Two Views • Value of naturopaths recognized by the state, but MDs fear dilution of health care
by: L.E. BASKOW, Jill Stanard, director of clinical operations at the National College of Natural Medicine in Portland, assesses the cervical spine of Shannon McCartor during a session of naturopathic manipulative therapy.

Peter Korn's Tribune story 'Paging Dr. Alternative' (April 1) serves as a cautionary tale.

In pitting medical doctors (MDs) against naturopathic doctors (NDs) in the article, what is overlooked is the urgent need for health care professionals to work collaboratively to address quality health care solutions for Oregonians.

In fact, cutting-edge medical clinics and hospitals throughout the country now offer integrative care with naturopathic physicians to ensure the best patient care. This level of cooperation speaks to the high level of trust and respect by many MDs and NDs in each other's professional training and knowledge.

Health care reform will add millions of Americans to the health care system who are seeking primary care providers - now in critically short supply. Health care professionals across all disciplines must be ready to work together to overcome this crisis.

Attacks leveled against different licensed health care practitioners, particularly those based on misperception and misinformation, are a disservice to the many patients who require and expect quality medical care and cooperation amongst their providers.

We believe naturopathic, allopathic and osteopathic doctors, nurse practitioners and physician assistants can and will be partners in solving the health care provider shortage. One way to do this is to know and understand each other's broad and rigorous training backgrounds.

Prescribing privileges date to 1953

• Myth: NDs don't prescribe and don't receive adequate training on pharmaceuticals.

• Fact: Since 1953, NDs in Oregon have had prescribing privileges for naturally derived pharmaceuticals - including potent medications like morphine. This year's law change only added synthetic pharmaceuticals to the already large formulary.

The question raised about the dangers posed to public health due to NDs prescribing additional pharmaceuticals is not borne out in reality. The Oregon Board of Naturopathic Medicine reports that very few complaints have been filed about ND prescribing errors and none of them have resulted in harm to the patient, demonstrating the overall safe prescribing habits of NDs.

Both MDs and NDs are trained to work from the evidence-based model of medicine, using best practices and standards of care. The primary difference in prescribing between MDs and NDs is that naturopathic doctors practice in an integrative fashion, treating patients with non-pharmaceutical methods whenever safely possible.

Prioritizing lifestyle changes, diet, prevention, herbal and nutritional medicine, and the prevailing mental and emotional conditions of the patient often limits the need for pharmaceuticals.

Interestingly, naturopathic doctors receive more training in the science of pharmacology than MDs and family nurse practitioners. The 2009 Legislature worked with the following educational comparison in determining that the naturopathic formulary could safely include synthetic drugs. The Oregon Medical Association adopted a neutral position on the bill.

Based on current curriculum, NDs are the only health care provider specifically trained in both herbal/botanical and pharmaceutical medicine, allowing them a unique perspective to assess drug-herb and drug-nutrient interactions.

With the National Institutes of Health estimating that nearly 40 percent of Americans use supplements and other forms of alternative health services, it's increasingly necessary to have licensed physicians trained in the efficacious use of these simple but powerful health tools who also have the knowledge to prescribe pharmaceuticals when necessary.

NDs as primary care for 100 years

• Myth: NDs provide 'complementary care.' Patients still need an MD primary care provider.

• Fact: The Oregon Association of Naturopathic Physicians was founded in 1909. In 1927, the state licensed NDs to practice as primary care physicians.

The National College of Natural Medicine graduates on average 70 NDs per year, all of whom are trained as (and nearly all practice as) primary care doctors.

Most major medical insurance plans offer some form of coverage for naturopathic care. In the Pacific Northwest, more than 70 companies, unions and organizations offer health plans that cover naturopathic medical services, including Microsoft, Boeing, Intel and Oregon's public employees. In addition, NDs have staff privileges at a growing number of hospitals and integrated clinics throughout the U.S.

For an array of reasons, patients, companies, hospitals and insurance are increasingly turning to naturopathic medicine to fill Oregon's urgent need for primary and preventive health care.

We challenge our medical colleagues to join us in creating new health care approaches by tearing down these isolated silos of medical philosophies. Once and for all, let's cease perpetuating uninformed prejudices and focus instead on creating a new paradigm of excellent health care for Oregonians.

Sheryl Estlund is a naturopathic doctor and board president of the Oregon Association of Naturopathic Physicians. She lives in Corbett.

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