The Pennsylvania House passed a naturopathic doctor (ND) licensing act (
What's the difference? My brief research did not disclose a definitive answer under Pennsylvania law. Generally, however, health care practitioner licensing grants an exclusive privilege to perform certain acts (e.g., surgery and prescribing drugs for MDs) for those who have demonstrated they have sufficient education and training. Registration,
This particular registration act seems to be of the title protection variety: one cannot use the term "naturopathic doctor" unless one enjoys the dubious distinction of having
NDs would be overseen by the Board of Medicine, which is authorized to enact regulations governing their practice. According to the bill, the Board can discipline a naturopath for
"making misleading, deceptive, untrue or fraudulent representations."
Considering the fact that a good chunk of what naturopaths do is misleading, deceptive, untrue or fraudulent, this provision could spell the end of naturopathic practice in Pennsylvania if it is properly enforced. Naturopathy, as SFSBM's own Board chairperson,
"nothing more than a hodge-podge of mostly unscientific treatment modalities based on vitalism and other prescientific notions of disease. As a result, typical naturopaths are more than happy in essence to "pick one from column A and one from column B" when it comes to pseudoscience, mixing and matching treatments including
If you think he's being uncharitable, read former naturopath Britt Hermes's
"from naturopaths describing their services as 'cutting edge,' to those claiming they can reverse the course of dementia, to others who make blanket statements that naturopathy can help anyone with any ailment fully restore his or her health."
The bill also says that registered naturopaths can be disciplined, even in the absence of patient harm, for "unprofessional conduct," which includes
"departure from or failing to conform to an ethical or quality standard of the profession. . .(i)the ethical standards of a profession are those ethical tenets that are embraced by the professional naturopathic medicine community in this commonwealth. (ii)a naturopathic doctor departs from, or fails to conform to, a quality standard of the profession when the naturopathic doctor provides a medical service at a level beneath the accepted standard of care. The board may promulgate regulations that define the accepted standard of care. In the event the board has not promulgated an applicable regulation, the accepted standard of care for a naturopathic doctor is that which would be normally exercised by the average professional of the same kind in this commonwealth under the circumstances, including locality and whether the naturopathic doctor is or purports to be a specialist in the area."
Apparently, the good Pennsylvania legislators are don't realize that the anemic naturopathic ethics code permits such obviously
You could think that giving the medical board oversight over naturopaths, including the authority to enact rules and prosecute them for misconduct, is a good idea. It's possible that a dedicated board could enact rules requiring an evidence-based practice standard of care and energetically enforce them. But I see this headed in a different direction. The goal of the American Association of Naturopathic Physicians is to have naturopaths licensed in all 50 states by 2025 with full primary care scope of practice. However, the AANP will settle for a reduced scope of practice as a foot-in-the-door strategy, only to come back to the legislature year after year with requests for an expanded scope.
This very strategy proved successful for Pennsylvania acupuncturists and Oriental Medicine practitioners. Originally, they were simply allowed to register with the state. Since then, their lobbying efforts have resulted in a
We've seen this playbook work for naturopaths in a number of other states recently: Connecticut "modernized" its naturopathic practice act to greatly increase scope of practice, Oregon gave patients the option to choose a naturopath as a PCP and Colorado expanded their prescription privileges. There have been failures too, most recently in California, where a bill removing NDs from physician supervision over prescribing failed. But they will be back, year after year, until they get what they want. Now that
Registration will confer undue legitimacy on naturopathic practice. Naturopaths who meet the statute's minimum requirements will be allowed to use the title "Dr." and claim they are registered practitioners to a public that likely has little notion of the difference between registration and licensing, however Pennsylvania may define those differences.The use of the word "registered" already carries some connotation of respectable authority in medicine – "RN" stands for "registered nurse" – simply adding to the confusion.
Pennsylvania should not put the imprimatur of the state on what is "