Naturopathy: A Critical Appraisal

Kimball C. Atwood IV, MD

In This Article

Brief History and Current Status

"Naturopathic physicians" are a recent manifestation of the field known as naturopathy, the origins of which were in the 19th-century German "natural living" movement. Early naturopaths objected to contemporary medical advances, such as the germ theory and vaccinations, but espoused the "water cure," fasting, herbs, homeopathy, colonic "detoxification," and other popular methods of the era.

The content of the field has changed little since then, but the trappings have become modern. A subset of naturopaths now seeks to distinguish itself from "traditional naturopaths": it professes to practice "a distinct form of primary health care," according to the official definition on the Web site of its national organization, the AANP.[6] At the National College of Naturopathic Medicine in Portland, Oregon, "naturopathic physicians" are described as

...primary care physicians, most of whom are in general private practice [and] trained to be the doctor first seen by the patient for general healthcare, for advice on keeping healthy, and for the diagnosis and treatment of acute and chronic conditions. [7]

"Naturopathic doctors" (NDs), as they also call themselves, state that they have received training appropriate to the practice of medicine, including a basic science curriculum equivalent to that taught in medical schools. This training occurs at 1 of 4 schools in the United States or 1 in Canada, each of which offers a 4-year, on-campus curriculum but no significant hospital or residency experience. Four of the schools are not attached to larger universities; the fifth, the University of Bridgeport College of Naturopathic Medicine in Connecticut, is owned by Reverend Sun Myung Moon's Unification Church.

These naturopaths are now licensed in 13 states (Alaska, Arizona, California, Connecticut, Hawaii, Kansas, Maine, Montana, New Hampshire, Oregon, Utah, Vermont, and Washington) and the District of Columbia. Their scope of practice is typically limited only by prohibitions against performing major surgery and prescribing controlled substances.[8] In all of these states they are free to make broad claims of medical expertise. In Washington, an "every category of provider" law forces private insurers to reimburse naturopaths.[9]


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