A Brief History of Naturopathic Medicine
Many of the beliefs and practices used by naturopaths are drawn from different cultures and traditions of the last several centuries, utilizing natural treatments for the purpose of healing. Over the last hundred years, the profession has gone through many changes. As medicine began to learn the incredible scientific breakthroughs that have led to what it is today, many people began to believe that the ancient healing techniques were no longer useful, never useful to begin with, or even fake or pseudo-medicine. However, groups of people decided that the tried-and-true healing methods that have been used for so long should not be forgotten or set aside, and passed along this deeply rooted knowledge about different healing techniques.
Within the last fifty years, there has been much change within the naturopathic profession, including legislature, regulations, and education. Early naturopaths were known primarily for modalities like hydrotherapy, physiotherapy, homeopathy, nutrition, botanical medicine, and mental therapy. Now, naturopathic education and practice incorporate these early methods with modern medicine.
Naturopaths (NDs) who have been through accredited naturopathic medicine training programs are trained in a wide variety of subjects. The curriculum is similar to that of most medical schools, with a learning of the basic medical sciences like anatomy, physiology, biochemistry, and pathophysiology, as well as clinical and laboratory diagnostic skills such as pharmacology, and minor surgery. The other part of their education includes ancient wisdom and historic treatments from a variety of cultures and eras that have developed the naturopathic principles and philosophy. It is important to understand that there are correspondence schools that claim to provide an accredited education in naturopathy, but these programs do not provide sufficient education to allow a person to sit for the Naturopathic Physicians Licensing Exams, which are required before they can get a naturopathic medical license.
Can a Naturopathic Practitioner Specialize After Medical School?
No, a naturopath cannot specialize in a different field of medicine. They are unable to sit for the United States Medical Licensing Examinations, which are the tests that are required for every Medical Doctor (MD) and Osteopathic Doctor (DO). After passing this exam, the MD or DO can apply for a residency in the field of their choosing (i.e. a Dermatologist, Cardiologist, neurologist, etc.). Naturopaths are unable to complete these residencies, and a naturopathic residency is optional. Naturopathic residencies are typically in a private practice under the guidance of one currently practicing naturopathic doctor. Others are in clinic settings, guided by several different physicians. There are very few of these residencies, so they are generally competitive. Most states do not require the ND to complete one, but Utah, for example, is one state that does require each naturopathic doctor to complete a residency before they are allowed to practice in that state.
Regulation of Naturopathic Medicine
In North America, each naturopath can have a different scope of practice depending on where that practitioner may live. Even what they are allowed to call themselves or how they abbreviate their title can vary by state. In some states, they are called Naturopathic Medical Doctors (NMD) and in others, they are called Naturopathic Doctors (ND). In certain locations, they can call themselves physicians or doctors, in others they cannot. In some areas, the regulations are similar to a medical doctor (MD), in which they are allowed to prescribe a large formulary of pharmaceutical medications and perform minor surgery. There are naturopathic doctors who are employed in prominent hospitals, working closely with cancer care and oncology, gastroenterology, cardiology, dermatology, rheumatology, as well as other departments, while there are others who are mainly involved in research. Most NDs are working in private practice.
Naturopathic Medicine Whole Body Assessments
Whole body assessments generally involve a comprehensive workup of possible systems, which may seem unrelated to the untrained eye, but in fact, may be correlated with the progression of symptoms or disease. It’s possible that only some of the systems of the body are evaluated, but as the name suggests, a whole-systems approach should include at least a brief assessment of every system. There are several commonly evaluated systems:
- Food hygiene, which evaluates the way a person obtains and consumes food. This seems simple, but can be related to community, amount of chewing per bite, environment during preparation and consumption of food, types of food, and other things related to eating.
- Transit time, which is how quickly the food moves through the body after it is eaten
- Absorption/assimilation: how much of the nutrients in the food are actually processed correctly and moved within the organism
- Evacuation: efficiency, frequency, and consistency of bowel movements
The circulatory system moves blood, cellular waste, oxygen, and carbon dioxide through the body. The health of the skin is closely related to the efficiency of blood vessels and heart to move blood around and through the various systems.
Hormones and neurotransmitters (i.e. thyroid, adrenal, sex hormones, and more) are important to consider because they are all generally small parts of a larger cascade that begins in the central nervous system. Any step within that cascade can have a disruption that causes a shift in the downstream hormones, which can ultimately lead to an imbalance of the general metabolic functions that we use for life.
Naturopathic Skin Therapies and Treatment Modalities
Plants are used in naturopathic skin therapies with the purpose of causing a shift in symptoms or disease progression. These plants can be used in a variety of forms. Depending on the plant and form, they can be applied topically, taken internally, or diffused into the air for the sake of breathing the aromatic parts of the plant.
This set of naturopathic skin therapies are performed with the intention of healing through physical touch, manipulation, mobilization, or movement of the body or body part, including any of the various forms of massage, myofascial work, craniosacral therapy, or joint work.
This modality within naturopathic skin therapies uses water, applied within or to the body, at varying temperatures. Often the temperature is contrasting, meaning there is an application of warm water alternated with an application of cold water or vice versa. In the case of a Sitz bath, both hot and cold are used at the same time. The contrasting temperature is thought to promote circulation through the area around the application. The treated water may or may not include products like minerals or oils to further enhance the therapeutic effect.
- Bathing, Hot/Cold Soaks, or Balneotherapy: Bathing for the purpose of managing or treating a disease. In balneotherapy, the water is typically mineral-rich, but other bathing techniques may also include other products in the baths, such as bleach, vinegar, essential oils, herbs, etc.
- Saunas, Steam inhalation, and Hot Tubs: The use of hot water or water vapor for the intended effects. There are additional types of saunas that should be mentioned, for example, infra-red saunas, that would technically not be a form of hydrotherapy because they use a dry heat instead of using water as a heat source, but are often used with similar intentions.
- Spraying water on the body, and applying water to the body: These are additional forms of hydrotherapy that include douching, colon hydrotherapy, therapeutic showers, and enemas
- Wet fabrics: These modalities can include wet sheet wraps, hot/cold towels or compresses, or other moistened fabric applied to the body externally.
Given the many different phrases based on healthy diet and nutrition: “you are what you eat”, “an apple a day keeps the doctor away”, “let food be thy medicine, and medicine be thy food”, it seems to be common knowledge that eating healthy is important to longevity. The things we take in provide us with the energy that we need to survive, and it is important that we choose to consume the best for ourselves with healthy food and clean water. NDs will often evaluate the diet and recommend any necessary changes as part of their naturopathic skin therapies. If there is a deficiency of specific nutrients, it may be necessary to supplement those in the diet.
Even though people generally understand the health risks, they may still choose to engage in unhealthy behavior like smoking or drugs and alcohol, or they choose not to engage in healthy behavior like exercise. This is where lifestyle counseling fits in. Sometimes a little motivation may be the catalyst necessary to initiate the behavior change that moves a person toward better health. Habit management is an essential part of naturopathic skin therapies.
Mental and emotional concerns can run deep. NDs are not psychologists, nor psychiatrists, but they often engage in conversations about stress and other emotional concerns because these may be correlated with their symptoms. Naturopathic medicine follows the principle of removing any obstacle to cure, and if the emotional or psychological concerns are worsening the pathology, they must be addressed in any way that could help. Common naturopathic skin therapies within the branch include deep breathing, meditation, cognitive behavioral therapy, life skills, counseling, positive reinforcement, or even simply an ear to listen because some people feel some relief simply from being heard. If necessary, it may be crucial to refer the patient to another professional.
Energy medicine or energy testing
One of the most commonly debated tools of the complementary and alternative medicine fields, these methods have avid followers as well as avid challengers. It is very difficult and often very subjective to measure energy in this sense. Reiki is mildly summarized as delivering energy through touch, homeopathy is the use of the energy of a specific substance in extremely dilute proportions taken by a person, and flower essences are the “essence” of a plant transferred into water that has basked in the sun. Applied kinesiology, muscle response testing, and autonomic response testing are essentially diagnostic tools that are using the energetic field of the patient.
Diagnosis and laboratory based medicine
Naturopaths are also trained in many Western medical practices such as clinical physical diagnosis, laboratory diagnosis, pharmaceuticals and medications, minor surgery, and have limited training in emergency medicine. Even though all naturopathic practitioners who have completed truly accredited programs learn these western methods, they may or may not be allowed to use these techniques depending on where they practice.
What Are Naturopathic Practitioners Not Able to Do?
Naturopathic education does not include much training in emergency care, nor do practitioners rotate through emergency rooms. They do, however, learn a systems-based pathology that provides them with the knowledge to recognize and appropriately manage an acute emergency within their means, meaning they understand when they need to refer to a specialist or send a patient to the emergency department. In certain areas, they have the legal privilege to admit patients to the hospital. Even though naturopathic doctors in certain locations can perform minor surgery, none are allowed to perform invasive surgery. The surgical training for naturopaths is only about removing benign skin lesions, cysts, lipomas, obtaining skin biopsies, and suturing the skin in a variety of ways. They are not allowed to go deeper than a layer of connective tissue called the fascia, and although they do receive training in suturing wounds, it is not common that patients go to naturopaths for wound repair.
Naturopaths have an additional in-depth focus on natural healing techniques and naturopathic philosophy. They excel at managing many different chronic conditions, and some acute conditions. Naturopaths are not specialists in any specific field beside natural medicine, so any in-depth treatment or service must be referred to someone with specialized training. If a person is having a true medical emergency, their naturopath should not be the first person they contact. They should go to the emergency department to ensure that all the proper equipment and knowledge is available for their care.
These investigative and treatment tools do not encompass the entire toolbox that is used by various NDs across the globe. As long as they have graduated from an accredited educational program, NDs are capable of managing a profound number of medical conditions. Each individual is different, the symptoms they feel are unique, and the condition they live with may not always be the same. Every person needs to be heard and evaluated in their own exclusive way.