2014: a losing legislative season for naturopaths

2014: a losing legislative season for naturopaths

By my count, naturopaths attempted to gain licensure in 10 states in 2014. (In states with two-year legislative sessions, the 2014 bill was in some cases a holdover from 2013). They attempted to increase their scope of practice in 4 states. On the other hand, in Hawaii there was a rare legislative attempt to put more backbone in naturopathic regulation. In Utah, a single bill both increased scope of practice and stiffened regulatory requirements.  There was a bill in Colorado which would have allowed "traditional naturopaths" a safe harbor from prosecution without registration. (It failed.) We won't count that in our tally because it wouldn't have affected the practice of "naturopathic doctors."

Many state legislatures have adjourned for the year, or at least will not vote on any more bills, although they may continue to meet.  The results are in for all naturopathic bills except in three states: New Jersey, Pennsylvania and Michigan. The Pennsylvania House passed a licensing bill with a disturbingly broad scope of practice, but it has been stuck in a Senate Committee since October, 2013.  The Michigan bill has been sitting in a House Committee since last year as well, and hasn't even made it to the Senate.   It may be a long time before we know the results in New Jersey, whose session doesn't end until January, 2016. 


Maryland passed a licensing bill, albeit with a scope of practice much narrower than what naturopaths wanted.  Importantly, they must have a collaborative relationship with an MD or DO physician, although how that will work is not defined in the new law.  As well, naturopaths will be under the jurisdiction of the state medical board, advised by a naturopathic committee consisting of 3 NDs, 2 MDs/DOs and a public member.  They must disclose their limited scope of practice to patients and cannot call themselves "physicians" or use colonic hydrotherapy.  Unfortunately, they can see any patient with any disease or condition.

Naturopaths achieved modest success in scope of practice expansion in Arizona, which will allow them to use telemedicine, and Utah, which will permit them to employ percutaneous injections.  Connecticut "modernized" naturopathic scope of practice, giving them considerably broader authority than they previously enjoyed.  

Other than that, 2014 has been pretty much a bust for naturopaths.  Six states -- New York, Massachusetts, Illinois, Idaho, Iowa and Rhode Island -- all rejected licensing naturopaths flat out.  I add Massachusetts with a bit of a caveat.  The last time out in that state, legislative shenanigans months after formal legislative sessions ended allowed licensing legislation to pass, but fortunately the Governor vetoed it.  Idaho actually passed licensing legislation a few years ago, but never implemented the law, so we count naturopaths' failed attempt to revive the licensing law from its moribund state as a rejection. 

As for practice expansion efforts, Alaska refused to expand prescription privileges and Colorado refused to eliminate important consumer protections designed to clip the newly-registered (in 2013) naturopaths' wings.  Naturopaths will still be prevented from seeing patients under 2 years of age and must recommend that parents of older pediatric patients follow the government's recommended vaccination schedule and have their children see a licensed pediatric health care provider.

There were efforts to improve regulatory oversight as well.  In Hawaii, a bill would have required naturopaths to have the same education and training as MDs/DOs to prescribe, which seems imminently reasonable.  Unfortunately, the bill was watered down to require additional education in prescribing.  Although Utah expanded scope of practice slightly, the state also replaced one of the NDs on the naturopathic formulary committee with an MD/DO physician. 

So, here are the mid-year naturopaths v. science and reason win-loss stats (counting Utah in two categories):  Licensing: 1-6. Practice expansion: 2-2. Improved regulation: 0-2. By any measure, a losing season.  Even if they win from here on out.  















Points of Interest 7/29/2014