The American Association of Naturopathic Physicians (AANP) describes the practice of naturopathic medicine as a primary healthcare profession that aims to promote health and to prevent, diagnose and treat disease. It is practiced most often as a complement but sometimes as an alternative to conventional medicine. In the US and Canada where the credentialing process is similar, naturopathic doctors are educated through 4 years of post-baccalaureate training and must be licensed to practice in 15 US states, 2 territories and 3 Canadian provinces. It is a small but growing profession with the number of graduates from accredited programs tripling in the last decade to about 4000 in the US and Canada while California, Idaho, Kansas and the District of Columbia adding licensure. There are 7 naturopathic physician training programs in the US and Canada accredited by the Council on Naturopathic Medical Education and regional accrediting authorities. The license typically is broad, allowing NDs to diagnose and treat using any “natural” means with some states allowing the use of a large formulary of prescription drugs. Licensed naturopathic physicians are the most broadly trained of CAM practitioners; they may be the best prepared for integration into the mainstream healthcare system because of training in basic and diagnostic biomedicine and their broad range of practice. There may be several thousand more unlicensed practitioners using the title of naturopath, though their training is highly variable.
The practice of naturopathic physicians is guided by principles re-articulated by the AANP in 1989:
- Do no harm. Utilize methods and substances that are non-toxic and minimize harm. Apply the least force for diagnosis and treatment. There is therapeutic order that increases the safety of therapy by using the least invasive interventions first.
- Nature’s healing power (Vis medicatrix naturae). Organisms are inherently self-organizing and it is the physician’s role to support this process by removing obstacles to health.
- Treat the cause. Symptoms are the body’s attempt to defend, adapt and recover. The physician’s optimal approach is to seek and treat causes of disease rather than suppress symptoms.
- Treat the whole person. The multifactorial nature of health and disease requires attention to the physical, mental, emotional, spiritual, social, and ecological aspects of the patient.
- Prevention and wellness. The attainment of optimal health and prevention of disease are primary objectives. The therapeutic order emphasizes a foundation of health maintenance.
- Doctor as teacher. The physician’s role is to educate the patient and support self-responsibility.
Pursuant to these principles, the foundation of treatment is health promotion. Then, after thorough assessment, naturopathic treatment is individualized for a particular patient’s condition rather than just for a disease. Almost universally in naturopathic practice, an individualized combination of treatments is applied with the objectives of healing the whole person and maximizing constitutional potential. There are 5 classic therapeutic “modalities”: nutrition (including both diets and dietary supplements), botanicals, homeopathy and physical medicine, though a wide variety of tools may be used including acupuncture, minor surgery, therapeutic injection and prescription drugs.
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