Jerry Kopel

"They" already have a lot of patients. But they have something more valuable: A lot of patience. I'm referring to the 34 naturopathic physicians in Colorado who were graduated from an accredited four-year post-graduate curriculum in naturopathic medicine, and who want their occupation regulated.

Chances are good it will happen in this year's legislature, but even if it doesn't, regulation will eventually occur. That's been the precedent for other forms of alternative medicine in Colorado.

Some examples: Acupuncture was once dismissed by medical physicians in the U.S. as mumbo-jumbo. When the legislative Sunrise-Sunset Committee began work in the summer of 1985, my recollection is that acupuncturists were among the first seeking regulation. And they were turned down, again and again.

By 1988, they had learned how to make an effective and compelling presentation. And by then, more states were regulating this occupation despite opposition from medical societies. Sen. Bob Martinez (D) carried their bill, approved by the Sunrise-Sunset Committee, which bill became law in 1989.

Lay midwives went through the same ordeal, appearing over and over again before the Sunrise-Sunset Committee only to be turned down with heavy opposition from the Colorado Medical Society. Finally, in 1993, in a measure carried by then Rep. Dave Owen (R), and approved by the Sunrise-Sunset Committee, lay midwives were allowed to practice without threats of imprisonment.

Dental hygienists are not part of alternative medicine, but dental hygienists practicing on their own and unsupervised provide a form of dental practice that was bitterly opposed by the Colorado Dental Association. But in 1986, dental hygienists achieved their goal of independent practice, under the experienced tutorship of lobbyist Leo Boyle and sponsor Sen. John Donley (R). According to a Dec., 1998 Governing Magazine article, Colorado is still the ONLY state to allow independent and unsupervised practice.

Unlicensed psychotherapists were practicing without regulation until 1988, when the legislature established a grievance board for psychotherapy-related occupations, and included the "unlicensed" under a bill carried by me. In 1998, the grievance board was abolished and each group, including the "unlicensed" was given a separate regulatory board.

According to the Dept. of Regulatory Agencies (DORA), "naturopathy is a system of health care based on the philosophy that the human body has the power to heal itself by restoring its natural balance. Therapy is directed at the whole person and at the underlying cause of illness, such as the patient's lifestyle, diet habits, and emotional state."

Treatment methods include nutritional advice, the use of homeopathic remedies, herbs and botanical medicines, vitamin and mineral therapy, physiotherapy, hyrdrotherapy, psychological counseling, stress management, and spinal manipulation.

To meet the standards for accreditation recognized by the U.S. Dept. of Education, the student needs three years of undergraduate premedical study from an accredited college or university and a four year naturopathic medical college program. The 34 naturopathic physicians in Colorado who meet that standard have an average of 2,000 patients per physician.

The problem recognized in the DORA report is that persons calling themselves naturopathic doctors range from someone with a seven year college degree, to someone with a six-week correspondence course certificate.

Naturopathic physicians tell DORA they don't support legislation that would affect approximately 600 others who presently call themselves naturopaths, but who lack the seven years of training. I don't believe that hands-off approach will work, at least as far as consumers of service are concerned.

Eleven states now license naturopathic physicians, several under "boards of alternative health care." Numbers licensed range from 369 in Washington, to 5 in Utah.

It would be expensive, but not impossible, to establish a regulatory board for 34 licensees on the assumption that more graduates would then come to Colorado. Another approach would be to share the overhead by including the 600 "unlicensed" who took correspondence courses or limited study programs under a regulatory approach that would LIMIT their scope of "practice". Disciplinary action could be taken against anyone who "performed services outside of such person's area of training, experience, or competence."

Naturopathic physicians have been trying, unsuccessfully since 1993, to obtain regulation through the Colorado legislature. Each previous attempt was vigorously opposed by the Colorado Medical Society.

This year's measure, HB 1051, is carried by House Speaker Russ George (R) in the House and Sen. Jim Dyer (D) in the Senate, assisted by lobbyists Greg Romberg and Leo Boyle.

One danger exists. If HB 1051 meets stiff resistance, will the naturopathic physicians opt for title protection under CRS 6-1-105, the deceptive trade practices act? That would protect the "title" but do nothing for the patients. Without a regulatory board, negligent treatment of a patient by someone with title protection doesn't provide Colorado government with a way to terminate that person's practice.

"Resistance" should always be put into historical perspective. Inoculation as a prevention for smallpox in colonial America was pushed by Cotton Mather and his fellow clergymen. Their leading opponents were doctors.

Jerry Kopel writes a column for the Statesman based on 22 years past experience as a state legislator.


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