Breaking Barriers as a Trifecta
My name is Dr. Maria Del Mar Rodriguez, N.D. best known as Dra. Maria Del Mar on Instagram. To my surprise, I’m the only Latina naturopathic physician pursuing a fellowship focused on health disparities research at an academic hospital located in Boston. I’m a licensed naturopathic physician with broad experience in public health and clinical research. I received my medical training at the Southwest College of Naturopathic Medicine in Arizona, after graduating with my Bachelor’s Degree in Biology at the University of Puerto Rico, Rio Piedras. The journey of becoming a Clinician-Researcher has been challenging for me, as I have not found a specific career model, or person whose background is similar to mine to follow their footsteps. Moreover, it has not been easy to make up space in places and tables where there is underrepresentation, or no representation of Latinx healthcare professionals like myself. Regardless of all the potential issues I may encounter because I’m different from the rest of the people in a room, the passion to dedicate my life to the service of others motivates me to stay centered and persistent, while achieving my career goals. I would like to share part of my story with you all, and spread the word of naturopathic medicine.
What is an N.D.?
A licensed naturopathic doctor (N.D.) is a healthcare professional who has completed a presential doctoral degree in an accredited naturopathic medical school recognized by the United States Department of Education, and has passed the two required biomedical and clinical boards called “Naturopathic Physicians Licensing Examination (NPLEX I & II)” by the North American Board of Naturopathic Examiners (NABNE). This eventually qualifies the individual for the application of a medical license according to a state jurisdiction. There are five accredited naturopathic medical schools in the U.S. and two in Canada. Currently, there are 25 states licensed and registered for the practice of naturopathic medicine, and many more in the process of becoming licensed. I encourage you to visit the Association of Accredited Naturopathic Medical Colleges website (https://aanmc.org/) for more information.
The practice of naturopathic medicine is a science and an art. Naturopathic physicians are clinically-trained to be primary care doctors to prevent, diagnose, and treat diseases. N.D.s respect the body’s ability to heal itself and also acknowledge a person as a whole entity, including the physical body, mind, spiritual, and emotional aspects. Naturopathic medicine may offer solutions by understanding the root cause of a variety of health conditions and concerns following these principles: (1) do no harm (2) the healing power of nature (3) identify and treat the causes (4) doctor as teacher (5) treat the whole person (6) prevention.
I decided to become a naturopathic physician mostly because I was very interested in receiving a comprehensive medical training based on those fundamental principles, and being able to offer different healing tools, public health education, and individualized care to diverse people, families, and communities. Naturopathic doctors are trained to provide medical diagnoses by performing physical exams, ordering and interpreting labs, and prescribing medications as necessary. In addition, we are trained to order and interpret functional medical tests such as lab assessments of personalized nutritional deficiencies, food allergies, environmental toxins, and comprehensive hormonal and neurotransmitters panels. Among the existing healing modalities include clinical nutrition, lifestyle and emotional counseling, botanical medicine, mind-and-body medicine, traditional Chinese medicine and acupuncture, physical medicine and chiropractic adjustments, homeopathy, use of physician-quality nutraceuticals and supplementation, hydrotherapy, and in few schools: intravenous therapies, prolotherapy and midwifery.
The five accredited naturopathic medical schools in the U.S. may have different academic curriculums of four to five years long, but all offer a variety of core coursework and medical training comparable to allopathic medical schools (please visit: https://aanmc.org for more information). The first two years are basic sciences courses (i.e., pathology, biochemistry, anatomy, pharmacology), and then two to three years of rigorous clinical courses (i.e., Oncology, Gynecology, Pediatrics) and training in diverse local, national, and abroad medical settings. Being an N.D. provides many career paths options, and it all starts with the decision of which school the student will like to pursue their medical degree. Also, on how many hours of clinical rotations should be focused or committed to receive training on different modalities and specialized areas of expertise. All these depend more on the particular interest a naturopathic medical student may have. Many clinical rotations are mostly focused in family medicine and primary care using all, or most of the healing modalities on our “tool box”. The greatest asset is that we are trained to be primary care doctors (PCPs) in many licensed states, which is very needed to address the gap of limited workforce in this field of care. However, I also have colleagues who chose to focus on many different areas, for instance: women’s health, endocrinology, pain management, aesthetics and dermatological procedures. There are also qualified naturopathic residencies, in which N.D.s may choose to receive additional clinical experience focused in specialties like pediatrics and oncology.
More about my career journey
In my case, I was fortunate to have so much clinical training and experiences during my medical school years at many community clinics, integrative and private practices, hospitals, and completing countless one-on-one preceptorships with physicians trained on diverse specialties (M.D., D.O. and N.D.). I felt I was ready to provide care to families and communities as soon as I graduated and acquired my license to practice. A typical clinic visit with me as an N.D. could be an hour long on average. I like to get to know my patients in depth, listen to their unique story, see them as a whole person, and address or provide potential solutions to their concerns using integrative and naturopathic modalities. I love what I do and empowering my patients. Being an N.D. provides me a broad scope of practice. I have seen entire families from babies to elderly, prenatal care, concerns like stress and pain management, and much more. Some concerns may be related to the lack of social determinants of health along with their main acute and/or chronic health concerns. I always consider these important elements in which I can be supportive to my patients. I have also practiced together with other healthcare providers and physicians to provide the best care possible for our patients. I’m always committed to support their healing journeys with compassion and respect. Sometimes I consider myself as a teacher, some days a student. I aspire to learn as much as possible with every experience I get to live in my career, and personal journey as well.
In my first year of medical school, I decided to volunteer as a bilingual medical translator in community clinics affiliated to my medical school in Arizona. One of the things I often recommend to many people who are considering a career in medicine or healthcare, is to expose themselves to field experiences early and volunteer in those settings. That way, they can confirm if that is their real interest and it might be motivational to pursue that particular career path. I had many volunteering experiences in hospitals, caring for vulnerable communities, and shadowing doctors during my pre-med years, and it was the best decision I made at that time.
When I first had experiences in microbiology labs and clinical research, is when I fell in love with research. Being a Latina doctor has given me the opportunity to provide care for culturally diverse patients and medically underserved populations, mostly Hispanics living in Arizona, Texas, and Puerto Rico. I feel that the combination of speaking their language and putting my naturopathic medical training into practice, fosters a strong and trusted patient-doctor relationship. My years of practice have been even more special and full of unforgettable experiences, especially knowing that I am serving people who really need my support as a doctor and as a person. My aim is to always make them feel heard, respected, and seen. That is one of the reasons I use Dra., the abbreviation for ‘Doctora’, which is a female (she/her) doctor in Spanish, regardless of where I am at. I’m Latina and proud!
After a few years living in the southwest coast, I decided it was time for me to go back to my homeland to serve my people and reconnect with my beautiful island and Caribbean roots. In Puerto Rico, I was able to combine my clinical work in an integrative medical practice with my passion for research. But it was also another opportunity for my own self-exploration, or “soul-searching” time. I re-discovered and studied few traditional healing modalities, and fully resumed my personal practice of yoga. For about two years, I was appointed as an Interventionist for the Promotion of Healthy Lifestyles and a Co-Investigator of a pilot study on yoga interventions at the main public hospital of the island, the University of Puerto Rico, Medical Sciences Campus. Those research initiatives were focused on the prevention of cardiometabolic diseases like hypertension, obesity, and diabetes.
I also conducted a small study evaluating the utilization of complementary and integrative medicine (CIM) therapies. My findings confirmed that about 88% of the participants of this cohort had never reported their usage of CIM therapies with their primary care doctors. I’m committed to promote this open dialogue between patients and healthcare providers. The experience I had researching on this topic highly motivated me to make it part of my purpose. People, and I mean the general public and healthcare providers, deserve to receive the appropriate education in CIM therapies. Many products labeled as alternative therapies are available for purchase over-the-counter and many people self-prescribe these, not knowing that many are of poor quality. These could be harmful if not taken properly, with the supervision and consultation of a trained healthcare provider. Unfortunately, several CIM therapies are not totally regulated, clinically and/or scientifically proven to be safe and effective. However, this issue has been continuously changing with the remarkable clinical work of licensed naturopathic doctors, the advancement of ongoing scientific research, continued medical education, more regulations, and funding from agencies like the National Institute of Health.
I value the use of healing arts and cultural traditions from all over the world. I respect when my patients express using particular healing modalities on their own. I make sure to provide education and address any of their concerns. One of the most common discussions I have with my patients is the proper use of botanicals. When discussing topics like these, I encourage healthcare providers to assess and approach patients with respect, humility, and cultural awareness, but also focusing on the patient’s safety and overall well-being.
My lifelong goal as a Clinician-Researcher has been to educate, support, and empower diverse communities, and to offer culturally appropriate interventions for optimal health and wellness. Once I established my private practice in Puerto Rico, I also wondered in what way I could continue with my research work. I decided to apply for a research fellowship at that point. It is a highly-competitive program, mainly designed for specialized physicians interested in clinical research. I was repeatedly told that they never had an N.D. apply for it before. As I went through interviews with the program directors, professors, and research personnel, Hurricane Maria hit Puerto Rico. I lost communication, electricity, and internet for around six months. That fellowship opportunity seemed like it was out of reach for me to begin with, and living under the consequences of a natural disaster made it almost impossible for me to be accepted. I did what I was capable of doing during that time, and decided to dedicate my efforts to serve a few communities in Puerto Rico by providing free counseling, acupuncture, and medical care when needed. I had never felt so empowered yet vulnerable in my life. As soon as I was able to connect to public Wi-Fi at a fast-food restaurant, I wrote back to the multiple attempted communications from the fellowship program explaining my situation. I expressed that I was still interested and they ended up considering me. I was accepted after passing another round of interviews. I jumped up and down and a few months after, I decided to take this official turn in my career.
My research interests include integrative medicine, health promotion and disease prevention, and collaborating with multidisciplinary sectors to reduce health disparities. I was fortunate to be an awardee of the Susan G. Komen Program to reduce health disparities during my fellowship. I was elected for two consecutive years as a wellness committee member of the Women in Medicine and Science Association at my academic hospital. I’m an active advocate for diversity inclusion. I’m honored to be the first naturopathic doctor and Latina completing this fellowship and taking these steps. It has not been an easy journey. Sometimes I feel discouraged to see that I’m the only one with this underrepresented “trifecta” (woman, Latina and N.D.) in many spaces and tables. But it is in those moments that I look back and recognize what I have accomplished so far and how far I have come. I celebrate my cultural roots as a born and raised Puerto Rican, and I’ve chosen to constantly practice resiliency and to never stop dreaming. I move forward in my unique journey, doing what my heart and soul loves to do, reminding myself to embrace every step I take.
I hope to continue my journey leading with compassion, gratitude, and persistence. I know that there are many Latinx like myself working hard to achieve their dreams. We need to stand up, represent, and serve our people with dignity. We deserve to succeed, it’s our time to thrive. Let’s go for more, Latinx!
By Dr. Maria Del Mar Rodriguez, N.D