In a perverse way, one almost has to admire naturopaths. If there’s anything that characterizes naturopaths in their pursuit of legitimacy and licensure, it’s an amazing relentlessness. In this, they are not unlike The Terminator. As Kyle Reese described him in the first Terminator movie, the Terminator “can’t be bargained with. It can’t be reasoned with. It doesn’t feel pity, or remorse, or fear. And it absolutely will not stop… ever, until you are dead!” The difference is that naturopaths won’t stop until they are licensed in all 50 states and science-based medicine is, for all intents and purposes, dead. Over the years, I’ve written about attempts by naturopaths to obtain licensure in various states, including my own.
I noted last summer that one state, Massachusetts, had taken a large step forward in licensing the quackery that is naturopathy with the passage by its Senate of S.2335. As Jan Bellamy noted at the time, this was, by her count, the eleventh legislative session in which a naturopathic practice bill had been introduced. Alarmingly, she also noted that a bill actually passed one year, “thanks to some questionable legislative shenanigans at the end of session,” but, fortunately, it was vetoed by the governor. Unfortunately, what happened before has happened again in Massachusetts:
A measure that emerged in the waning moments of the last legislative session this week would create a state licensing board for naturopaths — alternative medicine practitioners whose work is considered unproven and potentially dangerous by physician leaders but is defended as a helpful option by adherents.
If Governor Charlie Baker signs the bill into law, he will end a two-decade effort by naturopaths to obtain the legitimacy, oversight, and protection of having a professional license. Massachusetts would join 18 other states and Washington, D.C., in licensing naturopaths, including all bordering states except Rhode Island.
Amy Rothenberg, president of the Massachusetts Society of Naturopathic Doctors, cheered the vote as a victory for public health. She said the bill, if enacted, will protect patients from inadequately trained naturopaths who engage in dangerous practices, such as attempting to cure a patient of cancer with herbs and vitamins.
“We’ll be able to offer quality naturopathic medicine to the citizens of Massachusetts, where we will have both the protection of the law and also regulation,” Rothenberg said.
The bill passed is, again, s.2335. How it passed is a bit of a mystery to me. I don’t claim to understand how the Massachusetts legislature works. (I hardly understand how the Michigan legislature works.) Jann Bellamy, for instance, informs me that the legislature was not in session at the time it was passed (January 3). The bill, if signed by the governor, would grant naturopaths a wide scope of practice, including:
Section 266. (a) The practice of naturopathic health care shall include, but not be limited to:
(i) the prevention and treatment of human illness, injury or disease through education, dietary or nutritional advice and the promotion of healthy ways of living;
(ii) the use of non-invasive physical examinations and the ordering of clinical and laboratory procedures from licensed clinics or laboratories to evaluate injuries, illnesses and conditions in the human body;
(iii) dispensing, administering, ordering and prescribing natural medicines of mineral, animal or botanical origin, including, but not limited to, food products or extracts, vitamins, minerals, enzymes, digestive aids, natural hormones, plant substances, homeopathic preparations, natural antibiotics, topical medicines and nonprescription drugs, therapeutic devices and barrier contraceptives to prevent or treat illnesses, injuries and conditions of the human body;
(iv) the use of manual mechanical manipulation of body structures or tissues in accordance with naturopathic principles;
(v) the use of naturopathic physical medicine to maintain or restore normal physiological functioning of the human body; and
(vi) mandatory tracking and documentation of the immunization status of a patient under 18 years of age and the required referral of that patient to a primary care or collaborative care physician where evidence exists that the individual has not been immunized.
Given how reliably antivaccine the vast majority of naturopaths are, (vi) made me laugh, as did this provision:
(d) Licensed naturopathic doctors shall have the same authority and responsibilities as licensed physicians regarding public health laws, reportable diseases and conditions, communicable disease control and prevention, recording of vital statistics, health and physical examinations and local boards of health, except that the authority of licensed naturopathic doctors regarding such matters shall be limited to the scope of practice authorized by this chapter. Naturopathic doctors shall be mandated reporters as required of physicians and nurses.
In any case, I did a brief perusal of the utter quackery that naturopaths in Massachusetts offer the first time I wrote about this bill. Not surprisingly, many of them offer homeopathy, because you can’t have naturopathy without homeopathy. There was also the usual assortment of naturopathic quackery, including devices that resemble more than anything else Scientology e-meters, hyperbaric oxygen, immersion baths, footbath detoxification, and a lot more. It’s basically par for the course, the sort of nonsense I see any time I examine what naturopaths are doing.
Now here’s the funny thing. This bill, if signed by the governor, doesn’t actually require naturopaths to be licensed. Knowing how contentious various certifications, such as board certification, I can guess what happened here. Naturopaths who didn’t go to the “approved” schools of naturopathy raised a stink, as did other “natural health practitioners.” They didn’t want to risk being shut out of practicing all that lucrative woo. So, likely as a sop to them, the senate included this provision:
(vi) a person or practitioner who is not licensed as a naturopathic doctor from recommending ayurvedic medicine, herbal remedies, nutritional advice, homeopathy or other therapy that is within the scope of practice of naturopathic health care; provided, however, that the person or practitioner shall not represent or assume the character or appearance of a person practicing naturopathic health care or otherwise use a name, title or other designation which indicates or implies that the person is licensed to practice naturopathic health care.
In other words, if you’re a naturopath who didn’t go to an “approved” school or some other practitioner of “natural health,” you can still recommend quackery that is included in the naturopathic scope of practice, you can still ply that quackery. You just can’t call yourself a naturopath any more. I do have to hand it to the naturopaths. This is an excellent means of protecting their turf against other quack specialties. There are a lot of people out there calling themselves “naturopaths” who got their degrees through mail order schools or schools even less reputable than the “approved” schools of naturopathy out there. Licensure prevents those “practitioners” from calling themselves naturopaths.
Of course, naturopaths think that they are somehow protecting the public from “lesser” trained naturopaths, but in reality, given how much pseudoscience is inherent in naturopathy, there really isn’t a dime’s worth of difference between a “licensed” naturopath and the naturopaths who won’t be able to be licensed under this law.
Any bill like this requires a credulous legislator to champion it, and the Massachusetts law is no different:
Representative Jay R. Kaufman, Democrat of Lexington and a top proponent of licensing naturopaths, said the medical society has been “incredibly slow to appreciate the qualifications as well as the experience of folks who are alternative medicine practitioners.”
Years ago, Kaufman served on a legislative commission on naturopathy, which he said concluded that naturopathic practices and those of conventional medicine “had very comparable levels of credibility and scientific accuracy.”
“A broader array of options just means that overall health care of citizens of the Commonwealth will improve,” he predicted.
Rothenberg, of the Massachusetts naturopathic society, said responsible naturopaths work in concert with medical doctors and know when to refer cases to them. Oncologists often refer patients to her to help with the side effects of cancer treatment, she said.
I discussed Rothenberg’s case briefly. Regular readers who look at her case will recognize a typical alternative medicine cancer cure testimonial in which she underwent conventional therapy plus naturopathy but attributes the naturopathy for how well she’s doing. Everything Rothenberg subjected herself to is pure quackery that added nothing to her care. Surgery, chemotherapy, and radiation are what cured her, not the intravenous vitamin infusions (I’m guessing she was into high dose vitamin C), the hyperbaric oxygen chamber, and the enzyme therapy. In Kaufmann, Rothenberg and her fellow naturopaths have found a willing dupe. Let’s also not forget another great benefit to naturopaths of licensure: Reimbursement by insurance companies. Licensure makes it far more likely that insurance companies will reimburse naturopaths for their services.
The only hope now to protect the citizens of Massachusetts from the legalization of quackery is for the governor to veto the bill. This happened in 2002, the last time that naturopaths managed to get such a bill passed, but there’s a different governor now and there’s no way of knowing whether he will be disposed to do the same.