Naturopathic medicine is a distinct profession of primary health care, emphasizing prevention, treatment and the promotion of optimal health through the use of therapeutic methods and modalities, which encourage the self-healing process, the vis medicatrix naturae.
The U.S. Department of Labor defines the Naturopathic Physician as one who “diagnoses, treats, and cares for patients, using a system of practice that bases its treatment of all physiological functions and abnormal conditions on natural laws governing the body, utilizes physiological, psychological and mechanical methods, such as air, water, heat, earth, phytotherapy (treatment by use of plants), electrotherapy, physiotherapy, minor or orificial surgery, mechanotherapy, naturopathic corrections and manipulation, and all natural methods or modalities, together with natural medicines, natural processed foods, herbs, and natural remedies. Excludes major surgery, therapeutic use of x-ray and radium, and use of drugs, except those assimilable substances containing elements or compounds which are compounds of body tissues and are physiologically compatible to body processes for maintenance of life.” Most Naturopathic Physicians provide primary care natural medicine through office-based, private practice. Many receive additional training in disciplines or modalities such as midwifery, acupuncture and Oriental medicine.
Naturopathic diagnosis and therapeutics are supported by scientific research drawn from peer-reviewed journals from many disciplines, including naturopathic medicine, conventional medicine, European complementary medicine, clinical nutrition, phytotherapy, pharmacognosy, homeopathy, psychology and spirituality. Information technology and new concepts in clinical outcomes assessment are particularly well-suited to evaluating the effectiveness of naturopathic treatment protocols and are being used in research, both at naturopathic medical schools and in the offices of practicing physicians. Clinical research into natural therapies has become an increasingly important focus for Naturopathic Physicians.
Naturopathic Medicine provides holistic (whole body) healthcare by taking advantage of resources drawn from numerous traditional healing systems dating back to the 20th Century. Naturopathy is organized around three fundamental principles: The physician should strive to aid the body’s natural healing abilities; the root cause of an illness should be addressed rather than the symptoms; and only therapies that cause no harm should be used (which means that toxic drugs and surgery are avoided whenever possible. A naturopathic doctor (ND), takes into account the patient’s lifestyle. Naturopathic theory holds that physical, psychological, and even spiritual elements can all contribute to disease. In treating patients, the naturopathic practitioner may use a number of alternative therapies, including homeopathy, herbal remedies, traditional Chinese medicine, spinal manipulation, nutrition, hydrotherapy, massage and exercise.
Doctors of Naturopathy train at accredited four-year naturopathic medical schools. The first 2 years include many of the same core science classes as regular medical schools, while the final 2 years focus on natural healing techniques. At present, naturopathic doctors are licensed to practice in many states, most others allow them to practice in limited ways. Many private insurance plans cover naturopathic care.
History of Naturopathic Medicine by Peter Barry Chowka
Naturopathic medicine, sometimes called “naturopathy,” is as old as healing itself and as new as the latest discoveries in biochemical sciences. In the United States, the naturopathic medical profession’s infrastructure is based on accredited educational institutions, professional licensing by a growing number of states, national standards of practice and care, peer review, and an ongoing commitment to state-of-the-art scientific research. Modern American Naturopathic Physicians (NDs) receive extensive training in and use therapies that are primarily natural (hence the name naturopathic) and nontoxic, including clinical nutrition, homeopathy, botanical medicine, hydrotherapy, physical medicine, and counseling. Many NDs have additional training and certification in acupuncture and home birthing. These contemporary NDs, who have attended naturopathic medical colleges recognized by the U.S. Department of Education, practice medicine as primary health care providers and are increasingly acknowledged as leaders in bringing about progressive changes in the nation’s medical system.
The word “naturopathy” was first used in the U.S. exactly 100 years ago. But the natural therapies and the philosophy on which naturopathy is based have been effectively used to treat diseases since ancient times. As Rene Dubos noted in The Mirage of Health (1959), the word “physician” is from the Greek root meaning “nature.” Hippocrates, a physician who lived 2400 years ago, is often considered the earliest predecessor of Naturopathic Physicians, particularly in terms of his teaching that “nature is healer of all diseases” and his formulation of the concept vis medicatrix naturae — “the healing power of nature.” This concept has long been at the core of indigenous medicine in many cultures around the world and remains one of the central themes of naturopathic philosophy to this day.
The earliest doctors and healers worked with herbs, foods, water, fasting, and tissue manipulation — gentle treatments that do not obscure the body’s own healing powers. Today’s Naturopathic Physicians continue to use these therapies as their main tools and to advocate a healthy dose of primary prevention. In addition, modern NDs conduct and make practical use of the latest biochemical research involving nutrition, botanicals, homeopathy, and other natural treatments.
For many diseases and conditions (a few examples are ulcerative colitis, asthma, menopause, flu, obesity, and chronic fatigue), treatments used by Naturopathic Physicians can be primary and even curative. Naturopathic physicians also function within an integrated framework, for example referring patients to an appropriate medical specialist such as an oncologist or a surgeon. Naturopathic therapies can be employed within that context to complement the treatments used by conventionally trained medical doctors. The result is a team-care approach that recognizes the needs of the patient to receive the best overall treatment most appropriate to his or her specific medical condition.
Naturopathic medicine was popular and widely available throughout the U.S. well into the early part of the 20th century. Around 1920, from coast to coast, there were a number of naturopathic medical schools, thousands of Naturopathic Physicians, and scores of thousands of patients using naturopathic therapies. But the rise of “scientific medicine,” the discovery and increasing use of “miracle drugs” like antibiotics, the institutionalization of a large medical system primarily based (both clinically and economically) on high-tech and pharmaceutical treatments — all of these were associated by mid-century with the temporary decline of naturopathic medicine and most other methods of natural healing.
By the 1970s, however, the American public was becoming increasingly disenchanted with conventional medicine. The profound clinical limitations of conventional medicine and its out-of-control costs were becoming obvious, and millions of Americans were inspired to look for “new” options and alternatives. Naturopathy and all of complementary alternative medicine began to enter a new era of rejuvenation.
Looking to the Future
Today, licensed Naturopathic Physicians are experiencing noteworthy clinical successes, providing leadership in innovative natural medical research, enjoying increasing political influence, and looking forward to an unlimited future potential. Both the American public and policy makers are recognizing and contributing to the resurgence of the comprehensive system of health care practiced by NDs. In 1992, the NIH’s Office of Alternative Medicine, created by an act of Congress, invited leading Naturopathic Physicians (educators, researchers, and clinical practitioners) to serve on key federal advisory panels and to help define priorities and design protocols for state-of-the-art alternative medical research. In 1994, the NIH selected Bastyr University as the national center for research on alternative treatments for HIV/AIDS. At a one-million-dollar level of funding, this action represented the formal recognition by the federal government of the legitimacy and significance of naturopathic medicine.
Meanwhile, the number of new NDs is steadily increasing, and licensure of Naturopathic Physicians is expanding into new states. By April of 1996, eleven of fifty states had naturopathic licensing laws (Alaska, Arizona, Connecticut, Hawaii, Maine, Montana, New Hampshire, Oregon, Utah, Vermont, and Washington). A number of other states are likely to enact naturopathic licensing in the near future.
In October 1996, in a major development for both public health and Naturopathic medicine, the Natural Medicine Clinic opened in Kent, Washington. Funded by the King County (Seattle) Department of Public Health, the clinic is the first medical facility in the nation to offer natural medical treatments to people in the community, paid for by tax dollars. Bastyr University, one of the three U.S. naturopathic colleges, was selected over several leading Seattle-area hospitals to operate the clinic.
In the last half of the 1990s and the beginning of the 2000s, exactly one century after it put down roots in North America, naturopathic medicine is finally enjoying a well-deserved renaissance—people are beginning to recognize the value of natural healing compared to the synthetic prescription drug alternative.
A licensed Naturopathic Physician (ND) attends a four-year graduate level naturopathic medical school and is educated in all of the same basic sciences as an MD but also studies holistic and nontoxic approaches to therapy with a strong emphasis on disease prevention and optimizing wellness. In addition to a standard medical curriculum, the ND is required to complete four years of training in clinical nutrition, acupuncture, homeopathic medicine, botanical medicine, psychology and counseling (to encourage people to make lifestyle changes in support of their personal health).
A Naturopathic Physician takes rigorous professional board exams so that he or she may be licensed by a state or jurisdiction as a primary care general practice physician. Twelve states and four provinces allow the practice of naturopathic medicine: Alaska, Arizona, British Columbia, Connecticut, Hawaii, Kansas, Maine, Manitoba, Montana, New Hampshire, Ontario, Oregon, Saskatchewan, Utah, Vermont, and Washington. Puerto Rico and the U.S. Virgin Islands also have licensing laws for naturopathic doctors. Many states have realized that having physicians trained in preventive medicine and health promotion is a wise choice, and are now considering Naturopathic legislation.
The American Association of Naturopathic Physicians (AANP) strongly believes in and advocates for state licensing of Naturopathic Physicians in all 50 states. The AANP believe that other programs, such as certification and registration, do not go far enough. With the cost of healthcare slowly spiraling out of control there is a renewed interest in the development of a patient-centered system of health care delivery focused on restoring individual and community health while preventing illness. The drive for licensure of NDs is a sign of the times. Licensure creates accountability supported by law, affirming that people who are licensed are under the scrutiny of a board of examiners whose purpose is to protect the public by maintaining professional standards.
Certification, on the other hand, does not carry with it the scrutiny of a licensing board nor regulation of any sort, save that of the certifying organization itself. Unlike licensing boards, certifying organizations usually does not have members other than those they have certified. They also do not carry the weight of law should the need arise. Certification, at its best, merely indicates that the person certified has completed a course of study. It says nothing about the quality of that course of study. And there is no ongoing system to make certain of adherence to standards of practice.
Registration offers a little more control, but does not imply conformity to standards and guidelines, other than those required for registration. Anything can be registered: hotels register their guests in order to keep track of how many rooms are available; firearms are registered to keep track of who purchases them; and automobiles are registered and assessed a fee in order to maintain the road ways they use.
While anyone can educate themselves in the general knowledge of health and illness, a physician must be educated to be able to recognize, differentiate and diagnose serious illness; develop the social insight necessary to understand and utilize technical advances in the healing arts; and cooperate fully and legally with voluntary and public agencies in the pursuit of social conditions which make it possible for better health in the community.
The modern ND is trained in basic medical science and conventional diagnostics, and is qualified through licensing to scientifically apply natural therapeutics in the treatment of disease and restoration of health. The public has the right to know that those offering such services are competent as physicians, duly licensed as such, and are willing to be held accountable for their actions and results.
Does CNME recognize home-study schools or external-degree programs?
The Council on Naturopathic Medical Education is aware of several correspondence schools that offer an “N.D.” degree. Some are exempt from state regulations because they claim a religious purpose or they do not recruit students from their home states. Correspondence programs do not prepare students for practice as licensed Naturopathic Physicians, and the programs are not eligible for affiliation with CNME. In states without licensing laws, it is not illegal for graduates of N.D. correspondence schools to use the N.D. initials after their names; they may not, however, legally represent themselves as physicians or engage in the practice of medicine unless they are otherwise licensed as medical practitioners.
Although correspondence courses can be effective in many disciplines, we do not believe they are in any way adequate for preparing students to become physicians, and we do not consider the graduates to be part of the naturopathic medical profession. The accrediting agencies listed by N.D. correspondence schools are not in turn recognized by the U.S. Secretary of Education or the Council for Higher Education Accreditation.