There’s a very common misconception about naturopathic physicians, that they are ‘opposed’ to conventional treatments. This belief leads some to believe that naturopaths are ‘against’ vaccination, ‘against’ surgery, ‘against’ pharmaceuticals, etc. Unfortunately, this way of thinking can get in the way of optimal health care.
The reason this belief is so prevalent is hard to determine. It may be due to a small but vocal minority of naturopaths who claim to ‘oppose’ conventional treatments. On the other hand, it may be due to a similar vocal minority of MDs who make exactly the same claim, in an effort to discredit naturopathic doctors. It may be because naturopathic physicians, as a small profession, are lumped in with other movements or groups that indeed are opposed to conventional treatments. It may be simply due to the fact that some people find it easier to define naturopathic medicine by what it isn’t, than by what it is; thus it’s easier to call it anti-vaccination, anti-pharmaceutical, anti-surgery, rather than holistic, natural, and life-affirming. One way or another, this misconception is present and needs some mention.
I always like to quote a mentor of mine who passed along the following tidbit, ‘There’s no room for dogma in medicine.’ A born healer in the tradition of village wise women who treated the sick using herbs, she once said this to me while prescribing Paxil to a patient for whom that had been the most effective treatment. When practicing in a patient-centered ethic, your opinions and beliefs always come second to the needs of your patient. Sometimes this means working with a patient for an hour on improving their diet and exercise regimen (or introducing one where there hadn’t been one before), other times this means prescribing life-saving antibiotics.
I think any naturopathic doctor worth his or her salt would say that they support intelligent medicine, rather than strictly supporting one or another discipline of medicine. This means discerning use of lab testing, imaging, diet, supplements, medicines, and other therapies. It’s rare that you meet a naturopath who is ‘against’ conventional treatment, but it’s fairly common that you meet a naturopath who feels patients are frequently given treatments that are too forceful or invasive before milder, gentler options are fully explored (and sometimes even mentioned). On the other hand, most NDs have had experiences where a stronger treatment was the best option for a given patient, even given the ND’s preference for a gentler medicine.
I myself worked once with a patient who came in having had an acute flare of chest pain for which she had gone to the ER. This patient had a long history of anxiety, and specifically mild chest pain during anxiety attacks. She walked into my office with a number of complaints, including a feeling that despite a long list of tests and prescriptions, she didn’t know what was wrong with her. When she had gone to the ER, she was first evaluated to make sure she wasn’t having a heart attack. She wasn’t, which was good news. If anything, she was in excellent health. The hospital kept her overnight to do further evaluation. At each step along the way, everything was normal. Not merely normal, but actually excellent. In fact, all of her symptoms could have been explained by her history of anxiety, a fact she kept mentioning while at the hospital. In the end, she walked out with two prescriptions (neither of them for anxiety), a large stack of lab and imaging reports, and a feeling that she was dreadfully ill when in fact she wasn’t. In my time with her, we worked on her anxiety, as I was satisfied that she wasn’t suffering from cardiovascular disease. We worked on her diet, I had her doing regular exercise, a few other lifestyle changes, and I prescribed her a homeopathic remedy which helped relieve her anxiety symptoms. She was a patient best helped by mild treatments, but who had had too much testing, too much treatment, but not enough attention.
Now let me relate the tale of another patient. This patient came in with a vague feeling of being unwell, some vague symptoms of joint aches and fatigue, and a general sense of malaise. ‘Angst’, though far from a medical diagnosis, is a fairly common complaint in Seattle, where I received my education (it may or may not be due to the vitamin D deficiency which is fairly rampant in Seattle). I saw this patient while I was still in school, so I had the benefit of being able to read old chart reports, during which I noted a few references to a longstanding, non-healing skin ulceration. As any doc will tell you, this was a pretty big red flag, and so I made sure to check it out during the appointment. Fortunately for the patient, I was being supervised by a doc who specialized in dermatology, who identified the lesion as a dead ringer for squamous cell carcinoma, and immediately started writing a referral to a dermatologist. “But wait,” said the patient, “I came to you because I thought you didn’t believe in that stuff. I don’t want to go see a dermatologist, and even if I do go, I don’t want their treatment. I want to discuss the spiritual factors that caused this to develop. I want to work with you.” This was a patient who wanted less treatment but needed more. Far from being opposed to conventional treatment, I now had to make the case for a biopsy and whatever further treatment might be necessary. We eventually prevailed on her to take our referral to a dermatologist. The spiritual aspects of cancer are important, and an area in which naturopaths have an important role to play, but equally as important are proper diagnostics and potentially life-saving treatment. I told my patient that I too wanted to discuss her spiritual life, but that she needed conventional help as well, so that we could continue to have that discussion.
I hope this helps to capture the relationship of the naturopathic physician to conventional medicine. It’s far from simple, and certainly can’t be summed up as being ‘opposed’ to conventional treatment. Naturopathic physicians straddle the line in a lot of ways, between the old and the new, the gentle and the strong. In all cases, it’s the uniquely individual needs of the patient, seen in a totality, that determine what treatment is appropriate. As I now say too, ‘There’s no room for dogma in medicine.’
