For the past eight years, my naturopathic practice was in the integrative medicine setting, where I worked hand and hand with my conventional medical colleagues to optimize the health of our patients. My Naturopathic residency was in a mid-sized hospital in Western New York and in Northern Virginia I worked for many years for what was the largest integrative primary care medical home in the area. That practice is really where I was able to grow my clinical skills, see the many benefits of the integrative model, and see the value of providing patients access to naturopathic medicine at the primary care level. This model offered patients easy access to naturopathic services, many who would have never considered seeing naturopathic doctor outside of this setting. The model of conventional (medical doctors and osteopathic doctors) and naturopathic doctors working together can and does offer patients the best of both worlds in managing their health. The combined approach is often what patients are seeking.1,2 The naturopathic approach has emerging research in the realm of cost savings for healthcare systems as well.3,4
The National Center for Complementary and Integrative Health study of 2007 tells us that 38 percent of adults (about 4 in 10) and approximately 12 percent of children (about 1 in 9) are using some type of “complementary and alternative medicine”.5 Naturopathic doctors are the only physicians specifically trained in drug-herb and drug-nutrient interactions. Also, the training NDs receive in botanical medicine is invaluable. With up to 17.7% of American adults using non-vitamin and non-mineral over the counter supplements, often herbal supplements, access to providers who have expertise in both knowledge of the botanicals, drug-herb interactions, and quality concerns is imperative.5 In practice, I have seen patients suffer with digestive upset, low white blood counts, atopic dermatitis, and more, from incorrectly dosed or utilized natural products. I have become skilled at reviewing the literal laundry baskets full of supplements patients are taking and helping them to scale down to those that are most important to support their health and eliminating those that may not be supportive or may even be harmful. Helping to create solid nutritional plans, in terms of dietary counseling and support from key supplements is just one area where NDs excel and can offer support for patients.
Further, in States like Oregon and Vermont, many naturopathic doctors (NDs) are credentialed as primary care physicians, where they are providing physical exams and managing the patients’ overall healthcare, similar to other generalists or primary care physicians. In other states, such as Virginia, where there is not yet regulation or licensing available, NDs function in a specialist role. In this specialist role, even with the restricted scope of practice, NDs can and do play a significant role in the healthcare system as consultants. Given that all medically trained NDs are trained in primary care, we can and do offered added value and insights for patients in Virginia who seek out our consultation. Naturopathic doctors are often the trusted primary point person for patients, who value the naturopathic philosophy which considers a person’s overall health and emphasizes lifestyle and natural medicine in maintaining wellness and addressing chronic disease.4,5 Naturopathic doctors are trained when to refer and have respect for conventional approaches, such as in emergent medical situations.
Naturopathic doctors (NDs) are additionally trained to provide lifestyle counseling, look for those drug-herb and drug-nutrient interactions, and provide counseling on nutrition, exercise and supplements. With travesties to our clean water, such as in Flint, Michigan and Elk River, West Virginia, the importance of our environmental health on our physical health has been brought to the forefront. With the ever-toxic world we live in, knowing strategies to avoid toxic burdens and unburden the body of them is another area where NDs shine. Both air pollution and lead toxicities play a significant role in cardiovascular disease that is often overlooked. In my practice, I can think of multiple cases where the underlying cause of my patient’s symptoms was found to be environmental.
The qualification of a medically trained ND is key, and an important distinction. For example, in Virginia, a person with any type of training may call themselves an ND due to the lack of credentialing available in the Commonwealth for naturopathic doctors who are medically trained. Verified access to providers who are held accountable is essential. In society, we appreciate knowing that our medical doctors and lawyers are being held accountable for their skills and ethics. We also value regulating plumbers, electricians, cosmetologists and other professions for obvious reasons of public safety. Accordingly, the same value should be placed on making sure Virginians have safe access to qualified, medically trained naturopathic doctors. Licensing enables patients this access and also provides an environment where NDs can practice at least to a fuller scope of their primary care training, which attracts more providers to relocate to practice in such states. We know in states where NDs have a practice license, the number of NDs practicing in those states exponentially increased after that practice license was put into place.
While NDs can, and do, provide quality care even in a consulting role, the care that can be provided is more comprehensive when supported by a practice license. NDs aren’t a big enough profession to solve the primary care shortage, but we can, and do, play an important role by providing care to patients in need, especially for those with chronic diseases such as diabetes, high cholesterol, and chronic pain.
To find a medically trained naturopathic doctor in Virginia, please go to www.vaanp.org. As an organization, the Virginia Association of Naturopathic Physicians values the professional standards of training and continuing education that regulation enforces, therefore all our professional members are required to maintain their ND license in a jurisdiction that does license NDs.
We welcome your positive testimonials and donations to support increased access to Naturopathic care in Virginia at www.vaanp.org.
Dr. Sarah Giardenelli is a naturopathic doctor, acupuncturist, and owner of Collective Health Center in Leesburg, VA, with a mission to change the health of the community one patient at a time.
1. Vincent C, Furnham A. Why do patients turn to complementary medicine? An empirical study. Br J Clin Psychol. 1996;35 ( Pt 1):37-48.
2. Furnham A, Kirkcaldy B. The health beliefs and behaviours of orthodox and complementary medicine clients. Br J Clin Psychol. 1996;35 ( Pt 1):49-61.
3. Herman PM, Szczurko O, Cooley K, Seely D. A naturopathic approach to the prevention of cardiovascular disease: cost-effectiveness analysis of a pragmatic multi-worksite randomized clinical trial. J Occup Environ Med. 2014;56(2):171-176. doi:10.1097/JOM.0000000000000066
4. Herman PM, Szczurko O, Cooley K, Mills EJ. Cost-effectiveness of naturopathic care for chronic low back pain. Altern Ther Health Med. 2008;14(2):32-39.
5. The Use of Complementary and Alternative Medicine in the United States. NCCIH. https://nccih.nih.gov/research/statistics/2007/camsurvey_fs1.htm. Published December 22, 2011. Accessed June 9, 2018.