7 Reasons For MDs to Collaborate with NDs

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Dear Medical Doctor,

I am a naturopathic physician. On a Facebook page hosted by some peers in my profession, a young naturopathic doctor expressed distress at having her attempt to forge ties with one of her patients’ medical doctor thwarted. Needing her patient to obtain the diagnostic testing covered under provincial insurance only when ordered by a medical doctor, she wrote a letter to the patient’s MD, explaining the case, her assessment, the natural treatments that the patient was taking and her reasons for asking for diagnostic testing to be done. She expressed her hope to work collaboratively with this professional in order to provide better care for their mutual patient.

The response was less than ideal. The MD wrote a short, snappy letter, making clear his disinterest in “working collaboratively” with “alternative health practitioners”. He told her, bluntly, that he would not welcome further communications regarding their mutual patient.

Rooky mistake.

Whether a patient seeks consult from a naturopathic doctor or not, natural medicine is here to stay. The good news for medical doctors, however, is that naturopathic doctors can help make their lives easier and contribute significant benefits to patient management. Here are some reasons for working with naturopathic doctors:

1) Naturopathic doctors are highly trained: NDs go through 4 years of undergraduate education, taking prerequisite courses in biochemistry, biology, psychology, physiology and chemistry. Naturopathic medical school consists of an additional 4 years of intense, full-time study that includes the completion of two licensing exams, one board exam, 3 clinical exams and a 12-month clinical internship working with patients in an out-patient setting. NDs are trained in medical diagnostics, physical exams and can perform procedures such as taking blood, injections, pelvic exams and prostate exams. With extra training NDs are being certified in IV therapies, minor surgery and pharmaceutical prescribing.

Naturopathic doctors speak the same language as medical doctors and our training and medical opinions can be trusted.

2) Patients that see naturopathic doctors in addition to medical doctors do better overall. In a 2013 randomized clinical trial by the Canadian Medical Association Journal, it was found that high-risk patients decreased their risk of heart disease when using both naturopathic medicine and conventional treatments together rather than just conventional medicine alone. NDs have the time to teach patients how to make changes that benefit their long-term health. Adding a naturopathic doctor to your patient’s healthcare team can help decrease their risk of chronic diseases, such as cardiovascular disease, the leading cause of death among Canadians.

3) Naturopathic medicine decreases the burden on the healthcare system. A colleague of mine practised as a registered nurse in Ontario for several years before deciding to begin studies at the Canadian College of Naturopathic Medicine and become licensed as a naturopathic doctor. When I asked her why she told me that she was tired of the “revolving door.” “The revolving door?” I asked, puzzled. She explained that, as a nurse she would often see the same patients time and time again – patients with diabetes who were having trouble managing their blood sugar and mental health patients, for instance – who would come into the emergency room, receive treatment and leave, only to return again after a short time. There was no one addressing the root cause of these patients’ ailments and, therefore, it was only a matter of time before they returned to the emergency room. Working with a naturopathic doctor helps patients take responsibility for their health, addresses the root cause of disease and assists patient in learning how to manage chronic disease more effectively, freeing up the emergency room for actual emergencies.

4) Naturopathic doctors address family physician shortages. Many Canadians do not have a family doctor and many medical doctors are far too busy to take on new patients. Referring patients to be co-managed by a naturopathic doctor can reduce their need for doctors visits, reduce medical clinic wait-times and allow medical doctors to take on more patients on their rosters. Also, by focussing on lifestyle changes, finding the root cause of disease and anticipating health issues such as seasonal allergies, colds and flu or traveller’s diarrhea, NDs can help patients prevent disease. We can effectively take on the ailments that are not appropriately treated with pharmaceuticals (viral colds, for instance), freeing up time and space in medical clinics.

5) Naturopathic doctors can take on chronic, long-term cases. Chronic acne, digestive concerns, musculoskeletal pain, fatigue and mental illness, cardiovascular disease, hormonal imbalances such as uterine fibroids, PMS, PCOS and endometriosis are all chronic conditions, difficult to treat with medications, that benefit hugely from lifestyle changes. Many patients who suffer from these conditions experience immense benefit when treated with gentle, natural therapies and lifestyle changes. Naturopathic doctors excel at treating chronic, long-standing conditions that are upsetting to patients but often aren’t “serious” enough to warrant conventional care or perhaps aren’t responding to conventional care.

6) There is someone managing drug-nutrient or drug-herb interactions. It is estimated that more than 70% of Canadians have used a natural health product. That number is only increasing as the public recognizes the need for nutritional and herbal supplementation. However, interactions between natural remedies and medications are real. Naturopathic doctors are trained in pharmacology and are prepared to anticipate interactions and avoid products that have the potential to interfere with certain medications and medical procedures. Collaborating with an ND also means that there is a recorded history of all the natural products your patient is taking and your patient is far less likely to self-prescribe remedies that have the potential for harm.

7) NDs excel at providing stress relief. “My doctor told me it’s just stress,” a family friend told me over dinner. No surprise. What can sound to some patients like a back-handed dismissal is actually a concrete truth; some sources estimate that 90% of physician visits are stress-related. Naturopathic doctors offer a wide range of therapies such as talk therapy, lifestyle counselling, homeopathy, acupuncture, botanical therapy and nutritional supplementation all of which are effective at helping reduce stress and improve the body’s response to stress. As a society we tend to focus on physical health and lifestyle and neglect the importance of mental health. Naturopathic doctors are well-positioned to offer that kind of care.

Dear medical doctor, we naturopathic doctors appreciate everything that you do. We would love the opportunity to work with you as part of a collaborative team for the benefit of our mutual patients. So please, no more of the above-mentioned letters.

In the words of Vanilla Ice, “Stop. Collaborate and Listen.” Your patients will thank you for it.

Sincerely,

Talia Marcheggiani, ND Cand.

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4 thoughts on “7 Reasons For MDs to Collaborate with NDs

    1. Dear Talia — just wanted to point out your typo of “prostrate” exams. That detracts a bit from “speaking the same language as MDs”.

      It is unfortunate that your colleague met with such a closed minded repose from the MD she contacted. I hope this improves in the future.

      1. haha. Thank you, AL, your correction and irony is noted! I hope you can appreciate the slightly tongue-in-cheek nature of this piece.
        I share your hopes for the future as well.

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