What is a licensed Naturopathic Physician? Are they ‘real doctors?’ What is the difference?

Naturopathic physicians complete training similar in type, length and intensity to medical (MD) and osteopathic (DO) doctors. Naturopathic medical colleges are four-year postgraduate schools (meaning that an applicant first must have a Bachelor’s degree or similar type of training from an accredited college) with rigorous admissions requirements comparable to other medical schools. The Doctor of Naturopathic Medicine (ND or NMD) degree is awarded after classroom, clinic and practical study similar in many ways to that of an MD program, except that ND training usually focuses on outpatient care in a primary care setting rather than a hospital setting, and uses natural therapies first before resorting to pharmaceutical ones.

NDs are trained in the standard medical sciences including anatomy, physiology, biochemistry, microbiology, immunology, pharmacology, cardiology, neurology, radiology, minor surgery, obstetrics, gynecology, pediatrics, psychology, dermatology, and clinical diagnostic skills. Additional specialized naturopathic healing therapies include therapeutic nutrition, botanical medicine, homeopathy, natural childbirth and birth control, acupuncture, Ayurvedic medicine, PRP therapy, hydrotherapy, nutritional IV therapy, physical medicine, spinal manipulation therapy, counseling, hormone optimization therapies and more. Because there are so many effective natural therapies, there is a wide diversity among these physicians in terms of practice focus and treatment style.

Naturopathic Physicians are trained to be primary care physicians, though some elect to specialize after graduation and complete additional training and board certification. They are trained in clinical pharmacology and can prescribe medications (such as antibiotics or steroids) if needed according to state statue. Because their training is equivalent in scope, they can serve in the same capacity as a ‘regular’ physician by state law in Hawaii. For example, they can complete work, school and insurance physicals, create court required documents and service animal letters, and write absence letters for work and school.

Naturopathic Physicians perform and order a wide variety of diagnostic tests including physical exams, conventional and specialty laboratory testing, gynecological exams, nutritional and dietary assessments, metabolic analysis, allergy testing, X-ray, CT and MRI examinations. Trained in a wide variety of conventional, pharmaceutical and natural therapies, your physician will combine and tailor these tests and treatments to your specific needs to bring about changes necessary to overcome disease and assure optimal health. As with all physicians, NDs refer to and collaborate with other medical specialists when appropriate.

It is important to make sure that your physician has a legitimate degree from a CNME accredited medical school. The professionally-recognized, CNME credentialed colleges of Naturopathic Medicine in North America are: National College (NUNM) in Portland, Oregon, Bastyr University in Bothell, Washington and San Diego, Southwest College in Scottsdale, Arizona, University of Connecticut at Bridgeport and Canadian College in Ontario, Canada.

Like many states and provinces, Hawaii's laws require extensive post-doctoral board examination and certification for licensure, as well as ongoing continuing education requirements. This policy is supported by the American Association of Naturopathic Physicians, at www.naturopathic.org, which also maintains high standards of education and medical practice and encourages scientific research. In some states where there is no licensure yet for real Naturopathic Physicians, so the rule is ‘buyer beware’ in those states, as one must check to be sure that the person in question has an actual degree from one of the above reputable schools.

Insurance

In Hawaii, most insurance companies do not yet enroll Naturopathic Physicians as PCP ‘providers’ and therefore most Naturopathic Physicians do not accept insurance for payment. (If you would like for your insurance to cover your care with your ND, please call and ask your company to enroll your Naturopathic physician as your ‘PCP’.) On the plus side, this means that your ND works for YOU, and is not limited by insurance company rules and restrictions. Your needs and care are their primary concern. This results in more in-depth care, longer visits, more freedom of choice in care options for you, and less paperwork hassle for both patient and doctor.

Why do some people think that ‘Naturopaths’ are not ‘real doctors’?

This unfortunate misunderstanding has 2 main causes. While the term ‘MD’ or ‘Medical Doctor’ is a legally protected definition in all 50 states, the term ‘Naturopathic Doctor’ is only protected by state licensure law in about 15 states. This means that in those ‘unlicensed’ states, anyone, even someone with no training at all, can call themselves a ‘naturopath’ or even a ‘Naturopathic doctor’ because the term has no legal definition or protection. This puts the burden of awareness and safety back onto the patient. In those states, he or she has to check to be sure that the person they are trusting with their health has real training from a CNME accredited university and has passed comprehensive board exams. To help their patients tell the difference, many of the legitimate NDs in those states will go to the effort to maintain a medical license in a licensable state even though they do not live there. While traditional or ‘lay’ naturopaths can in some cases also be effective healers, their scope of training and the ability to safely diagnose illness are vastly different. Fortunately, Hawaii has full licensure for Naturopathic Physicians, with education requirements, board exams and ongoing continuing education requirements.

The second reason some people think this is more subtle and has to do with some deep differences in belief and philosophy of care between naturopathic and conventional medicine. While having much in common, these 2 professions also differ strongly in some beliefs about medicine and what ‘best practice’ means. For example, ND’s strongly believe in the principle “First, do no harm’, and interpret this to mean that pharmaceutical drugs should be the last resort rather than the first treatment option, due to their potential toxicities and side effects. ‘Allopathic’ (or conventional) physicians, on the other hand, while also citing the same principle, often use drugs as their first and only treatment option. This difference in belief about what this principle means, and the resulting difference in practice styles has led to a divisive medical culture, with fear, misunderstanding and defensiveness on both sides. It is often the case that someone trained in a conventional medical school does not even know that an ND has a respect for science and evidence based medicine as well as a respect for the emotional and energetic health of the patient, and, while different, has a similar depth and scope of training as a conventional physician. Since there are many more MD physicians than ND physicians, the dominant cultural beliefs about medicine reflect the belief that all Naturopathic physicians are ‘less than,’ ‘anti science,’ or ‘woo’. Fortunately, public awareness of the value of real, trained Naturopathic Physicians is growing.

 For more on the philosophy of care of Naturopath Physicians, see below.

Physician and Patient: Partners in Health

Your naturopathic physician works in collaboration with you to encourage your body's innate healing abilities and encourages health-promoting and disease-preventing practices through education. Naturopathic Doctors typically spend a significantly higher amount of time one-on-one with patients than a MD is usually allowed to (by insurance companies), allowing for a deeper understanding of the complete individual.

Naturopathic medicine relies upon an active and ongoing partnership between the patient and the physician. In this relationship, the physician is a guide and the patient takes responsibility for their own health and wellness, supported by the physician.