Q. In last week's "Prescriptions" column, a naturopath sought to explain the difference between medical and naturopathic physicians. It sounded as if medical doctors have little to offer besides pills and a scalpel. In contrast, I have had a rich and rewarding relationship with my own treating physicians, particularly during childbirth, and when dealing with my grief after the loss of a loved one. Am I missing something?

A. The oath of a physician — medical, osteopathic or naturopathic — is to dedicate oneself to prevent and treat the countless faces of human suffering. All three professions require four years of rigorous training to obtain a degree. The field of naturopathy has worked long and hard to gain recognition and professional licensure. Naturopaths possess knowledge and skills that are rare among medical doctors, and over the years, I have often sought their recommendations and, at times, referred my patients to them for care.

The description of the medical profession in last week's column, however, is both antiquated and selective. Pharmaceutical, surgical and emergency care are powerful tools but do not, by any means, comprise the entire practice of medicine. When a pediatrician is called upon to counsel a young teenager who has begun to smoke or use alcohol, when an obstetrician guides a first-time mother though an anxious pregnancy, when a surgeon discusses the genetic risks of breast cancer, when a psychiatrist engages in therapy with a single parent who has just lost a job and has three young children to raise, compassion and skillful means are the principal skills employed.

A primary-care physician today cannot practice medicine without partnering with patients to optimize lifestyle. Obesity, heart disease, hypertension, high cholesterol, diabetes, stroke and cancer all require and receive substantial and ongoing attention to the way a person lives and relates to this complex world.

Indeed, where a naturopath receives only a single course in pharmacology and is not required to complete a residency to practice, medical doctors train extensively throughout medical school in the measured use of medication. The standard is then to go on to complete three to seven more years of residency training before beginning to practice independently.

The practice of medicine, in part driven by changes in medical curriculum, continues to evolve rapidly toward in-depth prevention, lifestyle education, familiarity with complementary therapies, and knowledge of the risks and benefits of herbs and supplements.

We continue to function within a health care system that remains flawed. Efforts at meaningful reform are now apparently in jeopardy. Increased inter-professional collaboration and communication are needed to optimize the health of our society, minimize costs and maximize access to the underserved. Successful models of integrative medicine do exist in this state, where a naturopath can work together hand in hand with medical doctors, psychologists, physical therapists and acupuncturists in the spirit of mutual respect for the benefit of the people of Hawai'i.

Dr. Ira Zunin is medical director for the Manakai O Mālama Integrative Healthcare Group and Rehabilitation Center. He is board certified in preventive medicine. For more information, visit www.manakaiomalama.com and submit questions to info@manakaiomalama.com.