Times are a changing for naturopathy. The little kid on the block is growing up – and fast. Our profession is going through a transformative period of modernisation, as it rapidly remodels itself for greater legitimacy in the twenty-first century. With this, an increasingly large number of Australian naturopaths identify themselves as being scientific-based practitioners and a majority of contemporary practitioners use ‘evidence-based’ as one of their key branding points when they market themselves or their services. Accompanying this shift is an apparent rebranding of our naturopathic title, with more and more of us moving away from the use of the classic yet simple title ‘naturopath,’ instead adopting new and novel ways to identify our services.

These changes lead one to question the motives driving the move away from tradition – does naturopathy have a crisis of identity or has the title ‘naturopath’ become a dirty word that modern naturopaths are choosing to avoid?

An unprotected title

‘Naturopath’ remains an unprotected title in Australia, despite considerable efforts over the last few decades to formalise education and legitimise the profession. As it currently goes, any individual can call themselves a ‘naturopath’, set up a naturopathic practice, and use the same naturopathic medicines that qualified practitioners have spent many years learning how to use. Consequently, there have been some prominent cases where certain individuals have taken advantage of the lawless landscape, promoting themselves as ‘naturopaths’, using dubious practices, and ultimately causing harm and endangering members of the public. Unsurprisingly, these events ultimately end up tarnishing the title and reputation of naturopathy in the public eye, despite being entirely unrepresentative of the true nature of naturopathy or the practices of fully qualified, formally trained practitioners. This kind of condemnation is not easily undone and leaves lasting impacts on our name. For many of the uninitiated, ‘naturopath’ is synonymous with ‘quack,’ ‘charlatan,’ or ‘fraud.’

A fight for legitimacy

As naturopathy in Australia continues to grow in size and popularity, the profession fights fiercely for a seat at the table of Australia’s healthcare system, despite being the subject of constant criticism. Stemming primarily from the orthodox medical community, critics of naturopathy place pressure on our profession to produce evidence for our practices that can match those of their biochemical counterparts. They accuse anything that deviates from their paradigm of reductionist thinking as being pseudoscience unworthy of consideration, implying it to be nothing better than snake oil and its practitioners the salesmen pushing the product. Thus naturopathy is always on the defense, jousting for legitimacy in the mainstream arena. Furthermore, as an increasing number of Australian citizens seeking out naturopathic care, naturopaths are having to provide collaborative care for their patients and work alongside medical doctors, with added pressure to conform and integrate into the orthodox model. Naturally, once modern naturopaths have this newfound place in the system, they don’t want to lose face or reputation and therefore move further away from the very traditions and essence of naturopathy that are the target of orthodox scrutiny.

Out with the old, in with the new

When asked to choose between science and holism, many naturopaths positively declare themselves to be science-based. More and more contemporary naturopaths are de-identifying themselves with the holistic, traditional values of the profession, moving further towards the scientific end of the spectrum. Although many will argue that the two are not mutually exclusive and having to choose between them is a false dichotomy, many are, nonetheless reframing themselves and their practice away from the dirty word, ‘naturopath.’

So with this tarnished reputation, growing polarisation around the title ‘naturopath’, and the eternal quest for legitimacy in the mainstream arena, it is understandable that so many contemporary clinicians are finding new and novel way to describe themselves as practitioners. The plethora of pseudonyms rising out of the escape from stereotype is as creative as they are diverse, but in this rapidly changing marketplace, it leaves many a naturopath, especially the young sprouts, wondering what title, exactly, they should or could be using.

Practitioners who are classically trained as naturopaths and regularly practice what is easily recognisable as naturopathy are choosing from a new list of titles that are sometimes a small side-step from the original and at other times a large leap in a different direction.

Although this list is not exhaustive, some popular choices we have noticed in the natural healthosphere of recent times include:

  • Clinical naturopath
  • Functional medicine practitioner#
  • Natural health practitioner
  • ND^
  • Nutritionist*
  • Clinical nutritionist*
  • Nutritional medicine practitioner*
  • Medical herbalist
# While there is formal training for functional medicine, the title is not protected and many use it without appropriate certification

^ ND is ambiguously used in a postnominal form by many naturopath, despite the use of ‘doctor’ being a protected title even in the context of ‘ND’ (ND is typically used in American countries to signify naturopathic doctor). Many argue that ND stands for naturopathic diploma.

* Although nutrition is a modality and field of study in its own right, there are many ‘naturopaths’ choosing to use the title nutritionist over naturopath

Is it time for a makeover?

In recent years, there has been a swelling of interest from within the profession for statutory registration. Many view naturopathic registration as a pivotal milestone that would lead to not only greater legitimacy within the mainstream healthcare arena, but also complete protection of the title ‘naturopath’. This would arguably lead to the eventual makeover of our title, whereby the negative stereotypes would eventually be dusted off and a new age of naturopaths defined over time.

However, the push for statutory registration is not without its critics; significant fractions from within the profession itself adamantly oppose registration and continue to block efforts made for its attainment, and hence the protection of our title. The issues around statutory registration, particularly the ‘registration debate,’ require an in depth discussion in their own right, but it is in part because of these internal polarisations that naturopathy’s push for registration continues to make slow progress.

Risk of fragmentation

The elders of our ranks have expressed their concern about the risk they see for our profession splintering apart or becoming engulfed into other modalities. As a group that continues to struggle to unanimously define itself, the split between science versus holism in naturopathy, no matter how false of a dichotomy it may be, threatens to see parts of us swallowed up into the ranks of functional medicine. With fewer naturopaths identifying with the title ‘naturopath’ and more spin-off titles appearing every day, perhaps the elders are right?

The road ahead

The situation is tricky and no obvious solution exists. The pro-registration team will argue that the answer lies in registration and title protection, while the anti-registration team will counter by advocating for self-regulation and freedom. Others happily embrace the evolving landscape and shift towards functional medicine practices, while others again remain comfortable and content in our traditions.

In 2015, the Australian Naturopathic Federation (ANF) was formed in an effort to provide a vehicle for Australian naturopaths into the World Naturopathic Federation (WNF). The ANF aims to be a voice for naturopaths and present a united front for naturopathic issues on a national scale. So far, the National Herbalist Association of Australia (NHAA) remains the only member of ANF, with Australian Naturopathic Practitioners Association (ANPA) and Complementary Medicines Association (CMA) in the process of joining. This still leaves a notable number of associations out of the ‘united voice’, the most oppositional of which are the Australian Traditional Medicine Society (ATMS) – who’s naturopathic arm is staunchly anti-registration.

Proudly Naturopathic

Having considered all of this, it might be fair to imagine that these issues will continue to splinter and persist for as long as our title remains endangered. Unless the ANF can truly unite the profession and exert its own regulatory influence, the push for statutory registration remains high on the agenda for attenuating the current fragmentations.

At the end of the day, change is inevitable and most of us in naturopathy embrace it with open arms. We welcome the influx of new scientific understanding and the technologies that come with this as they make our job easier, our practices more effective, and improve patient outcomes. But for all of the rich history that comes with our name, naturopath, it would be a great loss to see it slowly disappear.

Around here we are proud to be naturopathic and will continue to wear our title like the badge of honour that we believe it to be.

The Naturopathic Insider xx

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