What About Naturopathic Medicine?

In late September, the White House Office of Public Engagement hosted a conference call about health care reform, inviting physicians all over the country to participate. I and about 2,700 others dialed in. Senior White House officials--including Tina Tchen, director of public engagement; Mike Hash, Senior Adviser in the Health and Human Services Office of Health Reform; and David Simas, policy adviser to David Axelrod--discussed the Obama administration's goals for making health care more affordable, accessible, and efficient. Their primary concerns:

• How do we reduce the overall cost of health care?
• How do we stop insurance companies' abusive practices?
• How do we make health care safer and more effective for patients?
• How can we expand the number of primary physicians in the country--particularly physicians willing to work with the uninsured?
• How do we give patients more control over their own care?

They mentioned their support for innovative care delivery models, such as a multidisciplinary approach, and their desire to reward physicians for positive outcomes in patients' health.

At the end of their remarks, they opened the line for 10 questions from listeners. I was among the 10 physicians who jumped onto their keypads fast enough.

Here's what I asked: What about naturopathic medicine?

Naturopathy offers the very kind of cost-effective, holistic, proactive treatment that the administration is looking for. It's the answer to most of their concerns. I and the nation's other naturopathic doctors are a large, underutilized population of practitioners with specialized training in preventing illness. We keep patients out of hospitals, and in the process we save lives--and millions of dollars.

The White House officials listened to my question. They responded that at present the administration's goals did not include promoting naturopathic medicine, "but they might certainly" use science-based inquiry to consider the merits of such an approach.

While we naturopathic doctors welcome more research into the quality of our care, there are already facts and figures available regarding its efficacy and cost.

Here's what policymakers need to know. All naturopathic physicians have earned four-year postgraduate degrees from accredited institutions. We are trained as primary care physicians to treat patients with safe and gentle disciplines such as homeopathic and botanical medicine, nutrition, massage, hydrotherapy, and acupuncture. We treat whole people--body, mind, and spirit--and not just diseases. Our fundamental beliefs are that disease happens to an entire body, not just one area of it, and that the body has an innate ability to heal itself and prevent disease if given proper support.

Naturopathic doctors and their patients work together as a team to help the patient make different choices and create better health habits. The word "doctor" comes from the Latin for "teacher," and we take this ancient association seriously, teaching people how to improve their health and quality of life through lifestyle changes. We pursue the root causes of illness, not just the symptoms.

Americans need more naturopathic medicine--badly. While technology advances and drugs grow ever more plentiful and expensive, our nation remains unhealthy and obese. Our children are more prone to diabetes and other long-term chronic illnesses than ever before. Naturopathic doctors set them on the path to health--often without the detour to the pharmacist's office.

USA Today reported recently that the average individual spends $47,000 per year on drugs, and that 51% of adults and children are taking prescription drugs for a chronic condition. Each of us receives an average of 12 prescriptions a year, adds NPR, and we spend $175 billion more per year on drugs than we did just 17 years ago. The department of Health and Human Services reported in 2004 that 1 in 6 people take 3 or more prescriptions daily.

We buy more medicine than any other country, and yet we remain chronically ill.

Perhaps this is why the number of Americans who have consulted naturopathic physicians--or used what has been called complementary medicine--has risen dramatically in the past two decades. Between 1991 and 1997, the use of herbal medicines in the United States grew by 380 percent; use of vitamin therapy grew 130 percent. The Journal of the American Medical Association reported that in 1998, more than one third of adults had pursued some form of naturopathic medicine. Americans made 627 million visits to practitioners and spent $27 billion of their own money on naturopathic healing. Harvard Medical School estimated in 1997 that one out of every two people between 35 and 49 had used at least one form of complementary therapy.

The exponential growth of the industry continues. In 2007, Americans spent more than $34 billion on complementary medicine, according to the National Center for Complementary and Alternative Medicine at the National Institutes of Health. And we're not the only ones who've discovered the benefits of naturopathy. Fifty-seven percent of the people in Australia, 46% of the people in Germany, and 49% of the people of France also use some form of naturopathic medicine.

Everybody knows that we need to make substantive changes in our health care system, but as we do, we need to add naturopathy to the plan for reform. It is not enough to talk about insurance companies and their unscrupulous tactics and policies. We need to talk about prevention, nutrition, and holistic care--practices that will keep people out of the hospital and the pharmacy. The American "sick care" system, as I call it, will continue to fail unless we complement it with what naturopathy has to offer.

A health care system--or rather a health promotion system--that utilizes educated, licensed, and accountable physicians of all types is crucial to solving our crises.

So I ask again: what about naturopathic medicine?

 

Comments

[OtayPanky]

07:56 PM on 12/13/2009

Why are the basic tools of science important when investigat­ing whether some protocol works, or not?

Because they are the only way we have of assessing that some set of clinical outcomes didn't occur by chance.

Anecdotal evidence of how a protocol cured you, or your cat, just doesn't provide an adequate assessment­.

When you apply basic statistica­l analysis to clinical studies done under controlled conditions by dis-intere­sted researcher­s (rather than advocates) you can determine whether there is (say) a 95% chance that the outcomes were not due to chance.

And then, some other group of disinteres­ted researcher­s can replicate the study - and hopefully improve upon it - and verify, or disprove, the statistica­l validity of the first study.

Has naturopath­y succeeded, at this clinical level, to prove its efficacy? That's the only question that really matters in this discussion­.

[RaisingAwareness]

12:01 AM on 12/14/2009

While convention­al medicine has done great things look at how many Americans die every year from properly prescribed presriptio­n drugs every year. It's nothing short of genocide. When naturopath­ic medicine has a body count similar to this then come back and we'll talk about which I should choose.

[OtayPanky]

01:12 AM on 12/14/2009

That's a non-argume­nt in response to what I said.

Everybody dies sometime, from something. Since many take convention­al meds, and few don't, the numbers will naturally skew that way. If you had the same number of people taking homeopathi­cs only, you'd have lots of them dying too.

The question is clinically proven efficacy. That's why Obama doesn't want to give my tax dollars to support your naturopath­. There's just no clinically proven efficacy.

Why make an objection to this most reasonable request for proof? We should request it of all the protocols that people claim will help us be healthier - no matter whether they come from convention­al or alternativ­e medicine.

What, exactly, is your problem with that request. Why wouldn't ANYBODY with a college education that includes a statistics class agree that it just makes sense?

[Liz Wacker]

06:31 PM on 01/15/2010

If non-biased clinical studies are the definitive guideline for practice, then how can our convention­al medical paradigm explain why many of these studies are directly or indirectly funded by pharmaceut­ical companies? How about the fact that funding is limited, and if it's something like nutritiona­l counseling or a naturally occurring nutrient, then no one can patent it. It is more profitable to study a drug that CAN be patented and thus lead to financial gain.

Taking these limitation­s into considerat­ion, there actually exists a large body of evidence to support nutritiona­l and naturopath­ic interventi­ons, which can be found in many well-respe­cted medical journals, such as The Lancet, or by simply searching Pub Med. Truth be told, there is a large disconnect between the world of research and the world of practicing medicine. Sadly, our convention­al paradigm relies on pharmaceut­ical reps to tell us the news. Naturopath­ic doctors work to integrate the most up-to-date scientific informatio­n about natural therapies with experience of what has been successful in the past. Any MD will tell you that they, too, rely on their experience to guide them, not merely double-bli­nd placebo controlled studies - this is common sense.

[Paradym]

07:51 AM on 12/12/2009

As long as it has proven medical efficacy, I'm all for it. By proven, that means double-bli­nd studies, peer-revie­wed research based upon sound scientific principles­. Sadly, naturopath­y does not fit that criteria.

[OtayPanky]

07:53 PM on 12/12/2009

This is the bar that the naturopath­ic community has to clear to get access to government funds.

Writing articles that define the word "doctor", or telling us about your accredited institutio­ns, won't cut it.

Like the commercial says, "Show us the Carfax".

Until then, society will judge naturopath­s as quacks, and thankfully they will continue to be "underutil­ized".

The burden of PROOF - by which we mean double-bli­nd, verified studies by disinteres­ted researcher­s - is 100% upon those who advocate for naturopath­y. Really, you folks need to put up, or shut up. Your anecdotes, your "wisdom", your flowery language is not an adequate substitute­.

Just show us the Carfax...n­ot the car fox.

[RaisingAwareness]

11:52 PM on 12/11/2009

Some people think being on 20 prescripti­on drugs is health. Others, like myself, believe health means not having to take any drugs and instead eating organic, taking high quality supplement­s, detoxing, exercising and working on your spiritual health. If prescripti­on drugs are so good for you then why do we know so few healthy prescripti­on drug users? Do you know any?

[Whatevah]

01:01 PM on 12/14/2009

It's odd that you mention this. It's a subject that has baffled me.

I know many gloriously healthy middle-age­d folks who use prescripti­on drugs to maintain themselves­. Statins, anti-infla­mmatory drugs and blood pressure meds (to name a few) can allow people to continue vital, active lifestyles much longer than our ancestors.

On the other hand, I know several very sickly folks who avoid convention­al medicine and rely instead on supplement­s, homeopathy and various quack remedies. The best example is my late mother-in-­law, who suffered from arthritis. She refused to take any drug - not even aspirin - but she gulped $130 worth of supplement­s every month. She claimed these potions worked, but the evidence said otherwise. She could barely climb a single step, and she had to drive the 100 feet to her mailbox. Her knees were very swollen, but she claimed that extra tissue was muscle!

I find it very odd that so many people embrace quack cures when they are faced with such overpoweri­ng evidence that it doesn't work.