Article

Frequency and characteristics of pediatric and adolescent visits in naturopathic medical practice

School of Naturopathic Medicine, Bastyr University, 14500 Juanita Dr NE, Kenmore, WA 98028, USA.
PEDIATRICS (Impact Factor: 5.3). 07/2007; 120(1):e142-6. DOI: 10.1542/peds.2006-2648
Source: PubMed

ABSTRACT This work sought to identify naturopathic physicians in Washington State who frequently provide pediatric care and to describe the conditions treated and therapies recommended for children.
A mailed survey of licensed naturopathic physicians residing in Washington State collected demographic information and practice descriptions. For naturopathic physicians treating > or = 5 pediatric patients per week, data were collected on the conditions seen and treatments provided to children during a 2-week period.
Of 499 surveys delivered to providers, 251 surveys were returned (response rate: 50.3%). Among the 204 naturopathic physicians currently practicing, only 31 (15%) saw > or = 5 children per week. For these pediatric naturopathic physicians, pediatric visits constituted 28% of their office practice. Pediatric naturopathic physicians were more likely to be licensed midwives (19.4% vs 0.6%) and treated significantly more patients per week (41.6 vs 20.2) than naturopathic physicians who provided less pediatric care. Eighteen of the 31 pediatric naturopathic physicians returned data on 354 pediatric visits; 30.5% of the visits were by children < 2 years old, and 58.5% were by those < 6 years old. The most common purpose for presentation included health supervision visits (27.4%), infectious disease (20.6%), and mental health conditions (12.7%). Pediatric naturopathic physicians provided immunizations during 18.6% of health supervision visits by children < 2 years old and 27.3% of visits by children between the ages of 2 and 5 years.
Although most naturopathic physicians in Washington treat few children, a group of naturopathic physicians provide pediatric care as a substantial part of their practice. Based on the ages of children seen and the conditions treated, pediatric naturopathic physicians may provide the majority of care for some children. Efforts should be made to enhance collaboration between naturopathic physicians and conventional providers so that optimal care can be provided to children.

0 Bookmarks
 · 
159 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Chronic pain in the pediatric population is a ­significant problem. It is estimated that 15–20% of children were affected by chronic pain (Goodman and McGrath 1991). The common pediatric chronic pain symptoms include headache, abdominal pain, and complex-regional pain syndromes (type I and type II). Other pain syndromes can be cerebral palsy (spasticity), malignant tumors, scoliosis, benign tumor, cystic fibrosis, irritable bowl syndrome, fibromyalgia, flat feet, and vertebral and spinal cord abnormalities.Despite advances in understanding and treating chronic pain in pediatric patients, treatment is inadequate in many cases (Anand and Hickey 1987; Romej et al. 1996; Kemper et al. 2000; Howard 2003). The major reasons are several: (1) Pain is multifactorial and that requires patient care considerations beyond the use of analgesics. (2) Pain is a subjective expression that can be easily influenced by the child’s developmental level, past experiences with pain, coping skills, anxiety level, culture, family dynamics, and peer issues, as well as the level of fatigue, focus of attention, and the child’s general state of well-being. (3) Since the treatment of pain relies on self-report, only children who have attained a certain degree of cognitive ability have been able to provide information. Several self-report pain scales/drawings, specifically designed for young children to understand and use, were developed. However, the sensitivity and specificity of these scales remain questionable and frequently rely on how a scale was presented to the child (McGrath et al. 1985). Objective measurements were developed such as behavioral observations, changes in physiologic characteristics, and/or combinations of these measures. Thus far, facial expression has been one of the most reproducible. However, this behavioral measurement is age related. Generally, the utility of physiologic measures is diminished because of the homeostatic mechanisms that tend to oppose such changes over time. Despite the fact that multiple scales have been developed, each having its advantages and limitations (such as more than 20 validated pain scales to assess the pain in infants), no individual scale has emerged as superior. The lack of a gold standard or a universally reliable indicator that can be used to accurately assess pain in pediatric patients has limited the health-care providers’ ability to treat pediatric pain adequately. KeywordsComplementary and alternative medical (CAM) therapies–Naturopathic physicians–Cupping–Acupressure–Acupuncture–ST-36
    06/2011: pages 293-302;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study investigated provider-based complementary/alternative medicine use and its association with receipt of recommended vaccinations by children aged 1-2 years and with acquisition of vaccine-preventable disease by children aged 1-17 years. Results were based on logistic regression analysis of insurance claims for pediatric enrollees covered by two insurance companies in Washington State during 2000-2003. Primary exposures were use of chiropractic, naturopathy, acupuncture, or massage practitioner services by pediatric enrollees or members of their immediate families. Outcomes included receipt by children aged 1-2 years of four vaccine combinations (or their component vaccines) covering seven diseases, and acquisition of vaccine-preventable diseases by enrollees aged 1-17 years. Children were significantly less likely to receive each of the four recommended vaccinations if they saw a naturopathic physician. Children who saw chiropractors were significantly less likely to receive each of three of the recommended vaccinations. Children aged 1-17 years were significantly more likely to be diagnosed with a vaccine-preventable disease if they received naturopathic care. Use of provider-based complementary/alternative medicine by other family members was not independently associated with early childhood vaccination status or disease acquisition. Pediatric use of complementary/alternative medicine in Washington State was significantly associated with reduced adherence to recommended pediatric vaccination schedules and with acquisition of vaccine-preventable disease. Interventions enlisting the participation of complementary/alternative medicine providers in immunization awareness and promotional activities could improve adherence rates and assist in efforts to improve public health.
    Maternal and Child Health Journal 09/2009; 14(6):922-30. DOI:10.1007/s10995-009-0519-5 · 2.24 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Naturopathy is a distinct type of primary care medicine that blends age-old healing traditions with scientific advances and current research. Naturopathy is guided by a unique set of principles that recognize the body's innate healing capacity, emphasize disease prevention, and encourage individual responsibility to obtain optimal health. Naturopathic treatment modalities include diet and clinical nutrition, behavioral change, hydrotherapy, homeopathy, botanical medicine, physical medicine, pharmaceuticals, and minor surgery. Naturopathic physicians (NDs) are trained as primary care physicians in 4-year, accredited doctoral-level naturopathic medical schools. At present, there are 15 US states, 2 US territories, and several provinces in Canada, Australia, and New Zealand that recognize licensure for NDs.
    Primary care 03/2010; 37(1):119-36. DOI:10.1016/j.pop.2009.09.002 · 0.81 Impact Factor

Preview

Download
0 Downloads