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)
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
——————————————————————————–
(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 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
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What about a person that has a doctorate of Naturopathy. Does that indicate a counselor or medical doctor or something else?
NPLEX exams are part of the requirements to become a licensed naturopathic doctor, but passing them does not guarantee licensure. Licensure is granted by the regulatory boards in the specific province or state where the naturopathic doctor practices.
Wow. Can't someone just answer the damn question with simplicity? Does there have to be freaking over 20 paragraphs of unnecessary information provided? No. Talk about beating around the bush. Get to the point and just say it in 3 sentences.
Love sid"s comment - right on the button
They are not actually real doctors.
Mightn't somebody at any point respond to the damn question with straightforwardness? Does there need to crack more than 20 sections of pointless data gave? No. Discuss shrinking away from the real issue. Cut to the chase and simply express it in 3 sentences.
Response to "Sid" and his supporters: Some of us actually DO want to know the differences in detail in order to determine which, if any, of such persons we will consult about specific health issues. Didn't your mama ever tell you that "haste makes waste"? Quick is not always better. It depends on the situation.
Reaction to "Sid" and his backers: Some of us truly DO want to know the specific differences so that we can decide which of these people, if any, we will counsel on particular health situations.
Nowhere else on this planet have I found such a wealth of informative material as you have. The articles I have are quite helpful. As a reader, I want to return frequently.
It's important to understand the distinction between ND and DNM practitioners. A Naturopathic Doctor (ND) has undergone rigorous training at accredited naturopathic medical schools, where they study a wide range of medical sciences and naturopathic modalities.
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They are BOTH Doctors!
Honestly - It’s time to stop belittling and minimizing the many caring humans who have spent their time, talents, money and dedication of a lifetime on learning - gaining education to be in service of others to help people overcome sickness…naturally! No other industry in the world is so persnickety about what someone ELSE is doing or how qualified they are to do it…in the same industry! That’s simply called overbearing manipulation and narcissistic control!
A Naturopathic Doctor (ND) is in fact “regulated” by one specific agency and educational system (consisting of a small # of 6 accredited schools). To most, accredited schools seem to be based more on an accepted political system of government control now. Schools that accept the designation by the government (designed to dictate what and HOW people are diagnosed & treated for illness & disease) are regularly assessed and evaluated for their compliance in things such as the recent push for world domination of healthcare & control! The same government says you can’t make a claim about certain natural health benefits - that go against their beliefs & approved agenda.
Critical thinking asks Why would only 6 schools in the world be “authorized” to receive government school funding & accreditation to provide medical degrees to those who attend the school? Seems more like a monopoly to maintain only ONE accepted form of programming & dissemination of information! If the CNME can’t include more schools which don’t cost people hundreds or thousands to attend, then to me it’s credibility is diminishing as much as government leadership is in the world these days!
The other Doctor mentioned, is a traditional Doctor of medicine (DNM). Doctor in Latin means teacher, and one who “practices”medicine in this context and title is using teaching modalities which are based on tried and true natural medicine - using the same natural remedies, resources & medical facts taught & used for thousands of years! The DNM are regulated by ALL other credentialing systems and agencies available to ALL natural doctors seeking licences and certification to practice natural medicine, certifying they understand natural medical facts. The ONLY one who won’t accept medical knowledge gained and certify them is the CNME - a faction who is only supporting 6 schools worldwide. What then, makes the CNME a more complete authority in the world of natural medicine…. accept perhaps the government dictators who control them?
A Doctor of natural medicine IS A REAL DOCTOR - one who is educated and trained in natural medical sciences. The DNM is one would rather prove thier ability to teach the same natural sciences learned, as your CNME certified NDs. The only difference is their knowledge of the same, can’t be regulated and dictated based on politics, religious beliefs & ideologies designed to promote whatever group-think form or concept that your government leaders have deemed most appropriate for individual citizens in their country.
There are many more humans seeking natural health remedies over the corrupt pharmaceutical products that corporations are touting & seeking commercial profits on, simply to gain wealth and control over the public sector. The more fear & division is placed on people by government - the easier they are to manage, manipulate, exploit and control!
Truth is - BOTH are in FACT natural doctors who have likely underwent rigorous training, education, time and research to ensure they are knowledgeable and capable of providing instruction & inspiring natural health practices for self-healing. Both are in fact, after attending medical schools and gaining education in natural medicine, eligible and able to be tested, licenced and certified by many highly respected regulatory agencies of natural medicine, who have national & worldwide standards, significance and expertise to help protect public health interests. Testing of natural health & medical knowledge is often just as rigorous as the education itself! The biggest difference between the two kinds of Doctors is the DOE (Dept of Education) accredited schools - they just cost way more than all the other highly recognized & respected schools of natural medicine …many of which have been teaching doctors and practitioners of natural health for decades. It’s the same level of learning - with a different pricetag ….and most importantly, less government intervention & influence!
Last thing I will state here - Ecclesiastical licencing IS the oldest form of licencing, given as a statement of truth and support for any doctor who is named and has passed exams proving their knowledge. These exams test knowledge of natural health & medicine - it is not simply a paid fee to claim one has a degree from a specific school and can be licensed to practice medicine.
Both kinds of Doctors are in fact able to get insurance coverage, can be certified & licenced in many states and countries to have clients/patients who use & pay them for their expertise & for medical purposes.
Both doctors will assess and test for ailments and can provide information about what’s happening in the body.
The biggest difference between the two forms of doctors is the client vs patient. A DNM will call you a client where an ND will call you a patient because they are registered by government to diagnose, treat and prescribe pharmaceuticals. A DNM is the original traditional naturopathic doctor - who will most often try avoid suggesting chemicals and unnatural substances at all costs!
If you tend to follow instructions better with a teacher vs being diagnosed and treated like a laboratory experiment or potentially chance being told to do (or not do) something because of a government political agenda (being pushed in the only 6 schools regulated enough to be accredited by government)…that is your choice. Many people base their decisions on who they can and do trust with their health…it is a very different world these days and many more are asking questions, challenging the status quo & finally thinking for themselves!
In all truth - we know Both forms of doctors are educated enough (based on hours of training) to be called Doctors if they pass exams to claim so! Both DO hope to help make you feel better using the best natural remedies they know. Both will consult and teach you how to use natural programs, products & treatment plans, designed to improve, prevent and remedy dis-ease. It’s 100% about using holistic practices that work! Both kinds of doctors will give advice, instructions and insights on natural concepts that will help improve your health and well being. An ND or DNM will likely not be one to perform surgery on you - but they can help you find the best pathways for your individual body!
What it all truly boils down to is what (& who) one believes will be most helpful in achieving goals in their health journey! Ask questions and seek answers from the doctors you meet. If, based on their knowledge & experience, you don’t believe or trust they have YOUR best interests in mind ….then seek natural solutions & help elsewhere! Intuitive reasoning & critical thinking often tells us all we need to know!