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Your Comments: 4 NDs on Whether They Go to "Medical School" and are "Naturopathic Medical Doctors" PDF Print E-mail
Written by John Weeks   

Your Comments: 4 Naturopathic Physicians on Whether NDs Go to "Medical Schools" and are "Naturopathic Medical Doctors"

Summary: In the last Your Comments Forum, naturopathic physician and researcher Julie Chinnock, ND, MPH, questioned the choice of language for her profession in a prior Integrator article and wrote: "I would like to clarify that NDs are medical doctors. It is a common misconception that I often see in print and in conversation. We are naturopathic medical doctors and MDs are allopathic medical doctors." I asked for reader response on my appropriate editorial line. Illinois-based Peter Green, ND, Colorado-based Jacob Schor, ND, an anonymous practitioner-educator ND and Chinnock each responded with a diversity of views, and, in one case, with tongue at least partly inserted into cheek. Hot topic.
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"I would like to clarify that NDs are medical doctors. It is a common misconception that I often see in print and in conversation. We are naturopathic medical doctors and MDs are allopathic medical doctors."
So wrote Julie Chinnock, ND, MPH, a researcher associated with the Helfgott Research Institute at National College of Natural Medicine, in a recent Your Comments Forum. In response, I commented on some of the known differences of views in the naturopathic profession, including the use of "NMD" - naturopathic medical doctor - in the state of Arizona. I finished with: "In short, I am not sure how to honor Chinnock's point editorially. Any ideas?" Three naturopathic doctors responded, and Chinnock wrote back with a little clarity.

Julie Chinnock, ND, MPH - a clarification
1.  The Last Word, as the First Word - Chinnock Responds

Chinnock read my comments on her comments and wrote to clarify that she was referring specifically to my use in one prior article and that she understood my editorial plight.
"On a follow-up note, my email to you on terms was specifically referring to your comments in the last issue: ' ...was that Dr. Shinto happens to not be a medical doctor. She is a naturopathic physician.'

"In this case, I think inserting MD and then ND (or naturopathic physician) would have been appropriate.

"I was not necessarily referring to your overall editorial use of the titles MD/ND or requesting that you spell out allopathic medical doc and naturopathic medical doc every time you refer to the corresponding person/degree.

"From an editorial point of view, you do have a challenge. I think in most cases it is appropriate to use MD and ND as a distinction, although this too can be confusing, as states differ (NMD, Naturopathic Physician - not in California - and ND)."

Julie Chinnock, ND, MPH
Portland, Oregon
Comment: Regarding Chinnock's "not in California." In various states, MD professional associations have successfully convinced legislatures to prohibit NDs from using the term "physician." In other states, the right to use "physician" is explicitly in statute. In California, a compromise on the way to gaining licensing of "naturopathic doctors" in 2002 was that these graduates of 4-year, post-premedicine, residential programs, accredited by the Council on Naturopathic Medicine Education (which is itself recognized by the United States Department of Education), are restrained, politically, from using the term "physician." My own bias on this matter (tongue partly in cheek) is that if student loan debt gets up over $125,000 for enough of the graduates, then, by, well, default (or potential thereof), a person has earned the right to the title, if only because he or she has a need to make a medical doctor-level income to pay off the debt. A sort of resource based relative value titling. From what I understand, the NDs have hit that debt threshold.

Commentator Jacob Schor, ND, with spouse Rena Bloom, ND
2.   If you are battling for licensing, hinting of ND/MD equality is political idiocy

Jacob Schor, ND
, was last seen in the Integrator in a short piece which noted that he and his spouse, Rena Bloom, ND, were once again taking up the banner of pushing for licensing of naturopathic doctors in the state of Colorado. Last year marked their 7th campaign on behalf of the Colorado Association of Naturopathic Physicians. Colorado is one of 36 states in which NDs do not presently have a license to practice.
"Your juxtaposition of Reed Philip's piece suggesting that ghetto is an appropriate term to use in connection with CAM practitioners and Dr. Chinnock's piece complaining about you making distinctions between types of doctor is thought provoking.

"My first thought in response to Dr. Chinnock, translated from the Hebrew is, 'Where do you live?'  How is it that you can have so naive a view of the world....?  You provided the answer at the end of the letter. Dr. Chinnock not only lives in Oregon, where the practice of naturopathy has been legal for four-score years, but also works for the Helfgott Institute.

"Hinting, insinuating or in
anyway suggesting that
(NDs) are medical doctors
to the public is an easy
way to draw the wrath of
the medical board upon us."

- Jacob Schor, ND

"For those of us who do not practice in the luxury of licensed states, who still scan the daily mail delivery for long expected Cease and Desist orders, her request for you to not distinguish between schools of medicine does not fall on appreciative ears. There are a number of reasons.  The most obvious is that hinting, insinuating or in any way suggesting that we are medical doctors to the public is an easy way to draw the wrath of the medical board upon us.  To plead for such equality of titles while practicing in the safety of a long licensed state is easy.  To do so outside of a licensed jurisdiction would be idiocy. Even for you to follow her suggestion, would in some little way put us in greater jeopardy.

"Aside from this though, there is a matter of pride.
I have no interest in being mistaken for a medical doctor.  Nor do I want anyone to think that I was indoctrinated into the study of medicine at one of their schools.  I graduated from National College of Naturopathic Medicine and am proud of that.

"Please continue to make these distinctions and encourage those of my profession to continue to do so."

Jacob Schor, ND
NCNM, Class of 1991
Comment: As a clarification, Chinnock is clearly not trying to end distinctions between the two disciplines. At the same time, using "medical school" does blur things.
His Royal Righteous Pomplitude Peter Green, ND
3.   Chinnock's right and you are not!

One comment arrived from a friend of nearly 20 years, Peter Glidden, ND, with whom I have maintained a relationship addled by silliness (a personal long suit, being addled that is). Glidden, writing with tongue well in cheek, offers a clear view of what needs to be corrected in this sorry writer's view.
"Relative to your query: '…how to honor Chinnock's point editorially. Any ideas?' The answer is simple: Just shut up and honor it. She’s right and you're not.

"It may not be politically correct to have ND’s refer to themselves as medical doctors, but it is inherently, academically, and semantically correct for them to do so. Anything else would be perjurious, weak and anathemic to the education and degree of Naturopathic Doctor.
"It may not be politically
correct to have ND’s refer
to themselves as medical
doctors, but it is inherently,
academically, and
semantically correct for
them to do so."

- Peter Green, ND


"Take some testosterone, have a beer, do some push-ups and recite 10 times out-loud: ND’s are medical doctors. (emphasis added)…

"Please feel free to forward all future inquires regarding any and all aspects of naturopathic medicine to my attention – as my IQ grows larger everyday due to my heavy metal detox program and extracurricular use of guarana root. I look forward to helping the foolish to become wise…

"Until that time, I remain, Yours in humble servitude"

Peter Glidden, ND – aka: O Captain, My Captain, Dr., Sir, Your Royal Righteous Pomplitude, etc., etc., ad nauseum
Lombard, Illinois
Comment: I confess that I also don't know what part of this to take seriously, other than the claims of his detox program.
4.   "Allopathic medical doctor" is a pejorative term, like a racial slur

One strong response came from a naturopathic physician and educator who preferred to remain anonymous. The writer believes the topic is an important one.
"This was an interesting post, as it touches on an issue that is important, though my views are diametrically opposed.  I teach students not to use the term 'medical school' to describe their education. This is something a certain other CAM profession is notorious for, and their reputation is not one worth emulating.
"Using the term 'medical school' to describe our education creates confusion in the minds of the audience, no matter how technically correct the statement is. It is misleading as the common usage of the term explicitly refers to those with conventional medical degrees (MD).  It's like comparing apples and oranges; both are highly nutritious fruits that complement each other. It's also like comparing PCs and Macs. By all technical definitions, a Macintosh is a PC, but when people say 'Mac' they know it as something else than what is called a 'PC.'

 It's also like comparing
PCs and Macs. By all
technical definitions, a
Macintosh is a PC. But
when people say 'Mac,'
they know it as something
else than what is called
a 'PC.'

- ND educator/clinician

"I feel that those compelled to use the word 'medical school' to describe ND education project an implied inferiority, trying to be something they are not. I have many colleagues with MD degrees. I certainly am not on the 'defensive' when educating these colleagues about our training, philosophy, or approaches to clinical care. I went to naturopathic school because I believe in the philosophy and approach to care. I am an ND by choice, and I am also not an MD by choice.

"I happened to have lunch with one of the ND profession's elders today and asked for thoughts on this issue. I found complete agreement. I learned that the original NMD title conferred on Arizona graduates was pushed by chiropractors (who were also NDs) who insisted on calling themselves 'medical doctors.' The American Association of Naturopathic Physicians, my national professional association, strongly opposed using the title 'Naturopathic Medical Doctor' when it was first introduced.

"Finally, I think it important that we not call conventional providers
'allopaths.' Why? This is a  pejorative term for conventional medicine coined by the Samuel Hahnemann, the homeopath. This is no different than using a racial slur to describe your favorite ethnic group."

"I do not want to be a source of contention. I also do not want to see you adopt a semantic position that (hopefully) doesn't represent a majority view."

Anonymous ND
Comment:  My editorial line will not change. That said, I think that more important question rumbling beneath the surface here is what strain of the naturopathic profession will dominate the profession's future. I directly addressed this in a recent article on the Foundations of Naturopathic Medicine Project. Will the NDs emulate the specialization, professionalism and rankism of the conventional medical profession - even as the integrative medicine movement seeks to correct the excesses of that increasingly specialized course?

Or will the direction of the professional maturation of the naturopathic profession be a re-commitment to the generalist, challenging, mundane, mind-body, relationship-centered work of meeting patients where they live and assisting them to the changes in behaviors and habits that constitute the basis of true healthcare reform?

If the former, the assertion of status as "medical doctor" will likely grow over time. If the latter, one imagines that, along with being a naturopathic medical doctor, one is also affirmatively becoming a naturopathic nurse, a naturopathic/whole person dietitian, a naturopathic behavioral counselor and even, in the effort to help link patients to themselves and their communities, a naturopathic social worker. If the NDs embrace this future, successfully, well, they will have grabbed health care's gold ring, "medical doctor" or not.

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