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Dr. Peter Bongiorno graduated
from Bastyr University, the leading accredited university
for science-based natural medicine, and was graduation class
speaker. He completed five years of training in naturopathic
medicine and acupuncture. Dr. Bongiorno is currently revising
and editing the Textbook of Natural Medicine. He is a member
of the American Association for Naturopathic Physicians,
New York Association of Naturopathic Physicians, Physicians
for Social Responsibility and is a Diplomat in Acupuncture.
Prior to medical school he worked as a researcher at the
National Institutes of Health in Bethesda, Maryland and
Yale University School of Medicine in New Haven, Connecticut.
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The term naturopathy refers to the idea of "nature cure,"
which uses the healing power of nature in an effort to allow the
patient to cure their own illness by stimulating the body's vital
force, or qi. The tenets of naturopathy hail from a number of
healing traditions, including Ayurveda, European eclectic medicines,
the Greeks, and the Chinese Taoist tradition. Although a few naturopathic
colleges were functional at the beginning of the 20th century,
subsequent monopolization by the conventional medical profession
led to legislation that severely restricted use of other health
care systems. However, in the last 30 years, public awareness
of natural modalities, combined with a genuine discontent for
the current healthcare system in the United States has led to
a resurgence of naturopathic medicine.
Although its practitioners are quite eclectic in style, the
foundation of naturopathy rests in philosophical principles shared
by all naturopathic doctors (NDs). These are:
[ The healing power of nature (vis medicatrix naturae): nature
works through innate systems of healing in the body, and it is
the ND's job to access this vital healing energy using the safest
methods possible. These methods often use nature themselves, in
the forms of water therapies, botanicals, diet, exercise, etc…
- First Do No Harm (Primum Non Nocere): naturopathic
physicians explore the least harmful methods possible, and will
resort to drugs and surgical means and/or refer to doctors who
use these only when necessary
- Find the Cause (Tolle Causam): the naturopathic doctor
is trained not just to look at symptoms, but to unearth the
underlying factors and mechanisms of the patient's condition
- Doctor as Teacher (Docere): inherent in the word "doctor"
derives the meaning "teacher". All doctors are obligated
to teach their patients about their health, in order to affect
the best healing possible.
- Treat the Whole Person: since health and disease is
subject to multiple factors, including physiologic, psychological,
spiritual, genetic, dietary, lifestyle and other factors, naturopathic
doctors are trained to spend time with each patient and ferret
out these factors.
- Preventive medicine: although naturopathic physicians
are successful at treating disease conditions, it is recognized
that the best medicine is to prevent illness by studying a patient's
life, history, family, history, and lab tests in order assess
which diseases they may be most susceptible to. In this way,
healthy changes can take place years before disease can take
hold.
Education & Licensure
Today, there are four accredited schools of naturopathic medicine
in the United States: Bastyr University (Washington State), the
National College of Naturopathic Medicine (Oregon), Southwest
College of Naturopathic Medicine (Arizona) and the University
of Bridgeport (Connecticut). There is also the Canadian College
of Naturopathic Medicine in Ontario.
The education of a naturopathic physician is equivalent to that
of a medical doctor. Rigorous coursework and includes basic and
clinical sciences as well as physical and laboratory diagnosis,
are at the same level as their allopathic medical doctor (MD)
counterparts. One addition to the curriculum is a pervasive philosophy
of holism, which is a motif present throughout most classes and
clinical supervision. Although a naturopathic medical student
has less access to hospital work than a standard allopathic doctor,
they do log many more hours in a supervised primary care setting.
A naturopathic doctor's education focuses less on pharmacologic
treatments, and instead focuses on holistic philosophy, western
botanical medicines, nutritional therapies, homeopathy, spinal
manipulation, counseling and stress reduction and hydrotherapy
techniques. Naturopathic doctors sit for both basic science and
clinical board examines which they must pass in order to be licensed
as a primary care provider.
Currently, fourteen U.S. states and most Canadian provinces
license naturopathic doctors as primary care physicians. The two
most recent additions to U.S. state licensure are California and
the District of Columbia. Legislative proceedings are also actively
moving forward in many states, including Florida and New York.
Scope of practice in licensed states generally includes all naturopathic
modalities, diagnostic testing and imaging rights, prescription
of some antibiotics and steroidal drugs, injections, minor surgery,
and naturopathic manipulation of the spine. An ND's scope of practice
does vary from state to state. Although not comprehensively covered
like their allopathic counterparts, insurance companies are covering
more and more naturopathic physicians.
As part of a standard curriculum, naturopathic doctors are generally
taught at least one class of Chinese Medicine fundamentals. For
this author, it was this first-year class that piqued my enthusiasm
for Chinese Medicine, and eventually led me to pursue a separate
master's degree in acupuncture. The naturopathic schools in Arizona
and Connecticut also broadly teach acupuncture theory and technique
basics, for in those states it is within a naturopath's scope
of practice to perform acupuncture. The acupuncture education
in these schools is adequate to competently practice, but is not
nearly as comprehensive as a standard Masters of Science program,
and does not confer a separate master's degree.
Similarities of Naturopathic Medicine and Acupuncture
Naturopathic physicians look at the body as a whole, similar
to Chinese medicine practitioners. Like a TCM practitioner, an
ND tends to have a broadly inclusive medical view, using standard
diagnostic lab tests and imaging, lifestyle and diet therapies,
and careful assessments of environment and psychological makeup
of the patient in order to create a comprehensive treatment plan.
As each patient's case is individual, naturopathic therapies tend
to work slowly by building and nourishing the body, and improving
the patient's vital force. Often, the ND will focus on digestive
function and liver health in order to achieve nutrient assimilation.
Although naturopathic doctors do use botanical medicines including
some Chinese herbs, the Western botanical formulary is generally
different from those utilized in Chinese medicine. Some naturopathic
doctors with a special interest in Chinese patent medicines may
use these instead of Western herbal preparations.
Differences from Chinese Medicine
In general, NDs do not take "qi" balance per se into
account when considering a diagnosis or treatment plan. A naturopathic
doctor's training does not encourage the acumen necessary for
pulse and meridian palpation as well as tongue diagnosis. Therefore,
he or she tends to rely on patient history, laboratory tests,
and previous diagnoses as a starting point to understand disharmonies.
Naturopathic doctors do not tend to assess pathogenic contributors
to illness such as heat, cold, dampness, and dryness and often
does not associate organ dysfunction with typical emotional disturbances
(for example, grief and the lung). Nevertheless, my personal experience
has found repeatedly that both naturopathic and Chinese medicine
thinking are generally very supportive of the vital qi energy
and are quite complementary to each other.
Benefits of Combination Therapies
In a time of an emerging nationwide integrative medicine model,
both naturopathy and Chinese medicine can learn from and substantially
support each other. Oftentimes, Chinese medicine can add a sense
of balance to a routine naturopathic program. For instance, naturopathic
doctors often offer patients nutritive and health protein shakes,
which are good idea in order for the patient to gain nourishment
and build their qi. Unfortunately if a patient has a lot of damp
cold, and low spleen function from a Chinese perspective, these
shakes can tend to "muck up" the system, and cause more
dampness, which can exacerbate the condition - especially in the
wintertime. Being able to assess this low spleen function and
drain damp first, from a Chinese perspective, can often help the
patient feel better, and increase their ability to absorb nutrients.
Later on, possibly in the summertime, a small shake with warming
herbs may prove more useful to support the body and reduce the
cold and dampness.
Similarly, when a Chinese practitioner treats a diabetic's yin
deficiency with excess heat, it would be wise to consider specific
naturopathic dietary and nutrient therapeutic protocols well known
to balance blood sugar and inhibit dysglycemia. My experience
with diabetic neuropathy patients have demonstrated the clear
advantage of combining both medicines to reduce hand and foot
pains, as well as to regulate blood sugar more effectively. Often,
naturopathic treatments can be used concomitantly with Chinese
loose herb formulas too, although the health care practitioners
involved should communicate to avoid any possible untoward treatment
interactions.
Conclusion
Naturopathic medicine has a long rich history of practical,
safe, and effective medicine. As a practitioner who actively employs
both Chinese and naturopathic medicine synergistically, I find
the potency of using them in combination far exceeds the capacity
of either medicine alone. To conclude, I strongly suggest that
it would be in the best interest of both acupuncturists/ Chinese
medicine practitioners and naturopathic physicians to be aware
of each other's therapeutic abilities, and possibly cross-refer
patients, as well as communicate with regards to common patients
so that the best of both philosophies can be employed for the
patient's optimal care. More information regarding naturopathic
medicine can be found in the links section of www.innersourcehealth.com.
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