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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, which can result in a team-care approach.
Only 17 states, the District of Columbia, and the U.S. territories of Puerto Rico and the 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.