#NatMEDWEEK2018 - First,Do No Harm

During Naturopathic Medicine Week this year, each day I hope to elaborate on each of the 6 principles that define the practice of Naturopathic Medicine. The reason being that these principles are what unite our profession. Licensed Naturopathic doctors (NDs) may choose to include some or all of the modalities in their practice such as, clinical nutrition, botanical medicine, homeopathy, hydrotherapy, pharmacology, IV nutrition and physical medicine, but the treatment plans are still created based on the six guiding principles. 

Today we begin the first and foremost principle which is familiar to people as a being a part of the original Hippocratic Oath: “First, do no harm”

Sounds simple enough and may seem self-explanatory - the treatment recommended by a doctor should not cause further harm to the patient. However, this simple phrase has a much deeper meaning when applied in Naturopathic Medicine. Two main implications of this principle are:

1. Start with the least invasive therapies such as diet and lifestyle modifications and incorporate progressively more invasive therapies as needed since more invasive therapies may be more effective but have the possibility of unwanted side-effects 
2. Do not hesitate to start with, recommend or refer for invasive therapies if your assessment indicates that IS most beneficial to the patient’s health, thus, preventing more harm. For example, if a patient has a malignant tumor, the best treatment, though heavily invasive, may be to refer them for surgery. This will prevent the cancer from metastasizing (spreading) to other parts. Less invasive therapies maybe beneficial post-surgery for such a patient.

As you can see, a simple phrase can have a complex meaning based on the context – in this case, the context is presented by the patient. More commonly than not, on a daily basis, most NDs see patients for whom the #1 scenario is more applicable and I have chosen to elaborate “first, do no harm” in that context.
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The initial intake visit with most NDs is at least an hour long in order to assess how multiple factors in a patient’s life may have contributed to and shaped their current state of health. This is what provides the context. This includes recording past injuries, surgeries, major illnesses, major life changes such as job change/loss, current living conditions & strain/status of relationships, dietary habits, drug & food allergies, exercise routine, social & lifestyle preferences and spiritual practices. This gives the doctor a 360 degree view of what makes the patient who they are and what changes can be made to stop further harm.
After a thorough history, physical examination and assessment, treatment recommendations that follow the use of the least invasive therapies come into 4 major categories:

• Stop/Eliminate actions:
  • That are detrimental to patient’s health and have known well-established negative outcomes such as smoking, excessive alcohol & recreational drug use. If a behavior has been diagnosed as an addiction, the patient will be referred to an appropriate rehabilitation center/specialist
  • That contribute to disease process all already in progress, example, increased intake of salty foods by patient who has elevated blood pressure

 

• Change/Transition to behaviors that Support health improvement
  • Increased reliance on fresh foods with decreasing intake of processed, packaged, fast foods that can multiple additives, preservatives and have very little nutritional value in terms of vitamins, minerals, anti-oxidants. Eating foods heavily laden with artificial colors and flavors can do more harm and no good to your health
  • Decreased screen time and spending time outdoors or interacting with friends, family and community members
    
    
• Start new actions that contribute to good heath:
  • Eating at regular intervals daily
  • Having an exercise routine based on a person’s need, ability and limitations. For example, if a patient complaints of knee pain, walking should not be their primary exercise- i.e., prevent more harm to the knees
  • Spending at least 10 minutes a day for meditation/prayer and at least 10 minutes doing an activity that is relaxing
  • Having a regular sleep routine

 

• Prevent internal imbalance:
  • Prevent dehydration by ensure adequate water intake. Water is essential for proper functioning of all organs in the body and adult bodies contain 50-65% water. Without adequate hydration many organs & organ systems operate at sub-optimal levels, especially since it is most essential for our main nutrient delivery and transportation system- blood circulation
  • Depletion of nutrients by regularly checking for deficiencies and supplementing as needed
  • By ordering functional tests to check for sub-optimal functioning of organ systems, such as the digestive tract that is our main source incoming nutrients
  • Support any organ systems that require additional support with botanicals, supplements or even medications (or refer you to an MD who would prescribe the medication depending on the State you live in).
    • Opposite to popular belief, NDs support the use of prescription medications as and when necessary based on the patient’s need. This resonates with the “First, do no harm” principle. For example, if a patient’s blood pressure is highly elevated putting them at risk for a stroke or cardiac event, this patient will be prescribed medication to lower the BP first. Then, factors contributing to the elevated BP can be addressed. 

On this first day of Naturopathic Medicine Week, I hope this article gives you some insight into how our first and foremost principle is incorporated in practice. Look out for other posts this week regarding our 5 other principles. I would like to sign off today with this philosophical quote by Voltaire that I find very interesting:
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"The art of medicine consists in amusing the patient while nature cures the disease"

Please be sure to call us for any of your health needs and will be happy to assist you. Thank you for reading and be sure to share if you would like to join me  in creating more awareness about licensed Naturopathic Doctors! 

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