Doctoring Naturally

 

When it comes to health, naturopaths and osteopaths

put doctoring in perspective.

  

by Laura Harrison McBride

 

There have been times when what today is considered

alternative medicine was known simply as medicine.

Even today, there are places where alternative

medicine isn't alternative at all.

For example, traditional Chinese medicine is not

considered "alternative" by the 1.2 billion residents

of China, one fifth of the world's population. Before

the Cultural Revolution modernized China, village

healers, who used acupuncture, herbs and other

techniques labeled by us Westerners as "alternative",

were paid only if the villagers stayed healthy. When

the local residents became sick, it was because the

healer wasn't doing his job so he wasn't compensated.

Now that would be an alternative to the United States'

health insurance system and its doctors. 

But we've got the best health care system in the

world, right? Put down your American flag and listen

to some facts. Though more money is spent per capita

on healthcare costs in the United States, the World

Health Organization ranks us 24th in terms of healthy

life expectancy and dead last among industrialized

nations in a number of key indicators, including

infant mortality.

 

And since the U.S. population is only about 285

million, less than five percent of the world's

population, who are we to call alternative medicine

alternative?

 

Redundant natural medicine

 

It's a matter of context and perspective, not only now

but historically, too.

To have called the use of herbs before the 20th

century natural medicine would have been redundant

because what else was there? About 90 percent of

doctors before 1900 weren't trained in medical schools

but instead practiced the local customs and cures..

In fact, before the advent of modern medicine, Western

doctors weren't much help at all. In fact, it has been

proposed that the reason kings and queens of Europe

during the 17th, 18th and 19th centuries lived shorter

lives than ordinary folk, in spite of having adequate

housing and nutrition, was because they had unlimited

exposure to one of the greatest health risks of the

day -- the medical profession whose treatments

included bleeding, blistering and purging.

Considering that in the past 10,000 years of modern

civilization, medical doctors have only been licensed

for the past 100 years -- less than a tick-tock on

history's clock -- and antibiotics have been around

for only about 60 years -- barely worth a tock, why

isn't today's conventional medicine considered

alternative?

See, it's a matter of context and perspective.

 

Helping the body

 

If you had visited the Native Americans before the

Europeans arrived -- indeed, if you had visited some

of the early European settlers who homesteaded out

West -- you would have found the wives practicing

herbal medicine. They used plants and practices they

knew from home -- wherever that had been for the

settlers -- and things they learned from other tribes

(or cultures) and from observing nature.

Modern day naturopaths follow these time-tested

traditions and more. They use age-old modalities, such

as acupuncture which has been around at least 3,000

years, and newer methods, such as homeopathy which was

developed as a system of medicine by a German

physician named Samuel Hahnemann a mere 200 years ago

or so, at least two tick-tocks on history's clock.

Naturopaths use virtually any proven means of helping

the body to heal, which in itself is a different

approach from conventional doctors who say they heal.

Again, a matter of context and perspective.

 

Improving the practice

 

Osteopaths, almost as familiar as conventional medical

doctors in some parts of the U.S. but less well-known

in Baltimore, also follow a system invented primarily

by a single doctor, Andrew Taylor Still.

Dr. Still practiced in Kansas around 1874 and had

become a doctor through apprenticeship, a common

method when medical schools were few and far between

and the AMA had not yet been established.

Unlike Hahnemann, who intended homeopathy to

completely revise medical practice as it was known at

the time, Still merely wanted to improve upon the

practice of medicine.

During his time as a Mid-West doctor, Still he had

seen frontier epidemics such as cholera, malaria,

pneumonia, small pox, diphtheria and tuberculosis. And

he had experienced the ravages of disease personally

when spinal meningitis claimed three of his children.

His system, Still decided, would support health,

rather than just attempt to cure disease and then

perhaps fewer people would contract or die from the

scourges of the day.

 

'Holistic approach'

 

There it is again, a difference in context and

perspective.

"Osteopathic physicians take a holistic approach to

health care," said Kathleen Kearns, public information

officer for the American Osteopathic Healthcare

Association (AOHA). "When they started  practicing

that way, it was very different from what everyone

else was doing.

"Even now, when you go to see a DO (Doctor of

Osteopathy), the doctor will do a complete physical

and history. DOs will look at the types of trauma you

might have suffered, the stresses you've gone through.

 

"Because they work with their hands, doing osteopathic

manipulations, DOs are able to detect those events in

your body. They can feel through their hands what is

happening in your body."

And, she adds, the anatomy studies of a DO goes

farther than that for conventional medical doctors

(MDs).

Osteopathy relies, Kearns says, on principles of

patient care, the foremost of which is that the sum of

the parts of the body is greater than the whole.

"DOs are taught that structure governs function," she

said, so fixing the structure will improve function,

which is at the foundation of osteopathic

manipulation.

 

A spiritual component

 

But there is another guiding principle, too, one that

osteopathy shares with naturopathy.

"Our philosophy is based on the idea that the body can

heal itself," said Dr. Binyamin Rothstein, an

osteopath who practices in Pikesville, "although

sometimes it may need some assistance, which could be

manipulation, hypnosis, acupuncture, or even surgery

and antibiotics.

"And DOs do some surgery or refer people for surgery

and we sometimes use antibiotics. But nothing I do is

palliative. I don't want to just temporarily relieve

pain; I want to help the body to heal."

And for Rothstein and other classical osteopaths,

there is very much a spiritual component involved.

"I am blessed," he said. "I'm gifted and do a good job

with it. It flows through my hands well."

A good look at that statement will reveal a key

underlying facet of Dr. Rothstein's practice of

osteopathy in Baltimore: "It flows through him. "It

is not his skills, his knowledge or his belief, but

rather the healing itself.

 

Classical healing arts

 

Though he admits to having been drawn spiritually to

healing since he was six years old, the practice is

not about Dr. Rothstein, either. It's about the

serious spiritual business of helping people get well.

"The way I practice," he said, "is so time-consuming,

it couldn't be about money and power and glamour. " 

Indeed, Rothstein adds, he believes Divine Providence

led him to become an osteopath. He turned down a spot

at a prestigious mainstream medical college for an

osteopathic medical school instead.

Similarly, he says, Divine Providence leads people to

his offices who want to be involved in their own

healing. People being led to a doctor? That sounds a

little unconventional and certainly alternative,

right?

Let's put it into context. All it means is that

sometimes a patient from Boston will tell a friend

from Pittsburgh and they both come to Baltimore

because Dr. Rothstein offers them the classical

healing arts they are looking for and need.

 

One big difference

 

Naturopaths also can use many of the healing arts,

including homeopathy, acupuncture, botanical medicine,

Oriental medicine,  nutrition, and counseling, says

Dr. Stacey Kargman, a naturopath who practices at the

Maryland Natural Health Center in Owings Mills..

"In the eleven states that license naturopathic

doctors," said Kargman, "we can also perform minor

surgery and prescribe medications" as can osteopaths.

And there is also naturopathic manipulation, a

physical intervention similar to osteopathic

manipulation or chiropractic.

(Chiropractic care bases its approach on aligning the

spine; osteopathy and naturopathy expand the

manipulation to other bones and even other tissues.

The osteo in osteopathy, however, comes from the Latin

for bone.)

While there are many similarities between the two

healing arts, in Maryland there is one important

difference. Osteopathy is regulated and licensed just

like conventional medical doctors. Naturopaths are not

which is a problem both for the naturopaths who

practice here -- Kargman estimates there are about

eight in the state -- and for Marylanders looking for

natural care.

 

Set state standards

 

"The fact that it's unlicensed doesn't mean it's

prohibited," explained Dr. Paul Faust, a naturopath

who practices at the Chesapeake Natural Health Center

in Towson. "But because we aren't licensed like MDs

and DOs are, anyone who does a mail-in degree or a

weekend seminar can call himself or herself a

naturopath. There are no standards established in the

state."

In the next year, Drs. Kargman and Faust say they will

work with the other naturopaths in the state, form an

association and then petition Maryland legislators to

not only set standards for naturopaths but also to

license them so they can prescribe medication and

perform minor surgery, as naturopaths can do in 11

other states.

"At this point, it has almost become a public health

issue, because the general public, not having much

familiarity with naturopathy, won't know the right

questions to ask to determine someone's background,"

said Dr. Faust.

"It would behoove the state to recognize those who

have the degree and passed certain entrance

requirements to become a member of the field. I think

we should have free access to health care, but you

can't choose your doctor and system of medicine you

prefer until all are equally licensed."

 

Education is key

 

Both doctors say that a big part of their service work

is education. In this case, they need to educate the

political and governing bodies about the value of

their profession and they need to educate healthcare

consumers.

Perhaps the first lesson for many is one of context

and perspective: naturopathy is not voodoo, anymore

than osteopathy is. Both kinds of doctors must have an

undergraduate degree and they must have had good

enough grades to get into a four-year medical school.

There are four nationally-accredited medical schools

for naturopathy in the U.S.; there are dozens for

osteopathy. In the case of both disciplines, the first

two years are virtually indistinguishable from the

first two years of any conventional medical college.

In the third year, students in naturopathy begin their

clinical studies. The future osteopaths, too, branch

away from the conventional studies and into the realm

of structure influencing function.

Third year medical students are the characters we see

on television's ER being introduced to conventional

medicine the hard way, by working for Dr. Carrie

Weaver, the scourge of the bedside manner.

 

Difference is real

AOHA Spokesperson Kearns gave a practical -- and

personal -- example of what the difference in training

can make to someone in agony.

Her own daughter was suffering for weeks from terrible

stomach pain that caused her to bend double. Despite

the discomfort, the daughter had to accompany Kearns

on a business trip to Michigan, a state where there

are many, many osteopaths in family practice.

While there, Kearns asked a conference attendee to

look at her daughter, who had been told she had

irritable bowel syndrome but conventional treatment

had not helped. It turned out the daughter had several

areas in her lower ribs and abdomen that were tight.

"After treatment, she was fine and hasn't had pain

since he treated her a year ago," recalled Kearns. "He

treated her twice in two days using manipulation and

no medication. Now she sees a local DO about every

eight weeks."

 

The problem's cause

Naturopathy, like osteopathy, considers the body as an

integrated, complex system, not just individual parts.

 

"We don't look just at symptoms," said Dr. Kargman.

"We look at the whole person. We want to figure out

what causes the problem, the pain or lack of function.

We might suggest something to alleviate the pain while

the underlying problem is being assessed and brought

back to a healthy state.

And, she says, the solution is rarely as simple as

popping a pill. Often, the solution may be a

combination of modalities and lifestyle practices.

"When I lived in Tucson, I treated a lot of HIV

patients," said Dr. Kargman. "Some of them took the

"pharmaceutical cocktails generally prescribed for

management of the problem; others did not. Either way,

naturopathic treatment improved their quality of life.

 

"For instance, many patients had been suffering from

diarrhea for years, some so badly that they thought it

might be too embarrassing to go out with friends.

Generally, dietary changes and acupuncture helped.

"Their viral load began to come down once their bodies

were operating better," she said.

In Tucson, Dr. Kargman was the designated

complementary practitioner for the city's HIV program.

 

Health from many angles

Being a naturopath actually gives Dr. Faust more

flexibility when treating patients, he says. 

"We can combine nutrition with homeopathics, with

botanicals and physical treatments," said Dr. Faust.

"The fascinating thing is that if someone comes into

the office, I'm not stuck with only one treatment

modality. I can determine the best combination of

interventions for this person, even incorporating

referrals to other professionals for everything from

Rolfing to psychotherapy or even conventional docs.

"There's an old saying that if the only tool you have

is a hammer, everything looks like a nail. That's not

naturopathy. It's multifaceted. I like to be able to

approach health from many angles."

Hey, is that context and perspective?

 

Based on prevention

Here is some more. Part of the appeal of osteopaths

and naturopaths for a patient seeking healthcare, say

Drs. Faust and Kargman, is the issue of time. In both

disciplines, the initial visit is likely to take up to

an hour or more, with follow-up visits lasting as much

as 45 minutes.

The norm for a conventional doctor's office visit?

Six minutes, as dictated by insurance companies.

"People actually get to tell their story, can come up

with a cohesive plan, get to know what's going on with

their health," said Dr. Faust.

And, he added, naturopathy is based on prevention.

Patients who see naturopaths want to know what they

can do to prevent sniffles or heart disease or

diabetes and so on.

"Once a patient has a relationship with us and

understand what they need to do, usually he can head a

symptom off and is not totally dependent on us," said

Faust.

"He may be more dependent on us at first, but once he

is educated, he can treat himself  for some things."

 

A fan of ER

As helpful as naturopathy is in managing chronic or

incurable conditions, it can often cure the more

common maladies of mankind without surgery or harsh

(and sometimes life-threatening) antibiotics.

Here's a good place for some context: Both Dr. Kargman

and Dr. Faust say they are not anti-antibiotics. Both

agree there are times when the patient is at a stage

in the illness where there is no time for natural

remedies to do the job and stringent intervention,

such as antibiotics, are necessart.

In licensing states, naturopaths themselves would do

the prescribing, except if "Schedule 3" controlled

substances were indicated. Here in Maryland,

naturopaths must refer the patient to a conventional

medical doctor.

And Kargman lauds the achievements of trauma medicine,

too, even admitting to being a fan of ER. Not

surprising; both naturopaths and Kearns say the

medicine they support is inclusive, not exclusive.

 

Watchful waiting

Drs. Faust and Kargman agree that conventional

medicine does bring some assets to healthcare --

emergency medicine is one -- and they do sometimes

find antibiotics and surgery useful.

But conventional medicine begins with treating

symptoms and providing relief. Osteopathy and

naturopathy begin with finding the cause of an ailment

and treating that.

"Lack of symptoms," said Dr. Faust, "is a long way

from optimal health."

For example, people may go to the doctor, get their

blood test results and be happy because the medical

doctor said everything was in the normal range. Yet

none may have been at the optimal range.

Still, the M.D. may not do anything at that point

because things are in the normal range. Strong

interventions are not warranted yet. It's called

watchful waiting.

Typically, with prostate cancer, for instance, the

doctor will wait until it is bad enough to become a

surgical case; one doesn't want to give systemic

chemotherapy for prostate cancer because the side

effects are so bad.

That's not how naturopaths and osteopaths practice.

Instead of waiting, they work to head off problems and

put you at your optimum health.

 

Work with the patient

Naturopaths also live by the age-old doctors' dictum:

first do no harm. But they take it to very specific

lengths. They learn to:

• Utilize methods and medical substances which

minimize the risk of harmful side effects, using the

least force necessary to diagnose and treat;

• Avoid, when possible, the harmful suppression of

symptoms. Antibiotics, among other drug classes, are

considered suppressive by alternative health

practitioners. And yet, they, too, have a place in

complementary therapies.

"Anthrax would be a case in which I would use

antibiotics," said Dr. Faust. "Part of good medical

care is to be able to recognize the level of

intervention required for a person now, for that

person' s level of infection.

"I wouldn't have a patient with anthrax go home and

meditate and use herbs. In such cases, they should get

antibiotics because they need a high level of

intervention to survive an event or infection."

• Acknowledge, respect and work with the individual's

self-healing process.

 

'An approach of synthesis'

It is all about, for any naturopath or osteopath,

treating the whole person: recognition of physical,

mental, emotional and spiritual components of health

is paramount

"We use an approach of synthesis," said Dr. Faust.

"It's not the reductionistic approach in which a person

will see a cardiologist for heart problems, an

urologist for a prostate problem and so on. We are not

looking at the body as a machine with separate parts;

we look at it as a whole, integrated organism."

And, in states that do license naturopaths, they are

able to do counseling at the same level as a licensed

clinical social worker, he added. With that additional

component for treatment, naturopaths can truly combine

mind-body-spirit into a complete system for people who

want optimal health.

Health, instead of the lack of symptoms. That's a lot

better than the alternative. Naturally it makes sense

when it's put into context and perspective.

 

 

For more information about naturopathy, you can

contact:

• Dr. Stacey Kargman, of Maryland Natural Health

Center,10806 Reisterstown Rd., Suite 1E,

Owings Mills, at 410-356-4600;

 

• Dr. Paul Faust, who practices at the Chesapeake

Natural Health Center, 7801 York Road, Suite 200, in

Towson at 410-821-1788, or visit his website at

www.chesapeakenaturalhealth.com.

 

For more information about osteopathy, please contact

Dr. Binyamin Rothstein, whose practice is located at

2835 Smith Ave., in  Pikesville at 410-484-2121.

 

These websites may be helpful to find a naturopathic

or osteopathic doctor:

• www.naturopathy.com

This site offers descriptions of the disciplines

involved in naturopathy, as well as a 'naturopath

finder' function. It also offers links to other sites

offering health information.

• www.aoa-net.org

This site offers basic information concerning the

history and use of osteopathy, as well as a tab that

lets users "find an osteopath by state."

• www.aacom.org

This site is directed more toward students of

osteopathy or prospective students than consumers.

 

 

TAGLINE

Laura Harrison McBride is a Baltimore-based freelance

writer who treated her horses with homeopathy before

indulging herself in what is now her preferred health

care modality.

 

 

SIDEBAR 

 

A Typical Case

 

Does all this palaver about treating the whole person,

Divine Providence leading people to healers and such

still sound unconventional? Maybe, but what's wrong

with that if it helps to create wellness?

It is, no matter what you label it, a life-changing

process that may require the doctor -- osteopathic or

naturopathic -- to work in many areas. And even

require some effort by the patient. Don't expect some

white-frocked doctor to just look at your chart, ask

you a couple of questions then tell you to get this

prescription filled. Come prepared to fully

participate in the creation a life-style that promotes

health and well being.

Here's an example of a typical case for naturopath Dr.

Paul Faust.

"Let's say the patient thinks she has a low-thyroid

problem. Usually, that would be treated by a

conventional medical doctor with synthetic human

replacement hormone therapy," said. Dr. Faust.

But popping a pill simply masks the symptom and allows

the problem to fester. Plus, the prescription

medication may have a myriad of harmful side affects

that could call for other interventions and you end up

taking pills to counteract the pills you're taking.

There's a better way and that's called treating the

problem, naturally.

A typical naturopathic approach -- which is anything

but typical because it is tailored for each individual

-- might go in any number of different ways, such as:

• It might begin with dietary recommendations to

increase vitamin C while avoiding soy products and

brassica vegetables like cabbage, Brussels sprouts,

broccoli.

• It might include contrast hydrotherapy, alternating

hot and cold to the area to improve blood flow to the

thyroid.

• It might also include the advice to sing or chant

frequently because, from a practical standpoint, that

would increase blood flow which could enhance healing.

• It might also include the advice to speak the truth,

reflect on one's assertiveness, remove one's self from

situations in which one couldn't speak up -- all this

is to honor the throat chakra.

(Simply, the chakras, in Eastern thought, are seven

power points in the body between the crown of the head

and the genitalia that influence the health and

function of the organs that are near them and the

activities those organs perform.)

• The inclusion of specific nutrients might be part of

the plan, such as selenium and zinc, both of which are

used in the peripheral conversion of thyroid hormone

(that is, in making thyroxin, ultimately).

• Practicing inverted yoga postures, such as downward

dog, might be recommended.

• Exercise could be suggested to improve vitality,

enhance the metabolic rate and circulation.

And still, added Dr. Faust, there are other

possibilities that would have been evaluated before a

program such as the one above was developed.

• Sometimes, what a patient has been diagnosed

elsewhere as low thyroid really isn't a thyroid

problem at all," he said. "Instead, it is [ad]renal

fatigue, what is called [ad]renal hypofunctioning. When

the [adrenals] are overtaxed, the thyroid tries to pick

up the slack and becomes abused, over-used and pooped.

"But unless a full history and other evaluations are

done, the easiest solution -- which is really of no

help at all -- is to prescribe a course of synthetic

hormones."

Ease and wrong. Good health doesn't just happen. You

have to work at it. Afterall, good health is not a

spectator sport.

-- Laura Harrison McBride