naturopathydigest.com -- AANMC Survey Reveals Rewards, Challenges of Being in Practice

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AANMC Survey Reveals Rewards, Challenges of Being in Practice

By Tina Beychok, Associate Editor

Difficulty establishing a viable practice, an often-uphill battle for acceptance by the conventional medical profession, the public, and the insurance industry, and relatively low salaries compared to their MD counterparts – despite all that and more, naturopathic physicians are for the most part satisfied with their work, according to a survey conducted by the Association of Accredited Naturopathic Medical Colleges (AANMC).

Results of the 2004 survey of 583 NDs were made available recently on the association's Web site.¹
Overall, 71 percent of respondents were satisfied with their annual income, which averaged around $70,000 to $80,000 for a busy/large practice. As expected, the amount of income satisfaction rose with the number of years in practice, from 57 percent at two years in practice to 87 percent at five-plus years. Combine this with a growing public demand for complementary and alternative health care, and the potential for even more income growth is on the rise, which should draw more practitioners to the field. In fact, the number of practicing NDs has tripled over the past 10 years, according to the survey.
This increase in income potential also was reflected in the level of overall career satisfaction reported by those surveyed. An overwhelming 98 percent of respondents reported loving their work (78 percent) or being satisfied with their work (20 percent). Only 1.7 percent of respondents reported being dissatisfied with their career as an ND. This is quite unprecedented, particularly compared to a 2003 Harvard Medical School survey, in which 18 percent of MDs surveyed reported being dissatisfied with their careers – despite average incomes double that of naturopathic physicians.²
With regard to the average naturopathic practice, 60 percent of respondents reported having a solo practice. The majority of these have been in practice for 10 or more years (47 percent versus 37 percent in practice for less than one year). Half of new practitioners reported working in a multidisciplinary practice, compared to only 38 percent of NDs who had been in practice longer.
In terms of the conditions NDs treat, the majority reported treating fatigue (63 percent), followed by menstrual/hormonal problems (62 percent), with allergies rounding out the top three at 41 percent. The AANMP noted that these are exactly the sort of conditions naturopathic medicine is best at treating – debilitating and chronic illnesses.
Despite the picture the survey presents of overall job satisfaction and income potential among naturopathic physicians, some believe the survey may not be an accurate "snapshot" of the industry.^3,4 John Weeks, publisher/editor of The Integrator Blog (www.theintegratorblog.com), commented: "A major short-coming of the portrait, however, is the response rate. Only 583 (19%) took part. How many of the non-responders couldn't make the shift from medical student to self-marketer and dropped out, despite student loan debt frequently at $100,000+?"
Robert Nay, ND, board member of the Washington Association of Naturopathic Physicians, responded to Weeks' comment with the following:
A big question for the profession related to the 81% non-responders is what is/will be the default rate on the huge loans that students graduate with. Significant default rates could potentially threaten availability of financial aid, and thus threaten the schools.
It's overwhelming to think of students coming out with over $100K in debt and the cost of starting a practice. The schools may be doing well, but time will tell if it is sustainable – and I'm concerned that prospective students don't hear that income data is based on a less than 20% response rate.
What I'd like to see is at least a commensurate strategic focus on clarifying the unique elements of naturopathic medicine, and then identification of a way for new docs to market that and make a good living. This would address the issue of the missing 81% of ND respondents. It also is the best insurance policy for naturopathic medicine, whereas becoming more mainstream could reduce the raison d'etre for NDs over the long term.⁴
Erik Goldman, co-founder and editor of Holistic Primary Care (www.holisticprimarycare.net), noted that $80,000 per year may not be as much of an income as some NDs would like to think.
Is it a hopeful sign that NDs can make 80K? That amount, five years out, isn't exactly a whole lot of money. Here in NYC, 80K is barely middle class. On the other hand, 80K, if you're in your early 30s, you're only working part-time and your mate/spouse/whatever also works, is a decent living by national standards. If factored against a debt of 100K or more, though, it doesn't go very far...
I've talked with [an ND colleague] at length, and he paints a pretty dire picture – at best, only 20% or so of the total ND/NMD universe is making what he calls a ‘real adult living' practicing medicine."
On a more positive note, Michael Traub, ND, past president of the American Association of Naturopathic Physicians, commented:
I don't think grads fail because they lack the marketing gene if they have excellent clinical potential. My experience, having had many students preceptor with me over the years, is that the ones who succeed do so because they demonstrate that they are confident (real or through acting like they are), and those who struggle are the ones who lack this ‘confidence' gene.
I also think that it makes a huge difference if one is willing to work a full 40-hour week, rather than try to get by with 3.5 – 4 days/week. And also that it makes a huge difference if you value your services sufficiently to charge fees that not only keep you in business, but [also] give you a cushion, a retirement plan, and money to take vacations to recharge your batteries.⁴
Overall, the picture seems to be that, even though naturopathic physicians do not make the same salary as medical doctors, they have a higher level of satisfaction with their career path. As Joseph Pizzorno, ND, founding president of Bastyr University, stated in the summary of the survey:
"I think one of the great strengths of natural medicine is our ability to understand why people are sick and deal with the underlying cause of their illness. More and more, conventional medical doctors are getting frustrated with drugs, because, by far, the majority of drugs only relieve the symptoms – they don't deal with the underlying cause of why that person is sick."
References

"Careers and Practice. What Kind of Doctor Do You Want to Be?" A survey of naturopathic doctors in North America, conducted by the American Association of Naturopathic Medical Colleges. Data available here.
Landon B, et al. "Wide Variation in Physician Career Satisfaction Seen Across Local Markets, Nearly 18 Percent of Physicians Dissatisfied With Career: Physician Autonomy More Important Than Income in Influencing Changes in Physician Satisfaction." Available here.
"Income for Naturopathic Physicians: Data From AANMC Survey." Available here.
"Your Comments: Income Influences for Naturopathic Physicians." Available here.