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Naturopathy
Naturopathic medicine (also known as naturopathy, or natural medicine) is a complementary and 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, and different, treatment modalities, with practitioners emphasizing a holistic approach to patient care, and may also recommend that patients use conventional medicine alongside their treatments, if indicated.
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 sixteen US states and five Canadian provinces, 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. Those 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.
History of naturopathic medicine
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.
In the USA, 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 founding 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.), and the rise of medical technology 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 be shut down by the U.S. Government 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— although 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 Natural 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 science with naturopathic principles and practice. Today there are six accredited naturopathic medical schools in North America.
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[11] 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
Naturopathy's focus is upon its philosophy of natural health rather than specific methods and so 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:
acupuncture and oriental medicine
botanical medicine
homeopathy
nutrition (examples include vegetarian and wholefood diet, fasting, and abstention from alcohol and sugar)
physical medicine (includes naturopathic, osseous and soft tissue manipulative therapy, physiotherapy, sports medicine, exercise and hydrotherapy)
nature cure - a range of therapies based upon exposure to natural elements such as sunshine and fresh air
psychological counseling (examples include meditation, relaxation and other methods of stress management)
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:
color therapy
iridology
Applied kinesiology
public health measures and hygiene
reflexology
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 trained in conventional medical sciences, diagnosis and treatment, and are 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.[citation needed] The training programs for traditional naturopaths can vary greatly, are less rigorous and do not provide the same basic and clinical science education as naturopathic medical schools do.[citation needed] 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 conventionally trained 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
The examples and perspective in this article may not represent a worldwide view of the subject. Please improve this article or discuss the issue on the talk page.
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.
North America
In North America, each jurisdiction that regulates naturopathic medicine 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.
Canada
Canadian provinces which license naturopathic doctors: British Columbia, Manitoba, Ontario, Saskatchewan and Nova Scotia.
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