The naturopathic path to primary care

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When I first started practicing naturopathic medicine in Idaho close to 30 years ago, I dove right into the licensing efforts with the hopes to be able to practice to the full scope of my education as a primary health care provider.

It has been a quite tumultuous, disappointing journey. As Idaho has been an unlicensed state surrounded by licensed states, there are many different kinds of naturopathic doctors, whose interests clashed during these licensing efforts. Over the years I have met many skilled naturopaths who didnít have the training that I had. Thatís what kept me going to keep trying to find a compromise.

However, our efforts to have a grand-fathering clause in a bill that passed legislation failed miserably to the point that the licensing board got shut down. The bill lingered for about 10 years until legislators, upon reintroduction of and further resistance to the bill, withdrew it completely.

Unfortunately that led to even naturopathic labs like US Biotek (food allergy and environmental testing) or Genova (functional medicine testing) not offering their services to us anymore, while midwives, nutritionists, and nurse practitioners were still able to do so. Very frustrating to say the least.

So you can imagine how exciting it was to finally get a naturopathic licensing bill through the Legislature. As of June 2020 those who, after pre-med school, have gone through a four-year accredited naturopathic doctoral program and have passed nationally approved board exams, will be licensed naturopathic physicians able to practice primary health care in Idaho. Those qualified will claim the title NMD and naturopathic physician, while other naturopaths will be able to continue to use the title ND and naturopathic doctor and continue to practice under the Smith Act as they have since the early 1900s.

Not only will this legislation clarify the long-term confusion about training and qualification of naturopaths, but it will also relieve other primary care providersí overload of patients, and provide more affordable options to patients to use natural healing methods for their health care. I canít count the times that I had to turn people away as insurance hasnít covered my services and reduction of fees can only go so far. Others have scraped together their resources as they truly valued natural health services. I recall one young lady who faithfully kept coming, saving every penny, as her health was priority to her. She had come in sheer desperation, having found herself unable to eat from any food group without serious, painful consequences. She says: ďDr. Gabrielle gave me the ability to be my own healer; to understand how to listen to my body, to heal the whole body, to recognize the connection between emotional and physical health and a great appreciation for natural healing.Ē

Hopefully future insurance coverage of naturopathic services will make that process available to more people who are perhaps not as motivated. While insurance coverage does not automatically cover newly licensed providers, it usually follows if insurance companies are willing. If you treasure having a covered natural health care option you might want to contact your insurance and ask them to provide coverage for naturopathic care equal to other primary care providers once the bill becomes active next June.

Not only will this licensure broaden health care options and affordability, it will also increase the breadth of practice of NMDís. Being able to prescribe from a pharmacy legend and order labs and imaging tests will eliminate the necessity of multiple provider visits and allow us to practice according to the full scope of our training. As I was not able to order basic labs anymore I have had to send patients to another provider for a visit in order to order even basic labs Ė not only time consuming but expensive.

In order to prescribe as part of primary care, those of us who have graduated a long time ago have to retake the brand new pharmacology exam, as we have not been able to prescribe for so long. While I can remember 100s of botanical scientific names, the pharmaceutical names keep escaping me. It will be good to refresh my knowledge not only to help manage the multiple drugs so many patients are on, but to be able to choose when I would want to switch from natural treatments to prescription items.

In the past 30 years of practice I have rarely had that need, as naturopathic medicine is very effective for chronic and acute ailments. However, anti-microbials are invaluable in certain acute situations, as are hormones and immune modulators like Low Dose Naltraxone. For example, I just had a family with Whooping Cough where the Mom really needed preventative antibiotics to prevent contagion in the day care she was working at. Many of my patients with cancer or auto-immune disorders such as MS could benefit from Low Dose Naltraxone as an immune system modulator to improve immune system function as well as energy.

As a primary care physician I might also take advantage of certain medications, such as blood pressure drugs or anti-depressants, as a bridge until the naturopathic approach takes effect. Compounded hormonal formulas can be invaluable for bio-identical hormone replacement therapy in women with severe menopause symptoms due to hormonal imbalances or radical hysterectomies. While the thyroid can be re-balanced with natural methods, once its function is destroyed, thyroid hormones are essential.

Though still almost a year in the coming, I truly am looking forward to serving this community in an expanded and more affordable format. If this is of interest to you please do let your insurance company know that naturopathic licensing is coming and that you would like to have our services covered in a fashion comparable to other primary providers. Writing up your personal story and sending that in with above request to expand your right to more health care options might be very helpful.

I can be reached at 208-290-5991 for more questions or comments.

Gabrielle Duebendorfer has practiced for close to 30 years as a licensed naturopathic physician combining natural medicine with mindfulness tools. Her other passion is to advocate for climate change action so that her grandkids and patients will have a future in a healthy environment. Watch for her upcoming website

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