Legislature(2011 - 2012)

03/09/2011 03:46 PM House L&C


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                       HB 122-NATUROPATHS                                                                                   
                                                                                                                                
4:31:35 PM                                                                                                                    
                                                                                                                                
CHAIR OLSON announced  that the final order of  business would be                                                               
HOUSE BILL  NO. 122, "An Act  relating to naturopaths and  to the                                                               
practice  of  naturopathy;  establishing an  Alaska  Naturopathic                                                               
Medical  Board; authorizing  medical assistance  program coverage                                                               
of naturopathic  services; amending  the definition  of 'practice                                                               
of medicine'; and providing for an effective date."                                                                             
                                                                                                                                
4:31:48 PM                                                                                                                    
                                                                                                                                
SANDY  WILLIAMS stated  she has  been seeing  a local  naturopath                                                               
(ND) for about  10 years.  She said she  generally spends an hour                                                               
with the  ND at  each appointment and  obtains knowledge  to help                                                               
improve  her health.    She offered  her belief  that  her ND  is                                                               
interested  in her  well being.   She  would like  to learn  more                                                               
about preventative  care and  believes her  ND provides  her with                                                               
guidance  that  has helped  her  achieve  lifestyle changes.  She                                                               
concluded by saying  she believes she deserves  an opportunity to                                                               
choose an ND as her health  care provider and spoke in support of                                                               
HB 122.                                                                                                                         
                                                                                                                                
4:33:14 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER  asked whether she thought  her choices in                                                               
selecting an ND were constrained.                                                                                               
                                                                                                                                
MS. WILLIAMS  related she  is a senior  citizen and  currently is                                                               
not  taking   any  prescribed  medication.     She   related  her                                                               
experience with  doctors has been  that appointments  are shorter                                                               
and the  opportunity to speak  is limited  to one or  two things.                                                               
She thought the  first response for treatment is to  take a pill,                                                               
and medical  doctors tend not to  work on prevention or  cause of                                                               
the ailment.                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER  asked  how   passage  of  this  HB  122,                                                               
establishing a ND's board would affect her life.                                                                                
                                                                                                                                
MS.  WILLIAMS answered  that she  was unsure,  but she  thinks it                                                               
would expand  her ND's  ability to provide  additional care.   In                                                               
response  to Representative  Saddler, she  stated her  ND is  Dr.                                                               
Emily Kane.                                                                                                                     
                                                                                                                                
4:34:46 PM                                                                                                                    
                                                                                                                                
DAVID OTTESEN  stated that for  the past  25 years, the  NDs have                                                               
been the primary  health care providers for his family.   The NDs                                                               
have treated his  family for a variety of  minor health problems,                                                               
including  ear,  sinus, and  urinary  tract  infection.   He  has                                                               
worked with  a number of NDs  and finds them to  be competent and                                                               
professional.    "I  think  this  legislation  really  should  be                                                               
completely non-controversial since every  other state on the West                                                               
Coast does  have a Naturopathic  Board," he  said.  He  stated he                                                               
was aware  some members of  the medical community  have expressed                                                               
concerned  that NDs  might practice  outside the  scope of  their                                                               
competence, but  he is  unaware of any  evidence to  suggest this                                                               
has happened in any other state, including Alaska.                                                                              
                                                                                                                                
4:36:48 PM                                                                                                                    
                                                                                                                                
MR. OTTESEN related a scenario  which highlighted his experience.                                                               
He stated  that about  five years  ago he  came back  from Africa                                                               
with  an illness  he initially  thought was  traveler's diarrhea,                                                               
which he  initially contracted  during the trip.   After  four or                                                               
five days  he continued  to experience fever  and chills  and was                                                               
getting  worse.   His  ND,  Emily Kane,  realized  he might  have                                                               
something more  serious.  She  went to  his home and  performed a                                                               
blood test for  malaria during a lunch hour.   His test came back                                                               
positive the  next day.   He went  to Bartlett  Memorial Hospital                                                               
and  was  transported  via  Medivac   to  Seattle  since  he  had                                                               
concocted cerebral malaria, which is  often fatal.  He attributed                                                               
his  treatment to  Dr. Kane's  care.   He related  his experience                                                               
points out the personalized care  NDs provide.  He reiterated she                                                               
came to his house on her lunch hour  to perform a blood test.  He                                                               
commented this is  not the first house call he  has received from                                                               
an ND.   Secondly,  his experience  provides an  example of  a ND                                                               
making a  good decision  and referring  a patient  to appropriate                                                               
care.   She referred him to  the hospital and did  not attempt to                                                               
treat his  condition with  any herbal  remedy.   She told  him he                                                               
needed to  go to  Bartlett Memorial  Hospital and  get treatment.                                                               
It  turns out  the hospital  did  not have  enough experience  to                                                               
treat his illness either so  he was transferred to the University                                                               
of Washington and  treated by a specialist  in tropical diseases.                                                               
Primary care  providers also work  in that manner since  not each                                                               
provider has  expertise in all  areas of  medicine.  NDs  work in                                                               
the same way, are aware  of their limitations, and refer patients                                                               
when they are beyond their area of expertise.                                                                                   
                                                                                                                                
MR.  OTTESEN pointed  out that  the U.S.  including Alaska  has a                                                               
shortage of  primary care providers.   NDs help  individuals take                                                               
responsibility for  their own illnesses, and  work in partnership                                                               
with their  clients to  help them  take steps  for wellness.   He                                                               
offered  his belief  that people  eating better,  exercising, and                                                               
taking steps  for wellness is precisely  the key to get  a handle                                                               
on medical costs.   He stressed that ND's excel  at wellness.  He                                                               
urged support for HB 122.                                                                                                       
                                                                                                                                
4:41:12 PM                                                                                                                    
                                                                                                                                
JANE MADISON offered  her belief that Alaskans  deserve access to                                                               
balanced approach of traditional medicine  and ND treatment.  She                                                               
expressed  gratitude  for  the  services  the  medical  community                                                               
provides.   Many medical conditions  can be prevented  or treated                                                               
with  diet, supplements,  and hormones  which represents  a small                                                               
part  of the  services an  ND provides  that traditional  medical                                                               
doctors do not have time for, she  said.  The NDs' hands are tied                                                               
since  they  do  not  have  a   state  board.    While  NDs  have                                                               
authorization to  write prescriptions  in other states,  they are                                                               
not  authorized to  write prescriptions  in Alaska.   She  stated                                                               
that  HB 122  will solve  many problems.   She  related that  six                                                               
years  ago  she   began  to  have  serious   thyroid  issues  and                                                               
complications.   Representatives Olson and Chenault  observed her                                                               
downward spiral including huge weight  gain.  She said within one                                                               
month the condition  was cured with a  natural thyroid medication                                                               
that  was not  available through  a  traditional MD.   Under  the                                                               
present regulations she  must see the ND, followed by  a visit to                                                               
advanced   nurse   practitioner  or   MD   who   can  write   her                                                               
prescription.                                                                                                                   
                                                                                                                                
MS. MADISON  stressed that this  bill could help others,  such as                                                               
those  who suffer  from the  side effects  of chemotherapy  since                                                               
ND's   can   help   lessen  the   side   effects   significantly,                                                               
particularly with  prescriptions.  She surmised  that some people                                                               
in Alaska  are passing  themselves off as  NDs and  sell products                                                               
for  profit.    A  board  could help  stop  this  and  raise  the                                                               
standards.   Her local hospital  cannot hire MDs unless  they are                                                               
state certified.  Therefore, her  hospital cannot hire NDs.  This                                                               
bill would  allow her hospital  to hire both  the MD and  the ND,                                                               
which  would provide  balanced care.   She  pointed out  that the                                                               
Mayo  Clinic offers  both NDs  and physicians.   This  bill could                                                               
help  the  state  since  it  is self  insured.    She  related  a                                                               
patient's history  and her  belief that  NDs could  have provided                                                               
less  costly  care for  the  patient.    She  named a  number  of                                                               
ailments that could be helped  by NDs, including treating thyroid                                                               
disorders or adrenal gland disorders.   These health problems can                                                               
be treated by either an MD or an ND, she said.                                                                                  
                                                                                                                                
4:46:39 PM                                                                                                                    
                                                                                                                                
WAYNE ALDERHOLT spoke  in support of HB  122.  He stated  he is a                                                               
36-year Alaskan resident  with about 18 years of  experience as a                                                               
consumer/patient   of   naturopathic   medicine.      Traditional                                                               
allopathic medicine and naturopathic medicine  each has a role in                                                               
Alaska and  both are necessary  for the  health care system.   He                                                               
related that  NDs excel in  prevention and management  of chronic                                                               
conditions.   Traditional  medicinal  doctors  excel in  emergent                                                               
conditions requiring aggressive  intervention and damage control.                                                               
An  unintentional  but critical  omission  in  the 1986  enabling                                                               
legislation  for  NDs left  the  profession  without a  governing                                                               
structure.   This  bill  would provide  an  independent board  to                                                               
oversee NDs.  Prescription ability  should be allowed and managed                                                               
by  the respective  boards.   With respect  to malpractice,  once                                                               
both boards  are established it  would be  up to those  bodies to                                                               
create clear standards and enforce them.   He served on his local                                                               
hospital board  and he learned  two things.  First,  the majority                                                               
of  malpractice  is  generated  by a  few  practitioners.    Most                                                               
malpractice  incidents are  preventable.   The medical  community                                                               
can police themselves.   He related that  he previously submitted                                                               
written testimony.   He  referred to  a flyer he  picked up  at a                                                               
conference.  He  read, "Members of both  professional bodies meet                                                               
to  share experiences,  ideas, and  skills on  specific areas  of                                                               
health  care for  the betterment  of the  participants and  their                                                               
patients."  He shared that  the national conference had seven MDs                                                               
and four NDs  who presented.  He described his  own diagnosis and                                                               
ND treatment, noting  he had to travel out of  state and selected                                                               
Arizona for treatment.   He said the clinic  he attended provided                                                               
cutting edge treatment.                                                                                                         
                                                                                                                                
4:51:20 PM                                                                                                                    
                                                                                                                                
MARY  ANN FOLAND,  Physician,  Immediate  Past President,  Alaska                                                               
Academy  of  Family  Physicians;  President-Elect,  Alaska  State                                                               
Medical Association,  stated she was a  family practice physician                                                               
for over  34 years in Anchorage.   She related that  she has been                                                               
in contact with other groups  including the Physician's Assistant                                                               
Association, the American Osteopathic  Association, and the State                                                               
Medical Board.   All of the  groups she has contacted  think this                                                               
bill is a bad idea.  The goal  of NDs is to expand their practice                                                               
to  be  the same  as  primary  care  physicians.   She  expressed                                                               
concern about this, not  the least of which is the  cost of a new                                                               
regulatory  board.    Using  doctor in  the  title  or  physician                                                               
creates confusion  and is misleading.   She referred to  a recent                                                               
study that  showed 90 percent  of the people surveyed  think only                                                               
licensed  medical doctors  should use  the term  physician.   She                                                               
highlighted   the  difference   in   training,  experience,   and                                                               
continuing education.   She  offered her belief  that NDs  do not                                                               
have the  breadth or depth  in education provided  in traditional                                                               
medical  school.   The  NDs  are not  required  to have  graduate                                                               
residency  that  is  essential  for patient  safety.    The  most                                                               
dangerous thing  she says she does  every day is to  pull out the                                                               
pad from her pocket to write a  prescription.  Even if NDs do not                                                               
have   the  ability   to  write   prescriptions  for   controlled                                                               
substances,    she   thought    many   drug    interactions   and                                                               
contraindications and  dangers in prescribing.   She said, "There                                                               
are no safe, simple  drugs.  I ask you to  please to not simplify                                                               
this or consider  it just a matter of competition."   She did not                                                               
think there  were enough  naturopaths in the  state to  really be                                                               
competition  for physicians  in  Alaska.   She cautioned  members                                                               
that this is about  safety.  This bill is a  "wants" list and not                                                               
a "needs"  list.  She  did not think  the NDs practice  should be                                                               
expanded.                                                                                                                       
                                                                                                                                
4:54:20 PM                                                                                                                    
                                                                                                                                
DR. FOLAND  characterized the public's  trust of physicians  as a                                                               
sacred  trust.   She reiterated  that the  groups she  previously                                                               
mentioned think this is a bad idea.   She read, "A physician is a                                                               
person who  has successfully completed  the prescribed  course of                                                               
studies in  medicine, in a  medical school  officially recognized                                                               
by the  country in which it  is located and who  has acquired the                                                               
requisite  qualifications  for  licensing   in  the  practice  of                                                               
medicine."   She  then read  the definition  for naturopathy,  "A                                                               
system of  treating diseases  largely employing  natural agencies                                                               
such as  air, sunshine, etc. and  rejecting the use of  drugs and                                                               
medication."    She  concluded   that  this  is  about  training,                                                               
experience,  and stated  mission.   She urged  members to  please                                                               
vote no on HB 122.                                                                                                              
                                                                                                                                
[HB 122 was held over.]                                                                                                         

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