California naturopathic practice expansion bill moves forward; NY, NC and RI licensing bills fail

California naturopathic practice expansion bill moves forward; NY, NC and RI licensing bills fail

Last August, expansion of naturopathic prescribing privileges in California seemed dead when Senate Bill 538 failed to pass in the Assembly Committee on Appropriations. The Committee then turned around and revived the bill by granting it reconsideration.There the bill sat in limbo for almost a year.

Now the bill is back in play, having been re-referred to the Committee on Appropriations, this time with a new sponsor. Having passed in the Senate, the bill would require approval by the full Assembly before making its way to the Governor's desk for consideration. According to the MultiState legislative calendar, the Legislature is currently in recess until July 31st, and is due to adjourn August 31st, so it's down to the wire.

The original version of Senate Bill 538 would have allowed naturopaths to order, prescribe and administer Schedule III through Schedule V drugs with no MD or DO supervision.  As amended, naturopaths would be limited to Schedule V drugs. Naturopathic practice could include Schedule III – IV drugs only under the supervision of an MD or DO and according to standardized procedures or protocols, including specifying which drugs can be used. As well, naturopaths must have additional coursework in pharmacology if they wish to expand their prescribing privileges.  For Schedule III drugs, protocols must be patient-specific. The Naturopathic Medicine Committee of the Osteopathic Medical Board, which regulates naturopathic practice, may establish regulations regarding ocular or intravenous routes of administration, although apparently it is not required to do so.

Naturopaths also sought to expand their scope by adding parenteral therapy and minor office procedures, as well as interpreting diagnostic imaging studies. The latest version of the bill, however, permits only those with appropriate training to conduct and interpret these studies, like MDs and DOs, although naturopaths may still order them.  Parenteral therapy and minor offices procedures were eliminated from the bill. 

This bill is yet another example of naturopaths' commitment to having full primary care scope of practice in all 50 states by 2025, an effort that is being funded by dietary supplement companies. It is also an example of legislative reluctance to allow them those privileges. Currently, only Oregon considers naturopaths full PCPs. The woeful inadequacy of naturopathic education and training, including pharmacology instruction, is well documented. Even worse, naturopaths reject evidence-based medicine in favor of "philosophy" and regularly subject patients to bogus diagnoses and dubious treatments.

Fortunately, three state legislatures have, in the past few weeks, rejected naturopathic licensing altogether. Naturopathic practice acts were introduced this legislative session, once again, in New York, North Carolina and Rhode Island. All three legislatures have adjourned without these bills having made much progress in their respective journeys through the committee process.

Still in play are licensing bills in Massachusetts (where a bill passed in the Senate), Michigan (also here), New Jersey and Pennsylvania (where a bill passed in the House). The Massachusetts legislature is scheduled to adjourn this month, but the others will stay in session until the end of the year. If you live in one of these states, your representatives need to hear why these bills are a terrible idea. In addition to the links already provided, there are plenty of additional resources on this site, as well as Science-Based Medicine and Naturopathic Diaries

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