well regulated naturopathic medicine

MN Statute 147E registers naturopathic doctors effective July 2009 and mandates a work group to recommend measures to ensure MN Statute 146A effectively protects unlicensed healers and, also, to study naturopathic regulation laws in other states. All opinions welcome. In the spirit of the work group, where the unregulated and regulated healers concerns will find an equitable solution, we hope this blog will engender a friendly and meaningful conversation.

Thursday, July 24, 2008

Run Tona, Run

Naturopathic legislative news from across the nation (The Daily Times, Maryville, TN) :

Candidate promoting questionable college degree


By Joel Davis
of The Daily Times Staff

Tona Monroe-Ball, District 20 House of Representatives candidate, has been promoting herself as a doctor of naturopathic medicine. Evidence seems to suggest otherwise.

In recent weeks, Monroe-Ball has lobbied The Daily Times staff to describe her as a doctor during election coverage and has been addressed as such at recent candidate forums. Her candidate and business Web sites both describe her as a "naturopathic doctor."

Although state law does not prohibit anyone from simply calling themselves a doctor, even without being licensed, it does prohibit the practice of naturopathy, a philosophy of health that embraces alternative treatments, such as acupuncture and herbalism, used outside of normal medical care.

Tennessee Code Annotated 63-6-205 defines naturopathy as "the prevention, diagnosis and treatment of human injuries, ailments and disease by the use of such physical forces, as air, light, water, vibration, heat, electricity, hydrotherapy, psychotherapy, dietetics or massage, and the administration of botanical and biological drugs."

Because of this prohibition, Monroe-Ball, who has not claimed to be a practitioner, has been relying on a degree, received in 2005, from Central States College of Health Sciences in Columbus, Ohio, to confirm her status. Closer investigation, however, raises questions about the legitimacy of the degree.

John Ware, executive director of the Ohio Board of Career Colleges and Schools, said the school did not have state authorization to issue degrees.

"They're not approved by this board," Ware said. "They're not approved by the Ohio Board of Regents. There was a lawsuit a couple years ago with this school and the Ohio Board of Regents about whether they should be offering degrees. My understanding is they weren't supposed to be."

When he founded CSCHS in 1994, Robert McKinney, the president of the school, resurrected a lapsed corporate charter that dated back to 1939. Attorneys for McKinney later argued in court that this exempted the school from needing certification because the college had technically been in existence prior to the effective date of the applicable state regulations, according to court records.

Court ruling

In 2005, a Franklin County, Ohio, court ruled that CSCHS was not authorized to issue degrees. This ruling was upheld by the Court of Appeals of Ohio in 2007. According to Karen Doty, general counsel for the Ohio Board of Regents, the Ohio Supreme Court declined to hear a further appeal.

"The Supreme Court declined to hear the case last March," Doty said. "We haven't heard from (CSCHS) since then."

Without authorization from the Board of Regents, degrees granted by CHCHS are not legally recognized in Ohio. Classes taken at the college would not even be transferable to other schools in Ohio.

"If we did not authorize it, then we would not recognize the degree," Doty said.

Whether CSCHS is still in operation is an open question. The college's Web site has not been updated since 2004. The phone number listed on the site is no longer in service.

CSCHS also never received accreditation from any agency recognized by the U.S. Department of Education. According to the department Web site, "accreditation is the process used in U.S. education to ensure that schools, postsecondary institutions, and other education providers meet and maintain, minimum standards of quality and integrity regarding academics, administration, and related services. It is a voluntary process based on the principle of academic self-governance. Both institutions and programs (faculties) within institutions participate in accreditation."

Monroe-Ball responds

In an e-mail to The Daily Times, Monroe-Ball argued that accreditation has nothing to do with the quality of education she received.

"All the recognition by the U.S. Department of Education does it qualify students for federal loan money," she wrote. "It means nothing in terms of educational standards. Thus, you've choose (sic) to set the basis of recognizing degrees around the ability of a school's students to received (sic) gov't money to go to school."

"... If you could give me a rational reason as to why the U.S. Department of Education is the gold standard for recognition, I am willing to listen. But instead you've choose (sic) to ignore the facts and fall in line with the 10th plank of the Communist Manifesto."

For reference's sake, in the 1888 Samuel Moore translation of the Communist Manifesto, the 10th point alluded to by Monroe-Ball reads: "Free education for all children in public schools. Abolition of children's factory labor in its present form. Combination of education with industrial production, etc."

Quality control process

The U.S. Department of Education recognizes only one accrediting agency for naturopathic schools, the Massachusetts-based Council on Naturopathic Medical Education. During a telephone interview, the council's executive director, Daniel Seitz, called accreditation a quality control process.

"The federal government wants to make sure that educational programs that may be funded through federal taxpayer dollars are legitimate programs," Seitz said. "That is the primary consideration."

Further, Seitz said that accreditation does matter if a naturopath hopes to become a licensed practitioner. The 14 states that license naturopaths require a degree from an accredited institution.

"I can't comment on the quality of her training, but, by the virtue of attending an unaccredited institution, she would not be eligible to be licensed as a naturopath in the United States," he said.

Another accreditation

Monroe-Ball did provide a copy of a certificate of accreditation for CSCHS from the "World Organization of Natural Medicine Practitioners." That agency is not listed as a recognized accrediting agency by the U.S. Department of Education. According to its Web site, the WONP purports to fall under the auspices of The Medical Order of the Knights Hospitalers, an organization that claims a thousand-year lineage from a historical order of knighthood; however, the current incarnation organization apparently only dates back to 2007.

Seitz said he had never heard of the WNMOP.

"Anyone can set up an organization that purports to be an accrediting agency," he said. "You have to dig a little deeper to see if it's a meaningful process."

Within hours of an e-mail exchange between The Daily Times staff and Monroe-Ball about the lack of accreditation, Chris Fortner, an area blogger who supports Monroe-Ball, contacted the newspaper vie e-mail. In reference to Monroe-Ball, he appeared to argue against medical licensing.

"Why should medicine be licensed other than to run a racket by those who operate it?" Fortner wrote. "The license, born in the late 19th Century, is nothing more than a shell game, designed to raise the incomes for the people already in these fields. In return for their serving as apologists for the new statism, the state was prepared to offer not only cartelized occupations, but also ever-increasing and cushier jobs in the bureaucracy to plan and propagandize for the newly statized society."

Monroe-Ball lives in Greenback. She runs a Web business selling natural medicine products. According to the site, she moved to Tennessee in 2003. She is seeking the Republican nomination for the House of Representatives seat being vacated by state Rep. Doug Overbey.

Originally published: July 07. 2008 3:01AM
Last modified: July 06. 2008 11:11PM

Sunday, June 8, 2008

Minneapolis Star Tribune article

A bitter fight over who can be called 'doctor'

June 7, 2008

It took 99 years, but Minnesota has finally given official recognition to the practice of naturopathic medicine, which relies on the body's powers to heal itself.

Under a new state law, naturopaths -- who use everything from herbal remedies to biofeedback -- will be allowed to register with the state and call themselves doctors without fear of running afoul of the medical establishment.

You might think that would be a cause for celebration throughout Minnesota's alternative-health community.

But you'd be wrong.

Instead, the new law has triggered a bitter rift among the vast array of people who practice alternative medicine, from homeopaths to folk healers to massage therapists.

To those covered by the new law, it's simply a way to get more respect and professional freedom for a particular brand of holistic medicine. But others see it as an assault in a turf war that could benefit a few highly trained practitioners at the expense of others.

"What they're trying to do is become the gatekeeper for natural health, so nobody else can practice," said Greg Schmidt, who runs the Minnesota Natural Health Legal Reform Project, which led a pitched battle to sink the law.

Despite assurances to the contrary, the fissure remains.

"I didn't realize how much of an issue it was going to be," said Rep. Neva Walker, DFL-Minneapolis, who championed the bill for years before it finally passed and was signed into law in May. "[I] didn't realize somebody who had supported all forms of alternative healing for years was going to be an enemy."

The quest for recognition

Naturopathic doctors call their work a mix of modern and traditional medicine.

In some states, they are licensed professionals, much like medical doctors. The main difference, they say, is that they rely on herbs, vitamins and other natural, low-tech remedies to treat ailments that, they believe, are often caused by stress and lifestyle.

"It's blending the best of what we know in science with the best of what we know in natural medicine," said Leslie Vilensky, of New Prague, president of the Minnesota Association of Naturopathic Physicians.

In Minnesota, supporters have tried, on and off, to pass a naturopathic law since 1909. But they have been lumped in with other folk healers, allowed to work with patients as long as they didn't cross into territory reserved for doctors or other licensed professionals.

Sometimes, that's been tricky.

In 1996, Helen Healy, a St. Paul naturopath, was accused by the state Board of Medical Practice of practicing medicine without a license. Her case instantly became a cause célèbre for alternative medicine supporters. Natural healers of all stripes, from herbalists to homeopaths, protested in the streets over her treatment. Eventually the medical board compromised, allowing Healy to see patients within certain limits.

At that point, Healy, who runs the Wellspring Naturopathic Clinic, vowed to try to change state law to allow naturopathic doctors to practice freely. She never imagined that the biggest resistance would come from former allies.

"We're not trying to take away anybody's rights to use these gifts from nature," she said last week. "We just need to have a place ... for naturopathic physicians."

A divide among healers

For years, Healy and her colleagues pushed futilely for a law to license naturopathic doctors. This year, they changed strategy and proposed a less-formal registration.

It allows those who qualify to use the title "naturopathic doctor" and expand their "scope of practice" to include such things as ordering blood tests and MRIs, and admitting patients to hospitals.

It only applies, however, to graduates of four-year naturopathic medical schools -- about 26 people now practicing in Minnesota, according to the naturopathic group.

At first, they ran into flak from both sides. The Minnesota Medical Association (MMA), representing conventional doctors, objected to allowing naturopaths to prescribe drugs and perform minor surgery. When those items were dropped, the MMA withdrew its opposition.

But the alternative-medicine groups dug in their heels. Boyd Landry, who heads the Coalition for Natural Health in Washington, D.C., argued that it could lead to restrictions on other people practicing alternative medicine. "This is about market share. This is about turf," he said.

Schmidt, of the Minnesota group, agreed. "Regulatory schemes create boxes, and boxes fence people in as much as they fence people out," he said. Schmidt worried what would happen to naturopaths who are self-taught or took correspondence courses and don't qualify under this law.

"Why should they be denied a title?" he asked.

Supporters, though, say the new law doesn't interfere with anyone's right to practice alternative medicine. "Take a look at the bill; it's not there. The bill doesn't prohibit anybody," Healy said. "We are not trying to control the universe of natural health care."

The debate isn't over. The new law, which takes effect in July 2009, calls for a work group of both sides to hammer out the details. Both sides said that's a good thing.

Meanwhile, after nearly a century of trying, naturopaths are relishing their victory.

"It's not necessarily as complete or thorough as other laws, where naturopaths practice in other states," said Vilensky, president of the Minnesota group. "But we're very happy that we're able to do what we can do under this law."

Maura Lerner • 612-673-7384

Friday, May 30, 2008

"They have Lust again"

Interesting link includes an account of Benedict Lust, the father of naturopathy.
From the article:


Dr. Benedict Lust enjoys a sun-bath at "Sonnenbichel" sun and air park in Kneipp-Bad Worishofen, Bavaria, Germany on a return to the Fatherland in the summer of 1926. The "Father of Naturopathy" in America, no single individual contributed more to natural healing and lifestyle in the world than Dr. Lust did through his many schools and publications. Everything from massage, herbology, raw foods, anti-vivisection and hydro-therapy to Eastern influences like Ayurveda and Yoga found their way to an American audience through Lust. Though he was repeatedly harassed by Medical authorities and Federal agents, his devotion to promoting Nature's methods of healing finaly gained wide acceptance. Like so many others from his generation, he was a tough man. (Photo from Naturopath, February, 1927)

Dr. Lust was "busted" repeatedly by American authorities and medical associations, for promoting natural methods of healing, massage and nude sun bathing at his Jungborn sanitarium. He was arrested 16 times by New York authorities and 3 times by Feds. One news headline read simply "They Have Lust Again".

Thursday, May 29, 2008

2004 Idaho Senate Committee testimony on naturopathic licensure

SB 1300 This legislation, SB1300, relating to naturopathic medicine, was presented by Senator Robert L. Geddes.

There are a significantly growing number of residents of the State of Idaho who choose natural health care. Naturopathic medicine is a distinct health care profession. The purpose of this legislation is to provide standards of practice and education, a code of ethics for practitioners, state administrative supervision, licensure, regulation and disciplinary procedures for every person providing naturopathic medical services in the state.

There is no fiscal impact to the general fund.


Boyd Landry, executive director of the Coalition for Natural Health, testified to oppose SB1300. He explained his opposition to licensing of naturopathic physicians. The Coalition for Natural Health is headquartered in the District of Columbia with a regional office in San Diego.

The Coalition for Natural Health (CNH) is a non-profit organization representing over 2,500 individuals nationwide who share a common goal: to promote the holistic approach to health and to ensure that natural health alternatives remain widely accessible to the public. The mission of the Coalition for Natural Health is:

  • to educate the public as to the true meaning and benefits of traditional naturopathy;
  • to educate legislators on the efficacy of traditional naturopathy; and
  • to prevent legislation that would prohibit traditional naturopaths from practicing now and in the future.


Before addressing the specific reasons for our opposition, I would like to address the proponents' true need to pass this legislation. As opposed to their stated need, the "naturopathic physician's" true agenda for this legislation is economic protection. The proponents need this bill because a new law creating a new medical profession is necessary to allow them to perform the range of medical services they want to perform and because some of these services would be interpreted as the practice of medicine. In other words, it is all about money and self-interest. Dr. Rena Bloom, a Denver "naturopathic physician" was quoted in the Colorado Daily (Exhibit 1) on Monday, January 18, 1999, as stating "We need this bill because at this point, we're illegal ­ we're practicing medicine without a license."

REQUIREMENTS OF LICENSURE - There are several contentious parts to SB1300: 1) Qualifications for Licensure; 2) Scope of Practice; and, 3) Title Protection. The proponents of this legislation will argue that twelve states have passed licensing legislation, of this type, and that Idaho should follow suit. However, since 1996, twenty states (Rhode Island, Massachusetts, North Carolina, West Virginia, Pennsylvania, New York, Florida, Texas, Minnesota, Kentucky, Iowa, Kansas, Missouri, Oklahoma, Louisiana, Arkansas, New Mexico, Colorado, Ohio, and Idaho) have rejected licensing legislation and twelve of these (Minnesota, Pennsylvania, Ohio, Oklahoma, Missouri, Idaho, Colorado, Massachusetts, New York, Florida, Rhode Island and Texas) rejected it more than once. In total, it has been rejected on over 50 different occasions in the past seven years.

Section 54-5102(1) provides as follows for all would-be licensees to be graduates from approved naturopathic colleges:

1) "Approved naturopathic medical program" means:

(a) A course of study from a college or university granting the degree of doctor of naturopathy or doctor of naturopathic medicine accredited by an accrediting agency recognized by the state or federal government; or

(b ) A college or university granting the degree of doctor of naturopathy, or doctor of naturopathic medicine that has the status of candidate for accreditation with the accrediting agency; or

( c ) A postgraduate degree granting college or university of the healing arts approved by the examining board and state or federal accrediting agency. Such college or university shall require a minimum of sixty (60) semester units for admission and a minimum of four thousand (4,000) hours in basic and clinical sciences, naturopathic philosophy, naturopathic modalities, and naturopathic medicine, of which not less than two thousand (2,000) hours shall be academic instruction and not less than two thousand (2,000) hours shall be school or college approved supervised clinical training. The college or university shall provide adequate instruction to maintain naturopathic medicine as a separate and distinct healing art."

A close look at "naturopathic medical" schools reveals inherent problems with this type of education. The faculty of Bastyr University (Exhibit 2), the only fully "accredited school" highlights the limitations of the "medical" education claimed by graduates of these schools. Recent information from www.bastyr.edu shows a total of 46 faculty members in the "naturopathic medicine" program with 43 of those listing degree of "N.D." as their primary qualification. Of the three "non-N.D." degreed professionals, there is only one M.D.! Thirty-nine of Bastyr's faculty, forty-six members hold N.D. degrees from Bastyr as their primary qualification. Seventeen of the thirty-nine have had their degrees for five years or less. Three hold N.D.'s from National College of Naturopathic Medicine in Portland.

Southwest College of Naturopathic Medicine (SCNM) located in Tempe, Arizona, is the newest "candidate" for accreditation. However, SCNM has an extensive list of problems. Initially, for the majority of time in SCNM's existence, the school could only attain candidacy status for accreditation with the Council on Naturopathic Medical Education (CNME). SCNM was only able to reach full accreditation with CNME after the CNME violated its own policies to accredit the school. Incredibly, CNME granted full accreditation less than 90 days after SCNM suspended operations to address severe financial problems in the summer of 1999. These egregious violations of its own policies resulted in the revocation of CNME' s recognition as an accrediting agency by the United States Department of Education.

In addition, The Arizona Republic (Exhibit 3) reported hazardous environmental conditions at SCNM in a September 12, 2001 article which stated, "Several students have alleged that the school, one of four of its kind in the country, has made them sick because of improper ventilation of its cadaver lab, among other things."

The Auditor General for the State of Arizona in a June 2000 (Exhibit 4) report to the Legislature reported that at least 19 individuals received a license to practice naturopathic medicine without properly passing the required examination given by the Arizona Board of Naturopathic Medicine. The report stated, "Everyone passed the February 1999 exam, but without scoring adjustments, no one would have passed." In fact, the auditor herself who had absolutely no training in naturopathic medicine took the exam and passed after using the same scoring adjustments. What does that say?

In the past, proponents of this bill have provided legislators with a chart that compares the three "naturopathic medical" schools to top medical schools such as Johns Hopkins, Yale, and Stanford. This chart compares course hours, and implies that these "naturopathic medical" schools are academically on par with, or better than, the best medical schools in the United States. However, these schools have practically no medical doctors on staff, and the first of these schools to be accredited (Bastyr) was not accredited until the late 1980s. National College and SCNM only have candidacy status. Most of the instructors at these schools are "naturopathic physicians," which means that most instructors either graduated from unaccredited schools or are relatively new to practice. I ask you to closely examine the faculty at National College in Exhibit 5 where you will find that 24 (60%) of the 40 faculty members with National College degrees received their degree prior to National receiving candidacy status. In fact, the faculty member who teaches oncology and gynecology lists National College as her only credential. Moreover, National College has had three different presidents in the past two-years, which is cause for additional concern.

The truth is "naturopathic medical" education and training mimics medical education and training in form, but not in content! Conventional medical students start clinical work under physician supervision in their third and fourth years, and are assigned to work in major teaching hospitals and clinics. Even after four years of medical school, graduates are ineligible for full medical licenses but must enter residency programs which last between three and eight years. It is clear that "naturopathic medical" colleges in the United States do not provide the equivalent of a medical education. Dr. Richard Roberts, Board Chairman of the American Academy of Family Physicians summed it up best in The Wall Street Journal, August 22, 2002, when he said, "Naturopaths should not be the coordinator of care. There's a world of difference [compared with M.D.s] in terms of the training, the ongoing education, and the day-to-day work. It is like having the flight attendants fly the plane."

The Council on Naturopathic Medical Education (CNME), the accreditation board that recently accredited naturopathic medical institutions and programs, had its recognition withdrawn in 2001 by the United States Department of Education (Exhibit 6) because it demonstrated "pervasive non-compliance" in "not following its own standards." If they are willing to cut corners with their accrediting agency, who is to say that they would not cut corners on the Advisory Committee on Naturopathic Medicine? History does have a way of repeating itself.

NATUROPATHY VS. NATUROPATHIC MEDICINE - A person who feels ill and sees an allopathic physician will typically be given a diagnosis to name the disease and then a prescription for medication to kill the germs that cause the illness. Once the symptoms have disappeared, the person is considered healthy. The allopathic approach to healing is to find the agent of disease-that is, bacteria or virus--and then to kill it.

Vis medicatrix naturae, or the healing power of nature, is central to traditional naturopathic philosophy. This philosophy holds that disease occurs when toxins that have accumulated internally­usually due to incorrect lifestyle, a poor diet, and improper care of the body which weakens the body. Bacteria and viruses, which are always present, seldom cause problems in a healthy body. While allopathic methods of treatment may get rid of symptoms, these treatments alone do not bring healing. The human body is designed to heal itself. Traditional naturopathic modalities stimulate the body's inner forces to get rid of accumulated toxins and thereby allow intrinsic healing to take place. Rather than trying to attack specific diseases, traditional naturopaths focus on cleansing and strengthening the body.

Traditional naturopaths avoid procedures that are common to medical care-diagnosing disease, treating disease, prescribing drugs and pharmaceuticals, and performing invasive procedures. Instead, traditional naturopaths focus on health and education, teaching their clients how to create internal and external environments that are conducive to good health. This is how naturopathy was meant to be practiced as described by Benedict Lust's obituary reported in The New York Times, "The members of the American Naturopathic Association do not believe in ...drug treatments, medicinal remedies or vivisection. " (Exhibit 7)

Traditional naturopathy is simply not the practice of medicine. Diagnosing and treating disease, prescribing drugs and pharmaceuticals, performing major and minor surgery, giving injections and drawing blood, and performing other invasive procedures are medical practices that are outside the scope of traditional naturopathy. Anyone who performs these procedures without a license is illegally practicing medicine and, under existing laws, can be and should be prosecuted for doing so without a license.

While self-styled "naturopathic physicians" seek to claim the same core philosophy as traditional naturopaths, in practice, they move into territory long held by allopathic physicians. "Naturopathic physicians" seek to have laws enacted that would authorize them to perform minor surgery, practice obstetrics including episiotomies, prescribe certain drugs including some synthetic antibiotics, and use many allopathic diagnostic procedures including X-rays, electrocardiograms, ultrasound, and clinical laboratory tests. These procedures move "naturopathic medicine" far from the realm of traditional naturopathy and into the practice of medicine. This is why, "naturopathic physicians" are seeking to be licensed; otherwise, in conducting their desired scope of practice they would be illegally practicing medicine.

FISCAL IMPACT - A close look at Senate Bill 1300 reveals that the potential licensees will not support the cost of regulation through fees. Given the fact that the program has no way to support itself, it is inappropriate for Idaho to create a new program for which only eleven (11) individuals will be eligible, especially a program Idaho would have to subsidize. There is no need for a new medical profession and certainly no legitimize basis for Idaho to subsidize it! Furthermore, if a person needs any surgery or prescription drugs there are already licensed medical doctors to fill this need. Practically and fiscally speaking there is simply no demonstrated need for this hybrid profession.

SCOPE OF PRACTICE - If "naturopathic physicians" are allowed by Idaho to "diagnose and treat" disease, prescribe medications, and perform surgery , a "new medical profession" will be created and they will be elevated to the status of primary care physicians. This promotion is high on their agenda because of the status and the money associated with it. Thomas Kruzel, Chief Medical Officer at Southwest College of Naturopathic Medicine and former President of the American Association of Naturopathic Physicians, was quoted in the Spring 1994 edition of The Naturopathic Phvsician (Exhibit 8) as saying, "Naturopathic physicians are primary care, family practice physicians, and as such are gate keepers to the medical system, along with family practice MDs and DOs." By licensing "naturopathic physicians" Idaho would be equating "naturopathic physicians" with MDs and DOs, because "naturopathic physicians" will inform their "patients" that there is no need to continue to see a regular medical physician, as they have consistently done in states where they are licensed. These "patients" assume "naturopathic physicians" have an education from legitimate medical schools approved by the Liaison Committee on Medical Education. The lack of a need for a "new medical profession" is one of the primary reasons licensing efforts like this one have been rejected on over 50 separate occasions in the last seven years.

In a sworn deposition (Exhibit 9) Mr. Kruzel defined minor surgery in this way:" . . . generally it means that you do not enter a body cavity." The Oregon "naturopathic medicine" licensing law defines minor surgery as "the use of electrical or other methods for the surgical repair and care incident thereto of superficial lacerations and abrasions, benign superficial lesions, and the removal of foreign bodies located in the superficial structures; and the use of antiseptics and local anesthetics in connection therewith." It is difficult to reconcile Kruzel's definition of minor surgery with the actual wording of the Oregon law.

Furthermore, Kruzel has given the following sworn testimony regarding his qualifications to perform vasectomies:

Q: You mentioned that you could do vasectomies on male gonads; is that correct? A: That's correct...Q: You don't consider that to be an invasive procedure? A: Certainly it's an invasive procedure, but it doesn't invade a body cavity, the scrotum is considered an appendix. Q: And is this procedure taught at National College? A: I don't know if it is or not. ..I'm saying that it's within the scope of naturopathic medical practice, and I believe that it probably is taught in school. ..Q: How many vasectomy operations did you do in school? ...A: I did no vasectomies. Q: Do you feel that the fact that you did no vasectomies in school qualifies you to do them in the scope of practice out here with the public? A: Yes. It's a relatively simple procedure to do. Q: Could you learn this procedure by a video tape? A: Possibly.

The Washington Association of Naturopathic Physicians (WANP) exposed their real agenda of displacing medical doctors as justification to expand prescriptive rights for "naturopathic physicians" to include Schedule II drugs. In a 1998 report to the Washington legislature, the WANP stated, "The primary reason for this language change is to ensure that patients seeking naturopathic care will not unnecessarily be burdened with seeking a second office visit by another licensed practitioner (i.e. a real medical doctor) in order to get, for example, codeine cough syrup or an antibiotic which is not currently in the list of legend drugs that a naturopathic physician can prescribe."

Fortunately, the Washington legislature exposed the ruse and did not grant additional scope.

UNIVERSITY OF CALIFORNIA. SAN FRANCISCO -CENTER FOR HEALTH PROFESSIONS - The Center for Health Professions at the University of California, San Francisco, released a study funded by The Arkay Foundation in September of 200 I titled, "Profiling the Professions: A Model for Evaluating Emerging Health Professions" and an accompanying profile titled, "Profile of a Profession: Naturopathic Practice." The study recognized the right of professions to not seek state regulation choosing to allow market forces and consumer choice to protect the public. It stated, ". ..professions have declined regulation, basing their decision on the low potential risk of harm to the public, evidence that regulation can negatively affect access to care, and the capacity of the market to weed out the lower qualified members of the profession."

The study also spoke to the true reason that groups seek state regulation-POWER -when it stated that:

" Although regulation is the legislatures' decision, legislatures virtually never seek to regulate a profession on their own. When it is enacted, it is almost always after long and contentious battles between competing or would-be competing professions. Therefore, though informative, the existence of regulation mayor may not mean much more beyond the capacity of the would-be regulated profession to gamer sufficient political power ."

WHITE HOUSE COMMISSION ON COMPLEMENTARY AND ALTERNATIVE MEDICINE POLICY (WHCCAMP) - By Executive Order 13147, the White House Commission on Complementary and Alternative Medicine Policy was created in March of 2000 and completed its work in March 2003 with the submission of its report, http://www.whccamp.hhs.gov/finalreport.html, to the Office of the President. The Commission was comprised of 20 members, and the Commission held 10 meetings in Washington, DC, and four town hall meetings around the United States. It is important to recognize that a study of this magnitude will have a number of divergent opinions on a wide variety of topics. The proponents sometimes represent that the Commission recommended that every state should license "naturopathic physicians." However, an accurate reading of the report reveals such representations are untrue. In the section titled " Access and Delivery," the commission provided guidance to Idaho when it stated, "Now is the time to look at policy options for the future and to design strategies for addressing potential issues of access and safety .Beyond these basic concerns, protecting the public, maintaining free competition in the provision of CAM services, and maintaining the consumer's freedom to choose appropriate health professionals are issues to be considered when developing strategies and policies."

Secondly, the Commission made it clear that concern exists in the CAM community over appropriate regulatory frameworks for CAM, especially frameworks designed using current regulatory models. The report stated, "Some CAM professionals believe that to reorganize CAM on the conventional professional model, with the kind of licensure, registration, or exemption procedures that this implies, will damage the fundamental character of much of CAM. Some believe that in the past, legislation to "protect the public" was often used to restrict competition in the provision of services."

Thirdly, a well-respected physician and a member of the Commission, Dr. Tieraona Low Dog, teamed up with another member of the Commission to send a letter to the Secretary of Health and Human Services to address a number of issues included in the report. One issue related to equating CAM practitioners with designated primary care specialties. They stated:

"While we endorse demonstration projects that seek to identify what, if any, value "CAM" providers add to established primary care teams, we want to go on record noting that we do not believe that CAM providers are fungible with the primary care providers enumerated in Title VII. Further, "Efforts (such as Senate Bill 1039) to equate their degree of training, or the scientific basis of their practice, with that of the designated primary care specialties puts the public at risk of receiving unvalidated and non-evidence based primary care."

CONCLUSION - The reasons set forth above demonstrate why licensure for this new "medical profession" should not be considered. It is clear that the education of "naturopathic physicians" does not meet the standards one would expect from primary care providers who diagnose and treat disease, prescribe medications, deliver babies, and perform surgery, and this is a role already being filled by medical doctors. If licensure is granted, those so-called "naturopathic physicians" will be so elevated in stature that they will be perceived by the public as equal to the far more extensively- trained allopathic physicians, thus creating the potential for confusion and providing of improper medical care.

If licensure is not granted, "naturopathic physicians" may continue to practice in the same manner that is legal today- without making diagnoses, without prescribing medications, and without performing invasive procedures. Those who perform these procedures without a license will be practicing medicine without a license and will be breaking the law. Legal procedures are already in place for addressing this problem, at no added cost to the state.

There has been no change in Idaho since last year that would establish a need for this legislation. There is absolutely no demonstrated need to create a new medical profession by licensing "naturopathic physicians." In the over 50 different occasions state legislatures have looked at this question in 1997, 1998,1999, 2000, 2001,2002, 2003, and thus far in 2004, they concluded that there is no need to create a new medical profession styled as "naturopathic medicine."

Since the public is not crying out for the licensure of "naturopathic physicians," then who is? The cry for licensure is coming from eleven (11) "naturopathic physicians" in the State and their trade organization, the American Association of Naturopathic Physicians. This is not about public protection. This is about trying to obtain legislative economic protection, status, and power. These three "naturopathic physicians" gambled on going to school for a profession that is not licensed in 38 of the 50 states, and they now expect Idaho to bail them out! Nancy Aagenes, Past-President of the American Association of Naturopathic Physicians, stated in 1996 and it is still true today, "Nonetheless a student coming out of our schools, uncertain and anxious anyway often simply will not practice in an unlicenced state. If enough of us default on our loans, a major source of income for our schools is cut off."

The State does not need to create a new medical profession known as "naturopathic medicine." Idaho needs to reject the position of the AANP as the nineteen states that considered this type of legislation in 1997, 1998, 1999, 2000, 2001, 2002, 2003, and thus far in 2004, rejected such licensing.

This legislation is nothing but a self-serving attempt by a minuscule special interest group to legitimize their alternative approach to the practice of medicine by mandating the creation of their own licensing process and to steal by legislative action the titles that have been used by registrants for over twenty years.

The attached above mentioned exhibits during this testimony, and also a CD-R containing a copy of the Arizona Office of the Auditor General Performance Audit, Arizona Naturopathic Physicians Board of Examiners - June 2000 report were presented. (See Attachments #1 and #2).


Lucy Pierson, represented herself, and testified to support SB1300. Her medical insurance does not pay for a naturopathic physician because Idaho does not require them to be licenced; therefore, insurance will not pay and a person must pay for their own medical care. Lincesure would require insurance companies to pay for medical care.

Donna Mussell, representing herself, testified to oppose SB1300. She explained she has operated a business in Boise for 15 years, and naturopathic medicine is a very established form of medical care. She does not want the law to the enforced licensing law in Idaho. She seeks natural health and wants the freedom of choice, wants to freely practice health care.

Michele S. Morgan, M.H., PhD, president of the Idaho Coalition for Natural Health, testified to oppose SB1300. On February 24, 2004, she submitted written testimony to oppose SB1300, as shown:

I am president of the Idaho Coalition for Natural Health. I am an Ordained Inter-faith Minister and a Holistic, Herbal and Homeopathic Practitioner. I have been in practice for more than 25 years and am now residing and maintaining an active alternative health care practice in Boise.

It is my understanding that a small but determined group of Naturopathic Physicians are once again attempting to gamer support for their bill, SB 1300, that would require licensing. This bill, not sponsored by all Naturopaths and alternative practitioners who are practicing in Idaho at this time, will have serious opposition.

This bill as it is written, does not represent the views of a majority of Naturopaths and alternative practitioners, but rather a small segment who are seeking to have the same legal rights as medical doctors to perform treatments and prescribe drugs without the benefit of a full medical education.

It is my intent to share with you both my own concerns and the concerns of the ICNH board and all the ICNH members across the state. We believe that licensing is unnecessary and would serve to eliminate alternative health care options. In our minds this is a slippery slope that will u1timately 1imit, not expand alternative health care for people in need.

The ICNH board and members will be attending the hearing of SB1300 on March 2, 2004. We trust that our statement of opposition and concern will be heard and taken very seriously by the committee. SB1300 asks to license Naturopaths under the guise of protecting the public but in reality this bill will only serve to compromise health freedom in Idaho. Thank you for consideration in this matter.


Today, Dr. Morgan testified opposing SB1300. She explained, I have a Ph.D. in the Health Science of Botanical Medicine specializing in Homeopathy and Herbal medicine from Union University in Los Angeles, California. I have been in private practice for 25 years.

I am here today to tell you of my experience with naturopathic lincesure in Montana in the year 2000.

In 1993, before the licensing law, I worked with two Naturopathic Physicians in Helena. They were my friends. I shared office space with one of them. We referred clients to one another and taught classes together .

In 1996, I was severely injured in a car accident and had to leave Montana for medical treatment. I handed over my client base to these two trusted friends. After a 3-year rehabilitation, I returned home to Helena to re-open my practice.

I placed ads in the newspaper, on cable TV and radio, had a web site built and printed thousands of new brochures. Within 3 days, after my advertising began, I received a call from my Naturopathic Physician friend informing me I could no longer advertise or practice homeopathy and herbal medicine in Montana because I was not an "N.D."

Her words to me were, and I quote, 'cease and desist or we'll find a way to take you out.' She stated she knew I was a respected, trusted practitioner with more years in the profession than either one of them, but that they had worked too hard for this law for me to be an exception.

I called my attorney for advice. After reading the law he informed me that there was no provision for me and that my education, degrees, experience, reputation...none of it mattered.

Soon, I received a letter from the Montana Medical Review Board informing me that the screening panel was considering prosecution for "practicing medicine without a license" and "holding myself out as a doctor without a license". If found guilty , I would face a $1,000 fine and 6 months in jail. My attorney replied that since being out of state, I was not informed of the licensing law and was innocent of all charges. The response was, if I agreed to maintain a silent practice, stop the ads, shut down the web site and destroy the brochures within 48 hours, the inquiry would be dropped.

I was in shock; heartbroken. My clients were enraged that their health freedom was being denied and begged me to fight it. But, truly, I couldn't face jail time or court fees. Ultimately, I was forced to leave the state I called home. I came to Idaho to practice under its current Health Freedom Law.

In my mind, SB 1300, as it is written, is the beginning of this story allover again­ for myself and all of Idaho's non-licensed practitioners, AND their clients­present and future. Please vote no on SB1300.


Laurence Smith, testified to oppose SB1300. He explained he is not a doctor, he is an herbalist and owner of a health food store. He had a heart attack and traditional medication did not work. He looked for a teacher and has studied herbal medicine for 19 years. He stated, I teach empower. He wants people to have the knowledge and power to change and improve their lives.

Laws should solve problems, so what is the problem? If there is a problem, is this the best solution? In the proposed law there is a list of things naturopaths do, but in the exclusions many of these items have been omitted. We have a good law.


Joan Haynes, ND, a naturopathic physician who is licensed in the state of Oregon, testified to support SB1300. She believes that due to the Idaho not requiring licensing it limits her abilities to operate.

Lyn Darrington testified to oppose SB1300, and that the Idaho Association of Health Plans , Regence Blue Shield of Idaho, does not support this legislation.

Mark Michaud, M.D., testified to support SB1300. He outlined the importance of having accountability and standards, and how important it is to know when to refer to a medical physician.

Debbie Dalrymple, testified to oppose SB1300. She believes people should have the right to choose to die with dignity. She asked what is wrong with the current law? Why spend money to fix something that is not broken?


Dr. Todd Schlapfer testified to support SB1300. He represented the Idaho Association of Naturopathic Physicians and testified, I am a practicing naturopathic physician in Coeur d'Alen. I received my doctorate in naturopathic medicine from the National College of Naturopathic Medicine, and hold a license to practice naturopathic medicine in our neighboring state of Montana. I am in favor of SB 1300.

Naturopathic medicine is a distinct, comprehensive system of natural health care based upon a thorough grounding in biomedical science. What conventional medicine and naturopathic medicine have in common is education in biomedical science. What is different and distinguishes our professions is our education in unconventional medical science and therapeutic modalities. It would never be possible to merge the two professions into an indistinguishable singularity. As an ND, if l wanted to become an MD, I would have to go to an MD school with the privilege of bypassing most of the already traversed medical science. If an MD wanted to become a naturopathic physician, one would have to do the same through an ND school. Unfortunately, because some states, like Idaho, do not yet license naturopathic physicians, this distinction is murky. For example, there's nothing stopping an MD or any citizen from claiming to be an instantaneous ND. No standard of education or accountability required. This has become a growing problem for an increasing number of states.

The established standard for a physician-level practitioner of health care is licensure. Educational qualifications are central to that determination. Accredited education is required for all licensed health care professions. SB 1300 is no exception. In the same way the Liaison Committee for Medical Education accredits medical schools, the Council on Naturopathic Education accredits naturopathic medical schools. Both are established at the federal level under the Department of Education. There is no higher educational standard.

POINTS OF CLARIFICATION - Contrary to the eloquently stated assertion, we do not "deliver babies, cut on people and hand out drugs."

Under 54-5108(2) it is clearly stated that one cannot do any OB without complying with established Idaho Code 54-1404, pertaining to the Idaho board of nursing. SB1300 establishes no exception to this statute.

Minor office procedures are limited to the repair and care of superficial abrasions and lesions, e.g., a wart or splinter. We are prohibited from using general or spinal anaesthesia, inducing or performing an abortion, procedures involving the eye, ear, tendon, nerves veins, or arteries extending beyond superficial tissue. We cannot treat any lesion suspected of malignancy unless in collaboration with an MD or DO. Two references: 54-5102 (3), and 54-5105 (4-9).

Prescriptive privileges is limited strictly to those prescription substances that are consistent with naturopathic education, training and board examination. These are natural-source medicines, e.g. thyroid, bio-identical hormones, and natural source antibiotics. This bill does not determine a formulary. SB1300 sets up a formulary council, an entity separate from and not under the authority of the board. There will be 5 members; 2 naturopathic physicians, 2 pharmacists nominated by the State Board of Pharmacy, and one MD or DO nominated by the State Board of Medicine. See 54-5109.

SB1300 provides for a restricted license. This applies to practitioners who have been practicing in Idaho for at least the past 5 years and who can demonstrate a minimum of 4000 hours of academic and clinically supervised naturopathic training. This allows established practitioner to continue to practice as they have, without diagnostic imaging privileges, minor surgery privileges or prescriptive privileges. Restricted licenses will be granted once. This provision closes after six months. See 54-5112

Estimated numbers of licenses granted for the first year is significantly larger than you were told yesterday by opposing testimony. The range somewhere between 120-150.

SB1300 provides no mandate for insurance coverage.

Testimony has been given that may have been misleading.

Florida is seriously considering a licensure bill for naturopathic physicians. A House bill will soon be introduced by Representative Bower. A number has already been assigned.

California is on course to establish rules and regulations for its licensees.

At the same time as our hearing, Washington D.C. voted 13-0 in favor of licensure for naturopathic physicians. It now is being prepared for signature by the mayor.


Laurence Hicks, a physician and surgeon from Rupert, Idaho, testified he is also a naturopathic physician, and was testifying to support SB1300. He explained the issue is on using the title doctor. He wants the public to understand the different levels of education required to be a medical physician. He believes this legislation was very carefully crafted and does support SB1300.

Written testimony was received from Townsend D. Wolfe from Boise, in opposition to SB1300, as follows: Empowering a few individuals with responsibility for which they are not fully trained (medical procedures and prescriptions) while at the same time taking away hundreds of jobs from individuals who serve others with SAFE and natural remedies is not a responsible position to take, and I strongly ask that you oppose this bill.

No only will this bill restrict free enterprise from hundreds of people, but it will severely limit the ability of Idahoans to take responsibility for their health care choices.


Written testimony was received from Terry Durst to oppose SB1300 in the strongest terms. In summary he reported: This licensing effort is another effort of the American Association of Naturopathic Physicians and has been around for several years now. In the Senate in 1998 and in the House in different iterations, as the proponents try to make it palatable to the Senate and House. Similar legislation did not get out of the Health and Welfare chairman's office last term in the House. Not getting out of your office would be a great service to the citizens of Idaho.

This is an organization that comprises the graduates of three Naturopathic Colleges in this country who are seeking exclusive use of the term "Naturopath." They are seeking primary care physician status without having the necessary education, internships, residencies, etc. This group advocates and has authorization in the few states where they have held sway to prescribe prescription drugs for which they are not qualified. Former Senator "Moon" Wheeler, a former pharmacist was against this effort because of the pharmaceutical qualifications issue.

The AANP also advocates minor surgeries. Minor surgery is defined as any surgery that does not penetrate the abdominal cavity. They also advocate episiotomies in "Natural childbirth." I'm sorry but that is NOT natural childbirth. The brand of Naturopathy or Natural Health practiced by the members of this association practice is a strange form of naturopathy. Traditional naturopathy uses no toxic substances and does no invasive procedures. Traditional naturopathy works with the natural order and in harmony with the body, while most allopathic and some of the methods of the members of AANP work against the body's natural rhythm.

The AANP seeks exclusive use of the term "naturopath" which would mean that should this ill advised bill pass, many good natural health practitioners who cause no harm to society by our modalities and methods, such as myself, would not be permitted to use the name I have become accustomed to in the last ten years. I worked very hard for about four years of structured study to earn my Doctor of Naturopathy degree, preceded by 25 years self-study, and living by those principles and now 10 years of private. The Idaho State Constitution give Idaho citizens the right to treat their health as they see fit, and that practitioners may ply their skills amongst the populace without fear of State involvement so long as they do not overstep their abilities the proscribed boundaries.

I urge you to oppose SB1300 in the strongest possible terms. The AANP has tried several times and will continue into the future to gain the exclusive use of the term Naturopath. They seek exclusive authority to practice what any traditional Naturopathy would shun like a bad habit. "Naturopathic heresy" is another term that could be used to describe this group which comprises only ten or eleven AANP backed and sanctioned Naturopaths. These NDs in Oregon have the title NMD. This is Naturopathic Medical Doctor. They seek primary care status and are MD wannabes. They are not qualified for such a title. It would be most unfair for all the wonderful Naturopaths and Natural Health Practitioners in this State to be thrown into limbo or worse, so that these eleven people may ply their trade as a very exclusive clique.

I have no personal animosity to any member of this organization. I'm sure every member of the AANP is a very nice person and is only practicing what they have been taught. My opposition is to the "only the eleven of us" attitude and the above stated procedures and practices they advocate.

I urge you to vote NAY when the time comes, and preserve the status quo in Idaho that serves its citizens very well. Do not throw many very good and well-meaning practitioners into limbo, or worse. Do not throw citizens who seek natural methods of health and healing into limbo. Many have been with particular health practitioners for years, and if that care giver doesn't meet the standards of the AANP or the State and must cease and desist, that client who may have great trust in their "natural doctor" will be searching for one of those NMDs (only eleven at this time).

This is a classic case of a special interest group, a very small special interest group that is not in the best interest of all the people in the state of Idaho. Please help keep health care decisions and those who practice natural health free, at least the freedom to choose for ones' self.


Written comments were received from Briana Werner. In summary, she reported: I am all for the naturopathic medicine. I have used a naturopathic physician in line with the regular doctors. I have avoided going to the regular doctor with sinus, menopause, cholesterol issues, sleeping, stress, and aches and pain problems.

I am glad we have Naturopaths because it is nice to use non-chemical remedies with the help of a naturopath. They keep you from using the wrong kind of remedies and they know which ones won't be bad with other medications you might be on.

We need someone to consult for all the vitamins, herbs and natural remedies that are out there. We really need to have the Naturopaths working side-by-side with regular doctors. I have met lots of people who are allergic to some chemicals, but can take natural remedies. It would be crazy to not have these two professionals working together. Yale has started to have them work side-by-side and so has Oregon, and some other states.

Please allow the Naturopaths to be licensed in Idaho. Let us have a choice, after all, isn't that what America stands for? Chiropractors and physical therapists are a form of natural remedy, and they are licensed.


Written comments were received from Jennifer Rizzuti, from Boise, to oppose SB1300. She wrote: As a citizen of Idaho, I would like to voice my concern over the pending Naturopath licensing bill, SB1300.

In reviewing SB1300, I fail to understand the problem this bill is trying to address. It appears there is a small number of Naturopathic physicians trained in a limited number of four year degreed, on-campus universities trying to exclude traditional Naturopaths and herbalists.

I am particularly disturbed by the freedom this bill provides to Naturopathic practitioners to diagnose, treat and prescribe. In addition, there appears to be no accountability to AMA-approved governing medical body.

SB1300 may be presented as protection for the Idaho public, but the question to answer is, "who is currently falling ill or dying at the hands of Naturopaths in this state?" In fact, many consumers are currently receiving exceptionally good care.

The existing health freedom law, Title 54-1804, continues to serve us very well to protect the natural health care community and consumers of those services in Idaho. Please vote "No" on SB1300.


The committee members asked numerous questions of persons testifying, both for and against SB1300, and conducted an in-depth review of the legislation.

Chairman Brandt announced the committee members must convene on the Senate Floor; therefore, he would continue hearing testimonies on Wednesday, March 3, 2004.

ADJOURNED: The meeting adjourned at 9:55 a.m.




DATE: Wednesday, March 3, 2004
TIME: 8:00 a.m.
PLACE: Room 437
MEMBERS PRESENT: Chairman Brandt, Acting Vice Chairman Duncan, Senators Darrington, Ingram, Sweet, Bailey, Burkett, and Kennedy
MEMBERS ABSENT/

EXCUSED:

Senator Stegner and Vice Chairman Compton
GUESTS: See the attached sign-in sheets
SB 1418 This legislation, SB1418 relating to the Department of Health and Welfare, was presented by the Intergovernmental and Fiscal Division Chief Bill von Tagen.

This legislation is to amend the statutory language to broaden the use of "do not resuscitate orders" and DNR protocols beyond emergency medical services personnel and to clarify the Department of Health and Welfare's role and rule making authority in the section.

The bill will have no fiscal impact.

MOTION: A motion was made by Senator Sweet to send SB1418 to the Floor with a Do Pass recommendation. The motion was seconded by Senator Bailey, and the motion was carried by a voice vote. Senator Bunderson will be the Floor sponsor.
SB 1300 SB1300 was introduced by Senator Robert Geddes on Tuesday, March 2, 2004, and the hearing was continued today.

Chairman Brandt announced he would call those persons to testify who registered on the sign-in sheets of March 2, and did not get a chance to present their testimony.


Dr. Todd Schlapfer, from Coeur d'Alene, continued his testimony from March 2, 2004, to support SB1300.

Historically, naturopathic medicine is one of the oldest continuously licensed health care professions in the U.S. Its origins can be traced back to late nineteenth-century European physicians, who wanted to re-orient medicine toward healthful living and therapies. It was brought to the U .S. and Canada in the 1890's and was adopted by physicians who established schools to educate and train physicians of natural medicine. I have a letter dated 1922 signed by Dr. Benedict Lust, one of most well known pioneers of naturopathic medicine, showing that education and training then was at least 3 years, which was customary for physicians at the time. Matriculation included medical science ( as it was known then), surgery, OB and prescriptive medicines. But the emphasis of therapeutics was on nature-based modalities, e.g., hydrotherapy, diet, exercise, homeopathy, etc.

In the middle years of the twentieth century , the development of miracle drugs such as antibiotics, and the large scale funding that became available from pharmaceutical companies, combined to create a near monopoly of heath care by conventional medicine. That stage lasted until the mid-1970's and resulted in the suppression of many alternatives to the mainstream system.

Over the past 25 years, the American public has become increasingly aware of the costs and consequences of relying primarily on drugs and surgery for health care. There began a large and growing demand that natural medicine alternatives be accessible in a consistent, effective way. The result has been the re-emergence of modern naturopathic medicine.

This is a bill for licensure of those who have met the respected and

conventional standards for physician level education and training to practice naturopathic medicine in the State of Idaho.

Why do we need this legislation?

I. To provide for full and legal access to what naturopathic physicians can provide. The public increasingly seeks access to naturopathic physicians, but find it untenable that they cannot receive the full benefit of naturopathic services. The current situation restricts the trade of our profession in Idaho.

2. To distinguish between physician-level practitioners of naturopathic medicine and natural health care providers that do not require licensure.

3. To create an environment of free choice and collaboration between naturopathic physicians and all variety of health care for the citizens of Idaho.

4. To create appropriate standards of education and practice for those using the title "Naturopathic Physician", or "Naturopathic Doctor."

In the United States Department of Labor, Dictionary of Occupational Titles, you will find Naturopathic Doctor defined: It's fairly long, so I'll summarize. Diagnoses, treats, and care for patients, using a system of practice that bases treatment of physiological functions and abnormal conditions on natural laws governing the human body. . . .It goes on to describe modalities, which include botanical, nutritional, food, mechanical, minor surgery , and prescriptive medicines compatible to body processes. SB1300 is precisely consistent with this definition.

In the American health care system, a doctor means someone who diagnoses and treats, and has met an established standard of education, training and board examination in order to accept this responsibility .Making a diagnosis requires a comprehensive understanding of human function, chemistry, anatomy, physiology,

pathology and disease processes, examination, etc. Unlicenced practitioners do not practice an established form of health care requiring a license. As such, practitioners not requiring a license to practice, e.g. "naturopaths", "traditional naturopaths", "natural health consultants", "herbalists", etc are not required to study the detail of human function, pathophysiology, and diagnostic evaluations for determining a diagnosis. Subsequently they agree, according to a recent publication from the Coalition for Natural Health,". ..not to diagnose and treat disease. . . ." This is consistent with not practicing as a doctor. To put oneself out as a doctor without physician-level training is completely inconsistent with responsible health care.

Those practicing as unlicenced practitioners do not seek licensure or regulation. Their literature and the laws under which they are allowed to practice specifically provides, among other limitations, that they do not diagnose, do not claim or make themselves out to be doctors. There is no established standard of education and practice for unlicenced practitioners. There is an established standard of education and practice for naturopathic physicians.

In order to resolve public confusion and ensure public safety , any reference to a practitioner using naturopathic modalities who does not have physician level education and training that meets an established standard to diagnose and treat, should not use any title referencing themselves as a doctor. The White House Commission on Complimentary and Alternative Medicine Policy along with the Center for the Health Care Professions at the University of California have been very clear about the fact that unlicenced practitioners are not doctors. They recommend titles, e.g., naturopath, traditional naturopath, natural health consultant, etc.

Both science and the people have found that health care is best delivered when we can integrate our varied professional expertise and help each other be successful in caring for our patients. Naturopathic medicine has entered the mainstream. For the same reason MDs, dentists or nurses are licensed, licensure of qualified naturopathic physicians is necessary.

I hope that you will carry this message to the people of Idaho by supporting the passage of SB'300, the Naturopathic Physicians Licensing Act.

Chuck Lempesis, an attorney and a representative of the Coalition of Health, testified in opposition to SB1300. He explained this issue has been ongoing for years. He wants to encourage natural health care in Idaho. He requested the committee to not adopt SB1300.


Dennis Davis, ND, briefly testified to support SB1300.

Gay Doman, briefly testified in opposition to SB1300.

Ken McClure, an attorney for the Idaho Medical Association (IMA), testified the IMA does not want to get involved in the scope of practice and does not see SB1300 as affecting public health. The IMA does not support or oppose SB1300.

Senator Geddes explained SB1300 does not put anyone out of business. He believes SB1300 is good legislation.

Larry Benton, a representative of the Idaho Association of Naturopathic Physicians, explained that a lot of effort and months of time was involved to develop SB1300. This legislation does not restrict persons from conducting their business, but that it does restricts the use of the term "doctor."

He presented an eight (8) page review of SB1300 with details relating to specific areas of change. (See Attachment #1).

He also presented a Bastyr University report relating to the Naturopathic Medicine Program of 2003-2004. (See Attachment #2)

Mr. Benton requested the committee to send SB1300, to the amending order.

A letter, dated February 18, 2004, from the Bingham County Commissioners to Senator Geddes, was submitted. The letter stated, as follows:

We, the Bingham County Commissioners, applaud your introduction and encourage your support of SB1300. This legislation will provide for the health and safety of the citizens of Idaho who seek health care from qualified naturopathic physicians.

As you may be aware, problems with unqualified practitioners led the Bingham County Commissioners to adopt Bingham County Ordinance 98-10. This Ordinance assures Bingham County citizens that practitioners are, in fact, qualified naturopathic physicians. Please find the Ordinance attached for your reference.

In as much as the legislation will provide the same assurance to the citizens of Idaho statewide, and upon passage of SB1300, the County will sunset Ordinance 98-10, which will then be replaced by the higher standards of this bill.


Also submitted was a letter, dated September 10, 2003, from Rod Page, the Secretary of Education in Washington D.C., addressed to Robert Lofft, the executive director of the Council on Naturopathic Medical Education in Eugene, Oregon. The letter reported, as follows:

At its June 9-10, 2003 meeting, the National Advisory Committee on Institutional Quality and Integrity recommended that I grant initial recognition for a period of two years to the Council on Naturopathic Medical Education as a nationally recognized accrediting agency. This recommendation was made under Sections 114 and 496 of the Higher Education Act of 1965 (HEA), as amended, and pursuant to relevant statutory and regulatory provisions.

I concur with the recommendation of the National Advisory Committee. I am satisfied that accreditation by the Council is a required element in enabling students and graduates of the programs the agency accredits or pre-accredits to participate in Federal programs administered by other Federal agencies. These other Federal programs include the Academic Research Enhancement Awards and the Loan Repayment Program administered by the National Institutes of Health's National Center for Complementary Alternative Medicine. Accordingly, For a period of two years from the date of this letter, I grant initial recognition to the Council on Naturopathic Medical Education as a nationally recognized accrediting agency for the accreditation and pre-accreditation throughout the United States of graduate-level, four-year naturopathic medical education programs leading to the Doctor of Naturopathic Medicine (N.M.D.) Or Doctor of Naturopathy (N.D.) Degree.

Please convey my best wishes to the members of the Council. I appreciate their continuing efforts to improve the quality of postsecondary education in the United States.


A letter, dated February 4, 2004, from Don Warren, B.SC.,N.D., to all Representatives and Senators of the Idaho State Legislature, relating to the confirmation of USDE Recognition Faculty Credentials of N.D. Programs, was submitted and reads as follows:

At the June 9-10, 2003 meeting, the National Advisory Committee on Institutional Quality and Integrity (NACIQI) recommended that the USDE grant initial recognition for a period of two years to the Council on Naturopathic Medical Education as a national accrediting agency. The Council will apply for continued recognition in the spring of 2005. The CNME will continue to remain in full compliance with USDE regulations and so anticipate this recognition being renewed.

It is also important to note that each of the programs that the CNME accredits in the U.S. are regionally accredited or pre-accredited by recognized regional accreditors.

The CNME recognizes that the quality and effectiveness of a naturopathic medicine program in fulfilling its mission and objectives depend largely on the competence and performance of its faculty. The first standard in Section IV, p.37, of the Handbook of Accreditation for Naturopathic Medicine Programs requires that:

Members of the faculty are appropriately qualified by education and experience for their teaching positions in the naturopathic medicine program. Advance or professional degrees, and other evidence of competence to teach at the doctoral level in a subject area are required.

A copy of the CNME's Handbook of Accreditation may be obtained by sending a request to cnme@bellsouth.net It is also available electronically in pdf format.


The committee members and the chairman conducted a second lengthy review of SB1300, and questioned and explored many areas of concerns.
MOTION: A motion was made by Senator Bailey to send SB1300 to the 14th Order. The motion was seconded by Senator Kennedy.

Discussion: Term of "doctor" implies a high degree of education; x-rays; treatments of superficial injuries; prescribed drugs and drug therapy and how they relate to people's health; this type legislation should not be formulated by the Senate on the amending order; Section 6, page 4, exemptions be removed from the bill. Further questions were asked and considered.

SUBSTITUTE MOTION: A substitute motion was made by Senator Burkett to Hold SB1300 in Committee until next year. The motion was seconded by Senator Darrington. A roll call vote was requested by Chairman Brandt.

Senators Burkett, Sweet, Darrington and Duncan voted AYE.

Senators Kennedy, Bailey, Ingram, and Brandt voted NAY.

Senator Stegner was absent and excused.

The substitute motion failed with a vote of 4 Ayes, 4 Nays, 1 absent.

ORIGINAL MOTION: A roll call vote was taken on the original motion made by Senator Bailey and seconded by Senator Kennedy to send SB1300 to the Amending Order.

Senators Kennedy, Bailey, Ingram, and Brandt voted Aye.

Senators Burkett, Sweet, Darrington, and Duncan voted Nay.

Senator Stegner was absent and excused.

The original motion failed with a vote of 4 Ayes, 4 Nays, 1 absent.

Contributors

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