Naturopathy and other healthcare professions

The Naturopath’s role

The Naturopathic profession differs in different parts of the world. In some states in America and Canada, Naturopathic Doctors are medical doctors who can diagnose disease and prescribe medications whereas Naturopaths lacking medical qualifications cannot, which is the case in most of the rest of the world. In Germany the heilpraktiker is able to work with certain diseases and is part of the healthcare system. In Italy, Naturopaths are not part of the healthcare system unless they possess concurrent medical qualifications. They have the following role:

Naturopaths help people improve their health and wellbeing by:

• suggesting how to improve a person’s lifestyle
• educating around healthy principles
• working to increase awareness of certain underlying factors & beliefs
• transforming these factors into opportunities for personal growth
• helping recognise & make use of innate talents and skills in order to reach their full potential
• help people make sense of the things that happen to them.

Naturopaths cannot:

• diagnose, treat or cure disease
• run labwork or psychological testing
• prescribe medications, diets or therapies
• diagnose or treat psychological illnesses

So Naturopaths do not diagnose or treat disease with prescribed therapies: this role is reserved for Medical Doctors and when dealing with acute, life-threatening situations and overt disease processes, people should of course always seek out appropriate medical care.

But diseases don’t just appear from nowhere. Long before people get a diagnosis from their Doctor, their health has often already been deteriorating for many years.

This could be due to lifestyle factors such as nutrition, exercise, circadian rhythms or stress or even underlying beliefs that shape a person’s behaviours, but whatever the cause, positive changes at this point can potentially restore a person’s health and reduce their chances of going on to develop more overt symptoms or disease. Viewed from this perspective, Naturopathy is not a substitute for modern medicine because it asks a different question: instead of asking how to reduce a particular symptom, the main question for a Naturopath is why did this situation arise and what could it lead to in the future?

Why is this important? Sometimes we don’t need to know why. If I am in a car accident, it is clear that my first priority should be lifesaving medical intervention, and for that we are lucky to have advanced, modern medicine, and the same goes for end-stage disease. But these days the majority of health issues that we face take years to develop as a result of lifestyle and environmental factors that chip away at our health. This huge and growing wave of physical and mental health challenges is putting healthcare systems and economies around the world under significant pressure, and it is clear that in these cases it would be better to intervene much earlier, correcting these issues before people get sick. I believe that when studied comprehensively and practiced ethically, Naturopathy has a great deal to offer in this respect in helping people become aware of these lifestyle, environmental and psycho-emotional factors so that they have the chance to correct them and change course.

But Naturopathy isn’t always applied in this way. As a profession that is not part of the medical system, Naturopathy is often self-referential and lacking in standards, which means that there is often some confusion about the role of Naturopaths. Instead of replacing modern medicines with ‘natural’ alternatives (which are rarely ‘natural’), my role as a Naturopath is always to look at the environmental factors, beliefs and behviours behind health issues and to suggest ways to correct them.

A multidisciplinary approach to health

When dealing with my own health conditions over the years, I have seen many different health professionals from all different spheres including medical doctors, nutritionists, psychotherapists, traditional Chinese, Japanese and Ayurvedic doctors, osteopaths, cranio-sacral practitioners, breathing instructors, reflexologists and also Naturopaths. The important takeaway for me was that none of these professions offered the complete solution to my health issues, but all of them contributed something important to my health and healing – and all of them had specific areas where they excel.

This experience showed me the importance of a multi-disciplinary approach to health and how these different perspectives can work synergistically together, but also that there is some overlap between them. For patients & clients, it is important to get the right kind of help for specific situations in order to maximise their chances of improvement. And for professionals, it is important that there is clarity around the different roles each have in order to avoid friction, enhance synergy and above all guarantee the best standard of care for people seeking to improve their health.

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Whenever choosing a health professional to work with, we should always take time to research more about their studies & perspectives and whether their approach is right for our situation, and this is especially true with Naturopathy.

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When to see which profession?

The first distinction we can make is between healthcare and non-healthcare professions. Healthcare professions include medical doctors, dentists, psychologists, psychotherapists, dietitians, nutritionists, physiotherapists, pharmacists, nurses, midwives, radiologists and other technicians and more recently, osteopathy. These professions have specific laws that govern them and many have degree courses, State exams and boards that professionals need to be a member of in order to practice legally.

Outside of the healthcare system, there are several other professions in the area of health such as naturopathy, kinesiology, coaching, cranio-sacral, breathing instructors, massage therapists and ancient traditions such as Traditional Chinese Medicine and Ayurveda (even if some techniques such as acupuncture can only be practiced medical doctors). As non regulated professions, there are no specific degree courses and State exams to complete before being legally able to practice, and board membership is usually replaced with membership of associations. Studies in these fields range from being extremely comprehensive all the way down to inadequate, so the onus is on the practitioner to demonstrate their competences and abilities and to practice in an ethical way.

Let’s look at some of the main professions:

Medical Doctor: the primary role of Medical doctors is to diagnose, treat and cure diseases and life-threatening situations using pharmaceuticals, surgery and other interventions like radiation. They are also free to practice nutrition, psychotherapy and nearly always follow further specialisations in areas such as cardiology, neurology, nephrology, psychiatry etc. They sometimes go into research and it is not uncommon to find PhDs who are also medical doctors. Basic medical training in Italy is 6 years, with specialisations a minimum of 4 years, and then there are State exams to complete and board membership to obtain.

It is clear that if I am dealing with a chronic or acute disease, an infection, physical trauma from accidents, acute intoxication or anything else that requires emergency care, surgery or pharmaceutical prescriptions, then I must seek out medical care from my doctor, emergency department, clinic etc. It is not the Naturopath’s role to substitute any of this as this can lead to dangerous outcomes for patients as well as legal penalties. Many people have the misconception that Naturopathy is all about finding natural alternatives to pharmaceutical drugs, but this is not the case. Ideally Naturopaths work with people to maintain and improve their health before they get sick, correcting lifestyle aspects and bringing awareness to underlying issues so as to reduce the risk of needing medical care in the first place.

Psychotherapist: to become a psychotherapist, you need a minimum of 4 years specialisation on top of 5 years of undergraduate and postgraduate study, with further years of specialisation with additions such as EMDR or CBT. Psychotherapists can diagnose, administer testing, and can work with specific mental health pathologies but cannot prescribe medications. The psychotherapist specialisations usually consist of following a particular school such as Freud, Gestalt, Erickson, Analytical psychotherapy or cognitive psychotherapy.

I took psychotherapy sessions consisting of Ericksonian therapy and EMDR for some time, and found huge benefit in re-elaborating past events that even though hidden away, were still having an impact on my daily life and relationships. For this kind of work and for dealing with more acutely traumatic experiences and/or diagnosed conditions such as PTSD or depression, it is necessary to be under the care of a psychotherapist because their extensive training becomes invaluable in dealing with and processing what comes up. For this reason Naturopaths do not and should not work on pathologies, past trauma or serious mental disturbances, but can offer support for personal growth, for bringing awareness to underlying beliefs and innate talents and for setting future-oriented goals and ways to achieve them. These should be short term and transitional in nature, and a psychotherapist should be sought out for anything requiring more long-term support.

Nutritionist: nutritionists in Italy are also biologists. and they complete a three year undergradute biology degree followed by a 2 year specialisation with a State exam. They are not allowed to diagnose diseases or prescribe medications and may only treat certain conditions with a nutritional approach if it has first been diagnosed by a doctor. Most nutritionists focus on elaborating diet plans with specific macronutrient and micronutrient goals in order to achieve improvements in physical health, weight control and previously specified conditions, and to do this they can also order and interpret labwork and run testing such as body composition analysis. General education around healthy eating is also an important part of their practice. Many nutritionists focus on metabolic health, diabetes and obesity given their widespread occurrence today, and may use specific diets such as the Mediterranean diet, the SCD diet or the Ketogenic diet to get the desired results.

Although nutrition is another area where Naturopaths are involved in, it is important to underline some key differences. Naturopaths focus more on general education around food quality, seasonality and individual needs so that people become more autonomous in their food choices. This may also involve notions about the energetic qualities of food from Traditional Chinese Medicine or Ayurveda. General recommendations are also given such as minimising junk food and increasing whole, natural foods, but Naturopaths don’t elaborate specific diet plans that contain certain macronutrient and micronutrient ratios for clients like nutritionists do. Personally, I have spent many years studying aspects such as the impact of intensive farming on food quality, contamination from agricultural chemicals and the impact of different cookware but I have also worked with a nutritionist for many years for more specific goals such as reducing oxalate issues and improving metabolism through the use of the cyclical ketogenic diet.

So hopefully this article has helped to inform you of some of the differences between both healthcare and health related professions, and where Naturopathy can fit in.