In July 2023, EXPLORE journal published an online version of an article I co-authored with David Katz, MD, MPH, entitled “Paradigm Shift in Medicine: Integrating Naturopathic Care in the Treatment of Chronic Disease. Want to follow best practices in chronic disease treatment? Look to naturopathic physicians.”1 In the article, we highlight the potential of naturopathic medicine as a model for whole person health. Nature-based medicine, which naturopathic doctors routinely practice, is a noteworthy approach to the current health care system and its overreliance on pharmaceutical medications.
Patient-centered care, whole person medicine, whole health, all refer to the same concept, that of placing the needs of the patient at the forefront and considering all variables in that patient’s life that may impact their state of health. It isn’t easy, it isn’t quick, but it is the right approach.
Our article discusses that the health care system has increasingly relied on prescription drugs, leading to a surge in opioid use and addiction. However, major medical organizations recommend nondrug approaches as the primary treatment for many conditions. Lifestyle changes are now recognized as crucial for whole person health. Naturopathic physicians who practice nature-based medicine offer a valuable alternative approach focused on lifestyle interventions for chronic pain and disease management.
The American College of Physicians released guidelines in 2017 recommending nondrug approaches like tai chi, physical therapy, stress reduction or yoga as the first line of treatment for chronic pain. These guidelines align with recommendations from other reputable medical organizations for conditions like hyperlipidemia, diabetes and hypertension, emphasizing the importance of lifestyle changes.
Despite these recommendations, prescription drug use has been on the rise, with opioids being a commonly prescribed example of a drug with unintended, extreme negative consequences. Long-term opioid use can lead to addiction. Prescription drugs are often the first resort in treating illness, while lifestyle interventions, like physical therapy and stress management, are underutilized. Nutrition counseling is frequently neglected, even though it can be highly effective in managing conditions like cardiovascular disease and diabetes.
Naturopathic physicians, with extensive training in holistic care, follow a systematic approach known as the Therapeutic Order. This approach prioritizes addressing the root cause of symptoms while using the least force necessary for treatment. It starts with removing obstacles to health, often related to lifestyle factors. Natural therapies and physical therapies are incorporated if needed, with prescription medications considered only as a last resort. This patient-centered approach tailors treatment plans to individual needs, considering factors like lifestyle, nutrition, stress and past injuries.
Mainstream medical clinics are now adopting complementary care options, such as yoga and acupuncture, recognizing the value of holistic approaches. Integrative care models incorporating naturopathic physicians have shown promise in treating complex cases where drugs alone are ineffective. These approaches aim to build a holistic understanding of the patient’s health and address underlying causes rather than just symptoms.
To support informed treatment decisions, a decision-guiding framework called CARE (Clinical Applications of Research Evidence) was developed, similar in concept to the Therapeutic Order. It considers safety, effectiveness, underlying evidence, exclusivity and patient preferences when choosing treatments.
In conclusion, the article highlights the importance of shifting the focus from prescription drugs to lifestyle interventions in chronic pain and disease management. Naturopathic physicians offer a patient-centered, holistic approach, emphasizing individualized treatment plans that address root causes. Integrating these approaches into conventional health care can improve outcomes and reduce reliance on prescription medications, ultimately leading to better overall health and reduced chronic disease risk.
I thank Dr. Katz for his leadership in lifestyle approaches to health and healing. He is in the vanguard of a growing movement that seeks to redefine health care. I am happy to be a part of this effort within the Institute for Natural Medicine (INM). We need to do better, and we can. One of our strengths is that humans learn and evolve our actions over time. Science never sleeps, so we continue to grow our understanding of ourselves and how we interrelate with our surroundings. Conventional wisdom is that it takes 20 years for a new scientific discovery to make its way into mainstream medical treatment protocols. That is too long to wait, especially with the advent of AI. Now is the time to reinvent the system strategically. It is already under reinvention through AI chatbots, health coaches and biometric monitoring devices, among many other factors. Being strategic about the physician’s role in patient care is our opportunity, and naturopathic medicine could be the model.
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. Twitter: #inaturemed Facebook: @INMWeAreNaturalMedicine.