ND & DNM: What’s the Difference?

I’ve seen the designation D.N.M after certain practitioners advertising in Vitality. I know that it stands for Doctor of Natural Medicine, and I know that isn’t the same as an ND, or Naturopathic Doctor. Can you explain exactly what the differences are?

Molly Wright, Toronto

Editor’s Note: This is an understandable confusion. Because some practitioners of complementary therapies are not regulated in any way, the conveying of titles and designations can be misleading and hard to understand. A Naturopathic Doctor is often referred to as a Doctor of Naturopathic Medicine, which, to some NDs, makes the ambiguous designation Doctor of Natural Medicine much too close for comfort.

We asked Iva Lloyd, a Markham ND and board member of the Canadian Association of Naturopathic Doctors, to explain the difference between ND and DNM.

We also asked Sheila McKenzie-Barnswell, a Doctor of Natural Medicine, who is affiliated with the World Organization of Natural Medicine Practitioners for her response.

Here is the full version of each of their responses.

(This, below, is the response from Dr. Iva Lloyd, a Naturopathic Doctor, and board member of the Canadian Association of Naturopathic Doctors)

NATUROPATHIC DOCTORS

Looking at the differences of ND and DNM or any other designation boils down to three main considerations: qualifications, regulation and designation.

Qualifications, or educational standards ensure that the practitioner has been adequately trained. Licensed naturopathic doctors are required to complete a minimum of three years of pre-medical studies at a recognized university followed by four and a half years of full-time naturopathic medical education at an approved naturopathic medical college. There are only six of these schools in North America, one of which is the Canadian College of Naturopathic Medicine in Toronto, Ontario. These schools have been accredited by the Council on Naturopathic Medical Education (CNME). The CNME is a member of the Association of Specialized and Professional Accreditors and abides by ASPA’s code of good practice. The U.S. Secretary of Education recognizes the CNME as the national accrediting agency for programs leading to degrees or diplomas as a Doctor of Naturopathic Medicine. The CNME is recognized as the accrediting body by all the approved schools as well as the professions national associations in both the U.S and Canada. This schooling involves training in the same medical sciences as medical doctors, as well as, training in natural forms of healing such as clinical nutrition, botanical medicine, Traditional Chinese Medicine and acupuncture, homeopathic medicine, naturopathic manipulation, physical medicines and lifestyle changes. Approved naturopathic colleges give students a thorough knowledge of diagnostic techniques that can only be acquired through contact with a patient. All of the approved naturopathic colleges also require 1,500 hours of supervised clinical practice with patients.

All licensed naturopathic doctors in Canada and the United States write board exams that are standardized for North America. These board exams are called the Naturopathic Physicians Licensing Exams (NPLEX) and are administered by the North American Board of Naturopathic Examiners (NABNE) which is similar in structure to the National Board of Medical Examiners. While NPLEX creates the exams, NABNE sets policy regarding the qualifications of applicants to take NPLEX, sets policy regarding the administration of NPLEX, verifies the qualifications of applicants to sit for NPLEX and administers the NPLEX at testing sites in the U.S. and Canada. The successful completion of the NPLEX is just one part of the requirements to become a licensed Naturopathic Doctor and NPLEX does not guarantee that the examinee will be licensed. Licensure is granted by the regulatory boards in the province or state where the Naturopathic Doctor practices.

To become a licensed Naturopathic Doctor in Canada you have to attend one of the approved naturopathic medical colleges (visit www.cnme.org for more information), write and pass NPLEX and write and pass any add-on examinations required by the provincial regulatory boards. As far as I am aware, there are no full-time programs or schools that train people to become a Doctor of Natural Medicine and correspondence programs do not prepare students for practice as licensed practitioners.

Regulations have to do with whether or not a provincial government recognizes and has approved a scope of practice for a specific practitioner group, such as Naturopathic Doctors, Chiropractors or Midwives. The main purpose and value of regulation is that it is an outside appointed group that protects the public. This provides them with a comfort level that there are standards of education and a defined scope of practice. It is because of the lack of regulation in many modalities that there is so much confusion for the public.

Naturopathic Medicine is regulated currently in four provinces in Canada: British Columbia, Manitoba, Saskatchewan, and Ontario. Alberta’s regulations are scheduled to be completed by the end of 2004 or early 2005. In a regulated province only those practitioners that have completed the appropriate training and obtain licensure are able to practise. Regulation also ensures title protection which helps identify qualified practitioners for the public.

The regulatory board for Naturopathic Doctors in Ontario is the Board of Directors of Drugless Therapy — Naturopathy (BDDT-N) see www.boardofnaturopathicmedicine.on.ca/. This board is a government-appointed board that is independent of any of the naturopathic associations and its job is to protect the rights of the public and to ensure a standard of patient care.

Doctors of Natural Medicine, Homeopaths, Herbalists and many other modalities are not currently regulated in any province in Canada. This means that there is no independent regulatory body that ensures that these individuals have appropriate training, or that standards of practice are being maintained. It also means that if a patient/client has any concerns their only recourse is a court of law. Most insurance companies only cover practitioners that are licensed.

Designations can be very confusing. In all provinces practitioners that have completed the required training and licensure are granted the title of Naturopathic Doctor (ND). For confirmation on qualification of any practitioner claiming to be a naturopathic doctor feel free to contact the CAND at www.cand.ca.

A naturopath or a Doctor of Natural Medicine is not a naturopathic doctor. When you looking for a practitioner in a non-regulated province or you are dealing with a non-regulated modality, such as Doctor of Natural Medicine it doesn’t really tell you anything. There may be ideals of educational standards or ideals of practice, but when anyone can use a designation without an outside, independent regulatory body overseeing each applicant and ensuring standards it leaves room for a lot of confusion.

Naturopathic Medicine is a primary health care profession that focuses on prevention and uses non-invasive methods and natural substances to enhance healing. Naturopathic doctors are trained to examine, diagnose and treat patients, emphasizing support and stimulation of the body’s natural healing mechanisms. Their treatment programs are tailored to each patient’s individual health condition and integrate dietary protocols, clinical nutrition, botanical medicine, acupuncture, Oriental medicine, homeopathic medicine, physical therapeutics and lifestyle counselling.

Doctors of Natural Medicine are not regulated in Canada. Therefore, you can’t compare a Naturopathic Doctor to a Doctor of Natural Medicine.

The best advice is to be informed. Verify the qualifications and licensure of any practitioner and check with your insurance company to confirm that they are providing coverage.

Iva Lloyd, ND
Doctor of Naturopathic Medicine and Chair of External Communications of the CAND

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(This, below, is the response from Sheila MacKenzie-Barnswell, mostly unedited, and Vitality takes no responsibility for the accuracy of the comments.)

DOCTORS OF NATURAL MEDICINE

Doctors of natural medicine are a multiple disciplinary group of Natural Health care professionals — Naturopaths, Homeopaths, Osteopaths, Dentist, Holistic Medical Doctors, Chiropractors, Orthomolecular Medical Doctors and Eastern Medicine Doctors, among others who have dedicated themselves to providing basic Natural Medicine health care worldwide.

Doctors of Natural Medicine have met the standards as established by the WONMP — World Organization of Natural Medicine Practitioners established to standardized the practice of Natural Medicine worldwide. Doctors of Natural Medicine in Canada are just a small portion of this larger body.

It is of interest to note that most recently the Louisiana Naturopathic association has modified themselves as the Louisiana association of Natural Medicine Doctors.

WONMP would like “Doctor of Natural Medicine” to become a household name. WONMP is dedicated to restoring the lost arts and science of Traditional Natural Medicine to it rightful place in the health care worldwide. WONMP is not concern with the politics in North America or the politics of a few Naturopaths and Allopathic Medicine but to service the world impoverished peoples.

Naturopaths can register as “Doctor of Natural Medicine” But a Doctor of Natural Medicine is not necessarily a Naturopath.

Under WONMP we have Doctors of Natural Medicine European Division, South America, North America, Africa, Canada (small group). All doctors of Natural Medicine have main stream medical training but because of a higher level of consciousness receive additional training in Natural Medicine therapies (at least 1,000 hours of additional training in Natural Medicine) Most Doctors of Natural Medicine outside of North America are engaged in areas of medicine that are restricted to non-allopathic doctors in North America. For more information see website at: https://www.wonmp.org. Every country has its own set of standards on regulation of health care professionals, The Doctor of Natural Medicine in Canada is in the same position as Naturopaths, Homeopaths, Chinese Medical Doctors and any other unregulated Doctors in Canada. It is also interesting to note that the Alberta Government recognize Doctors of Natural Medicine and a submission for regulation under Health and Wellness Alberta was submitted by the Alberta association of Natural Medicine Doctors three years ago. Many insurance are now reimbursing clients for services offer by Doctors of Natural Medicine.

I must also inform you that WONMP is accrediated and recognized by International Parliament for Safety and Peace (IPSP), under international law, recognized by the Vienna Convention of 1961 & 1963 (www.internationalparliament.org) Under international Law it is a crime to try to take away the civil liberty of the world people. DNM is a designation awarded to Doctors who meet the critera to receive it.

There are two levels of registration for doctors/physicians of Natural Medicine as per standards established by the World Organization of Natural Medicine Practitioners

Level I — Doctor of Natural Medicine (Traditional Natural Medicine Doctors)
Registrants accredited at this level have completed a four year formal program or equivalent ( approximately 4,000-4,500) hours of training) in traditional Natural Medicine: in-depth health sciences (800 hrs) Public Health (200 hrs) Clinical internship (1,000 hrs) and Natural Medicine courses: Nutrition, botanical medicine, homeopathic medicine, oriental medicine, lifestyle counselling, natural medicine diagnostics, manual therapy (2,000 hrs )

Level II
Registrants registered at this level are medical doctors with additional training in Natural Medicine — Medical School — 2,000 hrs in Natural Medicine studies. They must have primary physician skills in addition to training in: clinical nutrition, botanical medicine, homeopathic medicine, oriental medicine.

As of January 2005 all applicants must pass the doctor of Natural Medicine examination designed by WONMP before being accepted for registration. The examination is a standardized examination for all doctors of Natural Medicine world wide therefore if your are in North America, Africa, South America Europe etc. you will be required to sit for the same examination

Dr. Sheila Barnswell
Registrar North America