Thursday, November 17, 2011

A Naturopathic Physician By Any Other Name

In the course of writing this blog (and especially last week), I find that I sometimes use the terms naturopathnaturopathic doctor, and naturopathic physician somewhat interchangeably. Though this isn’t exactly wrong, there are differences between these terms, in some cases subtle ones, in other cases legal ones. Additionally, it may be confusing for consumers to tell the difference between these terms. Therefore, I’m devoting this week’s blog entry to a brief discussion of these terms, to help all of the consumers out there who are trying to get the healthcare solutions they want.

Naturopath – Without a doubt the oldest term of the three, naturopath is also the broadest in its meaning. The term arose in the late 19th century to describe a growing movement of health practitioners who utilized natural methods, including diet, lifestyle, exercise, and herbs. Most graduates from a four-year, accredited program in naturopathic medicine would identify themselves as naturopaths when asked. However, in states without naturopathic medicine licensure laws, a broad range of other practitioners can also call themselves naturopaths, many of whom have received their ‘degrees’ through mail-order correspondence courses. Naturopath and naturopathy do not imply physician-level training, and so they are the broadest terms for practitioners of natural health, including but not exclusive to licensed naturopathic doctors. These terms have fallen out of favor in recent years because they are non-specific. I sometimes think of these terms as being comparable to the label ‘natural’ on food products – there’s not a lot of regulation over the term, and you really need to read the label before buying, so likewise, you need to assess the credentials of anyone calling themselves a ‘naturopath’. Here’s a list of accredited programs that you can use when checking up on a practitioner’s credentials.

Naturopathic doctor – Starting in the late 1970s, the practice of naturopathy became significantly more medicalized. Four-year post-graduate programs combining didactic and clinical education had existed for a long time (notably at the National College of Naturopathic Medicine), but with the founding of the John Bastyr College of Naturopathic Medicine (now Bastyr University) in 1978, they became standard. These programs were now attracting college-educated young people who had strong scientific backgrounds, many of whom had considered pursuing MDs, but who were seeking to promote health through less invasive, non-toxic, more natural methods. The colleges began conducting research, with Bastyr being the first naturopathic college to receive funding from the NIH in 1984. Similarly, licensure laws began to expand, and licensed naturopathic doctors began to have access to pharmaceuticals in addition to the natural therapies that were and are the mainstay of naturopathic medicine. This major shift in education and practice called for updated terminology. Naturopathic doctor and naturopathic medicine were favored over the older terms. As I said earlier, though graduates of accredited programs would accept the term naturopath, most are more accustomed to referring to themselves as naturopathic doctors. The older term came into usage over a century ago, whereas the more modern term gained prominence in the closing decades of the 20th century and was reflective of seismic changes in the education and practice of naturopathic medicine.

Naturopathic physician – Reflective of the most recent wave of change in the naturopathic profession, naturopathic physician is becoming an increasingly preferred term. The term dates back to at least 1985, when the American Association of Naturopathic Physicians was founded, though the term was in usage before that. Taking the term naturopathic doctor a step further, naturopathic physician represents the trend within the naturopathic profession to move into the role of primary care providers. In states like Washington, that have a long history of licensing naturopathic physicians, with a broad scope of practice (including a range of pharmaceuticals and even minor surgery), and with insurance coverage, naturopathic physicians are increasingly playing the role not of ‘alternative’ providers, but of primary care providers. In this role, naturopathic physicians are family doctors who do yearly physicals, order screening labs to check up on things like cholesterol, and make sure you’re up to date on mammograms, for example. Not every person with an ND practices this way, but an increasing number are, and they are filling an important role in American healthcare. Though it is always important to check up on potential providers in states that do not license naturopathic doctors or physicians, the term naturopathic physician is rarely used by practitioners who have not graduated from one of the seven accredited programs.

As I hope you can see, these terms have their own unique meanings. Sometimes, the English major in me uses them interchangeably, just to prevent the writing from being monotonous, but the naturopathic physician in me grates against it every time.

One of the great advantages of licensure laws is that it takes the guesswork out of finding healthcare – if you live in one of the 16 US states or 5 Canadian provinces that license naturopathic doctors, you can rest assured that a person calling themselves a naturopath, naturopathic doctor or naturopathic physician went to an accredited program, and that you are in capable hands. If you aren’t so fortunate, always check the credentials of someone using these terms – someone who went to an accredited program will be more than happy to tell you about it, and most in fact hold licenses in another state, which they would be proud to show you. Licensure efforts are ongoing in many unlicensed states, so if you are truly motivated, find out how you can get involved with your local naturopathic organization!