Thread: ND as primary care to fill CAM Niche

The DO | Complement or threat? Naturopathic doctors aim to fill holistic healing niche

NDs are trying to unite both ends, as primary care docs, in addition to Alternative care providers, similar to what the DOs did 50 years ago.

Embracing a holistic philosophy of healing that resembles osteopathic medicine’s, naturopaths tout themselves as primary care doctors who can help remedy the country’s burgeoning physician shortage. Tapping the public’s growing interest in complementary and alternative medicine, they have been increasing their scope of practice state by state, much as the osteopathic medical profession did in the 20th century.
Licensed in 15 states and the District of Columbia, naturopathic doctors have limited but expanding prescriptive authority and other practice rights, with Oregon and Arizona NDs having the broadest prescribing privileges. In Arizona, Hawaii, Oregon, Vermont and Washington, naturopathic doctors can call themselves naturopathic physicians. Last year, two states—Oregon and Hawaii—passed legislation expanding ND scope of practice.
Most recently, the health reform bill that the U.S. Senate approved on Dec. 24, 2009, contains a “nondiscrimination” provision that could require health insurers to cover naturopathic and other alternative treatments provided by licensed health care professionals who are not fully licensed physicians, points out Virginia M. Johnson, DO, who practices neuromusculoskeletal and osteopathic manipulative medicine in Santa Monica, Calif.
“Those trained in a limited paradigm of healing who seek additional practice rights—without commensurate education or responsibility—pose a threat to patients,” Dr. Johnson contends. “What’s more, as a fully trained and licensed physician, I feel this is a lot like identity theft.”
The superficial similarities between naturopathy and osteopathic medicine belie deep differences in training, according to Dr. Johnson and many other osteopathic physicians, who note that the apparent similarities have caused considerable confusion among patients and health policymakers. In a possible example of such confusion, as well as political maneuvering, California Gov. Arnold Schwarzenegger in late July 2009 approved budget legislation requiring California’s Bureau of Naturopathic Medicine to merge with the Osteopathic Medical Board of California.
Some osteopathic physicians, however, fault the osteopathic medical profession for failing to reinforce osteopathic medicine’s distinctiveness. These DOs contend that the profession’s movement toward the mainstream and away from osteopathic manipulative medicine has provided an opening for naturopathic doctors to promote themselves as the true holistic healers.
But not all osteopathic physicians are worried about naturopathic doctors’ practice rights. A number of DOs work cooperatively with naturopathic doctors, referring patients to NDs in some circumstances and receiving referrals from them as well. These osteopathic physicians point out that naturopathy as a profession has improved its training and credentialing standards, just as the osteopathic medical profession did decades ago. While anyone can claim to be a naturopath, a licensed naturopathic doctor must have a doctor of naturopathy degree from an accredited four-year naturopathic medical college and pass the Naturopathic Physician Licensing Examination (known as NPLEX), administered by the North American Board of Naturopathic Examiners.

i like..everything..it's nice

Interesting article. However, NDs have a long way to go before they are on par with DO's. Dropping homeopathy from their practices would be a start.

Thing is DO's are not alternate providers. DO's dealt with a stigma of simply not having an MD behind their name but were more than qualified to provide the same care as an MD. DO's get virtually identical education in Physiology, Pathology, Pharmacology etc as MD, same amount of clinical training time, have to pass rigorous board exams, specialty exams. DO's were given the same rights as MD's because they were equally qualified regardless of the letters behind their names. I have a problem with NP's and PA acting as PCP's since they are not qualified to take on the "doctor" role. ND's simply do not have the amount of basic science education or the clinical training to handle patients safely.

I think its great, if anyone has looked into Naturopathic Medicine they know how similiar it is to gaining an MD or DO degree. However, they still do need a bit more before they can perform the same tasks as MD's or DO's. Its great though, similar to how DO's rose up to the priviledge of being able to have the broad scope of practice that they have now.

When will ND be considered Primary Care Physicians ???

Current Major improvements:
A. Current Admission: 3 years BA/BSc with 2.5 GPA
B. ND Program: 4 years in accredited ND College/University
C. Licensing Boards: NPLEX 1 (Basic Sciences) NPLEX 2 (Clinical Sciences)

The utilization of the NPLEX steps 1 & 2 (USMLE version for NDs.) and the requirement for 4 years in residence ND Degree are major improvements for the ND profession.

My Constructive opinion:
1. Admission Standards: I think if NDs will strict enrollment guidelines (i.e. MCAT and at least 3.0GPA with 90 credits BSc)
2. Clinical Rotations: Have the 6 compulsary clinical rotations in the last year of their 4 years training specifically: Internal Medicine, Pediatrics, OBGYN, Psychiatry, Family Medicine, and Surgery
3. Residency: require at least 1 year in hospital residency

then I don't see why they shouldn't be considered primary care.

the problem is they dont have the basic science background to practice medicine. the basic science curriculum is probably on par or below that of a nursing student. They are not taught pharmacology, how could they possibly serve as a PCP to a person whos cardiologist may have them on coreg, lisinopril etc. they simply have no idea as to the mechanism of the drug, side effects etc.

If a person wants to be a PCP then go get an MD or a DO and be a PCP. Without one of those degrees patients health and well-being is being put in danger.

Originally Posted by UHSADOC

When will ND be considered Primary Care Physicians ???



Current Major improvements:
A. Current Admission: 3 years BA/BSc with 2.5 GPA
B. ND Program: 4 years in accredited ND College/University
C. Licensing Boards: NPLEX 1 (Basic Sciences) NPLEX 2 (Clinical Sciences)

The utilization of the NPLEX steps 1 & 2 (USMLE version for NDs.) and the requirement for 4 years in residence ND Degree are major improvements for the ND profession.

My Constructive opinion:
1. Admission Standards: I think if NDs will strict enrollment guidelines (i.e. MCAT and at least 3.0GPA with 90 credits BSc)
2. Clinical Rotations: Have the 6 compulsary clinical rotations in the last year of their 4 years training specifically: Internal Medicine, Pediatrics, OBGYN, Psychiatry, Family Medicine, and Surgery
3. Residency: require at least 1 year in hospital residency

then I don't see why they shouldn't be considered primary care.

Correction:
ALL accredited ND programs REQUIRE 2 classes in Pharmacology they are even trained in minor surgery

Also, if you review their NPLEX (ND version of the USMLE) it seems that their scope and training is pretty advanced, and PCP focused....I don't see any issue having NDs work as PCPs as long as they are clinically trained on par with the DOs and MDs, specifically RESIDENCY Training, at least 12 months in all branches of medicine, should suffice in my opinion for PCP role....(I think the 3 years duration is somewhat excessive is for purely economical reasons not so much training focused....I learned the most in my first year as R1......R2, and R3 were just MORE of the same....)

NDs get way more clinical nutrition, as well as in counseling than MD/DOs, and therefore, have HUGE role in prevention, and patient education than we do...

I agree that certain courses taught in ND programs should be dropped out (Homeopathy for instance should be a one class elective, instead of 3-4 courses) and to be replaced by Pharm-Pathphys intensive courses...
Please review the following links:

http://www.naturopathic.org/
Council on Naturopathic Medical Education


Cheers,

Originally Posted by jackets5

the problem is they dont have the basic science background to practice medicine. the basic science curriculum is probably on par or below that of a nursing student. They are not taught pharmacology, how could they possibly serve as a PCP to a person whos cardiologist may have them on coreg, lisinopril etc. they simply have no idea as to the mechanism of the drug, side effects etc.

If a person wants to be a PCP then go get an MD or a DO and be a PCP. Without one of those degrees patients health and well-being is being put in danger.

ALL accredited ND programs REQUIRE 2 classes in Pharmacology they are even trained in minor surgery

This is true. And in a few states, they can even prescribe certain conventional medications, like anti-biotics and anti-inflammatories.

Again, i wouldn't go to an ND but they aren't a bunch of hippies that took a weekend course in selling herbs. They do get real training and can do some pretty advanced things these days.

1. Admission Standards: I think if NDs will strict enrollment guidelines (i.e. MCAT and at least 3.0GPA with 90 credits BSc)
2. Clinical Rotations: Have the 6 compulsary clinical rotations in the last year of their 4 years training specifically: Internal Medicine, Pediatrics, OBGYN, Psychiatry, Family Medicine, and Surgery
3. Residency: require at least 1 year in hospital residency

Doc, let me add one more thing to that list.

4. Drop all homeopathy from practice.


I have been reading up on homeopathy in my spare time and the more i learn, the more insane it becomes. I finally got so curious about the stuff that I obtained two types of homeopathic "medications". One was for lower back pain and one was supposedly sleeping medication. Tried both for a week, as instructed. Didn't do s**t. Without that expectation that it was going to work, I received no placebo effect and of course my back still hurts and i haven't been getting any more sleep. The stuff is a crock. I found several good documentaries about homeopathy if anyone is interested.

In the mean time, there is this entertaining two minute video.

YouTube - That ******** and Webb Look: Homeopathic A&E

LOL, I LIKED THAT
As I call it, HOMEO-PATHETIC !!!

Not sure why NDs if wish to become accepted INSIST on Nonesense placebo like Homeopathy.......they have too many good things going like Clinical Nutrition, environmental medicine,Physical Medicine & Botanical Medicine, that can actually provide some help....but HOMEO-PATHETIC ??? Common people ?!?!?
Ha-Ha-Ha

Originally Posted by AgActual

This is true. And in a few states, they can even prescribe certain conventional medications, like anti-biotics and anti-inflammatories.

Again, i wouldn't go to an ND but they aren't a bunch of hippies that took a weekend course in selling herbs. They do get real training and can do some pretty advanced things these days.

Doc, let me add one more thing to that list.

4. Drop all homeopathy from practice.


I have been reading up on homeopathy in my spare time and the more i learn, the more insane it becomes. I finally got so curious about the stuff that I obtained two types of homeopathic "medications". One was for lower back pain and one was supposedly sleeping medication. Tried both for a week, as instructed. Didn't do s**t. Without that expectation that it was going to work, I received no placebo effect and of course my back still hurts and i haven't been getting any more sleep. The stuff is a crock. I found several good documentaries about homeopathy if anyone is interested.

In the mean time, there is this entertaining two minute video.

YouTube - That ******** and Webb Look: Homeopathic A&E