When you go to the doctor, have you grown to expect a prescription over care? In naturopathic medicine, the important question isn’t what’s happening (which allows a prescription) but why something is happening. That’s a bit more detailed and requires further investigation.
Naturopathic doctors take this approach based on the therapeutic order. This framework helps them decide where to start, when to dig deeper, and when a prescription, specialist, or higher level of care is required. That order is a core part of naturopathic care, with its focus on preventive care and its prioritization of the foundations of health and individual patient needs.
Quick Links:
- What is the Therapeutic Order in Naturopathic Medicine?
- Why the Therapeutic Order Matters in Naturopathic Medicine
- The Therapeutic Order Leads With the Foundations of Health
- The Therapeutic Order and the Principles of Naturopathic Medicine
- The Therapeutic Order and Standard of Care
- The Therapeutic Order and Preventative Care in Naturopathic Medicine
- How a Naturopathic Doctor Uses the Therapeutic Order
What is the Therapeutic Order in Naturopathic Medicine?
How does a doctor decide how to treat a patient? What efforts and tools do they choose first? To answer those questions, naturopathic doctors use a framework called the therapeutic order. It helps determine the appropriate level of care for individual patients.
First, using this framework, NDs address the foundations of health (sleep, nutrition, etc.) and other factors that may be contributing to the condition or illness before moving on to other treatment options, some of which may be more intensive or targeted.
Some people mistakenly believe that NDs avoid medications, referrals, or more traditional medical treatments and procedures. While the therapeutic order helps guide clinical decision-making, it’s not so strict that it takes precedence over patient care and safety.
Why the Therapeutic Order Matters in Naturopathic Medicine
Before switching to an ND, many of us went to the doctor with a concern or complaint only to have the first response be to look at how to suppress symptoms, often by taking out the prescription pad. For many patients, this is a temporary fix, especially for health issues that are growing or ongoing concerns.
The therapeutic order allows NDs to consider not just symptoms or immediate concerns, but also what may be contributing to the problem, what might be preventing healing or health, and which clinical treatment is most appropriate for an individual patient, based on their health history and other factors.
The therapeutic order:
- Prioritizes patient safety, opting for lower-risk interventions when appropriate
- Evaluates potential contributing factors alongside existing symptoms
- Encourages and prioritizes communication, collaboration, and patient education
- Offers a clear strategy for managing health concerns and working toward health, including higher-level interventions if needed
- Prioritizes and supports long-term health vs symptom relief
The therapeutic order doesn’t just want to answer what could treat the current problem, but also why this might be a problem and what the lowest-risk intervention is that will help us cultivate good health over time.
The Therapeutic Order Leads With the Foundations of Health
Your body cannot function when basic needs are unmet. Many of us know we can’t go long without water and food, but when it comes to other foundations of health, we assume we’re just fine if we skip or skimp on them.
First, let’s define those foundations according to naturopathic care:
- Quality sleep
- Nutrient-dense and healthy diet
- Hydration
- Deep, Patterned Breathing
- Regular physical activity
- Daily spiritual practice
- Social connections and healthy relationships
- Emotional well-being
- Time outdoors (nature and natural light)
Let’s use sleep as an example. When we don’t get enough, especially over a few days, it becomes quite clear how essential it is to our energy levels, our ability to think clearly, and our mood stability. We might even get headaches and other physical symptoms. If we don’t get enough sleep, we just don’t function at optimum.
The same is true for other foundations of health, such as nutrition, hydration, movement, stress reduction, social connection, and more. All of these play a role in our energy levels, digestion, immune function, blood sugar levels, blood pressure, mood, and more. If we’re not managing them, they’re managing us and will manifest in other symptoms. Ultimately, ignoring these health factors will catch up with you.
So, when you go to a naturopathic doctor, they’ll often start by discussing these as well as collecting health history information. While some conditions can’t be solved by changing or adjusting your habits, sometimes they can play a significant role in your symptoms, ongoing conditions and concerns, or how well you’re responding to other treatments.
Let’s go back to sleep for a moment. A prescription for a sleep medication may help you fall asleep, but it will not necessarily treat the cause, especially if stress levels are high, nutrition is poor, activity is limited, or other medications and medical concerns are contributing to the problem. Medication may also cause unwanted side effects, and even though sleep hours may improve with the medication, the quality of sleep remains poor.
An ND will start with the foundations of health because adjusting one’s diet or increasing activity levels are non-invasive and lower risk than simply writing a prescription. Further, they work to build long-term health rather than simply addressing a symptom.
The Therapeutic Order and the Principles of Naturopathic Medicine
The Principles of Naturopathic Medicine are the values that guide how NDs provide care. They include:
- First, do no harm
- Support the body’s ability to heal naturally
- Identify and address the causes of illness
- Treat the whole person
- Preventive care is health care (and essential)
- Act as both doctor and teacher when helping patients understand and participate in care and care decisions
Those principles are turned into action via the therapeutic order. In other words, beginning with the foundations of health helps support the body naturally. Investigating symptoms is a core component, not suppressing them. And finally, choosing the least invasive, lowest-risk, yet still effective treatment supports the principle of “First, do no harm.”
The other essential factor here is the doctor-patient relationship. In traditional medical settings, the doctor often acts from a position of authority rather than as a partner. Decisions are made without conversation, in some cases, based on a “general” understanding rather than an understanding of the individual patient. In contrast, patient education is central to naturopathic care, enabling the doctor and patient to make decisions together.
The simple version: the principles define the goals while the order guides how to pursue them.
The Therapeutic Order and Standard of Care
One of the biggest misunderstandings about naturopathic care is that naturopathic doctors are not beholden to professional standards. Each state has its own Board of Naturopathic Medicine, which licenses NDs, establishes and oversees standards of practice and care, and investigates and takes action when necessary. The therapeutic order guides care and treatment, but decisions made by NDs must still adhere to the scope of practice and meet the standards set by the board.
Naturopathic doctors will:
- Discuss and evaluate your symptoms
- Consider diagnoses and potential causes
- Order labs and tests as needed
- Understand and advise when a concern is urgent
- Recommend treatments appropriate to the individual
Sometimes people misconstrue “least invasive” as “least effective,” but they are not the same. Nor does the therapeutic order lock an ND into a strict set of steps before providing appropriate care. Depending on the situation, a specialist referral or emergency care may be the best first step if the condition or concern is urgent.
However, when urgency is not a factor, NDs will first seek and then monitor lower-risk approaches that consider the individual, their health history, and their lifestyle. While therapeutic order influences clinical choices, patient safety, scope of practice, and the standard of care will ultimately shape a patient’s treatment plan.
The Therapeutic Order and Preventative Care in Naturopathic Medicine
What if routine care, in-depth discussions, and close attention to the foundations of health were able to prevent health concerns from becoming critical or urgent? This question informs naturopathic care’s approach to preventive care.
The therapeutic order bolsters this approach, as, rather than waiting for symptoms to reach a critical point, a naturopathic doctor considers a patient’s entire health picture. From sleep, nutrition, and movement to monitoring blood pressure, stabilizing blood sugar, and tracking exercise, working with an ND means staying on top of these foundations and staying current with routine exams.
While this focus on preventative care provides a solid foundation for a person’s health, it does not mean every health condition is avoidable. However, understanding a person’s health history, educating them on risks, maintaining an open dialogue with regular access, and routine exams and monitoring, all part of naturopathic care, can help reduce preventable risks.
It is through the therapeutic order that NDs can emphasize preventive care and build trusted relationships that improve patient care and outcomes.
How a Naturopathic Doctor Uses the Therapeutic Order
If you’re used to a quick visit with your doctor that typically ends with a prescription, then it’s easy to understand why naturopathic care feels different. Rather than prescribing something for a symptom, NDs consider the whole person, looking at underlying factors and starting with lower-risk, less invasive therapies when those are appropriate.
However, it’s important to clarify that the therapeutic order is not a rigid, structured checklist that takes precedence over necessary medical care. Everything you might need medically, from testing and medication to referrals and urgent treatment, is equally important in naturopathic care. Instead of immediately prescribing medication or sending out a referral, a naturopathic doctor will evaluate the appropriate level of care for their patient.
This process is a bit more in-depth and mindful than the doctor’s visit many Americans are used to. Naturopathic care creates opportunities for real discussions and questions, collaborative decision-making, and a doctor-patient relationship that operates with a team mindset.
Are you wondering how a naturopathic clinic and ND could fit into your healthcare? If you feel rushed at appointments, feel that questions go unanswered, and that prescriptions are always the solution, we invite you to reach out for a free consultation with one of our doctors.
Meet the team, ask questions, and learn why naturopathic medicine may provide a more individualized approach to healthcare that not only addresses problems but also focuses on preventive care and health. Reach out to our team today!