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Naturopathic Medicine


© Mary & Michael Morton
 
(Excerpted from Five Steps to Selecting the Best Alternative Medicine)

DID YOU KNOW THAT:

  • In 1983 the World Health Organization recommended the integration of naturopathic medicine into conventional health care systems.2
  • In 1994 Bastyr University of Natural Health Sciences, a naturopathic medical school, was awarded almost $1 million in research funds from the National Institutes of Health's Office of Alternative Medicine to research alternative therapies for patients with HIV and AIDS.3
  • Graduates of accredited naturopathic medical colleges are required to have more hours of study in basic sciences and clinical sciences than graduates of Yale or Stanford medical schools.4
  • The "anti-cancer" diet recognized by the National Cancer Institute was first published in a naturopathic medical textbook in the 1940s.5
  • Graduates of accredited naturopathic medical colleges receive more formal training in therapeutic nutrition than M.D.'s, osteopathic physicians, or registered dietitians.6
  • The government of Germany now requires conventional doctors and pharmacists to receive training in naturopathic techniques because they have been found to be so cost-effective.7
  • Today there are over one thousand licensed practicing naturopathic physicians (N.D.'s) in the United States.8
  • As of August 1996, twelve states in the U.S. and five provinces of Canada now license naturopathic doctors as primary-care physicians. (It is projected that all fifty states will license naturopathic physicians by the year 2010.)9
  • Three accredited colleges educate and train naturopathic doctors in North America.10
  • The County Council in Seattle, Washington, established the nation's first government-subsidized naturopathic medical clinic.11

The origin of naturopathy can be traced back to the ancient healing arts of a variety of cultures. Still, as a formal system of medicine and healing, it was developed in the United States nearly one hundred years ago by Benjamin Lust.

To heal in harmony with the natural functions of the body � without harm � is the underlying principle of the naturopathic system of medicine. The intent is to support the natural healing potential of the human body as validated by modern scientific research. It is this combination of the healing power of nature and scientific methods that makes naturopathic medicine an important system of medicine for today's health care.

Naturopathic medicine's basic principles are:

1. Utilize the healing power of nature
2. First, do no harm
3. Find the cause
4. Treat the whole person
5. Preventative medicine

The American Association of Naturopathic Physicians (AANP) more fully describes these tenets as:

Utilize the Healing Power of Nature: Vis Medicatrix Naturae Nature acts powerfully through the healing mechanisms of the body and mind to maintain and restore health. Naturopathic physicians work to restore and support these inherent healing systems when they have broken down, by using methods, medicines, and techniques that are in harmony with natural processes.

First Do No Harm: Prinum Non Nocere Naturopathic physicians prefer noninvasive treatments, which minimize the risks of harmful side effects. They are trained to know which patients they can treat safely, and which ones they need to refer to other health care practitioners.

Find the Cause: Tolle Causam Every illness has an underlying cause, often an aspect of the lifestyle, diet, or habits of the individual. A naturopathic physician is trained to find and remove the underlying cause of a disease.

Treat the Whole Person: Health or disease results from a complex interaction of physical, emotional, dietary, genetic, environmental, lifestyle, and other factors. Naturopathic physicians treat the whole person, taking these factors into account.

Preventative Medicine: The naturopathic approach to health care can prevent minor illnesses from developing into more serious, chronic, or degenerative diseases. Patients are taught the principles with which to live a healthy life; by following these principles, they can prevent major illnesses.12

Above all, naturopathic physicians respect the natural healing power present in all systems of the human body and they attempt to focus and mobilize that power in their treatment process. N.D.'s have found that this natural healing power, if effectively mobilized, can destroy invading organisms, cast off toxins, as well as rebuild strength and vitality. Dr. Stephen Speidel, an N.D. practicing in Poulsbo, Washington, says, "A good example of how we in naturopathic medicine use the healing force in the body is what we do or don't do when a child has a fever. Often times a fever is a way that the body rids itself of a bacteria that only grows in certain temperatures.

"Most parents say, 'My God, my child has a fever. We have to stop that fever. Give him aspirin or Tylenol.' I tell them, 'Imagine that your child has a helper, which is the immune system.' If you take the aspirin, it's like taking a sledge hammer to your child's immune system and saying, 'Be quiet and sit down!' And it will. You'll win. That helper will be quiet and sit down. But your child will stay sicker longer. There are a number of studies that show antihistamines prolong the course of a cold. But if the fever or cold is allowed to run its course, the body eliminates the problem and the child gets healthy."13

The role of a fever as healing process may seem strange to many health care consumers who are used to using medications to eliminate its presence. Yet, many systems of healing and medicine throughout the world since ancient times have recognized the healing wisdom of letting a fever run its course.

Clearly the principles of naturopathic medicine differ significantly from conventional medicine's. In conventional medicine, relieving symptoms is the primary focus. For example, in conventional medical treatment, in the aforementioned case, the fever would be controlled or stopped by drugs. Actually in most health care situations, the elimination of symptoms is achieved through the use of drugs and, in some cases, surgery.

It may surprise some people to know that N.D.'s and M.D.'s have some areas of common ground, namely their education. M.D.'s are schooled in basic sciences and clinical sciences to prepare them for the various illnesses and emergencies they will face during their practice. N.D.'s are also well trained in all these sciences in their education. But, unlike M.D.'s, they are also trained in a variety of traditional natural therapeutics, including botanical medicine, clinical nutrition, homeopathy, acupuncture, traditional Chinese medicine, hydrotherapy, and naturopathic manipulative therapies.

N.D.'s learn how to integrate this diverse knowledge by combining their conventional medical education with the goal of providing superior health care in their practices. They weave their conventional medical knowledge with the principles of naturopathic medicine and its treatments to create a natural health care program tailored for each individual patient.

In the past few years, naturopathic medicine has won the respect of federal and state government bodies, members of the conventional medical community, educators, celebrities, the media, and an ever-increasing number of American health care consumers. A main reason for naturopathic medicine's rise in popularity is its common-sense use of simple yet tremendously effective natural treatments. These treatments include:

Clinical Nutrition
Clinical nutrition has been one of the main cornerstones of naturopathic medicine since its inception. Studies from around the world, in a variety of medical traditions, have validated the benefits of naturopathic's nutritional principles. A vast number of documented cases of physical problems, including heart disease and diabetes, have been helped by nutrition, without unpleasant side effects or complications.

Naturopathic theory suggests that most illnesses are caused by digestive disturbances, which have led to a toxic environment in the body. As the body is overwhelmed by toxins it cannot eliminate, the health or strength of the body breaks down and symptoms of various illnesses surface. Nutritional changes are a main component to changing the diseased situation because today's processed foods and poor eating habits are the source of many of the body's toxins.

To treat chronic illnesses, many times nutritional changes are the first step toward healing in naturopathic medicine. For example, simple vegetable soups are often recommended because, as they are easy to digest and assimilate, they provide the body with vitamin and mineral nutrients without adding toxins to the body.

Hydrotherapy
If nutritional therapy is the first cornerstone of naturopathic medicine, then hydrotherapy is the second. Hydrotherapy improves digestive function by bringing additional blood (and all of its healing components) to the inner organs. The most common form of hydrotherapy is called the "constitutional," where two towels dipped in hot water, then squeezed, are placed on the front of the patient for five minutes. The hot towels are replaced with one cold towel for ten minutes. The same procedure is done on the back of the patient. During the hot portion of the hydrotherapy, the upper blood vessels are dilated while the deeper ones constrict. The cold portion of the treatment constricts the outer blood vessels but dilates the internal ones. The combination drives more blood to both the inner and outer systems, allowing the body to bring more healing nutrients to its organs and to carry away toxins.

Bernard Lust, considered the founder of naturopathic medicine, was cured of tuberculosis through hydrotherapy. According to Jared Zeff, N.D., L.Ac., former academic dean of the National College of Naturopathic Medicine, hydrotherapy is often used to treat terminal illnesses, such as cancer, as well as simple colds and infections.14

Dr. Zeff shares an example of how nutrition and hydrotherapy can be used together to heal an arthritic condition:

A man came to him with severe arthritis. This gentleman had artificial knees, artificial finger joints, and artificial hip joints, and he still had severe pain and swelling throughout his entire body. Dr. Zeff recommended that he eat nothing in the next week except vegetable soup (no potatoes) and to do hydrotherapy daily. Within a few days, the man's arthritis pain had greatly decreased and his swelling had decreased by 50 percent.

Naturopathic physicians often find that simple dietary changes and hydrotherapy effectively treat many illnesses.

Homeopathy
Homeopathy is used by many naturopaths and is a primary treatment in their practices. Based on the "law of similars," it uses minuscule doses of naturally occurring substances to treat illness. Naturopaths have found that homeopathy fits well into their philosophical principles, since it stimulates the body's own immune system without producing unpleasant side effects. It is also documented to be effective for many illnesses, including migraines, headaches, rheumatoid arthritis, acute diarrhea, flu, and allergies.

The history of homeopathy's use spans two hundred years. Many countries embrace it as a viable healing treatment, including England, whose Royal family retains the services of a homeopath for their personal health care.

Herbs
Herbs are used by naturopathic physicians as medicine. As such, they can be extremely powerful and beneficial when used in the right dosage and in the correct combination with other herbs.

Though herbs are the main ingredient for some of the drugs used in conventional medicine, N.D.'s use herbs in a different manner than M.D.'s use them. Most drugs prescribed by M.D.'s are intended to impose an external order on the body. For example, a medicine prescribed to lower blood pressure forces the body to lower the pressure but doesn't correct the reason why the body has increased the pressure in the first place. Therefore, many patients taking blood pressure medicine as prescribed by a conventional medical doctor must continue to take blood pressure medication for the rest of their lives. Regrettably, the patient also endures the probable side effects: impotency, sexual dysfunction, and nervousness.

In contrast, an N.D.'s goal is not to impose an outside order but to correct the underlying problem. In the case of a weakened heart, an N.D. would accomplish this by using herbs that nourish and strengthen the heart, such as hawthorne berry, or herbs that disperse congestion or toxins in the body, such as dandelion root. When strengthening and detoxification occur, a patient's vitality becomes stronger, the root cause of the illness is addressed, and a permanent recovery becomes possible.

Consider the following story of a woman unable to move from the neck down: She sought the help of Dr. Zeff for an unusual type of arthritis called CNS Sjogrens Syndrome. Her symptoms included severe joint pain as well as an autoimmune lesion on the brain stem. She had the use of many of her muscles but was too weak to make them work for her. Also, her condition was irregular. One day, several months ago, she was able to walk, but for only three hours. This one fact indicated to Dr. Zeff that, unlike patients with multiple sclerosis, she didn't have nerve damage, and therefore had the possibility of recovery.

During Dr. Zeff's examination, he found that her temperature was consistently 94 degrees, which he considered to be the key to her recovery. Dr. Zeff concluded that in order for her to heal, her body temperature must go up. So he prescribed for her a combination of herbs that were warming and improved blood flow. After a couple of weeks, her temperature had risen to 96 and some days to 97 degrees. The rise in temperature has resulted in more control of her hands, greater ability to move her knees, and twice she has been able to drive her own wheelchair. Dr. Zeff's goal with this patient is to maintain a higher temperature to support her body's ability to correct the under-lying causes of her condition.

Chinese Medicine
The treatments and diagnostic techniques as well as the fundamentals of Chinese medicine are a part of all naturopathic physician's training at the accredited medical colleges. (See Chapter 7 for more detail about traditional Chinese medicine.) Some naturopaths do advanced training and become licensed practitioners of Chinese medicine, using Chinese herbs, acupuncture, and acupressure in their practice.

For example, Dr. Zeff is also a licensed practitioner of Chinese medicine, and recently used acupuncture to help in a difficult case. A man came to Dr. Zeff with significant pain in his abdomen, which was the site of a "bathrobe fire" ten years before. The man had been through a number of conventional medical diagnostic regimens to find out why he was still in pain. No matter what they tried, the M.D.'s could not determine what exactly was causing his pain. Dr. Zeff talked with this man for about an hour and, from his conversation and examinations, surmised that the scarring from the burn had disrupted the flow of chi along the meridians in the area. As a result of this diagnosis, Dr. Zeff treated the man with acupuncture in order to normalize the flow of chi in the affected area.

Once the man had reclined on the treatment table, Dr. Zeff inserted five acupuncture needles, two in each foot and one in a point on the abdomen. After the insertion of the needles, the man first reported that the needle in the abdomen hurt. Then he said he felt movement and activity in the area. Then, after ten minutes, he said that he felt no pain � the first time in ten years.

The techniques of Chinese medicine can bring impressive and surprising results to many health care challenges and is considered an exceptional treatment for acute and chronic pain.

Natural Childbirth
Natural childbirth is offered by some naturopathic physicians in either a home or a clinic environment. N.D.'s are trained in natural prenatal and postnatal care involving noninvasive, nonpharmaceutical treatments. Through their treatments and techniques, N.D.'s continuously screen to make sure the mother and child are in a low-risk state. One important screening involves monitoring the mother's diet and supplements to ensure that the mother's inner nutrients are sufficient to create a healthy, normal baby. Naturopathic theory suggests that adequate nutrient levels in the mother minimize childbirth risks.

Naturopathic physicians believe counseling is an important component of their jobs as facilitators for childbirth care. Dr. Zeff says that he requires the mother and partner to invite him and his assistant to dinner. "One factor that we found that can significantly disrupt a birth is the emotional state of the mother," he says. "If, during our dinner time with the mother/couple, we notice any significant stress, then we know that counseling will be needed to minimize the mother's emotional distress so that she can relax during labor and have a normal birth."15

N.D.'s use many different treatments during the various stages of gestation and birth, including some that most conventional doctors are unfamiliar with. For instance, some N.D.'s use homeopathy before labor begins to help a breach baby turn to the correct "head-down" position. In some cases, the homeopathic remedy Pulsatilla is used when the baby is not yet in the right position for delivery. Naturopathic physicians have seen that within twelve hours of giving a dose of Pulsatilla to the mother, the baby turns by itself. Another remedy used by naturopathic physicians is a preparation of the herb cottonroot. This herb, usually given to the mother in tincture form, helps bring the placenta down if she has not delivered it within a normal time.

Although N.D.'s are well trained in most birthing situations, they are also quick to refer mothers to the appropriate M.D. or hospital if a risk is present that disqualifies the mother and child from a natural childbirth experience.

Counseling and Stress Management
Naturopathic physicians believe the patient's emotional and psychological makeup can greatly influence the patient's ability to heal. Therefore, they are trained in many psychological techniques, including counseling, stress management, hypnotherapy, biofeedback, and nutritional balancing.

Minor Surgery
Most people would be surprised to know that minor surgery is a part of some naturopathic physicians' practices. In addition to natural treatments of illnesses, N.D.'s are also trained to mend surface wounds; to remove unwanted foreign masses, cysts, and other superficial bodies with local anesthesia; as well as to perform circumcisions, skin lesion removal, hemorrhoid surgery, and setting of fractures.

Ayurvedic Medicine
Ayurvedic medicine is an ancient system of holistic medicine and healing from India. Its focus is on treating the whole person with diet, nutrition, and lifestyle recommendations. One of the key components of this system of healing is an appreciation of the role that one's vital energy, called "prana," plays in the healing process. Bastyr University now offers a specialization in this ancient system of medicine. As a result, some N.D.'s have earned specialty degrees in ayurvedic medicine and have incorporated it into their practices.

Physical Medicine
Naturopathic physicians use a combination of manipulative therapies, which move soft tissue as well as skeletal bones. These are collectively called naturopathic manipulative therapy and in some ways are similar to the techniques used by osteopathic physicians, chiropractors, massage therapists, and body workers in that structure is realigned to support the innate healing process of the body.

Not all naturopathic doctors use this as a major component of their practice. However, when other treatments fail to bring the desired response, then manipulative therapies can be helpful.

One gentleman who had tried a wide range of treatments to correct the weakness and pain he felt in his own right arm went to his N.D. for manipulative treatments. The N.D. found that the man had a combination of muscle spasm from stress and spinal misalignment. As a result, the nerve flow necessary for normal muscular activity was being blocked. The N.D. treated this man with manipulative therapy. The result: the gentleman felt better than he had in six months.

Misalignment of the spinal vertebrae as well as other skeletal structures can be the cause of pain or even illness in some cases. The return of vertebrae, bones, and joints to their optimal position can eliminate pain in as little as one treatment.

I had just arrived for a visit at the home of Rosalynd, an ill friend. "Don't fill that prescription!" I remember her exclaiming to her husband. She had just returned from her M.D.'s office. Her voice riddled with frustration and anger, she continued, "I've got cancer! Why would I use a lotion made with a carcinogen?!?"

Rosalynd was literally fighting for her life. Yet she couldn't get a decent night's sleep because of the tremendous itching she felt from the psoriasis that covered her upper body. To relieve her discomfort from psoriasis, her M.D. had prescribed a lotion containing coal tar derivatives. Many studies had verified that these derivatives can cause cancer and Rosalynd was well aware of it. Unfortunately, the prescribed lotion was her M.D.'s best solution.

While her husband got ready for work, I calmed her down by assuring her that we certainly wouldn't call the pharmacist to fill that particular prescription and suggested that we think about another solution to her psoriasis. Then Rosalynd and I remembered a doctor she had seen before, Konrad Kail, N.D., a well-respected naturopathic physician and at that time the newly elected president of the American Association of Naturopathic Physicians (AANP). We hoped he might have a better option.

I phoned Dr. Kail and reminded him of Rosalynd's case. I described the difficulty she was having sleeping from the itching of the psoriasis and asked for his advice. He was well aware that she was battling cancer and that her immune system was compromised. He was also aware that she had chosen to work with a European M.D. whose unique chemical treatment for cancer was unfamiliar to him. Dr. Kail decided to respect Rosalynd's choice to work with her M.D. on her cancer and therefore to treat only the symptom of her psoriasis � not the underlying cause of her illnesses.

To relieve her itchy skin, he suggested a lotion that he developed that had helped many of his other patients. I asked him for a list of the ingredients, which he gladly shared with me (the main ingredient being jojoba beans). He added, "You can be sure there are no carcinogens in this lotion." Rosalynd began using Dr. Kail's lotion. The following week she showed me that the lotion was working. I noticed that the large red scaly patches of skin on her arms and back were now smoother and a more natural color. When I asked her how she was feeling, she smiled and reported she was no longer kept awake by the terrible itching the psoriasis had caused. Three weeks later, Rosalynd proudly showed me that the psoriasis was completely gone.

I think it's possible that had Rosalynd's M.D. known of a nontoxic remedy, he would have offered it. I learned from this experience that most traditional medical schools do not teach nontoxic, noninvasive treatments. As a result, most M.D.'s are unaware of effective options like the herbal lotion prescribed by Dr. Kail. Fortunately I now know about naturopathic physicians. They are experts in nontoxic, noninvasive treatments and when I have a health care problem, I call them first.

Health Condition that Respond Well to Naturopathic Medicine
Naturopathic medicine is beneficial for a wide range of physical illnesses and conditions. Naturopaths claim that their ability to determine the underlying cause of the illness and to stimulate the body's own healing ability is why their medicine can be so effective where other systems of medicine are not.

One area where modern naturopathic medicine has been very effective is in the natural treatment of women's health problems. One series of clinical research studies for women suffering from cervical dysplasia (abnormal Pap smears) produced results in which of the forty-three women in the study, thirty-eight returned to normal Pap smears and normal tissue biopsy by using naturopathic medical treatments. Naturopathic medical formulas are also effectively being used as a natural alternative to hormone replacement therapy for women.16

An excellent example of naturopathic medical principles in action is the recent success of Dean Ornish, M.D., director of the Preventive Medicine Research Institute in Sausalito, California, in his work with heart disease. Dr. Ornish found that his patients with chronic coronary heart disease could actually reverse their conditions without drugs or surgery, a concept that before his study was not only discounted, but unheard of by the conventional medical profession. This extraordinary feat was accomplished through an extremely low-fat diet, stress reduction through meditation and yoga practices, modest exercise, and weekly participation in an emotional support group.17

Dr. Ornish's success validated naturopathic medicine's basic tenets and treatment approaches. Not only that, healing through nutrition, exercise, and stress management has now been recognized by many insurance companies, who reimburse for Dr. Ornish's program as an alternative to expensive and risky heart bypass surgery.

Another area where naturopathic medicine has proven to be effective is in preventative medicine and health maintenance. "I think the best position for N.D.'s is in the family practice," Dr. Kail says. "Naturopaths are the only physicians who have primary skills in health/risk analysis and disease prevention. We find that people do want more time with their physician, to be educated, to be given less toxic therapies. Most people are as yet unaware that naturopaths provide just those things." Kail says some of the benefits of using a naturopathic doctor are safer medicine, quicker recovery time, and, especially, prevention of future illness. "I tell my patients what they can do at home to keep themselves healthy," he says. "If we do our job right, then they don't have to see a [conventional] doctor as much. That saves money."17

Also, given that naturopaths are trained in natural childbirth, with their noninvasive and natural treatments, N.D.'s are able to avoid many of the complications associated with childbirth. The result is that births overseen by N.D.'s require far fewer cesarean sections than with conventional medical care.

Naturopathic medicine, although effective, does have its limitations. "The areas of expertise and efficacy of naturopathic medicine are not the same as conventional medicine," Dr. Zeff explains. "Conventional medicine excels in acute trauma care. We do not. If I were in an automobile accident, I'd want them to take me to a hospital where they can patch me up. The areas where I would not go to a naturopath are acute trauma, childbirth emergency, and orthopedic problems that require orthopedic surgery."19

Naturopathic medicine has been shown to be an effective approach for the treatment of ear inflammations, infections, and respiratory illnesses, as well as degenerative illnesses. Recently the National Institutes of Health took note of naturopathic medicine's success with terminal diseases and granted Bastyr University almost $1 million to research the effects of alternative therapies on HIV and AIDS patients. Leanna Standish, N.D., Ph.D., research director at Bastyr University of Natural Health Sciences and advisor to the Office of Alternative Medicine, states that initial research has found enhanced immune response and a decline in the progression of AIDS, when compared to the control study who only received conventional medical therapy.20

Whether patients need help in health maintenance or a reversal of a devastating disease, naturopathic medicine is a viable option worthy of consideration. If you decide to try the skills and expertise of a naturopathic physician, use the following questions to help you make your decision.

Additions to Step Two: Get Good Referrals
The best referral source for licensed naturopathic physicians who have graduated from an accredited four-year naturopathic medical college is the American Association of Naturopathic Physicians (AANP). For a small fee, they will send you a list of qualified members who have satisfied their stringent requirements.

Additions to Step Three: Screen the Candidates
Once you have a few naturopathic physicians to investigate, call their offices and ask to speak to someone on the staff. Asking well-targeted questions can assist you in determining if this is a good doctor for you. Here are a few suggestions:

What is the doctor's educational background?
If naturopathic medicine is new to you, it would be ideal if you could work with an N.D. who has completed all the hours of study and clinical residency to graduate from one of the three accredited naturopathic colleges: Bastyr University of Natural Sciences in Seattle, Washington; National College of Naturopathic Medicine in Portland, Oregon; the Canadian College of Naturopathic Medicine in Toronto, Ontario, Canada. A fourth college, Southwest College of Naturopathic Medicine and Health Sciences in Scottsdale, Arizona, is in the accreditation process.

However, since there are only about one thousand naturopathic physicians from these medical schools practicing across the nation, it is possible that a graduate of one of these institutions will not be available to you. In that case, you will need to determine if you want to work with a respected practicing naturopath in your area who received their education and training from other sources, such as competent apprenticeship programs and other viable training. Given that this particular group of naturopaths has not necessarily met the high standards required by the AANP, it is extremely important to use seven to ten years of full-time clinical experience as a guide when determining the competency of a naturopath who has not been formally trained at one of the accredited naturopathic medical schools.

Be very careful to thoroughly investigate N.D.'s who are not graduates of the three accredited naturopathic colleges. Not all "naturopaths" with the initials "N.D." after their name have competent training or the necessary expertise. For instance, some practitioners have been awarded Doctors of Naturopathy ("N.D.") after graduating from a mail-order school. These graduates have had possibly no clinical residency and significantly fewer hours of education, than required of graduates of the accredited naturopathic medical colleges. Training from a mail-order school is considered insufficient to legally gain licensure as an N.D. in the states that license naturopathic physicians as primary-care providers.

Knowing your practitioner is a well-trained, licensed N.D. assures a dependable level of competence. Someone who does not have that background can certainly be a risky choice and must be thoroughly investigated before beginning treatment.

Does the naturopath have experience with my condition?
Find out how many patients with your health care problem this doctor has successfully helped. The higher the number of successes by the naturopath, the better for you. Ask to talk to some of those patients. Make sure all your questions about their background, training, and expertise have been answered to your satisfaction before beginning treatment.

What is the doctor's specialty?
In most cases, in naturopathic medicine the answer to this question will be given in the types of treatment the N.D. specializes in rather than in specific physical conditions. Dr. Zeff explains, "We don't tend to specialize in systems like medical conventional doctors do, but we tend to create affinities for various therapeutic methods."21 For instance, due to Dr. Kail's training in conventional medicine, he tends to prescribe antibiotics to avoid bacterial complications, while Dr. Jared Zeff, who is also a licensed acupuncturist, tends to use more alternative treatments.

Does the doctor use health care techniques not taught in his or her formal training at medical school? If so, what are they, what training has the doctor had in them, and how long have they used them in practice?

Naturopathic medical education includes a wide variety of alternative health care modalities, but not all. Make sure your doctor is well trained in any technique that he or she may recommend for your recovery. Check for credit hours, board certifications, and certificates of completion.

Will my insurance cover naturopathic care?
There are about seventy health insurance companies that cover naturopathic medical fees at this time. Most naturopathic offices carry a list of insurance carriers that cover naturopathic medicine and should be able to verify whether your insurance company will reimburse you for their services.

Is this N.D. licensed?
At this writing, there are twelve states that license N.D.'s as primary-care providers: Alaska, Arizona, Connecticut, Florida, Hawaii, Maine, Montana, New Hampshire, Oregon, Utah, Vermont, and Washington. It is believed that by the year 2010, all fifty states will license naturopathic physicians.

If you live in a state where N.D.'s are not yet licensed, but you would still like to work with a naturopathic physician, there are four types of practitioners who call themselves "naturopaths" or "N.D.'s" that you will find in an "unlicensed" state:

The first type of practitioner:

  • Has graduated from an accredited naturopathic medical school
  • Is a recognized member of the American Association of Naturopathic Physicians
  • Is licensed to practice in one of the "licensable" states

    This practitioner is qualified to see you for almost any health condition.

    The second type of practitioner:

  • Has not graduated from one of the accredited naturopathic medical schools
  • May have received a degree or certification from a correspondence school
  • Has at least seven years of clinical experience through apprenticeship with a qualified naturopath coupled with full-time personal practice

This practitioner may be qualified enough to help you. However, it is essential that you investigate their exact education and training to make sure they are competent for your needs. Jim Massey, N.D., of Portland, Oregon, admits, "Not all effective healers have initials after their names."22

An example of an exceptional naturopathic practitioner who does not have the "N.D." initials after her name is Yvonne Sklar of Hermosa Beach, California. Yvonne is proficient at integrating holistic health alternatives and has provided service for thousands of people worldwide over the last twenty-five years. She earned her Master Herbalist Certification from John Christopher's School of Natural Healing in Utah, and received her certification in iridology from Bernard Jensen, D.C., and is a direct prot�g� of his. She has also received extensive training in fasting and tissue cleansing procedures. Yvonne is currently working alongside Dr. Hans Gruenn, M.D., at his practice in Marina Del Rey, California. Her main diagnostic and treatment tools are iridology, nutrition, and herbs. The following is a story of how she helped one gentleman with psoriasis:

In July, 1985, I was eating at an outside cafe on the Strand in Hermosa Beach on a very hot summer day. While I was enjoying my lunch, a large robust Hawaiian man sat down at a table in front of me. It was obvious that something was amiss with him because he was fully clothed in a thick long-sleeved turtleneck shirt and long pants during a heat wave. His female friend, on the other hand, was dressed in a bathing suit top, shorts, and rollerblades.

As he settled into his chair, he pushed up his sleeves above each elbow and exposed a severe case of psoriasis that looked like lizard skin - overlapping dark scales. I realized then that he was fully clothed to hide a severe psoriasis condition which covered his entire body. My companion said, "You must give this poor man your business card. He must be in great pain." I replied that approaching him would be an intrusion of his privacy, but I secretly hoped that he would somehow find his own way to me.

Two weeks later, to my complete surprise, that same female companion of the Hawaiian man literally rolled into my office on her rollerblades. She was followed by the large Hawaiian gentleman. After introductions were made, I explained to the man that I had lived in Hawaii for many years and was familiar with the local diet (which consisted mainly of "poi," a combination of taro root, white rice, and pork). I asked the man how much poi he was eating a day. When he told me he was eating eight large bowls a day, I knew where his psoriasis came from.

I admitted to him that I had seen him on the Strand and noticed his psoriasis. I said that I guessed that it covered his body. He hung his head as if he were responsible for some crime and sadly replied, "I am in such pain. I cannot live a normal life. Can you help me?" I said, "No more poi! That's what you have on your skin!"

After I examined the irises of his eyes, I gave him the following treatment:

Herbs: Cascara Sagrada, Hops, Valarian, Scullcap, Mullein, Bayberry, Goldenseal, Juniper, Capsicum, Burdock, Comfrey, Black Walnut, Horsetail, Sage.

Supplements: Liquid Dulse, Calcium, Selica, Niacin, 2 - 4 cups of Oat Straw tea daily, carrot and celery juice with liquid chlorophyll.

Treatments: Hydrotherapy, massage and dry skin brushing; aloe vera juice - topically and orally.

Dietary Changes: no pork, no poi, lots of vegetables and fruit, a few complex carbohydrates and a little chicken.

Exercise: Moderate.

In two to three months, his skin was completely clear. He now wears shorts, sandals, and short-sleeved T-shirts. He looks like a healthy, slim Hawaiian with beautiful skin and I hear from his friends that he is happily enjoying the beach. After his skin recovered, I never saw him again. However, he has sent me dozens and dozens of patients over the years. Most recently, three good-looking construction men with bad diets!23

Finding a naturopathic practitioner who is not an "N.D." and yet is also well trained and experienced like Yvonne is unusual, but not impossible. Again, if you are interested in trying naturopathic medicine but do not have an N.D. in your area, ask other respected alternative providers if they know of a good naturopath. Be sure to investigate the naturopath's training thoroughly.

The third type of practitioner:

  • Has not graduated from one of the accredited naturopathic medical schools
  • Received his or her degree from a correspondence school
  • Has not gained enough training and experience to competently treat you in naturopathic medicine

    We do not recommend that you work with practitioners in this category.

    The fourth type of practitioner:

  • Has no formal educational training
  • Has voluntarily designated him- or herself a "Naturopath" or an "N.D."
  • Has little or no training to competently treat you

Working with someone in this category can be dangerous. We do not recommend practitioners in this category.

Take extra screening precautions before agreeing to treatment with any practitioners of naturopathic medicine who are not graduates of one of the three accredited naturopathic medical colleges.

Additions to Step Four: Interview the Candidate
During an interview with a naturopathic physician, find out the personal philosophy of the naturopath. "I would need to know that I could trust the doctor and if they were well trained," Dr. Zeff suggests. "I would talk to them about what their ideas are about the nature of disease, the nature of my problem, and what approach they would take to improve it. I would ask how long I could expect improvement to take and what kinds of costs are involved. The most important thing is to get a sense of who this person is, what they have to offer, as well as their credentials. You are an individual. So choose someone who fits with you."24

If you're looking for an N.D. who is caring and capable, you may find your search fairly easy since naturopathic physicians value the healing power that can happen in the relationship between doctor and patient. Most take the time and effort to develop a good rapport with their patients.

What to Expect During a Naturopathic Medical Appointment
Naturopathic physicians use specific treatment(s) that can include homeopathy, Ayurveda, and Chinese medicine, or the traditional naturopathic approach of nutrition, herbology, and hydrotherapy in their practices. These "specialties," in addition to the specific health condition of the patient, make a session with each naturopath a unique experience. However, there are some standard procedures that all naturopathic physicians use.

The Office Visit
Most N.D.'s send questionnaires to new patients that ask many personal health history questions. During a first visit, which usually lasts about an hour and a half, these questionnaires are reviewed. In addition, the N.D. will ask many lifestyle questions regarding diet, vitamin and mineral supplements taken, sleep patterns, work conditions, smoking habits, and sugar and coffee intake. In addition, some standard medical diagnostic tests are administered, such as a physical exam, and blood and urine tests.

Some naturopathic physicians also add to the first visit tests such as the Heidelberg test, which measures digestive dysfunction through gauging stomach acidity, and the urine indican test, which measures levels of toxemia.

Dr. Kail, both an N.D. and a physician's assistant, describes some differences between a visit to an M.D. and an N.D. "I found the N.D.'s do the same basic diagnosis as the M.D.'s," he says. "Naturopathic physicians go a step further and add more examinations than the typical medical doctors. For instance, digestion analysis, spinal screening, disease prevention, diet, and stress factors."25

Once an N.D. has made a diagnosis, the treatments prescribed will be based on the N.D.'s adherence to the fundamental principles of naturopathic medicine and to their specialty. Sometimes N.D.'s will give their patients a choice of treatments if they have a preference. "If I see a patient who has pain in his arms because his neck is out of alignment," Dr. Kail says, "I explain to them that we can do spinal adjustments, acupuncture, homeopathy, or we can do all three. Then I wait for their choice."26

Generally, follow-up visits with an N.D. last between thirty and forty-five minutes and involve a continuation of the treatment plan as well as an evaluation of progress.

COST AND INSURANCE

Cost
According to the American Association of Naturopathic Physicians [AANP], sessions with naturopathic physicians are about half the cost of visiting an M.D. Because naturopaths primarily rely on their own diagnostic skills, costs for extensive tests are usually minimal. This can substantially reduce the cost of naturopathic health care.

Also, naturopathic physicians are well trained in preventative medicine. Many insurance companies are realizing the long-term savings of keeping their plan members healthy. Naturopathic physicians excel at preventative medical techniques and can pass those long-term savings on to you.

Initial office visits are usually between $75 and $100 and follow-ups are in the range of $35 - $50. The prescribed supplements are usually vitamin, mineral, herbal, and/or homeopathic. Each of these supplements are far less expensive than prescriptions filled at the pharmacy. However, in the states of Arizona, Oregon, and Washington, N.D.'s are licensed to prescribe antibiotics, thyroid medicine, progesterone, as well as other drugs that may end up costing you more.

Insurance
As mentioned above, a growing number of insurance companies have recognized the value of preventative health care, a specialty of naturopathic medicine. For this reason, naturopathic medicine is being covered by more and more insurance plans. If you are fortunate enough to live in the states of Connecticut or Washington, naturopathic medical coverage is mandatory by law from all health insurance companies.

For a list of insurance carriers that cover naturopathic medicine, call the AANP or your local naturopathic physician's office. Many N.D.'s carry a list of insurance providers who cover their services.

One insurance plan that has given special attention to naturopathic coverage is American Western Life Insurance Company of Foster City, California. Their "Wellness" medical director, Marcel Hernandez, is an N.D. American Western Life provides a twenty-four-hour hot line where you can talk directly to a licensed naturopathic physician at any time, day or night. In addition, they cover all naturopathic treatments, including homeopathy, nutritional counseling, Ayurveda, massage, and physical therapy.

Education, Training and Licensing

Education and Training
Naturopathic physicians are well educated in the basic clinical sciences as well as natural and alternative diagnostic and treatment methods. According to the American Association of Naturopathic Physicians, "Naturopathic physicians (N.D.'s) are general practitioners trained as specialists in natural medicine. They are educated in the conventional medical sciences, but they are not orthodox medical doctors (M.D.'s). Naturopathic physicians treat disease and restore health using therapies from the sciences of clinical nutrition, herbal medicine, homeopathy, physical medicine, exercise therapy, counseling, acupuncture, natural childbirth, and hydrotherapy. They tailor these approaches to the needs of an individual patient."27

Graduates of accredited four-year naturopathic medical schools are justifiably proud of their education. "Essentially, naturopathic medical training is similar to conventional medical training," Dr. Zeff explains. "The first two years are virtually the same as any medical school: anatomy, physiology, microbiology, biochemistry, etc. They are taught at the same level as any other medical school. If you look at the number of hours in our classroom situation, you'll find in most cases the number of hours we spend exceeds most medical schools." He adds, "We are required fifteen hundred hours of clinical education as a minimum to graduate from the school. This is under the supervision of naturopathic doctors."28 Medical educators and legislators have been impressed with the high standard of education required of naturopathic physicians.

Licensing
There are currently twelve states in the U.S. and five provinces in Canada that license naturopathic doctors as primary care physicians: Alaska, Arizona, Connecticut, Florida, Hawaii, Maine, Montana, New Hampshire, Oregon, Utah, Vermont, Washington, Alberta, British Columbia, Manitoba, Ontario, and Saskatchewan. All other states in the U.S. have licensable, trained naturopaths practicing. In these states, many N.D.'s who graduated from an accredited four-year college opt to apply for licenses in other health care modalities, such as acupuncture or chiropractic, in order to stay protected by law. Others choose to practice without protection of the law. In most states, naturopathic medicine is "alegal" (neither "legal" nor "illegal"). In these states, naturopathic medicine is neither protected nor regulated. Regrettably, this can be somewhat confusing for the health care consumer.

Jim Massey, N.D., says, "When I was in North Carolina, there must have been thirty people practicing as N.D.'s. Only four of them had been to four-year medical schools. You could pay $25 and set up a tax I.D. number and start practicing immediately. You'd have to kill somebody before they'd come after you for practicing without a license. It isn't fair to the public to be duped by these people with the phony initials after their names."29

Again, to protect yourself and your health, call the American Association of Naturopathic Physicians. They represent the largest contingency of licensed naturopathic physicians who have graduated from an accredited school.

Closing Thoughts

Licensed naturopathic physicians are filling an important need as primary health care providers who are experts in nontoxic, noninvasive treatments. As highly skilled and well educated about the human body as graduates of Stanford or Yale medical schools, they bring the best of ancient natural treatments and scientific research to their medicine. Naturopathic medicine could serve you as well as the growing number of Americans who are calling their naturopathic physician first for their health care needs.

Notes

1. Senator Claiborne Pell. Personal letter to Mrs. Hillary Rodham Clinton, March 31, 1993.
2. Burton Goldberg. Alternative Medicine: The Definitive Guide (Future Medicine Publishing, 1993), 360.
3. Bastyr University press release, October 4, 1994.
4. "Naturopathic and Major Medical Schools, Comparative Curricula." Document from the American Association of Naturopathic Physicians.
5. "Twenty Questions About Naturopathic Medicine." Document from the American Association of Naturopathic Medicine.
6. "Naturopathic and Major Medical Schools: Comparative Curricula." Document from the American Association of Naturopathic Physicians.
7. William Collinge. The American Holistic Health Association Complete Guide to Alternative Medicine (Warner Books, 1996), 125.
8. NIH. Alternative Medicine: Expanding Medical Horizons (U.S. Government Printing Office, 1993), 88.
9. American Association of Naturopathic Physicians brochure.
10. Ibid.
11. Bastyr University press release, February 27, 1995.
12. American Association of Naturopathic Physicians brochure.
13. Stephen Speidel, N.D. Personal interview, Summer 1990.
14. Jared Zeff, N.D., L.Ac., Personal interview, June 1996.
16. NIH. Alternative Medicine: Expanding Medical Horizons (U.S. Government Printing Office, 1993), 89.
17. Dean Ornish, M.D. Dr. Dean Ornish's Program for Reversing Heart Disease (Ivy Books, 1996).
18. Konrad Kail, N.D. Personal interview, Fall 1990.
19. Jared Zeff, N.D., L.Ac. Personal interview, June 1996.
20. "NIH Exploratory Study Coordination Centers for Alternative Medical Research." NIH Office of Alternative Medicine press release, June 1995.
21. Jared Zeff, N.D., L.Ac. Personal interview, June 1996.
22. Jim Massey, N.D. Personal interview, August 1990.
23. Yvonne Sklar. Personal correspondence, July 1996.
24. Jared Zeff, N.D., L.Ac. Personal interview, June 1996.
25. Konrad Kail, N.D. Personal interview, Fall 1990.
26. Ibid.
27. American Association of Naturopathic Physicians brochure.
28. Jared Zeff, N.D., L.Ac. Personal interview, June 1996.
29. Jim Massey, N.D. Personal interview, Summer 1990.


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