Strong ND-Patient Relationships, the Foundation for Healing

When doctors and patients work together, healing happens.

Naturopathic medicine takes a holistic approach to patient care. Therefore, the relationship between doctor and patient plays a key role in the healing process. An open relationship can help improve a patient’s health, while a closed relationship can be a barrier to recovery.

We asked naturopathic experts to weigh in on how they work to forge strong relationships with their patients.

Strong ND-patient relationships are grounded in honest communication and trust.

“Naturopathic medicine is a medicine of communication,” says Dr. Fraser Smith, assistant dean of naturopathic medicine at National University of Health Sciences and AANMC board president. “Treatments are individualized and that requires doctor and patient to share honestly and truly listen.”

“Trust and safety is foundational to ensure that the patient feels comfortable and at ease in divulging their health and life history,” adds Dr. Katherine Chung of the Canadian College of Naturopathic Medicine – Boucher Campus. “Thus, the physician gets an honest health history allowing for proper treatment protocols and confidence in clinical outcomes.”

“When a patient steps into my office and begins to share their health story, they are becoming vulnerable and sharing a very intimate part of their health with me,” says Dr. Daemon Jones. “They have to feel like they are in a safe space. I want them to know that their stories are safe with me.”

“They also have to trust that I have their best interests in mind when I ask them to implement their treatment plans,” she adds. “For example, the first time I introduce magic socks as a treatment for colds, sinus problems, or to improve sleep, many patients look at me like I am crazy. But when they come back and ailments are gone within a day or two, they love it! They trusted me and they got results.”

“The relationship is also a kind of partnership,” Dr. Smith continues. “The doctor provides expertise and a certain kind of leadership and the patient is ultimately in charge of what they do with their health. The partnership is built on the doctor working with the patient towards agreed upon goals and the patient doing the best that they can do. The patient is not a passive participant who has therapies done to them. The doctor does not simply write prescriptions and then walk away.”

Dr. Jones agrees. “I don’t fix my patients. I support them,” she says. “I work alongside them to support them in their healing process. My patients understand that their body and their mind is doing the healing. When we approach their healing in this way, we are on the same team and we both have our part to play in helping them get healthy.”

A strong relationship between the patient and the ND is crucial for effective healing.

Dr. JoAnn Yanez, executive director of the AANMC, recalls advice from a former professor. “To quote Dr. James Sensenig as he addressed our class my very first week of naturopathic school, ‘It all boils down to the relationship.’ If trust and communication are not there, the healing relationship will begin to erode,” she says. “That doesn’t mean healing can’t still occur, but now the relationship itself may become a barrier to healing.”

“Without a strong relationship, an honest health history cannot be obtained, a robust treatment plan cannot be created, and compliance and resolution cannot be attained,” Dr. Chung says. “It’s like any relationship; if you do not trust or have confidence in the other person, then there is absolutely no motivation to comply with what they are asking you to do and therefore growth and healing cannot happen.”

“Healing takes time, and often is punctuated by aggravations or reversals. The old adage, ‘two steps forward and one step back,’ can be true in chronic diseases. Over time, things can improve, but we are not in the business of suppressing symptoms and forcing overnight changes. We are creating the conditions for health. So, the relationship has to be able to work through various challenges and the strength of that relationship. A lot of patience and hard work can pay enormous dividends.”

There is a variety of ways an ND can strengthen a relationship with a patient.

“Naturopathic physicians often spend significant time listening to patients and creating the safe healing space to allow this relationship to develop,” Dr. Yanez says.

“Being honest and up front with patients builds trust,” Dr. Smith says. “That means admitting what one doesn’t know and being willing to try to find out through consultation and research.”

Dr. Jones conducted an anonymous survey to gauge her patients’ satisfaction with her practice. “One of the top characteristics they appreciate about me is my authenticity,” she says. “I am myself with patients. I share my stories and struggles around creating healthy habits and it allows them to connect with me as person as well as a doctor.”

“Another trait that patients appreciate is that I connect the dots to help them understand what is going on with them in a simple way,” she adds. “I find that people are more engaged with their treatment if they understand it. It takes away the fear of their illness or imbalance and it empowers them to take control and make a difference.”

Dr. Chung says that doctors need communicate up front about costs so patients can make informed decisions. “Many patients have experiences where they leave appointments overwhelmed with all the supplements, medications, and treatments that were prescribed to them, walk to the front desk to pay, and are surprised with the high cost of the appointment they just had. They walk out feeling even more overwhelmed now that they have to take care of a hefty charge on their credit card.”

To prevent this, Dr. Chung advocates for transparency. “Of course we are not going to be their financial advisor and we should not make our clinical decisions based on whether we think the patient can afford it or not. That is 100% their decision,” she says. “However, what we can do is be transparent about the procedure or treatment that we are offering, communicate alternatives, and the cost of each treatment. This way, we put the power back into the hands of the patient, they choose which treatment protocol they want, and they are fully aware of what they are getting into. I find patients appreciate this much more—honesty, transparency, and no surprises.”

Dr. Jones also suggests that NDs should utilize lab tests to help patients understand their health. “When patients can see objective tests with their treatments, it opens their eyes to how powerful simple naturopathic treatments can be. The labs can be used as teaching tools for patients and it changes their relationship with lab tests from avoidance to curiosity. Some patients get excited to see their labs because they know they will get a good report!”

Patients also have a vital role in improving the relationship with their ND.

First and foremost, Dr. Yanez encourages patients to do their homework. “Choose an ND who has the skillset you are looking for,” she says. “Then be open and honest about your expectations, and ready for the healing journey!”

“When patients are honest about their successes and failures, it strengthens the relationship,” Dr. Jones says. “I always ask about successes in the beginning of appointments to remind patients that they are making progress in their health goals. I also ask what is challenging them in their treatment plan to find blocks that need to be resolved so they can continue to heal.”

“The best way is to advocate for yourself and your needs and keep asking questions,” Dr. Chung says. “Questions are not offensive in any way and most naturopathic doctors are very open to being asked questions. Why? Because ND-patient relationships are a two-way street. The doctor and patient work as a team. By voicing your needs, the doctor gets feedback from you so they can individualize the treatment plan for your needs. Keeping an open line of communication with your doctor not only strengthens your relationship with your ND, but it also ensures that you are well taken care of and the doctor is able to support you 100%, exactly where you are in your life circumstances.”

“Patients can contribute by making an effort to do the things that are suggested,” Dr. Smith says. “Nobody is perfect and sometimes it is not possible to do every home exercise or make each diet change. But some effort is required and when the doctor sees that, they feel that the patient has genuine interest.”

“Taking a deep dive into a person’s life is often necessary in order to uncover the basis of an illness and the obstacles to cure,” Dr. Yanez says. “The more open patients are to exploring their personal health journey, the more likely they are to work as a team with their ND to find and address their specific issues.”

“A strong ND-patient relationship built on trust, safety, and empathetic communication will empower patients to take their health into their own hands and motivate them to stick to your treatment plan,” Dr. Chung explains. “Because you’ve taken the time to get to know your patient, you can give them a few treatment options that have both high compliance rate and good clinical outcomes. By allowing your patient to choose the option they want, it motivates them to stick to the plan because they chose it themselves rather than being told what to do.”

“A strong relationship will also increase a patient’s confidence in their doctor, which has a two-fold effect,” Dr. Chung adds. “One is placebo—if they are confident in the doctor and their treatment plan, then they are more likely to respond positively to the treatment. Two is, again, compliance–if your patient feels that you have confidence in your treatment plan, they are more likely to stick to it.

Dr. Chung and Dr. Jones have seen the power of strong relationships in their own practice.

Dr. Chung’s Success Story:

“I had a 50-60 year old male patient who was extremely nervous about going to see any medical practitioner. I remember he was quite literally sweating buckets during our first few appointments together. No eye contact, sitting very rigid and straight, did not want to divulge too much about himself, and was afraid of admitting any ‘flaws’ he had due to fear of judgement. He was surrounded by a lot of judgement from his family and friends and did not have anyone to listen to him or give him the time of day. I treated his physical symptoms with acupuncture, however I ensured I stayed in the room with him to listen to his mental and emotional needs through an empathetic, non-judgmental lens.

As the appointments progressed, he began trusting me more and more with information about his life because he knew that it would be received without any backlash, only kindness and understanding. I was finally able to create an open line of communication with him and as the trust grew, his confidence in me grew as well. This is when his response to treatment truly began to take a positive turn and he was much more open to comply with other treatment ideas I had for him. By finally allowing me to take a multifaceted approach to his case, we were able to resolve 95% of his complaints in a matter of six months. I remember our last appointment together; he looked me in the eye with a genuine smile and said ‘thank you.’ Not only were his physical symptoms resolved, but many of the obstacles to cure that resided in his psyche had resolved as well. He truly walked out a different man.”

Dr. Jones’ Success Story:

“I had a patient that had been suffering for many years with menopausal symptoms, specifically hot flashes, terrible insomnia, low energy, and back pain from an injury. She wanted relief immediately. I shared with her the steps in my process and set appropriate expectations on how long it would take for her to start feeling better. She was open to the treatment and she was willing try some options she didn’t think would work. She didn’t want to take ‘pill’ supplements but said she was willing to try them if she didn’t have to take them forever!

One of the first things that improved was her sleep—not a lot, but a little. She was grateful for the advancement of her treatment. This improvement engendered greater trust in me. She became willing to take the supplements for a longer period of time. Over the course of a year, all of her symptoms improved and most were completely eliminated. The trust we developed enhanced the treatment because she believed that I was always concerned for her well-being every step of the way. She refers other friends to me all the time! She knows the people that she refers are in good hands!”

When NDs and patients trust and listen to each other during the healing process, they see results across the board.