Saturday, July 12, 2014

Why I Chose Naturopathic Medicine

As I embark on this 4 year journey I want to articulate why it is that I chose naturopathic medicine so that on graduation day I can look back and reflect on whether it has been what I expected it to be. To start I will mention the principles of naturopathic medicine (as found on aanmc.org, the association of accredited naturopathic medical colleges)… 

First do no harm 
The healing power of Nature 
Identify and treat the cause 
Doctor as Teacher 
Treat the Whole Person 
Prevention 

A few months into my work as a scribe, one of the doctors asked me if working in the ER had made me interested in allopathic medicine. I had to admit that it had in fact made me feel more strongly about pursuing naturopathic medicine. While I had once considered going the MD or DO route for education, thinking it would be a better way to reach a wider range of people and get the message out about naturopathic ideals, after enough time in the ER this became less tempting. There are three primary reasons for this. 

1. Limited treatment options 

One thing I hope to get across as someone who hopes to practice naturopathic is that I am not against mainstream medicine. It has many uses. Drugs and surgery can be life savers. But they are also limited and can have potentially life harming consequences. 

As for the limits, there are many instances when doctors tell the patient that ‘there is nothing more I can do for you’ and send them back to their primary care doctor or ship them to another specialist. Naturopathic medicine opens the door to treatments that may include herbs, physical medicine and lifestyle modifications that can be profoundly effective. Naturopathic education also recognizes the importance of something called the therapeutic alliance. A treatment plan can be considerably more effective when the patient feels that their own needs and goals are acknowledged. 

Allopathic doctors (MDs) are taught to ‘First Do No Harm’ yet so many of the drugs and procedures they prescribe may harm more than help. It seems only right that, in non emergency settings, a doctor use the least invasive and least toxic therapy first, before advancing to something that has potential for serious side effects. 

2. Holistic care (the lack of it)

In an emergency setting it is clear that there is a necessity for speed. These days, even outpatient doctors are pressured to see more and more patients in a day. There is only time to address the acute problem and prescribe a remedy (and never to Identify and Treat the Cause). Patients often hint at the stress or other circumstances that may be underlying problems but doctors only have a moment to nod sympathetically and go on their way. There is limited time to even explain the disease or condition that the patient has and what treatment they are receiving. MDs don’t have the time to be a teacher. Personally I hope to be more than a teacher. Teacher/student seems to imply a one way street. I strive for collaboration where patients can teach me how I can best help them and others like them. This brings me to the fifth principle, ‘Treat the Whole Person.’ Naturopathic medicine respects that each person is different. No one medication, herb or diet will affect someone in precisely the same way. I think that acknowledging this has powerful potential. 

3. Burnout 

Sometimes it seemed that the doctors in the ER might prefer to practice medicine without dealing with the patients. After I started working as a scribe I began to read about burnout. It was much more commonplace than I had expected. When I researched burnout among naturopathic doctors I could hardly find any information. Based on my observations I would guess that there are a couple reasons for this. 

Burnout increase if someone is not enjoying their work or doesn’t feel that it is meaningful or making a difference. Some doctors may have entered the field for fame and money, but usually there is some element of interest in medicine and patient care. Having worked in the ER I saw so many cases where patients presented with complaints that could not be explained, or patients who kept returning with little to no resolution to their symptoms. So many doctors became frustrated and cynical of these people. The current healthcare environment leaves doctors too emotionally exhausted and too crunched for time to feel any sort of empathy. 

Since naturopathic medicine is not part of the mainstream medical system, naturopathic doctors (NDs) graduate with more freedom to mold their career into something that works for them. Many work in private practices that don’t accept insurance so there is less paperwork. Often, practices are individual or small teams so the group can decide their own working hours and how long to schedule patient visits. NDs are at lower risk for lawsuits since their treatment methods tend to be less risky than pharmaceutical drugs and surgery. NDs also tend to have less of a leadership role in the office. It can be stressful when doctors, particularly in a hospital setting, and sometimes in outpatient offices as well, are constantly being looked to for direction, especially since med school may not teach leadership skills. 

We shall see. Hopefully a few years down the line I will be able to report back if naturopathic education has been all I hoped it would be. 

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