I remember taking part in an online survey for Naturopathic physicians a few months ago. The survey was directed to evaluate the income and success of Naturopaths.
I came across the results in my inbox the other day and was shocked at the results. Here are some of the unsettling results:
89% are practicing as NDs and 56% are doing something else full or part time (such as teaching or sales).
-I know of many Naturopaths that have graduated and gone to work teaching at massage schools, med-tech schools, doing sales for vitamin companies. Very few Naturopaths practice full time and make a living.
65% are happy or very happy with the profession
-I agree! I wake up every day excited to be doing what I do. I add this so as to not make this too gloomy a post
38% spend 15 or less hours on direct patient care, while 29% spend 31 or more hours on direct patient care.
-This is very telling for our profession, 29% of Naturopaths work full time seeing patients. It seems that most Naturopaths do not have the patient base to support full time work.
47% answered "not really" or "not at all" when asked if they felt medical school prepared them to operate a medical office.
-To this I agree whole heartedly! There are very few jobs available for a Naturopathic physician to practice full time. In order to practice, it is essential to open a practice. The handling of a business, of a medical clinic is complex and confusing. Trying to open a medical clinic and practice medicine at the same time is near impossible.
This section was the most depressing of them all. No one who gets into Naturopathy does it for the money. But lets be fair- on average a Naturopath takes out a $250,000 student loan burden for the privilege of practicing Naturopathic medicine.
According to most student loan calculators that averages to $2000 a month in student loan repayment. A bank recommends your student loan payment should be 8% of your income. That means a Naturopath should be earning $20,000 a month, and 240,000 a year.
Here is the results of the survey:
34% made $30,000 or less
- That means you pay $24,000 of your income to student loans- $6,000 left for you per year.
14% made between $30,000-50,000
15% made between $50,000 and $70,000
9% made between $70,000 and $90,000
10% made between $90,000 and $125,000
12% made over $125,000 last year
These numbers are appalling and depressing. It seems in order to be a Naturopath you either need to:
A- Already have a lot of money
B- Apply for Income Based Repayment
C- Default on your student loans
D- Create a successful practice.
I have 3 small children depending on me so I chose D. I have been lucky and I have developed a thriving practice. Where I would like to say this is the norm, it is not.
Naturopathic Medicine is very effective in the hands of an experienced doctor. I have seen amazing results in my practice, and it has been these results that has brought me more patients.
With the deterioration of America's health why is it we are just scraping by?
Wednesday, March 24, 2010
Sunday, February 7, 2010
Fidelity
I was asked by a naturopathic student about how I practiced medicine. She thought since I had a masters in oriental medicine I used primarily acupuncture and herbs. This made me think about the state of medicine and specifically naturopathic medicine.
There is the saying if you are a hammer the world looks like a nail. Doctors can fall into this trap. Allopaths (MD's) have historically used prescriptions regardless of effect or even need (ear infections case in point).
In naturopathic medicine it is no less common, in fact I feel it is rampant. Take for instance the naturopathic physician treating autism. I had a patient seeing a renown ($350 per visit) naturopath who strictly practiced homeopathy. She had been under care for several years and after some reading decided to look into possible heavy metal exposure.
I provided her with the material for a provoked urinary toxic metals test. This included a prescription for Chemet. Chemet is a medication that binds to heavy metals and once bound causes them to be excreted via bowel movement or urination. The fecal matter in this case is collected and sent to a lab for evaluation.
At the end of our consult the patient called her homeopathic naturopath. He instructed her not to give her child the medication as that it may "interfere" with the child's remedy. When I confronted the physician, his reply is that there is no proven link between autism and heavy metals.
I reviewed the child's chart note from the homeopathic naturopath. There was no standard of tracking the improvement set in the protocol. The child's wellness and advancement was not evaluated based upon andy standard used to evaluate autism, that means no ATEC and no psych eval. There were however over a year's worth of chart notes evaluating everything but the autism. Unfortunately for the child there was no improvement even by the homeopathic naturopath's metrics.
The reason the homeopathic naturopath requested that the patient forgo any other therapy while taking the remedy was based on his belief that any medication would interfere with the remedy he prescribed. This theory is not new; it was written by Sammuel Hahnaman 400 years ago. It is believed that homeopathy must be done without any interference. But is a broad based approach to care with several interventions considered interference?
Should we have allegiance to a 400-year-old theory, or the life of a child? Because this is what is in the balance. At what point are we trying to prove to the world some ancient system of healing is effective at the expense of the patient?
This is when I question the fidelity of the physician. Do they have a fidelity to the patient or in this case the homeopathic remedy? If this were an allopath using drugs there would be an uproar in the naturopathic community. Not this time.
In my opinion, when a family presents with an autistic child everything must be put on the table. Therapy must be based upon symptoms and history. Areas such as digestion, environmental toxicity, and brain chemistry must be evaluated.
I feel therapy must be broad and aggressive. This is a child, and a child deserves maximal effort. Therapies such as music, occupational and speech should be utilized alongside diet and nutrients. All therapies must be evaluated based upon a standard metric to assess for success. I utilize the ATEC, but there are others available. If a therapy shows no impact it should be replaced with another until there is some mark of improvement.
I am not trying to debunk homeopathy. I know many intelligent people who swear by its effectiveness. But as with any therapy, it is only a tool: the patient is the work of art. All too often this gets confused in medicine.
I am dedicated to the health of the patient and whatever therapy will restore him or her to health. I am not vested in a single therapy. I have no fidelity to anything but the patient. For disclosure, I have a 6-year-old son with autism.
There is the saying if you are a hammer the world looks like a nail. Doctors can fall into this trap. Allopaths (MD's) have historically used prescriptions regardless of effect or even need (ear infections case in point).
In naturopathic medicine it is no less common, in fact I feel it is rampant. Take for instance the naturopathic physician treating autism. I had a patient seeing a renown ($350 per visit) naturopath who strictly practiced homeopathy. She had been under care for several years and after some reading decided to look into possible heavy metal exposure.
I provided her with the material for a provoked urinary toxic metals test. This included a prescription for Chemet. Chemet is a medication that binds to heavy metals and once bound causes them to be excreted via bowel movement or urination. The fecal matter in this case is collected and sent to a lab for evaluation.
At the end of our consult the patient called her homeopathic naturopath. He instructed her not to give her child the medication as that it may "interfere" with the child's remedy. When I confronted the physician, his reply is that there is no proven link between autism and heavy metals.
I reviewed the child's chart note from the homeopathic naturopath. There was no standard of tracking the improvement set in the protocol. The child's wellness and advancement was not evaluated based upon andy standard used to evaluate autism, that means no ATEC and no psych eval. There were however over a year's worth of chart notes evaluating everything but the autism. Unfortunately for the child there was no improvement even by the homeopathic naturopath's metrics.
The reason the homeopathic naturopath requested that the patient forgo any other therapy while taking the remedy was based on his belief that any medication would interfere with the remedy he prescribed. This theory is not new; it was written by Sammuel Hahnaman 400 years ago. It is believed that homeopathy must be done without any interference. But is a broad based approach to care with several interventions considered interference?
Should we have allegiance to a 400-year-old theory, or the life of a child? Because this is what is in the balance. At what point are we trying to prove to the world some ancient system of healing is effective at the expense of the patient?
This is when I question the fidelity of the physician. Do they have a fidelity to the patient or in this case the homeopathic remedy? If this were an allopath using drugs there would be an uproar in the naturopathic community. Not this time.
In my opinion, when a family presents with an autistic child everything must be put on the table. Therapy must be based upon symptoms and history. Areas such as digestion, environmental toxicity, and brain chemistry must be evaluated.
I feel therapy must be broad and aggressive. This is a child, and a child deserves maximal effort. Therapies such as music, occupational and speech should be utilized alongside diet and nutrients. All therapies must be evaluated based upon a standard metric to assess for success. I utilize the ATEC, but there are others available. If a therapy shows no impact it should be replaced with another until there is some mark of improvement.
I am not trying to debunk homeopathy. I know many intelligent people who swear by its effectiveness. But as with any therapy, it is only a tool: the patient is the work of art. All too often this gets confused in medicine.
I am dedicated to the health of the patient and whatever therapy will restore him or her to health. I am not vested in a single therapy. I have no fidelity to anything but the patient. For disclosure, I have a 6-year-old son with autism.
Thursday, November 1, 2007
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