Naturopathic medicine: the best preventive medicine

I strongly believe that prevention is the answer to our current healthcare crisis. 

I have heard a lot of discussion in the media lately saying preventive services are too expensive and significantly add to the enormous cost of healthcare in this country.  As I’ve mentioned in a previous post, the concept of prevention has become confused with screening.  Most primary care physicians now only practice screening, not prevention.  Screening is not cost-saving even though it is certainly life-saving, as it allows for early detection of many diseases. Preventive medicine is, by definition, cost-saving, since it prevents diseases that need to be treated at all.  Though preventive services may cost a couple hundred dollars for extra visits to a primary care physician, this is a tiny drop in the bucket compared with the cost of treating, say, cancer or cardiovascular disease.

The art of preventive medicine seems to be lost in much of the allopathic community.  This is more the fault of the healthcare system rather than the physicians.  Because of poor reimbursement rates for primary care, most physicians have extremely short patient visits which simply do not allow enough time for a discussion of prevention.  Physicians are paid for the diagnosis or management of a condition that the patient currently has; any extra time spent with a patient is not reimbursed (with a few exceptions). 

Many medical doctors also have limited training in therapies like nutrition, exercise prescription, or the preventive effects of many botanicals and micronutrients.  With the huge influence of the pharmaceutical industry in medical schools, discussion of disease treatment typically focuses on the use of drugs (or surgery).  The result: more patients are prescribed drugs than lifestyle changes.

For a naturopathic physician, prevention is foundational to our practice.  In fact, prevention is one of the six philosophical principles of our profession.  Bastyr University describes this principle as such: “Naturopathic physicians emphasize disease prevention, assessment of risk factors and hereditary susceptibility to disease and making appropriate interventions to prevent illness. Naturopathic medicine strives to create a healthy world in which humanity may thrive.”

Prevention is a huge passion of mine.  Though I am happy treating people when they get sick, I would much rather forestall my patients from getting ill in the first place.  Naturopathic medicine is unique in that we have the tools to develop an individualized health plan that promotes wellness and prevention of future diseases. 

Naturopathic medicine is the solution!

Prevention versus screening

What is prevention? The standard of care for preventive medicine specialists in conventional medicine is determined by the USPSTF (The US preventive services task force), which is an independent panel of experts in primary care (like internists, pediatricians, gynecologists, etc). The USPSTF determines when screening exams are necessary, which medications to take for prevention, and how to counsel patients.

The USPSTF comes up with guidelines based on a review of the scientific evidence, and publishes them in the form of “recommendation statements”. For example, the USPSTF determines at what age mammograms, physical exams, DEXA scans, blood tests, etc., are necessary. These are called “screening” tests because they are done for virtually every person of the recommended age and gender. The hope is that by screening millions of people, we can catch a few people who might actually have a certain disease (and thereby save lives).

Is this prevention? Screening exams, by definition, find people who actually have disease. A mammogram, for example, shows when a woman actually has breast cancer, it does not show that a woman might develop breast cancer in a few years. And it certainly doesn’t tell people how to prevent a disease from occurring in the first place.

Why is this important? Naturopathic physicians are experts in prevention, not screening (though we do a lot of that too). We want to work with our patients years before they get cancer, to talk about how to prevent it to begin with, not how to treat it when they already have it! We want to work with our patients to figure out the cause of their high blood pressure or high cholesterol, not just give them a drug to lower it.

Naturopathic physicians are the true preventive services task force! (We should get some fancy uniforms or something)