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.”
Nautropaths 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
Rhinebeck; (845) 876-3993
Glenn Finley and Ileana Tecchio
Kingston; (845) 331-2235 www.newleafholistichealth.com
Stone Ridge; (845) 389-2547 www.stoneridgenaturalmedicine.com
Rhinebeck; (845) 876-5556 www.drfrancescott.com
Kingston; (845) 626-1414 www.drtammi.com
New Paltz; (845) 594-6822 www.wholefamilymedicine.com
- Annie Internicola