The Licensing of Naturopathic Physicians in RI

Rhode Island licenses doctors and dentists, nurses, midwives, athletic trainers and dieticians for the medical community. They also license acupuncturists and their assistants, chiropractors, massage therapists and interpreters for the deaf. They do not license naturopathic physicians.

To find out why, I went to the Department of Health, which issues all licensing permits for RI. A supervisor said they would welcome the chance to license naturopathic physicians, but the decision wasn’t up to them. That privilege belongs to the RI Legislature, and it is a decision they have so far declined to make. The Naturopathic Physicians Bill has been bandied back and forth since 2000. On April 6, 2014, Senator Picard attempted to reintroduce the bill, but the issue never made it to the vote and was recommended held for further study.

It’s odd that the legislature didn’t feel it had sufficient information on which to base a decision, since they felt comfortable licensing virtually every other medical professional in the state. Did the naturopathic doctors drop the ball?

I found quite the opposite to be true. Dr. Marcy Feibelman, current president of the RI Association of Naturopathic Physicians (RIANP), gave me an impressive outline of the efforts the association is making to raise awareness and gain involvement with the RI community. As to the government’s response? “During last year’s hearings for licensure of naturopathic physicians, the bill was well received by both the Senate and House health committees.”

So why is the legislature dragging its heels on allowing the bill to go to vote?

In RI no one is talking, but online, the opposition ranges from skepticism to outright derision. Massachusetts’ Kimball C. Atwood, M.D. goes so far as to state: “Naturopathy is both potentially and actually injurious when practiced according to the accepted standards of the profession. This injury is likely to be due to the failure of the naturopathic practitioner to recommend appropriate medical treatment,” and, “irrational, unscientific beliefs and practices abound in naturopathy, likening it more to a cult than to a valid form of healthcare.”

These are alarming accusations. But the mission statement of ANP tells a somewhat different story: First Do No Harm (Primum Non Nocere.)

Naturopathic physicians follow strict guidelines to avoid harming patients. They use methods and medicinal substances that minimize the risk of harmful side effects. They respect and work with each individual’s selfhealing process. They are open to working as adjunct healers with medical professionals.

None of this seemed either irrational or likely to cause harm to a patient, so I decided to look at the patient harm track record western medicine has. In 2013, the Harvard School of Public Health issued a report that stated 43 million people are injured worldwide each year due to unsafe medical care. A recent update on a study by the Institute of Medicine in NY estimates that at least 210,000 deaths per year in this country are associated with preventable harm in hospitals; the true number may be more than 400,000.

This brings us to the heart of an important issue: the current health crisis in America. Nobody can deny the value of western medicine. If I were to be hit by a truck or have a medical emergency, I would head directly to an ER or critical care hospital. Western medicine is unparalleled in their skill at crisis intervention. The problem is that few people live their lives in a state of crisis. Far more of us fall into the category of “chronic.” And it is here that western medicine has serious failings. The facts are in:

• Chronic diseases are the cause of 7 out of 10 deaths each year in the United States.
• About 1 in 2 adults live with at least one chronic illness.
• More than 75% of healthcare costs are due to chronic conditions.
• The percentage of U.S. children and adolescents with a chronic health condition increased from 1.8% in the 1960s to more than 7% in 2004. The numbers are still climbing.

In western medicine, it is standard practice to diagnose patients according to symptom clusters and prescribe drugs or surgery for treatment. Once that patient walks out the door, they are usually on their own. Unfortunately, this is the real danger zone for people with chronic conditions. There are usually lifestyle factors that, if unaddressed, will lead to recurrent relapse. Yet surveys show medical doctors avoid emphasizing lifestyle changes because if they do, patients simply find another doctor who will give them pills or procedures. And no wonder — our public health education in America comes mostly from the pharmaceutical companies that spend billions of advertising dollars a year shoving their products down our throats.

Naturopathic doctors consider patient education vital. Their focus is on prevention, treatment and optimal health through methods that encourage an individual’s selfhealing process. NDs truly excel in the management and treatment of chronic health problems. It is not surprising that the medical community would pull out all the stops to launch a campaign against that goal. Let’s face it — a lot of MDs could be out of business if naturopathy were to succeed.

There is a real need for naturopathic medicine today. We can no longer afford to rely solely on our medical system for health. No matter what procedure we have or medication we take, when we walk out of that office, we go home to our own lives. The decisions we make there can mean the difference between constant relapse or personal recovery. Ultimately, responsible self-care is the only route to sustainable health.

RI and Massachusetts are the only remaining states in New England that do not license naturopathic doctors. I urge everyone to contact their representatives and give this issue the importance it deserves. The bill may not be reintroduced in 2015 without our support. Please visit ndaccess.com/rianp for further information on naturopathy and links to RI State Representatives.