Unproven, potentially dangerous — and possibly licensed under a new bill
A measure that emerged in the waning moments of the last legislative session this week would create a state licensing board for naturopaths — alternative medicine practitioners whose work is considered unproven and potentially dangerous by physician leaders but is defended as a helpful option by adherents.
If Governor Charlie Baker signs the bill into law, he will end a two-decade effort by naturopaths to obtain the legitimacy, oversight, and protection of having a professional license. Massachusetts would join 18 other states and Washington, D.C., in licensing naturopaths, including all bordering states except Rhode Island.
Amy Rothenberg, president of the Massachusetts Society of Naturopathic Doctors, cheered the vote as a victory for public health. She said the bill, if enacted, will protect patients from inadequately trained naturopaths who engage in dangerous practices, such as attempting to cure a patient of cancer with herbs and vitamins.
“We’ll be able to offer quality naturopathic medicine to the citizens of Massachusetts, where we will have both the protection of the law and also regulation,” Rothenberg said.
About 50 naturopaths practice in the state, and Rothenberg expects more to set up shop if licensing is offered.
But Dr. James S. Gessner, president of the Massachusetts Medical Society, said licensure won’t protect patients because naturopathy does not have standards for proper care. “It’s hard to know if there is a deviation from standards when it’s not clear what the standards are,” he said. “A license really doesn’t mean very much.”
The bill, approved a day before the new legislative session began Wednesday, establishes a board of registration in naturopathy to issue licenses and regulate the profession. It requires a four-year degree from an approved naturopathic college. The legislation prohibits naturopaths from performing surgery or prescribing medications, calling themselves “physicians,” or purporting to be primary care doctors.
Licensing would be optional. Practitioners could offer naturopathic health care without having a license — but they would be forbidden to call themselves naturopaths. Only those with licenses would be allowed to identify themselves as naturopathic doctors.
Similar bills have been considered in every legislative session since 2002, and one passed the Legislature in 2012. Then-Governor Deval Patrick vetoed it, objecting to the board’s administrative structure.
Naturopaths, who say their work encourages the body to heal itself, employ herbs, supplements, and homeopathic remedies; perform physical manipulation of body structures and tissues; and advise on nutrition and lifestyle changes.
The Massachusetts Medical Society, in written testimony to the Legislature, dismissed naturopathy as “a combination of nutritional advice, home remedies, and discredited treatments” and “a large assortment of erroneous and potentially dangerous claims mixed with a sprinkling of non-controversial dietary and lifestyle advice.”
Representative Jay R. Kaufman, Democrat of Lexington and a top proponent of licensing naturopaths, said the medical society has been “incredibly slow to appreciate the qualifications as well as the experience of folks who are alternative medicine practitioners.”
Years ago, Kaufman served on a legislative commission on naturopathy, which he said concluded that naturopathic practices and those of conventional medicine “had very comparable levels of credibility and scientific accuracy.”
“A broader array of options just means that overall health care of citizens of the Commonwealth will improve,” he predicted.
Rothenberg, of the Massachusetts naturopathic society, said responsible naturopaths work in concert with medical doctors and know when to refer cases to them. Oncologists often refer patients to her to help with the side effects of cancer treatment, she said.
A survivor of breast and ovarian cancer, Rothenberg relied on conventional medicine to beat back her cancer and traveled to New Hampshire to visit a licensed naturopath who advised her on “specific nutritional approaches to enhance the efficacy of my treatment.”
Rothenberg lives in Amherst but practices in Connecticut because without a license she cannot perform a physical exam or order laboratory work, among other tasks. Most insurers do not cover naturopathy, although such coverage is mandated in Connecticut.
Dr. Michelle Dossett, a Massachusetts General Hospital internist who specializes in mind-body medicine, said naturopaths often do a better job than physicians at “using lifestyle-based approaches to prevent and help to manage chronic disease.”
Dossett acknowledged that the benefits might result from the placebo effect (when a patient’s belief in a treatment causes it to work) or from the comforts of extra attention, but she said, “If patients are getting better and they’re taking less prescription medications and having fewer side effects, I don’t see a downside there.”
But Britt Marie Hermes, a former naturopath who left the profession and writes a blog lambasting it, urged the governor not to sign the bill. “Licensing provides the public with a sense of legitimacy,” she said. “Patients are being duped into believing naturopaths are trained just like doctors.”
Hermes, who is currently studying biological science in Germany, said the courses at naturopathic colleges have some of the same titles as at medical schools, but the content is thin and often bogus. For example, Hermes said she took a year of training in homeopathy, a discredited practice that purports to treat each illness with highly diluted amounts of the element that caused it.
Writing last year on the medical blog KevinMD.org, she said, “Naturopathic students are not trained in medical standards of care, let alone reality.”
Correction: An earlier version of this story gave incorrect information about the states that license naturopaths.