California May Allow Naturopaths To Prescribe Drugs

Thanks to the so-called "Scope Modernization Bill," naturopathic doctors in California may soon be able to do a lot more. Originally introduced last year, the bill passed the Assembly Committee on Appropriations last week and is scheduled to be voted on by the end of the month, Forbes reports. However, some doctors are worried about the effects the bill may have. California is one of 16 states, along with D.C. and Puerto Rico, that licenses naturopaths to work as primary care providers. To earn the title of naturopathic doctor (ND), one must go through a four-year accredited program. Naturopaths have an approach that combines many "natural" and "alternative" therapies, including things like acupuncture and homeopathy, which have little to no conclusive evidence in treating medical conditions. Currently, naturopaths in California can only prescribe certain controlled drugs under the supervision of an MD or DO. That has led the California Naturopathic Doctors Association to argue that the current need for supervision impedes naturopaths' ability to work with patients, because physicians are reluctant to supervise them. If the new bill is passed, their roles will widen considerably. In addition to ordering different kinds of imaging tests, they will be able to perform certain minor surgical procedures and prescribe schedule IV and V drugs on their own (including things like Valium and Ambien). Although that might seem like a good thing for NDs, some MDs are concerned that even licensed naturopaths are overstating their medical credentials, including how much training they receive in terms of prescribing pharmaceutical drugs — and that the new bill could open patients up to serious safety issues. "Although NDs may be well qualified to practice naturopathic medicine that utilizes natural medicine and treatments in a natural approach, NDs do not receive the education and training in naturopathic education programs to safely perform minor procedures and prescribe without physician supervision," Kimberly Kirchmeyer, executive director of the Medical Board of California, wrote in a letter opposing the bill to its sponsor. "By expanding the scope of practice for an ND and not requiring physician supervision, patient care and consumer protection could be compromised." It's interesting to note that naturopaths' perceived need for an expanded role may come from the same issue that brought nurse practitioners and physicians' assistants more responsibility: a shortage of primary care doctors. The California Medical Association noted in an e-mail to Refinery29 that since naturopaths aren't covered by Medicaid, Medicare, or Medi-Cal, access issues would remain. The impulse to find care elsewhere that may line up with your own values more than the traditional approach of an MD is understandable. But it also makes sense that appropriate training and an attention to science-backed treatment methods should be required for certain procedures and practices. Update: This post has been updated to include comments from the California Medical Association.