience” and “voo-doo practitioners” are used.
Let’s look at the stats in terms of the number of hours of medical training comparing 2 accredited Naturopathic medical schools, 3 conventional medical schools, and 2 non-accredited natural health schools:
Hours of training for NDs, MDs, and non-accredited natural therapy schools
Not only are Naturopaths taught varying degrees of science, but also modalities. I had the pleasure of working with a Naturopath who was well-versed in Ayurvedic medicine, a tool I’d not been exposed to but he was not taught physical exams, clinical lab workup analysis, pharmacology or Western nutrition.
This means, a patient would get valuable Ayurvedic information from him, but he is not a primary care physician.
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Naturopathic doctors are trained similarly to general practitioners (GP) in the Medical doctor model. We are able to identify emergency cases and potentially life-threatening diseases. We are trained in first aid and follow a ‘gold standard of treatment’ based on modern medicine and research.
For example, if you have Stage 3 cancer, it is our due diligence to recommend chemotherapy and radiation if research has indicated this the best treatment for removing the cancer, increasing quality and length of life.
Where we differ from MD’s is that we have other tools to work along side with Western medicine to aid in healing and dealing with side effects. And where modern Western medicine has run out of options to treat, we have the tools. There is always something a Naturopathic doctor can do to support quality of life, palliative care and personal growth.
My ND calls themselves a Naturopath, why?
Assuming that your ND is an actual licensed Naturopathic doctor, they shouldn’t be referring to themselves as a Naturopath. It confuses the general public. Even NDs sometimes don’t realize how important it is to differentiate our medical training from other holistic practitioners.
Naturopathic doctors (NDs) are also sometimes referred to as Naturopathic medical doctors (NMDs). Regardless of their title, make sure they have a license displayed in their office from one of the following schools:
Bastyr University (BU): Kenmore, Washington
Bastyr University California (BUC): San Diego, CA
Boucher Institute of Naturopathic Medicine (BINM): New Westminster, British Columbia
Canadian College of Naturopathic Medicine (CCNM): Toronto, Ontario
National College of Natural Medicine (NCNM): Portland, Oregon
National University of Health Sciences (NUHS): Lombard, Illinois
Southwest College of Naturopathic Medicine (SCNM): Tempe, Arizona
University of Bridgeport – College of Naturopathic Medicine (UBCNM): Bridgeport, Connecticut
Having this license ensures that the ND has the following education:
University undergraduate degree with a minimum 3.0 GPA
Medical prerequisites for biology, biochemistry, chemistry, organic chemistry, and psychology
Completion of more than 4,500 hours of Naturopathic training and 1,500 hours of supervised clinical experience
Successfully completed a 4-year full-time Naturopathic medical program at one of the accredited schools above.
Successfully passed the 2-part NPLEX (Naturopathic Physicians Licensing Examination) board exam series regulated by NABNE (North American Board of Naturopathic Examiners):
Part 1: Biomedical Science
Part 2: Core Clinical Science
Part 2: Practical Clinical Exam
Part 2: Jurisprudence and Jurisdiction Exam
Annual Continuing Medical Education (CME) required credits as per provincial and state regulations.
So far, Naturopathic doctors seem to be more similar to Medical doctors than Naturopaths in terms of their education, so let’s take a closer look at the differences between NDs and MDs.
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Naturopathic doctors vs. Medical doctors
Very few Medical doctors or health care practitioners understand what Naturopathic medicine is and so have a skewed perspective of our education and clinical skills. My MD colleagues told me they had a 30-minute lecture on ‘alternative medicine’ where everyone was clumped into non-scientific practices along with case studies of poor practice management. This isn’t all Medical schools and times are definitely changing. More and more NDs are speaking at Medical schools along with joined conferences for holistic approaches to medicine (ie. Restorative Medicine, Society for Integrative Oncology, American College for Advancement in Medicine)
As we saw with the statistics above, NDs and MDs have similar science training with a different emphasis on the tools and modalities they choose to treat patients with.
Here’s another example:
Science credits earned at the University of Washington MD program and Bastyr University ND program. Chart created by Dr. Erika Krumbeck, ND.
Medical students must pass a series of board examination called USMLE, while Naturopathic students write the NPLEX board exams. Here’s a comparison of board exam topics:
The NPLEX (Naturopathic Physicians Licensing Examination) board exam series is regulated by NABNE (North American Board of Naturopathic Examiners)
Models of healthcare
When it comes to the medical models of care that MDs and NDs use to treat their patients, it can be very different. MDs tend to focus on reactive healthcare; utilizing pharmaceutical prescriptions or surgeries when appropriate. This type of medicine supports our current reactive healthcare system and puts a massive burden on our hospitals and emergency departments.
Reactive healthcare is imperative in emergent, life threatening or severe physical injuries or poisonings. We need Medical doctors for this type of care.
Naturopathic doctors on the other hand are primary care physicians who specialize in preventative healthcare, chronic disease management and optimal living strategies. We are detectives for your health, combining your history, symptoms, lab tests and physical examinations to understand the patterns of imbalance.
Where reactive care can no longer safely suppress symptoms or cut out a diseased organ, we can provide empowering lifestyle changes to reverse the cause of distress and improve quality of life. We give patients back their autonomy and responsibility for their health.
But this is more challenging than we thought. Lifestyle changes take time and effort. Unfortunately, many people are not ready for this.
Don’t smash your gas light
Suppressing symptoms can only work for so long. Let’s take a car with the gas light turned on as an example:
The dull light is easily covered with a piece of duck tape and nothing happens, great. Eventually the light gets brighter and shines through the tape. If you take a hammer and smash the light, the car continues to drive along without any noticeable issues.
But at some point, the car will stop running and if you continue to push it or fill it with bad fuel it will start to affect other parts of the car and become a very big problem.
Most people can guess where the root of their health concerns lie (or at least contributing factors); poor diet, lack of exercise, stressful job, financial anxiety from buying a new house, etc. But only a few take the steps to fix the root of the problem before it become a major issue or health condition.
This is because we are human. It’s not your fault if you’ve been avoiding those warning signals. You just haven’t trained yourself to create short-term rewards for the long-term gains.
Taking an immediate pill to feel better is easy. Trading it for long-term health benefits, which take time and consistent, conscious effort is difficult, especially if it’s not guaranteed.
In Dan Ariely’s book Predictably Irrational, he talks about procrastination in so many aspects of our lives:
Spending on a new gadget instead of saving for retirement
Taking a high stress, demanding, but well paying job to afford a bigger house
Eating take out french fries instead making a salad
We live in a world of immediacy and need to create ways to reward consistent long-term efforts and avoid destructive temptations. This is how Naturopathic doctors and Medical doctors can co-exist and even support one another.
NDs working with MDs
Naturopathic doctors work with MDs synergistically. Our skills compliment each other. More importantly, NDs are training in pharmacology and understand drug interactions.
When we see a patient on an essential medication that causes him or her negative side effects, we can help. Instead of adding drug #2 to combat the side effects of drug #1, which can be a dangerous pharmaceutical roller coaster, Naturopathic doctors can help. By utilizing least harmful but effective natural treatments to combat deleterious symptoms without interfering with the primary action of the drug is a unique skill we posses.
Collaborative health care
We have the capacity to use a variety of tools to find the most appropriate therapy for each patient and his or her situation. For example:
For a patient with a vitamin deficiency and malabsorption issue, we would avoid oral supplements and instead utilize IV therapy and focus on healing the root of the gut dysfunction.
If you had difficulty coping with stress at work and were unable to change jobs, we could support you with acupuncture and incorporate coping strategies for acute stress and preventative supplemental support, like adaptogenic herbs.
NDs are trained to use the following tools:
Dietary nutrition and supplementation
Lifestyle counseling (exercise, stress management, new habit formations)
Botanical medicine
Homeopathy
Health psychology
Physical manipulation and adjustments
and most are trained in Traditional Chinese Medicine, including acupuncture
Additional training: IV therapy, physical therapies (ultrasound, laser therapy, trigger point dry needling), pharmaceutical prescriptions, prolotherapy, reiki, crano-sacral therapy, touch therapy, bioenergetic medicine, etc.
With all of our tools, most Naturopathic patients will tell you there is nothing more valuable than having someone listen to you with an empathetic ear and give you actionable and practical health advice to build into your daily life. Nowhere else can you find an evidence-based practitioner with extensive safe and effective tools who practice patient-focused healthcare.
Naturopathic doctors pride themselves on their high standards of patient quality care, medical responsibilities and ethical conduct.
Find a licensed Naturopathic Doctor in your local area today within Canada and the USA.
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Photo: Getty Images
This post was originally published on Dr. Alison Chen’s blog.
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