What Do Naturopathic Doctors Mean By “First, Do No Harm?”

What Do Naturopathic Doctors Mean By “First, Do No Harm?”

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The AANP and INM would like to acknowledge Amy Rothenberg, ND, for her contributions to the content of this FAQ.

Licensed naturopathic doctors (NDs) follow six guiding principles that serve as a philosophical platform for all of naturopathic medicine. The principles influence how NDs think about medicine, make clinical decisions, and most importantly, how you are treated as a patient. First,do no harm is one of these six core principles.

Naturopathic doctors follow a hierarchy in patient evaluation and treatment guided by the Therapeutic Order. To do no harm, NDs:

  1. Acknowledge and respect the individual’s healing process, using the least force necessary to diagnose and treat illness.
  2. Avoid, when possible, the harmful suppression of symptoms.
  3. Use treatments that minimize the risk of harmful side effects.

The body works hard on its own to support recovery from injury and illness. But certain genetic, environmental, and behavioral/lifestyle factors can slow or prevent optimal healing and recovery. Naturopathic doctors spend extra time with patients to identify and remove these obstacles to recovery in order to facilitate healing.

Therapies are aimed at supporting the body’s health restoring and maintenance processes, as opposed to only reducing symptoms. Naturopathic doctors view symptoms as nature’s attempt to correct imbalances. Consequently, naturopathic treatments are geared toward allowing the body to reestablish balance and heal rather than suppressing symptoms, which can disable the body’s most primary way of communicating that something is wrong.

Naturopathic doctors choose the gentlest and least-invasive therapies first to achieve the desired outcome for each patient. NDs apply their rigorous training in clinical nutritionbehavioral medicine, botanical medicine, and other natural therapies to provide the most beneficial and least harmful treatments. They are also trained to use pharmacological drugs when necessary. If their state license permits, an ND can prescribe medication as a bridge to manage symptoms while the body repairs itself. If such healing is not possible, naturopathic doctors refer patients to conventional medical colleagues and work collaboratively. For those patients who need to be on medications, naturopathic doctors can help to prevent side effects.

For example, here’s how a naturopathic doctor would apply first, do no harm to a patient who is diagnosed with gastroesophogeal reflux disease (GERD). The ND would:

  • Carefully examine and adjust the patient’s diet and lifestyle to identify and address behaviors that may be underlying causes for stomach discomfort and heartburn, such as overeating, alcohol consumption, spicy foods, lying down after eating, stress, and more.
  • Use lab tests and other clinical diagnostic approaches to assess the operation of the sphincter muscle and/or address inflammation in the lining of the esophagus, stabilizing these systems with natural supplements if appropriate.
  • Aim to avoid or eliminate the prescription of proton pump inhibitors (PPIs) like Prilosec, which can impair digestiondamage the body’s microbiome, are linked to depression, and other side effects.

 About 15 million people in the U.S. use PPIs every year, but studies suggest as many as 70 percent do not benefit from the prescription.

Because of their focus on the most natural, least toxic approaches to health care, naturopathic doctors may be a good fit for people looking for a more comprehensive perspective on health concerns, or for those seeking non-drug therapies.

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