What IS Naturopathic Medicine?

Happy Belated Naturopathic Medicine Week! Last week was our nationally recognized time to celebrate and promote our medicine and in the spirit of that I will try to answer that question we are all constantly asked, "What IS Naturopathic Medicine?"

Here's my little elevator speech: I am a student of naturopathic medicine. As naturopathic doctors, we are trained in primary care and specialize in natural and least-invasive therapies. We are trained to diagnose and treat disease and we work to address the cause of disease, rather than just treat the symptoms. We aim to engage our patients in their own healthcare.

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If I have a captive or particularly interested audience, I'll go on to explain that we train in an outpatient clinic, rather than in a hospital, but because we train specifically as primary care doctors this environment is most appropriate. We do not rotate through specialties as conventional MDs do; rather, we take those specialties as classroom courses while we are in our internship, seeing patients in our outpatient clinic. Our year-long training in an out-patient setting prepares us well for practice because we are providing direct primary care (with the supervision of our licensed clinicians) on a regular basis to an established group of patients.

When we graduate, residencies are optional and competitive. Part of the reason our residencies are optional is that our profession has to privately fund these opportunities. Did you know that conventional MD residencies are funded by Medicare? At this time, naturopathic doctors are not recognized by Medicare, and thus our residencies must be privately funded. So, there are the basics.

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Now, if I have an especially engaged audience I may launch into explaining our Therapeutic Order, or how a naturopathic doctor orders their thinking when it comes to a patient case.

  • Level 1 is Reestablish the Basis for Health.
    This means we look at the basics (in some ways comparable to Maslov's hierarchy, if you are familiar with that): food, water, air, shelter, sleep, exercise, spirituality, access to healthcare, toxic exposures, love, and community. Every single naturopathic treatment plan addresses some aspect of Level 1.
  • Level 2 is Stimulate the Vis.
    The Vis Medicatrix Naturae is the healing power of nature. When a surgeon stitches up a wound, dresses it, and sends a patient home to heal, he or she is relying on the healing power of nature, or the body's ability to knit that tissue back together. A naturopathic doctor might use homeopathy or acupuncture to support the Vis. In truth, every therapy we offer, including nutrition and a good night's sleep attend to the Vis because each therapy supports the body's ability to heal itself.
  • Level 3 is Tonify Affected/Engaged Organs and Systems.
    Here is where we apply therapies in a general sense. We prescribe liver-supportive foods to help a woman with PMS and menstrual cramps because the liver clears hormones that contribute to these ailments. In almost every patient we address the GI system because "we are what we digest." That is taken from that phrase, "You are what you eat," but we know that if you cannot digest the food you eat, then how can you assimilate those nutrients into your body and use them as building blocks?
  • Level 4 is Correct Structural Integrity.
    At NUHS, we go to school with chiropractic students and in that process we take adjusting classes with them. We learn to align the spine and extremities, and we learn some soft-tissue therapies like massage. We pay attention to all aspects of the physical body, including the structure, in order to optimize healing and maintain wellbeing.
  • Level 5 is Prescribe Specific Natural Substances.
    This is where many integrative doctors work, and where many of our patients assume we operate. This could be considered the level of "green allopathy," or replacing a drug with a natural substance. A naturopathic doctor uses therapies at this level when necessary, especially to help with palliation when a patient feels really sick, but we recognize that none of these "green" therapies will offer full recovery or true healing if we neglect the first 4 levels that come before it. This is where we categorize the use of botanicals and other natural substances that address specific pathologies. For example, giving a pain-relieving tincture of Viburnum to our patient with menstrual cramps. When these natural therapies "don't work" we must remember that a patient needs to attend to all the aspects of their being for nature's healing to work best. If someone eats Big Macs for every meal, they cannot expect plants alone to heal their pain.
  • Level 6 is Prescribe Specific Pharmacological or Synthetic Substances.
    Here is where most conventional medical doctors operate and where naturopathic doctors are trained to operate as well, when necessary. Sometimes we need to use pharmaceuticals in more dire situations in order to pull a patient out of a dangerous place. It is never our goal to keep a treatment plan at this level. This is a high level of intervention reserved for when it is necessary, but avoided if possible.
  • Level 7 is Use Higher Force Interventions.
    This means things like surgery and other invasive procedures. There are times when a patient needs this kind of care, for example, if they have been in a car accident and have broken bones. We will send this patient off for surgery, but will also offer supportive care at all the levels leading up to this one. We will offer everything from foods that support healthy inflammation, to homeopathics that assist bones in healing, to massage that keeps the muscles from going into spasm, to botanicals to dampen the pain and support healthy tissue regeneration in healing.

Whew! Thanks for sticking with me this far! There is no way I could explain everything about a naturopathic doctor's thought process in one (long!) blog post. Readers should know that our training includes pathology, and so when I write about treating the engaged organs and systems, that is informed by our understanding of pathology and diagnosis of disease. I could go on and on! But for now, any questions?