The Consequences of Naturopaths Receiving PCP Designation


Naturopathy has undeserved legitimacy in Oregon. There are two naturopathic schools in the NW.  Oregon has a Board of Naturopathic Medicine, naturopathic physicians have prescriptive privileges and the legislature, with House Bill 3301, has given naturopaths the status of primary care providers (PCP) as of 2016.

The result?  A class action suit filed by Oregon Association of Naturopathic Physicians against Health Net Health Plan of Oregon  alleging unlawful and discriminatory practices and seeking reimbursement for those who used an naturopath as a PCP.

As one naturopath noted “much of the alleged discrimination stems from ignorance about naturopaths’ training and licensure.”  When one understands naturopathic training and licensure, it becomes clear why insurance companies would be hesitant to pay for naturopathic care.

The state may have declared an naturopath a PCP, but like legislating the value of pi, legislating reality does not make it so.

-  The best and brightest do not attend naturopathic school, with an undergraduate GPA around 3.2 and a 66% acceptance rate to naturopathic school. Compare that to medical school, with a 3.7 GPA and a 3% acceptance rate.

-   Naturopathic educational foundation consists of imaginary pseudo-medicine: homeopathy, hydrotherapy, acupuncture, energy therapy, and more, all interventions divorced from reality. 

-  Naturopaths have little or no post graduate training, when real physicians learn their profession. Naturopaths receive around 1200 hours of clinical training compared to around 3000 hours in medical school followed by 10,000 hours for an internal medicine or family practice residency. Naturopathic clinical training primarily reinforces naturopathic pseudo-medicine, not learning science-based medicine.

- Once in practice, anything goes.  Naturopaths are proud of the fact that “There is no naturopathic-specific standard of care.” Naturopathic websites demonstrate a diverse hodgepodge of pseudo-medical diagnoses and treatments, much of it divorced from scientific reality.

- Naturopaths are generally anti-vaccine and opposed the mandatory vaccination law. As a result, children are significantly more likely to be diagnosed with a vaccine-preventable disease if they received naturopathic care.

- When compared to MD’s, naturopaths do an inferior job at primary care, falling short in cancer screening and vaccination. 

- Unethical practice. Many naturopaths sell unneeded supplements and homeopathic nostrums from their clinic or website,  a fundamental conflict of interest.

- No quality improvement.  There has never been a change or abandonment of a practice because it has been demonstrated to be useless or dangerous.  Naturopathic practice is immune to data.  

In every aspect of their education, training, and practice naturopaths are not qualified to be a PCP, despite the legislature declaring it so. As a practicing physician I have enough issues getting real, useful care reimbursed.  Those resources should not be wasted on naturopathic care.  The class action suit is like worrying about discrimination of astrologers by astronomy departments. 

There is a shortage of primary care providers in Oregon.  The wrong solution is paying providers who are not qualified and are extensively trained in ineffective pseudo-medicine. Just because there are issues with the airlines does not mean we should instead use magic carpets.  Oregonians deserve better.

Addendum 

A longer of this post, with references, can be found at sciencebasedmedicine.org.