COLUMBUS, Ohio — Nancy Foley knows the value of a good natural family planning-only physician. Her physician, Dr. James Patterson, might very well have saved her life.

Foley (not her real name) had charted her signs of fertility for nearly 12 years, but the signs she was experiencing seemed anything but typical. Concerned, she approached her natural family planning-only physician with her symptoms. Patterson's (not his real name) knowledge, coupled with his patient's, led to further tests and a final diagnosis of a pre-cancerous condition that was successfully treated.

Because Foley used natural family planning, not only was she was in tune with her body's signs but she was also able to identify an abnormality that led to an early diagnosis.

"I'm very thankful to have had a physician that recognizes and understands the medical applications behind natural family planning,” she said.

It used to be that natural family planning-only physicians — physicians who understand modern, scientific methods of natural family planning and do not perform sterilizations or prescribe contraceptives — were difficult to locate. That's less true today. Not only are there more natural family planning-only physicians than there were six years ago, but more and more are coming to the decision earlier in their careers.

Approximately six years ago, Steve Koob, director of the Dayton, Ohio-based apostolate One More Soul, created the country's first directory of natural family planning-only physicians. It began with 45 doctors from a variety of specialties and has now grown to contain more than 450.

"We get about three new NFP-only physicians each month,” Koob said.

While Koob is happy to see the growth, he's disappointed that the number isn't larger. "In 2000, I threw out the number 2,000 by the end of 2000,” he said.

He's convinced, however, that there will not be a dramatic leap in natural family planning-only physicians until clergy begin challenging doctors.

"Very often, everyone in a community knows that a physician is doing tubal ligations, and yet they are treated like great Catholics,” Koob said. "They are on the parish council, they serve as Eucharistic ministers, they teach CCD. That's a scandal.”

Indeed, some of the very physicians contained in One More Soul's directory came to be natural family planning-only at the admonition of clergy. That is certainly true for Dr. Michael Skoch of Lincoln, Neb.

"I had been trained at a Catholic hospital in Wichita, Kan., and [contraception] was what we were taught, so I assumed that it must be okay for me to prescribe,” Skoch said.

Eighteen months into his practice, Skoch found his professional life being addressed by his local priest.

"He asked me if I knew what I was doing,” Skoch said. "When I told him that I was doing what I had been taught, he replied that if I continued doing what I was doing, he could no longer continue giving me holy Communion.”

A year and a half later, Skoch finally stopped prescribing contraception.

In June 2000, Skoch left his five-physician family practice to launch the Moscati Health Center — a four-physician primary care medical practice incorporated with mental health services that does not compromise Skoch's values.

While Skoch said he did lose some patients during the transition, he estimated that 90% of his 2,000 families stayed with him.

For Skoch the decision to become a natural family planning-only physician came in midcareer. However, an increasing number of physicians are embracing natural family planning during residency or before. It's a trend Skoch has noticed.

"More and more young men and women have this figured out at a much earlier stage than I did,” he said. "It's an inspiration to me at this stage of my life. I firmly believe that the future is really bright and positive in this direction.”

Younger Doctors

Dr. Richard Cash is among those who have gone in that direction. Cash became a natural family planning-only physician during his third and fourth years of medical school. At that time he received information he previously wasn't taught or had ignored about the abortifacient nature of oral contraceptives.

Cash was awarded the Minnesota Academy of Family Practice Resident of the Year award last year and is in his first year of family practice with the St. Cloud Medical Group. He serves as one of two natural family planning-only physicians in the 45-member practice.

"When I made the decision to focus on NFP, I knew that the pill was used to treat the symptoms of a lot of different conditions,” Cash said. "I wanted the knowledge to be able to offer something more for my patients rather than saying, 'I'm sorry, I don't deal with that.'"

Cash was recently certified as a natural family planning medical consultant by completing a six-month program through the Omaha, Neb.-based Pope Paul VI Institute.

"That training will help me better treat some gynecologic conditions without using artificial hormones,” Cash said. "It's a disease-based approach, meaning that a lot of things that women have, such as infertility, painful menses and ovarian cysts, are symptoms of an underlying disease that is not often sought after by the medical community. They simply cover it up with contraceptives.”

Cash said he has seen a trend among younger physicians embracing the Church's teaching.

"The majority of people in the medical-consultant program were students, residents or physicians early in their practice,” he noted.

Another physician who has come to the decision early is third-year Ohio State University medical student Kyle Beiter. A biology major from Franciscan University of Steubenville, Ohio, Beiter hopes to bring a natural family planning-only approach to his work as an OB-GYN during his residence at Georgetown University. In his work he says he has already seen the failure of separating the unity of sexual intercourse from the procreative aspect.

"In one week I saw three women who were pregnant and were 13-14 years old,” Beiter said.

Beiter has found the support he needs along the way. He said he was fortunate to do his rotations with mentor Dr. Michael Parker, a natural family planning-only physician at Grant Hospital in Columbus, Ohio.

In addition, in preparation for his residency work, Beiter spoke with colleague Dr. Faith Daggs, a Camp Hill, Pa., OB-GYN.

"She went to Georgetown [University],” Beiter said, "and was kind of anxious going into it. Yet her peers supported her decision. She has been out for five years and is doing well.”

Clearly, the role of doctors in natural family planning is pivotal.

"The doctors are huge on this issue,” said Theresa Notare, assistant director of the U.S. Catholic bishops' Diocesan Development Program for Natural Family Planning. "Outside of the priest, if a couple is having trouble on this front they will go to their doctor and they will take what he says very seriously.”

As important as the doctors are, the support of teaching couples and the Church is just as crucial. Notare described it as a "trinity of support.”

"Whenever we survey the dioceses about the obstacles that stand in their way of getting the Church's NFP message out to people, they include: priests not speaking about birth control and NFP, couples not coming forward to witness or teach other couples, and then, of course, the medical profession,” she said.

Yet Notare is hopeful.

"I'm very encouraged when I see the young people that have somehow stumbled onto natural family planning and the theology of the body,” she said. "They are just jazzed about this. There is great hope out there.”

Tim Drake writes from St. Cloud, Minnesota.