An article in the British Journal of Medicine (BMJ) from July 2022 recently caught my attention. Titled the “International prevalence of consultation with a naturopathic practitioner: a systematic review and meta-analysis,” the meta-analysis calculated the use of naturopathic medicine globally, based on published studies, using the term naturopathy for the search.
The BMJ study looked at the number of consultations and found that visits with a naturopath or naturopathic doctor varied significantly, ranging from 20 percent in the Mediterranean to 5 percent in the Americas. Overall, the result was relatively modest.
Naturopathy and Naturopathic Medicine Usage by Country and Region
The following describes the frequency of the general population seeking the services of a naturopath/naturopathic doctor.
Israel – 20% (1993); 18% (2007)
Switzerland – 7.7%
Australia – 6.2%
Canada – 5%
USA – 4% to 1.6%
Utilization in the U.S. is roughly half of the national awareness level of naturopathic medicine as identified by a recent study Institute for Natural Medicine (INM) participated in. The study pointed to the frequency of use of naturopathic medicine in Canada as 11 percent in a lifetime, India with 7 percent rural and 12 percent urban consultations during a lifetime, and Southeast Asia at 10 percent (naturopathic medicine and yoga) with no specific time frame.
Then I looked at an editorial in the journal Medicina, “The Future of Medicine: Frontiers in Integrative Health and Medicine.” It was a special issue from Oct. 2021 that explored the scientific evidence of the “integration of conventional medicine with traditional, complementary and alternative medicine (TCAM).”
The authors defined integrative medicine using the Consortium of Academic Health Centers for Integrative Medicine and Health’s definition: “Integrative medicine is defined as the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is supported by evidence, utilized all appropriate therapeutic and lifestyle approaches, health care professionals and disciplines to achieve optimal health and healing.”
The editorial carved out various research studies pointing to the value of specific disciplines across the globe that fall into the category of TCAM, including ayruveda, traditional Chinese medicine, natural medicine using botanicals and dietary supplements, whole-person medicine, movement therapies, yoga and transcendental meditation (see Figure 1).
A list of secondary data showing a surge in public interest and the use of TCAM globally said that nearly 50 percent of the population in developed nations and up to 80 percent in developing nations use some form of TCAM.
• Africa 80 percent
• Chile 71 percent
• Canada 70 percent
• India 70 percent
• Australia 48 percent
• United States: 42 percent
• France 40 percent
• China 40 percent
Now, these are impressive numbers. The reasons for the rising interest included the COVID-19 pandemic (of course), the global rise in non-communicable or chronic diseases, and the lack of solutions within the modern medical community to address these conditions. Plus the side effects of treatments used to address the most common chronic conditions of heart disease, diabetes, cancer, and mental health issues (See Figure 2).
Is Naturopathic Medicine Getting Lost in TCAM?
As I mulled this over, I first felt proud to be part of a growing movement about greater awareness of whole-person health. It is what we do at the INM; we elevate the message about the importance of personalized, whole-person care, which is the foundation of naturopathic medicine.
But after the stark data differences and semantics sank in, I was frankly pretty miffed. As the world learns more about TCAM and integrative medicine, and everything that they believe goes into this multidisciplinary aspect of the “future of medicine,” nowhere or seldom does naturopathic medicine get mentioned, but we know the prevalence is significant. The BMJ article even noted that often patients who are being treated with naturopathy or naturopathic medicine don’t even realize it.
So, what do we do now? We can no longer watch the TCAM parade go by. It’s time to educate doctors in other traditional medical disciplines about naturopathic medicine as a proven platform that has helped birth modern-day integrative medicine or TCAM if you prefer. In addition, as the conversation in the U.S. about whole-person health takes shape, there is an emergent need to educate providers of all kinds about their potential role in helping bring this about. It will require strategic, specific interprofessional education to help providers understand how to involve other disciplines in the care of their patients. True whole-person health will require professions that specialize in diet, lifestyle and mental and emotional health for example.
My colleague and friend, Leonard A. Wisneski, MD, FACP, has been integral in the creation of an MD/DO Advisory board for INM. “Primary care should be focused on whole-person medicine,” he said. “Naturopathic doctors are educated as specialists in lifestyle and behavioral medicine, which hones in on healthy habits that support the prevention of chronic diseases. And as such, they should be more readily integrated into primary care settings. This board will help facilitate that process.”
The naturopathic profession is uniquely trained to address many of the pressing health issues that concern the nation, including:
1. Whole-person health care support for the treatment of acute illness and the behavioral aspects of chronic disease as outlined in the Naturopathic Determinants of Health.
2. The lingering physiological, biological and neurological after-effects of the pandemic.
3. The growing shortage of primary care physicians, particularly in rural and low-income areas.
4. Better, more available non-pharmaceutical treatments for pain management.
5. Chronic disease prevention in community health centers, primary care practices and teaching hospitals.
The purpose of this board is to provide free information to conventional providers about naturopathic medicine, integrative medicine and how to deliver whole-person health through a multidisciplinary, team approach for patient-centered care. This whole-health model of care addresses all aspects of the patient’s life and health: diet, environment, mental, emotional and social (see Figure 3).
It’s time to bring everyone together and stop siloing our disciplines. INM’s new inter-professional education initiative will be a bridge to integrative medicine certification and training programs, for providers who want to learn more. It will also deepen the understanding of naturopathic medicine as a system of medicine that holds promise to deliver whole-person health, thereby increasing their inclusion in integrative medicine teams of the future.
Naturopathic medicine, functional medicine and integrative medicine hold the key to patient-centered whole-person care. However, we need to start by educating all potential professionals on their role in this future health care model. This will ultimately change the character of the providers in our medical system and help many more patients actually achieve whole-person health. Want to learn more? Contact me at firstname.lastname@example.org.
Michelle Simon, PhD, ND President & CEO, Institute for Natural Medicine In 1992, the leadership core of naturopathic doctors established the Institute for Natural Medicine (INM) as a not for profit organization dedicated to advancing natural medicine. The purpose of the INM is to increase awareness of, broaden public access to, and encourage research about natural medicine and therapies. Among its milestones the INM counts the launch of the Association of Accredited Naturopathic Medical Colleges (AANMC) as an independent organization, leading California’s efforts to obtain licensure, developing an interactive childhood education program focused on healthy eating and lifestyles called Naturally Well in 2017, and expanding residency access by establishing and funding a residency program in 2018. INM has joined forces with the American Association of Naturopathic Physicians (AANP), serving as the charitable arm, to deepen access to naturopathic care, public education and research. Dr. Michelle Simon serves as president and CEO of INM, is a licensed naturopathic physician, clinician, educator and leader in many organizations dedicated to improving the quality and delivery of health care. In addition to holding a naturopathic doctorate from Bastyr University, she also holds a PhD in Biomedical Engineering from the University of North Carolina at Chapel Hill. Dr. Simon has served on the boards for the Integrative Healthcare Policy Consortium (IHPC), the AANP and the Naturopathic Physicians Research Institute (NPRI). Dr. Simon also served nine years on the Washington State Health Technology Clinical Committee which is part of the Health Technology Assessment program that examines the scientific evidentiary basis for efficacy, safety and cost effectiveness of health care technologies. She was also an invited participant for health care economics at “Summit on Integrative Medicine and the Health of the Public” at the Institute for Medicine (IOM) in 2009. Dr. Simon was recognized as the 2018 Physician of the Year by the AANP.