Although the aviation and nuclear energy industries are more likely to be considered high risk, shockingly they have a much better safety record than the health care industry. According to the World Health Organization, there is a one in a million chance of a person being harmed while traveling by plane compared to a 1 in 300 chance of a person being harmed during the course of health care interactions.1
The origins of patient safety concerns can be traced back to the beginning of medicine and the ancient Greek physician Hippocrates. However, some credit famous nurse, Florence Nightingale, as being the “Mother of Patient Safety and Healthcare Design.”2 This largely came about because of her view that the concepts of patient safety, healthcare quality, and outcomes of care must be viewed as a whole, together, and not in isolation from one another.
In the complexities of modern healthcare, many professional groups have published definitions of patient safety. Over time, the definition has evolved to identify the components of patient safety and quality care in the 21st century. Modern ideals of patient safety are centered on the conceptual components of quality rather than the measured indicators and outcomes of the past. The Institute of Medicine provides that, “quality care is safe, effective, patient centered, timely, efficient, and equitable.”3 The foundational concept of patient safety is the base upon which all other aspects of quality care are centered.
There are a number of ways in which naturopathic doctors can positively support patient safety in the contemporary medical setting:
Naturopathic doctors are experts in natural therapeutics dosing and usage.
We often hear about the potential side effects of pharmaceutical medications, however we rarely hear of the potential for side effects of vitamins, minerals, and other natural therapeutics. This can lead to the mistaken impression that simply because something is natural that it is also safe and free from risk. For example, vitamin B6 is a commonly consumed supplement, but taking too high of a dose for an extended time can lead to neuropathy (the feeling of pins and needles) in the extremities. Naturopathic physicians are extensively trained in the therapeutic dosing of natural substances and can provide knowledgeable input on their safe and effective, evidence-informed use.
Naturopathic doctors are the authority in detecting and monitoring herb/nutrient-drug interactions.
According to the Council for Responsible Nutrition’s 2018 Consumer Survey on Dietary Supplements, 75% of American adults take some kind of dietary supplement.4 Some of the potential for interactions are well-known within the mainstream medical community such as Vitamin K and anti-clotting drugs like Warfarin, but many more are not as recognized, particularly when it comes to herbal supplements. Core to naturopathic medical training includes learning about herb/nutrient-drug interactions as well as how to determine the potential for such interactions when limited empirical safety data exists. Awareness and monitoring for interactions enhances patient safety.
Naturopathic doctors are collaborative, valuable members of integrative healthcare teams.
The contemporary medical training model has largely resulted in a systems-based approach with each specialty physician covering a component of patient care. As such, the implementation of healthcare teams is becoming more commonplace. Naturopathic physicians are trained to work collaboratively not only with their patient, but with other healthcare providers as well. Including naturopathic physicians on the healthcare team can have a number of benefits for the patient and can support patient safety by increased monitoring for nutrient/herb-drug interactions, increased emphasis on prevention, identification of the root cause of illness, and lifestyle factors impacting disease. Naturopathic physicians also play an important role in referrals to both conventional and integrative practitioners, again supporting a team-based, patient-centered experience.
Naturopathic doctors can serve as primary care providers, thus reducing the burden on an already bulging medical system facing a significant provider shortage.
Delayed diagnosis in primary care is unfortunately among the costliest patient safety concerns both in terms of loss of life and monetary impact.5 Additionally, a delay in diagnosis can result in a delay in treatment. This may increase mortality risk, as well as reduce the number of treatment options available to a patient making more invasive treatments with higher risk necessary.6, 7 Among the key determinants in delayed diagnosis include factors such as missed diagnoses, incorrect diagnoses, and lack of access to care. Physician availability can be a key factor in reducing access to care. Recent estimates suggest that the US will face a significant physician shortage in the near future. Data published in 2018 by the American Association of Medical Colleges revealed a projected shortage of as many as 121,300 doctors by the end of the next decade.8 The shortage is expected to impact both primary care as well as specialty care.8 Graduates of accredited naturopathic medical colleges are trained diagnosticians who are well positioned to help fill this void and minimize delays in receiving a diagnosis and initiating care.
NDs see patients who may not have otherwise sought care.
Each year there is a portion of the population who choose to forgo conventional medical care. A substantial number turn to alternative medicine instead. Studies examining this trend have shown that from 16-26% of the US adult population does not receive conventional care.9 People choose to receive medical care outside the conventional setting for a number of reasons. Among these is interest in alternative approaches, financial concerns, religious basis for natural approaches, as well as the belief that conventional therapies would be of no help.9 For those that choose to forgo conventional care, about 25% seek alternative care.9
Naturopathic doctors are trained to provide patient-centered, specific, and individualized treatments that support prevention and overall wellness.
The training naturopathic physicians receive in naturopathic medical school centers on getting to know each patient on a deep level, and developing treatments that focus not only on improving the current condition but also in sustaining long-term health. This in-depth exploration can uncover issues that may have otherwise gone unreported. The totality of the naturopathic medical interview provides a substantial informational foundation in which the naturopathic physician can use to support the health of the patient, and implement prevention strategies to preserve health moving forward. Additionally, because of the significant time investment naturopathic physicians utilize in developing a relationship with their patient (first visit is often 1-2 hours), the patient may be more likely to reveal certain health habits that they might not otherwise share in a medical setting. Chief among these habits is their supplement use and lifestyle factors that may play a role in disease. Research has shown that although a substantial number of people use supplements, including 64% of those taking a prescription medication, and only half disclose their use to their conventional provider.10,11 Naturopathic physicians are trained to address these issues and ensure the safety of supplement, herb, and nutrient protocols.
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