Tired of feeling like assembly-line widgets when they go to the doctor's office, many North 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 some 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 [recognizes] that before treating a disease you have to establish the basis for health,' explains Pamela Snider, a naturopathic doctor (N.D.) and co-investigator on the North American Naturopathic Medical Research Agenda, funded by 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 treatment. For instance, many doctors will question patients extensively 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 must complete both a bachelor's degree and a four-year training program at an accredited naturopathic college. Students take many of the same core science classes offered at allopathic medical schools, including microbiology, anatomy, and physiology. Depending on state laws governing the scope of their practices, some naturopaths can prescribe medications such as antibiotics, order and read blood tests, perform minor surgery, take x-rays, and do gynecological exams. Though naturopathy prefers medicines more directly from nature, practitioners differ in how strictly they draw the line on pharmaceuticals.
An N.D. does the job of a primary-care physician. But unlike M.D. family practitioners, who often refer patients with intractable or chronic conditions to specialists, naturopaths routinely treat such cases. For instance, a naturopath might help asthmatics reduce their reliance on inhalers or other drugs, and some 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 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 undocumented -- history of clinical success. In fact, until recently, there's been little effort to test naturopathic therapies in a rigorous scientific way. With the new interest in exploring complementary and alternative medicine at the National Institutes of Health, that seems to be changing. The next big challenge to naturopathic schools may be from allopathic medical schools potentially siphoning off students and support for N.D. programs.
One thing is certain: With managed care limiting medical visits, consumers are looking for alternatives.
'In this day and age, with insurance requirements, an M.D. doesn't have more than five minutes to stay with you,' says Kathleen Warren, media director at Bastyr University north of Seattle. 'That's the way of the world.'
Today, there are four fully accredited naturopathic colleges in the United States and Canada: Bastyr, Portland's NCNM, Southwest College in Tempe, Arizona, and the Canadian College of Naturopathic Medicine in Toronto. According to 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. Thirteen states, five Canadian provinces, Puerto Rico, and the U.S. Virgin Islands now license naturopaths; they 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 or emergency conditions 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 lie on a couch and ignore your body's need to move.'