In practice, insurance coverage becomes a non-issue. I practice in Connecticut; the general statutes of the state Of Connecticut require fee for service reimbursement by insurance companies for care delivered by a naturopathic physician. Nonetheless PPOs and HMOs have essentially written this statute out.

I don\'t participate in insurance but I also have a sliding scale. You\'re in the business of taking care of people and, if all you really want to do is accomplish that and make enough so your family is comforatble, you\'ll find a way to work your fee structure around that. That\'s true for .D.s, D.Os and M.D.s

Regards treatment modalities: a responsible, licensed naturopathic doctor doesn\'t bring an agenda into the exam room. If a pharmaceutical or surgery is necessary, a patient is directed to a local M.D. or D.O.

That said, as an N.D. you can do homebirths, perform acupuncture or manipulation to relieve pain instead of writing for a pharmaceutical, direct care of HTN at diet, exercise and botanicals or supplements such as CoQ10 instead of writing for a pharmaceutical. The options are protean. M.D.s and D.O.s cannot do these things because (a) they haven\'t the first clue about them because they haven\'t been educated and (b) if they do choose to recommend a naturopathic protocol, they will be sanctioned or shunned by their colleagues.

I had a patient not too long ago who had CAD. This patient was curious about an Ornish-style approach but would only embark on it with the consent of his Yale cardiologist. I\'m vegan; I\'ve had success with diet, exercise and lifestyle/yoga in cardiac patients. I was set to try but when I spoke to the Yalie, this .D. explained in no uncertain terms that, yes, he understood what people like Ornish, Gould et al had published but at Yale they refused to okay such an approach.

That\'s just one example. As I\'d posted, I\'ve been in practice for sixteen years. I\'ve had very animated conversations with local M.D.s about clinical choices such as herbal ear oil for acute otitis media, acupunture for join pain or infertility, botanical medicines such as silymarin for hepatitis C, diet & lifestyle intervention for both diabetes and thyroid diseases...there are too many to list here. In the end, the evidence-based naturopathic approach has chosen more often than not by my patients (I\'ve been lucky enough to maintain a busy practice) and it\'s effective.

I take care of a D.O. and his family as well as a few M.D.s and their families. I\'m elective care for them. The physicians I see volunteer that they, too, have satisfying lives. It comes down to doing what you love.

I know that no other approach to care for the sick could have been as satisfying and effective for me as a practitioner. I really struggled with that choice in my early twenties. I\'m very, very happy that I\'m an N.D.; even just the homebirths of both my children would have been enough but the day-to-day of practice is so rewarding to my spirit and it\'s just so damned effective.

Best wishes,

John