The DO | Complement or threat? Naturopathic doctors aim to fill holistic healing niche
NDs are trying to unite both ends, as primary care docs, in addition to Alternative care providers, similar to what the DOs did 50 years ago.
Embracing a holistic philosophy of healing that resembles osteopathic medicine’s, naturopaths tout themselves as primary care doctors who can help remedy the country’s burgeoning physician shortage. Tapping the public’s growing interest in complementary and alternative medicine, they have been increasing their scope of practice state by state, much as the osteopathic medical profession did in the 20th century.
Licensed in 15 states and the District of Columbia, naturopathic doctors have limited but expanding prescriptive authority and other practice rights, with Oregon and Arizona NDs having the broadest prescribing privileges. In Arizona, Hawaii, Oregon, Vermont and Washington, naturopathic doctors can call themselves naturopathic physicians. Last year, two states—Oregon and Hawaii—passed legislation expanding ND scope of practice.
Most recently, the health reform bill that the U.S. Senate approved on Dec. 24, 2009, contains a “nondiscrimination” provision that could require health insurers to cover naturopathic and other alternative treatments provided by licensed health care professionals who are not fully licensed physicians, points out Virginia M. Johnson, DO, who practices neuromusculoskeletal and osteopathic manipulative medicine in Santa Monica, Calif.
“Those trained in a limited paradigm of healing who seek additional practice rights—without commensurate education or responsibility—pose a threat to patients,” Dr. Johnson contends. “What’s more, as a fully trained and licensed physician, I feel this is a lot like identity theft.”
The superficial similarities between naturopathy and osteopathic medicine belie deep differences in training, according to Dr. Johnson and many other osteopathic physicians, who note that the apparent similarities have caused considerable confusion among patients and health policymakers. In a possible example of such confusion, as well as political maneuvering, California Gov. Arnold Schwarzenegger in late July 2009 approved budget legislation requiring California’s Bureau of Naturopathic Medicine to merge with the Osteopathic Medical Board of California.
Some osteopathic physicians, however, fault the osteopathic medical profession for failing to reinforce osteopathic medicine’s distinctiveness. These DOs contend that the profession’s movement toward the mainstream and away from osteopathic manipulative medicine has provided an opening for naturopathic doctors to promote themselves as the true holistic healers.
But not all osteopathic physicians are worried about naturopathic doctors’ practice rights. A number of DOs work cooperatively with naturopathic doctors, referring patients to NDs in some circumstances and receiving referrals from them as well. These osteopathic physicians point out that naturopathy as a profession has improved its training and credentialing standards, just as the osteopathic medical profession did decades ago. While anyone can claim to be a naturopath, a licensed naturopathic doctor must have a doctor of naturopathy degree from an accredited four-year naturopathic medical college and pass the Naturopathic Physician Licensing Examination (known as NPLEX), administered by the North American Board of Naturopathic Examiners.