Naturopathic Physicians in the US

The Lowdown on ND/NMD Training and State Licensure

In the United States, naturopathic physicians are a hybrid breed of doctor, trained to integrate alternative and conventional medicine in primary care.

Alternative health strategies have gained substantial momentum in the United States over the past twenty years. As of 2008 38% of adults and 12% of children rely on a form of alternative health in the US. While use ranges across all groups, the largest consumers are women and those of higher income and educational levels. Therapists that combine safe and effective alternative approaches with conventional medicine are deemed practitioners of “integrated medicine.”
Trends towards integrated therapies tend to be driven by:

• Patient satisfaction
• Enhanced patient-doctor relationship
• Effective management of conditions with less adverse effects
• Cost efficiency

In the United States, naturopathic physicians (NDs) are primary care doctors trained to incorporate both alternative and conventional therapies in the comprehensive management of health. Educational requirements include at least eight years of on-site higher education that involve a four year undergraduate degree and four years of advanced education from an accredited naturopathic medical university. Upon completion, these candidates earn a Doctorate of Naturopathic Medicine and use ND or NMD to denote their status.

State Regulation of Naturopathic Physicians

Many US states and territories license and regulate naturopathic physicians as primary care doctors. To practice in these states NDs must achieve competency on a set of national boards called the Naturopathic Physicians Licensing Exams (NPLEX) and maintain minimum standards in continuing education and malpractice coverage. These doctors usually have prescriptive authority, DEA coverage, and the ability to order laboratory procedures. Medicare does not cover ND visits but private insurance coverage varies by state.

States and Territories Licensing Naturopathic Physicians:

• Alaska
• Arizona
• California
• Connecticut
• District of Columbia
• Hawaii
• Idaho
• Kansas
• Maine
• Minnesota
• Montana
• New Hampshire
• North Dakota
• Oregon
• Utah
• Vermont
• Washington
• United States Territories: Puerto Rico and Virgin Islands

Challenges in Finding a Naturopathic Physician

In the US states where NDs are regulated, only those graduating from an accredited institution and passing the NPLEX may legally claim to be a naturopathic physician and act in a clinical setting. In the other unlicensed states, anyone may call themselves an ND with little or no training whatsoever. Several entities in the US and abroad advertise to become a naturopathic physician by mail. While these programs may have informative merit and do not pose the obvious challenges of attending school full-time for eight years, they are not recognized by the US Government, and do not lead to clinical licensure. Unlicensable practitioners in unregulated states often refer to themselves as “traditional naturopaths” and state that they differ from naturopathic physicians in that they do not perform invasive procedures or prescribe medication. When searching for a qualified practitioner one may access the American Association of Naturopathic Physicians (AANP) or verify credentials with the five accredited US naturopathic schools.

Additional Resources

Bradley, R. and E. B. Oberg (2006). "Naturopathic medicine and type 2 diabetes: a retrospective analysis from an academic clinic." Altern Med Rev 11(1): 30-9.
Dunn, J. M. and J. M. Wilkinson (2005). "Naturopathic management of rheumatoid arthritis." Mod Rheumatol 15(2): 87-90.
Herman, P. M., O. Szczurko, et al. (2008). "Cost-effectiveness of naturopathic care for chronic low back pain." Altern Ther Health Med 14(2): 32-9.
Leung, B. and M. Verhoef (2008). "Survey of parents on the use of naturopathic medicine in children--characteristics and reasons." Complement Ther Clin Pract 14(2): 98-104.
Szczurko, O., K. Cooley, et al. (2007). "Naturopathic care for chronic low back pain: a randomized trial." PLoS One 2(9): e919.
Tippens, K. and E. Connelly (2007). ""Poverty and human development": the social responsibility of the naturopathic physician." J Altern Complement Med 13(8): 783-5.