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Licensure, Laws and Accreditation

Careers in Naturopathic Medicine

Naturopathic Medicine Education
Some material provided by the American Association of Naturopathic Physicians, and the Council on Naturopathic Medical Education.

Some answers provided by the author of Educational And Career Opportunities in Alternative Medicine, our online advisor, Rosemary Jones.

What does a naturopathic physician do?
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.

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What is the 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 US 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 US 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.

Recent History

Naturopathic medicine was popular and widely available throughout the US 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.

Naturopathic medical education is growing by leaps and bounds. Two of the three US naturopathic medical schools, National College of Naturopathic Medicine in Portland, Oregon, and Bastyr University in Seattle, Washington, are fully accredited. The third, Southwest College of Natural Health Sciences in Scottsdale, Arizona, has been accepted as a candidate for accreditation. Within the past year, all three US naturopathic medical schools and the Canadian College of Naturopathic Medicine in Toronto moved to considerably larger campuses in order to meet the accelerating demand on the part of prospective naturopathic medical students. In 1996, Bastyr University alone had almost 1,000 students enrolled in its various degree-granting programs.

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 US naturopathic colleges, was selected over several leading Seattle-area hospitals to operate the clinic.

In the last half of the 1990s, exactly one century after it put down roots in North America, naturopathic medicine is finally enjoying a well-deserved renaissance.

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What states license naturopathic physicians?
The following states license and regulate naturopathic physicians: Alaska, Arizona, Connecticut, Hawaii, Maine, Montana, New Hampshire, Oregon, Utah, Vermont and Washington.

Many states have realized that having physicians trained in preventive medicine and health promotion is a wise choice, and are now considering Naturopathic legislation.

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What is the value of attending a school that leads to licensure?

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.

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What schools are accredited by the Council on Naturopathic Medical Education (CNME)?

CNME Accredited Schools

CNME Candidates for Accreditation

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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.

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How much does a Naturopathic Doctor earn?
The average income of naturopathic doctors tends to fall in the low to mid-range of family practice doctors, according to a survey done by the AANP. A National College graduate advertising for a partner in his Conneticut practice estimated that an ND in his area could earn $90,000 or more a year

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What undergraduate majors are best for people considering becoming naturopathic doctors?
The schools require that the undergraduate degree include a minimum of 20 semester or 30 quarter credits of standard premed classes such as chemistry, biology, botany, anatomy/physiology and so on. Other than that, they encourage students to come from a well-rounded academic background. While many applicants have a pre-med BS, this is not a requirement. As long as you can fulfill the science prerequisites, major in an area that interests you. Right now, a popular undergraduate degree among naturopathic applicants is psychology.

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