Why work with Naturopathic Doctors (ND)?
According to Health Canada, over 70% of the population in Canada uses natural health products (NHPs), with vitamins and minerals being the largest category comprising more than 50% [1]. Interestingly, 71% of these individuals believe that NHPs are superior to chemical products or drugs, although this belief is not necessarily accurate and can lead to premature termination or rejection of necessary standard medical care.
Another emerging concern for medical doctors (MDs) is the increasing use of herbs and herbal teas, which have grown from virtually 0% in 2005 to 11% [1]. Many herbal products have the potential to interfere with important medical therapies, including pharmaceuticals.
Estimates indicate that around 16% of the general population in Canada utilize complementary and alternative medicine (CAM) services [2]. Studies suggest that CAM users tend to be female, of middle age, and have higher levels of education [2].
Interest in CAM extends beyond the general population, as evidenced by the implementation of integrative family medicine programs in various medical schools in the United States. Notable programs include the University of Arizona Program in Integrative Medicine and family medicine residency programs at institutions such as Beth Israel/Albert Einstein College of Medicine, Maine Medical Center, Middlesex Hospital, Oregon Health & Science University, and the Universities of Arizona and Wisconsin [3].
Given the increasing use of CAM among patients and the growing body of evidence supporting many CAM therapies, it is crucial to address CAM and its integration within medical settings. However, studies indicate that a significant portion of patients do not disclose their CAM use to their MDs, citing reasons such as perceived lack of interest or knowledge on the subject and a perceived negative bias from MDs [4]. This separation between CAM and conventional medical care can lead to conflicting information for patients, forcing them to make difficult choices.
Working with an evidence-based Naturopathic Doctor (ND) can help address these challenges. NDs are trained in various aspects of common CAM practices, including chiropractic manipulation, Traditional Chinese Medicine (TCM), acupuncture, botanicals (herbs), supplementation, homeopathy, clinical nutrition, dietary and lifestyle therapies. They are best equipped to determine appropriate CAM therapies within a medical setting based on an evidence-based approach.
Additionally, NDs can identify when referrals to MDs are necessary, as they are trained in basic primary care and conventional medicine and can recognize conditions that require medical intervention. They offer a holistic approach to patient care that encompasses all aspects of health, including emotional, mental, diet, and lifestyle factors, ultimately maximizing favorable patient outcomes.
By facilitating discussions about CAM use, NDs ensure that CAM therapies do not hinder the effective delivery of conventional therapies. Furthermore, maintaining open communication with primary care physicians allows for the exchange of information regarding the patient’s CAM therapies, addressing any major concerns and promoting coordinated and effective healthcare delivery.
Why patients would see a ND?
Naturopaths have a distinct approach to healthcare, aiming to identify and treat the underlying causes of problems:
- They bring a holistic perspective, considering not only biomedical factors but also addressing emotional, mental, lifestyle, and dietary aspects. By identifying and addressing these supporting factors, naturopaths can target the root cause of diseases or problems.
- While conventional medicine effectively addresses major factors, diseases are often multifactorial and influenced by various modifiable and non-modifiable factors. Naturopathic medicine goes beyond addressing the major factors and also considers minor contributing factors. This comprehensive approach maximizes patient outcomes in conjunction with medical treatment.
Preventative medicine and enhancing overall health are key focuses for naturopaths:
- Naturopaths aim to identify factors that may compromise good health and manage health issues before they escalate into diseases. While they also treat diseases, they recognize that medical physicians excel in managing health problems once they manifest as diseases. Naturopaths collaborate with medical professionals to provide supportive naturopathic therapies, enhancing the overall patient outcome from combined conventional and naturopathic care.
- Naturopaths understand that good health extends beyond the absence of disease. They prioritize long-term health improvements, aiming to prevent premature aging, minimize age-related diseases, and help patients feel youthful and healthy for as long as possible.
Naturopaths play a supportive role, bridging gaps and improving outcomes in conventional care:
- With their unique education encompassing both complementary and alternative medicine (CAM) and conventional care, naturopaths are well-equipped to fulfill this role.
- They offer an alternative to conventional care for individuals who prefer non-conventional approaches. While naturopaths acknowledge the importance of conventional medicine in healthcare, they respect patients’ choices regarding the type of healthcare they wish to receive.
- Naturopaths approach CAM use with an evidence-based mindset. Their extensive training covers various CAM modalities, including chiropractic manipulation, Traditional Chinese Medicine (TCM), acupuncture (both medical and TCM), botanicals (herbs), supplementation, homeopathy, clinical nutrition, dietary and lifestyle therapies. Thus, naturopaths can assist patients in deciding which CAM modalities are suitable and provide these therapies directly or through referrals.
However, naturopaths also recognize situations where conventional care is necessary and when a primarily naturopathic approach is appropriate.
What therapies does Dr. Brian use?
Dr. Brian adopts an evidence-based integrative approach to provide comprehensive healthcare. His primary therapies encompass:
- Identifying dietary and lifestyle factors: Dr. Brian assesses and eliminates factors that hinder good health while promoting those that contribute to it. He assists patients in implementing these changes in their daily lives, integrating them with any ongoing conventional therapies.
- Managing emotional and stress-related factors: Dr. Brian recognizes the impact of emotional well-being on optimal health. He offers counseling, lifestyle support, and other naturopathic therapies to address and manage these factors effectively.
- Judicial and evidence-based use of various therapies: Dr. Brian employs the following therapies for treatment, co-management of health conditions, and support to minimize side effects from conventional treatments:
- Dietary recommendations: Personalized monitoring and modification of diet based on individual needs.
- Lifestyle recommendations: Promoting healthy habits and suggesting therapeutic lifestyle adjustments tailored to specific conditions. Regular follow-up and feedback ensure proper implementation and maximize compliance.
- Nutritional supplementation: Therapeutic use of vitamins or minerals in addition to dietary changes.
- Acupuncture: Utilizing acupuncture and electroacupuncture techniques.
- Botanicals: Prescribing standardized botanical extracts in tablet or pill form, independently tested for purity and contamination.
- Injection and IV therapy: Administering vitamins and minerals via parenteral routes for optimal bioavailability.
- Emotional and mental counseling: Providing guidance and support, with appropriate referrals to a psychiatrist when necessary.
- Patient education: Dr. Brian prioritizes empowering patients by providing comprehensive information about their health condition and treatment options, both conventional and naturopathic. The goal is to enable patients to manage and improve their own health while understanding when it is crucial to seek professional medical guidance rather than relying solely on online sources.
Dr. Brian’s approach combines the best of evidence-based practices to deliver holistic healthcare, addressing various aspects of patients’ well-being and promoting self-care and informed decision-making.
Do your therapies have scientific evidence?
There is a wealth of evidence supporting various naturopathic therapies, such as dietary and lifestyle changes, as well as the use of standardized botanical extracts and supplements. While naturopathic medicine may not have the same level of funding and research as conventional medicine, there is still significant evidence for many complementary and alternative therapies that cannot be disregarded.
It is essential to understand that naturopathic medicine is not intended to replace conventional medical care, but rather to complement and enhance it. Naturopathic treatments aim to improve, support, or fill gaps in conventional care, offering additional options for patients.
In recent years, there has been an increased interest in evidence-based naturopathic medicine, leading to more research being conducted on these therapies. The establishment of organizations like the National Center for Complementary and Alternative Medicine (NCCAM) and the consistent increase in funding from the National Institutes of Health (NIH) demonstrate the growing dedication to research in this field [4].
Moreover, it is important to highlight that Dr. Yeung selectively practices CAM and naturopathic therapies based on their effectiveness and safety, as indicated by scientific research. Therapies that have been shown to be ineffective or potentially harmful are not utilized in his practice.
Are they safe?
Similar to pharmaceuticals and other conventional medical therapies, naturopathic medical therapies are not without their side effects, contraindications, and potential interactions. Naturopathic doctors (NDs) are well aware of these concerns and possess the necessary knowledge to discuss and address them with patients and other healthcare professionals they collaborate with. This includes taking precautions to avoid any potential interactions between prescribed drugs and herbal remedies or supplements.
In general, many naturopathic therapies tend to be less invasive and associated with a more favorable side-effect profile compared to conventional therapies. Nevertheless, I approach all naturopathic treatments with the same level of care and caution as medical doctors do with conventional therapies.
Will they interfere with conventional care?
Naturopathic medicine takes a holistic approach to healthcare that encompasses both conventional care and complementary and alternative medicine (CAM) practices.
It acknowledges the primary role of conventional care in treatment, and naturopathic doctors (NDs), being trained in various CAM modalities and basic primary care, work to ensure that patients receive the appropriate conventional medical care by making referrals when necessary.
The goal of naturopathic medicine is not to replace conventional medical care, but rather to enhance, support, and address any gaps in conventional care.
What kind of training do NDs have?
After completing their undergraduate program, naturopathic medical students undertake a rigorous four-year, full-time post-graduate program. This comprehensive program encompasses a wide range of subjects, including clinical anatomy, biomedical sciences, medical physiology and pathology, pharmacology, laboratory and physical diagnosis, minor surgery, and the diagnosis and treatment of patients. Furthermore, students gain valuable practical experience through 1200 hours of supervised clinical training.
In addition to the core medical curriculum, graduates of naturopathic medical programs are proficient in various naturopathic modalities. These modalities are integrated into their training and include Asian medicine/acupuncture, botanical medicine, clinical nutrition, homeopathic medicine, physical medicine, health psychology, and lifestyle counseling.
To practice as licensed naturopathic doctors, graduates must successfully pass two licensing exams: NPLEX (Biomedical Sciences) and NPLEX 2 (Clinical Sciences). They are also required to pass provincial licensing board and jurisprudence examinations. Continuing education is an ongoing requirement for naturopaths to stay up-to-date with the latest advancements in their field.
Some naturopaths, like Dr. Brian, undergo additional training in specialized areas. For instance, Dr. Brian has acquired additional qualifications in prescriptive authority and IVIT certification. These credentials enable him to prescribe certain medications and administer intravenous therapy, enhancing his ability to provide comprehensive care to his patients.
[1] Health Canada. Natural Health Product Tracking Survey: 2010 Final Report. Public opinion research (POR) reports, 2011.
[2] Bishop FL, Lewith GT. Who Uses CAM? A Narrative Review of Demographic Characteristics and Health Factors Associated with CAM Use. Evid Based Complement Alternat Med. 2010 Mar;7(1):11-28.
[3] Arizona Center for Integrative Medicine. integrativemedicine.arizona.edu/
[4] Robinson A, McGrail MR. Disclosure of CAM use to medical practitioners: a review of qualitative and quantitative studies. Complement Ther Med. 2004 Jun-Sep;12(2-3):90-8.
[5] National Center for Complementary and Alternative Medicine (NCCAM). NCCAM Funding: Appropriations History. http://nccam.nih.gov/about/budget/appropriations.htm