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Whole
Living
Naturopathic Medicine
A
Holistic Profession You Need to Know About
by Lorrie Klosterman and photographs by Annie Internicola, July 28, 2010
It is not a typical opener for an
article in Whole Living to encourage you to take action. I’m doing it now
because naturopathic doctors (NDs) in New York State are restricted from
applying their full range of skills until the legislature passes a bill that
licenses their profession. A few months ago, such a bill was blocked from
moving ahead by the Higher Education Committee, whose chair, Assemblywoman
Deborah Glick, cited concerns put forth by the Medical Society (an organization
of medical doctors), which sent five representatives to the committee meeting
to oppose the bill.
Licensure would allow health care consumers to choose an ND as a primary care
doctor. That’s possible in 16 states that already have passed licensing bills
(and in Puerto Rico and the US Virgin Islands), including our regional neighbors
Connecticut, Maine, New Hampshire, and Vermont. Many of New York State’s NDs
are licensed in one or more state already, but they are restricted from
prescribing pharmaceuticals or ordering standard diagnostic procedures—not even
a simple blood test—though they are trained to do so. They must collaborate
with an MD, an osteopathic doctor (DO), a nurse practitioner, or a physician’s
assistant to get those things for their patients.
“We’ve been working on this for 10 years,” says Donielle Wilson, president of
the New York Association of Naturopathic Physicians. “We’ve had our own
lobbyists in Albany, co-sponsors in the senate, and a lot of support, including
the majority on the Higher Education Committee. What happens, though, is that
the Medical Society comes in and scares everyone, bringing up things that
aren’t even in the bill, because medical doctors don’t want any profession to
do anything close to what they do. If the legislators would research it
themselves, they would see that naturopathic doctors are a group of highly
trained professionals and that the profession is well established nationally.
There is a shortage of health care providers in New York, and over a hundred
naturopaths are ready to provide that care.”
Not all MDs are against sharing the doctoring pie with NDs. Indeed, some
medical doctors align with NDs very successfully to offer integrative medicine,
and some MDs advocate licensing naturopaths. (For example, Andrew Weil, MD: www.youtube.com/watch?v=6h8OxUb6afU).
I urge you to read on about naturopathic doctors. If you wish you had access to
an ND’s full expertise, write or call your legislators and the Higher Education
Committee and tell them you support licensure. (Contact information is at the
end of this article.)
What Is a Naturopathic Doctor?
Just as MDs and DOs do, naturopathic doctors take four or five years of
graduate-level classes in medical sciences, pharmacology, and clinical
practice. They learn how to perform minor surgeries, prescribe drugs, and carry
out or order diagnostic procedures. NDs study at an accredited Naturopathic
School of Medicine (there are five in the country), some of which have
hospital-based training. But NDs also study topics not included in conventional
medical training: exercise physiology, physical medicine and rehabilitation,
medical herbalism, nutrition, homeopathy, counseling/mediation, and
whole-person medicine, which focuses on treating an individual as a
multifaceted being.
NDs are the only health care providers trained in the interactions among
pharmaceuticals, herbs, and nutrition. In addition to their ND degree,
naturopathic doctors often add specialized training in another modality, such
as acupuncture or oriental medicine, and they take continuing education
coursework to keep abreast of new developments in medicine, including in
pharmacology.
Because of their training, NDs can draw on a number of diverse modalities to
restore health; these include dietary changes, Chinese herbs, acupuncture,
massage, exercise, psychotherapy, and pharmaceuticals, where appropriate. NDs
also refer patients to specialists as needed.
“It’s natural that we would work with a team approach,” says Ileana Tecchio, an
ND in Kingston. “I work with a group of practitioners who are interested in
alternative medicine—an energy healer, a massage therapist, a breast surgeon—a
group of 15 of us has been meeting for about a year as an integrative medicine
network. A patient can see any of us in the network for a discount rate. It’s
to the benefit of the patient to have several practitioners working for them.”
Naturopathic Principles
Naturopaths work from the following set of foundational principles:
The Healing Power of Nature. The body has an inherent ability to
heal itself, and seeks a healthy equilibrium; a naturopathic physician guides
patients toward reestablishing health by addressing multiple factors that may
be out of balance.
First Do No Harm. Diagnostic methods and treatments with highest
safety are used first, whenever possible, while those with highest potential
for harm are used last.
Find and Treat the Cause. Treating symptoms is not treating the
problem; the true causes of health problems must be addressed and may reside in
physical, chemical, mental, emotional, social, and spiritual dimensions.
Doctor as Teacher. True doctoring is not just fixing problems,
but also becoming a patient’s tutor in how to maintain good health, and
empowering him or her to do so.
Treat the Whole Person. Each person is unique, and there is no
one-size-fits-all approach to treatment. Instead, learning a person’s full
story, including medical and nonmedical history and current factors, is
essential to an individualized treatment plan.
Prevention and Wellness. A key goal is to look at each person’s risk
factors for illness and then strengthen health naturally before disease becomes
an issue or recurs. This focus on prevention and wellness also extends to
community education and working to create healthy environments.
These principles play out in practical ways all the time. For instance, Tecchio
explains that she investigates which systems are out of balance and suggests
therapies that engage the body’s natural healing abilities. “If we are talking
about an infection, in addition to getting rid of the infection, we educate the
patient to keep it from happening again. A lot of times diet has been affected,
or the immune system, and we show the patient how to take responsibility to
correct their internal environment. If we just give them a pill, we take the
responsibility out of the person.”
A Different Kind of Doctoring
A visit with an ND is not what you may be accustomed to in a medical office. A
typical first visit lasts 90 minutes but can be longer. Subsequent visits are
usually an hour. “I can take time for the whole person,” says Sam Schikowitz,
an ND based in New Paltz. Besides addressing overt medical issues, he says, “I
check in on their mood and lifestyle, ask how they are sleeping, eating, whether
they exercise, what they’re watching on TV or the computer.” In fact,
Schikowitz chose this form of medicine precisely because it encompasses so
much. “I am able to touch and be touched by people in a way that is deeper than
any other thing I could possibly do. I feel that nothing else could get me in
touch with wisdom better.”
“We’re a lot like old-time doctors,” explains Rise Finkle, an ND who practiced
for 10 years in Connecticut before moving to the Hudson Valley four years ago.
“MDs are very good doctors too, but they just don’t have the time that we do to
spend with a patient. We get to know the whole person. Many times people come
to us after having been to lots of doctors and experts and are not getting
better, but often the way out of the situation is taking time to listen to
everything that is going on with the patient.”
The vast majority of people, says Schikowitz, primarily need to learn how to
care for themselves better. “Certainly some do need drugs, which is why we want
to have the ability to use that part of our training. But mostly they need to
change how they are spending time and energy, how they are eating, dealing with
stress, and in their mental hygiene.”
Naturopaths commonly see chronic conditions—fatigue, depression, anxiety,
digestive disorders—as well as acute things, like upper respiratory tract
infections. Cancer patients can benefit too. “People come to me with cancer in
different stages,” Schikowitz says. “For those undergoing chemo and radiation,
I am recommending techniques and substances that have a good body of scientific
evidence showing that they improve effectiveness or reduce side effects of
cancer treatment. People often need help with nausea, improving appetite, and
just having someone to talk to who is a touchtone for grounding.”
NDs are also committed to researching health issues, and help those patients
who want to do their own research navigate information overload. “We sort out
what’s right for them,” says Finkle. “There is also misinformation out there—a
lot of what you see on TV is just wrong.” The same is true with nutritional and
herbal supplements. “The number of companies putting products out there is
overwhelming,” she says. “A lot of times the newfangled things just don’t work
as well as the original Chinese or Ayurevedic herbs. When an ND sells
supplements, it’s because we’ve researched it and we want to make sure it’s the
highest quality.”
Weaning Off Pharmaceuticals
Naturopathic doctors refer to “the therapeutic order” when considering
interventions; it is a ranking of potential for harm. Dietary changes and
stress reduction, for instance, are at the bottom because they are extremely
safe. Pharmaceuticals are near the top of the ranking; chemotherapy and
radiation are highest in the order. Whenever possible, NDs choose the least
harmful approaches first (which is why their profession enjoys very low
malpractice insurance costs).
Schikowitz gives an example of how this strategy plays out, for the problem of
poor cholesterol/LDL levels. “Lipid imbalances are easy to deal with, in my
experience, because there are so many ways to address them. It’s a matter of
choosing what works best for each person to get them back into balance. Some
people with a highly inflammatory physiology respond fabulously to a vegan diet,
while others respond terribly and need to eat meat. So we have to figure that
out. When you are heavy-handed and use a drug to force a biochemical pathway,
like statin drugs inhibiting cholesterol, it reliably forces a certain effect,
but it doesn’t put a system back into balance like other therapies can. Red
yeast rice, a natural herb from Chinese medicine that has been used for
thousands of years, has a small amount of the substance that is in the patented
statin drug, and it has many other compounds as well. A study comparing red
yeast rice to a statin drug found similar effectiveness, but for the drug, side
effects were prevalent.”
Glenn Finley, an ND in Kingston, often sees patients who are already on many
drugs, including elder patients who get a lot of pressure, sometimes
condescendingly, from the conventional medical world to take medication. “I see
them on statins, hypertensive meds, insulin—it’s wild,” he says. “Insulin is a
treatment, not a cure, which pushes the system even more. In naturopathic
medicine, we don’t want to give the liver more things to do by adding foreign
chemicals. We already live in a toxic environment.” Speaking from his nutrition
training, he points out that just being sure elders get proper nutrition and
hydration can resolve some of their digestive ailments.
Care for Chronic Conditions
Chronic digestive illnesses, like colitis or Crohn’s disease, are one of
Finley’s areas of expertise. “Conventional medicine may be able to maintain you
symptom-wise, but there is no good long-term plan, and the opinion is to take
out a portion of the bowel. But each section has its own purpose, so if you
remove a portion, it’s going to have some ramifications. As naturopaths, we
want to look and see where the inflammation is coming from. The disease is not
the inflammation, but some lack of balance in the immune system.” He worked
with a patient who was in a support group for inflammatory bowel disease.
“Everyone else was scheduling their surgeries for bowel resection, while my
patient was seeking alternative therapies,” Finley says. “We were looking at
food allergies, changing diet, doing some detoxification, addressing her high
stress—nice, simple things. A year later, she was healed, without surgery.
That’s a plus.”
Finley illustrates the beneficial combination of conventional and complementary
approaches this way. “In Vermont, where we can use conventional imaging and
diagnostics, we can order blood work for a patient and see the herbs and
homeopathy affecting physiology. Someone will come in with a trainwreck of a
case, and we can see that physiology really shift, whether it’s a lipid panel,
or inflammatory markers, or the acidity or alkalinity of the blood—it’s really
nice.”
Having
access to that kind of health care approach would be nice as well. To support
licensure of NDs in New York State, write or call Assemblywoman Deborah Glick,
head of the Higher Education Committee, LOB 717, Albany, NY 12248; phone: (518)
455-4811; e-mail via online form at www.assembly.state.ny.us/mem). Also, write your
state legislators; you can send an online letter via this webpage: www.capwiz.com/naturopathic/issues/alert/?alertid=13069731.
NATUROPATHIC DOCTORS IN THE MID-HUDSON VALLEY
Janet Draves
Rhinebeck; (845) 876-3993
Glenn Finley and Ileana Tecchio
Kingston; (845) 331-2235 www.newleafholistichealth.com
Rise Finkle
Stone Ridge; (845) 389-2547 www.stoneridgenaturalmedicine.com
Tom Francescott
Rhinebeck; (845) 876-5556 www.drfrancescott.com
Tammi Price
Kingston; (845) 626-1414 www.drtammi.com
Sam Schikowitz
New Paltz; (845) 594-6822 www.wholefamilymedicine.com
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