What Are You Getting Yourself Into When You Work With A Naturopathic Doctor?
By: Dr. Nicole Roberts, ND
I once had a prospective patient come in for a 15 Minute Free Appointment to meet me & see the clinic before committing to working with me. When I asked about the reason behind their interest in Naturopathic Medicine, they replied “ I’m really just here to see what I am getting myself into.”
I think back fondly on this conversation because this patient was perfectly able to articulate what holds so many of us back from working with Naturopaths - we just don’t know what we are getting ourselves into.
I wanted to write this article because as a profession, Naturopathic Doctors have a really hard time articulating what we do. We can launch into a long discussion about how we do what we do - what forms of natural medicine we use, how we were trained, what testing options we can provide to you, etc, etc, etc - but as a collective group we have a hard time clearly and succinctly stating what we do in ways that everyone understand, as it relates to them and their health.
I have patients and especially colleagues, from chiropractors to RMTs to acupuncturists, that keep coming back to me saying, I have this friend / client that I think could benefit from working with you but I don’t know how to explain to do them what you do! As someone who has a history with naturopathic medicine dating back to when I was I was a patient of it myself at 14 years old, I may have thought my explanation of my job was perfectly clear, when in fact it was anything but.
In my mind, the confusion around naturopathic medicine is 3-fold.
1. Naturopathic medicine, while drawing on really old principles of healing that were around long before the drugs we have today, is actually a new profession in Canada that is still carving its place out in the medical paradigm. Naturopathic medical education began in Canada with the opening of the Ontario College of Naturopathic Medicine in 1978. Despite the huge effect we can have on a person’s health, as of yet, a referral to a naturopath from your Medical Doctor or another medical specialist is not as common as it will likely come to be in the future.
2. There is stigma around the use of natural medicine. Naturopathic doctors, despite having science backgrounds, undergraduates and 4 year doctorate of naturopathic medicine in evidence-based natural medicine, are routinely lumped in with natural health providers that do not have this level of training. In addition, while “Naturopath” and “Naturopathic Doctor” are protected terms in North America (meaning that you cannot legally call yourself either of these terms unless you have completed the requisite training, licensing and currently uphold the requirement set out by the regulatory college you practice under), they are not protected terms around the world. Many of the stories that surface about “Naturopaths treating cancer with only essential oils leading to significant worsening of a patient’s health condition” are not coming from North America and are referring to an unlicensed, likely untrained individual using the term in another country. The blow back is significant to the reputation of licensed, regulated North American ND’s.
3. Lastly, naturopaths approach healing in different ways. This is called the Art & Practice of Medicine, and it refers to the approach someone will take to a specific patient. This is both the most confusing and exciting part of this medicine. The current training of naturopaths teaches future NDs about the clinical standards of practice set out by Canadian & American Medical Associations. These standards outline how conditions are diagnosed, when testing is used, and which treatments are used as first line therapies. Drug regimes, along with some mention of diet and lifestyle, are the typical first line therapies for any given condition, from Depression to Gastric Reflux, etc. NDs are expected to know and follow these guidelines of care to ensure all patients are assessed effectively. Within the profession, the naturopathic standards of care are created and overseen by regulatory colleges, which serve to offer the public safe and effective naturopathic care. In Ontario, the regulatory body is the College of Naturopaths of Ontario. So why do naturopaths have such variability in the way they practice if the guidelines are set? Here’s why:
- Naturopaths tend to see patients who have already been from doctor to doctor and for whom current guidelines are not alleviating symptoms; these patients have done all the necessary testing as per the guidelines and/or been put on all the indicated drug therapies but are looking for more help
- The traditional guidelines and standards of care are really about disease models; diagnosing & treating disease; naturopathic medicine can certainly be about treating disease, but it is also about optimal functioning which is about maximizing how good your body and mind can feel (optimal health goes beyond not feeling “sick” and further into feeing “as good as you can”; in many cases, Naturopathic Doctors are working beyond the (already fulfilled) standards of care
- Naturopaths in Ontario do not have the scope to prescribed very many drugs, so while we may work with patients who use drugs, our primary therapies are not going to be a drug, and there are SO MANY possible avenues of non-drug therapy you can begin to work with
- Naturopathic Medicine works very hard to recognize the individuality of a patient; by treating a patient and not just a disease label, we can be more effective at getting to the root cause of what is going on in that patient; what works for Person A with low back pain is not necessarily the same thing as what will clear up low back pain in Person B - and the same can be applied to Autism, Anxiety, Bloating, Pain, etc for any given condition you can think of - different bodies work differently
Example: A patient comes in with frequent migraines. They have been formally diagnosed with migraines by their Family Doctor, they see a migraine specialist and have triptan drugs prescribed for their migraines. They currently avoid caffeine and are trying to keep their stress levels low, which is easier said than done. This patient has sought consultation with a naturopath because the migraines are now happening 3 times a week and getting in the way of their quality of life. They don’t love the way they feel on the medications and would like to find a way to heal their migraines and prevent recurrence. As the overseeing naturopath, I walk into the consult knowing that migraines are notoriously difficult to treat because they can be triggered by many different factors that are unique to the individual. In the effort to get this patient feeling as good as they can, as quickly as possible, I might suspect that foods, hormone fluctuations, allergen (i.e. mold) exposures, a past head trauma or low iron is at the root cause of their headaches and will create a plan to work on that in the long run, but may recommend something in the short term that will support releasing congestion in the head or nutritional therapy that will not interact with their triptan medication, should they need to use it. Our goal may be to reduce the severity and frequency of migraines by 50% in the first month, and then eventually clear them up completely over the next few months. Depending on the patient’s history with migraines, ability to make changes to their lifestyle, and of course factors outside of our control, we will be having continuous and frank conversations about expectations regarding treatment; this includes understanding that we may try things that won’t have the effect we want, which serves as education about what works in the individual and will in turn inform a better treatment plan. As we go, the patient will learn more and more about why & how their migraines present and what a migraine-free lifestyle may look like for them.
So, after that long-winded explanation of why it is so hard to define what we Naturopathic Doctors do, what do we actually do?
The American Association of Naturopathic Physicians (physicians being a term we do not in Canada) lists the following definition: “Naturopathic medicine is a distinct primary health care profession, emphasizing prevention, treatment, and optimal health through the use of therapeutic methods and substances that encourage individuals' inherent self-healing.”
Pardon my bluntness, but again, this is so incredibly vague for anybody who is new to Naturopathy. Inherent self-healing? I work in the profession and I’m even a little confused by this definition.
To be fair, it is really tough to capture all that this paradigm of medicine can do without being forced to use vague terms. Perhaps all the power and meaning behind Naturopathic Medicine can’t really be summed up in one sentence and that is why we find it so hard to articulate what we do.
In an effort to challenge myself, I have create my own definition.
As a naturopathic doctor I work with people in a human-centred model of care; these patients want to understand and treat the root cause of how all their symptoms relate to one another, they want to play an active role in their health care, and they are not satisfied with limitations being place on their ability to feel happy and healthy. What I help patients with is actually summed up really well by BJ Miller’s TED Talk, What really matters at the end of life, which I highly recommend watching:
“We need to set our sights on well-being. That life can become - that health and health care can become - about making life more wonderful rather than just less horrible.” - BJ Miller
If you are looking for more details, this is how I accomplish this:
- I spend time with you! This just makes sense. You need face-to-face time with a health care provider to ensure that provider knows the intricacies of your health, your life, your preferences, and most importantly, how you want to heal. Believe it or not, your opinion matters when it comes to creating a treatment plan - you will only improve with a plan that you feel comfortable following consistently and so your input is highly valuable.
- We create a detailed timeline of when your symptoms began and how they have evolved. Let’s put the time we have to work and really take a look at what has been going on. Your diagnosis is not a label that tells us all we need to know - a diagnosis does not define you. You are an individual with a unique biochemistry and environment so we need to look at how your symptoms have evolved in you to understand the root cause of them.
- I (we) develop a unique treatment plan for you! I use evidence based medicine and I apply this to cases, but in the end, there are no scientific studies about YOU as an individual. You may have seasonal allergies, but I bet your allergies don’t exist in a vacuum. Maybe you also have anxiety, or in-laws that stress you out every holiday and this worsens things. My point is, we need to put some creative thought into the kind of treatment plan you need for your life.
- I educating you about EVERYTHING I know as it relates to your health. From the how your prescribed anti-depressants work to why you wake up at 2am every morning or why you get a headache after storms - whatever it may be, we are going to talk it through. And guess what? Along the way, I’ll learn a whole lot from you too. Each patient I have teaches me something new and they are lessons I never forget.
- I work closely with you via lots of communication as you move forward with your treatment plan. We are essentially making changes to how you live, how your cells work, how your hormones signal, etc and we need to gauge regularly if this is working for you. I prefer really open lines of communication with my patients so we stay in contact as needed. This isn’t actually that common in the medical world, and I really enjoy watching patients thrive with a flexible, supporting doctor-patient relationship!
- I offer you the choice of using applicable testing to understand exactly what is going on at your metabolic, genetic, & cellular level if it is indicated in your case. Testing can be expensive, so we spend time talking about what the test can accomplish, if it is worth the money for your specific case, and how we would use the results to move forward.
Still wondering exactly what you are getting yourself into? Hit up your local naturopath for a Free 15 Minute Visit and chat to them over the phone or meet them face to face. We do our best work this way anyways!
Come see our office, shake our hand, meet our receptionists and learn about how this medicine can meet you where you are at and take you where you want to go health-wise.