Therapeutic Order: Why does it matter?

First year in naturopathic medical school is virtually identical to osteopathic medical school or conventional medical school, with mountains of books and anatomy lab and a big focus on how the body works. One thing that?s different between a naturopath, an osteopath, and a conventional doc is philosophy.

An MD spends time focusing on specific problems that can go wrong in a person, while a DO spends time learning how to bring the body into alignment, as the body is an interrelated structure that has many parts influencing health. NDs have a slightly different focus. Drawing from the vitalistic focus that the body is always trying to do its best to remain in health, an ND spends time trying to understand the root cause of illness by working through the therapeutic order with each patient in a strategy that produces very individualized and comprehensive medicine.
The very first thing that any doctor should do, regardless of their degree, is:

1. Remove Obstacles to Cure
This seems like a no-brainer, yet it is often missed in initial work ups. I can?t tell you how many times I?ve seen patients come in on some sort of antacid or proton pump inhibitor because no one sat down with them and talked about things that can cause heart burn, like high acidity foods and eating at night right before laying down. Time and time again, removing the cause is the only thing that needs to be done for the body to take over the healing process and return to a state of health

2. Stimulate the Vitality
Once the obstacles to cure have been removed, sometimes the body needs a brief nudge to show it where to pick up the pieces. Increasing blood flow to the area via hydrotherapy, working with diet, adding in acupuncture, and other therapies that essentially show your body what patterns it has been holding so that your body can change the pattern all achieve this increase in the body?s innate self healing ability. Our clinic is named after this force- the Vitality that each person has to heal themselves when shown the way.

3. Strengthen Weakened Systems
Sometimes body systems will need specific support. An example of this is heart health, where someone who has had high blood pressure for a long time might not only need to change the habits that led them to high blood pressure in the first place, but might need some hawthorne to relax blood vessel walls, or specific nutrients to help keep their cortisol levels in check. Botanical medicine, nutrition, physical therapy are all options at this level- all of these options are just tools for the body to use to support itself.

4. Correct Structural Integrity
Sometimes the body needs to be given a little bit of support to get back on track. This is the category where I put osteopathic or chiropractic manipulation, postpartum belly binding, massage therapy- anything where a practitioner needs to lay hands on the body and move it to where it needs to be. Body systems are beautifully and intricately connected, and function improves when everything is optimally positioned. This is also where osteopathic and naturopathic philosophy align really well with each other.

5. Use Natural Substances to Restore and Regenerate
This is basically using botanical medicine or other modalities to address a specific problem by altering the body?s normal response. An example of this is using bitter melon to improve response to insulin, to help preserve the body by decreasing blood sugars until a type 2 diabetic can work through some of the earlier steps to help reverse the way their body is processing sugar. Whatever the specific disease process is, the treatment is still a safe, effective, and natural substance that doesn?t add side effects or a further burden for the body to process.

6. Use Pharmacologic Substances to Halt Progressive Pathology
A naturopath in the state of Oregon has a wide prescriptive base, and I can and do meet people where they are at in regard to their prescription medications. It is very important to preserve function and the ability for someone to go through their activities of daily living, and using a substance to correct dysfunction is fully appropriate in this case. I add in essential oils to this category most often, as they are incredibly processed natural substances that dramatically alter body response. This is where most conventionally trained doctors focus.

7. Use High Force, Invasive Modalities: Surgery, Radiation, Chemotherapy
There is absolutely a time and a place for surgery, radiation, and chemotherapy. Preserving life, limb, and function is important and necessary. At every point of the therapeutic order, the previous steps are still options to coincide with treatment, support health, and provide increased healing.
By using the therapeutic order to guide decision making, you can return to a fuller state of health, with less side effects and a better return of function.

Trust your inner vitality.