The Rhode Island legislation should pass HB 5474 to license naturopathic doctors in the Ocean State to ensure the safe practice of naturopathic medicine in Rhode Island.

Naturopathic doctors have been at the forefront of the evolution of integrative medicine. In the last thirty years, the profession has grown from one that included just a few hundred practitioners who were licensed in 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 22 U.S. jurisdictions. In January 2017, Massachusetts Governor Charlie Baker signed the naturopathic licensure bill making Rhode Island the lone New England state without naturopathic licensure.

Dr. JoAnn Yanez, Executive Director of the Association of Association of Accredited Naturopathic Medical Colleges (https://aanmc.org/about/ ) 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.

State licensure of practitioners of naturopathic medicine helps protect public health, safety and welfare from unqualified practitioners delivering substandard care.

In the past several decades, there has been a paradigm shift in attitudes and acceptance of natural and integrative medicine, which is ongoing. 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. All the New England states except Rhode Island license NDs, most for over twenty years. Many Rhode Island NDs practice in neighboring states where there is licensure and Rhode Island residents, who can afford to, must travel across state lines to receive naturopathic care. Vermont has recognized NDs since 1995 and NDs are an integral part of the conventional medical landscape.

Naturopathic doctors are experts at the non-opioid treatment of pain. Bill Walter, an ND practices 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 use of opioid medication.

In my own practice, as a licensed naturopathic doctor in Connecticut, I see among others, physicians and their families and beyond that, 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 Rhode Island, but most of our medical doctor colleagues are not strongly educated to field such questions or provide such care.

It is time for Rhode Island consumers who seek out complementary therapies to be protected from unscrupulous practitioners, who can now falsely present themselves as naturopathic doctors. Licensure will set standards for training, education, and practice. This legislation has been vetted for years by policy makers in the legislature and executive branch, and by the other stakeholders, including the public. As we move to a system of more integrated health care, state licensure of NDs in Rhode Island is a good idea.