Naturopathic Doctor

[Jordan88]

Hey,

 

So as of about a year ago I decided to pursue medicine (after going through about 10 other career choices) and have, thanks to some persistence by my mother (who is very much into natural medicine) begun to also consider Naturopathic Medicine.

 

My view about medicine is that surgery and drugs should only be performed / given / advised when absolutely necessary. Instead, I believe that a doctor, specifically general practitioners, should make it their priority to instead promote a healthy lifestyle through physical activity, diet etc. However, especially in the US, drugs and surgery are often the first course of action. For example: Type 2 Diabetes can be managed by strictly controlling one's diet, making insulin injections necessary only on specific occasions. This method also greatly reduces the risks associated with Type-2 Diabetes. Unfortunately, particularly within the US, doctors either do not know about this or do not promote it because there is no money involved, while drug companies do their best to suppress this information by not allowing it to be published in any Journals that they sponsor. (If I remember correctly I got this information from one of Dr. McDougall's newsletters or dvds). Furthermore, instances of major surgeries are much higher within North America than within Europe. (I wanted to give a concrete example, but the book that I am looking for is hiding somewhere within my home)

 

While I do not know about the effectiveness of all Naturopathic techniques, I know from personal experience that much of it works just as well, if not better, than standard "western" medicine, without much of the associated risks of drugs / surgery. This can be something as simple diet to control blood pressure, weight, skin problems, etc., herbs for colds and flu (preventative and curative) or a variety of methods for treating joint and muscle pain without resorting to pain killers. For example, I have been getting severe back pain for years now, and after trying exercises my doctor gave me, physiotherapy, chiropractics (which I understand may not be "western" but is still very mainstream at this point), and general pain relievers I finally resorted to Yoga designed to eliminate most sources of lower back pain. I was quite skeptical, but within one week most of the pain was gone and after three to four weeks my back no longer hurt. It was the combination of repeated contraction and stretching of all back / supporting muscles in fluid motions that relieved the constant tension in my back, whereas physio only focuses on stretching and strengthening target muscles. (For anyone interested, it is Viniyoga, by Gary Kraftsow, and they have scientific research articles published in the "Annals of Internal Medicine").

 

Based on my experiences, readings, beliefs etc. it seems to me that Naturopathic Medicine promotes exactly what should be the most important role of a GP: using non-invasive methods and promoting overall health in order to prevent the use of drugs and surgery, unless absolutely necessary.

 

Anyways, I realize that this has mostly just been myself rambling, but I am now finally to my point:

 

What are your opinions of Naturopathic Medicine, whether it be the practises used by Naturopathic Medicine or just as a general career alternative to being and MD? Note: ND's in Canada (in Europe they have had this permission for some time) are now also being given further licenses to do such basic things as stitches and prescribing basic drugs such as antibiotics. Another major difference to note about the two professions is that a ND is paid hourly by patients (so they generally get patients who will be dedicated to whatever treatment you prescribe), whereas a GP is government paid per patient.

[A-Stark]

Your post posits a conspiracy theory (you seriously don't think management of NIDDM includes lots of issues surrounding diet???) which has no basis in fact, along with a variety of straw men concerning "western" medicine.

 

I'm also not clear on how yoga is regarded as something non-mainstream at this point. Certainly yoga pants are omnipresent at this point. There is also nothing intrinsically risky about drugs, no more so than so-called herbals. Any substance you put into your body that has a desirable effect may have a toxic effect at high doses, along with side effects that may be undesirable at varying doses. Look up St John's wort as a pertinent example. That most herbals have negligible potential for toxicity more reflects their lack of purity and/or active ingredients, with the flip-side being a lack of efficacy. Some do work, though, and are certainly being adopted by practicioners - you just don't have to be a self-righteous naturopath to recognize this.

[Madz25]

What are your opinions of Naturopathic Medicine, whether it be the practises used by Naturopathic Medicine or just as a general career alternative to being and MD? Note: ND's in Canada (in Europe they have had this permission for some time) are now also being given further licenses to do such basic things as stitches and prescribing basic drugs such as antibiotics. Another major difference to note about the two professions is that a ND is paid hourly by patients (so they generally get patients who will be dedicated to whatever treatment you prescribe), whereas a GP is government paid per patient.

 

Doesn't that go against the idea of "naturopathic medicine" in the first place? Why prescribe when your entire purpose is to provide patients with an alternative option?

[RapedByLifeSci]

kid. you only just decided to go down the career path of a naturopathic doctor. Don't prematurely come on an internet forum by telling us about your life and your opinions.

 

No one cares.

[A-Stark]

Doesn't that go against the idea of "naturopathic medicine" in the first place? Why prescribe when your entire purpose is to provide patients with an alternative option?

 

Yes. Because they want to be "primary care providers" and actually invade the responsibilities and privileges of actual physicians. The entire profession seems to be built around a series of myths and straw man arguments.

 

As for those Europeans and their apparent reluctance to use surgical treatments, the Austrian ORs are nonetheless filled with all the same kinds of things. Just this morning I got to help intubate and ventilate a patient who by now should be in recovery sans gallbladder. The previous treatment? Conservative management (meaning nothing really) and some kind of special tea.

[skvangs]

Doesn't that go against the idea of "naturopathic medicine" in the first place? Why prescribe when your entire purpose is to provide patients with an alternative option?

 

Lol, very good point Madz! There is no proof that Naturopathic medicine is very effective (let alone better than Allopathy). In fact, I shadow an ER doc, and one of the first questions asked when a patient is brought in, is whether or not they have been on any alternative medicine. This is asked because oftentimes these drugs contain something very potent and potentially nephro/hepato-toxic. The side effects of these mediciations has never been thoroughly studied, but that doesn't mean there are no side effects from these medications whatsoever, but rather we don't know of any. I have a strong suspicion that not only do these drugs have significant side effects, the side effects can be much more severe and dangerous than "studied and tested" allopathic medicine. There was a study recently (NEJM, and BMJ) that showed that on a double blind study of one specific naturopathic medication, efficacy was comparable to placebo. There was no significant correlation between naturopathic medication and symptomatic alleviation. If in fact they do work for headaches and other minor ailments, I suspect that this can be exclusively attributed to the placebo effect.

 

Why not study both? I know it is a long time of study, but you may be able to investigate efficacy of alternative medicine, with a bit more scientific method and knowledge in both pathways of medicine.

 

PS: Yoga is not considered alternative medicine, it is considered to be exercise. Excercise is supported in all facets and types of medicine. THIS has been proven.

[Jordan88]

I should probably make this clear, as I didn't really take the time last night to seriously go through and consider how what I wrote would come across like. I DO NOT believe that naturopathy is as a whole is more effective than allopathy, merely that certain treatments that I myself have used have been effective without the use of drugs. I was merely trying to do some sort of a lead in to provide some background into why I am BEGINNING to do some research on naturopathy, that is all. I apologize again if I came across as ignorant etc., but I do believe that surgery and drugs are relied on too heavily (though I am sure much of this is a patients unwillingness to change their lifestyle to a healthier one even if it means risking their own well-being).

 

Your post posits a conspiracy theory (you seriously don't think management of NIDDM includes lots of issues surrounding diet???) which has no basis in fact, along with a variety of straw men concerning "western" medicine.

 

I'm also not clear on how yoga is regarded as something non-mainstream at this point. Certainly yoga pants are omnipresent at this point. There is also nothing intrinsically risky about drugs, no more so than so-called herbals. Any substance you put into your body that has a desirable effect may have a toxic effect at high doses, along with side effects that may be undesirable at varying doses. Look up St John's wort as a pertinent example. That most herbals have negligible potential for toxicity more reflects their lack of purity and/or active ingredients, with the flip-side being a lack of efficacy. Some do work, though, and are certainly being adopted by practicioners - you just don't have to be a self-righteous naturopath to recognize this.

 

I understand, Yoga was probably a bad example, but my point was how many GPs would recommend it is to relieve back pain as opposed to merely saying something like "it is good exercise, nothing wrong with doing it" (which is my experience with doctors).

 

And yes, St. Johns wart is nasty stuff, I am not arguing that.

 

Doesn't that go against the idea of "naturopathic medicine" in the first place? Why prescribe when your entire purpose is to provide patients with an alternative option?

 

Being a naturopath does not mean you don't believe in allopathy as well, the goal is merely to provide an alternative. They (at least more recent ND's) do believe that allopathy is the correct course of action depending on the person's diagnoses

etc.

kid. you only just decided to go down the career path of a naturopathic doctor. Don't prematurely come on an internet forum by telling us about your life and your opinions.

 

No one cares.

 

No offense, but a forum is a place to express ideas, opinions, information etc. Like I mentioned earlier, I was merely meaning to share some reasons that I am considering being an ND. I did say that I dedicated myself to this path.

 

Lol, very good point Madz! There is no proof that Naturopathic medicine is very effective (let alone better than Allopathy). In fact, I shadow an ER doc, and one of the first questions asked when a patient is brought in, is whether or not they have been on any alternative medicine. This is asked because oftentimes these drugs contain something very potent and potentially nephro/hepato-toxic. The side effects of these mediciations has never been thoroughly studied, but that doesn't mean there are no side effects from these medications whatsoever, but rather we don't know of any. I have a strong suspicion that not only do these drugs have significant side effects, the side effects can be much more severe and dangerous than "studied and tested" allopathic medicine. There was a study recently (NEJM, and BMJ) that showed that on a double blind study of one specific naturopathic medication, efficacy was comparable to placebo. There was no significant correlation between naturopathic medication and symptomatic alleviation. If in fact they do work for headaches and other minor ailments, I suspect that this can be exclusively attributed to the placebo effect.

 

Why not study both? I know it is a long time of study, but you may be able to investigate efficacy of alternative medicine, with a bit more scientific method and knowledge in both pathways of medicine.

 

And finally, Thank You. I helpful post. This is the type of response I was looking for. Because I only recently began looking at naturopathy I do not know a lot about some of its treatments, only what I have been exposed to personally.

[Madz25]

Being a naturopath does not mean you don't believe in allopathy as well, the goal is merely to provide an alternative. They (at least more recent ND's) do believe that allopathy is the correct course of action depending on the person's diagnoses etc.

 

I never said that NDs don't believe in allopathic medicine. Yes, the goal is to provide an ALTERNATIVE. Why prescribe the same things that physicians prescribe? That's not providing an alternative....it's providing the same thing lol.

[Jordan88]

Because the government is finding that GPs are overcrowded and this will make it easier for people to get these treatments. plus NDs want to considered more like a primary care giver.

[A-Stark]

Because the government is finding that GPs are overcrowded and this will make it easier for people to get these treatments. plus NDs want to considered more like a primary care giver.

 

No, that's what Naturopathic associations are saying. Why should they be primary care providers when they lack the qualifications? (like, oh, clerkship and residency)

[Tango Charlie]

Like stoked, I dislike your diabetes example. It's very easy to say that type 2 diabetes can be controlled effectively by diet control, much in the same way it's very easy to say that obesity can be solved through diet control. Or smoking related pathologies through... not smoking. But people are not zen masters who're perfect in their application of doctors' advice. It's called non-compliance, and it's a huge pain in the ass for physicians everywhere. Hypoglycemia is tough to avoid for diabetics, and even in a hospital setting it crops up and is, in fact, a significant contributor to extended hospital stays and even patient death.

 

The $$ issue is another one I've heard repeatedly and something I find interesting. It's no secret that drug companies (like every company) is interested in making money. However, to act as if all or most MDs are in cahoots with Big Pharma is a bit silly. Furthermore, there are plenty of "natural" drugs and remedies which are of, at best, dubious efficacy, but I'm sure rake in a tidy profit themselves.

 

Homeopathy is an excellent example of the hucksters which permeate the natural "medicine" industry. Homeopathic products are, quite literally, water. Their mechanism of action is that of a placebo. Their former contents are often diluted far, far beyond Avagadro's limit. And yet they sell for ludicrous amounts of money per dose. Where is the scrutiny these snake oil vendors deserve?

 

Overall I think referring to naturopaths as doctors is a bit of a sham, and part of that industry's desire to give themselves more gravitas than they deserve. While I think people should be free to pursue their treatment options, naturopaths should supplement allopathic treatment, not replace it.

[AndrewB]

Overall I think referring to naturopaths as doctors is a bit of a sham

 

Or a huge sham.

[skvangs]

I agree with these points. As a physician, I would never suggest to a patient to go to an ND. If they wanted to go, I would suggest they research it further, but not to have too much hope.

 

 

Like stoked, I dislike your diabetes example. It's very easy to say that type 2 diabetes can be controlled effectively by diet control, much in the same way it's very easy to say that obesity can be solved through diet control. Or smoking related pathologies through... not smoking. But people are not zen masters who're perfect in their application of doctors' advice. It's called non-compliance, and it's a huge pain in the ass for physicians everywhere. Hypoglycemia is tough to avoid for diabetics, and even in a hospital setting it crops up and is, in fact, a significant contributor to extended hospital stays and even patient death.

 

The $$ issue is another one I've heard repeatedly and something I find interesting. It's no secret that drug companies (like every company) is interested in making money. However, to act as if all or most MDs are in cahoots with Big Pharma is a bit silly. Furthermore, there are plenty of "natural" drugs and remedies which are of, at best, dubious efficacy, but I'm sure rake in a tidy profit themselves.

 

Homeopathy is an excellent example of the hucksters which permeate the natural "medicine" industry. Homeopathic products are, quite literally, water. Their mechanism of action is that of a placebo. Their former contents are often diluted far, far beyond Avagadro's limit. And yet they sell for ludicrous amounts of money per dose. Where is the scrutiny these snake oil vendors deserve?

 

Overall I think referring to naturopaths as doctors is a bit of a sham, and part of that industry's desire to give themselves more gravitas than they deserve. While I think people should be free to pursue their treatment options, naturopaths should supplement allopathic treatment, not replace it.

[Jordan88]

Thanks for the responses. I would like to reiterate that despite what my original post may have made it sound like, I do not believe that naturopathy should replace allopathic treatment, but merely be an alternative. However, through my personal experiences, whether it be myself specifically or family and friends, I have found that there are some alternative treatments that for specific cases did work the best. This is the reason I have decided to do some research in to it. That being said, I know several people who suffer from severe chronic depression and there is absolutely no doubt that without allopathic medication life would be miserable (and is if their dedication to the prescription wavers), I know that surgery can be absolutely necessary very often etc. etc. etc. My goal was not to come here and argue on behalf of Naturopathic Medicine, but rather to just ask other peoples' opinions who know more about it than I do.

 

I understand that doctors do support a healthy diet and exercise, but from what I can tell it is generally not even suggested for anything more than improving general health and reducing the risk of some chronic disease. Here is an example of something that diet can do (and this is from an MD, not an ND):

 

http://www.drmcdougall.com/misc/2009nl/jan/ms.htm

 

Note: to the guy who said something about not doing residency etc., I understand your point. And although it isn't the same as a 3 year residency, part of the schooling is clinical internship (1200 hours) and time spent working with practising "physicians" (300 hours).

 

PS. For anyone interested, Here is an outline of the 4-year curriculum of Naturopathy (prerequisites for naturopathy are identical to that of med school, but a Bachelors degree is also needed for application):

http://www.binm.org/Curriculum.html

There is some stuff one here that I am unsure of, primarily Homeopathy.

[A-Stark]

Note: to the guy who said something about not doing residency etc., I understand your point. And although it isn't the same as a 3 year residency, part of the schooling is clinical internship (1200 hours) and time spent working with practising "physicians" (300 hours).

 

Said internship is not hospital based and 1200 hours is less than half of a year of clerkship (with no call, I might add). Consideration of complementary and alternative remedies is perfectly fine, but you do not need to be an ND to do it. "Healthy diet and exercise" are great, of course, and it is a real problem that many family docs lack sufficient time for proper lifestyle counselling.

 

That doesn't mean that such an approach is sufficient for endocrine disturbances and the like. It would further help a great deal if naturopaths stayed away from crackpot garbage like environmental sensitivity, nonsense like systemic candida, and non-specific syndromes like chronic fatigue.

[A-Stark]

3 units of differential diagnoses to 4 units of homeopathy. for a primary health care provider?!? this is not reassuring.

 

in any case, this is probably the wrong forum to try and legitimize naturopathy (and have people agree with you).

 

I note a conspicuous lack of pathology, embryology, histology, immunology, physiology, surgery, psychiatry, anaesthesia, and... need I go on? Instead we have such things as clinical ecology, personal wholeness and choice, and psychological models & transpersonal experience. No idea what that last one was.

[Jordan88]

Yeah, all very good points. Jeeze, I didn't even notice that there was no coverage of physiology and pathology etc... I guess what would be more appropriate to do would be to complete my medical degree and take continuing education courses in areas such as nutrition.

[da_birdie]

Here's a bit of fun reading material for ya (one of the threads on premed101 a couple months ago re: naturopaths prescribing)

http://www.premed101.com/forums/showthread.php?t=31735

 

And here are some sites for ya:

 

http://www.quackwatch.org

http://www.naturowatch.org

http://www.sciencebasedmedicine.org

 

And to cap it off, a video demonstrating how a naturopath/homeopath ER would look like:

 

[ploughboy]

And to cap it off, a video demonstrating how a naturopath/homeopath ER would look like:

 

 

 

I don't remember the last time I laughed so hard. Brilliant!

 

Addendum - I think my favourite line was "When someone comes in with a vague sense of unease, or a touch of the nerves, or even just more money than sense, you'll be there for them; a bottle of basically just water in one hand and a huge invoice in the other."

[AndrewB]

And to cap it off, a video demonstrating how a naturopath/homeopath ER would look like:

 

 

That is freakin unreal! Genius

[Ollie]

I understand that doctors do support a healthy diet and exercise, but from what I can tell it is generally not even suggested for anything more than improving general health and reducing the risk of some chronic disease.

 

OK, I was reading through this thread, mildly amused by your naivete, but this statement seriously pisses me off. You have no idea how much time I spend every day talking to my diabetic/hypertensive/hyperlipidemic/obese patients about diet and exercise. Many of them also see dieticians. A fraction of them are actually successful. In one year of family practice residency I have taken a whopping ONE patient off his BP meds because he followed the DASH diet and lost weight. (and did you know that the DASH diet is part of the Canadian Hypertension Guidelines, imagine that, doctors recommending dietary change!).

 

However, through my personal experiences, whether it be myself specifically or family and friends, I have found that there are some alternative treatments that for specific cases did work the best.

 

This is called anecdotal evidence, and it's what naturopaths rely heavily upon. The plural of "anecdote" is not "fact".

[mrhumble]

ND service is not covered by OHIP in Ontario (maybe the same for other provinces and territories).

 

Who will actually pay to use them for primary care purposes?

[Flame219]

Haha, poor guy. Being bashed upon as naive by some of you here. Ok, just to eliminate a sense of bias (if there is one) in a predominantly (apparently) allopathic premed forum, can you guys think of some good points (counter-arguments) if you're arguing for a realistic position for naturopaths in society?

 

Note: I'm really just curious lol, not in any way arguing for naturopaths in providing primary care.

 

Some obvious notions:

Modification of curriculum: ELIMINATE homeopathy! (WTF is that doing here) Like previous posters, add in physiology and pathology.

Remodelling ideology and some essential core approaches: A lot of things done in Naturopaths are not concrete in science, and do not have a basis to use them on the general public. That is really dangerous. However, they do have a realistic role in providing "alternative" medical care by exploring different principles and effectively try to rip them into shreds to let the remaining principles rooted in the basis of science as a holistic approach. First of all, they should eliminate the first Hippocratic principle: Above all, do no harm. I do not believe in a world where you can treat patients in a completely non-invasive manner.

Of course, that basically could be done (and are done) by doctors (allopathic), but let's say we don't want to engulf everything and absorb everything. Let's say for their sake we leave herbal medicine that withstand clinical trials for them to become experts.

Classify/change the belief system and include it in a branch of allopathic medical schools: it is theoretically possible, as herbal specialists or other verifired techniques with society trends promoting specialization of individuals.

[Jordan88]

Yeah, ok. I apologize for asking / inquiring. How stupid of me.

[KennethToronto]

Good on ya Jordan88 for considering Naturopathy, especially if you reside in BC: you can call yourself 'doctor' and more or less do everything their GPs do, without actually going through any of the training!