Naturopathic doctors (NDs) in the state of California (CA) have been practicing as licensed health care providers for the past 20 years and have held state licensure rights for several decades prior. NDs function as primary care providers designated by the state to diagnose and treat medical conditions, order and interpret lab work and imaging and to dispense pharmaceuticals with some restrictions. With state licensure solidly in place, NDs are poised to provide naturopathic medicine and expand opportunities for patient care. However, annual legislative initiatives to alter naturopathic doctors’ titles and scope of practice are commonly enacted. While the industry does gain political advancement and enhanced scope, such as a bill signed into place this year enabling NDs to hire LVNs to assist in office, more often than not, the profession is faced with concerning and pointed legislative initiatives that limit those advancements.
Most recently, a bill was written by Assemblyman Jim Wood to remove the use of the title ‘doctor’ by any practitioner who did not hold an ‘MD’ or ‘DO’ license (AB 765). While the intent of the bill was to protect anesthesiologists, initial language was broad-based and would also impact naturopathic doctors as well as dentists, pharmacists, chiropractors, PhDs, etc. NDs are the more vulnerable and less staffed organization affected by this change, which means less finances and manpower to fight such bills. With a small legislative team of five, a single lobbyist and financial support from donations, a lobby day in Sacramento this past March was successful in gaining approval of suggested language changes to the bill which will allow NDs to keep the title designation of ‘doctor.’ This is great news, and at the time of writing this article, the bill has passed its initial hearing and moves forward in the legislative process with a strong understanding that the language of the bill will be amended as discussed at lobby day.
“It is time to move forward and break barriers which limit patient access
to naturopathic medicine.”
Shannon Sinsheimer, ND
While this is positive news and hopefully a continued success, it underscores critical issues with legislative pressures that attempt to withhold the progression of naturopathic medicine. The California Naturopathic Doctors Association (CNDA) has an action plan and timeline to expand both doctor and patient rights in CA, such as insurance coverage for naturopathic medicine and expanded medical scope of care; however, when the CNDA and its legislative team spend all their resources and time protecting the ND title and license against bills like this, little is left to progress legislative initiatives.
As patients and consumers of naturopathic medicine, there are steps you can take to support these efforts. First, if an ND sends you an email asking you to send a pre-formed letter to your state representative supporting a bill in their favor, please take five minutes to do so. If you are not on an email list for these updates, please sign up at www.calnd.org. Secondly, send in your receipt and superbill from your patient appointment with your ND to your insurance provider. It is a small step, but the more pressure there is for in-network coverage and the more out-of-pocket coverage is requested, it can be impactful for insurance providers. Unfortunately, legislative pressure is best to gain insurance coverage for patients, but consumer advocacy can still be effective. Also, consider contributing financial support to your NDs state association, CNDA (www.calnd.org) to fight for your rights to receive quality health care from your preferred provider. Lastly, stay in touch with your ND even when your health relationship is annual versus monthly as this allows your ND to contact you when a letter campaign to state representatives is taking place.
Naturopathic doctors in the state of CA have had excellent relationships with many state representatives and allied health care providers. Legislative initiatives aimed at changing NDs’ success in providing health care in the state are often initiated by outside forces. With the help of ongoing communication with key state representatives, NDs have thus far been successful in protecting, and at times even expanding, license scope, but it is time to move forward and break barriers which limit patient access to naturopathic medicine.
Dr. Sinsheimer of Optimal Health is a member of the CNDA executive legislative team and spends her time lobbying in Sacramento with the organization. She can be reached at (760) 568.2598 or [email protected].