With Governor Charlie Baker signing a licensure bill, Massachusetts has become the 22nd jurisdiction to regulate naturopathic doctors in America. The Commonwealth now joins all other New England states, save Rhode Island, in offering state of the art natural medicine options to people in Massachusetts. This law ensures the safe practice of naturopathic medicine in Massachusetts and allows those with appropriate education, training and oversight to practice in the state.

That paragraph took about one minute to write. This legislative effort has taken over twenty-four years. Though Massachusetts would be considered by many as a seat of progressiveness and a stronghold in the advancement of medical research and delivery, this legislation took decades to realize.

In the last thirty years, the profession has grown from one that included just a few hundred practitioners who were licensed in just 6 states, and a single naturopathic medical school. There are now 8 naturopathic medical schools recognized by the Federal Department of Education and approximately 6,000 licensed practitioners in now, 22 U.S. jurisdictions. In November 2016, Pennsylvania joined in approving a licensure law. Naturopathic doctors work in private clinics, as part of integrative clinics and in the research environment.

Dr. JoAnne Yanez, Executive Director of the Association of Association of Accredited Naturopathic Medical Colleges writes, "NDs are rigorously trained in four year, in-residence, regionally and nationally accredited higher education institutions. Graduates pass psychometrically sound examinations prior to being eligible for licensure and require industry standard continuing education coursework."

Over the decades, there has been a paradigm shift in attitudes and acceptance of natural and integrative medicine, which is ongoing. Naturopathic doctors have been at the forefront of the evolution of integrative medicine. Scientific rigor applied to the evaluation of empirically based nutritional, botanical and other naturopathic treatments continues. Many naturopathic institutions are recipients of National Institutes of Health (NIH) funding and other grants to advance medical research. Additionally, naturopathic doctors are awarded highly competitive NIH fellowships.

The naturopathic medical profession has a 100-year history of promoting regulation of its own professional practice. In states like Arizona, which has had licensure since 1935, NDs work in a wide variety of settings including in accountable care organizations and in community health centers that care for the underserved. Many Massachusetts NDs practice in neighboring states where there is licensure and Massachusetts residents, who can afford to, must travel across state lines to receive naturopathic care. Vermont has recognized NDs since 1995, NDs are an integral part of the conventional medical landscape there.

Naturopathic doctors are experts at the non-opioid treatment of pain. Bill Walter, an ND practicing at a community health center in Oregon says, "Naturopathic doctors offer new perspectives on pain management and are leaders in changing the paradigm away from the first line use of opioid medication for chronic pain."

In my own practice, I see among others, physicians and their families and enjoy collegial respect. Our referral patterns are similar for both diagnostic and treatment support. I field questions on a daily basis from medical colleagues for everything from looking for a referral to an ND for a patient, to my opinion about particular natural medicine approach for a specific diagnosis, to trusting my thoughts about drug/nutrient or drug/herb interactions. Patients are using natural medicine in Massachusetts, but most of our medical doctor colleagues are not broadly educated to field such questions or provide such care.

We look forward to this licensure, which will set standards for training, education, and practice. As we move to a system of more integrated health care, we applaud Governor Baker's decision to sign this bill into law. We hope this will be a model for other states considering licensure. Naturopathic Medicine is Good for Massachusetts.