Written by Lucas Thomae
When Amy Hawkins was a master of medicine student at UNC-Chapel Hill, she always knew she wanted to continue her education at a traditional medical school. As she watched her loved one struggle to stay healthy despite her consistent medical care, she questioned the path.
Hawkins said her grandmother had chronic obstructive pulmonary disease, and she saw a health care system that focused more on treating symptoms than preventing disease.
“She kept being given more and more steroids and her health got worse and worse,” Hawkins said.
After graduating from UNC in 1995 with a degree in biology, Hawkins took a different path than he had originally planned, pursuing an interest in herbal medicine instead. In 2007, she earned her doctorate in naturopathic medicine from Bastyr University in Washington and shortly thereafter opened her own practice in Seattle.
Rather than treating symptoms, naturopathic doctors seek to identify and stop the root cause of disease. They avoid prescription drugs as much as possible, and treatment may include dietary plans and the provision of herbal medicines and supplements.
Naturopathic doctors are trained as primary health care providers and attend a four-year naturopathic medical school. (There are five accredited institutions in the United States and two in Canada.) Graduates of these schools must take the Naturopathic Doctor Licensing Examination to obtain licensure.
These doctors are licensed health care providers in Washington State, where Mr. Hawkins has been practicing for five years. They are recognized as family doctors and have the authority to prescribe medicines and work in hospitals. The same is true for naturopathic doctors in Oregon, Arizona, and a dozen other states.
That’s not the case in North Carolina, but naturopathic doctors here have been pushing for licensure for years. They argue that licensure would allow patients to receive more affordable care while protecting North Carolinians from unqualified health care providers. A new bill passing the General Assembly this session would create such a licensing commission.
Hawkins moved back to her home state of North Carolina in 2012 to be closer to family. She said the move “was not the best decision for her.” [her] She lost the primary care and prescribing privileges afforded to her by her Washington state license. Ms. Hawkins has opened a new clinic in Wilmington specializing in women’s health, but her practice is much more limited than what she was able to do previously in Washington.
Now, as president of the North Carolina Association of Naturopathic Physicians, Hawkins hopes that changes soon.
Healing Arts Commission
There have been several attempts to license naturopathic doctors in recent years, but major moves have been hampered by state legislatures’ reluctance to create new licensing boards. The latest strategy by the sponsors of House Bill 557 and its companion bill, Senate Bill 513, is to group several types of alternative health care providers into her single licensing committee.
The commission, called the North Carolina Healing Arts Commission, would license and regulate naturopathic doctors, music therapists, and reflexologists. Each group has advocated for licenses separately in past Congresses.
The American Music Therapy Association defines music therapy as “the use of clinical, evidence-based musical interventions to achieve individual goals within the therapeutic relationship.”
Reflexology is an alternative medical practice that applies pressure to the feet, hands, and ears. The American Reflexology Association claims that these techniques “stimulate the complex neural pathways that connect the body’s systems, supporting the body’s efforts to function optimally.” He is one of 15 certified members of the North Carolina Reflexology Association.
According to the North Carolina Music Therapy Association’s website, it has 14 members. Appalachian State University has a degree-granting program in music therapy.
Naturopathic physicians are the largest group, with the state association estimating there are about 40 licensed physicians in the state.
Currently, only a small number of naturopathic doctors are licensed in North Carolina, but Hawkins believes licensure would attract more practitioners to the state. She said naturopathic doctors in North Carolina are steadily moving to practice in states where they can obtain full licensure, such as Washington, Oregon and Arizona.
Whether it gets approved this year will depend on North Carolina lawmakers, who have frowned upon the creation of boards and commissions over the past decade. In 2012, Congress considered eliminating more than 50 state boards and commissions and cutting an additional 40. Eventually, those efforts came to nothing. Despite this, the General Assembly has been reluctant to add regulatory bodies.
Companion bills introduced this year in the state House and Senate to make this happen appeared to be on track in April and May. However, the proposed bill has since stalled in committee.
Naturopathic medicine is not new
Naturopathic doctors have been licensed in Washington and Connecticut for more than a century, and in the past decade seven other U.S. states have passed legislation to license these doctors. Supporters of a similar bill in Wisconsin, the most recent state to create a licensing board, cited the need for regulation as a driver for the 2022 law.
The push for authorization is also gaining momentum in response to the growing demand for alternative medical services and products. This practice is gaining acceptance among the general public and the scientific community. The National Center for Complementary and Integrative Health, one of 27 centers and institutes that make up the National Institutes of Health, is dedicated to “through rigorous scientific research to determine the utility, safety, and role of complementary and alternative health interventions.” It has a mission statement of “Defining.” Contribute to improving health and healthcare. ”
Susan Delaney, a 1975 graduate of UNC-Chapel Hill School of Nursing and a practicing naturopathic doctor in Carrboro, said public perception of alternative medicine has become dramatically more positive in recent years.
After graduating from UNC, Delaney attended the National College of Natural Medicine in Portland and then continued his studies in India. She returned to North Carolina in 1987 to practice naturopathic medicine.
“When I first came, [to North Carolina], I was thought to be a charlatan,” Delaney said. “But I have to say things have changed a lot in the last 36 years.”
Delaney cited acupuncture as an example of an alternative medicine that has become popular, regulated, and highly successful.
Acupuncture, a pain treatment derived from Chinese medicine that involves inserting tiny needles into the skin, first appeared in the United States in the early 1970s and has since become widely accepted. Acupuncturists work in hospitals across the country and are increasingly integrated into cancer treatment. North Carolina began regulating acupuncturists in 1993, and as of March 2022, there are 677 licensed acupuncturists in the state.
Herbal supplements, a common component of naturopathic medicine, have also exploded in popularity over the past few decades. According to a report in Nutrition Business Journal, sales of the herbal supplement industry grew from $4.2 billion in 2000 to $11.3 billion in 2020. The biggest annual change in its growth occurred during the COVID-19 pandemic, when the industry grew by 17.3 percent. In 2020 alone.
Still, naturopathic medicine has its fair share of detractors.
The American Academy of Family Physicians’ website states that it opposes licensure of naturopathic doctors. This statement, last updated in September 2022, states: “The theory and practice of naturopathy is not based on a fundamental body of knowledge related to health, disease, and health care that is widely accepted by the scientific community.” claims.
AAFP did not respond to an email asking if this is still their position.
Brit Marie Hermes, a former naturopathic doctor, is one of the therapy’s most outspoken critics. In an article published in Skeletal Inquirer in April 2020, Hermes said that she quit her job after learning that her boss was trying to treat cancer patients with drugs not approved by the FDA. she said.
“I have concluded that naturopathic medicine is a fraud,” Hermes wrote. “I was a fake doctor.”
Delaney said dangerous incidents like the one described by Hermes are why regulations are needed. Rather than rejecting naturopathic medicine as a whole, she argues that practitioners who engage in unsafe or misleading practices should be brought under greater scrutiny by the law.
“This is a public safety issue,” Delaney said.
What is the solution to the medical shortage?
Supporters of licensing argue that licensing not only protects North Carolinians but also makes it easier to receive primary health care services.
Once the licensing bill is in place, medical practitioners would be allowed to use their primary care training to provide basic services such as ordering lab tests and diagnostic imaging. They will not be allowed to prescribe medicine, perform surgery, or diagnose and treat cancer.
Data from the North Carolina Department of Health and Human Services shows 92 of the state’s 100 counties have some level of primary health care provider shortage. The areas with the greatest need are in the eastern part of the state.
“I believe [licensing naturopathic doctors] It would add health care providers to rural areas where they are really needed,” Senate Bill 513 sponsor Joyce Krawicz (R-Kernersville) told NC Health News.
However, most members of the North Carolina Association of Naturopathic Physicians live near the state’s urban centers. Hawkins, president of the Wilmington-based association, is one of a handful of naturopathic doctors serving the eastern part of the state. She said licensing would make the profession more attractive and bring practitioners to where they are needed most.
Although the bill does not mention insurance, Hawkins said the authorization could pave the way for insurance companies to begin covering naturopathic medicine in the state. This would remove new financial barriers to accessing care.
Naturopathic medicine may also be a more acceptable solution for people who distrust conventional medicine. Hawkins said many of his patients are dissatisfied with their traditional health care providers. This is something she noticed when she first started her practice in eastern North Carolina, and she says the pandemic has made that trend even worse.
“There is a growing distrust of the standard health care system, and unfortunately, the result is that people are not getting the care they need when they need it,” Hawkins said.
Hawkins hopes that by welcoming naturopathic doctors into the state’s medical “safety net,” the medical community can begin to build trusting relationships with naturopathic doctors and patients.
“Once we get the license, we become part of the system,” Hawkins said. “Physicians, physicians, nurses, nurse practitioners are more used to these referrals. They know us, they trust us, they know we’re accredited. , we know it’s a safe place to send patients.”
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