Massachusetts Medical Society: MMS Testimony in Opposition to H. 1992 and S. 1205, An Act to Create a Board of Registration in Naturopathy

MMS Testimony in Opposition to H. 1992 and S. 1205, An Act to Create a Board of Registration in Naturopathy

Before the Joint Committee on Public Health

The Massachusetts Medical Society wishes to be recorded in opposition to H.1992 and S.1205, legislation that would make “naturopathic doctors” licensed health care providers in the Commonwealth. 

Naturopathic medical school is not a medical school in anything but the appropriation of the word medical. Naturopathy is not a branch of medicine. It is a combination of nutritional advice, home remedies and discredited treatments. Those seeking licenses went to three or four schools which grant doctorates of naturopathy. Many who have petitioned the legislature over the last fifteen years are chiropractors with additional coursework and credits for their experience. Those the advocates seek to exclude from selling naturopathic remedies went to other schools or are self-taught, but their practices and beliefs are similar. Neither has hospital based residency or medical school training.

Naturopathic colleges claim accreditation but follow a true “alternative” accreditation method that is virtually meaningless. They are not accredited by the same bodies that accredit real medical schools and while some courses have similar titles to the curricula of legitimate medical schools the content is completely different. In essence their federal approval is only for student loans, just as appliance repair schools are federally accredited.
 
Naturopaths have worked hard to try to gain acceptance of their beliefs and status. They have changed some of the most glaring problems with their previous legislation but they have neither changed the nature of their beliefs or the ultimate purpose of their legislation. In fact, naturopaths cling to their approaches in the face of clinical trials and other evidence showing ineffectiveness or sometimes harm.

Naturopathic practices are unchanged by research and remain a large assortment of erroneous and potentially dangerous claims mixed with a sprinkling of non-controversial dietary and lifestyle advice. Naturopathy teaches that strokes in progress can be reversed by cold compresses applied over the carotid arteries. This is extremely bad advice and contrary to a well-funded public health campaign on the need for quick action to combat the effects of stroke. How on earth can we legitimize this approach when we are working to enhance preventive medicine, reduce costs and improve outcomes?

Vitamin C is an effective treatment for approximately 100 conditions, including glaucoma, male infertility, and AIDS according to naturopaths. We do not have the luxury of licensing people and integrating them into accountable care organizations who advocate such measures.

The examples cited above were found over the last few years on the websites of the national naturopathic organization and the four schools and in the only general textbook of the field. Consider the fact that naturopathy has one primary textbook with one major author/editor and it will put their academic claims in perspective. Superficial trappings of legitimacy, such as the existence of schools, exams, a national organization, boards of certification and licensure in a few states cannot provide protection for the public. These trappings cannot make ineffective and dangerous treatments effective or safe. 
 
There are two reasons that government should deny licensure to any group that professes irrational health claims. The first is that licensure is interpreted by the public as an endorsement of the field. Unsuspecting parents who lack sophistication in science or medicine couldn’t be faulted for having their sick children treated by a practitioner who is licensed and purports to use safe and natural healing. 

The second reason is that a self-regulating profession determines its own standards of practice. The bill lists what naturopathy includes but also states “shall not be limited to.” A self-regulating board can use that language to open up what its licensees may do. There may be as few as 50 naturopaths who are to benefit from this bill if adopted in Massachusetts. There may be as few as twenty actively practicing on a daily basis. Veterans of the Committee on Public Health will recognize many by now. How is a naturopathy board to function independently or receive adequate funds from licensing to investigate even one patient complaint? Even if there were 500 naturopaths willing to pay $500 in licensing fees per year, this would not generate sufficient funds for an office, investigators, staff or the framework for real regulation of the practice. Such a board would undoubtedly find that all the practices described above are within the appropriate “standards of care” for naturopaths. Naturopathy has been around for many years. The problems with established naturopathy boards in states such as Arizona are well documented. They simply do not protect the public, in fact, they protect only the licensees.

If medical doctors were to engage in many of the basic practices of naturopathy, they would be subject to discipline and malpractice suits, and rightly so.  They would be excluded from practice or at a minimum excluded from credentialing by hospitals and insurers. Massachusetts is in the forefront of the patient safety movement. We are home to the Coalition for the Prevention of Medical Errors, the Betsy Lehman Center, and some of the best medical care in the world. What does the Health Care Cost and Quality Council think of naturopathy?  We have strong initiatives and are making progress on cost, quality and the establishment of accountable care organizations.  Let’s not legitimize a combination of the worst methods of the 19th century and new age healing. Naturopathy is an ongoing belief system of perpetual medical errors.

There simply cannot be one standard of care for one group purporting to be doctors engaged in diagnosis and treatment of human beings and a different standard for legitimate physicians, nurse practitioners and physician assistants.  There must be a single standard, and in health care it must be based on rational decision-making informed by science and clinical research. 

The MMS urges the Committee on Public Health not to endorse H.1992/S.1205.  

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