The Private Health Insurance changes from April 1 could leave the impression that Naturopathy is a waste of time and money. The government review of private health insurance cover has removed items for which it found insufficient evidence of their efficacy. This means that natural therapies extras cover now only includes Acupuncture, Chinese herbal medicine and Massage therapy. Considering that Naturopathy comprises a range of well-established diet, lifestyle, nutritional and herbal medicine principles, how could the review find insufficient evidence of its efficacy? Even a spokesman for the medical sceptic group ‘Friends of Science in Medicine’ Prof John Dwyer agrees that diet, nutrition and lifestyle advice are effective – so how did the review reach its conclusion?
The answer to this question lies in the criteria selected to conduct the review. The reviewers decided not to look at the effectiveness of various herbal medicines or at other components of naturopathy such as nutritional and lifestyle advice (which are already proven), but rather looked at the evidence of the efficacy of naturopathy as a profession. At the time only one study was found which met this criterion. Although this study demonstrated the effectiveness of naturopathy for a range of conditions it was dismissed because it was conducted in North America and not Australia and so the positive findings were considered invalid when applied to Australia’s degree qualified naturopaths.
So just what is Naturopathy? Naturopathy is considered an eclectic ‘whole system’ approach which takes into account physical, mental, emotional and lifestyle aspects of health. It is also multi-modality, which means it typically uses at least two interventions together. These interventions or ‘tools’ are typically selected from clinical nutrition, diet therapy/counselling, nutritional supplementation, herbal medicine, and lifestyle counselling. Physical therapies such as yoga or muscle release techniques may also be included depending on a practitioner’s training and interests.
Critics of the review report that the findings are out of date and contradicted by more recent evidence. Professor Stephen Myers from Southern Cross University recently published a systematic scoping review of naturopathy. His study found consistent positive results worldwide for multi-modal naturopathic practice. Prof Myers reported evidence of effectiveness for naturopathy for a range of conditions including cardiovascular disorders, musculoskeletal pain, type 2 diabetes, PCOS, depression and anxiety. Research with lower methodological quality also suggests that naturopathic medicine is effective for treating chronic pain, menopausal symptoms, bipolar disorder, asthma and in increasing cancer survival time.
According to Prof Dwyer’s view on naturopathy ‘The emphasis on lifestyle and good living and nutrition, that’s all perfectly acceptable but that is just mainstream perfectly good medicine, not naturopathy.’ A contrast with ‘mainstream medicine’ and naturopathy is its multi-modal approach, the clinical priorities and the time a naturopath allows with a client to assess and deliver care and patient education. A naturopath may allow up to an hour for an initial assessment with 30 minute follow up appointments typical. A naturopath is not looking at medication as a first line of treatment, rather trying to work with the bodies natural tendency to heal which is often compromised by the modern scourge of poor diet, gut dysfunction, stress, and inactivity. The Natural Therapies Review points out that a lack of evidence does not mean that a therapy is ineffective, and in many cases simply reflects that more research is needed. Prof Myers seems to have found some of this research already. From April 1 a Naturopathic consultation continues to be time and money well spent on the path to supporting a healthy life.
Review of the Australian Government Rebate on Natural Therapies for Private Health Insurance 2015. Australian Government Department of Health
The State of the Evidence for Whole-System, Multi-Modality Naturopathic Medicine: A Systematic Scoping Review. 2019
Stephen P. Myers, PhD, BMed, ND and Vanessa Vigar, BNat (Hons)