Frequently Asked Questions
What is Naturopathic Medicine?
Naturopathic medicine is a distinct practice of medicine that emphasizes prevention and the self-healing process to treat each person holistically and improve outcomes while lowering health care costs.
Naturopathic doctors are educated and trained in accredited naturopathic medical colleges. They diagnose, prevent and treat acute and chronic illness, restore and establish optimal health by supporting the person's inherent self-healing process. Rather than just suppressing symptoms, naturopathic doctors work to identify underlying causes of illness, and develop personalized treatment plans to address them. Their Therapeutic Order™, identifies the natural order in which all therapies should be applied to provide the greatest benefit with the least potential for damage.
In addition to a standard medical curriculum, schools require their graduates to complete four years of training in disciplines such as clinical nutrition, acupuncture, homeopathic medicine, botanical medicine, physical medicine, and counseling. For at least the final two years of their medical program, naturopathic medical students intern in clinical settings under the close supervision of licensed professionals.
Naturopathic medical education curricula include certain areas of study not covered in conventional medical school. At the same time, aspiring naturopathic doctors receive training in the same biomedical and diagnostic sciences as MDs and osteopathic doctors (DOs). The result is a comprehensive, rigorous, and well-rounded scientific medical education that is both comparable and complementary to that of MDs and DOs. For more information on how naturopathic doctors are educated, trained, and licensed
*Obtained 11/9/2019 from the American Association of Naturopathic Physicians
Naturopathic doctors are educated and trained in accredited naturopathic medical colleges. They diagnose, prevent and treat acute and chronic illness, restore and establish optimal health by supporting the person's inherent self-healing process. Rather than just suppressing symptoms, naturopathic doctors work to identify underlying causes of illness, and develop personalized treatment plans to address them. Their Therapeutic Order™, identifies the natural order in which all therapies should be applied to provide the greatest benefit with the least potential for damage.
- Remove Obstacles to Health. Health, the “natural state” of one’s body, is disturbed by obstacles that lead to disease. The first step in returning to health is to remove the entities that disturb health such as: poor diet, digestive disturbances, inappropriate and chronic stress levels, and individual disharmony. Naturopathic doctors construct a healthy regimen based on an individual’s “obstacles to health” to change and improve the terrain in which the disease developed. This allows additional therapeutics to have the most beneficial effects possible.
- Stimulate the Self-Healing Mechanisms. NDs use therapies to stimulate and strengthen the body’s innate self-healing and curative abilities. These therapies include modalities such as clinical nutrition, botanical medicines, constitutional hydrotherapy, homeopathy, and acupuncture.
- Strengthen Weakened Systems. Systems that need repair are addressed at this level of healing. Naturopathic doctors have an arsenal of therapeutics available to enhance specific tissues, organs or systems including: lifestyle interventions, dietary modifications, botanical medicine, orthomolecular therapy (use of substances that occur naturally in the body such as vitamins, amino acids, minerals), and homeopathy.
- Correct Structural Integrity. Physical modalities such as spinal manipulation, massage therapy, and craniosacral therapy are used to improve and maintain skeletal and musculature integrity.
- Use Natural Substances to Restore and Regenerate. Naturopathic medicine’s primary objective is to restore health, not to treat pathology. However, when a specific pathology must be addressed, NDs employ safe, effective, natural substances that do not add toxicity or additionally burden the already distressed body.
- Use Pharmacologic Substances to Halt Progressive Pathology. NDs are trained in pharmacology and how to use pharmaceutical drugs when necessary. If their state license permits, they can prescribe these agents themselves or if not, refer to a conventional medical colleague.
- Use High Force, Invasive Modalities: Surgery, Radiation, Chemotherapy. When life, limb, or function must be preserved, NDs refer patients to MDs who are expertly trained in these arenas. At the same time, NDs use complementary or supportive therapies to decrease side effects and increase the effectiveness of these invasive procedures.
In addition to a standard medical curriculum, schools require their graduates to complete four years of training in disciplines such as clinical nutrition, acupuncture, homeopathic medicine, botanical medicine, physical medicine, and counseling. For at least the final two years of their medical program, naturopathic medical students intern in clinical settings under the close supervision of licensed professionals.
Naturopathic medical education curricula include certain areas of study not covered in conventional medical school. At the same time, aspiring naturopathic doctors receive training in the same biomedical and diagnostic sciences as MDs and osteopathic doctors (DOs). The result is a comprehensive, rigorous, and well-rounded scientific medical education that is both comparable and complementary to that of MDs and DOs. For more information on how naturopathic doctors are educated, trained, and licensed
*Obtained 11/9/2019 from the American Association of Naturopathic Physicians
Who Ensures the Quality of Naturopathic Medical Schools?
The AANP and INM would like to acknowledge Marianne Marchese, ND, and Daniel Seitz, JD, EdD, for their contributions to the content of this FAQ.
Accreditation is an external peer review and regulatory process for higher education. Its goal is to ensure high-quality education and training in various disciplines, including medical education, in order to protect the interests of students and the public, and to ensure safe and effective practice. Accreditation is usually carried out by private, non-profit organizations that are “recognized” (i.e., approved) by the U.S. Department of Education.
How are naturopathic medical schools accredited?
Naturopathic medical programs that award the naturopathic doctoral degree (ND degree) are accredited by the Council on Naturopathic Medical Education. This process is similar to the accreditation of the Doctor of Medicine (MD) and Doctor of Osteopathic Medicine (DO) degrees, and the U.S. Department of Education recognizes the accrediting agencies that oversee schools granting these three degrees. All three of these degree programs—MD, DO, and ND—must go through a rigorous process of initial accreditation, as well as periodic, ongoing re-accreditation—generally every five to 10 years, depending on the field—to ensure continued high-quality education and training.
Why is accreditation necessary?
Accreditation ensures that high educational standards reflecting the needs of a given medical profession have been established and are being met. Additionally, accreditation provides the foundation for practitioner licensing and regulation. Specifically, accreditation signifies that a college or educational program has met or exceeded the standards for:
Who oversees accreditation?
There are three U.S. accrediting agencies for the recognized medical professions. The Liaison Committee on Medical Education (LCME) is the accrediting body for the MD degree. The Commission on Osteopathic College Accreditation (COCA) is the accrediting body for the DO degree. And, as mentioned above, the Council on Naturopathic Medical Education (CNME) is the accrediting body for the ND degree. These three accrediting agencies are recognized by the United States Department of Education (USDE). In some fields, there are accrediting entities that are not recognized by USDE; in some cases, these entities are not legitimate. Thus USDE recognition is an important distinction to be aware of.
How rigorous is the accreditation process?
Accreditation is a highly demanding process. Generally, it involves the submission of extensive information and documentation by a school seeking initial or renewed accreditation, followed by two to three days of on-site assessment. The on-site assessment encompasses careful observation and evaluation of many aspects of the school including: facilities, administration, faculty, curriculum, student performance, and more. Members of the on-site review team and of the accrediting bodies are unpaid volunteers, and every effort is taken to ensure that there are no conflicts of interest that may interfere with objectivity. The medical school accrediting agencies are made up of professional members (physicians), institutional members (faculty or administrators of schools), and public members. Some agencies have student representatives as well. The U.S. Department of Education oversees all three medical school accrediting agencies in order to ensure that the accrediting process is thorough, objective, and fair.
*Obtained 11/9/2019 from the American Association of Naturopathic Physicians
Accreditation is an external peer review and regulatory process for higher education. Its goal is to ensure high-quality education and training in various disciplines, including medical education, in order to protect the interests of students and the public, and to ensure safe and effective practice. Accreditation is usually carried out by private, non-profit organizations that are “recognized” (i.e., approved) by the U.S. Department of Education.
How are naturopathic medical schools accredited?
Naturopathic medical programs that award the naturopathic doctoral degree (ND degree) are accredited by the Council on Naturopathic Medical Education. This process is similar to the accreditation of the Doctor of Medicine (MD) and Doctor of Osteopathic Medicine (DO) degrees, and the U.S. Department of Education recognizes the accrediting agencies that oversee schools granting these three degrees. All three of these degree programs—MD, DO, and ND—must go through a rigorous process of initial accreditation, as well as periodic, ongoing re-accreditation—generally every five to 10 years, depending on the field—to ensure continued high-quality education and training.
Why is accreditation necessary?
Accreditation ensures that high educational standards reflecting the needs of a given medical profession have been established and are being met. Additionally, accreditation provides the foundation for practitioner licensing and regulation. Specifically, accreditation signifies that a college or educational program has met or exceeded the standards for:
- educational quality with respect to mission, goals, and objectives
- governance, administration, and finance
- facilities, equipment, resources, faculty, student admissions, performance, and evaluation
- preclinical and clinical curriculum
- research and scholarship activity
Who oversees accreditation?
There are three U.S. accrediting agencies for the recognized medical professions. The Liaison Committee on Medical Education (LCME) is the accrediting body for the MD degree. The Commission on Osteopathic College Accreditation (COCA) is the accrediting body for the DO degree. And, as mentioned above, the Council on Naturopathic Medical Education (CNME) is the accrediting body for the ND degree. These three accrediting agencies are recognized by the United States Department of Education (USDE). In some fields, there are accrediting entities that are not recognized by USDE; in some cases, these entities are not legitimate. Thus USDE recognition is an important distinction to be aware of.
How rigorous is the accreditation process?
Accreditation is a highly demanding process. Generally, it involves the submission of extensive information and documentation by a school seeking initial or renewed accreditation, followed by two to three days of on-site assessment. The on-site assessment encompasses careful observation and evaluation of many aspects of the school including: facilities, administration, faculty, curriculum, student performance, and more. Members of the on-site review team and of the accrediting bodies are unpaid volunteers, and every effort is taken to ensure that there are no conflicts of interest that may interfere with objectivity. The medical school accrediting agencies are made up of professional members (physicians), institutional members (faculty or administrators of schools), and public members. Some agencies have student representatives as well. The U.S. Department of Education oversees all three medical school accrediting agencies in order to ensure that the accrediting process is thorough, objective, and fair.
*Obtained 11/9/2019 from the American Association of Naturopathic Physicians
Do Naturopathic Doctors Prescribe Medication?
The INM and AANP would like to acknowledge Christie Fleetwood, ND, RPh, for her contributions to the content of this FAQ.
Licensed naturopathic doctors (NDs) are trained as primary care providers to diagnose, prevent, and treat acute and chronic illness. NDs complete rigorous education in pharmaceutical drugs during their four-year, science-based medical education, and they may prescribe medications when indicated as allowed by state regulations. However, naturopathic doctors typically don't prescribe drugs at the first sign of symptoms or trouble. Instead, NDs choose to work with natural, less invasive therapies without strong side effect profiles before reaching for the prescription pad. They support and enhance a patient’s innate capacity for healing with evidence-based therapies such as lifestyle modification, clinical nutrition, botanical medicine, and behavioral medicine, to name a few.
Pharmacology education and training
Pharmacology is taught through a series of courses that build upon each other through an ND’s medical education. This training is reinforced through a minimum of 1,200 hours of hands-on, clinical training. Naturopathic medical programs are accredited and are recognized by the United States Department of Education. Pharmacology is an essential part of the Naturopathic Physicians Licensing Examination (NPLEX), the passage of which is required before a doctor of naturopathic medicine can be licensed or regulated by a state/province.
As part of the pharmacology curriculum, naturopathic doctors learn both medical and clinical pharmacology. They study primary therapeutic uses, mechanisms of action, potential adverse effects, and drug/drug interactions of medicines commonly encountered, including prescription drugs, controlled substances, and over the counter (OTC) medications. Additionally, they learn how to prescribe and manage pharmaceuticals for the most common presenting concerns in primary care medicine.
While pharmacology coursework is comparable to that taught in conventional medical schools, NDs receive additional training and focus in two important areas:
When NDs Use Pharmaceuticals
Naturopathic doctors prescribe drugs based on available evidence, clinical experience, patient preference, and the Therapeutic Order. They match the patient’s level of health and pathology with the necessary level of intervention. As a principle, naturopathic doctors support and enhance the body’s inherent ability to heal itself. They utilize a deep toolbox of natural therapies to help get a patient healthy enough to heal disease without strong interventions. Yet when a careful assessment of lifestyle, social/emotional factors, physical exam, and/or targeted laboratory testing reveals that the patient is not able to heal with natural therapies, NDs will refer or prescribe appropriate medicine.
The Therapeutic Order is the framework NDs use to evaluate the patient’s obstacles to healing and to choose therapeutic approaches in the most logical, least invasive ways first. If NDs do prescribe medication, they anticipate and address potential side effects of that medication with natural therapies. For example, if a patient requires antibiotics, which are known to wipe out needed, healthy bacteria in the microbiome in addition to harmful bacteria, NDs may also prescribe probiotic foods or supplements to help keep the GI system in healthy balance.
Here are two care scenarios when a naturopathic doctor may use pharmacology in addition to natural therapies to treat acute or chronic illness:
Overall, naturopathic doctors believe that natural medicine and conventional medicine are not mutually exclusive. They recognize that there are times when both approaches can be utilized together for the patient’s benefit.
*Obtained 11/9/2019 from the American Association of Naturopathic Physicians
Licensed naturopathic doctors (NDs) are trained as primary care providers to diagnose, prevent, and treat acute and chronic illness. NDs complete rigorous education in pharmaceutical drugs during their four-year, science-based medical education, and they may prescribe medications when indicated as allowed by state regulations. However, naturopathic doctors typically don't prescribe drugs at the first sign of symptoms or trouble. Instead, NDs choose to work with natural, less invasive therapies without strong side effect profiles before reaching for the prescription pad. They support and enhance a patient’s innate capacity for healing with evidence-based therapies such as lifestyle modification, clinical nutrition, botanical medicine, and behavioral medicine, to name a few.
Pharmacology education and training
Pharmacology is taught through a series of courses that build upon each other through an ND’s medical education. This training is reinforced through a minimum of 1,200 hours of hands-on, clinical training. Naturopathic medical programs are accredited and are recognized by the United States Department of Education. Pharmacology is an essential part of the Naturopathic Physicians Licensing Examination (NPLEX), the passage of which is required before a doctor of naturopathic medicine can be licensed or regulated by a state/province.
As part of the pharmacology curriculum, naturopathic doctors learn both medical and clinical pharmacology. They study primary therapeutic uses, mechanisms of action, potential adverse effects, and drug/drug interactions of medicines commonly encountered, including prescription drugs, controlled substances, and over the counter (OTC) medications. Additionally, they learn how to prescribe and manage pharmaceuticals for the most common presenting concerns in primary care medicine.
While pharmacology coursework is comparable to that taught in conventional medical schools, NDs receive additional training and focus in two important areas:
- Botanical or herb/drug and supplement/drug interactions. Seventy-five percent of Americans regularly take herbs and dietary supplements, and they don’t always inform their primary care doctor. Naturopathic doctors complete approximately 130 classroom hours of botanical medicine education. This encompasses the science and practice of using medicinal plants and extracts to improve overall health, support wellness, and treat acute and chronic disease. An extensive knowledge of herbs and supplements allows NDs to better help guide patients and prevent harmful interactions.
- Identification of nutrient depletions caused by long-term use of drugs. Some of the most commonly prescribed or recommended drugs can interfere with or cause deficiencies of vital nutrients with ongoing use. These include medicines prescribed for acid reflux, heartburn, cholesterol, and more. Naturopathic doctors are expert at identifying signs of nutrient depletion, and apply their extensive knowledge of clinical nutrition and botanical medicine to help reverse these harmful side effects.
When NDs Use Pharmaceuticals
Naturopathic doctors prescribe drugs based on available evidence, clinical experience, patient preference, and the Therapeutic Order. They match the patient’s level of health and pathology with the necessary level of intervention. As a principle, naturopathic doctors support and enhance the body’s inherent ability to heal itself. They utilize a deep toolbox of natural therapies to help get a patient healthy enough to heal disease without strong interventions. Yet when a careful assessment of lifestyle, social/emotional factors, physical exam, and/or targeted laboratory testing reveals that the patient is not able to heal with natural therapies, NDs will refer or prescribe appropriate medicine.
The Therapeutic Order is the framework NDs use to evaluate the patient’s obstacles to healing and to choose therapeutic approaches in the most logical, least invasive ways first. If NDs do prescribe medication, they anticipate and address potential side effects of that medication with natural therapies. For example, if a patient requires antibiotics, which are known to wipe out needed, healthy bacteria in the microbiome in addition to harmful bacteria, NDs may also prescribe probiotic foods or supplements to help keep the GI system in healthy balance.
Here are two care scenarios when a naturopathic doctor may use pharmacology in addition to natural therapies to treat acute or chronic illness:
- A hypertensive patient with a comprehensive physical exam showing multiple signs of ongoing vascular damage including swollen ankles, skin discoloration, hair loss, and multiple blood pressure readings of 200 over 120. A detailed intake reveals that the patient’s diet consists largely of fast food and coffee. In this case, the patient requires a high level of intervention to prevent further harm, and the ND is likely to write a prescription for an anti-hypertensive drug, a diuretic, and refer the patient to a cardiologist for further testing. This is in addition to recommending significant lifestyle changes and other natural medicine approaches.
- A patient is traveling and has left his "rescue inhaler" for asthma at home. He encounters an irritant (e.g. an excessive amount of smoke), and is wheezing and experiencing difficulty breathing. The ND would call in a prescription for an inhaler and work to restore the patient's health with natural approaches when he returns to his hometown.
Overall, naturopathic doctors believe that natural medicine and conventional medicine are not mutually exclusive. They recognize that there are times when both approaches can be utilized together for the patient’s benefit.
*Obtained 11/9/2019 from the American Association of Naturopathic Physicians
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