Naturopaths—also called naturopathic physicians, naturopathic doctors, and N.D.’s—are licensed health professionals who practice an approach to health care called naturopathic medicine. Naturopathic medicine (also called naturopathy) is a distinct system of health care that uses a variety of natural approaches to health and healing, including clinical nutrition, counseling, herbal medicine, homeopathy, and physical therapy. Naturopaths recognize the integrity of the whole person, and they emphasize the individual’s inherent capacity for self-healing. Some naturopaths are not licensed health professionals but have studied the field of naturopathy through correspondence programs, under the supervision of other naturopaths, or completed some other type of certificate-granting program. This article, however, focuses primarily on the career of naturopathic doctors.
Naturopath Career History
The therapies and philosophy on which naturopathic medicine is based can be traced back to the ancient healing arts of early civilizations. Healers in ancient times used natural treatments that relied on the body’s innate ability to heal itself. They made use of foods, herbs, water, massage, and fasting.
Hippocrates, who is thought by many to be the father of modern medicine, is also often considered to be the earliest predecessor of naturopathic physicians. He used many natural approaches to health care. He is reported to have told his followers, “Let your food be your medicine and your medicine be your food.”
During the 18th and 19th centuries, an alternative healing movement in Europe contributed to the development of naturopathic medicine. The German homeopathic practitioner John H. Scheel is credited with first using the term “naturopath” in 1895.
Dr. Benedict Lust introduced naturopathy to the United States. He founded the American School of Naturopathy, which graduated its first class in 1902. In 1909, California became the first state to legally regulate the practice of naturopathy. Early naturopaths, including Dr. John Kellogg, his brother Will Kellogg, and C. W. Post, helped popularize naturopathy.
Naturopathy flourished in the early part of the 20th century. By 1930, there were more than 20 naturopathic schools and 10,000 practitioners nationwide. With the rise of modern pharmaceuticals and allopathic (conventional) medicine, naturopathic medicine experienced a decline during the 1940s and 1950s. The latter part of the 20th century, however, saw a strong revival in the field of naturopathy due to rapidly growing public interest in alternative health care approaches. One sign of the importance of alternative medicine was the founding in 1992 of the Office of Alternative Medicine (OAM) as part of the National Institutes of Health. The OAM’s responsibilities included evaluating treatments and providing information to the public about them. In 1999 the OAM became the National Center for Complementary and Alternative Medicine (NCCAM), with greater access to resources for initiating and funding additional research projects.
Today, the NCCAM provides funding to numerous research centers evaluating alternative treatments in a wide variety of areas including addiction, cancer, cardiovascular diseases, pediatrics, and arthritis. The OAM began with an annual budget of $2 million. As officials realized the importance of this work, more money has been dedicated to the study of alternative medicine, and today the NCCAM’s annual budget has increased by tens of millions of dollars.
Naturopath Career Description
In states where naturopathic doctors are licensed medical professionals, they provide complete diagnostic and therapeutic services. They are consulted as primary care physicians, and they receive referrals from other physicians. Patients consult naturopaths for a variety of health problems, including digestive disorders, chronic fatigue, asthma, depression, infections, obesity, colds, and flu.
When seeing a new patient, licensed N.D.’s first take a careful medical history to understand the state of health of the whole individual—body, mind, and spirit. They consider the patient as a whole person who has something out of balance, and they don’t just focus on the symptoms of illness. Naturopathic doctors ask many questions about lifestyle, eating habits, stress, and many other issues. They listen carefully to determine what imbalance may be causing illness or preventing recovery. They may spend an hour to an hour and a half with a new patient.
Naturopathic doctors take a holistic approach to health care. They recognize the connection between the health of the mind and the health of the body. Depression, stress, and fear all can have an impact on physical health. Naturopaths listen carefully to their patients to learn about the impact of outside forces, such as a stressful work environment or family situation, that may be contributing to the illness.
Once they make a diagnosis, N.D.’s prescribe a course of treatment. Naturopathic doctors practice health care that supports the body’s self-healing processes. They recognize that the human body has a natural capability to heal itself, so they use methods of care that will work with these processes. Naturopathic doctors use many natural and noninvasive healing techniques. They are trained in counseling, herbal medicine, clinical nutrition, homeopathy, hydrotherapy, massage, and other types of physical medicine.
Naturopathic doctors believe that most conventional doctors treat only the illness, not the patient. In treating the patient, N.D.’s recommend methods that have more lasting effects. They recommend changes in diet, prescribe botanical medicine (herbs), and recommend vitamins. They may even offer counseling to help the patient make lifestyle changes.
Naturopathic medicine is most effective in treating chronic illness. Like many other alternative health care approaches, naturopathy is not usually used for acute, life-threatening illnesses. Some N.D.’s are trained in techniques of minor surgery. They do not perform major surgery, but they may be involved in the recovery process after surgery. For some conditions, naturopaths may refer a patient to a specialist, such as a cardiologist or oncologist. Even while a patient is seeing a specialist, the naturopath continues to work with the individual and the self-healing process. This can result in a team-care approach.
Only 15 states and the U.S. territories of Puerto Rico and the U.S. Virgin Islands currently license naturopathic physicians to provide medical care. Those who are licensed can maintain their licenses even if they practice in a state other than the license-granting one. (That is, a doctor licensed by Arizona, for example, can maintain that license even if he or she ends up moving and practices in another state.) However, N.D.’s who practice in states that do not offer licensing must restrict the scope of their practices to areas such as homeopathy (a form of therapy that emphasizes natural remedies and treatments) and nutrition counseling.
The majority of naturopaths are in private practice. That means that they must have the skills to run a business on a day-to-day basis. They interview, hire, and train staff and oversee the functioning of an office. More and more insurance companies are covering naturopathic medicine in states that offer licenses, and N.D.’s must be able to oversee complicated insurance billing procedures in order to be paid for their services.
Naturopath Career Requirements
If you want to pursue a career in naturopathy, you’ll be entering a premed program in college, so you’ll want to take high school science courses, such as biology and chemistry. The physical education courses of some high schools offer instruction in health, nutrition, and exercise that would help prepare you for important aspects of work as a naturopath.
English, psychology, and sociology courses will help you sharpen your communication and people skills. As a naturopath, you will need to be an excellent listener and communicator. Much of a naturopathic physician’s work involves listening to and counseling clients. Business, math, and computer classes will prepare you to run a business.
To become a naturopathic physician, you must first complete a premed undergraduate program before pursuing the graduate degree doctor of naturopathic medicine (N.D. or sometimes N.M.D.). Your undergraduate courses should be those of a typical pre-med curriculum, including biology, inorganic chemistry, and organic chemistry. Courses in nutrition and psychology are also important. You should contact the accredited naturopathic colleges as early as possible in order to ensure that you complete the courses required by the school of your choice.
When you’re searching for a naturopathic medical school, find one that’s accredited and offers the Doctor of Naturopathic Medicine degree. Schools without accreditation offer correspondence courses and may offer certificates. Only a degree from an accredited school, however, will prepare you to become a licensed naturopath. There are only five naturopathic schools in the United States and Canada accredited by the Council on Naturopathic Medical Education. They are Bastyr University, Kenmore, Washington (http://www.bastyr.edu/); the National College of Naturopathic Medicine, Portland, Oregon (http://www.ncnm.edu/); the Southwest College of Naturopathic Medicine and Health Sciences, Tempe, Arizona (http://www.scnm.edu/); the Canadian College of Naturopathic Medicine, Ontario, Canada (http://www.ccnm.edu/); and the University of Bridgeport College of Naturopathic Medicine, Bridgeport, Connecticut (http://www.bridgeport.edu/academics/graduate/naturopathic-medicine-nd/). The Boucher Institute of Naturopathic Medicine in New Westminster, British Columbia (http://www.binm.org/), has been granted candidacy status. Candidacy status does not ensure accreditation, but it is an important initial step toward it.
The naturopathic doctoral degree is a four-year program requiring courses in anatomy, physiology, biochemistry, and other basic medical sciences. Students must also take courses in nutrition, botanical medicine, homeopathy, naturopathic obstetrics, psychological medicine, and minor surgery. In addition to course instruction, students receive extensive clinical training.
If you are not interested in completing the N.D. or N.M.D. degree, other postsecondary training is available. The American Naturopathic Medical Accreditation Board Web site (http://www.anmab.org/) can provide you with information on correspondence and resident programs. These programs, however, do not typically have the broad medical background of N.D. programs, and those educated in this way do not meet requirements in states with licensing regulations.
Certification or Licensing
To practice medicine as a naturopathic physician, you must be licensed in the state in which you practice. Currently licensing is available in 15 states—Alaska, Arizona, California, Connecticut, District of Columbia, Hawaii, Idaho, Kansas, Maine, Montana, New Hampshire, Oregon, Utah, Vermont, Washington—as well as in Puerto Rico and the Virgin Islands. While Florida does have a few licensed naturopaths, the state stopped granting new licenses in the 1960s. As the public’s awareness of this field grows and as it becomes more popular, more and more states are considering setting licensing requirements. The AANP also promotes licensure and is working to have statutes regulating the profession in all 50 states by the end of the first decade of the 21st century. All state licenses are contingent upon passing the Naturopathic Physicians Licensing Examinations (NPLEX), a standardized test for all naturopathic physicians in North America. As this field of health care continues to gain wide acceptance, the number of licensed states is expected to grow. To maintain their licenses in naturopathic medicine, N.D.’s are required to complete a certain amount of continuing education throughout their professional lives.
Naturopathic physicians who practice in unlicensed states are not allowed to practice as physicians. They can still use their skills and knowledge to help people improve their lives, but they usually limit their practices to homeopathy or nutritional counseling.
The American Naturopathic Medical Association (ANMA) is not in favor of licensure. This group is composed of a broader range of naturopaths, including those who do not hold N.D. degrees, those who have gotten their education through correspondence programs, and those who believe naturopathy treatments should involve only natural methods and nonprescription substances. Instead of licensure, the ANMA offers and promotes certification through its American Naturopathic Certification Board.
A primary requirement for a successful naturopath is a strong desire to help people improve their lives. You must also have a fundamental belief in the whole-person approach to healing. Because counseling plays such an important role in treatment, naturopathic physicians need excellent listening and communication skills. Keen powers of observation and good decision-making abilities are essential to accurate medical assessment. Like other medical professions, naturopathy requires a commitment to lifelong learning. Idealism and a firm belief in the efficacy of natural approaches to medicine are important. You must have the courage of your convictions and be willing to stand up for your beliefs. Naturopathy has become much more respected within the medical profession in recent years, but it is still not accepted by some conventional doctors.
Exploring Naturopath Career
Do some reading on the history and practice of naturopathy. You can visit the National Center for Complementary and Integrative Health Web site (https://nccih.nih.gov/) to learn about developments in the field of naturopathy and other alternative medicines.
Make an appointment for a medical checkup with a naturopathic physician. Find out what the practice of naturopathy is like, and think about whether you would like to practice medicine this way. Ask a naturopath to talk with you about the field. Perhaps that person will be willing to be a mentor for you.
Visit the naturopathic colleges that interest you. Sit in on classes. Talk to students about their experiences. Find out what they like and what they don’t like. Talk to the faculty and learn about their approaches to teaching. Ask what they see as the best opportunities in the field.
Most naturopaths go into private or group practice. A few N.D.’s find positions in natural health clinics. Due to the small number of accredited doctoral programs, only a very small percentage of naturopaths become teachers. The federal government is encouraging research into the efficacy of alternative health care approaches. More research opportunities are becoming available, and an increasing number of naturopaths are pursuing this aspect of the profession. The thriving natural food industry is providing more opportunities for naturopaths as consultants. The majority of N.D.’s work in the states that license them; however, naturopathic physicians can be found throughout the country.
The placement office of the naturopathic college you attend can help you in searching for that first job. Join professional organizations, attend meetings, and get to know people in your field. Networking is one of the most powerful ways of finding a new position. Get to know professionals in other areas of alternative health care. As other alternative health care modalities expand, they will be more likely to include naturopaths in alternative clinics.
As a newly licensed naturopathic physician, you might begin working on a salary or income-sharing basis in a clinic or in an established practice with another naturopath or other health care professional. This would allow you to start practicing without the major financial investment of equipping an office. You might be able to purchase the practice of an N.D. who is retiring or moving. This is usually easier than starting a new solo practice because the practice will already have patients. However, some newly licensed practitioners do start immediately in private practice.
Because most naturopaths work in private or group practice, advancement frequently depends on the physician’s dedication to building a patient base. N.D.’s in private practice need a general sense of how to run a successful business. They must promote their practices within the community and develop a network of contacts with conventional medical doctors or other alternative practitioners who may refer patients to them.
Some naturopaths advance by starting their own clinics with other naturopaths or with other alternative health practitioners. In any medical field, learning is life-long, and many naturopaths derive a sense of professional satisfaction from keeping up on changes in allopathic medicine and in natural health research. A few very experienced N.D.’s write textbooks or become professors at the accredited universities. With the growing government interest in research into natural health care, more naturopathic physicians will find opportunities for advancement as researchers.
Most naturopaths can make a comfortable living in private practice, but generally naturopathic medicine is not as financially rewarding as some other branches of medicine. Financial success as a naturopath requires dedication to building up a practice and promoting natural health treatment. Although a well-established naturopath in an urban area may make about $200,000 a year, most earn less. A beginning naturopath may have an annual income of around $25,000 to $30,000. After some years of practice, N.D.’s generally earn between $40,000 and $80,000 per year. N.D.’s who run their own practices take their earnings once expenses such as rent or mortgages, insurance premiums, equipment costs, and staff salaries have been paid. For an example of the difference between a clinic’s income and that of the N.D., consider an established practice in Lake Havasu City, Arizona, advertised for sale in the February 2006 issue of Naturopathic Physician magazine, published by the American Association of Naturopathic Physicians. The clinic’s gross receipts were listed as $250,000+ per year, but the N.D. could expect his or her annual net income after paying all expenses to be much less.
Income also depends on such factors as the size and geographic location of a practice. In states that license N.D.’s, the population is typically more interested in natural health. In those states, naturopaths may have larger practices than in states that do not license, and thus they have higher incomes.
Since most naturopathic physicians are in private practice, they must provide their own benefits. Those who are employed by universities, research institutes, or clinics run by others may receive benefits, such as vacation and sick pay, insurance, and contributions to retirement accounts.
Naturopathic physicians work in clean, quiet, comfortable offices. Most solo practitioners and group practices have an office suite. The suite generally has a reception area. In clinics, several professionals may share this area. The suite also contains examining rooms and treatment rooms. In a clinic where several professionals work, there sometimes are separate offices for the individual professionals. Many naturopaths have an assistant or office staff. Those who are in private practices or partnerships need to have good business skills and self-discipline to be successful.
Naturopaths who work in clinics, research settings, or universities need to work well in a group environment. They frequently work under supervision or in a team with other professionals. They may have offices of their own, or they may share offices with team members, depending on the facility. In these organizations, the physical work environment varies, but it will generally be clean and comfortable. Because they are larger, these settings may be noisier than the smaller practices.
Most naturopathic physicians work about 42 hours per week, although many put in longer hours. Larger organizations may determine the hours of work, but N.D.’s in private practice can set their own hours. Evening and weekend hours are sometimes scheduled to accommodate patients’ needs.
Naturopath Career Outlook
While the U.S. Department of Labor does not provide specific information on the employment outlook for naturopathic physicians, it does project overall employment in the field of health care occupations to grow faster than the average through 2014.
As public interest in alternative health care grows, many health-conscious individuals are attracted to naturopathy because of its natural, holistic, preventive approach. Additionally, the average life span is increasing. As a result, the number of older people is also increasing. The elderly frequently have more health care needs, and the growth of this segment of the population is likely to increase the demand for N.D.’s who provide personalized and attentive care. Another sign that the future is bright for naturopaths is the growing number of insurance policies that provide coverage for alternative health care services. Coverage still varies according to the insurer, but in states where N.D.’s are licensed, more companies are paying for their services.
All of these factors should contribute to the employment of naturopathic physicians to grow faster than the average in the 21st century. According to Robert Lofft, former executive director of the Council on Naturopathic Medical Education, “N.D.’s are in great demand. Many cannot accept any more patients. The demand is outpacing the supply.” While the demand for naturopathy is increasing, college enrollments are also growing. New N.D.’s may find increasing competition in geographic areas where other practitioners are already located.