The State Legislature of Michigan - which, significantly, is a No-Fault state - has introduced a bill to license Naturopaths. The proposed law, which you can read here,
would permit properly credentials Naturopaths to do the following:
(A) ORDER AND PERFORM PHYSICAL AND LABORATORY EXAMINATIONS FOR
DIAGNOSTIC PURPOSES, INCLUDING, BUT NOT LIMITED TO, PHLEBOTOMY,
CLINICAL LABORATORY TESTS, ORIFICIAL EXAMINATIONS, OR PHYSIOLOGICAL
(B) ORDER DIAGNOSTIC IMAGING STUDIES.
(C) DISPENSE, ADMINISTER, ORDER, OR PRESCRIBE OR PERFORM ANY OF THE
(i) FOOD, EXTRACTS OF FOOD, NUTRACEUTICALS, VITAMINS, AMINO ACIDS, MINERALS, ENZYMES, BOTANICALS AND THEIR EXTRACTS, BOTANICAL MEDICINES, HOMEOPATHIC MEDICINES, ALL DIETARY SUPPLEMENTS, OR NONPRESCRIPTION DRUGS AS DEFINED BY THE FEDERAL FOOD, DRUG, AND COSMETIC ACT, 21 USC 301 TO 399D.
(ii) PRESCRIPTION OR NONPRESCRIPTION MEDICINES AS DESIGNATED BY THE NATUROPATHIC FORMULARY COUNCIL.
(iii) HOT OR COLD HYDROTHERAPY; NATUROPATHIC PHYSICAL MEDICINE; ELECTROMAGNETIC ENERGY; OR THERAPEUTIC EXERCISE.
(iv) DEVICES, INCLUDING, BUT NOT LIMITED TO, THERAPEUTIC DEVICES, BARRIER CONTRACEPTION, OR DURABLE MEDICAL EQUIPMENT.
(v) HEALTH EDUCATION OR HEALTH COUNSELING.
(vi) REPAIR AND CARE INCIDENTAL TO SUPERFICIAL LACERATIONS OR ABRASIONS.
(D) UTILIZE ROUTES OF ADMINISTRATION THAT INCLUDE, BUT ARE NOT LIMITED TO, ORAL, NASAL, AURICULAR, OCULAR, RECTAL, VAGINAL, TRANSDERMAL, INTRADERMAL, SUBCUTANEOUS, INTRAVENOUS, OR INTRAMUSCULAR CONSISTENT WITH HIS OR HER NATUROPATHIC EDUCATION AND TRAINING.
(E) OTHER NATUROPATHIC THERAPIES AS APPROVED BY THE BOARD
The bill does not permit Naturopaths to prescribe controlled substances, perform chiropractic manipulation, perform acupuncture, perform surgery other than superficial procedures, or use lasers or radiation.
According to the American Association of Naturopathic Physicians, their practice "includes the following diagnostic and therapeutic modalities: nutritional medicine, botanical medicine, naturopathic physical medicine including naturopathic manipulative therapy, public health measures and hygiene, counseling, minor surgery, homeopathy, acupuncture, prescription medication, intravenous and injection therapy, naturopathic obstetrics (natural childbirth), and appropriate methods of laboratory and clinical diagnosis.... Naturopathic practice includes the following diagnostic and treatment modalities: utilization of all methods of clinical
and laboratory diagnostic testing including diagnostic radiology and other imaging techniques; nutritional
medicine, dietetics and therapeutic fasting; medicines of mineral, animal and botanical origin; hygiene and public health measures;
naturopathic physical medicine including naturopathic manipulative therapies; the use of water, heat, cold, light, electricity, air, earth, electromagnetic and mechanical devices, ultrasound, and therapeutic exercise; homeopathy; psychotherapy and counseling; acupuncture, injection and intravenous therapy; minor surgery; prescription medication; and naturopathic obstetrics (natural childbirth)."
Naturopathy has its critics: among them, as one might expect, are M.D.s. One in particular, David Gorski, a surgical oncologist, wrote a scathing critique of the proposed Michigan law and Naturopathy in general in the blog Science Based Medicine. Dr. Gorski calls Naturopathy "a cornucopia of almost every quackery you can think of. Be it homeopathy, traditional Chinese medicine, Ayurvedic medicine, applied kinesiology, anthroposophical medicine, reflexology, craniosacral therapy, Bowen Technique, and pretty much any other form of unscientific or prescientific medicine that you can imagine, it's hard to think of a single form of pseudoscientific medicine and quackery
that naturopathy doesn't embrace or at least tolerate." Some Naturopathic methods rely on immaterial "vital energy fields", the existence of which has not been proven, and there is concern that naturopathy as a field tends towards isolation from general scientific discourse. But there are growing collaborative efforts between naturopaths and medical doctors to evaluate the safety and efficacy of naturopathic medicine
in prevention and management of a broad range of common ailments, and to decide whether accessibility of naturopathic services will enhance patient health in a cost-effective way.
The Michigan bill was introduced on 31 January 2013. In 2012, the Governor of Massachusetts refused to sign a similar law. Currently, the following states and territories license Naturopathic practitioners:
- District of Columbia
- New Hampshire
- North Dakota
- Puerto Rico and Virgin Islands
If passed, will Michigan PIP pay for Naturopathic testing and treatment? And if so, how will it be peer reviewed? What criteria will be used for denying and/or cutting off treatment and testing? Stay tuned.