Naturopathic physician

"Naturopathic Physicians Defined
A question I'm often asked by readers is why I interview naturopathic physicians (NDs) for articles instead of 'real doctors.' The short answer is because they have the specialized training to know about things like herbal remedies and nutritional supplementation. But the issue is more complicated. What is clear to me is that there is much confusion about exactly what a naturopathic physician is... what his/her education is... and what role he/she could or should play in the individual's health-care team. To get clarification on the ND's role and practice, I spoke with Jane Guiltinan, ND, president of the American Association of Naturopathic Physicians.
A NATUROPATH'S EDUCATION
In North America, there are five naturopathic medicine programs currently accredited by The Council on Naturopathic Medical Education (CNME), and one naturopathic program that is a candidate for accreditation by the CNME. Candidates for admission must earn a baccalaureate degree (or equivalent) prior to admission, including standard pre-med training. The ND degree is a doctoral degree and typically takes four years to complete, just like an MD.
There are many similarities between the naturopathic and conventional medical school curriculum. The first two years of both curriculums involve basic science courses -- anatomy, pathology, physiology, biochemistry, and other Western medical sciences. In addition, naturopathic philosophy courses expose students to:

The first two years of both curriculums involve basic science courses -- anatomy, pathology, physiology, biochemistry, and other Western medical sciences. In addition, naturopathic philosophy courses expose students to the concepts and principles and practices of natural medicine, said Dr. Guiltinan. These include nutrition, homeopathy, botanical medicine, acupuncture and a variety of mind-body approaches.
During the third and fourth years, there's a mix of classroom courses such as gynecology, pediatrics and rheumatology, plus approximately 1,200 hours of clinical training under the supervision of licensed naturopathic physicians. In this phase of training, naturopathy students observe and help manage patients in an outpatient setting.

THE NATUROPATH'S ROLE
Think of the ND as the equivalent of a family practice physician, said Dr. Guiltinan. Naturopaths provide excellent primary health care for individuals and families. Like the conventional general practitioner with an MD, an ND will assess your health and direct your treatment, either by treating you directly or by referral to other mainstream or natural care specialists such as chiropractors, acupuncturists, nutritionists or specialists in homeopathy, to name a few.
In Dr. Guiltinan's view, conventional physicians and naturopaths are most effective at different points in the spectrum of the health-care system. "At one end of the spectrum is crisis medicine," she says "and it's here where I think conventional medicine is excellent. Emergency care intervention, trauma care, serious infections -- this is where conventional medicine excels."
"Where I think conventional medicine has not done its most effective work is in chronic disease management and in conditions that don't really fit into a clear medical box -- chronic fatigue syndrome, for example, fibromyalgia or depression. With these types of conditions, the conventional, technological or pharmaceutical approach is not always effective as it focuses on symptom suppression, rather than the naturopathic process of finding the underlying causes and addressing these to support healing and the creation of health and wellness. This is where naturopathic physicians can play an important role."
THE ND OFFICE VISIT: WHAT TO EXPECT
What is different about a visit to an ND? At your initial visit you'll be asked about your health history and receive a physical exam that is similar to the physical at a conventional medical office. And like a conventional MD, an ND may order lab tests or diagnostic imaging tests. So, what's different?
"You'll find much more in-depth questioning about your current lifestyle," said Dr. Guiltinan. Naturopaths ask about your diet -- at minimum they will ask you to describe it but more likely you'll be asked to complete a diet diary, detailing your food intake for a week or so. We're also very interested in finding out if you exercise or not, and what your mental and emotional state is.
PHILOSOPHY AND TREATMENT
Dr. Guiltinan said that extensive questioning is necessary to get to the underlying issues around a health problem and address them, rather than just addressing the presenting symptoms of a problem.
Because naturopaths believe that the human body has an incredibly powerful ability to heal itself if given the chance, she said, one principle is to take a look at what the "obstacles to cure" are in an individual patients' life. What are obstacles to cure?
Well, sometimes its genetics, which we can do little about, she said, but some obstacles can be removed (for example, eating poorly, being too stressed out with work, exposure to environmental toxins, lack of exercise). If you can add support in the form of a good diet, proper exercise and stress reduction to promote the healing responses of the body, then you can further capitalize on the body's ability to heal.
In naturopathic medicine, most treatment plans, regardless of the condition, begin with diet modifications. The famous quote from Hippocrates, "Let food be thy medicine and medicine be thy food" is a basic tenet of naturopathic treatment. In addition, supplements (vitamins and minerals) may be prescribed. In some cases, NDs will do the nutritional counseling themselves... in other instances that require more sophisticated or specialized care, patients may be referred on to a nutrition specialist.
Other common treatment modalities are homeopathy, botanical medicine, physical medicine and acupuncture and mind/body therapies. Again, depending on the patient's needs, the ND may provide treatment himself or refer the patient on to a specialist. NDs also offer psychological counseling. In this area, Dr. Guiltinan said a big part of her naturopathic practice is preparing patients to make the little and big lifestyle changes that will impact their health. In naturopathic medicine, the patient's participation in his/her own health care is crucial.
HOW CAN I FIND A NATUROPATH IN MY AREA?
To find a qualified, licensed ND in your area, visit the American Association of Naturopathic Physicians Web site, naturopathic.org and click "Find a doctor."
So, to all my readers who wonder "why don't I interview 'real doctors'" ... I do. As always"