Governor Charlie Baker should sign into a law a bill now before him that would license naturopathic doctors and ensure the safe practice of naturopathic medicine in Massachusetts.
Naturopathic doctors have been at the forefront of the evolution of integrative medicine. In the last 30 years, the profession has grown from one that included just a few hundred practitioners who were licensed in six states, and a single naturopathic medical school. There are now eight naturopathic medical schools recognized by the federal Department of Education and approximately 6,000 licensed practitioners in 21 US jurisdictions. In November 2016, Pennsylvania approved a licensure law.
Dr. Joanna Yanez, executive director of the Association of Accredited Naturopathic Medical Colleges, writes, “NDs are rigorously trained in four-year, in-residence, regionally and nationally accredited higher education institutions. Graduates pass psychometrically sound examinations prior to being eligible for licensure and require industry standard continuing education coursework.”
In the spring of 2000, the Joint Committee on Health Care recommended a special commission to study and advise it on the licensing of naturopathic doctors. The commission was chaired by William Wood, director of the Division of Registration and Professional Licensure. In 2002, the majority report concluded that:
“State licensure of practitioners of naturopathic medicine is both appropriate and necessary for the protection of the public health, safety, and welfare. Those practitioners who are unqualified and delivering substandard care pose a threat to public safety and welfare.”
Of course, since that time, there has been a paradigm shift in attitudes and acceptance of natural and integrative medicine, which is ongoing. Scientific rigor applied to the evaluation of empirically based nutritional, botanical, and other naturopathic treatments continues. Many naturopathic institutions are recipients of National Institutes of Health funding and other grants to advance medical research. Additionally, naturopathic doctors are awarded highly competitive NIH fellowships.
The naturopathic medical profession has a 100-year history of promoting regulation of its own professional practice. In states like Arizona, which has had licensure since 1935, NDs work in a wide variety of settings including in accountable care organizations and in community health centers that care for the underserved. All the New England states except Rhode Island and Massachusetts have licensed NDs for more than 20 years. Many Massachusetts NDs practice in neighboring states where there is licensure and Massachusetts residents, who can afford to, must travel across state lines to receive naturopathic care. Vermont has recognized NDs since 1995; they are an integral part of the conventional medical landscape.
Naturopathic doctors are experts in the non-opioid treatment of pain. Bill Walter, an ND who practices at a community health center in Oregon, says, ”Naturopathic doctors offer new perspectives on pain management and are leaders in changing the paradigm away from the use of opioid medication.”
In my own practice, I see among others, physicians and their families — and enjoy collegial respect. Our referral patterns are similar for both diagnostic and treatment support. I field questions on a daily basis from medical colleagues for everything from looking for a referral to an ND, to seeking my opinion about particular natural medicine approach for a specific diagnosis, to trusting my thoughts about drug/nutrient or drug/herb interactions. Patients are using natural medicine in Massachusetts, but most of our medical colleagues are not strongly educated to field such questions or provide such care.
As part of our legislative documents shared in the State House, we had countless letters of support from MDs in practice and from those working in our state-of-the-art educational and medical institutions.
It is time for Massachusetts consumers who seek out complementary therapies to be protected from unscrupulous practitioners, who can now falsely present themselves as naturopathic doctors. Licensure will set standards for training, education, and practice. This legislation has been vetted for 24 years by policymakers in the Legislature and in the executive branch, and by the other stakeholders, including the public. As we move to a system of more integrated health care, state licensure of NDs is a good idea.
Amy Rothenberg, ND, lives in Amherst and is a licensed naturopathic doctor in Enfield, CT.