Massachusetts Senate Bill 2148, (a re-do of House Bill 1992 and Senate Bill 1205, which it now supplants), allowing naturopaths to practice legally in Massachusetts, was voted favorably out of the Joint Committee on Public Health. This is unsurprising, as the Committee itself is the bill's sponsor. What is surprising, however, is that any legislative committee supposedly devoted to public health would sponsor a naturopathic practice act, a point we'll return to in a moment.The bill is now before the Committee on Health Care Financing.
This will be, by my count, the 11th legislative session in which a naturopathic practice bill has been introduced. A bill actually passed one year, thanks to some questionable legislative shenanigans at the end of session, when the bill, under any fair interpretation of Massachusetts legislative procedure, should not have been considered. Fortunately, it was vetoed by the governor, who apparently had the good sense to smell a rat and dispose of it properly.
SB 2148 gives naturopaths a broad scope of practice. Committee members have apparently fallen for the naturopathic lobbying line that naturopathy "a distinct form of primary care" using "natural" substances for preventive health care and chronic disease. What the bill actually does is allow poorly educated and trained "doctors" to diagnose any patient with any disease or condition and treat those patients with an array of ineffective and potentially dangerous remedies. The bill states that naturopaths may not "assume the character or appearance of a primary care provider," but then turns around and gives naturopaths the same scope of practice as a physician by allowing them to diagnose and treat any patient who walks in the door. The bill limits only the means by which they may do so.
Naturopathic education and training are woefully inadequate to the task. Family practice doctors practice with four years of medical school and 3 years of residency.(You can see a chart comparing medical and naturopathic education and training here, showing that family practice doctors have a whopping 15,000+ hours more education and training than naturopaths.) Naturopathic "medical" schools do not offer nearly that level of education and training, yet any patient can see either practitioner, no matter how ill he is or obscure his disease might be.
Naturopaths like to say they will refer patients who are beyond their skill set. But how could they possibly know that the patient has a condition they don't know how to properly diagnose and treat if they've never seen a patient with that particular problem?
Britt Hermes, herself a former naturopath, has detailed the inadequacies of her education and clinical training at Bastyr, supposedly the premier naturopathic program in the U.S. in two posts on Science-Based Medicine:
No one considering voting in favor of SB 2148 should vote without reading her posts first. Still not convinced? Then read Hermes's own blog, Naturopathic Diaries, which provides a less sanitized, and more realistic, look at naturopathic practice than the naturopathic lobbyists would like the legislators to see.
Unfortunately, their ability to diagnose these nebulous conditions, which are not recognized as legitimate by other health care practitioners, will be greatly facilitated by the authority this bill gives them to order clinical and laboratory procedures "to evaluate injuries, illnesses and conditions in the human body."
Naturopaths would be regulated by a "Board of Registration in Naturopathy" ("registration" in Massachusetts is comparable to licensing in other states). Two of its members would be naturopaths, two are physicians, one is a pharmacologist and one is a public member. One of the physicians must have experience working with naturopaths. Unfortunately, this can lead to the appointment of an "integrative" physician sympathetic to naturopathic practices who might be less effective in supporting science (or even evidence) based medicine and who may himself engage in some of the practices naturopaths use.
And "public health?" Naturopaths are notoriously against vaccination, which is widely considered the crowning public health achievement of the last century. Naturopaths like to hide their opposition with dog whistles like parental "choice" and giving patients information "pro" and "con." But make no mistake: they are anti-vaccination. In fact, this bill implicitly recognizes public health concerns about naturopathic opposition to vaccination by requiring that the naturopath track and document the immunization statues of patients under 18 years old and refer unimmunized patients to physicians.
Rather than legitimizing naturopathy, Massachusetts should be acting to shut down the currently practicing naturopaths who are clearly practicing medicine without a license and fleecing the public.
I am always a bit amazed when I fly. I am over Minnesota on my way to NECSS in New York for a day of science-based medicine and a weekend of science and skepticism. And the Book of Mormon.
In 5 hours...
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