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With the help of a national advocacy parent group, the New York Association of Naturopathic Physicians is attempting to have Senate Bill 1617, introduced by Senator Dale Volker, Republican of Rochester, and Assemblyman Sam Hoyt, Democrat of Buffalo, passed in Albany. The bill would permit only those with a four-year degree from an accredited naturopathic college (there are four in North Americanone in New York) to earn the right to have the designation "ND" embroidered on their lab coats. Similar laws are already in place in 14 other states, as well as Washington, D.C., but the effort in New York is being met with significant resistance.
Though the most predictable opposition comes from MDs who say they don't want to lend further legitimacy to methods of healing they consider unproven, it's not just conventional docs who want to put on the brakes; a whole group of fellow naturopaths are less than enthusiastic about the proposed legislation.
First there's the American Naturopathic Medical Association, whose members say licensing proponents aren't real naturopaths at all, because, in their view, these advocates are attempting to expand the definition of naturopathy to include techniques inconsistent with the underlying philosophy of the practice. Evelyn Morgan, executive director of the Nevada-based group, objects to proponents' claims that NDs are qualified to perform minor surgeries and prescribe drugs. "Naturopaths [aren't supposed to] remove moles, we don't stitch people up, we don't give shots. If they want to practice allopathic [conventional] medicine, they should go to medical school," she says. (Licensed NDs actually can serve as primary-care physicians in a few states, although a reputable one, says Doni Wilson, president of the New York Association of Naturopathic Physicians, would "never consider supplanting allopathic physicians.")
Then there's the Coalition for Natural Health, a D.C.-based group that makes it its business to fight states' efforts to license naturopaths. Executive director Boyd Landry, who counts among recent successes lobbying efforts to block legislation in Florida, Missouri, and North Carolina, admits that his organization has played a small part in stalling bill 1617. "[Licensing advocates] want a monopoly on naturopathy; we don't want them to have it," he says, adding that while advocates claim that the public is confused over which naturopaths are trained and which are not, licensing naturopaths will cause greater confusion. "People won't know when to go to an ND and when to go to an MD."
It should be noted that some people consider a discussion on the correct form of naturopathy a waste of time. The outspoken Dr. Kimball Atwood and the controversial former shrink Stephen Barrett (creator of Quackwatch, a website devoted to debunking pseudoscience) both believe that whether naturopaths spend six months or four years learning their trade is irrelevant, since naturopathyin their opinionhas zero value.
But the line between allopathic and alternative medicine is growing narrower all the time. Some MDs are using silymarinmilk thistle extractto treat mild cases of liver dysfunction, and breast cancer patients' demands for answers to questions about natural therapies have prompted physicians such as Katherine Crew, an oncologist at Columbia, to refer patients to a naturopath. But the herbs naturopaths suggest to clients can be expensive, and Crew is among those who hope that if New York institutes a licensing system, insurance companies will consider covering certain herbal mixtures.
Those affiliated with schools like Bastyr University in Seattle (a leading accredited naturopathic university) point to what they say is the rigor of their curriculum. Graduates are usually required to earn an undergraduate degree with a pre-med focus, then complete four years of grad school, including 3,000 hours of academic study and 1,100 hours of clinical training. There is a world of difference, university officials say, between a naturopath who has earned a degree from a school like Bastyr that teaches from what president emeritus Joseph Pizzorno calls a "science-based" curriculum and a person who feels qualified to heal after taking a six-week correspondence course.
Though many senators feel the licensing bill needs some tweaking, it has at least substantial theoretical support in Albany. If proponents can come to an agreement with the New York Medical Society, the bill has a good chance of inching forward this year.
Senator Liz Kruger, Democrat of Manhattan, who would like to see some version of the bill regulating naturopaths pass, says, "There is clearly much evidence that various types of alternative health care have a record of success, but without licensure, there can be no mechanism for tracking complaints." But those who call themselves traditional naturopaths are not likely to agree. Bill Bailey of North Carolina (who got his degree from one of the correspondence schools bill proponents think so little of) says people like him don't want to get the state involved, nor do they want to relinquish the suffix ND. "I give lifestyle and nutritional advice," Bailey says. "We take a moderately healthy person and make them stronger."