First, the New York Association of Naturopathic Physicians would like to thank writer Maria Pascucci for bringing to light naturopathic licensing efforts in New York State in her July 17 News article, "M.D. or N.D.?".

Second, the NYANP would like to state that we share Andrew Skolnick's concerns in his July 27 article about practitioners using the title "naturopath" who have no scientific, medical or accredited medical educational background.

There are currently quite a few persons claiming to be "naturopathic doctors" with online or mail-order degrees practicing in New York. These people lack the critical training and understanding in drug-herb, drug-nutrient interactions and the required clinical training in conventional medical diagnostics and understanding of diseases. Yet they still give natural medical advice -- sometimes to the patient's detriment.

The NYANP is trying to correct this serious problem by establishing educational and licensing standards that would allow the public to clearly identify a licensed naturopathic doctor (N.D.) with extensive science-based training in the safe use of natural therapies.

The bill supported by the NYANP requires that all practitioners using the title N.D. be graduates of a federally accredited four-year naturopathic medical school or program, complete a clinical training internship, complete national board examinations and maintain ongoing continuing education hours for relicensure. Other conventional medical professions have similar standards.

N.D.s who meet the criteria for licensure in the state bill complete an educational curriculum that requires over 4,600 hours of instruction. Like conventional medical schools, the first two years concentrate on the basic biomedical sciences: anatomy, physiology, histology, embryology, pathology and biochemistry. The second two years integrate the basic biomedical sciences with clinical sciences, focusing on a broad range of preventive therapeutic interventions: clinical nutrition and diet, botanical medicine, homeopathy, naturopathic physical medicine and hydrotherapy and counseling.

All N.D.s receive over 100 hours in pharmacology (the equivalent to medical schools) and have an average 1,327 hours of clinical training under close supervision of a licensed physician (M.D., D.O. or N.D.). All N.D.s receive training and testing in conventional medical diagnostics (labs, X-ray, etc.).

Licensed N.D.s have been appointed to President Bush's Medicare Coverage Advisory Committee, President Clinton's White House Commission on Complementary and Alternative Medicine Policy and other federal panels.

Complementary and alternative medicine is becoming a major part of American health care. It is crucial that state legislators act now to establish standards of competency and regulate the practice of naturopathic medicine through licensure in order to protect the public health, safety and welfare.

Raffaella Marcantonio, N.D., of Tonawanda is a board member and treasurer of the New York Association of Naturopathic Physicians.1

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