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'''Naturopathy''' or '''naturopathic medicine''' is a form of ] employing a wide array of "natural" modalities, including ], ], and ], as well as ] and lifestyle counseling. Naturopathic medicine contains many ] concepts and is considered ineffective and can be harmful, which raises ] issues.<ref name= atwood2003/><ref>{{cite journal|last1=Gorski|first1=David H.|title=Integrative oncology: really the best of both worlds?|journal=Nature Reviews Cancer|date=18 September 2014|volume=14|pages=692–700|doi=10.1038/nrc3822|ref=Gorski Nature|pmid=25230880}}</ref><ref name=tot/> Naturopaths and naturopathic doctors have repeatedly been accused of being ]s and practicing ].<ref name=atwood2003/><ref name=atwood2004/><ref name=Barrett-Naturopathy/><ref name=Harvey2015>{{cite news|last1=Harvey|first1=Claire|title=Don’t duck the law by sending kids to quacks|url=http://www.dailytelegraph.com.au/news/opinion/claire-harvey-dont-duck-the-law-by-sending-kids-to-quacks/story-fni0cwl5-1227438195104|accessdate=2 September 2015|work=The Daily Telegraph|date=11 July 2015}}</ref><ref name=Chivers2014>{{cite news|last1=Chivers|first1=Tom|title=How does naturopathy work? A bit like a flying vacuum-cleaner to Mars|url=http://health.spectator.co.uk/how-does-naturopathy-work-a-bit-like-a-flying-vacuum-cleaner-to-mars/|accessdate=2 September 2015|work=Spectator|date=10 November 2014}}</ref><ref name=Caulfield2013>{{cite news|last1=Caulfield|first1=Timothy|title=Don't legitimize the witch doctors|url=http://news.nationalpost.com/full-comment/timothy-caulfield-dont-legitimize-the-witch-doctors|accessdate=2 September 2015|work=National Post|date=22 January 2013}}</ref> '''Naturopathy''' or '''naturopathic medicine''' is a form of ] employing a wide array of "natural" modalities, including ], ], and ], as well as ] and lifestyle counseling. Naturopathic medicine contains many ] concepts and is considered ineffective and can be harmful, which raises ] issues.<ref name= atwood2003/><ref>{{cite journal|last1=Gorski|first1=David H.|title=Integrative oncology: really the best of both worlds?|journal=Nature Reviews Cancer|date=18 September 2014|volume=14|pages=692–700|doi=10.1038/nrc3822|ref=Gorski Nature|pmid=25230880}}</ref><ref name=tot/> Naturopaths and naturopathic doctors have repeatedly been accused of being ]s and practicing ].<ref name=atwood2003/><ref name=atwood2004/><ref name=Barrett-Naturopathy/><ref name=Harvey2015>{{cite news|last1=Harvey|first1=Claire|title=Don’t duck the law by sending kids to quacks|url=http://www.dailytelegraph.com.au/news/opinion/claire-harvey-dont-duck-the-law-by-sending-kids-to-quacks/story-fni0cwl5-1227438195104|accessdate=2 September 2015|work=The Daily Telegraph|date=11 July 2015}}</ref><ref name=Chivers2014>{{cite news|last1=Chivers|first1=Tom|title=How does naturopathy work? A bit like a flying vacuum-cleaner to Mars|url=http://health.spectator.co.uk/how-does-naturopathy-work-a-bit-like-a-flying-vacuum-cleaner-to-mars/|accessdate=2 September 2015|work=Spectator|date=10 November 2014}}</ref><ref name=Caulfield2013>{{cite news|last1=Caulfield|first1=Timothy|title=Don't legitimize the witch doctors|url=http://news.nationalpost.com/full-comment/timothy-caulfield-dont-legitimize-the-witch-doctors|accessdate=2 September 2015|work=National Post|date=22 January 2013}}</ref>


The ideology and methods of naturopathy are based on ] and self-healing, rather than ].<ref name=Jagtenberg2006/> Naturopathic education contains little of the established clinical training and curriculum completed by ]s, as naturopaths mostly study unscientific notions and learn unproven diagnoses and treatments.<ref name=atwood2003/><ref>{{cite web|title=Family Physicans versus Naturopaths|url=http://www.aafp.org/dam/AAFP/documents/advocacy/workforce/gme/ES-FPvsNaturopaths-110810.pdf|website=aafp.org|publisher=American Academy of Family Physicians|accessdate=20 July 2015|ref=aafp}}</ref> Naturopaths generally recommend against ], including ], ], and ], in favor of methods claimed to be ] and non-invasive. Naturopaths tend to oppose ] and teach their students anti- and alternative vaccine practices, resulting in lower vaccination rates.<ref>{{cite journal|last1=Wilson|first1=K.|title=Characteristics of Pediatric and Adolescent Patients Attending a Naturopathic College Clinic in Canada|journal=Pediatrics|date=1 March 2005|volume=115|issue=3|pages=e338–e343|doi=10.1542/peds.2004-1901}}</ref><ref>{{cite journal|last1=Busse|first1=Jason W.|last2=Wilson|first2=Kumanan|last3=Campbell|first3=James B.|title=Attitudes towards vaccination among chiropractic and naturopathic students|journal=Vaccine|date=November 2008|volume=26|issue=49|pages=6237–6243|doi=10.1016/j.vaccine.2008.07.020|pmid=18674581}}</ref><ref name=wilson>{{cite journal|last1=Wilson|first1=Kumanan|last2=Mills|first2=Ed|last3=Boon|first3=Heather|last4=Tomlinson|first4=George|last5=Ritvo|first5=Paul|title=A survey of attitudes towards paediatric vaccinations amongst Canadian naturopathic students|journal=Vaccine|date=January 2004|volume=22|issue=3-4|pages=329–334|doi=10.1016/j.vaccine.2003.08.014|ref=naturopathi_students_low_vax}}</ref><ref name=Mielczarek2014>{{cite journal|last1=Mielczarek|first1=Eugenie V.|last2=Engler|first2=Brian D.|title=Selling Pseudoscience: A Rent in the Fabric of American Medicine|journal=Skeptical Inquirer|date=2014|volume=38.3|url=http://www.csicop.org/si/show/selling_pseudoscience_a_rent_in_the_fabric_of_american_medicine/|accessdate=2 September 2015}}</ref> According to the ], "scientific evidence does not support claims that naturopathic medicine can cure ] or any other disease."<ref name=ACS-2009>{{cite book|editor1-last=Russell|editor1-first=Jill|editor2-last=Rovere|editor2-first=Amy|title=American Cancer Society Complete Guide to Complementary and Alternative Cancer Therapies|date=2009|publisher=American Cancer Society|location=Atlanta|pages=116–119|edition=Second|accessdate=28 September 2015}}</ref> The ideology and methods of naturopathy are based on ] and self-healing, rather than ].<ref name=Jagtenberg2006/> Naturopathic education contains little of the established clinical training and curriculum completed by ]s, as naturopaths mostly study unscientific notions and learn unproven diagnoses and treatments.<ref name=atwood2003/><ref name=AAFP>{{cite web|title=Family Physicans versus Naturopaths|url=http://www.aafp.org/dam/AAFP/documents/advocacy/workforce/gme/ES-FPvsNaturopaths-110810.pdf|website=aafp.org|publisher=American Academy of Family Physicians|accessdate=20 July 2015|ref=aafp}}</ref> Naturopaths generally recommend against ], including ], ], and ], in favor of methods claimed to be ] and non-invasive. Naturopaths tend to oppose ] and teach their students anti- and alternative vaccine practices, resulting in lower vaccination rates.<ref>{{cite journal|last1=Wilson|first1=K.|title=Characteristics of Pediatric and Adolescent Patients Attending a Naturopathic College Clinic in Canada|journal=Pediatrics|date=1 March 2005|volume=115|issue=3|pages=e338–e343|doi=10.1542/peds.2004-1901}}</ref><ref>{{cite journal|last1=Busse|first1=Jason W.|last2=Wilson|first2=Kumanan|last3=Campbell|first3=James B.|title=Attitudes towards vaccination among chiropractic and naturopathic students|journal=Vaccine|date=November 2008|volume=26|issue=49|pages=6237–6243|doi=10.1016/j.vaccine.2008.07.020|pmid=18674581}}</ref><ref name=wilson>{{cite journal|last1=Wilson|first1=Kumanan|last2=Mills|first2=Ed|last3=Boon|first3=Heather|last4=Tomlinson|first4=George|last5=Ritvo|first5=Paul|title=A survey of attitudes towards paediatric vaccinations amongst Canadian naturopathic students|journal=Vaccine|date=January 2004|volume=22|issue=3-4|pages=329–334|doi=10.1016/j.vaccine.2003.08.014|ref=naturopathi_students_low_vax}}</ref><ref name=Mielczarek2014>{{cite journal|last1=Mielczarek|first1=Eugenie V.|last2=Engler|first2=Brian D.|title=Selling Pseudoscience: A Rent in the Fabric of American Medicine|journal=Skeptical Inquirer|date=2014|volume=38.3|url=http://www.csicop.org/si/show/selling_pseudoscience_a_rent_in_the_fabric_of_american_medicine/|accessdate=2 September 2015}}</ref> According to the ], "scientific evidence does not support claims that naturopathic medicine can cure ] or any other disease."<ref name=ACS-2009>{{cite book|editor1-last=Russell|editor1-first=Jill|editor2-last=Rovere|editor2-first=Amy|title=American Cancer Society Complete Guide to Complementary and Alternative Cancer Therapies|date=2009|publisher=American Cancer Society|location=Atlanta|pages=116–119|edition=Second|accessdate=28 September 2015}}</ref>


The term "naturopathy" was created from "natura" (] root for birth) and "pathos" (the ] root for suffering) to suggest "natural healing".<ref name=NCAHF_np/> Modern naturopathy grew out of the ] of ]. According to the Merriam-Webster Dictionary, the first known use of "naturopathy" in print is from 1901.<ref>{{cite web|url=http://www.merriam-webster.com/dictionary/naturopath|title=Naturopathy - Definition of Naturopathy by Merriam-Webster|publisher=}}</ref> The term was coined in 1895 by ] and popularized by ], who is considered to be the "father of U.S. naturopathy".<ref name=Baer2001 /> Beginning in the 1970s, there was a revival of interest in the ] and ], in conjunction with the "holistic health" movement. The term "naturopathy" was created from "natura" (] root for birth) and "pathos" (the ] root for suffering) to suggest "natural healing".<ref name=NCAHF_np/> Modern naturopathy grew out of the ] of ]. According to the Merriam-Webster Dictionary, the first known use of "naturopathy" in print is from 1901.<ref>{{cite web|url=http://www.merriam-webster.com/dictionary/naturopath|title=Naturopathy - Definition of Naturopathy by Merriam-Webster|publisher=}}</ref> The term was coined in 1895 by ] and popularized by ], who is considered to be the "father of U.S. naturopathy".<ref name=Baer2001 /> Beginning in the 1970s, there was a revival of interest in the ] and ], in conjunction with the "holistic health" movement.
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=== Licensed naturopaths === === Licensed naturopaths ===
] trains students in naturopathic medicine who are eligible to become licensed in some jurisdictions in North America.]] ] trains students in naturopathic medicine who are eligible to become licensed in some jurisdictions in North America.]]
Naturopathic doctors are licensed in 17 US states and 5 Canadian provinces.<ref>{{cite web|title=Naturopathic Doctor Licensure|url=http://aanmc.org/careers/licensure/|website=Association of Accredited Naturopathic Medical Colleges|accessdate=25 December 2014}}</ref> In jurisdictions where ''naturopathic doctor'' (ND or NMD) or a similar term is a protected designation, naturopathic doctors must pass the ] (NPLEX) administered by the North American Board of Naturopathic Examiners (NABNE)<ref>{{cite web |url= https://www.nabne.org/home/about/ |title= About Us |work= |accessdate= 3 September 2013 |publisher=North American Board of Naturopathic Examiners |author= <!-- no byline --> |date= <!-- no date in source --> }}</ref> after graduating from a college accredited by the Council on Naturopathic Medical Education (CNME).<ref name=CNME-handbook /> The NPLEX has been called a mystery by those outside the naturopathic profession<ref name=atwood2004/><ref name=MMStestimony2015>{{cite web|title=MMS Testimony in Opposition to H. 1992 and S. 1205, An Act to Create a Board of Registration in Naturopathy|url=http://www.massmed.org/Advocacy/MMS-Testimony/MMS-Testimony-in-Opposition-to-H--1992-and-S--1205,-An-Act-to-Create-a-Board-of-Registration-in-Naturopathy/#.VtgJaZMrKrO|website=Massachusetts Medical Society|publisher=Massachusetts Medical Society|accessdate=May 2016}}</ref> and criticized for testing on homeopathic remedies,<ref name="GorskiSBM">{{cite web|last1=Gorski|first1=David|authorlink1=David Gorski|title=Naturopathy and Science|url=https://www.sciencebasedmedicine.org/naturopathy-and-science/|publisher=ScienceBasedMedicine.org|accessdate=3 March 2016|date=21 February 2011}}</ref> even for pediatric medical emergencies.<ref name="Senapathy2016"/> Licensed naturopaths may be referred to as "naturopathic doctors" or "naturopathic physicians" in 17 US states and 5 Canadian provinces.<ref>{{cite web|title=Naturopathic Doctor Licensure|url=http://aanmc.org/careers/licensure/|website=Association of Accredited Naturopathic Medical Colleges|accessdate=25 December 2014}}</ref> Licensed naturopaths must pass the ] (NPLEX) administered by the North American Board of Naturopathic Examiners (NABNE)<ref>{{cite web |url= https://www.nabne.org/home/about/ |title= About Us |work= |accessdate= 3 September 2013 |publisher=North American Board of Naturopathic Examiners |author= <!-- no byline --> |date= <!-- no date in source --> }}</ref> after graduating from a program accredited by the Council on Naturopathic Medical Education (CNME).<ref name=CNME-handbook /> These accredited programs have been criticized for misrepresenting their medical rigor and teaching subjects that are antithetical to the best understandings of science and medicine.<ref name="GorskiSBM"/><ref name="Hermes2015">{{cite web|last1=Hermes|first1=Britt|authorlink1=Britt Marie Hermes|title=ND Confession, Part 1: Clinical training inside and out|url=https://www.sciencebasedmedicine.org/nd-confession-part-1-clinical-training-inside-and-out|website=Science-Based Medicine|accessdate=23 July 2016|date=13 March 2015}}</ref><ref name= Barrett-Naturopathy/>, and the CNME as an accrediting authority has been characterized as unreliable and suffering from conflicts of interest.<ref name="Mangan1999">{{cite news|last1=Mangan|first1=Katherine S.|title=Report Recommends Stripping Naturopathy Council of Its Accrediting Authority|url=http://chronicle.com/article/Report-Recommends-Stripping/113719|accessdate=23 July 2016|work=]|date=2 December 1999}}</ref><ref name="Hermes2015b">{{cite web|last1=Hermes|first1=Britt|authorlink1=Britt Marie Hermes|title=ND Confession, Part II: The Accreditation of Naturopathic “Medical” Education|url=https://www.sciencebasedmedicine.org/nd-confession-part-ii-the-accreditation-of-naturopathic-medical-education/|website=Science-Based Medicine|accessdate=23 July 2016|date=29 August 2015}}</ref><ref name=sfsbmNDreport>{{Cite report |author=Society for Science-Based Medicine |date=2014 |title=Report to the Maryland Board of Physicians Naturopathic Advisory Committee: Recommendations for Naturopathic Regulation |url=http://sfsbm.org/index.php?option=com_content&view=article&id=486:naturopathic-board&catid=52:legislative&Itemid=435 |accessdate=23 July 2016}}</ref> The naturopathic licensing exam has been called a mystery by those outside the naturopathic profession<ref name=atwood2004/><ref name=MMStestimony2015>{{cite web|title=MMS Testimony in Opposition to H. 1992 and S. 1205, An Act to Create a Board of Registration in Naturopathy|url=http://www.massmed.org/Advocacy/MMS-Testimony/MMS-Testimony-in-Opposition-to-H--1992-and-S--1205,-An-Act-to-Create-a-Board-of-Registration-in-Naturopathy/#.VtgJaZMrKrO|website=Massachusetts Medical Society|publisher=Massachusetts Medical Society|accessdate=May 2016}}</ref> and criticized for testing on homeopathic remedies,<ref name="GorskiSBM">{{cite web|last1=Gorski|first1=David|authorlink1=David Gorski|title=Naturopathy and Science|url=https://www.sciencebasedmedicine.org/naturopathy-and-science/|publisher=ScienceBasedMedicine.org|accessdate=3 March 2016|date=21 February 2011}}</ref> even for pediatric medical emergencies.<ref name="Senapathy2016"/>


Naturopathic doctors are not eligible for ], which are available exclusively for medical doctors and doctors of osteopathic medicine. There are limited post-graduate "residency" positions available to naturopathic doctors offered through naturopathic schools and naturopathic clinics approved by the Council on Naturopathic Medical Education.<ref name=CNME_residency>{{cite web|title=Hanbook on CNME Postdoctoral Naturopathic Medical Education Sponsor Recognition Process and Standards (2005)|url=http://www.cnme.org/resources/residency_handbook.pdf|publisher=Council on Naturopathic Medical Education}}</ref> Most naturopathic doctors do not complete such a residency,<ref name="Boon HS"/> and naturopathic doctors are not mandated to complete one for licensure,<ref name=ACS-2009 /> except in the state of Utah.<ref name= "UT license app">{{cite web |url=http://www.dopl.utah.gov/licensing/forms/applications/072_naturopathic_phys.pdf |title=Application for Licensure: Naturopathic Physician |author=Division of Occupational and Professional Licensing, Utah Department of Commerce, State of Utah |date=February 17, 2012 |page=1 |accessdate= 2013-09-08}}</ref> ] in naturopathic modalities for health care professionals varies greatly.<ref name=PoaP/> Naturopathic doctors are not eligible for ], which are available exclusively for medical doctors and doctors of osteopathic medicine. There are limited post-graduate "residency" positions available to naturopathic doctors offered through naturopathic schools and naturopathic clinics approved by the CNME.<ref name=CNME_residency>{{cite web|title=Hanbook on CNME Postdoctoral Naturopathic Medical Education Sponsor Recognition Process and Standards (2005)|url=http://www.cnme.org/resources/residency_handbook.pdf|publisher=Council on Naturopathic Medical Education}}</ref> Most naturopathic doctors do not complete such a residency,<ref name="Boon HS"/> and naturopathic doctors are not mandated to complete one for licensure,<ref name=ACS-2009 /> except in the state of Utah.<ref name= "UT license app">{{cite web |url=http://www.dopl.utah.gov/licensing/forms/applications/072_naturopathic_phys.pdf |title=Application for Licensure: Naturopathic Physician |author=Division of Occupational and Professional Licensing, Utah Department of Commerce, State of Utah |date=February 17, 2012 |page=1 |accessdate= 2013-09-08}}</ref> ] in naturopathic modalities for health care professionals varies greatly.<ref name=PoaP/>


Licensed naturopaths present themselves as ].<ref name=Gale_Frey /><ref name=CNME-handbook/> Doctor of Naturopathy training includes basic medical diagnostics and procedures such as rudimentary physical exams and common ]s, in addition to pseudoscientific modalities, such as homeopathy.<ref name= atwood2003>{{cite journal|last=Atwood |first= Kimball C., IV |year= 2003|doi= |title= Naturopathy: A critical appraisal |url= http://www.medscape.com/viewarticle/465994 |journal= Medscape General Medicine |volume= 5 |issue= 4 |page= 39 |pmid= 14745386}}{{registration required}}</ref><ref name= atwood2004 /><ref name= Barrett-Naturopathy/><ref name=Gale_Frey /> Jann Bellamy has characterized the process by which naturopaths and other practioners of pseudoscience convince state lawmakers to provide them with medical licenses as "legislative alchemy."<ref name="Bellamy2014">{{cite web|last1=Bellamy|first1=Jann|title=Legislative Alchemy 2014 (so far)|url=https://www.sciencebasedmedicine.org/legislative-alchemy-2014-so-far/|website=Science-Based Medicine|accessdate=21 July 2016|date=15 May 2014}}</ref> Licensed naturopaths present themselves as ].<ref name=Gale_Frey /><ref name=CNME-handbook/> Training in CNME-accredited programs includes basic medical diagnostics and procedures such as rudimentary physical exams and common ]s, in addition to pseudoscientific modalities, such as homeopathy, acupuncture, and energy modalities.<ref name= atwood2003>{{cite journal|last=Atwood |first= Kimball C., IV |year= 2003|doi= |title= Naturopathy: A critical appraisal |url= http://www.medscape.com/viewarticle/465994 |journal= Medscape General Medicine |volume= 5 |issue= 4 |page= 39 |pmid= 14745386}}{{registration required}}</ref><ref name= atwood2004 /><ref name= Barrett-Naturopathy/><ref name=Gale_Frey /> Licensed naturopaths do not receive comprobable training to medical doctors in terms of the quality of education or quantity of hours.<ref name= atwood2003/><ref name=AAFP/> Jann Bellamy has characterized the process by which naturopaths and other practioners of pseudoscience convince state lawmakers to provide them with medical licenses as "legislative alchemy."<ref name="Bellamy2014">{{cite web|last1=Bellamy|first1=Jann|title=Legislative Alchemy 2014 (so far)|url=https://www.sciencebasedmedicine.org/legislative-alchemy-2014-so-far/|website=Science-Based Medicine|accessdate=21 July 2016|date=15 May 2014}}</ref>


In 2005, the ] opposed licensure based on concerns that NDs are not required to participate in residency and concerns that the "practices" of naturopaths included many "erroneous and potentially dangerous claims."<ref name=MassMed2005>{{cite web |first= <!-- contact not author Richard P. --> |last= <!-- contact not author Gulla --> |title= Massachusetts Medical Society Testifies in Opposition to Licensing Naturopaths |date= May 11, 2005 |publisher= ] |url= http://www.massmed.org/AM/PrinterTemplate.cfm?Section=Home&CONTENTID=12458&TEMPLATE=/CM/ContentDisplay.cfm | work = | pages = | accessdate = 2009-04-17 | language = |archivedate= 2011-07-16 |archiveurl= https://web.archive.org/web/20110716132319/http://www.massmed.org/AM/PrinterTemplate.cfm?Section=Home&CONTENTID=12458&TEMPLATE=/CM/ContentDisplay.cfm |deadurl=yes}}</ref> The Massachusetts Special Commission on Complementary and Alternative Medical Practitioners rejected their concerns and recommended licensure.<ref name=MassCtte>{{cite web |title=Majority Report of the Special Commission on Complementary and Alternative Medical Practitioners: A Report to the Legislature |date=January 2002 |author= The Special Commission on Complementary and Alternative Medical Practitioners |publisher=Massachusetts: The Special Commission on Complementary and Alternative Medical Practitioners |url=http://www.quackwatch.com/01QuackeryRelatedTopics/Naturopathy/majority.pdf |accessdate=2010-11-10 |postscript= .}}</ref> In 2005, the ] opposed licensure based on concerns that NDs are not required to participate in residency and concerns that the "practices" of naturopaths included many "erroneous and potentially dangerous claims."<ref name=MassMed2005>{{cite web |first= <!-- contact not author Richard P. --> |last= <!-- contact not author Gulla --> |title= Massachusetts Medical Society Testifies in Opposition to Licensing Naturopaths |date= May 11, 2005 |publisher= ] |url= http://www.massmed.org/AM/PrinterTemplate.cfm?Section=Home&CONTENTID=12458&TEMPLATE=/CM/ContentDisplay.cfm | work = | pages = | accessdate = 2009-04-17 | language = |archivedate= 2011-07-16 |archiveurl= https://web.archive.org/web/20110716132319/http://www.massmed.org/AM/PrinterTemplate.cfm?Section=Home&CONTENTID=12458&TEMPLATE=/CM/ContentDisplay.cfm |deadurl=yes}}</ref> The Massachusetts Special Commission on Complementary and Alternative Medical Practitioners rejected their concerns and recommended licensure.<ref name=MassCtte>{{cite web |title=Majority Report of the Special Commission on Complementary and Alternative Medical Practitioners: A Report to the Legislature |date=January 2002 |author= The Special Commission on Complementary and Alternative Medical Practitioners |publisher=Massachusetts: The Special Commission on Complementary and Alternative Medical Practitioners |url=http://www.quackwatch.com/01QuackeryRelatedTopics/Naturopathy/majority.pdf |accessdate=2010-11-10 |postscript= .}}</ref>

Revision as of 06:11, 23 July 2016

Naturopathy
Alternative medicine
Old homeopathic remedy, Hepar sulph.A homeopathic preparation of Hepar sulph
Claims"Nature Cure"
Related fieldsAlternative medicine
Year proposedearly 20th century
Original proponentsBenedict Lust; Sebastian Kneipp
MeSHD009324
See alsoHumorism, heroic medicine, Vitalism
Part of a series on
Alternative medicine
General information
Fringe medicine and science
Controversies
Classifications
Traditional medicine
Alternative diagnoses

Naturopathy or naturopathic medicine is a form of alternative medicine employing a wide array of "natural" modalities, including homeopathy, herbalism, and acupuncture, as well as diet and lifestyle counseling. Naturopathic medicine contains many pseudoscientific concepts and is considered ineffective and can be harmful, which raises ethical issues. Naturopaths and naturopathic doctors have repeatedly been accused of being charlatans and practicing quackery.

The ideology and methods of naturopathy are based on vitalism and self-healing, rather than evidence-based medicine. Naturopathic education contains little of the established clinical training and curriculum completed by primary care doctors, as naturopaths mostly study unscientific notions and learn unproven diagnoses and treatments. Naturopaths generally recommend against modern medicine, including surgery, drugs, and vaccinations, in favor of methods claimed to be holistic and non-invasive. Naturopaths tend to oppose vaccines and teach their students anti- and alternative vaccine practices, resulting in lower vaccination rates. According to the American Cancer Society, "scientific evidence does not support claims that naturopathic medicine can cure cancer or any other disease."

The term "naturopathy" was created from "natura" (Latin root for birth) and "pathos" (the Greek root for suffering) to suggest "natural healing". Modern naturopathy grew out of the Natural Cure movement of Europe. According to the Merriam-Webster Dictionary, the first known use of "naturopathy" in print is from 1901. The term was coined in 1895 by John Scheel and popularized by Benedict Lust, who is considered to be the "father of U.S. naturopathy". Beginning in the 1970s, there was a revival of interest in the United States and Canada, in conjunction with the "holistic health" movement.

History

Monsignor Sebastian Kneipp, 1821–1897
Benedict Lust, 1872–1945

Naturopaths claim the ancient Greek "Father of Medicine", Hippocrates, as the first advocate of naturopathic medicine, before the term existed. Naturopathy has its roots in the 19th-century Nature Cure movement of Europe. In Scotland, Thomas Allinson started advocating his "Hygienic Medicine" in the 1880s, promoting a natural diet and exercise with avoidance of tobacco and overwork.

The term naturopathy was coined in 1895 by John Scheel, and purchased by Benedict Lust, the "father of U.S. naturopathy". Lust had been schooled in hydrotherapy and other natural health practices in Germany by Father Sebastian Kneipp; Kneipp sent Lust to the United States to spread his drugless methods. Lust defined naturopathy as a broad discipline rather than a particular method, and included such techniques as hydrotherapy, herbal medicine, and homeopathy, as well as eliminating overeating, tea, coffee, and alcohol. He described the body in spiritual and vitalistic terms with "absolute reliance upon the cosmic forces of man's nature".

In 1901, Lust founded the American School of Naturopathy in New York. In 1902 the original North American Kneipp Societies were discontinued and renamed "Naturopathic Societies". In September 1919 the Naturopathic Society of America was dissolved and Benedict Lust founded the American Naturopathic Association to supplant it. Naturopaths became licensed under naturopathic or drugless practitioner laws in 25 states in the first three decades of the twentieth century. Naturopathy was adopted by many chiropractors, and several schools offered both Doctor of Naturopathy (ND) and Doctor of Chiropractic (DC) degrees. Estimates of the number of naturopathic schools active in the United States during this period vary from about one to two dozen.

After a period of rapid growth, naturopathy went into decline for several decades after the 1930s. In 1910 the Carnegie Foundation for the Advancement of Teaching published the Flexner Report, which criticized many aspects of medical education, especially quality and lack of scientific rigour. The advent of penicillin and other "miracle drugs" and the consequent popularity of modern medicine also contributed to naturopathy's decline. In the 1940s and 1950s, a broadening in scope of practice laws led many chiropractic schools to drop their ND degrees, though many chiropractors continued to practice naturopathy. From 1940 to 1963, the American Medical Association campaigned against heterodox medical systems. By 1958 practice of naturopathy was licensed in only five states. In 1968 the United States Department of Health, Education, and Welfare issued a report on naturopathy concluding that naturopathy was not grounded in medical science and that naturopathic education was inadequate to prepare graduates to make appropriate diagnosis and provide treatment; the report recommends against expanding Medicare coverage to include naturopathic treatments. In 1977 an Australian committee of inquiry reached similar conclusions; it did not recommend licensure for naturopaths. As of 2009, fifteen U.S. states, Puerto Rico, the US Virgin Islands and the District of Columbia licensed naturopathic doctors, and the state of Washington requires insurance companies to offer reimbursement for services provided by naturopathic physicians. South Carolina and Tennessee prohibit the practice of naturopathy.

Beginning in the 1970s, interest waxed in the United States and Canada in conjunction with the holistic health movement.

Practice

A patient undergoing a hydrotherapy session.
A nutritional supplement of Chromium(III) picolinate, Chromax II.

Naturopathic practice is based on a belief in the body's ability to heal itself through a special vital energy or force guiding bodily processes internally. Diagnosis and treatment concern primarily alternative therapies and "natural" methods that naturopaths claim promote the body's natural ability to heal. Naturopaths focus on a holistic approach, often completely avoiding the use of surgery and drugs. Naturopaths aim to prevent illness through stress reduction and changes to diet and lifestyle, often rejecting the methods of evidence-based medicine.

A consultation typically begins with a lengthy patient interview focusing on lifestyle, medical history, emotional tone, and physical features, as well as physical examination. Many naturopaths present themselves as primary care providers, and some naturopathic physicians may prescribe drugs, perform minor surgery, and integrate other conventional medical approaches such as diet and lifestyle counselling with their naturopathic practice. Traditional naturopaths deal exclusively with lifestyle changes, not diagnosing or treating disease. Naturopaths do not generally recommend vaccines and antibiotics, based in part on the early views that shaped the profession, and they may provide alternative remedies even in cases where evidence-based medicine has been shown effective.

Methods

A 2004 survey determined the most commonly prescribed naturopathic therapeutics in Washington State and Connecticut were botanical medicines, vitamins, minerals, homeopathy, and allergy treatments. A examination published in 2011 of naturopathic clinic websites in Alberta and British Columbia found that the most commonly advertised therapies were homeopathy, botanical medicine, nutrition, acupuncture, lifestyle counseling, and detoxification.

The particular modalities used by a naturopath vary with training and scope of practice. These may include herbalism, homeopathy, acupuncture, nature cures, physical medicine, applied kinesiology, colonic enemas, chelation therapy, color therapy, cranial osteopathy, hair analysis, iridology, live blood analysis, ozone therapy, psychotherapy, public health measures and hygiene, reflexology, rolfing, massage therapy, and traditional Chinese medicine. Nature cures include a range of therapies based on exposure to natural elements such as sunshine, fresh air, or heat or cold, as well as nutrition advice such as following a vegetarian and whole food diet, fasting, or abstention from alcohol and sugar. Physical medicine includes naturopathic, osseous, or soft tissue manipulative therapy, sports medicine, exercise, and hydrotherapy. Psychological counseling includes meditation, relaxation, and other methods of stress management.

Evidence basis

A rectal bulb syringe. Enemas and colonic irrigation are commonly used by naturopaths for a wide range of medical conditions, for which there are no known health benefits.
Patient undergoing Ozone IV Therapy
Person undergoing ozone IV therapy with ultraviolet irradiation. The U.S. FDA declares, "Ozone is a toxic gas with no known useful medical application in specific, adjunctive, or preventive therapy.
See also: Evidence-based medicine

Naturopathy lacks an adequate scientific basis, and it is rejected by the medical community. Some methods rely on immaterial "vital energy fields", the existence of which has not been proven, and there is concern that naturopathy as a field tends towards isolation from general scientific discourse. Naturopathy is criticized for its reliance on and its association with unproven, disproven, and other controversial alternative medical treatments, and for its vitalistic underpinnings. Natural substances known as nutraceuticals show little promise in treating diseases, especially cancer, as laboratory experiments have shown limited therapeutic effect on biochemical pathways, while clinical trials demonstrate poor bioavailability. According to the American Cancer Society, "scientific evidence does not support claims that naturopathic medicine can cure cancer or any other disease.

In 2015 the Australian Government's Department of Health published the results of a review of alternative therapies that sought to determine if any were suitable for being covered by health insurance; Naturopathy was one of 17 therapies evaluated for which no clear evidence of effectiveness was found.

Kimball C. Atwood IV writes, in the journal Medscape General Medicine,

Naturopathic physicians now claim to be primary care physicians proficient in the practice of both "conventional" and "natural" medicine. Their training, however, amounts to a small fraction of that of medical doctors who practice primary care. An examination of their literature, moreover, reveals that it is replete with pseudoscientific, ineffective, unethical, and potentially dangerous practices.

In another article, Atwood writes that "Physicians who consider naturopaths to be their colleagues thus find themselves in opposition to one of the fundamental ethical precepts of modern medicine. If naturopaths are not to be judged "nonscientific practitioners", the term has no useful meaning".

A retired licensed naturopathic doctor, Britt Marie Hermes, states that "any product that is sold by a naturopath almost guarantees that there is no reliable scientific data to support whatever health claims are made.

Practitioners

Naturopaths represent a diverse group of practitioners. In general, they can be categorized into three groups: 1) those with a government issued licensed; 2) those who practice outside of an official status; 3) those who are primarily another kind of health professional who also practices naturopathy.

In Switzerland, these divisions fall between those with a federal diploma, those recognized by health insurances, and those with neither federal diploma nor recognition by health insurances. Naturopaths with federal diploma can be divided into four categories: European traditional medicine, Chinese traditional medicine, ayurvedic medicine and homeopathy. The number of listed naturopaths (including traditional healers) in Switzerland rose from 223 in 1970 to 1835 in 2000.

Naturopathic practitioners in the United States can be divided into three groups: licensed naturopaths, traditional naturopaths, and other health care providers who offer naturopathic services.

Licensed naturopaths

National University of Natural Medicine trains students in naturopathic medicine who are eligible to become licensed in some jurisdictions in North America.

Licensed naturopaths may be referred to as "naturopathic doctors" or "naturopathic physicians" in 17 US states and 5 Canadian provinces. Licensed naturopaths must pass the Naturopathic Physicians Licensing Examinations (NPLEX) administered by the North American Board of Naturopathic Examiners (NABNE) after graduating from a program accredited by the Council on Naturopathic Medical Education (CNME). These accredited programs have been criticized for misrepresenting their medical rigor and teaching subjects that are antithetical to the best understandings of science and medicine., and the CNME as an accrediting authority has been characterized as unreliable and suffering from conflicts of interest. The naturopathic licensing exam has been called a mystery by those outside the naturopathic profession and criticized for testing on homeopathic remedies, even for pediatric medical emergencies.

Naturopathic doctors are not eligible for medical residencies, which are available exclusively for medical doctors and doctors of osteopathic medicine. There are limited post-graduate "residency" positions available to naturopathic doctors offered through naturopathic schools and naturopathic clinics approved by the CNME. Most naturopathic doctors do not complete such a residency, and naturopathic doctors are not mandated to complete one for licensure, except in the state of Utah. Continuing education in naturopathic modalities for health care professionals varies greatly.

Licensed naturopaths present themselves as primary care providers. Training in CNME-accredited programs includes basic medical diagnostics and procedures such as rudimentary physical exams and common blood tests, in addition to pseudoscientific modalities, such as homeopathy, acupuncture, and energy modalities. Licensed naturopaths do not receive comprobable training to medical doctors in terms of the quality of education or quantity of hours. Jann Bellamy has characterized the process by which naturopaths and other practioners of pseudoscience convince state lawmakers to provide them with medical licenses as "legislative alchemy."

In 2005, the Massachusetts Medical Society opposed licensure based on concerns that NDs are not required to participate in residency and concerns that the "practices" of naturopaths included many "erroneous and potentially dangerous claims." The Massachusetts Special Commission on Complementary and Alternative Medical Practitioners rejected their concerns and recommended licensure.

In 2015, a former naturopathic doctor, Britt Marie Hermes, who graduated from Bastyr University and practiced as a licensed ND in Washington and Arizona, began advocating against naturopathic medicine. In addition to opposing further licensure, she believes that NDs should not be allowed to use the titles "doctor" or "physician," and be barred from treating children.

Traditional naturopaths

Traditional naturopaths are represented in the United States by the American Naturopathic Association (ANA), representing about 1,800 practitioners and the American Naturopathic Medical Association (ANMA).

The level of naturopathic training varies among traditional naturopaths in the United States. Traditional naturopaths may complete non-degree certificate programs or undergraduate degree programs and generally refer to themselves as Naturopathic Consultants. These programs often offer online unaccredited degrees, but do not offer proper biomedical education or clinical training. Those completing a Doctor of Naturopathy (ND) degree from an ANMCB-approved school can become a licensed Doctor of Naturopathic Medicine.

Traditional naturopathic practitioners surveyed in Australia perceive evidence-based medicine to be an ideological assault on their beliefs in vitalistic and holistic principles. They advocate the integrity of natural medicine practice.

Naturopaths graduating from accredited programs argued in 2002 that their training used evidence-based scientific principles, but this claim remains inaccurate.

Treatments and practices

Clark Stanley's Snake Oil Liniment

Naturopaths are often opposed to mainstream medicine and take an antivaccinationist stance.

According to Arnold S. Relman, the Textbook of Natural Medicine is inadequate as a teaching tool, as it omits to mention or treat in detail many common ailments, improperly emphasizes treatments "not likely to be effective" over those that are, and promotes unproven herbal remedies at the expense of pharmaceuticals. He concludes that "the risks to many sick patients seeking care from the average naturopathic practitioner would far outweigh any possible benefits".

The Massachusetts Medical Society states,

Naturopathic practices are unchanged by research and remain a large assortment of erroneous and potentially dangerous claims mixed with a sprinkling of non-controversial dietary and lifestyle advice.

In terms of education, The Massachusetts Medical Society states:

Naturopathic medical school is not a medical school in anything but the appropriation of the word medical. Naturopathy is not a branch of medicine. It is a hodge podge of nutritional advice, home remedies and discredited treatments...Naturopathic colleges claim accreditation but follow a true “alternative” accreditation method that is virtually meaningless. They are not accredited by the same bodies that accredit real medical schools and while some courses have similar titles to the curricula of legitimate medical schools the content is completely different.

Certain naturopathic treatments offered by naturopaths, such as homeopathy, rolfing, and iridology, are widely considered pseudoscience or quackery. Stephen Barrett of QuackWatch and the National Council Against Health Fraud has stated that naturopathy is "simplistic and that its practices are riddled with quackery". "Non-scientific health care practitioners, including naturopaths, use unscientific methods and deception on a public who, lacking in-depth health care knowledge, must rely upon the assurance of providers. Quackery not only harms people, it undermines the ability to conduct scientific research and should be opposed by scientists", says William T. Jarvis.

Safety of natural treatments

Naturopaths often recommend exposure to naturally occurring substances, such as sunshine, herbs and certain foods, as well as activities they describe as natural, such as exercise, meditation and relaxation. Naturopaths claim that these natural treatments help restore the body's innate ability to heal itself without the adverse effects of conventional medicine. However, "natural" methods and chemicals are not necessarily safer or more effective than "artificial" or "synthetic" ones, and any treatment capable of eliciting an effect may also have deleterious side effects.

Vaccination

Measles cases 1944-1963 followed a highly variable epidemic pattern, with 150,000-850,000 cases reported per year. A sharp decline followed introduction of the first measles vaccine in 1963, with fewer than 25,000 cases reported in 1968. Outbreaks around 1971 and 1977 gave 75,000 and 57,000 cases, respectively. Cases were stable at a few thousand per year until an outbreak of 28,000 in 1990. Cases declined from a few hundred per year in the early 1990s to a few dozen in the 2000s.
Measles cases reported in the United States fell dramatically after introduction of the measles vaccine.
See also: Vaccine controversies

Naturopathy is based on beliefs opposed to vaccination and have practitioners who voice their opposition. The reasons for this opposition are based, in part, on the early views which shaped the foundation of this profession. In general, evidence about associations between naturopathy and pediatric vaccination is sparse, but "published reports suggest that only a minority of naturopathic physicians actively support full vaccination". In Washington state from 2000 to 2003, children were significantly less likely to receive immunizations if they had seen a naturopath. A survey of naturopathic students published in 2004 found that students at the Canadian College of Naturopathic Medicine became less likely to recommend vaccinations to their patients and became more distrustful of public health and conventional medicine as they advanced in the program.

A naturopathy textbook recommends "a return to nature in regulating the diet, breathing, exercising, bathing and the employment of various forces" in lieu of the smallpox vaccine. The British Columbia Naturopathic Association lists several major concerns regarding the pediatric vaccine schedule and vaccines in general. The Oregon Association of Naturopathic Physicians reports that many naturopaths "customize" the pediatric vaccine schedule.

As of 2016, the American Association of Naturopathic Physicians, which is the largest professional organization for naturopaths in the U.S., is "still discussing its stance on vaccinations."

Regulation

Naturopathy is practiced in many countries and is subject to different standards of regulation and levels of acceptance. The scope of practice varies widely between jurisdictions. The practice of naturopathy is illegal in two USA states.

Australia

In 1977 a committee reviewed all colleges of naturopathy in Australia and found that, although the syllabuses of many colleges were reasonable in their coverage of basic biomedical sciences on paper, the actual instruction bore little relationship to the documented course. In no case was any practical work of consequence available. The lectures which were attended by the committee varied from the dictation of textbook material to a slow, but reasonably methodical, exposition of the terminology of medical sciences, at a level of dictionary definitions, without the benefit of depth or the understanding of mechanisms or the broader significance of the concepts. The committee did not see any significant teaching of the various therapeutic approaches favoured by naturopaths. People reported to be particularly interested in homoeopathy, Bach's floral remedies or mineral salts were interviewed, but no systematic courses in the choice and use of these therapies were seen in the various colleges. The committee were left with the impression that the choice of therapeutic regime was based on the general whim of the naturopath and, since the suggested applications in the various textbooks and dispensations overlapped to an enormous extent, no specific indications were or could be taught.

The position of the Australian Medical Association is that "evidence-based aspects of complementary medicine can be part of patient care by a medical practitioner", but it has concerns that there is "limited efficacy evidence regarding most complementary medicine. Unproven complementary medicines and therapies can pose a risk to patient health either directly through misuse or indirectly if a patient defers seeking medical advice." The AMA's position on regulation is that "there should be appropriate regulation of complementary medicine practitioners and their activities."

India

In India, naturopathy is overseen by the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH); there is a 5½-year degree in "Bachelor of Naturopathy and Yogic Sciences" (BNYS) degree that was offered by twelve colleges in India as of August 2010. The National Institute of Naturopathy in Pune that operates under AYUSH, which was established on December 22, 1986 and encourages facilities for standardization and propagation of the existing knowledge and its application through research in naturopathy throughout India.

North America

In five Canadian provinces, seventeen U.S. states, and the District of Columbia, naturopathic doctors who are trained at an accredited school of naturopathic medicine in North America, are entitled to use the designation ND or NMD. Elsewhere, the designations "naturopath", "naturopathic doctor", and "doctor of natural medicine" are generally unprotected or prohibited.

In North America, each jurisdiction that regulates naturopathy defines a local scope of practice for naturopathic doctors that can vary considerably. Some regions permit minor surgery, access to prescription drugs, spinal manipulations, midwifery (natural childbirth), and gynecology; other regions exclude these from the naturopathic scope of practice or prohibit the practice of naturopathy entirely.

Canada

Five Canadian provinces license naturopathic doctors: Ontario, British Columbia, Manitoba, Saskatchewan, and Alberta. British Columbia has the largest scope of practice in Canada allowing certified NDs to prescribe pharmaceuticals and perform minor surgeries.

United States

United Kingdom

Naturopathy is not regulated in the United Kingdom. In 2012, publicly funded universities in the United Kingdom dropped their alternative medicine programs, including naturopathy.

Switzerland

The Swiss Federal Constitution defines the Swiss Confederation and the Cantons of Switzerland within the scope of their powers to oversee complementary medicine. In particular, the Federal authorities must set up diplomas for the practice of non-scientific medicine. The first of such diplomas has been validated in April 2015 for the practice of naturopathy. There is a long tradition for naturopathy and traditional medicine in Switzerland. The Cantons of Switzerland make their own public health regulations. Although the law in certain cantons is typically monopolistic, the authorities are relatively tolerant with regard to alternative practitioners.

See also

References

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Further reading

  • Gorski D (21 February 2011). "Naturopathy and science". Science-Based Medicine. Retrieved January 2015. Unfortunately, naturopathy is a hodge-podge of mostly unscientific treatment modalities based on vitalism and other prescientific notions of disease. {{cite web}}: Check date values in: |accessdate= (help)
  • Hermes B (13 March 2015). "ND Confession, Part 1: Clinical training inside and out". Science-Based Medicine. Retrieved April 2015. ...naturopathic training is not as the profession presents. I'll say it anyway: naturopathic education is riddled with pseudoscience, debunked medical theories, and experimental medical practices. {{cite web}}: Check date values in: |accessdate= (help)

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