In North Carolina, Senate Bill 573 and House Bill 993 to license naturopathic doctors, are making progress in the legislature. Both bills provide standards for the practice of naturopathic medicine and ensure the maintenance of professional competence and acceptable standards of care. In essence, this legislation has the potential to expand health care provider choices for North Carolina consumers. Adding licensed naturopathic doctors who focus on whole-body health and prioritize natural, non-drug therapies, to the list of providers in North Carolina makes good sense.
Naturopathic doctors have been at the forefront of the evolution of integrative medicine. In the last thirty years, the profession has grown from one that included just a few hundred practitioners who were licensed in six states, and a single naturopathic medical school. There are now eight naturopathic medical schools recognized by the Federal Department of Education and approximately 6,000 licensed practitioners in 25 U.S. jurisdictions. In the last six years, Colorado, Maryland, Massachusetts, Pennsylvania, Rhode Island, Idaho and New Mexico have joined the ranks of states that license NDs.
Over the past two decades, there has been a paradigm shift in attitudes and acceptance of natural and integrative medicine. Naturopathic doctors apply scientific rigor to the evaluation of empirically based nutritional, botanical and other naturopathic treatments. Many naturopathic institutions are recipients of National Institutes of Health (NIH) funding and other grants to advance medical research. Additionally, naturopathic doctors are awarded highly competitive NIH fellowships.
Licensed naturopathic doctors complete a four-year, doctoral level, medical education at an accredited school of the Council on Naturopathic Medical Education, recognized by the United States Department of Education. Naturopathic doctors spend two years studying the same biomedical sciences as medical colleagues. In addition, naturopathic doctors have advanced training in clinical nutrition and behavioral medicine. Only naturopathic medical students who graduate from these programs are eligible to take the Naturopathic Physicians Licensing Examination, required for licensure. A growing number of naturopathic doctors complete residency programs.
The naturopathic medical profession has a 100-year history of promoting regulation of its own professional practice. In states like Arizona, which has had licensure since 1935, NDs work in a wide variety of settings including in accountable care organizations and in community health centers that care for the underserved. NDs are an integral part of prominent health systems, hospitals, cancer treatment centers and other conventional medical practices in many of the states where licensed.
Naturopathic medicine is safe, effective and evidence-based. Numerous research studies of naturopathic treatments for conditions such as heart disease, diabetes, anxiety and chronic low back pain show naturopathic medicine to be both safe and effective. Few medical treatments are 100% safe, but naturopathic doctors follow the Therapeutic Order, a roadmap for clinical decision-making, emphasizing gentler approaches first. Conventional medical errors are the number three cause of death in the US, so preventive and lifestyle-based approaches are an imperative public health priority.
Naturopathic doctors offer first-line, non-opioid, non-benzodiazepine approaches to the treatment of pain, anxiety, depression and insomnia. Studies show efficacy when nutritional, botanical, and lifestyle medicine are employed for these complaints. Naturopathic medicine is both effective and cost effective for the treatment of chronic back pain. Research underscores the positive impact of mindfulness meditation for insomnia. Acupuncture is a promising intervention for patients with chronic anxiety.
In my own practice, I see physicians and their families and enjoy collegial and mutual respect across medical professionals. ND referral patterns are similar to MDs for both diagnostic and treatment support. I field questions on a daily basis from medical colleagues for everything from referral to an ND, to my opinion about a particular natural medicine approach for a specific diagnosis, to my knowledge about drug/nutrient/botanical interactions. Patients are already using natural medicine in North Carolina, but most of our medical doctor colleagues are not strongly educated to field such questions or provide such care.
It is time for North Carolina consumers who seek out complementary therapies to be protected from unscrupulous individuals, who can now falsely present themselves as naturopathic doctors. Licensure will set standards for training, education, practice and continuing education. This legislation has been vetted for years by policy makers in the legislature and by the other stakeholders, including the public. As we move to a system of more integrated health care, North Carolina state licensure of naturopathic physicians will benefit patients and other health practitioners and improve the health care access across the state.
Knowing about the education, training, scope of practice, and role of naturopathic medicine expands health care options. For more information, these FAQs and this patient gallery, from the Institute of Natural Medicine and the AANP offer further resources. To find a member of the naturopathic doctor in North Carolina Association of Naturopathic Doctors, click here.