Naturopathic way

By Orna Izakson

Tired of feeling like assembly-line widgets when they go to the doctor's office, many Americans are turning to a form of health care that relies on natural medicines that have been healing humans for centuries.

Known as naturopathic medicine or naturopathy, the field was born officially 100 years ago, though many of its practices can be traced back to the dawn of both Eastern and Western medicine. Naturopaths rely on an amalgam of herbs, nutritional supplements, dietary advice, physical manipulation, counseling, and homeopathy (the use of extremely diluted solutions to cure what the same substances in concentrated form would cause). Their philosophy holds that "nature cures," and that addressing the underlying causes of a disease-not just its symptoms-allows the body to heal itself.

"Naturopathic philosophy has a recognition that before treating a disease you have to establish the basis for health," explains Dr. Pamela Snider, a naturopathic physician and co-investigator on the North American Naturopathic Medical Research Agenda of the National Institutes of Health. "That's what allows the self-healing process to work. You establish healthy habits, and provide the body what it needs naturally, and many conditions resolve themselves."

A typical first visit can take an hour or longer, as the doctor gathers health information and performs a thorough physical examination. Those details help the naturopath form a clear picture of the patient and get ideas for how to treat her. For instance, many doctors will extensively question patients about their diet, on the theory that the body can't fight (or prevent) disease without the right biochemical tools.

In the United States and Canada , a licensed naturopathic doctor, or N.D., must complete both a bachelor's degree and a 4-year training program at an accredited naturopathic college. Students take many of the same core science classes offered at a mainstream (or "alopathic") medical school, including microbiology, anatomy, physiology and pharmacology. Depending on state laws, some naturopaths can prescribe medications such as antibiotics, order and read blood tests, and perform minor surgery, x-rays, and gynecological exams. Though naturopaths generally prefer medicines more directly from nature, practitioners differ in how strictly they draw the line on allopathic drugs.

NDs do the job of a primary-care physician. But unlike MD family practitioners, who often refer patients with intractable or chronic conditions on to specialists, naturopaths routinely treat such cases. For instance, a naturopath might help asthmatics reduce their reliance on inhalers or other drugs, and many cancer patients look to naturopathy as an adjunct to the harmful radiation or chemotherapy they may need to stay alive. Similarly, people turn to naturopaths for help with pain and other problems that mainstream medicine fails to diagnose or relieve.

In the 1920s, more than 10,000 naturopathic physicians attended their professional conventions, more than 20 medical colleges trained them, and most U.S. states granted them licenses. Those numbers plummeted in the 1940s and 1950s as pharmaceutical drugs and surgery rose in public favor-and as the medical establishment tried to brand other approaches as quackery. Between 1956 and 1979, the National College of Naturopathic Medicine in Portland , Oregon , was the lone training ground for the profession, graduating only 70 doctors in its first two decades.

Critics say there's little scientific evidence that naturopathy works, despite a long - if not fully documented - history of success. In fact, until recently there's been little effort to find out using rigorous scientific methodology. With the new interest in exploring complementary and alternative medicine ( CAM ) at the National Institutes of Health, that seems to be changing. Some predict that the next big test for naturopathic schools will be the new competition mainstream medicine as it begins adopting the field's time-tested methods. Numerous well-known research centers have begun studying such therapies-and applying for the available federal funds to do so. Some of the winners in the quest for that money have been NCNM and Bastyr University in Seattle , where researchers are investigating natural therapies for cancer, diabetes and AIDS.

One thing is certain: With managed care limiting medical visits, consumers are looking for alternatives.

"An MD in this day and age, with insurance requirements.they don't have more than five minutes to stay with you," says Kathleen Warren, media director at Bastyr University in Seattle . "That's the way of the world."

Today, there are four accredited naturopathic colleges in the United States and Canada : Bastyr, NCNM, Southwest College of Naturopathic Medicine in Arizona , and Canadian College of Naturopathic Medicine in Ontario . According to Dr. Snider, the number of people studying to join the profession jumped 500 percent between 1990 and 2001, when 1,523 were enrolled in U.S. schools. Twelve states, five Canadian provinces, and Puerto Rico now license naturopaths, although the doctors also work without licenses in many other places.

Naturopathy isn't for everyone. Although some cures can be quick and dramatic, natural healing methods generally work slowly and subtly. Serious conditions or emergency may require drugs or invasive procedures such as surgery or chemotherapy. And with naturopathy, healing ultimately depends on the patient, not the doctor.

"Natural medicine requires more of you," Warren explains. "It says to you 'You have to eat right, you have to exercise, you have to have a lifestyle that is more conducive to helping your health.' You can't just eat crap and take something for your heartburn. You can't just lay on a couch and ignore your body's need to move."

A version of this story originally appeared in the June, 2004 edition of Utne magazine.

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