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Naturopathic Medicine is a traditional system of health care that blends centuries-old knowledge of effective, natural therapies with current scientific advances in the treatment of patients.  The scope of practice of naturopathic doctors includes all aspects of natural medicine.

According to a recent editorial in the Anchorage Daily News, there is a severe doctor shortage in Alaska (see Appendix A:  Doctor Shortage).  They cite a report from the Alaska Physician Supply Task Force that found we would need an increase of 28% (375 doctors) in order to catch up with the lower 48.  In the rural areas, the situation is even bleaker with one in six positions unfilled. 

Alaska first licensed naturopathic physicians in 1987 (see Appendix B:  History of Naturopathic Licensing in Alaska).  In January, 2004, the Alaska Association of Naturopathic Physicians proposed legislation to the 23rd Alaska State Legislature that would have expanded the scope of practice for naturopathic doctors in Alaska.  The purpose of this legislation was threefold:

1)  To provide our patients with an integrated approach to medical care that draws from the best of conventional and alternative medicine without the barrier to optimal care created when well-trained naturopathic physicians are prohibited from prescribing appropriate medications, which they have been trained to prescribe (see Appendix C:  Health Care Is Changing).

2)  To calibrate our licensing law in accord with current trends in other states that license naturopathic physicians (see Appendix D:  States' Prescriptive Authority and Minor Surgery Scope of Practice for Licensed Naturopathic Doctors).

3)  To update our law to allow naturopathic physicians in Alaska a scope of practice commensurate with modern naturopathic education (see Appendix E:  Comparison of Naturopathic and Major Medical Schools).
The proposed legislation easily passed in the Senate (19-1) but was stalled in the House in May, 2004.  A re-written bill was passed that established a task force with representatives from the naturopathic, medical, nursing, pharmacist, physician’s assistants professions to work with legislators in order to “…contribute to a better understanding of issues related to the safety and scope of the practice on naturopathy …”   

In consultation with the task force and as we look at how naturopathic governance compares to other states (see Appendix F: Comparison of Naturopathic Governance), we have modified our scope of practice bill to include the following:

1)   Formation of a Naturopathic Advisory Committee  (see Appendix G) to act in an advisory role to the Alaska Department of Licensing in oversight of the naturopathic profession;

2)   Authorization to perform minor office procedures including repair of superficial lacerations and abrasions, superficial lesions and the removal of foreign bodies located in superficial tissues;

3)   Formation of  a Naturopathic Medical Formulary Council (see Appendix H) authorized to determine the formulary list of prescription medications naturopathic physicians will be authorized to prescribe;

4)   Establishment of continuing education requirements.

Naturopathic Education:

Naturopathic physicians licensed in Alaska have graduated from four year graduate level programs accredited by the Council on Naturopathic Medical Education and by their local accrediting agencies, all of which are federally recognized the US Department of Education.  The USDE also recognizes the Liaison Committee on Medical Education that accredits medical education programs within the United States leading to the M.D. degree (see Appendix I:  Accrediting Agencies).
Naturopathic physicians are obligated to keep up with changes in medicine and to critically and without bias evaluate methods which may be of benefit to their patients.  In order to assure naturopathic physicians’ prescriptive writing authority is up to date for all licensed doctors in Alaska, including those who graduated twenty or more years ago, naturopathic physicians seeking such authority must fulfill certain criteria:

1)  Completion of 60 hours training in pharmacology training based on the State of Arizona’s program for naturopathic doctors (see Appendix J:    Pharmacy CE Program).

2)  Once prescriptive authority has been granted, naturopathic physicians are required to acquire 30 hours of continuing education, half of which is instruction in pharmacology and phamacotherapeutics, every two years.

Naturopathic Medical Formulary Council:
In states that allow naturopathic physicians to have prescription writing authority, most have a formulary of drugs that are permitted.

In the past year, Idaho and Washington State have formed advisory councils whose purpose is to advise their respective licensing authorities regarding appropriate formulary lists.  These councils are multidisciplinary in nature.  Washington’s advisory council is comprised of pharmacists and naturopathic physicians; Idaho’s is comprised of pharmacists, allopathic and naturopathic physicians.

Naturopathic Track Record of Safety

Fortunately, naturopathic physicians have been licensed in numerous other states for some time now and there is a track record of public safety which is impressive. (See Appendix K:  Naturopathic Disciplinary Reports).  Please note these reports include all complaints and disciplinary actions and are not restricted to complaints specific to prescription writing.  However, it is important to recognize that unlike conventional providers, naturopathic providers see fewer patients per day (5-15 compared to 20-30). Naturopathic doctors typically spend more time with patients and, thus, get to know them better.  They are inclined to use prescriptions as a last resort and are less likely to put people on multiple drug regimes than our conventional colleagues (see Appendix L: letter from Rick Chester, ND, RPh, LAc).

Why Now?

Alaskans are scrambling to find family doctors to address a wide variety of health care needs.  Based on epidemiologic estimates, 20-30% of patients seen in a conventional provider’s office are using alternative/complementary medicines.   Twenty percent of adults who take prescription medicine also rely on herbal products ; whether the provider knows or approves of this fact or not.  Americans spend in excess of $10 billion annually on herbal and dietary supplements , often without the guidance of a health care professional or awareness of potential interactions with conventional therapies. 

Naturopathic physicians have taken the lead on writing the texts on integrating the best scientifically validated complementary and alternative therapies along with conventional medicine .  This can be done safely to the benefit of the medical community and, more importantly, for the communities we serve.


SB 306, section 1.

Eisenberg, et al, Unconventional medicine in the United State—prevalence, costs and patterns of use.” N Engl J. Med 1993, 328:246-252.

Eisenberg, et al, Trends in alternative medicine use in the United States, 1990-1997:  Results of a follow-up national survey, JAMA, 1998; 280: 1569-1575.

Pizzorno, Joseph, The path ahead: education, evolution and collaboration, Integrative Medicine, vol. 3, #2, April/May, 2004, pg. 6.

Including but certainly not limited to:  Herb Contraindication and Drug Interactions, Francis Brinker, ND, Eclectic Publications, 1998; Encyclopedia of Natural Medicine, Joseph Pizzorno, ND and Michael Murray, ND, Prima Publishing, 1990; Clinical Botanical Medicine, Eric Yarnell, ND, Mary Ann Liebert, Inc, 2003; Women’s Encyclopedia of Natural Medicine, Tori Hudson, ND, McGraw-Hill, 1999; Managing Menopause Naturally, Emily Kane, ND, Basic Health Media, 2004.

 

 

 

 

 

 

Alaska Association of Naturopathic Physicians

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