Scope of Practice

The scope of practice of naturopathic physicians (NDs) varies by jurisdiction. Currently, seventeen states, Puerto Rico, and five Canadian provinces license naturopathic physicians. Several of these jurisdictions regard NDs as primary care physicians and provide them with the scope of diagnostic and therapeutic privileges necessary to be the doctor first seen by the patient for general health care, for advice on keeping healthy, and for the diagnosis and treatment of acute and chronic conditions. In those jurisdictions in which NDs are not licensed, the scope of practice excludes the diagnosis and treatment of disease.

The naturopathic physician is defined by the U.S. Department of Labor as one who

“diagnoses, treats, and cares for patients, using a system of practice that bases its treatment of all physiological functions and abnormal conditions on natural laws governing the body, utilizes physiological, psychological and mechanical methods, such as air, water, heat, earth, phytotherapy (treatment by use of plants), electrotherapy, physiotherapy, minor surgery, mechanotherapy, naturopathic corrections and manipulation, and all natural methods or modalities, together with natural medicines, natural processed foods, herbs, and natural remedies. Excludes major surgery, therapeutic use of x-ray and radium, and prescribing of drugs, except those substances containing elements or compounds which are compounds of body tissues and are physiologically compatible to body processes for maintenance of life.”

The therapeutic modalities used by NDs are described below. It should be noted that the state of Utah requires a one–year residency before licensing NDs. Like other physicians, recently graduated NDs are encouraged to seek additional clinical experience under the supervision of a licensed physician, in the form of residencies and mentorships.

Botanical Medicine: Many plant substances are powerful medicines. Where isolated chemically derived drugs may address only a single problem, botanical medicines are able to address a variety of problems simultaneously. When properly utilized, most botanical medicines can be applied effectively with minimal likelihood of side effects.

Clinical Nutrition: Food is the best medicine and is a cornerstone of naturopathic practice. Many medical conditions can be treated more effectively with foods and nutritional supplements than they can by other means, with fewer complications and side effects. NDs use diet, natural hygiene, fasting, and nutritional supplementation in their practices.

Homeopathic Medicine: Homeopathic medicine is based on the principle of “like cures like.” Clinical observation indicates that it works on a subtle, yet powerful, energetic level, gently acting to promote healing on the physical, mental, and spiritual levels.

Mind/Body Medicine: Mental attitudes and emotional states may influence, or even cause, physical illness. Counseling, nutritional balancing, stress management, hypnotherapy, biofeedback, and other therapies are used to help patients heal psychologically.

Minor Surgery: Naturopathic physicians do in–office minor surgery, including repair of superficial wounds and removal of foreign bodies, cysts, and superficial lesions.

Natural Childbirth/Midwifery: With extended training and in some states Naturopathic Physicians provide natural childbirth care in an out–of–hospital setting. They offer prenatal and postnatal care using modern diagnostic techniques combined with ancient midwifery wisdom.

Physical Medicine: Naturopathic medicine has its own methods of therapeutic manipulation of soft tissue, muscles, bones, and spine. NDs also use ultrasound, diathermy, exercise, massage, water, heat and cold, and gentle electrical therapies.

Naturopathic practice also includes the use of any medical substances which contain elements that are components of bodily tissues or can be utilized by the body for the maintenance of life and the repair of tissues. All methods of diagnostic testing and imaging are used, including x–ray and ultrasound. The current scope of practice excludes major surgery and the use of many synthetic drugs.

“Scope of practice” is specifically defined by the legislation in the various states and provinces that license or regulate naturopathic medicine, and practice varies significantly among states, provinces, and countries.