Naturopaths push for greater acceptance
Kansas is the latest state to regulate naturopathy, as public
acceptance of alternative practitioners grows.
By
Myrle Croasdale, AMNews staff. Oct. 28, 2002.
Additional information
Physicians who beat back scope-of-practice incursions in statehouses
across the country are meeting a new foe as naturopaths take advantage of
the public's increasing interest in alternative and complementary
medicine.
Several states already license naturopaths, and naturopaths are
actively seeking licensing in several more. But physicians remain firm in
their opposition to using state legislatures to expand naturopathic scope,
or any scope for that matter.
"We believe the way to become trained is by education not legislation,"
said John C. Nelson, MD, secretary-treasurer of the American Medical
Association.
The issue isn't likely to go away anytime soon.
According to some studies, 43% of Americans have used some form of
alternative or complementary medicine and are spending $40 billion a year
on such treatments or remedies.
"The trends are clear," said Michael Traub, ND, president of the
American Assn. of Naturopathic Physicians, a group aggressively lobbying
state legislatures to expand naturopathic scope of practice. "The use of
alternative medicine in the United States is well recognized. People are
not getting what they need with conventional physicians. People are
looking for forms of medicine that are less invasive, less harmful and
have fewer side effects."
43% of Americans have used alternative or complementary remedies.
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Dr. Nelson acknowledged that the pull of alternative medicine is
stronger these days for a variety of reasons. He said that traditional
medicine still has its limits and that people with terminal or chronic
illnesses are now turning to unproven alternative therapies when they feel
their traditional avenues of treatment have been exhausted.
He said managed care constraints have dented the physician-patient
relationship, sending some people in search of a different approach to
care.
"Sometimes naturopaths and others take more time with patients, to be
frank. Pressured by managed care, doctors are rushed and people are not
pleased," said Dr. Nelson.
Naturopaths in Kansas sought to expand their scope with a bill that
would have given them the right to prescribe certain prescription drugs,
perform minor surgery and deliver babies.
The legislation, which was in committee for several years and was
contested by the Kansas Medical Society, was eventually whittled down. The
final bill, enacted in July, merely requires naturopaths to be registered.
The bill's greatest distinction is to separate naturopaths trained at
an accredited four-year college from those that got their title from
unaccredited sources, according to the AANP.
Americans spend $40 billion a year on alternative or complementary
remedies.
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"I'm glad Kansas did pass this bill, and every state should, to protect
the public," said Mehdi Khosh, ND, an avid supporter of the legislation.
"This bill says who is qualified and who is not."
Jerry Slaughter, executive director of the Kansas Medical Society, said
the KMS was able to gut the bill but state government felt it had to take
some action.
"Our goal was to make sure we didn't have folks out there practicing
medicine without a medical license and doing things that they weren't
trained to do," he said. "Kansas ultimately decided to create a law to get
a handle on the people who were out there doing this."
The AANP estimates there are 4,000 to 5,000 naturopathic practitioners
in the United States who've graduated from one of five accredited colleges
in the United States and Canada.
Eleven states license naturopaths, and their licensing requirements
vary widely. In states silent on the topic, naturopaths are guided by how
the state defines the practice of medicine.
In New York, for example, where naturopaths are not licensed, they
aren't allowed to diagnose patients, but they can treat them with vitamins
and herbs.
A licensed naturopathic practitioner attends a four-year graduate-level
program and is educated in basic sciences and holistic approaches with an
emphasis on disease prevention. Their studies include clinical nutrition,
acupuncture, homeopathic medicine and botanical medicine.
Part of the team
Some physicians are tapping into naturopaths' knowledge of nutrition
and natural remedies.
Family physician Lynn Durand, MD, of Concord, N.H., said naturopaths
make a valuable contribution to patient care.
11 states license naturopaths.
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"The reason that I got interested is that I listened to people who were
getting better," Dr. Durand said of his introduction to naturopaths.
He said many physicians are afraid they'll lose their patients to such
alternative doctors but shouldn't be.
"Doctors don't admit it, but their core concern is 'If patients go to
another kind of doctor, does that mean they won't come back to me?'
Demographics show they go to alternative and conventional people" so they
don't drop one for the other, he said.
The other assumption physicians make is that naturopaths are quacks.
"Physicians don't know what's included in a naturopathic education and
assume it's substandard," Dr. Durand said. "I feel it's quite good, and in
some areas it's superior, like in the area of nutrition."
Bethany Hays, MD, an ob-gyn who is medical director for True North in
Falmouth, Maine, also shares patients with naturopaths and is looking to
hire one to join the practice. While on the board of the American Holistic
Medicine Assn., she researched their educational background and was
impressed with what she found.
"My goal is to practice the best medicine available," Dr. Hays said.
"When I realized there were big holes in my knowledge base, I found there
were other practitioners who could fill in those holes in complementary
modalities."
What she values about naturopaths is that they'll spend time educating
patients on healthy eating and lifestyles, she said. Patients with complex
multisystem disorders like chronic fatigue, fibromyalgia and irritable
bowel syndrome often benefit from the naturopathic approach.
"These are problems conventional doctors don't have much patience or
time for and often don't feel like they're helping," Dr. Hays said.
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ADDITIONAL INFORMATION:
State control
Several states monitor naturopaths through some form of licensing or
registration.
States that require licensing: Alaska, Arizona, Connecticut,
Hawaii, Maine, Montana, New Hampshire, Oregon, Utah, Vermont, Washington
States that require registration: Kansas, District of Columbia
Source: American Assn. of Naturopathic Physicians, American
Naturopathic Medical Assn.
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Copyright 2002 American Medical Association. All
rights reserved.
