Principles of Healing
The practice of naturopathic medicine emerges from six principles of healing. These principles are based on the objective observation of the nature of health and disease and are examined continually in light of scientific analysis.
These principles stand as the distinguishing marks of the profession:
The healing power of nature -- vis medicatrix naturae
The body has the inherent ability to establish, maintain, and restore health. The healing process is ordered and intelligent; nature heals through the response of the life force. The physician’s role is to facilitate and augment this process, to identify and remove obstacles to health and recovery, and to support the creation of a healthy internal and external environment.
Identify and treat the cause -- tolle causam
Illness does not occur without cause. Underlying causes of disease must be discovered and removed or treated before a person can recover completely from illness. Symptoms are expressions of the body’s attempt to heal, but are not the cause of disease; therefore, naturopathic medicine addresses itself primarily to the underlying causes of disease, rather than to the symptoms. Causes may occur on many levels, including physical, mental-emotional, and spiritual. The physician must evaluate fundamental underlying causes on all levels, directing treatment at root causes as well as seeking relief of symptoms.
First do no harm -- primum no nocere
The process of healing includes the generation of symptoms, which are, in fact, expressions of the life force attempting to heal itself. Therapeutic actions should be complementary to and synergistic with this healing process. The physician’s actions can support or antagonize the actions of vis medicatrix naturae; therefore, methods designed to suppress symptoms without removing underlying causes are considered harmful and are avoided or minimized.
Treat the whole person -- in perturbato animo sicut in corpore sanitas esse non potest
Health and disease are conditions of the whole organism, involving a complex interaction of physical, spiritual, mental, emotional, genetic, environmental, and social factors. The physician must treat the whole person by taking all of these factors into account. The harmonious functioning of all aspects of the individual is essential to recovery from and prevention of disease, and requires a personalized and comprehensive approach to diagnosis and treatment.
The physician as teacher -- docere
Beyond an accurate diagnosis and appropriate prescription, the physician must work to create a healthy, sensitive interpersonal relationship with the patient. A cooperative doctor-patient relationship has inherent therapeutic value. The physician’s major role is to educate and encourage the patient to take responsibility for his or her own health. The physician is a catalyst for healthful change, empowering and motivating the patient to assume responsibility. It is the patient, not the doctor, who ultimately creates or accomplishes healing. The physician must strive to inspire hope as well as understanding. The physician must also make a commitment to her/his personal and spiritual development.
Prevention -- principiis obsta: sero medicina curatur
The ultimate goal of naturopathic medicine is prevention. This is accomplished through education and promotion of lifestyle habits that foster good health. The physician assesses risk factors and hereditary susceptibility to disease and makes appropriate interventions to avoid further harm and risk to the patient. The emphasis is on building health rather than on fighting disease. Because it is difficult to be healthy in an unhealthy world, it is the responsibility of both physician and patient to create a healthier environment in which to live.
History of Naturopathic Medicine
The roots of naturopathic medicine go back thousands of years, drawing on the healing wisdom of many cultures including Indian (Ayurvedic), Chinese (Taoist), Greek (Hippocratic), Arabian, Egyptian, and European (monastic medicine) traditions.
With the age of scientific inquiry, medicine took on exciting dimensions and developed new tools for fighting disease. In fact, many older time-tested healing and health maintenance methods were discarded at a rapid rate as doctors began treating disease almost solely with surgery and drugs.
Some practitioners in Europe and America, however, perceived that valuable, empirically proven natural therapies were being lost, and struggled to retain the practice of promoting health through stimulation of the vital force and the rational use of natural agents.
As a distinct American health care profession, naturopathic medicine is 100 years old, tracing its origins to Dr. Benedict Lust and Dr. Robert Foster. Dr. Lust came to the United States from Germany to practice and teach the hydrotherapy techniques popularized by Sebastian Kneipp in Europe.
A committee of Kneipp practitioners met in 1900 and determined that the practice should be expanded to incorporate all natural methods of healing, including botanical medicines, nutritional therapy, physiotherapy, psychology (mind-body connection), homeopathy and the manipulative therapies. They called their profession “Naturopathy.”
The first school of naturopathy was founded by Dr. Lust in New York City and graduated its first class in 1902. During the same period, Dr. Foster founded a similar institution in Idaho that trained the early naturopathic pioneers responsible for establishing licensing laws in Oregon and Washington states.
Naturopathic medical conventions in the 1920s attracted more than 10,000 naturopathic physicians. There were more than 20 naturopathic medical colleges, and N.D.s were licensed in a majority of states. Naturopathic medicine experienced a decline in the 1940s and ’50s with the rise of pharmaceutical drugs, technological medicine, and the idea that drugs could eliminate all disease. As one after another N.D. degree program closed down, National College of Naturopathic Medicine was founded to keep the medicine alive. The drop-off in popularity was so steep that during its first 20 years, National College of Naturopathic Medicine graduated only 70 students. From its founding in 1956 until 1979, when three of its alumni founded John Bastyr College (now Bastyr University) in Seattle, it was the only naturopathic college in the U.S.
While naturopathic medicine has been present in the United States for a century, National College of Natural Medicine, the oldest accredited naturopathic medical school in North America, is less than half as old. NCNM has been at the center of the profession, preserving and extending the legacy of naturopathic medicine, founded by those who started practice in the 1920s and ’30s, and training those who would follow them generations later. The profession has experienced a resurgence in the past two decades as a health-conscious public has sought alternatives for conditions that conventional medicine has not adequately addressed.
Since the late 1970s, three more naturopathic colleges have opened, and National College of Natural Medicine’s enrollment has quadrupled. This growth is in direct response to the changing needs of our society; not only is the public demanding a medical model in which the individual plays a more active role in her/his health and healing process, but doctors also want a medical model that is more patient-centered and holistic.
NCNM is alma mater to more than 1200 naturopathic physicians who practice in nearly every state and province and many foreign countries. Many are nationally recognized spokespersons and teachers as well as successful physicians who have gone on to found new naturopathic colleges. National College of Natural Medicine alumni have also founded professional associations to promote and expand naturopathic medicine. This is an exciting time to join the profession and help make history in the field of naturopathic medicine.
Scope of Practice
The scope of practice of naturopathic physicians (N.D.s) varies by jurisdiction. Currently, eleven states, Puerto Rico, and five Canadian provinces license naturopathic physicians. Several of these jurisdictions regard N.D.s as primary care physicians and provide them with the scope of diagnostic and therapeutic privileges necessary to be the doctor first seen by the patient for general health care, for advice on keeping healthy, and for the diagnosis and treatment of acute and chronic conditions. In those jurisdictions in which N.D.s are not licensed, the scope of practice excludes the diagnosis and treatment of disease.
The naturopathic physician is defined by the U.S. Department of Labor 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 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 prescribing 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.”
The therapeutic modalities used by N.D.s are described below. It should be noted that the state of Utah requires a one-year residency before licensing N.D.s. Like other physicians, recently graduated N.D.s are encouraged to seek additional clinical experience under the supervision of a licensed physician, in the form of residencies and mentorships.
Botanical Medicine: Many plant substances are powerful medicines. Where isolated chemically derived drugs may address only a single problem, botanical medicines are able to address a variety of problems simultaneously. When properly utilized, most botanical medicines can be applied effectively with minimal likelihood of side effects.
Clinical Nutrition: Food is the best medicine and is a cornerstone of naturopathic practice. Many medical conditions can be treated more effectively with foods and nutritional supplements than they can by other means, with fewer complications and side effects. N.D.s use diet, natural hygiene, fasting, and nutritional supplementation in their practices.
Homeopathic Medicine: Homeopathic medicine is based on the principle of “like cures like.” Clinical observation indicates that it works on a subtle, yet powerful, energetic level, gently acting to promote healing on the physical, mental, and spiritual levels.
Mind/Body Medicine: Mental attitudes and emotional states may influence, or even cause, physical illness. Counseling, nutritional balancing, stress management, hypnotherapy, biofeedback, and other therapies are used to help patients heal psychologically.
Minor Surgery: Naturopathic physicians do in-office minor surgery, including repair of superficial wounds and removal of foreign bodies, cysts, and superficial lesions.
Naturopathic Obstetrics/midwifery: Naturopathic physicians provide natural childbirth care in an out-of-hospital setting. They offer prenatal and postnatal care using modern diagnostic techniques combined with ancient midwifery wisdom. The naturopathic approach strengthens healthy body functions so that complications associated with pregnancy may be prevented.
Oriental Medicine: Within the N.D. program, Oriental medicine is a healing philosophy that is complementary to naturopathic medicine. Oriental medical theory offers an important understanding of the unity of the body and mind and adds to the Western understanding of physiology.
Physical Medicine: Naturopathic medicine has its own methods of therapeutic manipulation of soft tissue, muscles, bones, and spine. N.D.s also use ultrasound, diathermy, exercise, massage, water, heat and cold, and gentle electrical therapies.
Naturopathic practice also includes the use of any medical substances which contain elements that are components of bodily tissues or can be utilized by the body for the maintenance of life and the repair of tissues. All methods of diagnostic testing and imaging are used, including x-ray and ultrasound. The current scope of practice excludes major surgery and the use of many synthetic drugs.
“Scope of practice” is specifically defined by the legislation in the various states and provinces that license or regulate naturopathic medicine, and practice varies significantly among states, provinces, and countries.
Program of Study for Naturopathic Doctors
The N.D. degree course of study at National College of Naturopathic Medicine is an intensive four-year doctoral program that prepares candidates for state board licensing examinations and the general practice of naturopathic medicine. Upon graduation, alumni are eligible to sit for board examinations in states and provinces that license naturopathic physicians. The core, or required, curriculum provides the foundation and skills necessary for naturopathic family practice.
First year comprises the study of the normal structure and function of the body with a solid introduction to naturopathic theory, philosophy, and therapeutics.
Second year focuses on the study of disease and diagnosis with the beginning of the botanical, therapeutic manipulation, clinical nutrition, and homeopathic medicine sequences. To enter into the clinical training of the third year, students must pass all basic sciences and diagnostic courses as well as a clinic entrance examination.
Third year continues with focus on the botanical, manipulation, clinical nutrition, and homeopathic medicine sequences, begins the organ systems courses (which emphasize case management), and gives major emphasis to clinical training. Students must pass a clinical primary status exam to proceed in the clinic.
Fourth year continues the organ systems courses. The major focus of the fourth year is practical clinical training, working side by side with licensed physicians caring for patients. A clinic proficiency exam ensures clinical competency prior to graduation.
Because the program is rigorous and the course load heavy, students may choose to complete the N.D. degree in five rather than four years. In some cases, students may be required to be in the five-year track. The student may take no more than seven years to complete the program.
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