A ghost haunts Europe’s CAM professions: diagnosis!

Dr. Vera Paola Termali, President of SIHeN, Professional Association of Italian Heilpraktikers and Naturopaths

Last month the discussion about CAM in Italy became hot, when the Ministry of Health realized that at the beginning of 2013 a law was issued which allowed all professions without a dedicated regulation to be practiced under the supervision of professional associations and through a UNI Norm, a quality standard  certification.
This framework law includes a variety of professions, ranging from web designers to graphologists, but some professional associations of naturopaths decided to put also naturopathy under this umbrella. The UNI Norm defines Naturopathy following the “Benchmarks for Training in Naturopathy”, issued by the WHO back in 2010, which also gives a standard education value of 1500 hours, 400 of which dedicated to practice.

It seemed a step forward, but, being a norm and not a law, it is not compulsory, so that an important issue continues to be missing: the harmonization and implementation of education, which in Italy can range from 300 to 1500 hours, without any control. Stimulated by other professional associations, both academic and naturopathic,  the Ministry of Health made the critical question: “are Italian naturopaths diagnosing and curing? If yes, then this is a health profession and must undergo limitations, either by a new law or by specific regulations issued by the Ministry.”

Terror spread among schools and associations, who since decades prefer no recognition at all, so that they can continue to give poor education at a high cost, exposing their students at a high risk of being accused of abuse of the medical profession. This policy is the typical behavior of the ostrich which buries its head in the sand. But now it’s over, now the Italian naturopathic world has to give an answer which will deeply affect the future of our discipline and the answer will have to consider also what is going on in other European countries.

 I can’t believe that Italy might become the first state in which naturopaths will not be allowed to even make prevention, because “prevention” is a sanitary concept! We must get rid of the labeling “sanitary vs. non-sanitary” and talk about competency and profile, starting from the right of each European citizen to approach his/her state of health by the means he/she prefers.

In Italy we will have to explain to those who want to go on hiding behind words, without understanding that terminology is substance, that this is not the right way to make naturopathy assess itself as cultural heritage of the European peoples.
If we maintain that we do not “diagnose” but “evaluate”,  that we do not “prescribe” but “suggest”, that we do not have “patients” but “clients” we are simply playing a childish game, which pretends to hide reality.

This is exactly the right way to put an end to our profession as it was conceived some hundreds years ago and as it is practiced in those countries where the need of institutional control was coupled with our need to stick to tradition.

Let’s go, once again, back to etymology, quoting the Online etymology dictionary:

Diagnosis:  1680’s medical Latin application of Greek diagnosis "a discerning, distinguishing," from stem of diagignoskein "discern, distinguish," literally "to know thoroughly," from dia- "apart" (see dia-) + gignoskein "to learn" (see gnostic). From the dictionary we learn that the attribution to the medical profession of the term “diagnosis” dates back only a couple of centuries (as the profession in our modern sense did not exist neither).

From the dictionary we learn that the attribution to the medical profession of the term “diagnosis” dates back only a couple of centuries (as the profession in our modern sense did not exist neither).
When we want “to know thoroughly” the nature and circumstances of a health condition, as another dictionary defines “diagnosis”,  and do not use the most accredited method (the academic one), but another method as f. i. the naturopathic, chinese,  ayurvedic or  homeopathic method,  are we threatening people’s health?

Does it make sense that people, who do ignore the methods we use, say that our way of “discerning” is the wrong one? Does it make sense that they want a validation of our disciplines, following their approaches? And on the other hand, does it make sense to continue claiming that we make diagnosis, ” but not in a medical way”? Speaking too much about energetical diagnosis is useful for an overall acceptance of naturopathy? People come to us because they have a pain, a disturbance, an illness, not because they have an energetical imbalance. Let’s speak out clearly! Let’s use the words everybody can understand! Let’s stop hiding behind words!

This defensive policy, this mental dependency from the academic world, is not the one which will allow us to protect our disciplines and support our professional profiles, as to allow CAM professionals to settle down in each member state and do their job.

YES, WE DIAGNOSE and thereafter we cure with our own, specific methods, as “therapy” literally means "attend, do service, take care of".

We must be proud of what we do and claim the recognition of the  value of our competences for people’s health, be it on the side of prevention, education to healthy lifestyles or treatment of illness in an holistic way.

What can institutions demand? That we are properly educated and in order to identify life-threatening situations and this is what serious professional associations in Italy also want, in order to avoid charlatanism and fraud. We can walk on the same path, but we have to start from reciprocal respect and from the assumption of freedom of choice, both for professionals and patients.