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Why Naturopaths Should Not Be Licensed
Kimball C. Atwood IV, M.D.
Naturopaths are licensed as independent practitioners in eleven
states (Alaska, Arizona, Connecticut, Hawaii, Maine, Montana,
New Hampshire, Oregon, Utah, Vermont, and Washington) and the
District of Columbia, and can legally practice in a few others.
Naturopaths who have attended on-campus schools are pressing for
licensure in the remaining states.
Approximately 30 naturopaths are lobbying for licensure in
Massachusetts. They portray themselves as "primary care physicians,"
consider themselves superior to other naturopaths whose "degrees"
were obtained from nonaccredited correspondence schools, and assert
that licensure is needed to protect the public from unqualified
practitioners. However, the existing naturopathic licensing agencies
have done little or nothing to protect the public from naturopathy's
Since treatment by incompetent practitioners can cause great
damage, health professions should be held to very high standards.
To be considered a health profession, an occupational group
should be able to demonstrate an objective, scientific, and ethical
basis. Naturopathy fails to meet this standard. I believe that
it is dangerous and that no amount of regulation can control the
danger. Moreover, as noted by William T. Jarvis, Ph.D., past-president
of the National Council Against Health Fraud:
The difference between more and less educated naturopaths
is . . . . like comparing more and less educated witch doctors.
It could actually be argued that less schooled naturopaths are
safer because they may have a smaller bag of tricks and, because
they don't consider themselves "primary health physicians,"
they are more apt to refer patients to M.D.'s for additional
The Massachusetts Medical Society strongly opposes naturopathic
licensure in Massachusetts. Our reasons include:
- 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.
- Unscientific naturopathic beliefs pose irrational challenges
to proven public health measures, most notably childhood immunizations.
- Irrational, unscientific beliefs and practices abound in
naturopathy, likening it more to a cult than to a valid form
of health care. These beliefs and practices are not merely at
the fringes but are the standards of the field. They are advocated
by the leaders themselves.
- Naturopathic practitioners are incapable of self-regulation
commensurate with public safety. No study has demonstrated that
naturopaths who attend full-time schools are any less dangerous
than those who have mail-order degrees.
- Naturopaths prescribe numerous "natural medicines"
with a standard for safety and efficacy that is unacceptably
low, as evidenced by the leading textbook in the field.
- The scientific pretensions of naturopathy and naturopathic
training programs are baseless. There is ample evidence that
the basic science courses do not teach students to think critically.
Research performed at naturopathic colleges is lacking in scientific
rigor and has not investigated common naturopathic claims. The
libraries at naturopathic colleges are filled with books and
journals that promote trendy but implausible notions regarding
health care. The major journal in the field is filled with articles
that are both absurd and dangerous. The oft-repeated claim that
the major textbook in the field cites "more than 10,000
scientific references" is a misrepresentation, as exemplified
by the textbook's claims for "natural remedies."
- Collaboration with medical doctors is uncommon in naturopathic
- Naturopathy involves many nonsensical diagnostic practices
that mainstream medicine considers quackery but naturopaths consider
- There are ubiquitous claims of dubious clinical "syndromes,"
among which are multiple "food allergies," "toxemia,"
and chronic yeast infections, which cast further doubt on the
science and ethics of naturopathic practice.
- The duration and setting of naturopathic clinical training,
even overlooking its content, is inadequate for producing competent
primary care physicians. This is clear from a comparison of the
training of medical doctors to that of naturopaths. Just as a
newly graduated medical doctor, no matter how well-intentioned,
would not be allowed to assume the role of a primary care physician,
neither should this be allowed for a naturopath whose training
is clearly inferior.
Naturopathic services are not covered by Medicare or most insurance
policies. Expansion of naturopathic licensing will make naturopaths
appear more legitimate and could help them gain passage of laws
forcing insurance companies to cover their services.
Dr. Atwood, who practices in Newton, Massachusetts, is board
certified in anesthesiology and internal medicine. He is also
his state medical society's representative on the Massachusetts
Special Commission on Complementary and Alternative Medical Practitioners,
an ad hoc group whose purpose is to inform state legislators about
naturopathy. This article is modified from a lengthy report that
Dr. Atwood submitted to the Commission.
This article was revised on December
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