Naturopathic medicine
From Free net encyclopedia
Naturopathic medicine is defined by its practitioners as the practice of attempting to improve health through naturopathy, i.e. a method of treating disease, using food, exercise, heat, etc., that assists the natural healing processes (Webster Unabridged definition). It is practiced and regulated widely differently throughout most of the United States, but prohibited in two states. Because there are few reports of evidence based medicine trials for naturopathy it is considered a pseudoscience by some. (See discussion page).
Naturopathic medicine utilizes physiological, psychological and mechanical methods, such as air, water, light, heat, earth, phytotherapy, food and herb therapy, psychotherapy, electrotherapy, physiotherapy, minor and orificial surgery, mechanotherapy, naturopathic corrections and manipulation and natural methods or modalities, together with natural medicines, natural processed foods and herbs and natural remedies. Naturopathic medicine excludes major surgery, therapeutic use of x-rays and radium and the use of drugs, except those assimilable substances containing elements or compounds which are components of body tissues and are physiologically compatible to body processes for maintenance of life.[1]. Naturopathy is a broad term encompassing a variety of fields of practice.
Contents |
History of naturopathic medicine
The term naturopathy was coined before 1900, by John Scheel, and used by Benedict Lust. Lust had been schooled in hydrotherapy and other natural health practices in Germany by Father Sebastian Kneipp, who sent Lust to the United States to bring them Kneipp's methods. In 1905, Lust founded the American School of Naturopathy in New York, the first naturopathic college in the United States. Lust took great strides in promoting the profession, culminating in passage of licensing laws in several states prior to 1935, including Arizona, California, Connecticut, Hawaii, Oregon, and Washington and the existence of several naturopathic colleges.
Naturopathic medicine went into decline, along with most other natural health professions, after the 1930s, with the discovery of penicillin and advent of synthetic drugs such as antibiotics and corticosteroids in the post-war era, Lust's death, conflict between various schools of natural medicine (homeopathy, eclectics, physio-medicalism, herbalism, naturopathy, etc.), the rise of medical technology, and consolidation of political power in conventional medicine were all contributing factors. In 1910, when the Carnegie Foundation for the Advancement of Teaching published the Flexner Report which criticized many aspects of medical education in various institutions (natural and conventional), it was mostly seen as an attack on low-quality natural medicine education. It caused many such programs to shut down and contributed to the popularity of conventional medicine.
Naturopathic medicine never completely ceased to exist, however, as there were always a few states in which licensing laws existed—though at one point there were virtually no schools. One of the most visible steps towards the profession's modern renewal was the opening in 1956 of the National College of Naturopathic Medicine in Portland, Oregon. This was the first of the modern naturopathic medical schools offering four-year naturopathic medical training with the intention of integrating mainstream science and naturopathic principles and practice.
Naturopathic physicians and traditional naturopaths
There are two groups calling themselves "naturopaths" who have recently been engaged in legal battles. The term when originally coined by John Scheel, and popularized by Dr. Benedict Lust (a German name pronounced "loost") was to apply to those receiving an education in the basic medical sciences with an emphasis on natural therapies:
- Naturopathic physicians
- "Traditional" naturopaths
Naturopathic physicians
Naturopathic physicians are independent providers with training in conventional medical sciences, diagnosis and treatment, and natural therapeutics with licenses or registration granted by an individual state Naturopathic Board of Medical Examiners. They graduate from four-year nationally accredited naturopathic medical graduate schools. Naturopathic physicians training with respect to modalities is different, with a focus on nutrition, botanical medicine, homeopathy, hydrotherapy, physical manipulation, pharmacology, and minor surgery. Some naturopathic physicians have additional training in the following: natural childbirth, acupuncture, and Chinese medicine. These subspecialties often involve additional years of study. Naturopathic physicians are required to attend continuing education yearly in order to maintain and renew their license.
Naturopathic physicians are licensed to diagnose and treat disease in Alaska, Arizona, California, Connecticut, District of Columbia, Hawaii, Idaho, Kansas, Maine, Montana, New Hampshire, Oregon, Utah, Vermont, Washington, US Territories: Puerto Rico and Virgin Islands.
Naturopathic Physicians are working in cooperation with both conventional and alternative practitioners to provide patients with complete medical care. Naturopathic physicians can bridge disparate fields with their training in both conventional and non-conventional treatment. Naturopathic physicians are able to identify and prescribe appropriate treatment including referral to conventional medical doctors.
Traditional naturopaths
The traditional naturopathic doctor practices in a complementary fashion by applying natural means in an attempt to improve the patient's health. Through application of good dietary and lifestyle practices, combined with the addition of modalities such as herbalism (also known as botanical medicine), bodywork (also known as manual adjustment, physiotherapy, massage, physical medicine), spiritual and mental exercises; this type of naturopathic practitioner claims that he/she "returns control of the patient's mind and body to the patient. Naturopathic physicians consider these practices as being complementary rather than alternative.
The Principles of Naturopathic Medicine
Naturopathy is based on six tenets or principles [2][3]:
- "The healing power of nature"
- "Identify and treat the cause"
- "First do no harm"
- "Treat the whole person"
- "The physician as teacher"
- "Prevention"
"The healing power of nature"
The healing power of nature, has two aspects: first that the body has the ability to heal itself and it is the naturopathic doctor's role to facilitate this natural process, and second that nature heals. Following this principle includes getting enough sleep, exercising, feeding the body nutritional food and, if needed, additional earth food such as herbs and algae which is a living food. Plants can gently move a body into health without the side effects of synthetic chemicals like many pharmaceuticals.
"Identify and treat the cause"
The underlying root causes of disease must be removed for complete healing to take place. These root causes can exist at many levels: physical, mental, emotional, and spiritual. It is the naturopaths's role to identify this root cause, in addition to alleviate suffering by treating symptoms.
"First do no harm"
The process of healing includes the manifestations of symptoms, so that any therapy that interferes with this natural healing process by masking symptoms is considered suppressive and should be avoided. The natural life force of the individual should be supported to facilitate healing.
"Treat the whole person"
A core tenet of naturopathy is the belief that health must go beyond treatment of immediate symptoms (as with medicine), and instead treat the entire person's well being, that is to treat the entire body, as well as the spirit and mind.
"The physician as teacher"
It is the role of the naturopath to educate an individual in their practices and encourage that individual to "take responsibility for their own health." This cooperative relationship between doctor and patient is essential to healing.
"Prevention"
The ultimate goal of the naturopathic physician is prevention. The emphasis is on building health not fighting illness. This is done by fostering healthy lifestyles.
Regulation in North America
Jurisdictions that currently regulate naturopathic medicine include:
- U.S. jurisdictions with full licensure: Alaska, Arizona, California, Connecticut, District of Columbia, Hawaii, Idaho, Maine, Montana, Vermont, New Hampshire, Oregon, U.S. Virgin Islands, Utah, Washington
- U.S. state with registration for naturopathic physicians: Kansas
- U.S. jurisdictions with two-tier licensure: Puerto Rico
- U.S. states with legal basis for practice: Minnesota, Rhode Island
- U.S. states which specifically prohibit the practice of naturopathy: South Carolina, Tennessee
- Canadian provinces with full licensure: British Columbia, Manitoba, Ontario, Saskatchewan
Regulation in the United Kingdom
In the United Kingdom, naturopathy as a profession is very closely aligned with osteopathy. There is no government sponsored regulation of the profession, the largest body, The General Council & Register of Naturopaths recognises three courses in the UK, two being taught at osteopathic schools and one at Westminster University under the auspices of the B.Sc Health Science(Naturopathy)course. Members of this register will either have completed a three or four year full time degree level course or possibly be a healthcare professional (Medical Doctor, Osteopath, Chiropractor, Nurse) who has completed a two year post-graduate diploma. As the naturopathic profession has developed along different lines in the UK, naturopaths do not perform minor surgery or have prescribing rights.
Scope of practice
Since both naturopathic physicians and traditional naturopaths use the degree designation of N.D. (doctor of naturopathic medicine) there is considerable confusion about the scope of practice, education and training of a naturopathic practitioner. There is great contention between the two factions; naturopathic physicians and traditional naturopaths, as their political agendas are in opposition to each other. Naturopathic physicians, whose national professional organization is the American Association of Naturopathic Physicians, strive to recover licensure in all 50 states, whereas traditional naturopaths, whose professional organization is the American Naturopathic Medical Association, oppose licensure and often block licensing attempts. Negotiation is currently in progress between naturopathic physicians and traditional naturopaths to come to a resolution to this problem and agree to use different degree titles and designations, but so far this has not been a successful endeavour.
Science and naturopathy
There is scientific agreement that an evidence based medicine framework should be used to assess health outcomes and that systematic reviews with strict protocols are essential. Organisations such as the Cochrane Collaboration and Bandolier publish such reviews.
There are reports of evidence based medicine trials published for naturopathy. (See discussion page)
Some forms of naturopathy are pseudoscience. Medical doctors often cite the large differences between naturopathic practitioners and the lack of scientific documentation of the safety and efficacy of their practices in order to justify limiting naturopathic scope. Advocates claim that naturopathic practitioners find it difficult to obtain financing for research due to the lack of prior research in many areas. Proponents state that this is slowly changing as naturopathic physicians develop research programs to help build up a foundation for evidence based treatment.
Conventional medicine is required to undergo rigorous testing; drug trials often last for a decade. A criticism of alternative therapies is that they are not subject to detailed safety assessment, and can be harmful. This arises from another criticism which is that 'natural' does not necessarily correspond to being good or harmless.
See also
External links
Advocacy
Naturopathic physicians:
- American Association of Naturopathic Physicians
- Canadian Association of Naturopathic doctors
- What is Naturopathic Medicine? by Gary Piscopo, ND, LAc and Eric Yarnell, ND, RH
Traditional naturopaths:
Criticism
- Index to Information about Naturopathy – Quackwatch
- Naturopathy by Robert T. Carroll – The Skeptic's Dictionary
- The National Council Against Health Fraud
North American Schools
- National College of Naturopathic Medicine - Portland, Oregon
- Bastyr University - Seattle, Washington
- Southwest College of Naturopathic Medicine - Tempe, Arizona
- Canadian College of Naturopathic Medicine - Toronto, Ontario
- College of Naturopathic Medicine of University of Bridgeport - Bridgeport, Connecticut
- Boucher Institute of Naturopathic Medicine - New Westminster, British Columbia
- Association of Accredited Naturopathic Medical Colleges - Association of the six above schools
Australian Schools
- Australasian College of Natural Therapies - Sydney, New South Wales