Naturopathic Medicine

Brief history
Naturopathic medicine began in the late 1800s as an outgrowth of the era of "eclectic physicians" who explored many different kinds of healing. Dr. Benedict Lust coined the term in 1896 to describe the growing group of physicians who brought together a wide array of natural treatments under a developing philosophy of healing. Although the profession nearly died out in the United States, it has experienced a dramatic rebirth in the last 25 years and is now more widely available than it has been for nearly half a century. Many other countries have naturopathic doctors, including Canada, Germany, Great Britain and Australia; however, the recognized colleges in the United States offer the highest level of training in the world. Today, two NDs sit on the Advisory Council for the NIH National Center for Complementary and Alternative Medicine; others are occupying leadership roles in natural products research and development, and still others are publishing widely (journals, consumer-level books and texts for professionals).

Philosophy
Naturopathic medicine is based in a set of fundamental principles and philosophies about how the body functions and heals. The naturopathic doctor uses these principles to identify the problems and the therapies which will help to create healing in the patient. The most fundamental principle of naturopathic medicine is that the body contains a powerful, innate healing ability which should be supported and encouraged as much as possible (the healing power of nature); closely tied to this is the belief that, whenever possible, therapies that work in harmony with the healing power of nature should be the first line of treatment. Other principles include: · Find the cause - do not be content with alleviating symptoms if the underlying causes of disease can be identified and eliminated. · First of all, do no harm - begin treatment with therapies that do not harm the body or damage its innate ability to heal. · Doctor as teacher - people must be taught how to take responsibility for their own health care; a lot of time with an ND can be spent in learning how to do self-care and to change behaviors which are causing problems.

Scope of practice
Naturopathic doctors are trained to provide primary care natural medicine. They use conventional medical diagnostics (laboratory diagnosis, physical exam, medical history and diagnostic imaging), and a broad range of natural therapeutics, including botanical medicine, clinical nutrition (vitamins, minerals and nutriceuticals), dietary interventions, homeopathy, acupuncture and oriental medicine, physical medicine (naturopathic manipulation, physiotherapy and hydrotherapy), and counseling. The exact scope of practice will depend on the state laws (in those states which license NDs).

Regulatory scope
Naturopathic doctors today are licensed in 12 jurisdictions and they practice in many other states as well, although without the protection of a licensing law. They generally practice as family doctors in natural medicine, and often they will be the patient's primary care provider, but each state has a different scope of practice mandated by law. If you live in a state that does not license NDs, be sure to check the credentials of anyone you choose to see, because the unlicensed states do nothing to ensure that the education and credentialing of those who call themselves NDs meet today's highest standards. Naturopathic doctors are trained to refer to and do co-management with many other health care providers, both conventional and alternative; they can function as key partners in your health care team (most easily in the licensed states).

Education and credentialing
Naturopathic colleges and programs which are recognized by the licensed states are accredited by the Council on Naturopathic Medical Education, and offer four years of in-residence, post-baccalaureate, naturopathic medical education. A diploma from a recognized school is required to sit for the Naturopathic Physicians Licensing Exam, the only national examination recognized by the licensed states for purposes of licensure. Many NDs have additional certifications in acupuncture, botanical medicine, homeopathy or natural childbirth.

Typical first office call or visit
Your first office call with a naturopathic doctor will often take one to 1-1/2 hours and will require an extensive health history; a physical exam may be done on this visit, or deferred to a return visit. Your ND will be trying to gain a broad understanding of your health status and of all the influences which may be acting on your health - family circumstances, work, nutrition, exercise, stress, spirituality, psychological well being, and so forth. Laboratory work may be ordered to assist with diagnosis and to evaluate early signs of chronic disease. A comprehensive treatment plan may be deferred until all the information is available, although there are many natural remedies which can be prescribed to alleviate acute symptoms.

Limitations to be aware of
NDs do not normally have hospital privileges, but will generally have referral relationships for those patients who need hospital-based care. In certain states, they have no prescription privileges; in others, they have a specific formulary agreed upon by the state licensing board, often in consultation with the state pharmacy board or some other conventional regulatory body and usually focusing primarily on naturally-derived products such as natural hormones, antibiotics and the like. They do not do acute care of trauma (broken bones, serious wounds and burns, etc.) and some may limit their practice to specialize in a particular discipline such as homeopathy or to focus on certain conditions such as allergies.

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ARTHRITIS