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{{Alternative medical systems|Medical systems}}
{{Alternative medical systems|Medical systems}}


'''Naturopathy''', or '''naturopathic medicine''', is a [[Pseudoscience|pseudo-scientific]] form of [[alternative medicine]] based on a belief in [[vitalism]], which posits that a special energy called vital energy or vital force guides bodily processes such as [[metabolism]], reproduction, growth, and adaptation.<ref>{{cite book|last1=Sarris|first1=Jerome|last2=Wardle|first2=Jon|title=Clinical Naturopathy: An evidence-based guide to practice|url=http://books.google.com/books?id=lpEAJ9vjPyUC&pg=PT32|accessdate=2013-09-01|year=2010|publisher=Churchill Livingstone / Elsevier Health Sciences |location= Sydney |isbn=9780729579261|pages=32–36}}</ref> Naturopathy favors a [[holistic health|holistic]] approach with non-invasive treatment and generally avoids the use of [[surgery]] and [[Medication|drugs]].<ref name=ACS /> Among naturopaths, complete rejection of biomedicine and modern science is common.
'''Naturopathy''', or '''naturopathic medicine''', is a form of alternative medicine which favors a [[holistic health|holistic]] approach with non-invasive treatment, and encourages minimal use of [[surgery]] and [[Medication|drugs]]. <ref>Sarris, J., and Wardle, J. 2010. Clinical naturopathy: an evidence-based guide to practice. Elsevier Australia. Chatswood, NSW.</ref>


The term "naturopathy" is derived from Latin and Greek, and literally translates as "nature disease".<ref name=NCCAM>
The term "naturopathy" literally means addressing illness with natural means, being derived from the structure of words like osteopathy, homeopathy, and allopathy.<ref name=NCCAM>
{{Cite web
{{Cite web | title =Naturopathy: An Introduction | publisher =[[National Center for Complementary and Alternative Medicine]], [[National Institutes of Health]], [[United States Department of Health and Human Services]] | origyear = Created April 2007 |month= March |year= 2012 |archiveurl = |archivedate= | url = http://nccam.nih.gov/health/naturopathy/naturopathyintro.htm?nav=gsa | accessdate =2013-03-16 |author= <!-- no byline --> |volume= NCCAM Pub. No. D372}}</ref> Modern naturopathy grew out of the Natural Cure movement of Europe.<ref name= pmid1139856>{{cite journal |pmc= 1139856 |title= Nineteenth-century American health reformers and the early nature cure movement in Britain |last= Brown |first= P.S. |journal= Medical History |volume= 32 |pages= 174–194 |pmid= 3287059 |issue= 2 |date= April 1, 1988 |doi=10.1017/S0025727300047980}}</ref><ref name=N-UK-hist>{{Cite web |last=Langley |first= Stephen |title= History of Naturopathy |work= College of Naturopathic Medicine website |publisher=<!-- College of Naturopathic Medicine redundant to website name--> |location=UK |url=http://www.naturopathy-uk.com/blog/2007/11/28/history-of-naturopathy/ |accessdate= }}</ref> The term was coined in 1895 by John Scheel and popularized by [[Benedict Lust]],<ref name=ama_1997 /> the "father of U.S. naturopathy".<ref name=Baer2001 /> Beginning in the 1970s, there was a revival of interest in the United States and Canada in conjunction with the holistic health movement.<ref name=Baer2001/><ref name=Gale_Frey>{{cite book |first1= Barbara |last1= Boughton |first2= Rebecca J. |last2= Frey |chapter= Naturopathic Medicine |year= 2005 |url= http://www.healthline.com/galecontent/naturopathic-medicine |title= Gale Encyclopedia of Alternative Medicine |publisher= [[Gale (publisher)|Gale]] |edition= Online}}</ref> Today, naturopathy is primarily practiced in the United States and Canada.<ref name="Romeyke-2011">{{cite journal |year= 2011 |month= May |title= A study of costs and length of stay of inpatient naturopathy – evidence from Germany |first1= Tobias |last1= Romeyke |first2= Harald |last2= Stummer |journal= Complementary Therapies in Clinical Practice |volume= 17 |issue= 2 |pages= 90–5 |pmid= 21457898 |doi= 10.1016/j.ctcp.2010.09.001}}</ref> The scope of practice varies widely between jurisdictions, and naturopaths in unregulated jurisdictions may use the [[Doctor of Naturopathic Medicine|Naturopathic Doctor]] designation or other titles regardless of level of education.<ref name="IMB_policy" />
| title =Naturopathy: An Introduction
| publisher =[[National Center for Complementary and Alternative Medicine]]
| year =2007
| url =http://nccam.nih.gov/health/naturopathy/naturopathyintro.htm?nav=gsa


| accessdate =16 Mar 13 }}
Naturopathic practitioners in the US can be divided into three categories: traditional naturopaths; naturopathic physicians; and other health care providers that provide naturopathic services.<ref name=NCCAM/> Naturopathic physicians employ the principles of naturopathy within the context of conventional medical practices. Naturopathy comprises many different treatment modalities such as nutritional and herbal medicine, lifestyle advice, counseling, flower essence, homeopathy and remedial massage.
</ref> Modern naturopathy grew out of the Natural Cure movement of Europe.<ref name=pmid1139856>{{cite journal |pmc=1139856 |title=Nineteenth-century American health reformers and the early nature cure movement in Britain |author=Brown PS |journal=Medical History |volume=32 |pages=174–194 |pmid=3287059 |issue=2 |date= April 1, 1988 }}</ref><ref name=N-UK-hist>{{Cite book |author=Langley, Stephen |chapter=History of Naturopathy|title=Excerpt from The Naturopathy Workbook|publisher=College of Natural Medicine (CNM)|location=UK |url=http://www.naturopathy-uk.com/blog/2007/11/28/history-of-naturopathy/ |year=2007 |postscript=<!-- Bot inserted parameter. Either remove it; or change its value to "." for the cite to end in a ".", as necessary. -->{{inconsistent citations}}}}</ref> The term was coined in 1895 by John Scheel and popularized by [[Benedict Lust]],<ref name=ama_1997 /> the "father of U.S. naturopathy".<ref name=Baer2001 /> Beginning in the 1970s, there was a revival of interest in the United States and Canada in conjunction with the [[holistic health]] movement.<ref name=Baer2001/><ref name=Gale_Frey>
{{Cite web
| last =Frey
| first =Rebecca
| title =Naturopathic medicine
| work =Encyclopedia of Medicine
| publisher =[[Gale (Cengage)]]
| date =April 1
| url =http://findarticles.com/p/articles/mi_g2601/is_0009/ai_2601000954
| accessdate =20 Nov 10 }}
</ref> Naturopathy is regulated and practiced in several countries.<ref name="Romeyke-2011">{{cite web|url=http://www.ncbi.nlm.nih.gov/pubmed/21457898 |year=2011 |title=A study of costs and length of stay of inpatient naturopathy--evidence from Germany |publisher=Complement Ther Clin Pract |accessdate=2012-09-28>}}</ref> The scope of practice and training varies widely.<ref name="IMB_policy" />

Traditional naturopaths and naturopathic physicians comprise two distinguishable types of naturopaths.<ref name=NCCAM/> Naturopathic physicians employ the principles of naturopathy within the context of conventional medical practices. Naturopathy comprises many different treatment modalities of varying degrees of acceptance by the conventional [[medicine|medical]] community.


Much of the ideology and methodological underpinnings of naturopathy are in conflict with the paradigm of [[evidence-based medicine]] (EBM).<ref name=Naturo2006/> Many naturopaths have opposed [[vaccination]] based in part on the early views that shaped the profession.<ref name=Ernst-2001/> According to the [[American Cancer Society]], "scientific evidence does not support claims that naturopathic medicine can cure [[cancer]] or any other disease, since virtually no studies on naturopathy as a whole have been published."<ref name=ACS/>


==History==
==History==
[[File:SKneipp.jpg|thumb|Monsignor Sebastian Kneipp, 1821–1897]]
[[File:SKneipp.jpg|thumb|Monsignor Sebastian Kneipp, 1821–1897]]
[[File:BenedictLust.jpg|thumb|115px|Benedict Lust, 1872–1945]]
[[File:BenedictLust.jpg|thumb|115px|Benedict Lust, 1872–1945]]
Some see the ancient Greek "Father of Medicine", [[Hippocrates]], as the first advocate of naturopathic medicine, before the term existed.<ref>{{cite web |url= http://www.naturopathy-uk.com/home/home-what-is-naturopathy/ |title= What is Naturopathy? |work= College of Naturopathic Medicine website |location= UK |accessdate= |author= <!-- no byline --> }}</ref><ref name=NCAHF_np>{{cite web |url= http://www.ncahf.org/articles/j-n/naturo.html |title= NCAHF Fact Sheet on Naturopathy |accessdate= 2009-04-17 |date= January 30, 2001 |origyear= copyright 1997 |last= Jarvis |first= William T. |publisher= [[National Council Against Health Fraud]] }}</ref> The modern practice of naturopathy has its roots in the Nature Cure movement of Europe during the 19th century.<ref name=pmid1139856 /><ref name=N-UK-hist /> In [[Scotland]], [[Thomas Allinson]] started advocating his "Hygienic Medicine" in the 1880s, promoting a natural diet and exercise with avoidance of tobacco and overwork.<ref>{{cite web |title= How it all began |url= http://www.allinsonflour.co.uk/history/ |author= <!-- no byline --> |work= [[Allinson|Allinson Flour]] website |publisher= Silver Spoon, [[British Sugar]], [[Associated British Foods]] |accessdate= }}
Some see the ancient Greek "Father of Medicine", [[Hippocrates]], as the first advocate of naturopathic medicine, before the term existed.<ref>{{cite web|url=http://www.naturopathy-uk.com/home/home-what-is-naturopathy/ |title=What is Naturopathy? |year=1998 |accessdate= |doi= |pmid= }}</ref><ref name=NCAHF_np>{{cite web|url=http://www.ncahf.org/articles/j-n/naturo.html |title=NCAHF Fact Sheet on Naturopathy |accessdate=2009-04-17 |date=2001-07-30 |publisher=[[National Council Against Health Fraud]] }}</ref> The modern practice of naturopathy has its roots in the Nature Cure movement of Europe during the 19th century.<ref name=pmid1139856 /><ref name=N-UK-hist /> In [[Scotland]], [[Thomas Allinson]] started advocating his "Hygienic Medicine" in the 1880s, promoting a natural diet and exercise with avoidance of tobacco and overwork.<ref>{{cite web |url=http://www.allinsonflour.co.uk/history/|title=How it all began |accessdate= |doi= |pmid=}}</ref><ref>{{Cite journal|url=http://www.bmj.com/cgi/content/extract/336/7651/1023-a |journal=British Medical Journal |title=Views & Reviews Medical Classics A System of Hygienic Medicine (1886) and The Advantages of Wholemeal Bread (1889) |author=John A S Beard |issue=336 |page=1023 |date=3 May 2008 |doi=10.1136/bmj.39562.446528.59 |volume=336 }}</ref> The term ''sanipractor'' has sometimes been used to refer to naturopaths, particularly in the Pacific Northwest region of the United States.<ref name=Baer2001 />
</ref><ref>{{Cite journal |url= |journal= [[BMJ]] |series= Views & Reviews: Medical Classics |title= A system of hygienic medicine (1886) and The advantages of wholemeal bread (1889) |first= John A.S. |last= Beard |issue= 336 |page= 1023 |date= May 3, 2008 |doi= 10.1136/bmj.39562.446528.59 |volume= 336 }}</ref>


The term ''naturopathy'' was coined in 1895 by John Scheel,<ref name=ama_1997 /> and purchased by [[Benedict Lust]], the "father of U.S. naturopathy".<ref name=Baer2001>{{Cite journal |last= Baer |first= Hans A. |year= 2001 |month= September |title= The sociopolitical status of U.S. naturopathy at the dawn of the 21st century |journal= [[Medical Anthropology Quarterly]] |pmid= 11693035 |volume= 15 |issue= 3 |pages= 329–46 |doi= 10.1525/maq.2001.15.3.329 }}</ref> Lust had been schooled in [[Water cure (therapy)|hydrotherapy]] and other natural health practices in [[Germany]] by Father [[Sebastian Kneipp]]; Kneipp sent Lust to the [[United States]] to spread his drugless methods.<ref name=Barrett-Naturopathy>{{cite web |url= http://www.quackwatch.org/01QuackeryRelatedTopics/Naturopathy/naturopathy.html |last= Barrett |first= Stephen |title= A close look at naturopathy |work= [[QuackWatch]] |date= December 23, 2003 |accessdate= 2010-11-20 |archiveurl= http://web.archive.org/web/20110406111422/http://www.quackwatch.org/01QuackeryRelatedTopics/Naturopathy/naturopathy.html |archivedate= 2011-04-06}}</ref> Lust defined naturopathy as a broad discipline rather than a particular method, and included such techniques as hydrotherapy, [[herbal medicine]], and homeopathy, as well as eliminating overeating, tea, coffee, and alcohol.<ref name=Gale_Frey /> He described the body in [[spirituality|spiritual]] and vitalistic terms with "absolute reliance upon the cosmic forces of man's nature".<ref name=Whorton_2002>Lust, Benedict cited in: {{cite book|last=Whorton|first=James C.|title=Nature Cures : The History of Alternative Medicine in America: The History of Alternative Medicine in America|url=http://books.google.com/books?id=N21eyOQlE0kC&pg=PA224|accessdate=2013-09-03|year=2002|publisher=[[Oxford University Press]]|location=Oxford|isbn=9780195349788|page=224}}</ref>
The term ''naturopathy'' was coined in 1895 by John Scheel,<ref name=ama_1997 /> and purchased by [[Benedict Lust]], the "father of U.S. naturopathy".<ref name=Baer2001>{{Cite journal | last = Baer |first =H. A. | year = 2001 | title = The sociopolitical status of U.S. naturopathy at the dawn of the 21st century | journal = Medical Anthropology Quarterly | pmid = 11693035 | volume = 15 | issue = 3 | pages = 329–346| doi = 10.1525/maq.2001.15.3.329 }}</ref> Lust had been schooled in [[hydrotherapy]] and other natural health practices in [[Germany]] by Father [[Sebastian Kneipp]]; Kneipp sent Lust to the [[United States]] to spread his drugless methods.<ref name=Barrett-Naturopathy>{{cite web|url=http://www.quackwatch.org/01QuackeryRelatedTopics/Naturopathy/naturopathy.html|author=Barrett S|title=A close look at naturopathy|publisher=www.quackwatch.org|date=23 Dec 03 |accessdate=20 Nov 10|pmid=}}</ref> Lust defined naturopathy as a broad discipline rather than a particular method, and included such techniques as [[hydrotherapy]], [[herbal medicine]], and [[homeopathy]], as well as eliminating overeating, tea, coffee, and alcohol.<ref name=Gale_Frey /> He described the body in [[spirituality|spiritual]] and [[vitalism|vitalistic]] terms with "absolute reliance upon the cosmic forces of man's nature".<ref name=Whorton_2002>Benedict Lust, cited in: {{cite book |author=Whorton, James C. |title=Nature cures: the history of alternative medicine in America |publisher=Oxford University Press|location=Oxford [Oxfordshire] |year=2002 |page=224 |isbn=0-19-517162-4 |oclc= |doi=|accessdate=}}</ref>


In 1901, Lust founded the American School of Naturopathy in [[New York]]. In 1902 the original North American Kneipp Societies were discontinued and renamed "Naturopathic Societies". In September 1919 the Naturopathic Society of America was dissolved and Benedict Lust founded the American Naturopathic Association to supplant it.<ref name=Baer2001 /><ref name= DC_Incorp/>{{Verify source|date=September 2013}}<ref name=Beyerstein_NW>{{cite web |title= Naturopathy: A Critical Analysis |last1= Beyerstein |first1= Barry L. |last2= Downie |first2= Susan |date= May 12, 2004 |accessdate= 2009-03-21 |work= NaturoWatch |publisher= QuackWatch |url= http://www.naturowatch.org/general/beyerstein.html}}</ref> Naturopaths became licensed under naturopathic or drugless practitioner laws in 25 states in the first three decades of the twentieth century.<ref name=Baer2001 /> Naturopathy was adopted by many [[chiropractic|chiropractors]], and several schools offered both Doctor of Naturopathy (ND) and Doctor of Chiropractic (DC) degrees.<ref name=Baer2001 /> Estimates of the number of naturopathic schools active in the United States during this period vary from about one to two dozen.<ref name=ACS>{{Cite web |title= Naturopathic Medicine | publisher = [[American Cancer Society]] |date= November 1, 2008 <!-- url points to page updated after accessdate --> |url= http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/MindBodyandSpirit/naturopathic-medicine <!-- url points to page updated after accessdate --> | accessdate = 2010-11-20 |archiveurl= http://web.archive.org/web/20101130114645/http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/MindBodyandSpirit/naturopathic-medicine |archivedate= 2010-11-30 <!-- url points to page updated after accessdate -->}}</ref><ref name=ama_1997>{{cite web |url= http://www.idt.mdh.se/kurser/ct3340/archives/ht03/assignment-2d-extra-articles/Alternative%20Medicine.pdf |title= Report 12 of the Council on Scientific Affairs (A-97) |year= 1997 |publisher= [[American Medical Association]] |laysummary= http://www.ama-assn.org/resources/doc/csaph/csaa-97.pdf |laysource= 1997 Annual Meeting of the American Medical Association:Summaries and Recommendations of the Council on Scientific Affairs |laydate= 1997}}<!-- main link substituted with convenience copy --></ref><ref name=Baer2001 />
In 1901, Lust founded the American School of Naturopathy in [[New York]]. In 1902 the original North American Kneipp Societies were discontinued and renamed "Naturopathic Societies". In September 1919 the Naturopathic Society of America was dissolved and Benedict Lust founded the American Naturopathic Association to supplant it.<ref name=Baer2001 /><ref>DC Department of Consumer Affairs, Corporate Division. (Continuously Incorporated since 1909)</ref><ref name=Beyerstein_NW>{{cite web|url=http://www.naturowatch.org/general/beyerstein.html |title=Naturopathy: a critical analysis |accessdate=2009-03-21 |last=Beyersteine |first=Barry L. |coauthors=Susan Downie }}</ref> Naturopaths became licensed under naturopathic or drugless practitioner laws in 25 states in the first three decades of the twentieth century.<ref name=Baer2001 /> Naturopathy was adopted by many [[chiropractic|chiropractors]], and several schools offered both Doctor of Naturopathy (ND) and Doctor of Chiropractic (DC) degrees.<ref name=Baer2001 /> Estimates of the number of naturopathic schools active in the United States during this period vary from about one to two dozen.<ref name=ama_1997>{{cite web
|url=http://www.ama-assn.org/ama/no-index/about-ama/13638.shtml |title=Report 12 of the Council on Scientific Affairs (A-97) |year=1997 |publisher=[[American Medical Association]] |laysummary=http://www.ama-assn.org/resources/doc/csaph/csaa-97.pdf |laysource=1997 Annual Meeting of the American Medical Association: Reports of the Council on Scientific Affairs |laydate=1997 }}{{dead link|date=February 2013}}<!-- main link is dead; laysummary link is live. Failed attempt to fix deadlink --></ref><ref name=Baer2001 /><ref name=ACS>
{{Cite web
| title =Naturopathic Medicine
| publisher =[[American Cancer Society]]
| date =01 Nov 08
| url =http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/MindBodyandSpirit/naturopathic-medicine
| accessdate =20 Nov 10 }}
</ref>


After a period of rapid growth, naturopathy went into decline for several decades after the 1930s. In 1910 the [[Carnegie Foundation for the Advancement of Teaching]] published the [[Flexner Report]], which criticized many aspects of medical education, especially quality and lack of scientific rigour. The advent of [[penicillin]] and other "miracle drugs" and the consequent popularity of modern medicine also contributed to naturopathy's decline. In the 1940s and 1950s, a broadening in scope of practice laws led many chiropractic schools to drop their ND degrees, though many chiropractors continued to practice naturopathy. From 1940 to 1963, the [[American Medical Association]] campaigned against heterodox medical systems. By 1958 practice of naturopathy was licensed in only five states.<ref name=Baer2001 /> In 1968 the [[United States Department of Health, Education, and Welfare]] issued a report on naturopathy concluding that naturopathy was not grounded in medical science and that naturopathic education was inadequate to prepare graduates to make appropriate diagnosis and provide treatment; the report recommends against expanding [[Medicare (United States)|Medicare]] coverage to include naturopathic treatments.<ref name=ACS /><ref name=HEW1968>{{cite web |title= HEW Report on Naturopathy (1968) |url= http://www.quackwatch.org/01QuackeryRelatedTopics/Naturopathy/hew.html |author= <!-- no byline --> |date= August 30, 1999 |work= QuackWatch |accessdate= 2013-09-03}} Citing: {{cite book |last = Cohen |first = Wilbur J. |title = Independent Practitioners Under Medicare: A Report to the Congress | publisher = [[United States Department of Health, Education, and Welfare]] |year= 1969 |oclc= 3000280 |url= | isbn= }}</ref> In 1977 an Australian committee of inquiry reached similar conclusions; it did not recommend licensure for naturopaths.<ref name=Aust1977>{{cite web |title= Naturopathy: Report of the Australian Committee of Inquiry (1977) |url= http://www.naturowatch.org/hx/australia.html |author= <!-- no byline --> |work= NaturoWatch |publisher= QuackWatch |date= December 25, 2003 |accessdate= 2013-09-03}} Citing: {{cite book |last= Webb |first= Edwin C. |last2= et al. |title= Report of the Committee of Inquiry into Chiropractic, Osteopathy, Homoeopathy and Naturopathy |publisher= Australian Government Publishing Service |location= Canberra |year= 1977 |pages=|isbn= 064292287X |oclc= |doi= |url= }}</ref> As of 2009, fifteen U.S. states, Puerto Rico, the US Virgin Islands and the District of Columbia licensed naturopathic doctors,<ref name= "LicState">{{cite web |url= http://www.naturopathic.org/content.asp?contentid=57 |title= Licensed States & Licensing Authorities |work= American Association of Naturopathic Physicians website |author= <!-- no byline --> |publisher= <!-- redundant to website name --> |year= 2009 |accessdate= |archiveurl= http://web.archive.org/web/20091130234327/http://naturopathic.org/content.asp?contentid=57 |archivedate= 2009-11-30}}</ref> and the state of Washington requires insurance companies to offer reimbursement for services provided by naturopathic physicians.<ref name="WAC 284-43-205">{{cite web |title= Washington Administrative Code: Title 284, Chapter 43, Section 205: Every category of health providers |url= http://apps.leg.wa.gov/WAC/default.aspx?cite=284-43-205 |publisher= Washington State Legislature |date= August 28, 1999 (effective)}}</ref><ref name="PBS_WA">{{cite episode |title= Insuring Alternatives |series= NewsHour with Jim Lehrer |serieslink= PBS NewsHour |last= Minott |first= Rod |transcript= Online NewsHour transcript |transcripturl= http://www.pbs.org/newshour/bb/health/july96/alt_medicines_7-3.html |date= July 3, 1996 |network= [[PBS]]}}</ref> South Carolina and Tennessee prohibit the practice of naturopathy.<ref name= "SC Code"/><ref name= "TN Code"/><ref name=AMA_report_2006 />
After a period of rapid growth, naturopathy went into decline for several decades after the 1930s. In 1910 the [[Carnegie Foundation for the Advancement of Teaching]] published the [[Flexner Report]], which criticized many aspects of medical education, especially quality and lack of scientific rigour. The advent of [[penicillin]] and other "miracle drugs" and the consequent popularity of modern medicine also contributed to naturopathy's decline. In the 1940s and 1950s, a broadening in scope of practice laws led many chiropractic schools to drop their ND degrees, though many chiropractors continued to practice naturopathy. From 1940 to 1963, the [[American Medical Association]] campaigned against heterodox medical systems. By 1958 practice of naturopathy was licensed in only five states.<ref name=Baer2001 /> In 1968 the [[United States Department of Health, Education, and Welfare]] issued a report on naturopathy concluding that naturopathy was not grounded in medical science and that naturopathic education was inadequate to prepare graduates to make appropriate diagnosis and provide treatment; the report recommends against expanding [[Medicare (United States)|Medicare]] coverage to include naturopathic treatments.<ref name=ACS /><ref name=HEW1968>{{cite book | last = Cohen | first = Wilbur J | authorlink = | coauthors = | title = Independent Practitioners Under Medicare: a report to the Congress | publisher = [[United States Department of Health, Education, and Welfare]] | date = 1968-12 | location = | pages = | url=http://www.quackwatch.org/01QuackeryRelatedTopics/Naturopathy/hew.html | doi = | id = | isbn =}}</ref> In 1977 an Australian committee of inquiry reached similar conclusions; it did not recommend licensure for naturopaths.<ref name=Aust1977>{{cite book |author=Webb, Edwin C|title=Report of the Committee of Inquiry into Chiropractic, Osteopathy, Homoeopathy and Naturopathy |publisher=Australian Government Publishing Service |location=Canberra |year=1977 |pages=|isbn=0-642-92287-X |oclc= |doi= |url=http://www.naturowatch.org/hx/australia.html}}</ref> As of 2009, fifteen of fifty U.S. states, Puerto Rico, the US Virgin Islands and the District of Columbia licensed naturopathic doctors,<ref>{{cite web |url=http://www.naturopathic.org/content.asp?contentid=57 |title=Licensed States & Licensing Authorities |publisher=American Association of Naturopathic Physicians |date=2 July 2009}}</ref> and two states (WA, VT) require insurance companies to offer reimbursement for services provided by naturopathic physicians.<ref name="WAC 284-43-205">{{cite web |title=Every category of health care providers |url=http://apps.leg.wa.gov/WAC/default.aspx?cite=284-43-205 }}</ref><ref name="PBS_WA">{{cite news | title = Insuring Alternatives | date = 1996-07-03 | publisher = [[Public Broadcasting Service]] |url=http://www.pbs.org/newshour/bb/health/july96/alt_medicines_7-3.html | work = Online Newshour | accessdate = 2010-11-19}}</ref>


Naturopathy never completely ceased to exist. Beginning in the 1970s, interest waxed in the United States and Canada in conjunction with the holistic health movement.<ref name=Baer2001 /><ref name=Gale_Frey />
Naturopathy never completely ceased to exist. Beginning in the 1970s, interest waxed in the United States and Canada in conjunction with the [[holistic health]] movement.<ref name=Baer2001 /><ref name=Gale_Frey />


== Ideology ==
== Ideology ==
Naturopathy focuses on naturally occurring substances, minimally invasive methods, and the promotion of natural healing through [[vitalism]].<ref name=ACS /> Prevention through stress reduction and a healthy diet and lifestyle is emphasized, and pharmaceutical drugs, ionizing radiation, and surgery, are generally avoided.<ref name=ECHP>{{cite book |editor1-last= Clark |editor1-last= Carolyn C. |editor2-last= Gordon |editor2-first= Rena J. |title= Encyclopedia of Complementary Health Practice |chapterurl= http://books.google.com/books?id=cwYnA1qunUwC&pg=PA57 |accessdate= 2013-09-03 |year= 1999 |publisher= [[Springer Publishing]] |isbn= 9780826117229 |pages= 57–59 |chapter= Naturopathy: Practice Issues |last= Pizzorno |first= Joseph E.}}</ref>
Naturopathy focuses on naturally occurring substances, minimally invasive methods, and encouragement of natural healing.<ref name=ACS /> Naturopaths generally favor an intuitive and [[Vitalism|vitalistic]] conception of the body, and complete rejection of [[biomedicine]] and modern science is common.<ref name=ACS /><ref name="Beyerstein_NW"/> [[Preventive medicine|Prevention]] through stress reduction and a healthy diet and lifestyle is emphasized, and pharmaceutical drugs, ionizing radiation, and surgery are generally minimized. The tenet of naturopathic practice is self-described by six core values.<ref name=ECHP>{{cite book | last1 = Clark | first1 = Carolyn Chambers | last2 = Gordon | first2 = Rena J. | title = Encyclopedia of complementary health practice | publisher = Springer | year = 1999 | pages = 57–58 | accessdate = 2010-11-19 | isbn = 978-0-8261-1239-2}}</ref> Multiple versions exist in the form of the naturopathic doctor's oath,<ref name="oath">{{cite web|title=Naturopathic Doctor's Oath|url=http://www.naturopathic.org/viewbulletin.php?id=62}}</ref> various mission statements published by schools<ref name="ccnm-principles">{{cite web|title=Principles of Naturopathic Medicine |url=http://www.ccnm.edu/?q=about_ccnm/principles_naturopathic_medicine |accessdate= |doi= |pmid= }}</ref> or professional associations, and ethical conduct guidelines published by regulatory bodies:<ref name=BDDTN>{{cite web |title=Guide to the Ethical Conduct of Naturopathic Doctors |url=http://www.boardofnaturopathicmedicine.on.ca/pdf/guide_ethical_conduct.pdf|format=PDF}}</ref>


#First, do no harm; provide the most effective health care available with the least risk to patients at all times ([[primum non nocere]]).
== Lack of evidence ==
#Recognize, respect and promote the self-healing power of nature inherent in each individual human being. ([[Vis medicatrix naturae]], a form of [[vitalism]]).<ref name="Di Stefano 2006">{{cite book|author=Vincent Di Stefano |title=Holism and Complementary Medicine: Origins and Principles|publisher=Allen & Unwin Academic |location= |year=2006 |page=107 |isbn=1-74114-846-4 |oclc= |doi=|accessdate=}}</ref>
Naturopathy lacks an adequate scientific basis; it is not [[evidence-based medicine]] (EBM).<ref name=Naturo2006/> Members of the medical community show a critical or rejecting view of naturopathy.<ref name="Beck T"/> Traditional naturopathic practitioners surveyed in Australia perceive EBM as an ideologic assault on their beliefs in vitalistic and holistic principles.<ref name=Naturo2006/> They advocate the integrity of natural medicine practice.<ref name=Naturo2006/> Traditional natural medicine practitioners surveyed in Australia could have problems in understanding and applying the concept of EBM.<ref name=Naturo2006>{{cite journal |journal= [[Journal of Alternative and Complementary Medicine]] |year= 2006 |month= April |volume= 12 |issue= 3 |pages= 323–8 |title= Evidence-based medicine and naturopathy |first1= Tom |last1= Jagtenberg |first2= Sue |last2= Evans |first3= Airdre |last3= Grant |first4= Ian |last4= Howden |first5= Monique |last5= Lewis |first6= Judy |last6= Singer |displayauthors= 4 |doi= 10.1089/acm.2006.12.323 |pmid=16646733}}</ref> If naturopathy offers verifiable results for specific conditions, greater scientific knowledge of the mechanisms of those naturopathic protocols could result in improved therapy models.<ref name="Beck T">{{cite journal |title= Zu den grundlagen von naturheilverfahren und komplementärmedizin |trans_title= On the general basis of naturopathy and complementary medicine |journal= Forsch Komplementärmed Klass Naturheilkd &#91;Research in Complementary Medicine&#93; |volume= 8 |issue= 1 |year= 2001 |last= Beck |first= T. |pmid= 11340311 |doi= 10.1159/000057191 |pages= 24-32 |month= February |language= German}} Abstract in English.</ref> Some naturopathic physicians have begun to contribute to research and adapt modern scientific principles into clinical practice.<ref name="Smith MJ, Logan AC 2002 173–84">{{cite journal |journal= Medical Clinics of North America |year= 2002 |month= January |volume= 86 |issue= 1 |pages= 173–84 |title= Naturopathy |last1= Smith Michael J. |last2= Logan |first2= Alan C. |doi= 10.1016/S0025-7125(03)00079-8|pmid=11795088}}</ref>
#Identify and remove the causes of illness, rather than eliminate or suppress symptoms (''Tolle Causam'').

#Educate, inspire rational hope and encourage self-responsibility for health (''Doctor as Teacher'').
Naturopathy is criticized for its reliance on and its association with unproven, disproven, and other controversial alternative medical treatments, and for its vitalistic underpinnings.<ref name=McKnight2009>{{cite news
#Treat each person by considering all individual health factors and influences. (''Treat the Whole Person'').
|first= Peter |last= McKnight |title= Naturopathy's main article of faith cannot be validated; Reliance on vital forces leaves its practises based on beliefs without scientific backing |date= March 7, 2009 |url= http://www.vancouversun.com/story_print.html?id=1364389 |newspaper= [[Vancouver Sun]] |page= C5 |edition= final |accessdate= 2009-03-21 }}{{Dead link|date=September 2010|bot=H3llBot}}<!-- available for purchase via Infomart - http://www.fpinfomart.ca/ as of Feb 2013 --></ref> As with any medical care, there is a risk of misdiagnosis; this risk may be lower depending on level of training.<ref name=Gale_Frey /><ref name=atwood2004 /> Certain naturopathic treatments offered by [[Naturopathy#Practitioners|traditional naturopaths]], such as homeopathy, [[rolfing]], and [[iridology]], are widely considered [[pseudoscience]] or [[quackery]].<ref name="NSBattitudes">{{cite web |title= Chapter 7 Science and Technology: Public Attitudes and Public Understanding, Section: Belief in Alternative Medicine |url= http://www.nsf.gov/statistics/seind02/c7/c7s5.htm#c7s5l2a |work= Science and Engineering Indicators - 2002 |date= January 15, 2002 |author= [[National Science Board]] |publisher= Division of Science Resources Statistics, [[National Science Foundation]] |location= Arlington, VA}}</ref><ref name="WahlbergQuack">
#Emphasize the condition of health to promote well-being and to prevent diseases for the individual, each community and our world. (''Health Promotion, the Best Prevention'')
{{cite journal |last= Wahlberg |first= Ayo |year= 2007 |month= December |doi= 10.1016/j.socscimed.2007.07.024 |title= A quackery with a difference—new medical pluralism and the problem of 'dangerous practitioners' in the United Kingdom |journal= [[Social Science & Medicine]] |volume= 65 |issue= 11 |pages= 2307–16 |pmid= 17719708}}</ref><ref>{{cite web |title= Iridology is Nonsense |url= http://www.quackwatch.com/01QuackeryRelatedTopics/iridology.html |last= Barrett |first= Stephen |date= March 28, 2008 |work= QuackWatch |accessdate= 2013-09-08}}</ref>

"Natural" methods and chemicals are not necessarily safer or more effective than "artificial" or "synthetic" ones; any treatment capable of eliciting an effect may also have deleterious [[side effect]]s.<ref name=ACS /><ref name=Barrett-Naturopathy /><ref name=SkepDic_natural>{{cite web |url= http://skepdic.com/natural.html |title= Natural |accessdate= 2013-09-08 |last= Carroll
|first= Robert |work= The Skeptic's Dictionary |date= November 26, 2012}}</ref><ref name=NCAHF_herb>{{cite web |url= http://www.ncahf.org/pp/herbal.html |title= NCAHF Position Paper on Over the Counter Herbal Remedies (1995) |accessdate= 2009-04-17 |year= 1995 |publisher= National Council Against Health Fraud}}</ref>

[[Stephen Barrett]] of [[QuackWatch]] and [[the National Council Against Health Fraud]] has stated that Naturopathy is "simplistic and that its practices are riddled with quackery".<ref name=Barrett-Naturopathy /> "Non-scientific health care practitioners, including naturopaths, use unscientific methods and deception on a public who, lacking in-depth health care knowledge, must rely upon the assurance of providers. Quackery not only harms people, it undermines the ability to conduct scientific research and should be opposed by scientists", says William T. Jarvis.<ref name="Jarvis WT">{{cite journal |pmid= 1643742 |year= 1992 |month= August |last1= Jarvis |first1= William T. |title= Quackery: A national scandal |volume= 38 |issue= 8B Pt 2 |pages= 1574–86 |journal= [[Clinical Chemistry (journal) |Clinical chemistry]]}}</ref>

[[Kimball C. Atwood IV]] writes, in the journal ''Medscape General Medicine'', "Naturopathic physicians now claim to be primary care physicians proficient in the practice of both "conventional" and "natural" medicine. Their training, however, amounts to a small fraction of that of medical doctors who practice primary care. An examination of their literature, moreover, reveals that it is replete with pseudoscientific, ineffective, unethical, and potentially dangerous practices".<ref name=atwood2003 /> In another article, Atwood writes that "Physicians who consider naturopaths to be their colleagues thus find themselves in opposition to one of the fundamental ethical precepts of modern medicine. If naturopaths are not to be judged "nonscientific practitioners", the term has no useful meaning". An article by a physician exposing quackery, moreover, does not identify its author as "biased", but simply as fulfilling one of his ethical obligations as a physician.<ref name=atwood2004>{{cite journal |last= Atwood IV |first= Kimball. C. |date= March 26, 2004 |title= Naturopathy, pseudoscience, and medicine: Myths and fallacies vs truth |journal= Medscape General Medicine |volume= 6 |issue= 1 |page= 33 |pmid= 15208545|pmc= 1140750}}</ref>

According to [[Arnold S. Relman]], the ''Textbook of Natural Medicine'' is inadequate as a teaching tool, as it omits to mention or treat in detail many common ailments, improperly emphasizes treatments "not likely to be effective" over those that are, and promotes unproven herbal remedies at the expense of pharmaceuticals. He concludes that "the risks to many sick patients seeking care from the average naturopathic practitioner would far outweigh any possible benefits".<ref name=Relman_text>{{cite web |url= http://www.quackwatch.org/01QuackeryRelatedTopics/Naturopathy/relman1.html |title= Textbook of Natural Medicine |accessdate= 2009-04-17 |last= Relman |first= Arnold S. |authorlink= Arnold S. Relman |origyear= January 9, 2001 |date= April 10, 2002 (revised) |publisher= QuackWatch }}</ref>


== Practice ==
== Practice ==
Naturopaths use a wide variety of treatment modalities, focusing on the concept of natural self-healing rather than any specific method.<ref name=Gale_Frey /><ref name=Skepdic_naturopathy>{{cite web |url= http://skepdic.com/natpathy.html |title= Naturopathy |accessdate= 2009-04-17 |date= February 23, 2009 |last= Carroll |first=Robert T. |work= [[The Skeptic's Dictionary]] |archivedate= 2009-05-05 |archiveurl= http://web.archive.org/web/20090505052716/http://www.skepdic.com/natpathy.html <!-- page updated since accessdate --> |deadurl= no}}</ref> Some methods rely on immaterial "vital energy fields", the existence of which has not been proven, and there is concern that naturopathy as a field tends towards isolation from general scientific discourse.<ref name=NCAHF_np /><ref name=Herbert1994>{{cite book |last1= Herbert |first1= Victor |last2= Barrett |first2= Stephen |title= The Vitamin Pushers: How the "Health Food" Industry is Selling America a Bill of Goods |publisher= Prometheus Books |location= Buffalo, NY |year= 1994 |pages= |isbn=9780879759094 |oclc= |doi= |accessdate=}}</ref><ref name="isbn0-87975-761-2">{{cite book |last1= Barrett |first1= Stephen |last2= Raso |first2= Jack |title=Mystical Diets: Paranormal, Spiritual, and Occult Nutrition Practices |publisher=Prometheus Books |location=Buffalo, New York |year=1993 |pages= |isbn=0879757612 |oclc= |doi= |accessdate=}}</ref> The effectiveness of naturopathy as a whole system has not been systematically evaluated, and efficacy of individual methods used varies.<ref name=ACS /><ref name=ToT_Ernst>{{cite book |last2= Ernst |first2= Edzard |last1= Singh |first1= Simon |authorlink1= Simon Singh|authorlink2 = Edzard Ernst|title= [[Trick or Treatment : The Undeniable Facts About Alternative Medicine]] |publisher= W. W. Norton |location= New York |year= 2008 |pages= |isbn= 0393066614 |oclc= 181139440}}</ref>
Naturopaths use a wide variety of treatment modalities, focusing on natural self-healing rather than any specific method.<ref name=Gale_Frey /><ref name=Skepdic_naturopathy>{{cite web|url=http://skepdic.com/natpathy.html |title=Naturopathy |accessdate=2009-04-17 |last=Carroll |first=Robert Todd |work=Skeptic's Dictionary }}</ref> Some methods rely on immaterial "[[vitalism|vital energy fields]]", the existence of which has not been proven. A consultation typically begins with a lengthy patient interview focusing on lifestyle, medical history, emotional tone, and physical features, as well as physical examination.<ref name=Gale_Frey /> The traditional naturopath focuses on lifestyle changes and approaches that support the body's innate healing potential. Traditional naturopaths do not undertake to diagnose or treat diseases but concentrate on whole body wellness and facilitating the body healing itself. Practitioners of naturopathic medicine hold themselves to be primary care providers and in addition to various natural approaches seek to prescribe [[prescription drug]]s, perform minor surgery and apply other conventional medical approaches to their practice. Naturopaths do not necessarily recommend [[vaccine controversy|vaccines]] and [[antibiotic]]s, and may provide alternative remedies even in cases where [[evidence-based medicine]] has been shown effective.<ref name="Downey2009" /><ref name=LiveSci2004 /> "All forms of naturopathic education include concepts incompatible with basic science, and do not necessarily prepare a practitioner to make appropriate diagnosis or referrals."<ref name="ToT_Ernst"/><ref name=LiveSci2004 /><ref name=MassMed2005>{{cite news | first=Richard P. | last=Gulla | title=Massachusetts Medical Society Testifies in Opposition to Licensing Naturopaths | date=May 11, 2005 | publisher=[[Massachusetts Medical Society]] |url=http://www.massmed.org/AM/PrinterTemplate.cfm?Section=Home&CONTENTID=12458&TEMPLATE=/CM/ContentDisplay.cfm | work = | pages = | accessdate = 2009-04-17 | language = }}</ref>

A consultation typically begins with a lengthy patient interview focusing on lifestyle, medical history, emotional tone, and physical features, as well as physical examination.<ref name=Gale_Frey /> The traditional naturopath focuses on lifestyle changes, not diagnosing or treating diseases. Practitioners of naturopathic medicine hold themselves to be primary care providers and in addition to various natural approaches seek to prescribe [[prescription drug]]s, perform minor surgery and apply other conventional medical approaches to their practice. Naturopaths do not generally recommend vaccines and [[antibiotic]]s, and may provide alternative remedies even in cases where [[evidence-based medicine]] has been shown effective.<ref name="Downey2009" /><ref name=LiveSci2004 /> "All forms of naturopathic education include concepts incompatible with basic science, and do not necessarily prepare a practitioner to make appropriate diagnosis or referrals."<ref name="ToT_Ernst"/><ref name=LiveSci2004 /><ref name=MassMed2005>{{cite web |first= <!-- contact not author Richard P. --> |last= <!-- contact not author Gulla --> |title= Massachusetts Medical Society Testifies in Opposition to Licensing Naturopaths |date= May 11, 2005 |publisher= [[Massachusetts Medical Society]] |url= http://www.massmed.org/AM/PrinterTemplate.cfm?Section=Home&CONTENTID=12458&TEMPLATE=/CM/ContentDisplay.cfm | work = | pages = | accessdate = 2009-04-17 | language = |archivedate= 2011-07-16 |archiveurl= http://web.archive.org/web/20110716132319/http://www.massmed.org/AM/PrinterTemplate.cfm?Section=Home&CONTENTID=12458&TEMPLATE=/CM/ContentDisplay.cfm |deadurl=yes}}</ref>


===Methods===
===Methods===
The particular modalities used by an individual naturopath varies with training and scope of practice. The demonstrated efficacy and scientific rationale also varies. These include: [[Acupuncture]], [[applied kinesiology]],<ref name=PoaP /> [[botanical medicine]], [[brainwave entrainment]], [[Chelation therapy#Heart disease|chelation therapy]] for [[atherosclerosis]],<ref name=atwood2004>{{cite journal |last= Atwood IV |first= Kimball. C. |date= March 26, 2004 |title= Naturopathy, pseudoscience, and medicine: Myths and fallacies vs truth |journal= Medscape General Medicine |volume= 6 |issue= 1 |page= 33 |pmid= 15208545|pmc= 1140750}}</ref> [[Colon cleansing|colonic enemas]],<ref name=Barrett-Naturopathy /> [[color therapy]],<ref name=PoaP>{{Cite book |url= http://www.pewscholars.com/pdf_files/Naturo2.pdf |title= Profile of a Profession: Naturopathic Practice |first1= Holly J. |last1= Hough |first2= Catherine |last2= Dower |first3= Edward H. |last3= O’Neil |publisher= Center for the Health Professions, [[University of California, San Francisco]] |month= September | year= 2001 |page= 54 |deadurl= yes |archivedate= 2008-10-02 |archiveurl= http://web.archive.org/web/20081002072928/http://www.pewscholars.com/pdf_files/Naturo2.pdf }}</ref> [[cranial osteopathy]],<ref name=LiveSci2004 /> [[Hair analysis (alternative medicine)|hair analysis]],<ref name=LiveSci2004>{{cite web |authorlink= Andrew A. Skolnick |first= Andrew A. |last= Skolnick |title= Voice of Reason: Licensing Naturopaths May Be Hazardous to Your Health | date= November 18, 2004 | publisher= [[TechMediaNetwork]] |url= http://www.livescience.com/health/naturopathy_license_041118.html | work= [[LiveScience]] | pages = |accessdate= 2009-04-17}}</ref> [[homeopathy]],<ref name="Boon HS"/> [[iridology]],<ref name=PoaP/> [[live blood analysis]], ''nature cures''—i.e.&nbsp;a range of therapies based upon exposure to natural elements such as [[sunshine]], fresh air, heat, or cold, [[nutrition]] (examples include [[vegetarian]] and [[wholefood]] diet, [[fasting]], and [[abstention]] from [[alcohol]] and [[sugar]],<ref name=dummy>{{Cite book |title= Complementary Medicine for Dummies |first= Jacqueline |last= Young |isbn=9780470026250 |year= 2007|publisher= Wiley |location= Chichester, England |oclc= 174043853 |chapter= Chapters 8 & 13}}</ref> [[ozone therapy]],<ref name=ACS /> [[physical medicine]] (e.g.,&nbsp;naturopathic, osseous, and soft tissue [[manipulative therapy]], [[sports medicine]], [[Physical exercise|exercise]], and [[hydrotherapy]]), [[Counseling psychology|Psychological counseling]] (e.g.,&nbsp;[[meditation]], [[Relaxation technique|relaxation]], and other methods of [[stress management]]<ref name=dummy />), [[public health]] measures and [[hygiene]],<ref name=ECHP /> [[reflexology]],<ref name=PoaP /> [[rolfing]],<ref name=Beyerstein_NW /> and [[traditional Chinese medicine]].
The particular modalities used by an individual naturopath varies with training and scope of practice. The demonstrated efficacy and scientific rationale also varies. These include: [[Acupuncture]], [[applied kinesiology]],<ref name=PoaP /> [[botanical medicine]], [[brainwave entrainment]], [[Chelation therapy#Heart disease|chelation therapy]] for [[atherosclerosis]],<ref name=atwood2004 /> [[Colon cleansing|colonic enemas]],<ref name=Barrett-Naturopathy /> [[color therapy]],<ref name=PoaP>{{Cite book |url=http://www.pewscholars.com/pdf_files/Naturo2.pdf |format=PDF |title=Profile of a profession: naturopathic practice |author=Holly J. Hough, Catherine Dower, Edward H. O’Neil |publisher=Center for the Health Professions, University of California |month=September | year=2001 |page=54 |doi= |accessdate= }}</ref> [[cranial osteopathy]],<ref name=LiveSci2004 /> [[Hair analysis (alternative medicine)|hair analysis]],<ref name=LiveSci2004>{{cite news|authorlink=Andrew A. Skolnick| first=Andrew A. | last=Skolnick | coauthors= | title=Voice of Reason: Licensing Naturopaths May Be Hazardous to Your Health | date=2004-11-18 | publisher= | url =http://www.livescience.com/health/naturopathy_license_041118.html | work =Live Science | pages = | accessdate = 2009-04-17 | language = }}</ref> [[homeopathy]],<ref name="Boon HS"/> [[iridology]],<ref name=PoaP/> [[live blood analysis]], ''nature cures''—i.e.&nbsp;a range of therapies based upon exposure to natural elements such as [[sunshine]], fresh air, heat, or cold, [[nutrition]] (examples include [[vegetarian]] and [[wholefood]] diet, [[fasting]], and [[abstention]] from [[alcohol]] and [[sugar]],<ref name=dummy>{{Cite book |title=Complementary Medicine for Dummies |author=Jacqueline Young |isbn=978-0-470-02625-0|year=2007|publisher=Wiley |location=Chichester, England |oclc=174043853 |chapter=8, 13}}</ref>[[ozone therapy]],<ref name=ACS /> [[physical medicine]] (e.g.,&nbsp;naturopathic, osseous, and soft tissue [[manipulative therapy]], [[sports medicine]], [[Physical exercise|exercise]], and [[hydrotherapy]]), [[Counseling psychology|Psychological counseling]] (e.g.,&nbsp;[[meditation]], [[Relaxation technique|relaxation]], and other methods of [[stress management]]<ref name=dummy />), [[public health]] measures and [[hygiene]],<ref name=ECHP /> [[reflexology]],<ref name=PoaP /> [[rolfing]],<ref name=Beyerstein_NW /> and [[traditional Chinese medicine]].


A 2004 survey determined the most commonly prescribed naturopathic therapeutics in Washington State and Connecticut were botanical medicines, vitamins, minerals, homeopathy, and allergy treatments.<ref name="Boon HS">{{cite journal |journal= BMC Complementary & Alternative Medicine |year= 2004 |volume= 20 |issue= 4 |page= 14 |title= Practice patterns of naturopathic physicians: Results from a random survey of licensed practitioners in two U.S. States |last1= Boon |first1=Heather S. |last2= Cherkin |first2= Daniel C. |last3= Erro |first3= Janet |last4= Sherman |first4= Karen J. |last5= Milliman |first5= Bruce |last6= Booker |first6= Jennifer |last7= Cramer |first7= Elaine H. |last8= Smith |first8= Michael J. |last9= Deyo |first9= Richard A. |last10= Eisenberg |first10= David M. |displayauthors= 4 |doi= 10.1186/1472-6882-4-14 |pmc= 529271|pmid= 15496231}}</ref>
A 2004 survey determined the most commonly prescribed naturopathic therapeutics in Washington State and Connecticut were botanical medicines, vitamins, minerals, homeopathy, and allergy treatments.<ref name="Boon HS">{{cite journal |journal=BMC Complement Altern Med |year=2004 |volume=20 |issue=4 |page=14 |title=Practice patterns of naturopathic physicians: results from a random survey of licensed practitioners in two U.S. States|author= Boon H. S., Cherkin D. C., Erro J., Sherman K. J., Milliman B., Booker J., Cramer E. H., Smith M. J., Deyo R. A., Eisenberg D. M.|doi= 10.1186/1472-6882-4-14 |pmc=529271|pmid=15496231}}</ref>


=== Vaccination ===
=== Vaccination ===
Many forms of [[alternative medicine]], including naturopathy, [[homeopathy]], and [[chiropractic]] are based on beliefs opposed to [[vaccination]] and have practitioners who voice their opposition. This includes non-medically trained naturopaths. The reasons for this negative vaccination view are complicated and rest, at least in part, on the early views which shape the foundation of these professions.<ref name=Ernst-2001>{{cite journal |journal=Vaccine |year=2001 |volume=20 |issue= Suppl 1 |pages=S89–93 |title=Rise in popularity of complementary and alternative medicine: reasons and consequences for vaccination |author=Ernst E |doi=10.1016/S0264-410X(01)00290-0 |pmid=11587822}}</ref> A survey of a cross section of students of a major complementary and alternative medicine college in Canada reported that students in the later years of the program opposed vaccination more strongly than newer students.<ref>{{cite journal |journal=Vaccine |year=2008 |volume=26 |issue=49 |pages=6237–42 |title=Attitudes towards vaccination among chiropractic and naturopathic students |author= Busse J. W., Wilson K., Campbell J. B.|doi=10.1016/j.vaccine.2008.07.020 |pmid=18674581}}</ref>
{{See also|Vaccination|Vaccine controversies}}
Many forms of alternative medicine, including naturopathy, homeopathy, and [[chiropractic]] are based on beliefs opposed to vaccination and have practitioners who voice their opposition. This includes non-medically trained naturopaths. The reasons for this negative vaccination view are complicated and rest, at least in part, on the early views which shape the foundation of these professions.<ref name=Ernst-2001>{{cite journal |journal= [[Vaccine (journal)|Vaccine]] |year= 2001 |volume= 20 |issue= Suppl. 1, 5th European Conference on Vaccinology: A Safe Future with Vaccination
|pages= S90–3 |title= Rise in popularity of complementary and alternative medicine: reasons and consequences for vaccination |last= Ernst |first= Edzard |authorlink= Edzard Ernst|doi= 10.1016/S0264-410X(01)00290-0 |pmid= 11587822}}</ref> A survey of a cross section of students of a major complementary and alternative medicine college in Canada reported that students in the later years of the program opposed vaccination more strongly than newer students.<ref>{{cite journal |journal= Vaccine |year= 2008 |volume= 26 |issue= 49 |pages= 6237–42 |title= Attitudes towards vaccination among chiropractic and naturopathic students |last1= Busse |first1= Jason W. |last2= Wilson |first2= Kumanan |last3= Campbell |first3= James B. |doi= 10.1016/j.vaccine.2008.07.020 |pmid=18674581}}</ref>


A [[University of Washington]] study investigated insurance claim histories for alternative medicine use in relation to the receipt of vaccinations against preventable illnesses, grouped into children aged 1–2 years and 1–17 years. Both groups were significantly less likely to receive a number of their vaccinations if they visited a naturopath. The study found a significant association between visits to naturopaths with a reduced receipt of pediatric vaccinations and with increased infection by [[vaccine-preventable diseases]].<ref name="Downey2009">{{cite journal |journal= Maternal and Child Health Journal |year=2009 |volume= 14 |issue= 6|pages= 922–30|title=Pediatric vaccination and vaccine-preventable disease acquisition: associations with care by complementary and alternative medicine providers |last1= Downey |first1= Lois |last2= Tyree |first2= Patrick T. |last3= Huebner |first3= Colleen E. |last4= Lafferty |first4= William E. |displayauthors= 4 |pmid= 19760163 |url= |pmc= 2924961 |doi= 10.1007/s10995-009-0519-5}}</ref>
A [[University of Washington]] study investigated insurance claim histories for alternative medicine use in relation to the receipt of vaccinations against preventable illnesses, grouped into children aged 1–2 years and 1–17 years. Both groups were significantly less likely to receive a number of their vaccinations if they visited a naturopath. The study found a significant association between visits to naturopaths with a reduced receipt of pediatric vaccinations and with increased infection by vaccine-preventable illnesses.<ref name="Downey2009">{{cite journal |journal= Matern Child Health J |year=2009 |volume= 14 |issue= 6|pages= 922–30|title=Pediatric vaccination and vaccine-preventable disease acquisition: associations with care by complementary and alternative medicine providers |author=Downey L., Tyree P. T., Huebner C. E., Lafferty W. E.|pmid=19760163 |url=http://www.springerlink.com/content/2mpl5g3480466684/ |pmc= 2924961 |doi=10.1007/s10995-009-0519-5}}</ref>


==Practitioners==
==Practitioners==
A consultation with a naturopathic practitioner typically begins with a lengthy patient interview focusing on lifestyle, medical history, emotional tone, and physical features, as well as physical examination.<ref name=Gale_Frey /> Naturopathic practitioners can be divided into three groups, naturopathic physicians, traditional naturopaths and other health care providers who offer naturopathic services.<ref name=ACS /><ref name=NCCAM/><ref name=IMB_policy>{{cite web |author= Iowa Board of Medicine |title= A Policy Statement on Naturopathy |url= http://medicalboard.iowa.gov/policies/naturopathy.html |publisher= <!-- Iowa Board of Medicine, redundant to author -->Iowa Department of Public Health, State of Iowa |date= February 7, 2002 |accessdate= 2013-09-01}}
A consultation with a naturopathic practitioner typically begins with a lengthy patient interview focusing on lifestyle, medical history, emotional tone, and physical features, as well as physical examination.<ref name=Gale_Frey /> Naturopathic practitioners can be split into two groups, naturopathic physicians and traditional naturopaths.<ref name=NCCAM/><ref name=IMB_policy>[http://medicalboard.iowa.gov/policies/naturopathy.html Iowa Board of Medicine policy statement on naturopathy]</ref><ref name=ACS /><ref>The Platform of the American Naturopathic Association as drawn up by the Golden Jubilee Congress. July 27th – August 2nd, 1947</ref><ref name=MNNWG>{{cite web |url=http://www.health.state.mn.us/divs/hpsc/hop/nawg/summary092308.pdf |title=Traditional Naturopathy Working Session Summary |author=Naturopathy Work Group |publisher=Minnesota Department of Health |accessdate=20 Nov 10}}</ref>
</ref><ref>The Platform of the American Naturopathic Association as drawn up by the Golden Jubilee Congress. July 27th – August 2nd, 1947</ref>{{Verify source|date=September 2013}}<ref name=MNNWG>{{cite web |url= http://www.health.state.mn.us/divs/hpsc/hop/nawg/summary092308.pdf |title= Traditional Naturopathy Working Session Summary September 23 and October 1, 2008 |author= Naturopathy Work Group |publisher= Minnesota Department of Health |accessdate=2010-11-20}}</ref>


=== Doctors of Naturopathic Medicine ===
=== Doctors of Naturopathic Medicine ===
{{Main|Doctor of Naturopathic Medicine}}
{{Main|Doctor of Naturopathic Medicine}}
Naturopathic Medicine is represented in the United States by the American Association of Naturopathic Physicians (AANP), which was founded in 1985 and has 2,000 student, physicians, supporting, and corporate members.<ref name=ACS /><ref>[http://www.naturopathic.org/content.asp?pl=9&contentid=9 American Association of Naturopathic Physicians<!-- Bot generated title -->]</ref>
Many naturopaths present themselves as primary care providers.<ref name=Gale_Frey /><ref name=CNME-handbook>{{cite web |url= http://www.cnme.org/resources/2007_hoa.pdf |title= Handbook of Accreditation for Naturopathic Medicine Programs |year= 2007 |publisher= Council on Naturopathic Medical Education |accessdate= 2010-11-20}}</ref> Doctor of Naturopathy (ND) training includes basic medical diagnostic tests and procedures such as [[medical imaging]] and [[blood test]]s, as well as vitalism and pseudoscientific modalities such as homeopathy.<ref name=Gale_Frey /><ref name= Barrett-Naturopathy/><ref name= atwood2004 /><ref name= atwood2003>{{cite journal|last=Atwood |first= Kimball C., IV |year= 2003|doi= |title= Naturopathy: A critical appraisal |url= http://www.medscape.com/viewarticle/465994 |journal= Medscape General Medicine |volume= 5 |issue= 4 |page= 39 |pmid= 14745386}}{{registration required}}</ref><ref name=McKnight2009>{{cite news |first= Peter |last= McKnight |title= Naturopathy's main article of faith cannot be validated; Reliance on vital forces leaves its practises based on beliefs without scientific backing |date= March 7, 2009 |url= http://www.vancouversun.com/story_print.html?id=1364389 |newspaper= [[Vancouver Sun]] |page= C5 |edition= final |accessdate= 2009-03-21 }}{{Dead link|date=September 2010|bot=H3llBot}}<!-- available for purchase via Infomart - http://www.fpinfomart.ca/ as of Feb 2013 --></ref>
Many naturopaths present themselves as [[primary care physician|primary care providers]].<ref name=Gale_Frey /><ref name=CNME-handbook>{{cite web|url=http://www.cnme.org/resources/2007_hoa.pdf |title=Handbook of Accreditation for Naturopathic Medicine Programs |format=PDF |year=2007 |publisher=[[Council on Naturopathic Medical Education]] |accessdate= 20 Nov 10}}</ref> Doctor of Naturopathy (ND) training includes basic medical diagnostic tests and procedures such as [[medical imaging]] and [[blood test]]s, as well as [[vitalism]] and pseudoscientific modalities such as [[homeopathy]].<ref name=Gale_Frey /><ref name=Barrett-Naturopathy/><ref name=atwood2004 /><ref name=atwood2003>{{cite journal|author=Atwood KC|year=2003|doi=|title=Naturopathy: a critical appraisal|journal=MedGenMed : Medscape general medicine |volume=5 |issue=4 |page=39 |pmid=14745386}}</ref><ref name=McKnight2009 /> The [[Council on Naturopathic Medical Education]] (CNME) also provides for the inclusion of optional modalities including minor [[surgery]], [[natural childbirth]], and [[intravenous therapy]], though they are not generally licensed to perform these functions; these modalities require additional training and may not be within the scope of practice in all jurisdictions. This training includes naturopathic manipulation, psychological counseling and homeopathy.<ref>{{cite web|url=http://www.aanmc.org/education/academic-curriculum.php |title=Academic Curriculum - Association of Accredited Naturopathic Medical Colleges |publisher=Aanmc.org |date= |accessdate=2009-09-22}}</ref>


The core set of interventions defined by the Council on Naturopathic Medical Education (CNME) and taught at accredited naturopathic schools in North America includes: [[acupuncture]] and [[traditional Chinese medicine]], [[botanical medicine]], homeopathy, nature cure (a range of therapies based upon exposure to natural elements), [[nutrition]], [[physical medicine]], and counseling.<ref name=CNME-handbook />
The core set of interventions defined by the [[Council on Naturopathic Medical Education]] and taught at all six accredited schools in North America includes:<ref name=CNME-handbook /> [[acupuncture]] and [[traditional Chinese medicine]], [[botanical medicine]], [[homeopathy]], ''nature cure'' (a range of therapies based upon exposure to natural elements), [[nutrition]], [[physical medicine]], and [[counseling psychology|psychological counseling]].

Naturopathic medical license in most areas of North America requires graduation from one of the schools accredited by the [[Association of Accredited Naturopathic Medical Colleges]].

Naturopathic Medicine is represented with seven [[List of Accredited Naturopathic Medical Schools in North America|accredited naturopathic medical schools]]. In 1956, Charles Stone, Frank Spaulding, and W.&nbsp;Martin Bleything established the [[National College of Natural Medicine]] (NCNM) in [[Portland, Oregon|Porltand]], [[Oregon]], in response to plans by the [[Western States Chiropractic College]] to drop its ND program. In 1978, Sheila Quinn, Joseph Pizzorno, William Mitchell, and Les Griffith established John Bastyr College of Naturopathic Medicine (now [[Bastyr University]]) in [[Seattle]], [[Washington (state)|Washington]]. That same year, the [[Canadian College of Naturopathic Medicine]] was founded in [[Toronto]], [[Canada]]. More recently founded schools include the [[Southwest College of Naturopathic Medicine]] in [[Tempe, Arizona]], founded in 1992, and [[Boucher Institute of Naturopathic Medicine]] in [[New Westminster]], [[British Columbia]], also founded in 1992. The [[University of Bridgeport]] in [[Bridgeport]], [[Connecticut]] grants ND degrees through the College of Naturopathic Medicine, and the [[National University of Health Sciences]] in [[Lombard, Illinois]] offers a naturopathic program that is fully accredited by the Council on Naturopathic Medical Education (CNME).


==== Licensure ====
==== Licensure ====
In jurisdictions where Naturopathic doctor (ND or NMD) or a similar term is a protected designation, naturopathic doctors must pass the [[Naturopathic Physicians Licensing Examinations]] administered by the North American Board of Naturopathic Examiners (NABNE)<ref>{{cite web |url= https://www.nabne.org/home/about/ |title= About Us |work= North American Board of Naturopathic Examiners website |accessdate= 2013-09-03 |publisher= <!-- redundant to website name --> |author= <!-- no byline --> |date= <!-- no date in source --> }}</ref> after graduating from a college accredited by the CNME.<ref name=CNME-handbook /> Residency programs are offered at four of these colleges.<ref>{{cite web |url=http://www.bastyr.edu/education/naturopath/degree/training.asp |title= Academic Degree Programs: Naturopathic Medicine Degree Program |work=[[Bastyr University]] website |publisher= <!-- redundant to website name --> |date= <!-- 2009-05-28 not given in source -->|accessdate=2009-09-22 |archivedate= 2010-01-28 |archiveurl= http://web.archive.org/web/20100128013520/http://www.bastyr.edu/education/naturopath/degree/training.asp <!-- page updated and redirected since accessdate -->}}</ref><ref>{{cite web|url= http://www.ncnm.edu/naturopathic-medicine-residency-program.php |work= [[National College of Natural Medicine]] website |title= Doctor of Naturopathic Medicine Residency Program |date= <!-- 2009-01-26 no date in source --> |accessdate=2013-09-03}}</ref><ref>{{cite web |title= Residencies |url= http://www.scnm.edu/residencies.html |accessdate= 2009-09-22 <!-- page updated since accessdate --> |work= [[Southwest College of Naturopathic Medicine]] website |date= <!-- no date in source --> |publisher= <!-- redundant to website name --> |archivedate= 2010-05-27 |archiveurl= http://web.archive.org/web/20100527120823/http://www.scnm.edu/residencies.html}}</ref><ref>{{cite web |url=http://www.bridgeport.edu/academics/graduate/naturo/clinic/residency.aspx |title=Residency Programs at Bridgeport |publisher=[[University of Bridgeport]] |date= |accessdate=2010-11-19}}</ref> NDs are not required to engage in residency training, except in the state of Utah.<ref name=ACS /><ref name= "UT license app"/>
In jurisdictions where [[Naturopathic doctor]] (ND or NMD) or a similar term is a protected designation, naturopathic doctors must pass board exams set by the [[North American Board of Naturopathic Examiners]] (NABNE)<ref>{{cite web |url=http://www.nabne.org |title=NABNE |publisher=North American Board of Naturopathic Examiners |accessdate= }}</ref> after completing academic and clinical training at a college certified by the [[Council on Naturopathic Medical Education]] (CNME).<ref name=CNME-handbook /> Residency programs are offered at [[Bastyr University]],<ref>{{cite web |url=http://www.bastyr.edu/education/naturopath/degree/training.asp |title=Degree : Naturopathic Medicine |publisher=[[Bastyr University]] |date=2009-05-28 |accessdate=2009-09-22}}</ref> [[National College of Natural Medicine]],<ref>{{cite web|url=http://www.ncnm.edu/naturopathic-medicine-residency-program.php |publisher=National College of Natural Medicine |title=Naturopathic Medicine Residency Program |date=2009-01-26 |accessdate=2009-09-22}}</ref> [[Southwest College of Naturopathic Medicine]],<ref>{{cite web|url=http://scnm.edu/residencies.html |title=Residencies at SCNM |publisher=Scnm.edu |accessdate=2009-09-22}}</ref> and [[University of Bridgeport]].<ref>{{cite web |url=http://www.bridgeport.edu/academics/graduate/naturo/clinic/residency.aspx |title=Residency Programs at Bridgeport |publisher=[[University of Bridgeport]] |date= |accessdate=2010-11-19}}</ref> NDs are not required to engage in residency training.<ref name=ACS />


In 2005, the [[Massachusetts Medical Society]] opposed licensure in that [[Massachusetts|commonwealth]] based on concerns that NDs are not required to participate in residency, and are trained in inappropriate or harmful treatments.<ref name=MassMed2005/> The Massachusetts Special Commission on Complementary and Alternative Medical Practitioners rejected their concerns and recommended licensure.<ref name=MassCtte>{{cite web |title= Majority Report of the Special Commission on Complementary and Alternative Medical Practitioners: A Report to the Legislature |month= January |year= 2002 |author= The Special Commission on Complementary and Alternative Medical Practitioners |publisher= Massachusetts: The Special Commission on Complementary and Alternative Medical Practitioners |url= http://www.quackwatch.com/01QuackeryRelatedTopics/Naturopathy/majority.pdf |accessdate= 2010-11-10 |postscript= .}}</ref>
In 2005, the [[Massachusetts Medical Society]] opposed licensure in that [[Massechusetts|commonwealth]] based on concerns that NDs are not required to participate in residency, and are trained in inappropriate or harmful treatments.<ref name=MassMed2005/> The Massachusetts Special Commission on Complementary and Alternative Medical Practitioners rejected their concerns and recommended licensure.<ref name=MassCtte>{{Cite web | author =Special Commission on Complementary and Alternative Medical Practitioners | year =2002 | title =Majority Report of the Special Commission on Complementary and Alternative Medical Practitioners: A Report to the Legislature | publisher =www.quackwatch.com | url =http://www.quackwatch.com/01QuackeryRelatedTopics/Naturopathy/majority.pdf
| accessdate =20 Nov 10 | postscript =<!-- Bot inserted parameter. Either remove it; or change its value to "." for the cite to end in a ".", as necessary. -->{{inconsistent citations}}}}</ref>


In the state of Washington, where naturopathic doctors are licensed comparably to primary care physicians,<ref>{{cite web |url=http://apps.leg.wa.gov/RCW/default.aspx?cite=18.36A&full=true |title=Chapter 18.36A RCW: Naturopathy |publisher=Apps.leg.wa.gov |date= |accessdate=2009-09-22}}</ref> many naturopathic doctors also accept insurance, with some plans offering the option of designating a naturopath as a primary care provider.<ref name="fammed.washington.edu">{{cite web |title=Naturopathic medicine |url=http://www.fammed.washington.edu/predoctoral/CAM/images/naturopathy.pdf |format=PDF |date=21 October 2004}}</ref> In Connecticut and Washington, state law requires insurance providers to provide some coverage of naturopathic services, while Oregon, another state with significant numbers of naturopathic doctors, does not.<ref name="fammed.washington.edu"/>
Naturopathic doctors are licensed in the state of Washington.<ref>{{cite web |title= Revised Code of Washington: Title 18, Chapter 18.36A: Naturopathy |url= http://apps.leg.wa.gov/RCW/default.aspx?cite=18.36A&full=true |publisher= Washington State Legislature |date= January 1, 1988 (effective) |accessdate= 2009-09-22}}</ref>


=== Traditional naturopaths ===
=== Traditional naturopaths ===
Traditional naturopaths are those who have not graduated from accredited naturopathic medical colleges and are not eligible to obtain a license to practice naturopathic medicine.<ref>{{cite web |title= Eligibility Requirements |url= http://www.nabne.org/nabne_page_4.php |deadurl=yes |work= North American Board of Naturopathic Examiners website |accessdate= 2012-07-11 |archivedate= 2012-08-20}}</ref> In licensed states they are not permitted to refer to themselves as NDs or NMDs. They are represented in the United States by national organizations, including the American Naturopathic Association (ANA) founded in 1919 by Benedict Lust,<ref name= DC_Incorp>American Naturopathic Association Certificate of Incorporation and Standing, Issued by the D.C. Department of Consumer Affairs, Corporate Division.</ref>{{Verify source|date=November 2010}}<ref name=Gale_Frey/> representing about 1,800 practitioners <ref name="Swartout(Firm)2006">{{cite book|editor1-last=Swartout|editor1-first=Kristy A.|author2=Thomson Gale (Firm)|title=Encyclopedia of Associations|url=http://books.google.com/books?id=Wf6PPHSMD4IC|accessdate=2013-09-04|year=2006|publisher=Thomson Gale|isbn=9780787682866|pages=1777–1778}}</ref> and the American Naturopathic Medical Association (ANMA).<ref>{{cite web |url= http://anma.org/ |title= American Naturopathic Medical Association |work= American Naturopathic Medical Associaton website |publisher= <!-- redundant to website name --> |author= <!-- no byline --> |date= <!-- no date in source -->}}{{Self-published source|date=September 2013}}</ref>{{Self-published inline|date=September 2013}}
Traditional naturopaths are those who have not graduated from accredited naturopathic medical colleges and are not eligible to obtain a license to practice naturopathic medicine.<ref>{{cite web |url=http://www.nabne.org/nabne_page_4.php |title=NABNE - Eligibility Requirements |publisher==North American Board of Naturopathic Examiners |accessdate=July 11, 2012}}</ref> In licensed states they are not permitted to refer to themselves as NDs or NMDs. They are represented in the United States by two national organizations, the American Naturopathic Association (ANA) founded in 1919 by Benedict Lust,<ref>American Naturopathic Association Certificate of Incorporation and Standing, Issued by the D.C. Department of Consumer Affairs, Corporate Division.</ref>{{Verify source|date=November 2010}}<ref>Boughton, Barbara, and Rebecca J. Frey. "Naturopathic Medicine." ''The Gale Encyclopedia of Alternative Medicine.'' Ed. Laurie J. Fundukian. 3rd ed. Vol. 3. Detroit: Gale, 2009. 1577-1581. ''Gale Virtual Reference Library.'' Web. 21 Dec. 2011.
</ref> representing about 5,000 practitioners,<ref>The Encyclopedia of associations: 40th edition pp 1594</ref>{{Verify source|date=February 2010}} and the American Naturopathic Medical Association (ANMA), founded in 1981 and representing about 4,000 practitioners, with several levels of certification.<ref>[http://anma.org/ American Naturopathic Medical Association]</ref> The ANMA also recognizes MDs, DOs, and other medical professionals who have integrated naturopathy into their practices.


The level of naturopathic training varies among traditional naturopaths in the United States. Traditional naturopaths may complete non-degree certificate programs or undergraduate degree programs and generally refer to themselves as Naturopathic Consultants. These programs are often online "degrees" and offer no biomedical education as well as no clinical training. Those completing a Doctor of Naturopathy (ND) degree from an ANMCB approved school can become a Board Certified Naturopathic Doctor.<ref name="ANMCB">{{cite web |url= http://www.anmcb.org |title= American Naturopathic Medical Certification Board |work= American Naturopathic Medical Certification Board website |accessdate= 2010-03-12 |publisher= <!-- redundant to website name --> |date= <!-- no date in source --> |author= <!-- no byline -->}}{{Self-published source|date=September 2013}}</ref>{{Self-published inline|date=September 2013}}<ref>{{cite book |first= Paul |last= Wendel |title= Standardized Naturopathy |year= 1951 |location= Brooklyn, NY |publisher= Wendel |oclc= 6617124}}{{Self-published source|date=September 2013}}</ref>{{Self-published inline|date=September 2013}} This board certification is in no way the same as holding an ND license and holds no weight in states that regulate the practice of naturopathic medicine.
The level of naturopathic training varies among traditional naturopaths in the United States. Traditional naturopaths may complete non-degree certificate programs or undergraduate degree programs and can certify at a practitioner level with the American Naturopathic Medical Certification Board (ANMCB) and generally refer to themselves as Naturopathic Consultants.<ref name="ANMCB">{{cite web |url=http://www.anmcb.org |title=American Naturopathic Medical Certification Board |publisher==American Naturopathic Medical Certification Board |accessdate=March 12, 2010}}</ref> These programs are often online "degrees" and offer no biomedical education as well as no clinical training. Those completing a Doctor of Naturopathy (ND) degree from an ANMCB approved school can become a Board Certified Naturopathic Doctor.<ref name="ANMCB" /><ref>{{cite book |author=Paul Wendel |title=Standardized Naturopathy |year=1951 |location=Brooklyn |publisher=Wendel |oclc=6617124}}</ref> Physicians with supplemental training in Naturopathy can become National Board Certified Naturopathic Physicians through the ANMCAB.<ref name="ANMCB" /> This board certification is in no way the same as holding an ND license and holds no weight in states that regulate the practice of naturopathic medicine.


Traditional naturopathy as defined by the profession and the U.S. Congress in the early twentieth century<ref>"The Healing Arts Practice Act, District of Columbia 1928." Chap. 352 @ 1326, 5.3936, Public Law 831 [also found as 45 St. 1339] dated February 27, 1929 and its clarifying amendments H.R. 12169 of May 5, 1930 & January 28, 1931 and corresponding House Report #2432 of January 30, 1930.</ref>{{verify source|date=September 2013}} does not require a license in the United States.<ref>{{cite court |litigants= Lawton v. Steele |vol= 152 |reporter= U.S. |opinion= 133 |date= 1894 |url= http://scholar.google.com/scholar_case?case=7077533481738997304&hl=en&as_sdt=2&as_vis=1&oi=scholarr}}</ref>{{Failed verification|date=September 2013}} Traditional naturopaths are not permitted to practice as NDs or NMDs in the 17 states where naturopathic medicine is regulated.<ref>{{cite web |url= http://www.cnme.org/programs.html |title= Accredited Schools |work= Council on Naturopathic Medical Education website |publisher= <!-- redundant to website name --> |accessdate= 2012-07-11}}</ref>{{Failed verification|date=September 2013}}
Traditional naturopathy does not require a license in the U.S., though use of the titles ND and NMD is regulated.<ref>Chap. 352 @ 1326, 5.3936, Public No. 831 [also found as 45 St. 1339] dated February 27, 1929 and its clarifying amendments H.R. 12169 of May 5, 1930 & January 28, 1931 and corresponding House Report #2432 of January 30, 1930.</ref><ref>''Lawton v. Steele'', 152 U.S. 133 (1894)</ref>{{Verify source|date=November 2010}} Traditional naturopaths, because they have not received comprehensive naturopathic medical training, as defined by the Council on Naturopathic Medical Education, are not permitted to practice as NDs or NMDs in the 17 licensed states where naturopathic medicine is regulated.<ref>{{cite web |url=http://www.cnme.org/programs.html |title=Council on Naturopathic Medical Education: Accredited Schools |publisher==Council on Naturopathic Medical Education |accessdate=July 11, 2012}}</ref>


==== Other health care professionals ====
==== Other health care professionals ====
Texas has begun establishing practice guidelines for MDs who integrate alternative and complementary medicine into their practice.<ref>{{cite web |work= Texas Administrative Code, Title 22, Part 9, Chapter 200, Rule 200.3, |title= Practice Guidelines for the Provision of Complementary and Alternative Medicine |date= November 22, 1998 (effective) |publisher= Secretary of State, Texas |url= http://info.sos.state.tx.us/pls/pub/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=22&pt=9&ch=200&rl=3 }}</ref> Continuing education in naturopathic modalities for health care professionals varies greatly but includes offerings for many professions, including [[physician]]s, [[physical therapy|physical therapists]], [[chiropractor]]s, [[acupuncture|acupuncturists]], [[dentistry|dentists]], [[Doctor of Philosophy|researchers]], [[veterinarian]]s, [[physician assistant]]s, and [[Registered Nurses|nurses]].<ref name=PoaP/>
According to a 1998 task force report, some physicians are choosing to add naturopathic modalities to their practice,<ref>{{cite web |url=http://www.futurehealth.ucsf.edu/pdf_files/RTF.PDF |format=PDF |author=Finocchio LJ, Dower CM, Blick NT, Gragnola CM and the Taskforce on Health Care Workforce Regulation |title=Strengthening Consumer Protection: Priorities for Health Care Workforce Regulation |publisher=Pew Health Professions Commission |location=San Francisco |year=1998 |month=October |accessdate=2009-04-01}}</ref> and states such as Texas have begun to establish practice guidelines for MDs who integrate alternative and complementary medicine into their practice.<ref>Texas Administrative Code title 22, part 9 § 200.3, 1998</ref> Continuing education in naturopathic modalities for health care professionals varies greatly but includes offerings for many professions, including [[physician]]s, [[physical therapy|physical therapists]], [[chiropractor]]s, [[acupuncture|acupuncturists]], [[dentistry|dentists]], [[Doctor of Philosophy|researchers]], [[veterinarian]]s, [[physician assistant]]s, and [[Registered Nurses|nurses]].<ref>{{cite web |url=http://www.futurehealth.ucsf.edu/pdf_files/Naturo2.pdf |format=PDF |author=Hough HJ, Dower C, O’Neil EH |title=Profile of a profession: naturopathic practice |publisher=Center for the Health Professions, University of California, San Francisco |location=San Francisco |year=2001 |month=September |doi= |pmid= |accessdate=2009-04-21 }}</ref> These professionals usually retain their original designation but may use terms such as "holistic", "natural", or "integrative" to describe their practice. The American Naturopathic Medical Association (ANMA) and American Naturopathic Medical Certification and Accreditation Board (ANMCAB) has recognition and certification programs for [[Doctors of Medicine]] (M.D.) and [[Doctors of Osteopathic Medicine]] (D.O.) who have supplemented their education with naturopathic studies and integrate naturopathy into their practice.<ref name="ANMCB" />


== Regulation ==
== Regulation ==
Naturopathy is practiced in many countries, primarily the United States and Canada, and is subject to different standards of regulation and levels of acceptance. The scope of practice varies widely between jurisdictions, and naturopaths in some unregulated jurisdictions may use the Naturopathic Doctor designation or other titles regardless of level of education.<ref name="IMB_policy" /> The practice of naturopathy is illegal in two states.<ref name= "SC Code"/><ref name= "TN Code"/><ref name=AMA_report_2006 />
Naturopathy is practiced in many countries, primarily the United States and Canada, and is subject to different standards of regulation and levels of acceptance. The scope of practice varies widely between jurisdictions, and naturopaths in some unregulated jurisdictions may use the Naturopathic Doctor designation or other titles regardless of level of education.<ref name="IMB_policy" />


=== North America ===
=== North America ===
In five Canadian provinces, seventeen U.S. states, and the [[District of Columbia]], naturopathic doctors who are trained at an [[naturopathic medical school in North America|accredited school of naturopathic medicine]] in North America, are entitled to use the designation ND or NMD. Elsewhere, the designations "naturopath", "naturopathic doctor", and "doctor of natural medicine" are generally unprotected or prohibited.<ref name="IMB_policy" /><ref name=AMA_report_2006 />
In five Canadian provinces, seventeen U.S. states, and the [[District of Columbia]], [[Doctor of Naturopathic Medicine|naturopathic doctors]] who are trained at an [[naturopathic medical school in North America|accredited school of naturopathic medicine]] in North America, are entitled to use the designation ND or NMD. Elsewhere, the designations "naturopath", "naturopathic doctor", and "doctor of natural medicine" are generally unprotected.<ref name="IMB_policy" />


In North America, each jurisdiction that regulates naturopathy defines a local scope of practice for naturopathic doctors that can vary considerably. Some regions permit minor surgery, access to prescription drugs, spinal manipulations, obstetrics and gynecology and other regions exclude these from the naturopathic scope of practice or prohibit the practice of naturopathy entirely.<ref name=AMA_report_2006 /><ref name="Sunrise-2008">{{cite web|url=http://www.dora.state.co.us/OPR/archive/2008NaturopathicPhysiciansSunrise.pdf |deadurl= yes |archivedate= 2008-10-02 |archiveurl= http://web.archive.org/web/20081002001141/http://www.dora.state.co.us/opr/archive/2008NaturopathicPhysiciansSunrise.pdf |date= January 4, 2008 |title=2008 Sunrise Review: Naturopathic Physicians |pages=18–19 |author= Office of Policy, Research and Regulatory Reform, Department of Regulatory Agencies, State of Colorado |publisher= <!-- redundant to author State of Colorado -->}}</ref>
In North America, each jurisdiction that regulates naturopathy defines a local scope of practice for naturopathic doctors that can vary considerably. Some regions permit minor surgery, access to prescription drugs, spinal manipulations, obstetrics and gynecology and other regions exclude these from the naturopathic scope of practice.<ref name="Sunrise-2008">{{cite web|url=http://www.dora.state.co.us/OPR/archive/2008NaturopathicPhysiciansSunrise.pdf |format=PDF |year=2008 |title=Sunrise Review: Naturopathic Physicians |page=19 |publisher=State of Colorado |accessdate= |pmid= |doi= }}</ref>


==== Canada ====
==== Canada ====
Several Canadian provinces license naturopathic doctors: [[British Columbia]], [[Alberta]], [[Ontario]], and [[Saskatchewan]].<ref>{{cite web |url= http://www.cand.ca/index.php?40 |title= Questions: Education and Regulation |accessdate= 2013-09-06 |work= Canadian Association of Naturopathic Doctors website |publisher= <!-- redundant to website name --> |author= <!-- no byline --> |date= <!-- no date in source -->}}</ref> British Columbia has regulated naturopathic medicine since 1936 and together with Ontario (since 2009) are the only two Canadian provinces that allow certified NDs to prescribe pharmaceuticals and perform minor surgeries.<ref>{{cite news |title= B.C. gives naturopaths right to prescribe drugs |url= http://www.cbc.ca/news/health/story/2009/04/10/bc-naturopaths.html |date= April 10, 2009 |author= <!-- no byline CBC News staff --> |work= [[CBC News]]}}</ref>
Several Canadian provinces license naturopathic doctors: [[British Columbia]], [[Alberta]], [[Manitoba]], [[Ontario]], and [[Saskatchewan]].<ref>[http://www.cand.ca/index.php?40 Canadian Association of Naturopathic Doctors]</ref> British Columbia has regulated naturopathic medicine since 1936 and together with Ontario (since 2009) are the only two Canadian provinces that allow certified NDs to prescribe pharmaceuticals and perform minor surgeries.<ref>[http://www.cbc.ca/health/story/2009/04/10/bc-naturopaths.html CBC News - B.C. gives naturopaths right to prescribe drugs]</ref>

The province of Quebec does not directly regulate naturopathy. The Quebec Ministry of Education has prohibited schools from offering doctoral programs in the subject, and there are no universities with a naturopath program. Therefore, studies must be done out of province. Furthermore, in Quebec, the [[Collège des médecins du Québec]] (CMQ) has exclusive rights to perform certain activities including but not limited to: ordering diagnostic examinations, prescribing medication and other substances and clinically monitoring the condition of patients whose state of health presents risks. This severely restrains the scope of practice for a naturopathic doctor.<ref>{{cite web |title= Illegal practice of medicine
|url= http://www.cmq.org/en/Public/Profil/Commun/AProposOrdre/ProcessusDisciplinaire/Enquetes/ExerciceIllegal.aspx |work= Collège des médecins du Québec website |date= 2009 <!-- date of copyright for website -->|author= <!-- no byline --> |publisher= <!-- redundant to website name -->}}</ref>

In Quebec, group benefits insurance is mandatory if offered by the employer, and coverage for a naturopathic doctor is typically included in these policies. As a result of the limitations (scope of practice, title, education) in Quebec concerning naturopathic doctors, the term naturotherapy has been accepted by some insurance carriers.<ref>{{cite web |title= Welcome |url= http://www.anpq.qc.ca/index.php?option=com_content&view=article&id=110%3Adefinition&catid=35&Itemid=82&lang=en |work= Association des Naturothérapeutes du Québec website}}</ref>{{Failed verification|date=September 2013}}<ref>{{cite web |title= Naturopathie - Présentation |url= http://www.passeportsante.net/fr/Therapies/Guide/Fiche.aspx?doc=naturopathie_th |work= PasseportSanté.net website |publisher= |date= |language= French |accessdate= }}</ref>{{Verify source|date=September 2013}}

The minimum requirement for a naturotherapist is usually between 400 or 800 hours of study.<ref>{{cite web |url= http://www.association.quebec.aqtn.ca/description_of_therapies.php#natural_therapy |title= Description of Represented Therapies |work= Alliance Québécoise des Thérapeutes Naturels website |date= <!-- no date in source --> |author= <!-- no byline --> |publisher= <!-- redundant to website name --> }}{{Self-published source|date=September 2013}}</ref>{{Self-published inline|date=September 2013}}

[[Medavie Blue Cross]] is an insurance provider, and listed ten associations it accepted as naturopathic providers for compensation and thirty it refuses to pay in a contract document with Syndicat des employés de métiers d'Hydro-Québec published on March 20, 2013.<ref>{{cite web |url= http://www.scfp1500.org/pdf/comites/avantages-sociaux/paramedicaux20032013.pdf |title= Régime D’assurance Maladie et Hospitalisation et Santé D’hydro-Québec |date= March 20, 2013 |publisher= Syndicat des employés de métiers d'Hydro-Québec |language= French}}</ref>


====United States====
====United States====
* U.S. jurisdictions that currently regulate or license naturopathy include: [[Alaska]], [[Arizona]], [[California]] (see [[California Bureau of Naturopathic Medicine]]), [[Connecticut]], [[Colorado]], [[District of Columbia]], [[Hawaii]], [[Idaho]], [[Kansas]], [[Maine]], [[Minnesota]], [[Montana]], [[New Hampshire]], [[North Dakota]], [[Oregon]], [[Puerto Rico]],<ref>{{cite web |url=http://www.oslpr.org/download/ES/1997/208s0783.pdf |title=Ley para Reglamentar el Ejercicio de la Medicina Naturopática en Puerto Rico [Law to Regulate the Practice of Naturopathic Medicine in Puerto Rico] |language=Spanish |date= December 30, 1997 |deadurl= yes |archiveurl= http://web.archive.org/web/20081002072926/http://www.oslpr.org/download/ES/1997/208s0783.pdf |archivedate= 2008-10-02}}</ref> [[US Virgin Islands]], [[Utah]], [[Vermont]], and [[Washington (U.S. state)|Washington]].<ref name="LicState"/> Additionally, [[Florida]] and [[Virginia]] license the practice of naturopathy under a [[grandfather clause]].<ref name=AMA_report_2006>{{cite web |authorlink= American Medical Association | title= Reports of the Board of Trustees |chapter= 2. Licensure of Naturopaths |year= 2006 |month= November |author= Board of Trustees, American Medical Association |url= http://www.ama-assn.org/ama1/pub/upload/mm/38/i-06bot.pdf |publisher= American Medical Association |pages= 25–28 | accessdate = 2009-03-19 }}</ref>
* U.S. jurisdictions that currently regulate or license naturopathy include: [[Alaska]], [[Arizona]], [[California]] (see [[California Bureau of Naturopathic Medicine]]), [[Connecticut]], [[Colorado]], [[District of Columbia]], [[Hawaii]], [[Idaho]], [[Kansas]], [[Maine]], [[Minnesota]], [[Montana]], [[New Hampshire]], [[North Dakota]], [[Oregon]], [[Puerto Rico]],<ref>{{cite web |url=http://www.oslpr.org/download/ES/1997/208s0783.pdf |format=PDF |title=Ley para Reglamentar el Ejercicio de la Medicina Naturopática en Puerto Rico [Law to Regulate the Practice of Naturopathic Medicine in Puerto Rico] |language=Spanish |date=30 December 1997}}</ref> [[US Virgin Islands]], [[Utah]], [[Vermont]], and [[Washington (U.S. state)|Washington]].<ref name="AANP_licensed">{{cite web |url=http://www.naturopathic.org/content.asp?contentid=57 |title=Licensed States & Licensing Authorities |publisher= [[American Association of Naturopathic Physicians]] |accessdate=2010-10-06}}</ref> Additionally, [[Florida]] and [[Virginia]] license the practice of naturopathy under a [[grandfather clause]].<ref name=AMA_report_2006>{{cite news | first= | last= | coauthors= |authorlink= | title=Reports to the Board of Trustees | date=2006-11 | publisher=[[American Medical Association]] | url =http://www.ama-assn.org/ama1/pub/upload/mm/38/i-06bot.pdf |format=PDF| work = | pages = | accessdate = 2009-03-19 | language = }}</ref>
:* U.S. jurisdictions that permit access to prescription drugs: [[Arizona]], [[California]], [[District of Columbia]], [[Hawaii]], [[Idaho]], [[Kansas]], [[Maine]], [[Montana]], [[New Hampshire]], [[Oregon]], [[Utah]], [[Vermont]], and [[Washington (U.S. state)|Washington]].
:* U.S. jurisdictions that permit access to prescription drugs: [[Arizona]], [[California]], [[District of Columbia]], [[Hawaii]], [[Idaho]], [[Kansas]], [[Maine]], [[Montana]], [[New Hampshire]], [[Oregon]], [[Utah]], [[Vermont]], and [[Washington (U.S. state)|Washington]].
:* U.S. jurisdictions that permit minor surgery: [[Arizona]], [[District of Columbia]], [[Idaho]], [[Kansas]], [[Maine]], [[Montana]], [[Oregon]], [[Utah]], [[Vermont]], and [[Washington (U.S. state)|Washington]].
:* U.S. jurisdictions that permit minor surgery: [[Arizona]], [[District of Columbia]], [[Idaho]], [[Kansas]], [[Maine]], [[Montana]], [[Oregon]], [[Utah]], [[Vermont]], and [[Washington (U.S. state)|Washington]].
*U.S. states which specifically prohibit the practice of naturopathy: [[South Carolina]],<ref name= "SC Code">{{cite web |url= http://www.scstatehouse.gov/code/t40c031.htm |work= South Carolina Code of Laws (Unannotated), Current through the end of the 2007 Regular Session |title= Title 40, Chapter 31, Sections 10 & 20 |deadurl= yes |archiveurl= http://web.archive.org/web/20090112214025/http://www.scstatehouse.gov/code/t40c031.htm |archivedate= 2009-01-12 |publisher= South Carolina Legislative Council}}</ref><ref name=AMA_report_2006 /> and [[Tennessee]].<ref name= "TN Code">{{citation |chapter-url= http://web.lexisnexis.com/research/xlink?app=00075&view=full&interface=1&docinfo=off&searchtype=get&search=Tenn.+Code+Ann.+%A7+63-6-205 |chapter=
*U.S. states which specifically prohibit the practice of naturopathy: [[South Carolina]],<ref name=AMA_report_2006 /><ref>{{cite web|url=http://www.scstatehouse.net/code/t40c031.htm|title=South Carolina Code of Laws Section 40-31-10}}</ref> and [[Tennessee]].<ref name=AMA_report_2006 /><ref>{{cite web|url=http://www.michie.com/tennessee/lpext.dll/tncode/257b9/25b48/25b6e/25ba9?f=templates&fn=document-frame.htm&2.0#JD_63-6-205 |title=Tennessee Code 63-6-205 |publisher=Tennessee State Legislature |date= |accessdate= |doi= }}</ref>
63.6.205 Practice of naturopathy |title= Title 63 Professions of the Healing Arts, Chapter 6 Medicine and Surgery, Part 2 General Provisions |work= Tennessee Code Annotated |author= State of Tennessee |publisher= [[LexisNexis]] |year= 2013 |accessdate= 2013-09-07}}</ref><ref name=AMA_report_2006 />


[[Doctor of Naturopathic Medicine|Naturopathic doctors]] are not mandated to undergo [[residency (medicine)|residency]] between graduation and commencing practice,<ref name=ACS /> except in the state of Utah.<ref name= "UT license app">{{cite web |url= http://www.dopl.utah.gov/licensing/forms/applications/072_naturopathic_phys.pdf |title= Application for Licensure: Naturopathic Physician |author= Division of Occupational and Professional Licensing, Utah Department of Commerce, State of Utah |date= February 17, 2012 |page= 1 |accessdate= 2013-09-08}}</ref>
Like D.O. and P.A. programs, clincial work is mandated as a part of training by certified programs. [[Doctor of Naturopathic Medicine|Naturopathic doctors]] are not mandated to undergo [[residency (medicine)|residency]] per say between graduation and commencing practice,<ref name=ACS /> except in the state of Utah.<ref>{{cite web|url=http://www.dopl.utah.gov/licensing/forms/applications/072_naturopathic_phys.pdf
|format=PDF
|title=Application for licensure : naturopathic physician
|publisher=State of Utah Division of Occupational and Professional Licensing
}}</ref>


=== Australia ===
=== Australia ===
Currently the industry is self-regulated. There is no protection of title, meaning that technically anyone can practise as a naturopath. The only way to obtain [[insurance]] for professional [[indemnity]] or public [[liability insurance|liability]] is by joining a [[professional body|professional association]], which can only be achieved by having completed an [[School accreditation|accredited]] course and gaining [[professional certification]]. From mid-2013 the Australian Register of Naturopaths and Herbalists is to provide a database of accredited and educated practitioners of Naturopathy.<ref>[http://www.aronah.org/ Australian Register of Natural Therapists]</ref>
Currently the industry is self-regulated. There is no protection of title, meaning that technically anyone can practice as a naturopath.


In 1977 a committee reviewed all colleges of naturopathy in Australia and found that, although the syllabuses of many colleges were reasonable in their coverage of basic biomedical sciences on paper, the actual instruction bore little relationship to the documented course. In no case was any practical work of consequence available. The lectures which were attended by the committee varied from the dictation of textbook material to a slow, but reasonably methodical, exposition of the terminology of medical sciences, at a level of dictionary definitions, without the benefit of depth or the understanding of mechanisms or the broader significance of the concepts. The committee did not see any significant teaching of the various therapeutic approaches favoured by naturopaths. People reported to be particularly interested in homoeopathy, Bach's floral remedies or mineral salts were interviewed, but no systematic courses in the choice and use of these therapies were seen in the various colleges. The committee were left with the impression that the choice of therapeutic regime was based on the general whim of the naturopath and, since the suggested applications in the various textbooks and dispensations overlap to an enormous extent, no specific indications are or can be taught.<ref name=Aust1977 />
In 1977 a committee reviewed all colleges of naturopathy in Australia and found that, although the syllabuses of many colleges were reasonable in their coverage of basic biomedical sciences on paper, the actual instruction bore little relationship to the documented course. In no case was any practical work of consequence available. The lectures which were attended by the committee varied from the dictation of textbook material to a slow, but reasonably methodical, exposition of the terminology of medical sciences, at a level of dictionary definitions, without the benefit of depth or the understanding of mechanisms or the broader significance of the concepts. The committee did not see any significant teaching of the various therapeutic approaches favoured by naturopaths. People reported to be particularly interested in homoeopathy, Bach's floral remedies or mineral salts were interviewed, but no systematic courses in the choice and use of these therapies were seen in the various colleges. The committee were left with the impression that the choice of therapeutic regime was based on the general whim of the naturopath and, since the suggested applications in the various textbooks and dispensations overlap to an enormous extent, no specific indications are or can be taught.<ref name=Aust1977 />


=== India ===
=== India ===
In India there is a 5½-year degree course offering a "Bachelor of Naturopathy and Yogic Sciences" (BNYS) degree. The first college of naturopathy was started in [[Hyderabad, Andhra Pradesh]] by B. Venkatrao which offered a Diploma in Naturopathy (ND). There are a total of fifteen naturopathy colleges in [[India]].<ref>{{cite web |author= No author given |date= ''nd'' |url= http://www.punenin.org/attach/BNYS.pdf |publisher= Hosted on the National Institute of Naturopathy website (Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy, Ministry of Health and Family Welfare, Government of India) |accessdate= 2013-09-08 |title= BNYS (list of colleges with university affiliation / government recognition)}}{{Self-published source|date=September 2013}}</ref>{{Self-published inline|date=December 2012}}
In India there is a 5½-year degree course offering a "Bachelor of Naturopathy and Yogic Sciences" (BNYS) degree. The first college of naturopathy was started in [[Hyderabad, Andhra Pradesh]] by B. Venkatrao which offered a Diploma in Naturopathy (ND) and 3½-year "Diploma in Naturopathic Medicine & Yogic Science" (DNYS) run by [[Akhil Bhartiya Prakritik Chikitsa Parishad]], New Delhi, but now has a full-time residential degree course. There are a total of fifteen naturopathy colleges in [[India]].<ref>{{cite web|url=http://www.punenin.org/attach/BNYS.pdf |title=Institutions conducting 5 or 5-1/2 years B.N.Y.S. degree course |publisher=National Institute of Naturopathy |date= |accessdate=2013-05-08}}</ref>{{Self-published inline|date=December 2012}}


Naturopathy and Yoga, as an Indian system of medicine, falls under the Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy ([[AYUSH]]), Ministry of Health & Family Welfare, Government of India.<ref name="AYUSH">{{cite web |url= http://www.indianmedicine.nic.in/ |title= Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) website, (Ministry of Health & Family Welfare, Government of India) |date= <!-- no date in source --> |publisher= <!-- redundant to website title --> |author= <!-- no author in source -->}}</ref>{{Failed verification|date=September 2013}}<!-- probably available somewhere on website not on this page, implied by name -->
Naturopathy and Yoga, as an Indian system of medicine, falls under the Department of [[AYUSH]], Ministry of Health & Family Welfare, Government of India.<ref name="AYUSH">[http://www.indianmedicine.nic.in/ Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH)]</ref>


The Indian government established the "Central Council for Research in Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy” in 1969 as an autonomous organization under the Ministry of Health and Family Welfare. This organization was tasked to conduct scientific research into those branches of alternative medicine, until 1978. During this period, the development of Naturopathy was looked after by the Ministry of Health & Family Welfare directly. In March 1978 the composite council was dissolved and replaced by four independent research councils, one each for Ayurveda and Siddha, Unani, homoeopathy and yoga and naturopathy.<ref>{{cite web|url=http://www.findnd.com/regulation/67-india/112-central-council-for-research-in-yoga-and-naturopathy-.html |title=Central Council for Research in Yoga and Naturopathy |publisher=Findnd.com |date= |accessdate=2009-09-22}}</ref>{{Self-published inline|date=December 2012}}
The National Institute of Naturopathy in [[Pune]] was established on December 22, 1986. It encourages facilities for standardization and propagation of the existing knowledge and its application through research in naturopathy throughout India. This institute has a governing body, with the Union Minister for Health as its president.<ref>{{cite web |url= http://www.punenin.org/ |title= National Institute of Naturopathy website (Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy, Ministry of Health & Family Welfare, Government of India)}}</ref>{{Failed verification|date=September 2013}}<!-- probably available somewhere on website not on this page -->

The National Institute of Naturopathy in [[Pune]] was established on 22 December 1986. It encourages facilities for standardization and propagation of the existing knowledge and its application through research in naturopathy throughout India. This institute has a governing body, with the Union Minister for Health as its president.<ref>[http://www.punenin.org/ National Institute of Naturopathy, Pune]</ref>


=== United Kingdom ===
=== United Kingdom ===
Naturopathy is not regulated in the [[United Kingdom]]. In 2012, publicly funded universities in the United Kingdom dropped their alternative medicine programs, including naturopathy.<ref>{{cite news |last= Bevanger |first= Lars |title= UK universities drop alternative medicine degree programs |url= http://www.dw-world.de/dw/article/0,,15673133,00.html |accessdate= 2012-02-05 |newspaper= [[Deutsche Welle]]|date= January 18, 2012}}</ref>
Naturopathy is not regulated in the [[United Kingdom]]. The largest registering body, the General Council & Register of Naturopaths, recognises only two courses in the UK, being taught at osteopathic schools: the [[British College of Osteopathic Medicine]] and The [[College of Osteopaths Educational Trust]].{{Citation needed|date=July 2008}} In 2012, publicly funded universities in the United Kingdom dropped their alternative medicine programs, including naturopathy.<ref>{{cite news|last=Bevanger|first=Lars|title=UK universities drop alternative medicine degree programs|url=http://www.dw-world.de/dw/article/0,,15673133,00.html|accessdate=February 5, 2012|newspaper=Deutsche Welle|date=January 18, 2012}}</ref>

There are also the ''Association of Naturopathic Practitioners'', ''The British Naturopathic Association'', and ''Incorporated Society of Registered Naturopaths''.{{Citation needed|date=February 2012}}

== Critisms ==

Some of the ideology and methodological underpinnings of naturopathy are in conflict with the paradigm of [[evidence-based medicine]] (EBM).<ref name=Naturo2006/> Many naturopaths have opposed [[vaccination]] based in part on the early views that shaped the profession.<ref name=Ernst-2001/> According to the [[American Cancer Society]], "scientific evidence does not support claims that naturopathic medicine can cure [[cancer]] or any other disease, since virtually no studies on naturopathy as a whole have been published".<ref name=ACS/><ref name=Naturo2006/>

To the extent of naturopathy's isolation from scientific discourse, members of the medical community have raised concerns.<ref name="Beck T"/> <ref name=NCAHF_np /><ref name=Herbert1994>{{cite book |author=Herbert Victor, Barrett Stephen |title=The vitamin pushers: how the "health food" industry is selling America a bill of goods |publisher=Prometheus Books |location=Buffalo, New York |year=1994 |pages= |isbn=0-87975-909-7 |oclc= |doi= |accessdate=}}</ref><ref name="isbn0-87975-761-2">{{cite book |author=Barrett, Stephen; Raso, Jack |title=Mystical diets: paranormal, spiritual, and occult nutrition practices |publisher=Prometheus Books |location=Buffalo, New York |year=1993 |pages= |isbn=0-87975-761-2 |oclc= |doi= |accessdate=}}</ref> The effectiveness of naturopathy as a whole system has not been systematically evaluated, and efficacy of individual methods used varies.<ref name=ACS /><ref name=ToT_Ernst>{{cite book |author2=Ernst E|author2-link=Edzard Ernst|author1=Singh S |title=Trick or treatment : the undeniable facts about alternative medicine |publisher=W. W. Norton |location=New York |year=2008 |pages= |isbn=0-393-06661-4 |oclc=181139440}}</ref>
Unproven, disproven, and controversial [[alternative medicine|alternative medical]] treatments, and [[vitalism|vitalism]] are several sources of critism.<ref name=McKnight2009>{{cite news
|first=P |last=McKnight |title=Naturopathy's main article of faith cannot be validated; Reliance on vital forces leaves its practises based on beliefs without scientific backing |date=2009-03-07 |url=http://www.vancouversun.com/story_print.html?id=1364389 |newspaper=[[Vancouver Sun]] |page=C5 |edition=final |accessdate=2009-03-21 }}{{Dead link|date=September 2010|bot=H3llBot}}<!-- available for purchase via Infomart - http://www.fpinfomart.ca/ as of Feb 2013 --></ref> Nevertheless, there are growing collaborative efforts between naturopaths and [[medical doctor]]s to evaluate the safety and efficacy of naturopathic medicine in prevention and management of a broad range of common ailments, and to decide whether accessibility of naturopathic services will enhance patient health in a [[cost-effective]] way.<ref>{{cite journal |journal=Journal of Family Practice|year=2005 |volume=54 |issue=12 |pages=1067–72 |title=Naturopathic medicine: what can patients expect?|author=Dunne N., Benda W., Kim L., Mittman P., Barrett R., Snider P., Pizzorno J.|url=http://www.jfponline.com/Pages.asp?AID=3698 |doi= |pmid=16321345}}</ref> To the extent that naturopathy offers verifiable results for specific conditions, greater scientific knowledge of the mechanisms of those naturopathic protocols could result in improved therapy models.<ref name="Beck T">{{cite journal |journal=Forsch Komplementarmed Klass Naturheilkd |year=2001 |volume=8 |issue=1 |pages=24–32 |title=[On the general basis of naturopathy and complementary medicine]|author=Beck T.|doi= |pmid=11340311}}</ref> Some naturopathic physicians have begun to contribute to research and adapt modern scientific principles into clinical practice.<ref name="Smith MJ, Logan AC 2002 173–84">{{cite journal |journal=Med Clin North Am |year=2002 |volume=86 |issue=1 |pages=173–84 |title=Naturopathy|author=Smith MJ, Logan AC |doi= 10.1016/S0025-7125(03)00079-8|pmid=11795088}}</ref><ref name=Gale_Frey /><ref name=atwood2004 /> Certain naturopathic treatments offered by [[Naturopathy#Practitioners|traditional naturopaths]], such as [[homeopathy]], [[rolfing]], and [[iridology]], are widely considered [[pseudoscience]] or [[quackery]].<ref name="NSBattitudes">
{{cite web
|author=National Science Board
|month=April
|year=2002
|title=Science and engineering indicators
|chapter=7
|chapter_title=Science and technology: public attitudes and public understanding
|url=http://www.nsf.gov/statistics/seind02/c7/c7s5.htm
|section_title=Science Fiction and Pseudoscience
|location=Arlington, Virginia
|publisher=National Science Foundation Directorate for Social, Behavioral and Economic Sciences
}}</ref><ref name="WahlbergQuack">
{{cite journal
|author=Wahlberg A
|year=2007
|doi=10.1016/j.socscimed.2007.07.024
|title=A quackery with a difference—new medical pluralism and the problem of 'dangerous practitioners' in the United Kingdom
|journal=Social Science & Medicine
|volume=65
|issue=11
|pages=2307–2316
|pmid=17719708
}}</ref><ref>
{{cite web
|url=http://www.quackwatch.com/01QuackeryRelatedTopics/iridology.html
|title=Iridology Is Nonsense
|accessdate=
}}, a web page with further references</ref>

[[Stephen Barrett]] of [[Quackwatch]] and [[the National Council Against Health Fraud]] has stated that Naturopathy is "simplistic and that its practices are riddled with quackery".<ref name=Barrett-Naturopathy /> "Non-scientific health care practitioners, including naturopaths, use unscientific methods and deception on a public who, lacking in-depth health care knowledge, must rely upon the assurance of providers. Quackery not only harms people, it undermines the ability to conduct scientific research and should be opposed by scientists", says William T. Jarvis.<ref name="Jarvis WT">{{cite journal |pmid=1643742 |year=1992 |month=August |last1=Jarvis |first1=WT |title=Quackery: a national scandal |volume=38 |issue=8B Pt 2 |pages=1574–86 |issn=0009-9147 |journal=Clinical chemistry}}</ref> "Natural" methods and chemicals are not necessarily safer or more effective than "artificial" or "synthetic" ones; any treatment capable of eliciting an effect may also have deleterious [[side effect]]s.<ref name=ACS /><ref name=Barrett-Naturopathy /><ref name=SkepDic_natural>
{{cite web
|url=http://skepdic.com/natural.html
|title=Natural
|accessdate=2009-03-21
|last=Carroll
|first=Robert
|work=[[The Skeptic's Dictionary]]
}}</ref><ref name=NCAHF_herb>{{cite web|url=http://www.ncahf.org/pp/herbal.html |title=NCAHF Position Paper on Over the Counter Herbal Remedies (1995) |accessdate=2009-04-17 |year=1995 |publisher=[[National Council Against Health Fraud]] }}</ref>


K. C. Atwood writes, in the journal ''Medscape General Medicine'', "Naturopathic physicians now claim to be primary care physicians proficient in the practice of both "conventional" and "natural" medicine. Their training, however, amounts to a small fraction of that of medical doctors who practice primary care. An examination of their literature, moreover, reveals that it is replete with pseudoscientific, ineffective, unethical, and potentially dangerous practices".<ref name=atwood2003 /> In another article, Atwood writes that "Physicians who consider naturopaths to be their colleagues thus find themselves in opposition to one of the fundamental ethical precepts of modern medicine. If naturopaths are not to be judged "nonscientific practitioners", the term has no useful meaning. An article by a physician exposing quackery, moreover, does not identify its author as "biased", but simply as fulfilling one of his ethical obligations as a physician.<ref name=atwood2004>{{cite journal|author=Atwood K. C. |date= March 26, 2004 |title=Naturopathy, pseudoscience, and medicine: myths and fallacies vs truth|journal=Medscape General Medicine|work=Medscape Gen Med |volume=6 |issue=1 |page=33 |pmid=15208545|pmc=1140750}}</ref>

According to [[Arnold S. Relman]], the ''Textbook of Natural Medicine'' is inadequate as a teaching tool, as it omits to mention or treat in detail many common ailments, improperly emphasizes treatments "not likely to be effective" over those that are, and promotes unproven herbal remedies at the expense of pharmaceuticals. He concludes that "the risks to many sick patients seeking care from the average naturopathic practitioner would far outweigh any possible benefits".<ref name=Relman_text>{{cite web |url=http://www.quackwatch.org/01QuackeryRelatedTopics/Naturopathy/relman1.html |title=Textbook of Natural Medicine |accessdate=2009-04-17 |last=Relman |first=Arnold S. |date=2001-01-09 |publisher=Quackwatch }}</ref>

Traditional naturopathic practitioners surveyed in Australia perceive EBM as an ideologic assault on their beliefs in vitalistic and holistic principles.<ref name=Naturo2006/> <ref name=Naturo2006/> <ref name=Naturo2006>{{cite journal |journal= J Altern Complement Med |year=2006 |volume=12 |issue=3 |pages=323–8 |title=Evidence-based medicine and naturopathy |author=Jagtenberg T., Evans S., Grant A., Howden I., Lewis M., Singer J.|doi= 10.1089/acm.2006.12.323 |pmid=16646733}}</ref>


==See also==
==See also==
{{Portal|Medicine}}
{{div col|3}}
{{div col|3}}
* [[Friedrich Eduard Bilz]]

* [[Arnold Ehret]]
* [[Arnold Ehret]]
* [[Essential nutrient]]
* [[Essential nutrient]]
* [[Friedrich Eduard Bilz]]
* [[Evidence Based Medicine]]
* [[Health freedom movement]]
* [[Health freedom movement]]
* [[Heilpraktiker]]
* [[Heilpraktiker]]
* [[Herbalism]]
* [[List of ineffective cancer treatments]]
* [[Holism]]
* [[Hydrotherapy]]
* [[Medicinal mushrooms]]
* [[Medicinal mushrooms]]
* [[Megavitamin therapy]]
* [[Megavitamin therapy]]
Line 147: Line 215:
* [[Osteopathy]] and [[osteopathic medicine]]
* [[Osteopathy]] and [[osteopathic medicine]]
* [[Phytonutrient]]
* [[Phytonutrient]]
* [[Whole medical system]]
{{div col end}}
{{div col end}}


Line 153: Line 222:


==External links==
==External links==
*[http://www.anma.org American Naturopathic Medical Association]
*[http://www.naturopathic.org American Association of Naturopathic Physicians]
*{{DMOZ|Health/Alternative/Naturopathy}}
*{{DMOZ|Health/Alternative/Naturopathy}}
*[http://www.futurehealth.ucsf.edu/pdf_files/Naturo2.pdf Profile of Profession: Naturopathic Practice PDF] (312 Kb) at UCSF Center for the Health Professions
*[http://www.cnme.org Council on Naturopathic Medical Education]
*[http://www.cnme.org Council on Naturopathic Medical Education]
*[http://www.naturopathicassoc.ca Canadian Association of Naturopathic Physicians]
*[http://www.naturaldatabase.com/(S(eqksko55xppvuhehdii3xn55))/home.aspx?cs=&s=ND Natural Medicines Comprehensive Database: Unbiased, Scientific Clinical Information on Complementary, Alternative, and Integrative Therapies]
*[http://www.wgfnms.com/index.asp World General Federation of Natural Medicine Societies (WGFNMS)]
*[http://www.wgfnms.com/index.asp World General Federation of Natural Medicine Societies (WGFNMS)]


{{Traditional Medicine}}
{{Traditional Medicine}}
{{Pseudoscience}}


[[Category:Alternative medical systems]]
[[Category:Alternative medical systems]]

Revision as of 17:59, 13 January 2014

Naturopathy, or naturopathic medicine, is a form of alternative medicine which favors a holistic approach with non-invasive treatment, and encourages minimal use of surgery and drugs. [1]

The term "naturopathy" literally means addressing illness with natural means, being derived from the structure of words like osteopathy, homeopathy, and allopathy.[2] Modern naturopathy grew out of the Natural Cure movement of Europe.[3][4] The term was coined in 1895 by John Scheel and popularized by Benedict Lust,[5] the "father of U.S. naturopathy".[6] Beginning in the 1970s, there was a revival of interest in the United States and Canada in conjunction with the holistic health movement.[6][7] Naturopathy is regulated and practiced in several countries.[8] The scope of practice and training varies widely.[9]

Traditional naturopaths and naturopathic physicians comprise two distinguishable types of naturopaths.[2] Naturopathic physicians employ the principles of naturopathy within the context of conventional medical practices. Naturopathy comprises many different treatment modalities of varying degrees of acceptance by the conventional medical community.


History

Monsignor Sebastian Kneipp, 1821–1897
Benedict Lust, 1872–1945

Some see the ancient Greek "Father of Medicine", Hippocrates, as the first advocate of naturopathic medicine, before the term existed.[10][11] The modern practice of naturopathy has its roots in the Nature Cure movement of Europe during the 19th century.[3][4] In Scotland, Thomas Allinson started advocating his "Hygienic Medicine" in the 1880s, promoting a natural diet and exercise with avoidance of tobacco and overwork.[12][13] The term sanipractor has sometimes been used to refer to naturopaths, particularly in the Pacific Northwest region of the United States.[6]

The term naturopathy was coined in 1895 by John Scheel,[5] and purchased by Benedict Lust, the "father of U.S. naturopathy".[6] Lust had been schooled in hydrotherapy and other natural health practices in Germany by Father Sebastian Kneipp; Kneipp sent Lust to the United States to spread his drugless methods.[14] Lust defined naturopathy as a broad discipline rather than a particular method, and included such techniques as hydrotherapy, herbal medicine, and homeopathy, as well as eliminating overeating, tea, coffee, and alcohol.[7] He described the body in spiritual and vitalistic terms with "absolute reliance upon the cosmic forces of man's nature".[15]

In 1901, Lust founded the American School of Naturopathy in New York. In 1902 the original North American Kneipp Societies were discontinued and renamed "Naturopathic Societies". In September 1919 the Naturopathic Society of America was dissolved and Benedict Lust founded the American Naturopathic Association to supplant it.[6][16][17] Naturopaths became licensed under naturopathic or drugless practitioner laws in 25 states in the first three decades of the twentieth century.[6] Naturopathy was adopted by many chiropractors, and several schools offered both Doctor of Naturopathy (ND) and Doctor of Chiropractic (DC) degrees.[6] Estimates of the number of naturopathic schools active in the United States during this period vary from about one to two dozen.[5][6][18]

After a period of rapid growth, naturopathy went into decline for several decades after the 1930s. In 1910 the Carnegie Foundation for the Advancement of Teaching published the Flexner Report, which criticized many aspects of medical education, especially quality and lack of scientific rigour. The advent of penicillin and other "miracle drugs" and the consequent popularity of modern medicine also contributed to naturopathy's decline. In the 1940s and 1950s, a broadening in scope of practice laws led many chiropractic schools to drop their ND degrees, though many chiropractors continued to practice naturopathy. From 1940 to 1963, the American Medical Association campaigned against heterodox medical systems. By 1958 practice of naturopathy was licensed in only five states.[6] In 1968 the United States Department of Health, Education, and Welfare issued a report on naturopathy concluding that naturopathy was not grounded in medical science and that naturopathic education was inadequate to prepare graduates to make appropriate diagnosis and provide treatment; the report recommends against expanding Medicare coverage to include naturopathic treatments.[18][19] In 1977 an Australian committee of inquiry reached similar conclusions; it did not recommend licensure for naturopaths.[20] As of 2009, fifteen of fifty U.S. states, Puerto Rico, the US Virgin Islands and the District of Columbia licensed naturopathic doctors,[21] and two states (WA, VT) require insurance companies to offer reimbursement for services provided by naturopathic physicians.[22][23]

Naturopathy never completely ceased to exist. Beginning in the 1970s, interest waxed in the United States and Canada in conjunction with the holistic health movement.[6][7]

Ideology

Naturopathy focuses on naturally occurring substances, minimally invasive methods, and encouragement of natural healing.[18] Naturopaths generally favor an intuitive and vitalistic conception of the body, and complete rejection of biomedicine and modern science is common.[18][17] Prevention through stress reduction and a healthy diet and lifestyle is emphasized, and pharmaceutical drugs, ionizing radiation, and surgery are generally minimized. The tenet of naturopathic practice is self-described by six core values.[24] Multiple versions exist in the form of the naturopathic doctor's oath,[25] various mission statements published by schools[26] or professional associations, and ethical conduct guidelines published by regulatory bodies:[27]

  1. First, do no harm; provide the most effective health care available with the least risk to patients at all times (primum non nocere).
  2. Recognize, respect and promote the self-healing power of nature inherent in each individual human being. (Vis medicatrix naturae, a form of vitalism).[28]
  3. Identify and remove the causes of illness, rather than eliminate or suppress symptoms (Tolle Causam).
  4. Educate, inspire rational hope and encourage self-responsibility for health (Doctor as Teacher).
  5. Treat each person by considering all individual health factors and influences. (Treat the Whole Person).
  6. Emphasize the condition of health to promote well-being and to prevent diseases for the individual, each community and our world. (Health Promotion, the Best Prevention)

Practice

Naturopaths use a wide variety of treatment modalities, focusing on natural self-healing rather than any specific method.[7][29] Some methods rely on immaterial "vital energy fields", the existence of which has not been proven. A consultation typically begins with a lengthy patient interview focusing on lifestyle, medical history, emotional tone, and physical features, as well as physical examination.[7] The traditional naturopath focuses on lifestyle changes and approaches that support the body's innate healing potential. Traditional naturopaths do not undertake to diagnose or treat diseases but concentrate on whole body wellness and facilitating the body healing itself. Practitioners of naturopathic medicine hold themselves to be primary care providers and in addition to various natural approaches seek to prescribe prescription drugs, perform minor surgery and apply other conventional medical approaches to their practice. Naturopaths do not necessarily recommend vaccines and antibiotics, and may provide alternative remedies even in cases where evidence-based medicine has been shown effective.[30][31] "All forms of naturopathic education include concepts incompatible with basic science, and do not necessarily prepare a practitioner to make appropriate diagnosis or referrals."[32][31][33]

Methods

The particular modalities used by an individual naturopath varies with training and scope of practice. The demonstrated efficacy and scientific rationale also varies. These include: Acupuncture, applied kinesiology,[34] botanical medicine, brainwave entrainment, chelation therapy for atherosclerosis,[35] colonic enemas,[14] color therapy,[34] cranial osteopathy,[31] hair analysis,[31] homeopathy,[36] iridology,[34] live blood analysis, nature cures—i.e. a range of therapies based upon exposure to natural elements such as sunshine, fresh air, heat, or cold, nutrition (examples include vegetarian and wholefood diet, fasting, and abstention from alcohol and sugar,[37]ozone therapy,[18] physical medicine (e.g., naturopathic, osseous, and soft tissue manipulative therapy, sports medicine, exercise, and hydrotherapy), Psychological counseling (e.g., meditation, relaxation, and other methods of stress management[37]), public health measures and hygiene,[24] reflexology,[34] rolfing,[17] and traditional Chinese medicine.

A 2004 survey determined the most commonly prescribed naturopathic therapeutics in Washington State and Connecticut were botanical medicines, vitamins, minerals, homeopathy, and allergy treatments.[36]

Vaccination

Many forms of alternative medicine, including naturopathy, homeopathy, and chiropractic are based on beliefs opposed to vaccination and have practitioners who voice their opposition. This includes non-medically trained naturopaths. The reasons for this negative vaccination view are complicated and rest, at least in part, on the early views which shape the foundation of these professions.[38] A survey of a cross section of students of a major complementary and alternative medicine college in Canada reported that students in the later years of the program opposed vaccination more strongly than newer students.[39]

A University of Washington study investigated insurance claim histories for alternative medicine use in relation to the receipt of vaccinations against preventable illnesses, grouped into children aged 1–2 years and 1–17 years. Both groups were significantly less likely to receive a number of their vaccinations if they visited a naturopath. The study found a significant association between visits to naturopaths with a reduced receipt of pediatric vaccinations and with increased infection by vaccine-preventable illnesses.[30]

Practitioners

A consultation with a naturopathic practitioner typically begins with a lengthy patient interview focusing on lifestyle, medical history, emotional tone, and physical features, as well as physical examination.[7] Naturopathic practitioners can be split into two groups, naturopathic physicians and traditional naturopaths.[2][9][18][40][41]

Doctors of Naturopathic Medicine

Naturopathic Medicine is represented in the United States by the American Association of Naturopathic Physicians (AANP), which was founded in 1985 and has 2,000 student, physicians, supporting, and corporate members.[18][42] Many naturopaths present themselves as primary care providers.[7][43] Doctor of Naturopathy (ND) training includes basic medical diagnostic tests and procedures such as medical imaging and blood tests, as well as vitalism and pseudoscientific modalities such as homeopathy.[7][14][35][44][45] The Council on Naturopathic Medical Education (CNME) also provides for the inclusion of optional modalities including minor surgery, natural childbirth, and intravenous therapy, though they are not generally licensed to perform these functions; these modalities require additional training and may not be within the scope of practice in all jurisdictions. This training includes naturopathic manipulation, psychological counseling and homeopathy.[46]

The core set of interventions defined by the Council on Naturopathic Medical Education and taught at all six accredited schools in North America includes:[43] acupuncture and traditional Chinese medicine, botanical medicine, homeopathy, nature cure (a range of therapies based upon exposure to natural elements), nutrition, physical medicine, and psychological counseling.

Naturopathic medical license in most areas of North America requires graduation from one of the schools accredited by the Association of Accredited Naturopathic Medical Colleges.

Naturopathic Medicine is represented with seven accredited naturopathic medical schools. In 1956, Charles Stone, Frank Spaulding, and W. Martin Bleything established the National College of Natural Medicine (NCNM) in Porltand, Oregon, in response to plans by the Western States Chiropractic College to drop its ND program. In 1978, Sheila Quinn, Joseph Pizzorno, William Mitchell, and Les Griffith established John Bastyr College of Naturopathic Medicine (now Bastyr University) in Seattle, Washington. That same year, the Canadian College of Naturopathic Medicine was founded in Toronto, Canada. More recently founded schools include the Southwest College of Naturopathic Medicine in Tempe, Arizona, founded in 1992, and Boucher Institute of Naturopathic Medicine in New Westminster, British Columbia, also founded in 1992. The University of Bridgeport in Bridgeport, Connecticut grants ND degrees through the College of Naturopathic Medicine, and the National University of Health Sciences in Lombard, Illinois offers a naturopathic program that is fully accredited by the Council on Naturopathic Medical Education (CNME).

Licensure

In jurisdictions where Naturopathic doctor (ND or NMD) or a similar term is a protected designation, naturopathic doctors must pass board exams set by the North American Board of Naturopathic Examiners (NABNE)[47] after completing academic and clinical training at a college certified by the Council on Naturopathic Medical Education (CNME).[43] Residency programs are offered at Bastyr University,[48] National College of Natural Medicine,[49] Southwest College of Naturopathic Medicine,[50] and University of Bridgeport.[51] NDs are not required to engage in residency training.[18]

In 2005, the Massachusetts Medical Society opposed licensure in that commonwealth based on concerns that NDs are not required to participate in residency, and are trained in inappropriate or harmful treatments.[33] The Massachusetts Special Commission on Complementary and Alternative Medical Practitioners rejected their concerns and recommended licensure.[52]

In the state of Washington, where naturopathic doctors are licensed comparably to primary care physicians,[53] many naturopathic doctors also accept insurance, with some plans offering the option of designating a naturopath as a primary care provider.[54] In Connecticut and Washington, state law requires insurance providers to provide some coverage of naturopathic services, while Oregon, another state with significant numbers of naturopathic doctors, does not.[54]

Traditional naturopaths

Traditional naturopaths are those who have not graduated from accredited naturopathic medical colleges and are not eligible to obtain a license to practice naturopathic medicine.[55] In licensed states they are not permitted to refer to themselves as NDs or NMDs. They are represented in the United States by two national organizations, the American Naturopathic Association (ANA) founded in 1919 by Benedict Lust,[56][verification needed][57] representing about 5,000 practitioners,[58][verification needed] and the American Naturopathic Medical Association (ANMA), founded in 1981 and representing about 4,000 practitioners, with several levels of certification.[59] The ANMA also recognizes MDs, DOs, and other medical professionals who have integrated naturopathy into their practices.

The level of naturopathic training varies among traditional naturopaths in the United States. Traditional naturopaths may complete non-degree certificate programs or undergraduate degree programs and can certify at a practitioner level with the American Naturopathic Medical Certification Board (ANMCB) and generally refer to themselves as Naturopathic Consultants.[60] These programs are often online "degrees" and offer no biomedical education as well as no clinical training. Those completing a Doctor of Naturopathy (ND) degree from an ANMCB approved school can become a Board Certified Naturopathic Doctor.[60][61] Physicians with supplemental training in Naturopathy can become National Board Certified Naturopathic Physicians through the ANMCAB.[60] This board certification is in no way the same as holding an ND license and holds no weight in states that regulate the practice of naturopathic medicine.

Traditional naturopathy does not require a license in the U.S., though use of the titles ND and NMD is regulated.[62][63][verification needed] Traditional naturopaths, because they have not received comprehensive naturopathic medical training, as defined by the Council on Naturopathic Medical Education, are not permitted to practice as NDs or NMDs in the 17 licensed states where naturopathic medicine is regulated.[64]

Other health care professionals

According to a 1998 task force report, some physicians are choosing to add naturopathic modalities to their practice,[65] and states such as Texas have begun to establish practice guidelines for MDs who integrate alternative and complementary medicine into their practice.[66] Continuing education in naturopathic modalities for health care professionals varies greatly but includes offerings for many professions, including physicians, physical therapists, chiropractors, acupuncturists, dentists, researchers, veterinarians, physician assistants, and nurses.[67] These professionals usually retain their original designation but may use terms such as "holistic", "natural", or "integrative" to describe their practice. The American Naturopathic Medical Association (ANMA) and American Naturopathic Medical Certification and Accreditation Board (ANMCAB) has recognition and certification programs for Doctors of Medicine (M.D.) and Doctors of Osteopathic Medicine (D.O.) who have supplemented their education with naturopathic studies and integrate naturopathy into their practice.[60]

Regulation

Naturopathy is practiced in many countries, primarily the United States and Canada, and is subject to different standards of regulation and levels of acceptance. The scope of practice varies widely between jurisdictions, and naturopaths in some unregulated jurisdictions may use the Naturopathic Doctor designation or other titles regardless of level of education.[9]

North America

In five Canadian provinces, seventeen U.S. states, and the District of Columbia, naturopathic doctors who are trained at an accredited school of naturopathic medicine in North America, are entitled to use the designation ND or NMD. Elsewhere, the designations "naturopath", "naturopathic doctor", and "doctor of natural medicine" are generally unprotected.[9]

In North America, each jurisdiction that regulates naturopathy defines a local scope of practice for naturopathic doctors that can vary considerably. Some regions permit minor surgery, access to prescription drugs, spinal manipulations, obstetrics and gynecology and other regions exclude these from the naturopathic scope of practice.[68]

Canada

Several Canadian provinces license naturopathic doctors: British Columbia, Alberta, Manitoba, Ontario, and Saskatchewan.[69] British Columbia has regulated naturopathic medicine since 1936 and together with Ontario (since 2009) are the only two Canadian provinces that allow certified NDs to prescribe pharmaceuticals and perform minor surgeries.[70]

United States

Like D.O. and P.A. programs, clincial work is mandated as a part of training by certified programs. Naturopathic doctors are not mandated to undergo residency per say between graduation and commencing practice,[18] except in the state of Utah.[76]

Australia

Currently the industry is self-regulated. There is no protection of title, meaning that technically anyone can practise as a naturopath. The only way to obtain insurance for professional indemnity or public liability is by joining a professional association, which can only be achieved by having completed an accredited course and gaining professional certification. From mid-2013 the Australian Register of Naturopaths and Herbalists is to provide a database of accredited and educated practitioners of Naturopathy.[77]

In 1977 a committee reviewed all colleges of naturopathy in Australia and found that, although the syllabuses of many colleges were reasonable in their coverage of basic biomedical sciences on paper, the actual instruction bore little relationship to the documented course. In no case was any practical work of consequence available. The lectures which were attended by the committee varied from the dictation of textbook material to a slow, but reasonably methodical, exposition of the terminology of medical sciences, at a level of dictionary definitions, without the benefit of depth or the understanding of mechanisms or the broader significance of the concepts. The committee did not see any significant teaching of the various therapeutic approaches favoured by naturopaths. People reported to be particularly interested in homoeopathy, Bach's floral remedies or mineral salts were interviewed, but no systematic courses in the choice and use of these therapies were seen in the various colleges. The committee were left with the impression that the choice of therapeutic regime was based on the general whim of the naturopath and, since the suggested applications in the various textbooks and dispensations overlap to an enormous extent, no specific indications are or can be taught.[20]

India

In India there is a 5½-year degree course offering a "Bachelor of Naturopathy and Yogic Sciences" (BNYS) degree. The first college of naturopathy was started in Hyderabad, Andhra Pradesh by B. Venkatrao which offered a Diploma in Naturopathy (ND) and 3½-year "Diploma in Naturopathic Medicine & Yogic Science" (DNYS) run by Akhil Bhartiya Prakritik Chikitsa Parishad, New Delhi, but now has a full-time residential degree course. There are a total of fifteen naturopathy colleges in India.[78][self-published source?]

Naturopathy and Yoga, as an Indian system of medicine, falls under the Department of AYUSH, Ministry of Health & Family Welfare, Government of India.[79]

The Indian government established the "Central Council for Research in Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy” in 1969 as an autonomous organization under the Ministry of Health and Family Welfare. This organization was tasked to conduct scientific research into those branches of alternative medicine, until 1978. During this period, the development of Naturopathy was looked after by the Ministry of Health & Family Welfare directly. In March 1978 the composite council was dissolved and replaced by four independent research councils, one each for Ayurveda and Siddha, Unani, homoeopathy and yoga and naturopathy.[80][self-published source?]

The National Institute of Naturopathy in Pune was established on 22 December 1986. It encourages facilities for standardization and propagation of the existing knowledge and its application through research in naturopathy throughout India. This institute has a governing body, with the Union Minister for Health as its president.[81]

United Kingdom

Naturopathy is not regulated in the United Kingdom. The largest registering body, the General Council & Register of Naturopaths, recognises only two courses in the UK, being taught at osteopathic schools: the British College of Osteopathic Medicine and The College of Osteopaths Educational Trust.[citation needed] In 2012, publicly funded universities in the United Kingdom dropped their alternative medicine programs, including naturopathy.[82]

There are also the Association of Naturopathic Practitioners, The British Naturopathic Association, and Incorporated Society of Registered Naturopaths.[citation needed]

Critisms

Some of the ideology and methodological underpinnings of naturopathy are in conflict with the paradigm of evidence-based medicine (EBM).[83] Many naturopaths have opposed vaccination based in part on the early views that shaped the profession.[38] According to the American Cancer Society, "scientific evidence does not support claims that naturopathic medicine can cure cancer or any other disease, since virtually no studies on naturopathy as a whole have been published".[18][83]

To the extent of naturopathy's isolation from scientific discourse, members of the medical community have raised concerns.[84] [11][85][86] The effectiveness of naturopathy as a whole system has not been systematically evaluated, and efficacy of individual methods used varies.[18][32] Unproven, disproven, and controversial alternative medical treatments, and vitalism are several sources of critism.[45] Nevertheless, there are growing collaborative efforts between naturopaths and medical doctors to evaluate the safety and efficacy of naturopathic medicine in prevention and management of a broad range of common ailments, and to decide whether accessibility of naturopathic services will enhance patient health in a cost-effective way.[87] To the extent that naturopathy offers verifiable results for specific conditions, greater scientific knowledge of the mechanisms of those naturopathic protocols could result in improved therapy models.[84] Some naturopathic physicians have begun to contribute to research and adapt modern scientific principles into clinical practice.[88][7][35] Certain naturopathic treatments offered by traditional naturopaths, such as homeopathy, rolfing, and iridology, are widely considered pseudoscience or quackery.[89][90][91]

Stephen Barrett of Quackwatch and the National Council Against Health Fraud has stated that Naturopathy is "simplistic and that its practices are riddled with quackery".[14] "Non-scientific health care practitioners, including naturopaths, use unscientific methods and deception on a public who, lacking in-depth health care knowledge, must rely upon the assurance of providers. Quackery not only harms people, it undermines the ability to conduct scientific research and should be opposed by scientists", says William T. Jarvis.[92] "Natural" methods and chemicals are not necessarily safer or more effective than "artificial" or "synthetic" ones; any treatment capable of eliciting an effect may also have deleterious side effects.[18][14][93][94]


K. C. Atwood writes, in the journal Medscape General Medicine, "Naturopathic physicians now claim to be primary care physicians proficient in the practice of both "conventional" and "natural" medicine. Their training, however, amounts to a small fraction of that of medical doctors who practice primary care. An examination of their literature, moreover, reveals that it is replete with pseudoscientific, ineffective, unethical, and potentially dangerous practices".[44] In another article, Atwood writes that "Physicians who consider naturopaths to be their colleagues thus find themselves in opposition to one of the fundamental ethical precepts of modern medicine. If naturopaths are not to be judged "nonscientific practitioners", the term has no useful meaning. An article by a physician exposing quackery, moreover, does not identify its author as "biased", but simply as fulfilling one of his ethical obligations as a physician.[35]

According to Arnold S. Relman, the Textbook of Natural Medicine is inadequate as a teaching tool, as it omits to mention or treat in detail many common ailments, improperly emphasizes treatments "not likely to be effective" over those that are, and promotes unproven herbal remedies at the expense of pharmaceuticals. He concludes that "the risks to many sick patients seeking care from the average naturopathic practitioner would far outweigh any possible benefits".[95]

Traditional naturopathic practitioners surveyed in Australia perceive EBM as an ideologic assault on their beliefs in vitalistic and holistic principles.[83] [83] [83]

See also

References

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