For several sessions I have worked hard, mostly with the help of Senator Bettye Davis, Representative Cathy Munoz and her former staffer Kendra Kloster, to expand the scope of naturopathic physicians so we may practice to the extent of our training. NDs are deeply educated over 6-8 years as primary care docs, but our hands are tied in Alaska. We have 20% more pharmacy training than advanced nurse practitioners, as an example, but have very little — none, according to the Division of Professional Licensing — ability to prescribe basic medications. We are thoroughly trained in minor surgery, though not all naturopaths will want to use this skill set. There have been political impediments to the modernization of our scope of practice bill, which unfortunately for me currently involves being targeted in an ill-conceived legal accusation (click on “Read more” below). Please stay tuned for legislative efforts (SB 175 and SB 266) to prevent erosion of the current, limited, naturopathic scope of practice in Alaska. We will continue to build with small gains, legislatively, so we can better serve our patients. Thanks for your support and interest!
VIOLATING FREEDOM OF CHOICE IN HEALTHCARE
UPDATE Winter 2012
To most of the rest of the country, Alaska seems very remote. Sometimes larger economic forces will “experiment” with new ideas in this tucked-away backwater. Here’s an example of what I’m talking about. In 2006 the American Medical Association (AMA) spent millions of dollars developing a huge document called the “Scope of Practice Partnership” (or SOPP). This weighty and nasty tome has one sole purpose: to stamp out any growth of healthcare professions outside the conventional AMA/FDA/DEA endorsed model. So-called “alternative” healthcare is becoming big enough business that the politically oriented conventional docs are getting more abrasive in their push back.
In 2009, the Alaska Association of Naturopathic Physicians had the dubious honor of being the first group of NDs “attacked” by SOPP. NDs in Alaska have been sporadically attempting to modernize our scope of practice law for two decades. Luckily for us, this SOPP attack did not work so well since the unwieldy tome had a lot of ridiculously outdated information about naturopaths. The Alaska legislators involved in HB 122 mostly were underwhelmed by this heavy-handed power play. However, the bill did not progress because the bulk of last session was taken up with decoupling the oil and gas taxation structures.
The following session, the state AMA lobby is employing a different strategy: attack and malign the president of the ND State association.
I have been targeted in a malicious prosecution case which started in 2008 when a Juneau surgeon “reported” me for trigger point therapy, a technique which is allowed in ND scope of practice in Alaska and in all states licensing NDs. I had actually referred a patient to him who wasn’t improving optimally with the injection technique. Instead of a normal collegiate response, which would have been calling to discuss the patient with me, this arrogant bully chose to report me to the State law enforcement agency. The State didn’t like me using procaine as part of the mix in the trigger point solution, so I stopped. Procaine is biologically identical to a combination of two B vitamins; a mild analgesic in which use I was trained over 20 years ago. Nonetheless, it is a prescription substance and the language of the ND law is ambiguous. The language of the ND law needs clarification, but meanwhile I’m basically being treated as a criminal until I can change the statute (through legislation) or change the regulation (through an administrative trial) so these two parts of the law governing the ND profession are not in contradiction.
During the 2008 investigation which followed the unfounded complaint filed by this surgeon, the State agents did a sweep of local pharmacies and found that I had written scripts for bio-identical hormones, which I and most other NDs in the State have done safely and effectively since our licensure in 1986. The AK statutes for NDs say we “may not give, dispense or recommend in practice a prescription drug.” But the regulations, which qualify and expound upon the very terse “boiler plate” statutes, state that if the medicine is not a controlled substance (such as a narcotic) and is derived from a natural substance, then NDs may prescribe such substances. The bureaucrats have a different idea about interpreting the language of our law than do the professionals (naturopathic physicians and their pharmacists). Nonetheless, I stopped writing scripts in 2008 to the chagrin of many patients. The case was dropped.
Last spring (March 2011) when the AK ND scope modernization bill was moving along in Legislature, my case mysteriously re-opened with no new accusations. This vicious piece of business is the work of the state’s AMA lobbyist in collusion with the director of the Division of Professional Licensing, the agency which currently regulates NDs in Alaska.
I faced either a hugely expensive trial to clarify the language of the law in order to establish that neither I nor my colleagues in Alaska have practiced criminally since 1986, or accept a punitive “consent agreement” which drastically curtails my scope of practice even further. On December 20, 2011 I signed a consent agreement with which I neither agree nor willingly consent to.
If the ND law were “up to speed” with our training and capabilities, we would have a board. My “case” would be reviewed by a jury of peer professionals — not by bureacrats who are unduly influenced by the AMA lobby. Creating a board is the first priority for a future scope modernization bill. This year Alaska NDs are strictly in survival mode.
Bureaucratically, NDs have been compromised in Alaska because our regulators at the Division of Professional Licensing don’t really understand what we do. Nor are they interested. The role of administrative overseers in any professional regulating agency should be to ensure that the professionals have the proper credentials to “hang out their shingle.” It is NOT the role of the regulating agency to favor one group of professionals. However, the Division of Professional Licensing, which is under the Department of Commerce and Economic Development, has clearly been favoring the AMA lobby. This is in direct violation of consumer rights.
In reaching out to colleagues across the country I have received a flood of emails expressing outrage, dismay and encouragement. Many other NDs (and nurses and dental hygienists and optometrists and chiropractors etc) have been vilified and persecuted at the hands of AMA bullies.
If you are a consumer of wellness medicine, and appreciate having REAL HEALTH CARE (not just drug-based disease management) as an option for yourself and your family, please contact me at DrEmilyKane@gmail.com to learn about directing your voice to protect freedom of choice in healthcare.
If you are a naturopathic physician who has been bullied by your state’s AMA lobby, join me in coming together to explore legislative, administrative and activist options to stop the harassment, and to promote freedom of choice in healthcare.
The basic message here is the Alaska Naturopaths need a full scope law. Rural and urban citizens alike deserve access to high quality naturopathic care. Currently, naturopathic physicians in Alaska are being denied full scope practice both by administrative bureaucrats and by legislators susceptible enough to AMA lobbyists to hinder forward movement. The AK legislators have been educated about the training and capabilities of naturopathic physicians over the decades of our efforts to expand scope since licensure in 1986. The state insurers figured out years ago that naturopaths are a “good bet” in terms of cost and quality. NDs have insurance parity in Alaska. However, we have our hands tied when it comes to full scope practice. Legislatively, NDs just don’t have clout or money equal to our opponents. However, we are hugely rich in another resource: the genuine gratitude and love of our patients. This is what will win over this attempt to co-opt our healthcare system by the disease-management proponents. Patients will simply not tolerate a medical monopoly indefinitely.
Stand up with me now to protect your health and your freedom.