Holistic Health Medicine Doctors: Licensing Naturopaths in Massachusetts
Should Naturopaths (NDs) be regulated and licensed? This question is being debated right now in Massachusetts and, hopefully, by the time you read this article a licensing bill will have made it into the legislature. So far, eleven states including Connecticut, New Hampshire, Vermont, and Maine license NDs. I recently spoke with Dr. Barbara Silbert, DC, ND, about the situation in Massachusetts. Barbara is a chiropractor and ND who has been in practice for twelve years. She is licensed in Connecticut and would love to be licensed in her home state of Massachusetts. For the past seven years she has been actively working to get a licensing bill passed. Finally, last August a bill was approved that created a commission to study medical alternatives in general and naturopathy specifically. The commission consists of twelve people, including three senators and three representatives plus representatives from the state medical board, the Massachusetts Medical Society, and the Department of Public Health. Barbara, along with a representative from the New England School of Acupuncture are also on the Commission. It is chaired by the director of Professional Licensing who oversees all boards except for the Medical Board.
What exactly are naturopaths? According to the American Association of Naturopathic Physicians (AANP), which fully supports state certification and licensing, naturopathic medicine "is primarily defined by its fundamental principles." Primary among these principles is the recognition of the "ordered and intelligent" healing power of nature. NDs provide a supporting role by "identifying and removing obstacles to health and recovery." Like other alternative healthcare providers, NDs focus on the cause of an illness rather than on simply treating and eliminating symptoms and they apply the least possible force or intervention to achieve the desired results. People who chose NDs are taught the importance of taking responsibility for their own health and the importance of disease prevention. Most importantly, NDs treat the whole person and take all factors – physical and genetic as well as mental, emotional, spiritual, social, and environmental – into account.
In diagnosis and treatment, NDs make use of a wide variety of modalities such as clinical and laboratory testing including x-rays and other imaging techniques, nutritional medicine, dietetics and fasting, homeopathy, acupuncture and Chinese medicine, herbs as well as animal and mineral-based medicines, psychology and counseling, therapeutic exercise, the use of heat and cold, manipulative therapies, and routine office procedures. Naturopathic practice excludes major surgery and the use of most synthetic drugs.
To qualify for a license in states with a licensing board and standards of practice, NDs must attend a four-year graduate level naturopathic medical school where they are educated in all the basic sciences as MDs with the addition of holistic health studies and non-toxic approaches to treatment. NDs are also required to complete four years of training in clinical nutrition, acupuncture, homeopathic medicine, botanical medicine, psychology, and counseling. In the last two years of training, naturopathic physicians are required to be supervised by licensed doctors in outpatient clinics as well as in internships.
There are only a few accredited schools that offer such training: Bastyr University in Seattle, WA; National College of Naturopathic Medicine in Portland, OR; and Southwest College of Naturopathic Medicine in Tempe, AZ; Canadian College of Naturopathic Medicine in Toronto; and relatively new University of Bridgeport College of Naturopathic Medicine in Bridgeport, CT. None of the schools offering naturopathic training by mail are accredited and none of their graduates have been allowed to take any state-approved exam or have ever been licensed by any state licensing board.
To those of us who support alternatives to conventional Western medicine, licensing may seem to be a no-brainer. Why would anyone be opposed to it? It's a win-win situation: consumers are protected from ill-trained practitioners and outright charlatans, and the integrity of the practice of naturopathy is upheld. Opponents are mostly hard-line conventional Western doctors who claim that the science of naturopathy just isn't there. They tend to reject not only naturopathy, but all medical alternatives including acupuncture, herbalism, homeopathy, etc. They also reject MDs who integrate alternatives into their standard practice. They support prosecution for practicing without a license rather than licensing. In addition, some MDs say that if naturopathy has any validity then they (the MDs) should be the ones who research, teach it in their schools and practice it.
In non-license states virtually anyone can hang out a shingle and call themselves a naturopath. For patients, the lack of credible licensing can be confusing and, in the worst circumstances, even dangerous. Barbara spoke of a case in North Carolina being brought against a man with a mail-order degree from the Universalist Light Church. This man, who called himself a naturopathic doctor, told the mother of a ten year old diabetic girl to stop giving her daughter insulin. The mother, who assumed he was a doctor and knew what he was doing, obeyed and the girl died. Licensing could have prevented this tragedy.
What you can do: At the time of this writing, Barbara is cautiously optimistic that the commission's report, due out June 15, will support licensing. "We have a slim majority in favor," she told me, although there are no guarantees. Then it's up to the citizens of Massachusetts to contact your senators and representatives and ask them to vote in favor of naturopathic licensing. The Legislature goes into recess July 31, so act right away!
Resource American Association of Naturopathic Physicians, 8210 Greensboro Drive, Ste. 300, Mclean, VA 22102; 703-610-9037; http://www.naturopathic.org To find out the name/address of your Senators and Representatives: http://www.state.ma.us/legis/legis.htm