Disclaimer:
My purpose here is not to place one practitioner over another. Rather my agenda is simply to educate those who are interested as to the general difference and similarities between doctors found in both worlds. When I started out in medicine, I was very ignorant as to the differences, the validity, let alone the existence of multiple types of Primary Care Physician's (PCP). If your PCP is a Medical Doctor, then great. If they are a Chiropractic doctor, then awesome. The goal here is to give each person the tools to understand a little bit better the divided world of medicine.
MODEL OF DISEASE IN ALLOPATHY
It was in the mid 1800's that Louis Pasteur made popular the Germ Theory, initially developed over a hundred years before Pasteur's time by a Viennese Physician, M. A. Plenciz. Simply put this theory states that micro-organisms outside of the body invade the human condition causing disease. It is from Pasteur that the vaccine was introduced to the world.
Years later medicine in the Western hemisphere became dominated by the biochemical approach, as developed in Germany, and spread to North America. It is from this approach to disease that an emphasis on synthetic compounds (pharmaceuticals) and surgical intervention was developed and later gained dominance in the early 1900's. Very simply put this philosophy of disease and treatment is what characterizes Pharmaceutical (or Allopathic) medicine.
MODEL OF DISEASE IN NATUROPATHY
With conservative medicine there is a unifying philosophy that the body has the capacity and ability to heal itself. The goal of the Naturopathic Doctor is to identify those blockages and to remove them so that the body can function without impediment. Disease is simply a result of the body no longer being in harmony with itself. When in harmony stress is not a problem, bacterial or viral infection is not a problem. The body can compensate any stress. It is when the body ceases to compensate that disease like symptoms are expressed.
When speaking of harmony there are three factors that make up the human triad that must be optimized. These involve the Emotions (thoughts, beliefs), Chemical (environmental or internal toxins), and Structure of the body itself. Once this human trifecta is in harmony then disease if averted.
For expedience sake I will be referring to Pharmaceutical based medicine as Allopathic and Natural based medical practitioners as CAM (Conservative Alternative Medicine).
DOCTOR OF MEDICINE AND OSTEOPATHY
Most of us are very familiar with the Medical Doctor and I won’t spend too much time here. To become an MD in Europe of the United States one must complete a 4 year Bachelor’s Pre-Med degree, complete 4 years in a Medical school, and finally spend 4 or more years of residency working grueling hours in a hospital. During residency the interns can specialize in a variety of fields. In some countries, such as India and Pakistan, students do their Pre-Med courses in high school and go directly into Medical school after graduation.
The practitioner most people will not be familiar with will be the Doctor of Osteopathy. Back in the day Osteopathic Doctors were very similar to their cousin, the Chiropractic Doctor. They were in every way CAM practitioners and focused generally on enhancing blood and lymph flow as well as bone alignment. It was in 1968 that, due to a shortage of physicians due to the Vietnam war, the Osteopathic Doctor was ushered into the Allopathic Medical institution. Today the DO is virtually indistinguaishable from the MD in practice and philosophy. One distinction is that the DO is given some training in manipulating joints. Like the MD the DO in the United States must complete a Pre-Med degree, attend a 4 year Medical school, and complete a 4 or more year residency program. Areas of specialization are more limited than with the MD.
DOCTOR OF CHIROPRACTICS AND NATUROPATHY
The Chiropractic Doctor is often considered a Spine Doctor. Their specialty is correcting structural and Nerve problems with the human body, especially in the spine. The Chiropractic Doctor is not limited to structural problems though. In the State of Illinois, where they enjoy the greatest scope of practice, they are considered Primary Care Physicians and may do anything short of prescribing Pharmaceuticals and surgery. To become a Chiropractic doctor, students must have a Bachelors degree (with certain letters and science pre requirements) and finish a 4 year Medical School for Chiropractors. Being excluded from the hospital system there are no residency requirements. However, many students opt to spend a few years working under an older DC as an Associate for a few years.
In the evidence based Medical school where I'm attending (National University of Health Science) both ND and DC students are trained in taking and reading blood tests, interpreting X-rays, nutrition, herbal remedies, diagnosing pathology, some pharmacology, etc. Our school's curriculum was designed to closely mirror the Allopathic curriculum closely. The great difference here is less of a focus on pharmaceutical and more on the musculoskeletal intervention. This is not true for all DC or ND schools, and in some ways NUHS is unique having been founded by MD DC practitioners.
The Naturopathic Doctor is similar to the DC in the requirements include a Bachelor's Degree with certain pre requirements, completion of a 4 year Medical program, and then possible Associate work under older Doctors if desired. Although recognized in only 20 states and territories, the ND is trained significantly in internal medicine. Their arsenal of treatment includes a heavy education in botanical remedies, homeopathy, counseling, hydrotherapy, and much more. In Arizona and Oregon ND's can prescribe most pharmaceutical and perform some minor surgery. In Utah they may prescribe non-controlled drugs, while in Maine they must finish a one-year collaborative relationship with a MD.
Unlike the DO and MD there is no MCAT entrance exam needed for the CAM practitioner. However, for the CAM practitioner the DC must pass a 4-step board exam and ND a two-step board exam before they can be licensed upon graduation. The MD and DO must complete a 3-step Medical Board Exam for licensure in the US.
SCIENCE BACKED MEDICINE
The Gold Standard for Medicine in the West is Double Blinded Clinical Trials (DBCT). Generally, this controls the evaluators bias and the placebo effect by disguising who is being given the real treatment.
I'm going to first consider the assumption that all Allopathic medicine meets the Gold Standard of DBCT. Although billions are spent on pharmaceuticals, we know the mechanism of action for about 50% of all drugs. This means that 50% of pharmaceuticals are given based on clinical evidence. That is, we see that the drug is getting rid of the unwanted symptoms.
Surgical intervention certainly does not meet this high standard either. Surgical protocols do not undergo double blind clinical trials by and large. The one instance a placebo controlled trial was used to evaluate protocols for knee surgery, the patient who was given the placebo (small skin incisions over the knee) recovered as though he were given the surgery.
As one might guess, due to the cost and other reasons, CAM relies far less on DBCT. Rather, if a protocol or supplement works for 90 out of 100 patients then you keep using that treatment. We call this Case Studies or, if the group is larger, Cohort studies. CAM is none-invasive so it does not have to monitor closely for severed arteries or life threatening side effects from a synthetic drug.
At the same time current papers have been published in medical journals validating the benefits of Chiropractic adjustments. Studies have shown that many patients who qualified for spinal surgery, due to herniated disks, were successfully treated by Chiropractic care.
Research has shown that disease can not only by caused by improper food, but it can also be cured by appropriate food. Studies have shown that people with high cholesterol can reduce their cholesterol by taking high doses of vitamin B3 (niacinamide) by 20%. This is getting close to a statin drug. In other studies foods like turmeric have been shown to greatly reduce osteoarthritis.
CONCLUSION
There are legitimate reasons for using either practitioner. Depending on what philosophy of medicine you adhere to, either way, the doctor that you choose will typically have research and evidence behind their treatment. The doctor that you choose, whether CAM or Allopathic, will have a great deal of education behind their license. But like anything, we must always look at the individual Doctor. For their license is only as good as they are.
I hope this has given you a brief overview as to the credentials behind whatever doctor you choose and well as reasons for why different options are available in medicine today.
Comments