Naturopathic medicine is recognized by various names including Complementary Alternative Medicine (CAM) and Traditional Medicine (TM). What is naturopathic medicine? Naturopathic medicine can be defined as a unique and comprehensive approach to improving health and treating illness. Focusing on prevention and using natural substances and treatments, naturopathic doctors (ND's) clinicaly support and stimulate the body's ability to heal itself. The primary goal of naturopathic treatment is to address the cause of illness, rather than to simply treat or suppress symptoms. The patient is seen as a whole person and the ND takes the physical, mental, emotional and spiritual dimensions into account when diagnosing and developing a treatment plan.
The primary therapies used by naturopathic physicians include: clinical nutrition, botanical medicine, homeopathic medicine, acupuncture, and oriental medicine, physical therapies and counselling. Naturopathic treatments are often combined with conventional medical treatments. It is becoming more common to find NDs working with medical doctors and specialists for the good of the patient.
How are naturopathic doctors trained? NDs are required a fullfill a minimum of three years premedical studies at an accredited university, followed by four years at a recognized and accredited college of naturopathic medicine. The education encompasses the same intensive medical sciences undertaken by medical doctors but also includes naturopathic principles, therapies, and a clinical internship. There are four recognized schools of naturopathic medicine in North America: The Canadian College of Nautropathic Medicine (Toronto, Canada), Bastyr University (Seattle, Washington), National College of Naturopathic Medicine (Portland, Oregon), Southwest College of Naturopathic Medicine (Temple, Arizona). Graduates from one of these four institutions receive a Doctor of Naturopathic Medicine (ND) diploma and are required to take the Naturopathic Physician Licensing Exam (NPLEX). The North American Board of Naturopathic Examiners (NABNE) is responsible for both the approval and the administrative process of the NPLEX exam.
Should the Bahamas embrace naturopathic – traditional medicine? The answer to that question should be considered in light of the following: "TM (Traditional Medicine) has maintained its popularity in all regions of the developing world and its use is rapidly spreading in industrialized countries.
* In China, traditional herbal preparations account for 30%-50% of the total medicinal consumption.
* In Europe, North America and other industrialized regions, over 50% of the population have used complementary or alternative medicine at least once.
* In San Francisco, London and South Africa, 75% of people living with HIV/AIDS use TM/CAM.
* 70% of the population in Canada have used complementary medicine at least once.
* In Germany, 90% of the population have used a natural remedy at some point in their life. Between 1995 and 2000, the number of doctors who had undergone special training in natural remedy medicine had almost doubled to 10,800.
* In the United States, 158 million of the adult population use complementary medicines and according to the USA Commission for Alternative and Complementary medicines, US $17 billion was spent on traditional remedies in 2000.
* In the United Kingdom, annual expenditure on alternative medicine is US$ 230 million."1
The purpose of the article is to consider the integration of various aspects of the Bahamian healthcare system defined as the merging of allopathic / conventional medicine with non-allopathic / naturopathic medicine. The term allopathic was first coined "in 1842 by C.F.S. Hahnemann, a German physician, to designate the usual practice of medicine by MD (medial doctors) and DO (doctor of osteopathy) as apposed to homeopathy."2 There are five important reasons why Bahamians should embrace naturopathic medicine.
First, from a healthcare delivery perspective, naturopathic medicine makes perfect sense. "Traditional and complementary/alternative medicine has demonstrated efficacy in areas such as mental health, disease prevention, treatment of non-communicable diseases, and improvement of the quality of life for persons living with chronic diseases as well as for the ageing population. Although further research, clinical trials, and evaluations are needed, traditional and complementary/alternative medicine has shown great potential to meet a broad spectrum of health care needs. However, the most commonly reported reasons for using traditional and complementary/alternative medicine are that it is more affordable, more closely corresponds to the patient's ideology, and is less paternalistic than allopathic medicine. ."3
Second, from both a personal preventative health and financial perspective, naturopathic medicine offers undeniable benefits. The prevention of disease and the attainment of optimal health have short and long term cost benefit value to the individual that will not only increase quantity but also improve quality of life. Not only do naturopathic physicians educate and promote safe lifestyle choices, they also assess risk factors, heredity and susceptibility to disease, and make appropriate timely interventions in partnership with the patient to prevent illness. Furthermore the Bahamas is home to nearly 100 indigenous plants like the Spotted Basil (Basily), Guiacum Officinal (tree of life -"Nightly Whitey"), Sweetwood, and the Kalanchoe that have been used for medicinal purposes such as indigestion, colds, diarrhea, and headaches.4 When taken under the supervision of a trained naturopathic physician, most standardized herbs, that is herbs (containing a consistent level of a major active constituent or marker compound or the botanical extract)5 and other naturopathic modalities have proven to be in some cases more effective, less physiologically taxing and expensive than chemical based pharmaceuticals. Based on the undeniable value of both allopathic (surgery in particular) and non-allopathic medicine, integration can provide the best of both worlds.
Third, from a business point of view, naturopathic medicine has significant value to existing business owner and future entrepreneurs. For example, "the bark of ……, Cascarilla, also called Sweetwood, is used to make a tonic for digestive irritations and stomach aches …..and Sweetwood is exported from Nassau to Italy."6 "The global market for herbal medicines currently stands at over US $ 60 billion annually and is growing steadily"7. With a steady growth of awareness among the Bahamian population concerning naturopathic medicine, there will be an equal proportionate increase in the demand for the supply of all items pertaining to naturopathic care and the organized delivery of an integrative healthcare system. The hospitality industry can also place itself in a position to capitalize from vacationers who are predisposed and rely on CAM care. The micro and macro economic return on investing in the future of naturopathic medicine is an investment opportunity that should not be ignored.
Fourth, from a naturopathic standards perspective, it is important to set up licensing standards for practitioners of natural medicine in the Bahamas. There needs to be a national policy articulation regarding who should be eligible to practice in the Bahamas. These measures would help establish standards for the use of naturopathic medicine and serve as guidelines and protocols to protect consumers and patients alike.
Finally, from a nation-state building perspective, naturopathic medicine provides the best assistance in managing the growing difficulties of healthcare delivery in the Bahamas. The rising cost and challenges facing of the national health insurance system is best met with the low cost and prevention reality of naturopathic medicine. As many governments worldwide step up to the plate and evaluate the merit of adopting integrative medicine, the Bahamas should likewise follow suit.
As with every argument there are two sides to an issue. Although there is ample evidence to support the efficacy and safety of natural medicine, there is a legitimate concern for the improper use of combining conventional and non-conventional medicine. Likewise, a lack of cohesive communication between healthcare practitioners on both sides can prove to be problematic. For example, "…..there have been many cases of consumers unknowingly using suspect or counterfeit products; choosing inappropriate therapies in self-care; as well as several reports of unintentional overdose. Similarly, there have been reports of consumers being injured by unqualified practitioners. Another potential risk is that patients do not inform their doctors about their use of traditional and complementary medicines."8 "Because naturopathic physicians and allopathic physicians practicing naturopathic modalities may prescribe both herbal and pharmaceutical preparations, it is imperative …. to encourage doctor-patient interaction and be aware of known or potential drug-herb interactions." 9
Hippocrates' quote provides the best synopsis for this article, "Healing is a matter of time, but it is sometimes also a matter of opportunity." The time has come for Bahamians to follow the lead of Europeans and Asians in investigating and applying the best of both the conventional and non-conventional medical worlds. Furthermore "…in many modern European nations (Germany and Austria), the employment of herbs and phytomedicines (plant derived treatments) in conventional medical practice is …….considered ………"rational phytotherapy".10 Non-government Bahamian institutions should assist the government by launching symposiums that will promote and solidify the debate on integrative medicine in the Bahamas.
The views expressed are those of the author, and not necessarily those of the Nassau Institute (which has no corporate view), or its Advisers or Directors.
Daniel Jovin is a third year law student, educator, freelance writer, research and sustainable economic development analyst and education policy consultant. He has a degree in History / Legal Studies from Barry University. Mr. Jovin can be reached via email at: jovin_1@yahoo.com.
2 MedicineNet.com. 31 March 2005.
4 Laurel Richey, "Bahamian Bush Medicine" March 26, 2005.
5 Mark Blumenthal, et al., The ABC Clinical Guide to Herbs, (Austin, Texas: American Botanical Council, 2003) xix.
9 Holly J. Hough, Catherine Dower, and Edward O'Neal, "Profile of a Profession: Naturopathic Practice" Center for Health Professions, University of California, San Francisco, September 2001.
10 Mark Blumenthal, et al., The ABC Clinical Guide to Herbs, (Austin, Texas: American Botanical Council, 2003) xxiii.
