Bill Aims To Expand Naturopathic Physicians’ Scope of Practice

The California senate this week advanced a bill (SB 538) that would expand the scope of practice for naturopathic physicians in the state -- a move that many medical and osteopathic doctors' groups oppose, MedPage Today's "The Gupta Guide" reports.

Background

According to the California Naturopathic Doctors Association's website, naturopathic doctors "are trained at accredited, four-year, post-graduate, residential naturopathic medical programs."

However, their training does not include a residency program, according to "The Gupta Guide."

In 2003, California began issuing restricted licenses to naturopathic physicians that required a medical doctor or doctor of osteopathic medicine to supervise any prescribing.

CNDA argues that the restriction "places significant limitations" on naturopathic doctors because medical and osteopathic physicians often are not interested in supervising them.

Details of Bill

Under SB 538, by state Sen. Marty Block (D-San Diego), naturopathic doctors would be:

• Allowed to order more kinds of imaging studies;
• Authorized to perform certain operative procedures related to superficial abrasions, superficial lacerations and some superficial lesions; and
• Authorized to prescribe, administer and order Schedule IV, Schedule V and unclassified prescription drugs without supervision.

Block said the bill is aimed at addressing a shortage of primary care doctors in the state.

The state Senate advanced the bill on Wednesday. The measure now heads to the Assembly.

Medical, Osteopathic Doctors React to Bill

According to "The Gupta Guide," several medical groups have expressed concerns about the bill.

Last month, Kimberly Kirchmeyer, executive director of the Medical Board of California, sent a letter to Block noting that naturopathic doctors "do not receive the education and training in naturopathic education programs to safely perform minor procedures and prescribe without physician supervision." Kirchmeyer added, "By expanding the scope of practice for an ND and not requiring physician supervision, patient care and consumer protection could be compromised."

Kaiser Permanente also said it opposes SB 538.

However, some practicing physicians support expanding naturopathic doctors' scope of practice.

Daniel Brousseau, a Pasadena-based osteopathic physician, testified during a state Senate committee hearing in April that he "is continually impressed with the rigor of [the] clinical training" among the naturopathic providers he works with and "never had an opportunity to be concerned because they were undertrained in any area, including pharmaceuticals" (Frieden, "The Gupta Guide," MedPage Today, 6/3).