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Naturopathic medicine
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Naturopathy (also known as naturopathic or natural medicine) is an alternative medicine which emphasizes the body's intrinsic ability to heal and maintain itself. Naturopaths use natural remedies such as herbs and foods rather than surgery or synthetic drugs. Naturopathic practice includes many different treatment modalities, with practitioners emphasizing a holistic approach to patient care. Practitioners sometimes recommend that patients seek the advice and care of a doctor to complement their naturopathic treatments.
Naturopathy has its origins in the Nature Cure movement of Europe.
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Encyclopedia
Naturopathy (also known as naturopathic or natural medicine) is an alternative medicine which emphasizes the body's intrinsic ability to heal and maintain itself. Naturopaths use natural remedies such as herbs and foods rather than surgery or synthetic drugs. Naturopathic practice includes many different treatment modalities, with practitioners emphasizing a holistic approach to patient care. Practitioners sometimes recommend that patients seek the advice and care of a doctor to complement their naturopathic treatments.
Naturopathy has its origins in the Nature Cure movement of Europe. It is practiced in many countries but subject to different standards of regulation and levels of acceptance.
In five Canadian provinces, fifteen US states and the District of Columbia, naturopathic doctors who are trained at an accredited school of naturopathic medicine in North America, are entitled to use the designation ND or NMD. Elsewhere, the designation is generally unprotected. Practitioners from these particular accredited schools are trained to use diagnostic tests such as imaging and blood tests before deciding upon the full course of treatment, and to refer to other health professionals for standard medical care where it is required. However, the scope of practice for Naturopathic doctors varies widely amongst jurisdictions, and naturopaths in unregulated jurisdictions may use the ND designation or other titles regardless of level of education.
Naturopaths are trained in scientifically unproven treatments, including homeopathy, which is typically considered a form of pseudoscientific quackery. Although all naturopaths are trained in homeopathy, not all will use it.
History
Some see the ancient Greek "Father of Medicine", Hippocrates, as the first advocate of naturopathic medicine, before the term existed. In Scotland, Dr Thomas Allinson started advocating his "Hygienic Medicine" in the 1880s, promoting a natural diet and exercise with avoidance of tobacco and overwork. The term sanipractor has sometimes been used to refer to naturopaths, particularly in the Pacific Northwest region of the United States.
The term naturopathy was coined in 1895 by John Scheel, and purchased by Benedict Lust, the "father of U.S. naturopathy". Lust had been schooled in hydrotherapy and other natural health practices in Germany by Father Sebastian Kneipp. Kneipp sent Lust to the United States to spread his methods. In 1901, Lust founded the American School of Naturopathy in New York; in 1902 he founded the Naturopathic Society of America (reorganized in 1919 as the American Naturopathic Association, ANA). Naturopaths became licensed under naturopathic or drugless practitioner laws in 25 states in the first three decades of the twentieth century. Naturopathy was adopted by many chiropractors, and several schools offered both Doctor of Naturopathy (N.D.) and Doctor of Chiropractic (D.C.) degrees. Estimates of the number of naturopathic schools active in the United States during this period vary from about one to two dozen.
After a period of rapid growth, naturopathy went into decline for several decades after the 1930s. In 1910, the Carnegie Foundation for the Advancement of Teaching published the Flexner Report, which criticized many aspects of medical education, especially quality and lack of scientific rigour. The advent of penicillin and other "miracle drugs" and the consequent popularity of modern medicine also contributed to naturopathy's decline. Following Lust's death in 1945, the ANA split into six distinct organizations. In the 1940s and 1950s, a broadening in scope of practice laws led many chiropractic schools to drop their N.D. degrees, though many chiropractors continued to practice naturopathy. From 1940 to 1963, the American Medical Association campaigned against heterodox medical systems. By 1958, practice of naturopathy was licensed in only five states.
Naturopathy never completely ceased to exist, and today there are six accredited naturopathic medical schools in North America. In 1956, Charles Stone, Frank Spaulding, and W. Martin Bleything established the National College of Natural Medicine (NCNM) in Portland, Oregon in response to plans by the Western States Chiropractic College to drop its N.D. program. In 1978, Sheila Quinn, Joseph Pizzorno, William Mitchell, and Les Griffith established John Bastyr College of Naturopathic Medicine (now Bastyr University) in Seattle, Washington. The rise of the holistic health movement in the early 1970s contributed to this revival.
Principles
The philosophy of naturopathy is often described by six core values. Multiple versions exist in the form of the naturopathic doctor's oath, various mission statements published by schools or professional associations, and ethical conduct guidelines published by regulatory bodies:
- First, do no harm; provide the most effective health care available with the least risk to patients at all times (Primum Non Nocere).
- Recognize, respect and promote the self-healing power of nature inherent in each individual human being. (Vis Medicatrix Naturae).
- Identify and remove the causes of illness, rather than eliminate or suppress symptoms (Tolle Causum).
- Educate, inspire rational hope and encourage self-responsibility for health (Doctor as Teacher).
- Treat each person by considering all individual health factors and influences. (Treat the Whole Person).
- Emphasize the condition of health to promote well-being and to prevent diseases for the individual, each community and our world. (Health Promotion, the Best Prevention)
Modalities
Since Naturopathy's focus is upon its philosophy of natural health rather than specific methods, practitioners use a wide variety of treatment modalities. The core set of interventions defined by the Council on Naturopathic Medical Education and taught at all six accredited schools in North America includes:
The CNME also provides for the inclusion of optional modalities including minor surgery, natural childbirth and intravenous therapy. These modalities require additional training and may not be within the scope of practice in all jurisdictions.
In addition to the standard modalities used by naturopathic doctors listed above, individual naturopaths may incorporate practices from other disciplines:
Practitioners
There are two groups in North America calling themselves "naturopaths". The term when originally coined by John Scheel, and popularized by Dr. Benedict Lust was to apply to those receiving an education in the basic medical sciences with an emphasis on natural therapies. This usage best describes modern day naturopathic doctors. In the absence of universal regulation of naturopathy, another group of practitioners (the so-called 'traditional naturopaths') has emerged. Additionally, a variety of health care professionals may incorporate naturopathic principles and modalities into their practice.
Naturopathic doctors
Naturopathic doctors in North America are primary care providers who are given some training in medical sciences, diagnosis, and treatment, though only a small amount of that given to an MD or DO, and who are additionally considered experts in "natural therapeutics". Licensing and training requirements vary from state to state, but at least 16 states, the District of Columbia, and five Canadian provinces have formal licensing and educational requirements.
- In these jurisdictions, naturopathic doctors must pass comprehensive board exams set by the North American Board of Naturopathic Examiners (NABNE) after having completed academic and clinical training at a college certified by the Council on Naturopathic Medical Education (CNME). The letters ND usually designate a naturopathic doctor in jurisdictions where such a title is protected by law, although other designations exist. In unregulated jurisdictions, the ND title is not protected and may be used by any practitioner regardless of qualifications.
Traditional naturopaths
Traditional naturopaths are guided by the same naturopathic philosophies and principles as board-licensed naturopathic doctors and often prescribe similar treatments. Traditional naturopaths however, are not primary care providers, whereas graduates of CNME accredited naturopathic medicine schools are classified as both alternative or complementary practitioners as well as primary care providers. Traditional naturopaths may voluntarily join a professional organization, but these organizations do not accredit educational programs in any meaningful way or license practitioners, per se. The training programs for traditional naturopaths can vary greatly. Compared to naturopathic medical schools, traditional naturopaths' training programs are less rigorous and do not provide the same basic and clinical science education. The professional organizations formed by traditional naturopaths are not recognized by the government of the USA or any US State or Territory.
Other health care professionals
According to a 1998 taskforce report, some physicians are choosing to add naturopathic modalities to their practice, and states such as Texas have begun to establish practice guidelines for MDs who integrate alternative and complementary medicine into their practice. Continuing education in naturopathic modalities for health care professionals varies greatly but includes offerings for practitioners: physicians, chiropractors, acupuncturists, dentists, researchers, veterinarians, physician’s assistants, and nurses. These professionals usually retain their original designation but may use terms such as 'holistic', 'natural', or 'integrative' to describe their practice.
Regulation
In some jurisdictions the practice of naturopathic medicine is unregulated and so the titles like "naturopath", "naturopathic doctor", and "doctor of natural medicine" are not protected by law. This may lead to difficulty in ensuring that a practitioner is trained to a particular standard or has adequate liability insurance.
Australia
There is currently no state licensure in Australia, rather the industry is self-regulated. There is no protection of title, meaning that technically anyone can practise as a naturopath. The only way to obtain insurance for professional indemnity or public liability is by joining a professional association, which can only be achieved having completed an accredited course and gaining professional certification. Currently the only registered modalities of natural medicine in Australia are those relating to Chinese medicine, and only in the state of Victoria.
In 1977 a committee reviewed all colleges of naturopathy in Australia and found that, although the syllabuses of many colleges were reasonable in their coverage of basic biomedical sciences on paper, the actual instruction bore little relationship to the documented course. In no case was any practical work of any consequence available. The lectures which were attended by the Committee varied from the dictation of textbook material to a slow, but reasonably methodical, exposition of the terminology of medical sciences, at a level of dictionary definitions, without the benefit of depth or the understanding of mechanisms or the broader significance of the concepts. The Committee did not see any significant teaching of the various therapeutic approaches favoured by naturopaths. Persons reported to be particularly interested in homoeopathy, Bach's floral remedies or mineral salts were interviewed, but no systematic courses in the choice and use of these therapies were seen in the various colleges. The Committee was left with the impression that the choice of therapeutic regime was based on the general whim of the naturopath and since the suggested applications in the various textbooks and dispensations overlap to an enormous extent no specific indications are or can be taught.
North America
In North America, each jurisdiction that regulates naturopathy defines a local scope of practice for naturopathic doctors that can vary considerably. Some regions permit minor surgery, access to prescription drugs, spinal manipulations, obstetrics and gynecology and other regions exclude these from the naturopathic scope of practice.
United States
- US jurisdictions that currently regulate naturopathy include: Alaska, Arizona, California, Connecticut, District of Columbia, Hawaii, Idaho, Kansas, Maine, Minnesota, Montana, Vermont, New Hampshire, Oregon, Puerto Rico, US Virgin Islands, Utah, Washington.
- US jurisdictions that permit access to prescription drugs: Arizona, California, District of Columbia, Idaho, Kansas, Maine, Montana, Vermont, New Hampshire, Oregon, Utah, and Washington.
- US jurisdictions that permit minor surgery: Arizona, District of Columbia, Idaho, Kansas, Maine, Montana,Oregon, Vermont, Utah, and Washington.
- US states which specifically prohibit the practice of naturopathy: South Carolina, and Tennessee,.
Canada
Canadian provinces which license naturopathic doctors: British Columbia, Manitoba, Ontario, Saskatchewan and Nova Scotia. As of 2009, British Columbia is considering expanding the remit of naturopathic doctors to include the abilities to prescribe, perform minor surgeries, order lab tests, and other activities traditionally reserved for physicians.
United Kingdom
In the United Kingdom, as there is no government sponsored regulation of the naturopathy profession, naturopaths are unregulated. The largest registering body, The General Council & Register of Naturopaths, recognises three courses in the UK, two being taught at osteopathic schools: the British College of Osteopathic Medicine; The College of Osteopaths Educational Trust; and one at the University of Westminster School of Integrated Health under the auspices of the BSc Health Science (Naturopathy) course. These organisations are not recognized by the UK regulatory frameworks.
Members of this register will either have completed a three or four year full time course or possibly be a healthcare professional who has completed a two year post-graduate Naturopathic Diploma (ND).
Alternatively, there are the Association of Naturopathic Practitioners and The British Naturopathic Association whose members can practice and get indemnity insurance.
India
In India there is a 5 1/2 year degree course offering a Bachelor of Naturopathy and Yogic Sciences (BNYS) degree. There are a total of 11 colleges in India, of which 4 colleges are in the state of Tamilnadu.
Naturopathy and Yoga, as an Indian system of medicine, falls under the Department of AYUSH, Ministry of Health & Family Welfare, Govt. of India.
Central Council for Research in Naturopathy & Yoga:
The Govt. of India after having recognized the need for systematic Research and Development of Yoga & Naturopathy in the country, established the “Central Council for Research in Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy” in 1969 as an autonomous organization under the Ministry of Health and Family Welfare. This organization, first of its kind was established in India by the Central Govt. to conduct Scientific Research in Ayurveda, Siddha, Unani and Yoga, existed upto 1978. During this period, the development of Naturopathy was looked after by the Ministry of Health & Family Welfare directly. Later, in March 1978, this composite Council was dissolved to pave way for the formation of four independent Research Councils, one each for Ayurveda and Siddha, Unani, Homoeopathy and Yoga & Naturopathy.
Hence, this Council (CCRYN) was established in 1978 with a view to provide better opportunities for alround development of Yoga and Naturopathy independently according to their own doctrines and fundamental principles.
National Institute of Naturopathy - Dept. of AYUSH, Ministry of Health & Family Welfare, Govt. of India:
The National Institute of Naturopathy, Pune came into existence on 22.12.1986. It encourages facilities for standardization and propagation of the existing knowledge and its application through research in Naturopathy throughout India. This Institute has a “Governing Body” headed by Union Minister for Health as its President.
Criticism
Naturopathy is viewed with skepticism by critics who contend that it relies on unproven and controversial alternative medical treatments. Certain naturopathic treatments, such as homeopathy and iridology, are widely considered pseudoscience or quackery.
Dr. Stephen Barrett (of Quackwatch and the National Council Against Health Fraud) has stated that the philosophy of naturopathy is "simplistic and that its practices are riddled with quackery."
K. C. Atwood writes, in the journal Medscape General Medicine, "'Naturopathic physicians' now claim to be primary care physicians proficient in the practice of both "conventional" and "natural" medicine. Their training, however, amounts to a small fraction of that of medical doctors who practice primary care. An examination of their literature, moreover, reveals that it is replete with pseudoscientific, ineffective, unethical, and potentially dangerous practices."
See also
External links
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