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In five Canadian provinces, fifteen US states and the District of Columbia, [[Doctor of Naturopathic Medicine|naturopathic doctors]] who are trained at an [[naturopathic medical school in North America|accredited school of naturopathic medicine]] in North America are entitled to use the designation ND or NMD. Elsewhere the designation is generally unprotected.<ref>[http://medicalboard.iowa.gov/Naturopathy.html A Policy Statement on Naturopathy]</ref> Those from these particular accredited schools are trained to use diagnostic tests such as [[imaging]] and [[blood tests]] before deciding upon the full course of treatment,<ref name="CNME-handbook"> [http://www.cnme.org/resources/2007_hoa.pdf Handbook of Accreditation for Naturopathc Medicine Programs, p45]</ref> and to refer to other health professionals for standard medical care where it is required. However, the scope of practice for Naturopathic doctors varies widely amongst jurisdictions, and naturopaths in unregulated jurisdictions may use the ND designation or other titles regardless of level of education.
In five Canadian provinces, fifteen US states and the District of Columbia, [[Doctor of Naturopathic Medicine|naturopathic doctors]] who are trained at an [[naturopathic medical school in North America|accredited school of naturopathic medicine]] in North America are entitled to use the designation ND or NMD. Elsewhere the designation is generally unprotected.<ref>[http://medicalboard.iowa.gov/Naturopathy.html A Policy Statement on Naturopathy]</ref> Those from these particular accredited schools are trained to use diagnostic tests such as [[imaging]] and [[blood tests]] before deciding upon the full course of treatment,<ref name="CNME-handbook"> [http://www.cnme.org/resources/2007_hoa.pdf Handbook of Accreditation for Naturopathc Medicine Programs, p45]</ref> and to refer to other health professionals for standard medical care where it is required. However, the scope of practice for Naturopathic doctors varies widely amongst jurisdictions, and naturopaths in unregulated jurisdictions may use the ND designation or other titles regardless of level of education.

Naturopathy relies on scientifically unproven treatments,<ref name=Barrett-Naturopathy/><ref name="atwood">Atwood KC (2004) Naturopathy, pseudoscience, and medicine: myths and fallacies vs truth. ''Medscape Gen Med''6:e53 [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1140750 available online]</ref> including [[homeopathy]], which is a form of [[pseudoscience]], often considered [[quackery]].<ref name="NSBattitudes"/><ref name="WahlbergQuack">
{{cite journal
|author=Wahlberg A
|year=2007
|doi=10.1016/j.socscimed.2007.07.024
|title=A quackery with a difference—New medical pluralism and the problem of 'dangerous practitioners' in the United Kingdom
|journal=Social Science & Medicine
|volume=65
|issue=11
|pages=2307–2316
|pmid=17719708
}}</ref>


==History of naturopathic medicine==
==History of naturopathic medicine==

Revision as of 22:30, 15 February 2009

Part of a series on
Alternative medicine
General information
Fringe medicine and science
Controversies
Classifications
Traditional medicine
Alternative diagnoses

Naturopathic medicine (also known as naturopathy, or natural medicine) is a complementary and alternative medicine which emphasizes the body's intrinsic ability to heal and maintain itself. Naturopaths use natural remedies such as herbs and foods rather than surgery or synthetic drugs. Naturopathic practice includes many, and different, treatment modalities, with practitioners emphasizing a holistic approach to patient care, and may also recommend that patients use conventional medicine alongside their treatments, if indicated.

Naturopathy has its origins in the Nature Cure movement of Europe.[1][2] It is practiced in many countries but subject to different standards of regulation and levels of acceptance.

In five Canadian provinces, fifteen US states and the District of Columbia, naturopathic doctors who are trained at an accredited school of naturopathic medicine in North America are entitled to use the designation ND or NMD. Elsewhere the designation is generally unprotected.[3] Those from these particular accredited schools are trained to use diagnostic tests such as imaging and blood tests before deciding upon the full course of treatment,[4] and to refer to other health professionals for standard medical care where it is required. However, the scope of practice for Naturopathic doctors varies widely amongst jurisdictions, and naturopaths in unregulated jurisdictions may use the ND designation or other titles regardless of level of education.

History of naturopathic medicine

Some see the ancient Greek "Father of Medicine", Hippocrates, as the first advocate of naturopathic medicine, before the term existed.[5] In Scotland, Dr Thomas Allinson started advocating his "Hygienic Medicine" in the 1880s, promoting a natural diet and exercise with avoidance of tobacco and overwork.[6][7]

In the USA, the term naturopathy was coined before 1900 by John Scheel, and used by Benedict Lust. Lust had been schooled in hydrotherapy and other natural health practices in Germany by Father Sebastian Kneipp, who sent Lust to the United States to bring them Kneipp's methods. In 1905, Lust founded the American School of Naturopathy in New York, the first naturopathic college in the United States. Lust took great strides in promoting the profession, culminating in passage of licensing laws in several states prior to 1935, including Arizona, California, Connecticut, Hawaii, Oregon, and Washington and the founding of several naturopathic colleges.

Naturopathic medicine went into decline, along with most other natural health professions, after the 1930s, with the discovery of penicillin and advent of synthetic drugs such as antibiotics and corticosteroids. In the post-war era, Lust's death, conflict between various schools of natural medicine (homeopathy, eclectics, physio-medicalism, herbalism, naturopathy, etc.), and the rise of medical technology were all contributing factors. In 1910, when the Carnegie Foundation for the Advancement of Teaching published the Flexner Report which criticized many aspects of medical education in various institutions (natural and conventional), it was mostly seen as an attack on low-quality natural medicine education. It caused many such programs to be shut down by the U.S. Government and contributed to the popularity of conventional medicine.

Naturopathic medicine never completely ceased to exist, however, as there were always a few states in which licensing laws existed— although at one point there were virtually no schools. One of the most visible steps towards the profession's modern renewal was the opening in 1956 of the National College of Natural Medicine in Portland, Oregon. This was the first of the modern naturopathic medical schools offering four-year naturopathic medical training with the intention of integrating science with naturopathic principles and practice. Today there are six accredited naturopathic medical schools in North America.

Principles

The philosophy of naturopathy is often described by six core values.[8] Multiple versions exist in the form of the naturopathic doctor's oath,[9] various mission statements published by schools[10] or professional associations, and ethical conduct guidelines published by regulatory bodies:[11]

  1. First, do no harm; provide the most effective health care available with the least risk to patients at all times (Primum Non Nocere).
  2. Recognize, respect and promote the self-healing power of nature inherent in each individual human being. (Vis Medicatrix Naturae).
  3. Identify and remove the causes of illness, rather than eliminate or suppress symptoms (Tolle Causum).
  4. Educate, inspire rational hope and encourage self-responsibility for health (Doctor as Teacher).
  5. Treat each person by considering all individual health factors and influences. (Treat the Whole Person).
  6. Emphasize the condition of health to promote well-being and to prevent diseases for the individual, each community and our world. (Health Promotion, the Best Prevention)

Modalities

Naturopathy's focus is upon its philosophy of natural health rather than specific methods and so practitioners use a wide variety of treatment modalities. The core set of interventions defined by the Council on Naturopathic Medical Education and taught at all six accredited schools in North America includes:[12]

The CNME also provides for the inclusion of optional modalities including minor surgery, natural childbirth and intravenous therapy. These modalities require additional training and may not be within the scope of practice in all jurisdictions.

In addition to the standard modalities used by naturopathic doctors listed above, individual naturopaths may incorporate practices from other disciplines:

Practitioners

There are two groups in North America calling themselves "naturopaths". The term when originally coined by John Scheel, and popularized by Dr. Benedict Lust was to apply to those receiving an education in the basic medical sciences with an emphasis on natural therapies. This usage best describes modern day naturopathic doctors. In the absence of universal regulation of naturopathy, another group of practitioners (the so-called 'traditional naturopaths') has emerged. Additionally, a variety of health care professionals may incorporate naturopathic principles and modalities into their practice.

Naturopathic doctors

See also: Doctor of Naturopathic Medicine

Naturopathic doctors in North America are primary care providers trained in conventional medical sciences, diagnosis and treatment, and are experts in "natural therapeutics". Licensing and training requirements vary from state to state, but at least 16 states, the District of Columbia, and five Canadian provinces have formal licensing and educational requirements.[15][16] - In these jurisdictions, naturopathic doctors must pass comprehensive board exams set by the North American Board of Naturopathic Examiners (NABNE)[17] after having completed academic and clinical training at a college certified by the Council on Naturopathic Medical Education (CNME).[18] The letters ND usually designate a naturopathic doctor in jurisdictions where such a title is protected by law, although other designations exist. In unregulated jurisdictions, the ND title is not protected and may be used by any practitioner regardless of qualifications.

Traditional naturopaths

Traditional naturopaths are guided by the same naturopathic philosophies and principles as board-licensed naturopathic doctors and often prescribe similar treatments. Traditional naturopaths however, are not primary care providers, whereas graduates of CNME accredited naturopathic medicine schools are classified as both alternative or complementary practitioners as well as primary care providers. Traditional naturopaths may voluntarily join a professional organization, but these organizations do not accredit educational programs in any meaningful way or license practitioners per se.[citation needed] The training programs for traditional naturopaths can vary greatly, are less rigorous and do not provide the same basic and clinical science education as naturopathic medical schools do.[citation needed] The professional organizations formed by traditional naturopaths are not recognized by the government of the USA or any US State or Territory.

Other health care professionals

According to a 1998 taskforce report, some conventionally trained physicians are choosing to add naturopathic modalities to their practice,[19] and states such as Texas have begun to establish practice guidelines for MDs who integrate alternative and complementary medicine into their practice.[20] Continuing education in naturopathic modalities for health care professionals varies greatly but includes offerings for practitioners: physicians, chiropractors, acupuncturists, dentists, researchers, veterinarians, physician’s assistants, and nurses.[21] These professionals usually retain their original designation but may use terms such as 'holistic', 'natural', or 'integrative' to describe their practice.

Regulation

In some jurisdictions the practice of naturopathic medicine is unregulated and so the titles like "naturopath", "naturopathic doctor", and "doctor of natural medicine" are not protected by law. This may lead to difficulty in ensuring that a practitioner is trained to a particular standard or has adequate liability insurance.

Australia

There is currently no state licensure in Australia, rather the industry is self-regulated. There is no protection of title, meaning that technically anyone can practise as a naturopath. The only way to obtain insurance for professional indemnity or public liability is by joining a professional association, which can only be achieved having completed an accredited course and gaining professional certification. Currently the only registered modalities of natural medicine in Australia are those relating to Chinese medicine, and only in the state of Victoria.[22]

In 1977 a committee reviewed all colleges of naturopathy in Australia and found that, although the syllabuses of many colleges were reasonable in their coverage of basic biomedical sciences on paper, the actual instruction bore little relationship to the documented course. In no case was any practical work of any consequence available. The lectures which were attended by the Committee varied from the dictation of textbook material to a slow, but reasonably methodical, exposition of the terminology of medical sciences, at a level of dictionary definitions, without the benefit of depth or the understanding of mechanisms or the broader significance of the concepts. The Committee did not see any significant teaching of the various therapeutic approaches favoured by naturopaths. Persons reported to be particularly interested in homoeopathy, Bach's floral remedies or mineral salts were interviewed, but no systematic courses in the choice and use of these therapies were seen in the various colleges. The Committee was left with the impression that the choice of therapeutic regime was based on the general whim of the naturopath and since the suggested applications in the various textbooks and dispensations overlap to an enormous extent no specific indications are or can be taught.[1]

North America

In North America, each jurisdiction that regulates naturopathic medicine defines a local scope of practice for naturopathic doctors that can vary considerably. Some regions permit minor surgery, access to prescription drugs, spinal manipulations, obstetrics and gynecology and other regions exclude these from the naturopathic scope of practice.[23]

United States

Canada

Canadian provinces which license naturopathic doctors: British Columbia, Manitoba, Ontario, Saskatchewan and Nova Scotia.[27]

United Kingdom

In the United Kingdom, as there is no government sponsored regulation of the naturopathy profession, naturopaths are unregulated. The largest registering body, The General Council & Register of Naturopaths, recognises three courses in the UK, two being taught at osteopathic schools: the British College of Osteopathic Medicine; The College of Osteopaths Educational Trust; and one at the University of Westminster School of Integrated Health under the auspices of the BSc Health Science (Naturopathy) course.[citation needed] These organisations are not recognized by the UK regulatory frameworks.

Members of this register will either have completed a three or four year full time course or possibly be a healthcare professional who has completed a two year post-graduate Naturopathic Diploma (ND).

Alternatively, there are the Association of Naturopathic Practitioners and The British Naturopathic Association whose members can practice and get indemnity insurance.[citation needed]

India

In India there is a 5 1/2 year degree course offering a Bachelor of Naturopathy and Yogic Sciences (BNYS) degree. There are a total of 11 colleges in India, of which 4 colleges are in the state of Tamilnadu. [citation needed]

Naturopathy and Yoga, as an Indian system of medicine, falls under the Department of AYUSH, Ministry of Health & Family Welfare, Govt. of India. [citation needed]

Central Council for Research in Naturopathy & Yoga: The Govt. of India after having recognized the need for systematic Research and Development of Yoga & Naturopathy in the country, established the “Central Council for Research in Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy” in 1969 as an autonomous organization under the Ministry of Health and Family Welfare. This organization, first of its kind was established in India by the Central Govt. to conduct Scientific Research in Ayurveda, Siddha, Unani and Yoga, existed upto 1978. During this period, the development of Naturopathy was looked after by the Ministry of Health & Family Welfare directly. Later, in March 1978, this composite Council was dissolved to pave way for the formation of four independent Research Councils, one each for Ayurveda and Siddha, Unani, Homoeopathy and Yoga & Naturopathy. [citation needed]

Hence, this Council (CCRYN) was established in 1978 with a view to provide better opportunities for alround development of Yoga and Naturopathy independently according to their own doctrines and fundamental principles. [citation needed]

National Institute of Naturopathy - Dept. of AYUSH, Ministry of Health & Family Welfare, Govt. of India: The National Institute of Naturopathy, Pune came into existence on 22.12.1986. It encourages facilities for standardization and propagation of the existing knowledge and its application through research in Naturopathy throughout India. This Institute has a “Governing Body” headed by Union Minister for Health as its President. [citation needed]

Criticism

Naturopathic medicine is viewed with skepticism by critics who contend that it relies on unproven and controversial alternative medical treatments. Certain naturopathic treatments, such as homeopathy and iridology, are widely considered pseudoscience or quackery.[28][29][30]

Dr. Stephen Barrett (of Quackwatch and the National Council Against Health Fraud) has stated that the philosophy of naturopathic medicine is "simplistic and that its practices are riddled with quackery."[31]

K. C. Atwood writes, in the journal Medscape General Medicine, "'Naturopathic physicians' now claim to be primary care physicians proficient in the practice of both "conventional" and "natural" medicine. Their training, however, amounts to a small fraction of that of medical doctors who practice primary care. An examination of their literature, moreover, reveals that it is replete with pseudoscientific, ineffective, unethical, and potentially dangerous practices."[32]

See also

References

  1. ^ P S Brown (April 1988), "Nineteenth-century American health reformers and the early nature cure movement in Britain", Medical History, 32(2): 174–194
  2. ^ "History of Naturopathy". 2007.
  3. ^ A Policy Statement on Naturopathy
  4. ^ Handbook of Accreditation for Naturopathc Medicine Programs, p45
  5. ^ "What is Naturopathy?". 1998.
  6. ^ "How it all began".
  7. ^ John A S Beard (3 May 2008), "Views & Reviews Medical Classics A System of Hygienic Medicine (1886) and The Advantages of Wholemeal Bread (1889)", British Medical Journal (336): 1023, doi:10.1136/bmj.39562.446528.59
  8. ^ a b Carolyn Chambers Clark (1999), Encyclopedia of Complementary Health Practice, pp. 57–58, ISBN 9780826112392
  9. ^ "Naturopathic Doctor's Oath".
  10. ^ "Principles of Naturopathic Medicine".
  11. ^ "Guide to the Ethical Conduct of Naturopathic Doctors" (PDF).
  12. ^ "Handbook of Accreditation for Naturopathic Programs" (PDF). 2008. p. 51.
  13. ^ a b c d Jacqueline Young (2007), Complementary Medicine for Dummies, ISBN 9780470026250 {{citation}}: Unknown parameter |chapters= ignored (help)
  14. ^ a b c d Holly J. Hough, Catherine Dower, Edward H. O’Neil (September 2001), Profile of a Profession: Naturopathic Practice (PDF), Center for the Health Professions, University of California, p. 54{{citation}}: CS1 maint: multiple names: authors list (link)
  15. ^ a b American Association of Naturopathic Physicians
  16. ^ Canadian Association of Naturopathic Doctors - Welcome!
  17. ^ NABNE
  18. ^ Council on Naturopathic Medical Education
  19. ^ http://www.futurehealth.ucsf.edu/pdf_files/RTF.PDF
  20. ^ Texas Administrative Code title 22, part 9 § 200.3, 1998
  21. ^ Profile of Profession: Naturopathic Practice
  22. ^ The Royal Australian College of General Practitioners. Joint RACGP/AIMA Working Party Terms of Reference
  23. ^ 2008 Sunrise Review: Naturopathic Physicians, p19
  24. ^ "Ley 208" (PDF).
  25. ^ "South Carolina Code of Laws Section 40-31-10".
  26. ^ "Tennessee Code 63-6-205".
  27. ^ Canadian Association of Naturopathic Doctors
  28. ^ National Science Board (2002). "Science and engineering indicators". Arlington, Virginia: National Science Foundation Directorate for Social, Behavioral and Economic Sciences. {{cite web}}: |chapter= ignored (help); Unknown parameter |chapter_title= ignored (|chapter= suggested) (help); Unknown parameter |month= ignored (help); Unknown parameter |section_title= ignored (help)
  29. ^ Wahlberg A (2007). "A quackery with a difference—New medical pluralism and the problem of 'dangerous practitioners' in the United Kingdom". Social Science & Medicine. 65 (11): 2307–2316. doi:10.1016/j.socscimed.2007.07.024. PMID 17719708.
  30. ^ Iridology Is Nonsense, a web page with further references
  31. ^ A Close Look at Naturopathy
  32. ^ Atwood KC (2003). "Naturopathy: a critical appraisal". 5 (4): 39. PMID 14745386. {{cite journal}}: Cite journal requires |journal= (help)
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