During 2015-2016, over a dozen bills were introduced in the state legislatures to license naturopaths and acupuncturists as health care professionals. Several dozen more were introduced to expand the scope of practice for chiropractors, naturopaths and acupuncturists. This count does not include bills trying to force public and private insurers to cover CAM practitioner services.
Today, we'll wrap up our coverage of 2015-2016 by looking at how bills pending during the past year fared. For the full story, check out the Legislative Updates page under the Advocacy tab.
A major goal of the American Association of Naturopathic Physicians is full primary care scope of practice privileges in all 50 states. Currently, they've achieved that status in exactly one state: Oregon, although they have some form of regulation in 16 states. In 2016, naturopathic licensing acts were pending in Illinois, Iowa, Massachusetts (for the 11th time), Michigan, Mississippi, New Jersey, New York (for the 8th time), North Carolina, Pennsylvania and Rhode Island.
New Jersey's bill remains pending in 2017. In Pennsylvania, a licensing bill giving naturopaths a broad scope of practice was replaced by a registration bill, which simply permits them to register with the state without defining their scope of practice. The
Naturopathic practice expansion bills in California, Connecticut, Hawaii, Oregon, Vermont and Washington failed. In California, Hawaii, and Washington, naturopaths wanted expanded prescription privileges, but the legislatures refused. The Maryland legislature passed a bill establishing a
In sum, naturopaths gained little in 2016: registration in one state and a formulary in another, both of which will be controlled by medical doctors.
Chiropractors are already licensed in all 50 states, so their 2016 bills continued to focus on practice expansion, including efforts by some chiropractors to rebrand themselves as primary care physicians, a boondoggle both Harriet Hall and I
Their only success in 2016 was in Ohio, where a bill passed allowing chiropractors to recommend, administer and sell to patients vitamins, minerals, antioxidants, enzymes, glandulars, homeopathic remedies, non-prescription drugs and other dietary supplements to "restore and maintain health."This conflict of interest is frowned upon in medical practice but is considered perfectly ethical among chiropractors and naturopaths. Except for non-prescription drugs, most of these have never been tested for safety or efficacy prior to sale.
Similar bills allowing chiropractors to use what is euphemistically called "clinical nutritional methods" failed in Hawaii and Idaho.The Idaho bill would have allowed chiropractors to administer vitamins, minerals and herbal remedies via injection, including IVs, leading the way to their operating infusion clinics for IV administration of
Chiropractors also wanted the right to perform school physicals in California, return concussed student athletes to play in Oregon, and prescribe physical therapy in Michigan. All those bills failed as well.
"assessment, evaluation, prevention, treatment or correction of any abnormal physiology or pain by means of controlling and regulating the flow and balance of energy . . . and stimulating the body to restore itself."
In addition to traditional needle acupuncture, Kansas practitioners will be able to employ "
"the practice of acupuncture, Chinese herbology and Asian bodywork therapy as part of a comprehensive health care system encompassing a variety of traditional health care therapies that have been used for more than 3,000 years to diagnose and treat illness, prevent disease and improve well-being."
Of course, "used for" is not synonymous with "is effective for." Practitioners can make recommendations based on "eastern dietary therapy," supplements and lifestyle and offer information about herbs, vitamins, amino acids, carbs, sugars, enzymes, food concentrates, and dietary supplements. It's always a wonder how acupuncturists and the like bootstrap themselves into legitimacy with the argument that their methods are "thousands" of years old, then tack on all sorts of stuff that the ancients either had no idea existed, like amino acids and enzymes, or simply didn't exist "thousands" of years ago, like dietary supplements and food concentrates.
Rhode Island added the practice of "Oriental medicine" to its acupuncture practice act last year, defining it as a form of "primary health care." This year, the Rhode Island legislature gifted acupuncturists with self-regulation, creating a Board of Acupuncture and Oriental Medicine. The state also has a new law allowing chemical dependency professionals to use "auricular acudetox." Like Ohio, Rhode Island is treating its addicts with magical thinking.
But on it goes. A bill allowing naturopaths and chiropractors to return students to play following a concussion is already being drafted in the Oregon legislature for consideration in 2017. We'll be watching as this and other Legislative Alchemy as makes its way through the state legislatures in the coming year.