Whole System Research: Survey on Naturopathic Practice Studies Published

Erica Oberg, ND, MPHThe peer-reviewed and indexed BMC Open has published “Estimated Effects of Whole-system Naturopathic Medicine in Select Chronic Disease Conditions: A Systematic Review.” The 8-person US and Canadian research team, led by Erica Oberg, ND, MPH, (pictured) and Ryan Bradley, ND, MPH, found 15 studies that “were of goodquality and had low to medium risk of bias.” These met a set of inclusion criteria, one of which was that each of the studies most focus on “chronic diseases of public health significance.”

In most of the studies, “a quality of life metric was included and found statistical significance in some subscales.” On primary medical outcomes ofthese randomized controlled trials, which varied across the studies, they found statistically significant positive outcomes (P<.05) in 10 out of 13 studies. The authors, mainly naturopathic physicians with significant research histories, concluded: “Previous reports about the lack of evidence or benefit of naturopathic medicine are inaccurate.” They add, “A small but compelling body of research exists. Further investigation is warranted into the effectiveness of whole practice NM for arange of health conditions.”

Comment: The study has value beyond the naturopathic field: while with a naturopathic twist, there is much here of use to the whole field of whole-systems, mind-body, integrative practice. One take-home is the mixed methods approach. Given the attacks on naturopathic medicine a sutterly unscientific by academics opposed to integrative medicine, the sober conclusion of the authors can remind one of 19th-century humorist Mark Twain’s reported comment upon seeing his own obituary: “Reports of my death have been greatly exaggerated.”

I am similarly reminded of the statement of RAND researcher Patricia Herman, PhD, ND, on completing her exhaustive cost-effectiveness review of complementary and integrative medicine: “I’m tired of this talk that there is no evidence forcost-effectiveness of complementary and integrative medicine. There is evidence. We need to move onto phase two and look at how transferable these findings are. We can take this evidence and run.” The integrative health community can take pride in this review of the outcomes of whole-person,integrative care.

Unfortunately for the naturopathic research community, one of the rules by which research proposals to the US National Institutes of Health are gauged is the breadth of the usefulness of the outcomes. Thus, without positioning these as exploration of integrative, whole-person care, any proposal by NDs can be declined due to the small size of their profession (5,000). Reviewers need to respect the model that the naturopathic doctors provide for all care relative to integrative treatment. Past review practices need to change. That said, kudos to the naturopathic research team. Now, someone in the MD integrative medicine field needs to undertake a similar piece that surveys the still-limited number of whole-practice studies for the broader IM field.

Carlo Calabrese, ND, MPHFinally, kudos to Carlo Calabrese, ND, MPH, (pictured), one of the authors and a former member of the advisory council tothe NIH National Center for Complementary and Integrative Medicine. Calabrese, the founding executive director of the Naturopathic Physicians Research Institute where he still sits on the board with Oberg and Bradley (and this writer), is the godfather of outcomes and whole-practice research in that field. We like to call it researching the way we practice. Carlo has also been a mentor and influencer of many, including me, for more than 25 years. Here’s hoping this publication is satisfying evidence of your life work moving things forward, Carlo.