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The Integrator Blog. News, Reports and Networking for the Business, Education, Policy and Practice of Integrative Medicine, CAM and Integrated Health Care. - AMA News: Resistance to New ND Licensing
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AMA News: Resistance to New ND Licensing PDF Print E-mail
Written by John Weeks   

American Medical News Focuses on MD Resistance to ND  Licensing

"State medical groups resist naturopaths' licensure push," beams the headline in the March 27, 2006 American Medical News. The weekly is an organ of the American Medical Association (AMA). In recent years, licensing of naturopathic physicians has expanded to 14 states and the District of Columbia. Most recently the states of Idaho and California joined the ranks. "Naturopathic physicians," or "naturopathic doctors" as the California Medical AssociationImage (CMA) forced them to limit their self-description in that state, are presently pushing licensing in eight new states. These include New York, but are mainly in the Midwest and South, according to a map in the article.

Opposition to ND licensing is not a formal platform of either the AMA or of the American Academy of Family Physicians (AAFP). A member of the AAFP board is quoted as having concerns about whether the education equips them for practice as primary care doctors. Says the member, Jim King, MD: "Much of this legislation is looking to bypass going to medical schools." The article suggests that additional substantive issues, have to do with pharmacy rights, and minor surgery. The Medical Society of the State of New York (MSSNY) isopposing a bill in that state which just moved through a state Senate committee. MSSYN considers the measure overly broad, especially practice-to-curriculum language which the MSSNY is taking to mean even general surgery, if the schools add this
Jane Guiltinan, ND, AANP Pres.
level of training. Jane Guiltinan, ND, president of the American Association of Naturopathic Physicians, is quoted as saying that licensure is a form a public protection.

The article doesn't add up to the pitched battle framed by the headline writer. In truth, in many states, licensing of naturopathic doctors has either not been fought by medical associations, or only quietly so. The latter strategy has sometimes been to have other groups, if there are any, take the first arrows. Organized chiropractic and AOM have sometimes served as these foot-soldiers to the medical association's major artillery in those turf wars. The state medical society sometime weighs in at the last moments. An MSSNY newletter opens the potential for negotiation, including the following:

Legislation (S.1617, Volker) was recently reported by the Senate Higher Education Committee to the floor of the NYS Senate. The measure would license naturopaths and allow them to prescribe, administer, dispense and perform natural therapies and to prescribe and administer drugs, immunizing agents, diagnostic tests and devices and to order laboratory tests. MSSNY has been assured that the bill will not be voted on until both sides have met and are satisfied with the bill. MSSNY has written in opposition to the proposal as have several of the Specialty Medical Societies.  It is expected that all interested parties will meet to discuss the bill’s provisions.   
In some other states cases, respect and understanding have grown, compromises have been reached, and the medical association decides to get out of the way. 

I would venture that the comment of Dr. King about the med school "bypass" is either not very evidence based or suggests great stupidity in the ND students. "Bypass" sounds easy. However, taking $150,000 of naturopathic medical school debt, like many of these new graduates have, out into a culture where there remains limited acceptance and are few salaried jobs for members of their profession cannot fairly be called an easy way to anything.
Red State, Blue States, Populous States, New States

As an aside, the pattern of licensing of naturopathic doctors follows almost a "blue state/red state" pattern, with the exceptions of the old Northwest zones of Wisconsin and Michigan, and new York and Massachusetts, on the "D" side, and the inclusion of typically "R" Idaho, Nevada and Arizona axis. Current campaigns begin to take on a chunk of the Nation's heartland and south. There are licensing campaigns in Illinois, Missouri, Arkansas, Tennessee, Virginia and Florida as well as New York. Of particular interest is Illinois, where National University of Health Sciences is starting up a naturopathic medical program to expand an institution which already includes chiropractic and AOM. The state is also home of Cancer Treatment Centers of America, which have pioneered inpatient integrative care through a team led by naturopathic physician Tim Birdsall, ND. Illinois is also home of the AMA and the American Hospital Association.

Illinois, New York and Florida are all key to the profession's future, as each is a major population states. The profession gains practice terrain, and , potentially, more federal clout. Before passage of licensing in California, Washington State was the most populous state with ND licensing.

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