The natural health world is in the midst of a profound sea change with a rapidly escalating level of professionalism being required from both governing bodies and the public.
There is now a much greater emphasis on higher standards, evidence-based treatments and `integration’ spanning both the scientific and natural worlds.
An example of where natural health is headed is in the US where naturopathic physicians can do minor surgery, give intravenous nutrition and do in-depth diagnostic work. These physicians are now licensed to work in Arizona, Washington and Oregon with 17 more states pending.
A lead driver of greater professionalism in this country is the NZ Association of Medical Herbalists which is in the process of gaining national registration by working with the Health Practitioners Competency Assurance Act requirements.
Wellpark College of Natural Therapies (www.wellpark.co.nz) has prepared the following guideline as to what to expect from a good natural health practitioner.
College principal Phillip Cottingham expects a future where the government will part fund visits to natural health practitioners with an emphasis on helping prevent illness and alleviating the load on the hospital system.
How do you find a good natural therapist?
- Go to relevant association websites and look for a practitioner in your area
- Contact the Natural Health Council who keeps a list of qualified practitioners (www.naturalhealthcouncil.org.nz)
- Contact Wellpark who keep a list of graduates and their specialisation (www.wellpark.co.nz)
- Ask for word of mouth referrals from health food stores
- Email or phone prior to visiting natural therapist to check their qualifications – the higher the level of qualification, the more critical thinking is going on
- Ensure they have a practicing certificate from their governing body, ideally someone like the Naturopaths of New Zealand (www.naturopathsofnz.org.nz), Society of Naturopaths (www.naturopath.org.nz) or NZ Association of Medical Herbalists (www.nzamh.org.nz)
- Ensure they also have a practicing certificate from the Natural Health Council which means they have met NZQA Level 6 standards. “Going to people who don’t have a practicing certificate doesn’t wash these days,” says Cottingham. “It’s a safety and ethics issue and shows what they are doing is evidence-based.”
- Go a Google check to find out about practitioner and where they are involved in health
- If happy with information, make an appointment
What makes a good natural therapist?
- An ability to really listen and be genuinely interested in you
- A commitment to finding the real `source’ of your condition
- Someone with a keen mind who is an enquiring and critical thinker
- Someone with the research skills to seek out the latest scientific information and combine that with traditional empirical knowledge
- Someone who offers individual care rather than follows a set protocol
- Shared decision making. “They should have a real commitment to discuss treatment and expected outcomes with you,” says Phillip.
- Someone who likes people and is prepared to work in a collaborative way with you and orthodox health professionals such as GPs
- Someone who knows the strengths and weaknesses of their modality and is realistic about what they can achieve
- Needs to know when to refer to GP or other health practitioner
- Needs to follow through and be dependable
- Takes good case notes
- Is professional in all they do – professionally dressed and presented and work in professional rooms or a dedicated clinic room in their own home
- If doing body therapies, everything should be hygienic and your modesty should be protected at all times
- Takes time to spend with you. “Studies have shown consultation length is one of the fundamental premises that people choose natural health practitioners over GPs and conventional medicine,” says Cottingham
What sort of qualifications should they have?
- As an absolute minimum a NZQA Level 6 diploma from a reputable natural therapies college
- Wellpark’s Head of Faculty for Herbal Medicine Jill Dunn suggests a bachelor in related health sciences as a minimum
What should I expect from a first consultation with them?
- Expect a longer session of up to an hour and a half
- This will include an information gathering exercise where a health history back to infancy is taken – this may include questions about the health of parents and other family members and also about dental work
- Natural health practitioners want to know what makes that person who they are so they can treat the individual properly
- The case taking may take up to an hour. The practitioner will then initiate some preliminary treatment as part of a broader research plan that will be addressed bit by bit
- Some practitioners may request the collection of anonymous data for any future research project
- Be prepared to take tests result with you and details of any pharmaceutical drugs, herbs or supplements you may be taking
- Expect your practitioner to be well versed in your health issue – and if they aren’t that they will go away and do research on it
- Expect to form a good working relationship with your chosen practitioner. If you are not comfortable with the person, find someone with whom you are
- If they refer you to another health practitioner, expect to leave with a referral letter
- Expect openness and transparency – you should be able to read any case notes they take if you want
- Expect to be given some work to do in terms of making lifestyle changes
- Expect an individualised therapeutic plan to put in place according to your individual needs
What should I expect from ongoing sessions?
- They are likely to see you for a half to one hour session in around a month, but this could be sooner depending on the condition they are treating
- They will want to follow up and see what has changed since the first visit
- Dunn says a practitioner will progressively work through all presenting aspects (nutrition, exercise, wellbeing) and will prescribe a therapeutic modality, for example a herbal medicine
- During each session the practitioner should be altering the health plan to more closely align with what is going on for you
- The practitioner will be the facilitator for you as you go on a personal discovery of how to improve and take control of your own health
- Practitioner should refer you if you are not responding to treatment
Should they belong to any professional organisation? Which ones do you recommend?
- They must belong to an association as membership almost always requires they do some form of continuous professional education and keep their skills updated
- Membership of a professional association should be displayed on their clinic wall
- “If they don’t belong to an association, steer well clear of them,” says Cottingham. “We don’t support practitioners who do not belong to an association as they are not doing anyone any favours.”
What should I do if I’m not happy with their advice or how they work?
- Discuss your concerns with the practitioner directly at first as they may be an easy remedy to the situation
- If you are still not happy, contact their professional association and you should find resolution there
- If you are still not satisfied, or if the complaint is of a more serious nature, contact the Health and Disability Commissioner (www.hdc.org.nz)
- The complaints procedures for Health and Disability Commissioner should be on the natural therapist’s consultation room wall
- If you are not happy with the practitioner, ask for a referral to someone else or self refer
Is it good to get a second opinion when it comes to natural therapists?
- Cottingham’s advice is that all natural practitioners work differently, so doing this could create confusion. “Find someone you are confident with and stick with them,” he says
- Dunn says: “If someone is not comfortable with their practitioner or their recommendation they should seek another opinion, just as you would with a doctor”.
What kind of money should I expect to pay for consultation?
- This depends on modality, but generally around $80 to $160
- The higher end of the scale should be for longer consultations
- Many practitioners will do cheaper half-hour sessions
What if they suggest I buy a lot of natural supplements and these are expensive? Is it a good idea or not? What about buying them from the supermarket?
- The basis of treatments should be on nutritional changes as opposed to dietary supplements
- Dietary supplements should only be recommended around what people can easily afford – there are always other options if finances are an issue
- Dietary supplements should have clear evidence for recommendation and only be used to support required changes
- Dunn says most practitioners should list supplements in order of importance/need and ideally these should be purchased elsewhere so the practitioner has no financial gain. “Although for convenience sake, some clients do like to purchase direct from practitioners.”
- She would have no worries about clients buying supplements from the supermarket – however practitioners often use products for therapeutic as opposed to preventative usage and these may have more expensive ingredients that are different to those found on supermarket shelves
- Cottingham says a practitioner that wants you to spend hundreds of dollars on supplements is a concern. “Are they doing this because this is what you need – or do they need you to sell it to? As an ethical issue doctors are not allowed to have anything to do with selling pharmaceutical drugs, or even owning shares in pharmaceutical companies so they are impartial when it comes to prescribing,” he says.
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