Legislature(2009 - 2010)BARNES 124
03/10/2010 03:15 PM House LABOR & COMMERCE
| Audio | Topic |
|---|---|
| Start | |
| HB282 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 282 | TELECONFERENCED | |
| + | TELECONFERENCED |
HB 282-NATUROPATHS
3:38:08 PM
CHAIR OLSON announced that the only order of business would be
HOUSE BILL NO. 282, "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."
3:38:22 PM
KENDRA KLOSTER, Staff, Representative Cathy Munoz, Alaska State
Legislature, paraphrased the sponsor statement, which read
[original punctuation provided]:
House Bill 282 creates a Naturopathic Medical Board
for the purpose of expanding allowed practices and
procedures of Naturopathic Doctors (NDs) and regulates
the practice of naturopathic medicine. The board will
consist of three Naturopaths, one licensed pharmacist,
and one public member. The board will work with the
Division of Occupational Licensing to issue licenses,
and will have authority to investigate and discipline
as required. In addition, the state will authorize
prescription endorsement which will be offered for the
first time for NDs who have practiced for five years;
participated in 60 hours of pharmacology education
from an approved program; and met all the requirements
relating to administration and prescription of drugs,
vaccinations, hormones, and medical devices. The
prescription endorsement must be renewed every two
years. The bill mandates continuing medical education
of 35 hours bi-annually, 15 of which must be in
pharmacy education.
Prescribing authority will give flexibility to NDs to
provide necessary medical treatment to patients.
Prescription rights, which are already permitted for
advanced nurse practitioners, will allow access to a
range of commonly prescribed medicines that can be
used in correlation with naturopathic treatment to
improve patient care.
HB 282 will align the definition of a naturopathic
physician with the U.S. Department of Labor which
released a new definition of naturopathic physician to
include job titles of "Naturopathic Doctor, Physician,
and Doctor of Naturopathic Medicine." This is an
important step in recognizing NDs as qualified doctors
and primary care physicians.
Naturopathic doctors are highly trained medical
professionals. NDs attend a four-year post-graduate
professional naturopathic medical program and are
educated in the same basic sciences as conventional
medical students. Studies concentrate on holistic and
traditional approaches to therapy with a strong
emphasis on disease prevention and optimization of
wellness. Naturopathic doctors take similar rigorous
professional board exams for licensure and continue
educational training each year.
As Alaska continues to face shortages in the
healthcare professions, HB 282 provides an avenue to
help fill the gap of primary care physicians. This
bill will reasonably expand the services of
Naturopaths and follow the responsibilities set forth
by the board while providing the important services
for keeping Alaskans healthy.
3:39:46 PM
MS. KLOSTER referred to the section-by-section analysis of the
bill. She explained that Sections 1-3 would establish an Alaska
Naturopathic Medical Board under AS 08, and adds to the list of
boards under the purview of the Department of Commerce,
Community, & Economic Development (DCCED). Sections 4-5 would
amend Alaska statutes to require the board to review
qualifications for licensure. Section 6 would add a new section
to AS 08, which defines the scope and practice of Naturopathy.
Section 7 would amend the restrictions on the practice of
Naturopathy and allows a licensed ND to prescribe certain
medications and engage in minor surgery. This section also
would remove the restriction of a ND to use the title of
physician, which is tied to the federal definition, such as
Naturopathic physician.
MS. KLOSTER related that Section 8, which would add a new
section under AS 08 to establish a two-tier prescription
endorsement. A Type 1 endorsement would allow an ND to
prescribe non-controlled substances such as antibiotics.
Naturopaths would be required to practice for five years prior
to receiving a prescription endorsement and meet other
requirements before receiving this endorsement. To receive a
Type 2 endorsement, a ND must meet the requirements for a Type 1
endorsement and must also be registered with the Federal Drug
Enforcement Administration (DEA). The DEA monitors medical
practitioners who prescribe controlled prescription drugs. She
related that most NDs do not prescribe controlled substances
such as narcotics. She explained that Section 8 also includes
continuing Education requirements for Naturopaths.
3:42:00 PM
REPRESENTATIVE BUCH referred to Section 8 and asked whether this
bill would enhance the ability for NDs to practice beyond what
is currently allowed.
MS. KLOSTER answered yes. Currently, Naturopaths cannot
prescribe medications, she said.
REPRESENTATIVE BUCH referred to page 6, lines 9, and asked what
is included in Type I endorsement.
MS. KLOSTER explained that this provision would set up the
prescription endorsements. The proposed Naturopathic Medical
Board would regulate the prescriptions allowable. Thus, this
subsection would establish the first-tier designation for NDs to
prescribe non-controlled substances, which are non-addictive in
nature. She referred to lines 13-16, which would set up a Type
II endorsement. The proposed board would establish the
prescriptions Naturopaths could prescribe.
3:44:48 PM
MS. KLOSTER continued. Section 9 would instruct the proposed
board and DCCED to adopt regulations to implement AS 08.45.
Section 10 would add a new section to provide authority for the
DCCED to charge fees, such as for licensure, license renewal,
and prescription endorsement. Section 11 would add a definition
for board, which means the Alaska Naturopathic Medical Board.
Section 12, would amend the statutory definition of "practice of
medicine" to permit a practitioner of Naturopathy to use the
words "doctor of medicine" or "physician" if, and only if, the
designation contains the word "Naturopathy or Naturopathic". As
previously stated, this is to align the definition of a
Naturopathic doctor with the federal definition. Section 13
would add Naturopaths to the list of licensees. Sections 14-15,
would add Naturopathic services to reference the federal
Medicaid program. The fiscal note from the Department of Health
and Social Services reflects a one-time cost for upgrades to the
computer system to allow for federal reimbursement.
3:46:21 PM
MS. KLOSTER explained that Sections 16-20 would add provisions
for the DCCED and Alaska Naturopathic Board to proceed to adopt
regulations necessary to implement the changes made by this
bill.
3:47:20 PM
ASHLEY MAY, Doctor of Naturopathy, (ND), explained that he is
supportive of this bill. He said he has reviewed the letter
sent by the Alaska State Medical Association [March 1, 2010].
He did not agree with the allegation that Naturopaths (NDs) do
not have sufficient education and training. He related that
most Naturopathic students earn from 55 to 110 credits in
pharmacology classes, which does not include their additional
education and training in order to prescribe for pediatric and
geriatric patients. Additionally, Naturopathic students obtain
244 hours of botanical medicine and herb drug interaction course
work. With respect to minor surgery, he stated that
Naturopathic students receive from 50 to 66 hours of minor
surgery. Further, Naturopathic students have clinical shifts.
He related that his school had clinical shifts supervised by a
medical doctor. Naturopathic students must complete
competencies for minor surgery and must pass a minor surgery
test, which is included in national board examination. He
recalled most NDs scored exceptionally well on these
examinations. Most of the pharmacological classes are taught by
pharmacists or doctorate level teachers. Some are taught by
medical doctors. Naturopathic students graduate from federally-
funded and accredited Naturopathic Medical Schools. He offered
that he faces restrictions on his practice on a daily basis. He
explained that it is often necessary to refer patients to
medical doctors to prescribe antibiotics for strep throat, or
the removal of a cyst. This takes money from the patient since
they select a naturopathic doctor but must subsequently be
treated by a medical doctor.
3:50:14 PM
DR. MAY described an example of a patient he treated this
morning who had high blood pressure which indicated the need for
pharmaceutical treatment. He had to refer his patient to Urgent
Care to see a doctor or other medical person authorized to
prescribe, which points out how this limitation provides
disjointed care to ND patients. He would also like to volunteer
to go to villages to provide care and dispense vaccines, or
perform minor surgeries, in addition to providing botanicals,
herbs, and other supplements, but cannot do so. He restated
that NDs have limitations in scope of practice. He related that
most Naturopathic schools are similar in the education they
provide.
3:51:24 PM
REPRESENTATIVE BUCH asked whether Dr. May had reviewed letters
from the Alaska State Medical Association. He referred to an
ASMA letter of March 1, 2010 in opposition to the bill.
DR. MAY summarized his view that ASMA's concern was that
patients with serious disease would rely solely on treatments
provided by practitioners by Naturopathy ignoring the treatments
proven to be safe and effective by science-based medical
physician. He responded that NDs work closely with other
practitioners and refer out to physicians. He stated that NDs
do not solely rely on botanical or herbs and can distinguish
when the need for pharmaceuticals or minor surgery is indicated.
3:53:13 PM
DR. MAY related that the ASMA references a 1968 report which
indicated Naturopathic theory and practice was not based on the
body of basic knowledge related to health and disease. However,
this research was prior to the founding of most of the
Naturopathic schools. Thus, the information is outdated. The
ASMA asserts that naturopathic doctors have little or no
training to perform surgical procedures, which is not true, he
said. He restated the substantial hours of education and
training that most NDs complete. The same claim is made with
respect to pharmaceuticals. Prescribing drugs is not something
that NDs normally perform, but as primary care physicians, NDs
should have the ability to prescribe and are handicapped without
it.
3:54:33 PM
REPRESENTATIVE BUCH asked for comparison of credentials for
naturopathic doctors compared to medical doctors. He asked for
similarities and differences in education and training.
DR. MAY again referred to the ASMA letter, which states that
Naturopaths do not have a Bachelor's degree. This is not true.
He related that during the first two years of medical school the
course work for NDs and medical students is nearly identical.
The Naturopathic student's course work includes classes such as
anatomy, physiology, and pathology. However, in the last two
years Naturopathic students learn botanical, nutrient therapy,
and homeopathy. Naturopaths have approximately 1,000 more hours
of classroom time than a conventional medical school. The
difference in training begins during the last two years of
medical school since medical students primarily perform clinical
work, including clinical rotations and specialties. However,
naturopathic students are not generally required to perform a
residency although some states require residencies. He surmised
that the lack of residencies and limited opportunities available
for them is due to the growing number of naturopathic graduates.
3:57:35 PM
REPRESENTATIVE BUCH asked about improving the scope to prescribe
contained in HB 282. He asked Dr. May to identify the
differences.
DR. MAY explained that currently, NDs cannot prescribe any
pharmaceutical drugs. This bill would allow NDs to prescribe
certain controlled substances based on the proposed ND board's
recommendations. He offered his belief that NDs do not want to
prescribe cancer drugs and many other drugs, but NDs would like
the ability to prescribe medications such as antibiotics or
thyroid medications, which would be especially helpful for those
engaged in primary care practices. He pointed out that he faces
this limitation on a daily basis and his patients must
subsequently see a medical doctor to seek routine prescriptions.
The effect is that the patients are charged fees twice: once
for the naturopathic doctor's visit and once for the medical
doctor's visit.
3:59:33 PM
REPRESENTATIVE BUCH related that the proposed ND board would be
comprised of Naturopaths to oversee Naturopaths. He asked for
comments on the composition of the proposed board.
DR. MAY thought a broad composition would be best. He recalled
that HB 282 outlines the board composition to include three NDs,
one licensed pharmacist, and one public member. He also thought
having a medical doctor on the board would be beneficial. He
offered that NDs need some prescribing authority, and achieving
a broad perspective and balance on the proposed Naturopathic
Medical Board would be helpful to determine the appropriate
prescribing allowable.
4:00:30 PM
DR. MAY, in response to Chair Olson, related currently
approximately 20-25 Naturopaths practice in Alaska. He recalled
conversations with colleagues in other states who would move to
Alaska as primary care naturopathic doctors, but the lack of
prescription and minor surgery keeps the numbers lower. He
predicted that passage of HB 282 would encourage other
naturopathic doctors to practice in Alaska.
CHAIR OLSON referred to page two of a letter in members' packets
from the medical community. He said, "Only 20 states currently
license Naturopaths. Many of these states do not permit
Naturopaths to prescribe controlled substances or perform
surgeries." He asked how many states currently allow those
activities.
DR. MAY answered that he did not know. He offered that
Washington State, where he attended school, and Arizona do allow
for an expanded scope of practice. The problem is the lack of
communication on the education level of Naturopaths. He stated
that some NDs do not prescribe pharmaceuticals and have not
"pushed for this." He characterized the process as molding this
traditional medicine into conventional medicine and the need for
convergence of the two types of medicine is becoming more
evident.
4:02:46 PM
CHAIR OLSON remarked that other medical professions have weighed
in heavily with opposition, including the American Osteopathic
Association and several physicians' associations. He expressed
surprise at so much opposition with so few Naturopaths
practicing in the state.
DR. MAY suggested that many other practitioners do not
understand the practice of Naturopathy or do not have knowledge
of the level of education of Naturopaths. Thus, professionals
may fear what the NDs can or cannot do. He surmised that 30
years ago the same arguments applied to Osteopathic physicians.
4:03:55 PM
REPRESENTATIVE LYNN asked whether Dr. May is comfortable with a
medical doctor or osteopath serving on the proposed Naturopathic
Medical Board.
DR. MAY answered yes. He related that he does not want this
debate to be an "us" against "them" situation. He said he works
with MDs and Osteopathic doctors in Fairbanks. He characterized
his working relationship with MDs as a good working
relationship, offering that they refer clients to one another.
He expressed an interest in working together on this issue to
benefit Alaskans.
4:04:57 PM
REPRESENTATIVE NEUMAN asked whether he would like to become a
primary care physician or if he currently considers himself one.
DR. MAY responded that he considers himself a primary care
physician.
4:05:35 PM
REPRESENTATIVE NEUMAN asked Dr. May to evaluate whether he has
enough education and experience to evaluate all health
experiences.
DR. MAY answered that he is confident and competent as a primary
care physician.
REPRESENTATIVE NEUMAN asked if Dr. May thought he should be able
to prescribe class I and class II prescription medications. He
disclosed that his wife is a pharmacist. He then recalled
several discussions he held with physicians and pharmacists, who
expressed concerns that NDs do not have the practical and hands-
on experience of mixing drugs and solutions and how the body
reacts to different chemicals. He remarked that nurse
practitioners can do so because they spend a considerable amount
of time alongside doctors. However, under this bill NDs would
take on the responsibilities as a primary role, which is similar
to the MD's current practice. He asked whether Dr. May feels he
has the ability to make the calls.
4:07:04 PM
DR. MAY answered that he does. He stated NDs need the expanded
role. He related that he works with a nurse practitioner and
they have held many discussions on prescribing. He believes the
process is quite similar. Additionally, NDs are trained in
drug, herb, and supplement interactions. He suggested that 66
percent of the general population takes some type of supplement
or herb, but often do not mention it to their medical doctor.
However, the supplements, herbs, drugs, and nutrients can have
significant interactions. He pointed out that he would heed the
advice of pharmacists. He noted that in 2003, a study was
released by the Nutrition Institute of America that showed the
total deaths from properly prescribed pharmaceuticals totaled
783,000, which is the number one cause of death in the U.S. He
noted that figure is higher than the number of people who died
from heart disease or cancer. He remarked that NDs hold a one-
hour long initial consultation with patients, which allows him
to get to know his patients. He can consider interactions with
herbs, supplements, and drugs. He compared that to the average
seven-minute visit with medical doctors. He did not wish to
criticize medical doctors, but would like to illustrate that NDs
spend considerable time with their patients. The reason for
this is that NDs believe it is a better way to provide adequate
care to their patients.
4:10:06 PM
REPRESENTATIVE NEUMAN affirmed that he consulted three different
pharmacists who expressed concerns about allowing Naturopaths to
prescribe due to the reactions to solutions and drugs.
4:10:32 PM
CHAIR OLSON asked about the limited liability insurance for
malpractice that NDs carry.
DR. MAY offered his belief that the minimum amount of
malpractice insurance that NDs carry is $1 - 3 million. He
remarked that NDs are required to carry malpractice insurance.
In further response to Chair Olson, he did not believe any
problem would exist with adding the drug endorsement. He did
think it would impact the cost of medical malpractice, but he
thinks the cost would be warranted.
4:11:25 PM
EMILY KANE, Naturopathic Doctor (ND), stated that she has
practiced for 16 years as a naturopathic doctor in Juneau. She
stated she graduated from an Ivy League college in 1978, and
decided to attend medical school at age 30. She related that
she stretched out a four-year program to six years to include
specialty training. She attended Bastyr University in Seattle,
graduating in 1992, the Naturopathic and Acupuncture/Oriental
Medicine program. She describe Bastyr University as probably
the preeminent university in North America, although she
mentioned that all six North American schools' were cited in the
Princeton review of medical schools as being some of the top
medical schools in the country. Thus, all six schools doctorate
programs were cited for excellence. The Naturopaths undergo a
preceptorship, which is similar to a residency. She divided her
time between Arizona, West Virginia, and China. She related she
selected China for her residency since not many opportunities
existed for hospital residencies. She explained that currently
all the Naturopathic training schools are located in major
cities and are connected to hospitals. She offered that Bastyr
University participates in a program at the University of
Washington which allows medical students to learn at Bastyr
University about Naturopathy, and naturopathic students attend
UW for residency work.
4:13:52 PM
DR. KANE explained her experience in China exposed her to many
diseases, including pulmonary and obstructive diseases. Now all
new graduates, such as Dr. May, as a recent graduate must weigh
whether to continue to practice in Alaska due to the limited
scope of practice. She pointed out several errors in the ASMA
letter addressed to Governor Parnell. Only 15 states license
naturopathic doctors, of which 9 allow prescription endorsement
and minor surgery. Alaska is the only state which licenses NDs
that do not allow them to have a self-governing board. She said
that this bill specifically identifies the composition of the
board consisting of three naturopathic doctors, one pharmacist,
and one public member who may be a medical doctor (MD). She
stated that the NDS did not want to force doctors to serve on
their proposed board. She commented that she has had hospital
privileges for many years. Some medical doctors are vocal in
their opposition. However, a well-oiled scope of practice
partnership (SOPP) effort was begun by the AMA in 2006. She
explained that NDs are one of the 10 targeted mid-level medical
professionals. She characterized this as an unfortunate turf
war. She opined that a small number of medical colleagues are
"waging this turf war." She offered her belief that she works
well with the medical community. She said, "We refer patients
to each other. They completely understand my level of
intelligence around human physiology, anatomy, and diagnostic
skills. And that I refer when appropriate. They appreciate my
referrals and we work very well together."
4:16:54 PM
DR. KANE pointed out that what interferes with her practice is
that she cannot treat patients the way she is trained to treat
them. She described several issues which arose with her
patients, including one in which a woman who had lost
significant weight, and during a routine visit, she determined
her patient's blood pressure was very high. She recommended her
patient see the nurse practitioner, but she would have liked to
have prescribed drugs at the time. She related that her
patients have chosen her as their primary health care provider
and she would like to be able to treat them since she has the
education, training, and experience to do so.
4:21:32 PM
DR. KANE stated that she helps her patients understand their
health and encourages working as a team. She referred to
several letters from pharmacists and the Board of Pharmacy, who
have written in support of the bill. Some pharmacists may not
be accustomed to working with NDs. Until a few years ago, NDs
had access by regulation to some prescription natural
substances. Some natural substances are presented in
pharmaceutical dosage and since the statute superseded the
regulations, the NDs could no longer prescribe some
pharmaceuticals. She related a number of pharmacists have
worked with NDs, while others do not have the familiarity.
4:23:47 PM
DR. KANE said she often received referrals for bio-identical
hormone prescription, which she can no longer prescribe, but
works with precursors to the hormone. She would like to have
the ability to prescribe when patients need stronger support of
the bio-identical hormone. She said, "I'm never going to reach
for the prescription pad first unless that's clearly the most
indicated. So my therapeutics will remain less potentially
dangerous." She related that she pays $800 per year for
malpractice insurance. The rates are low because few problems
happen with naturopathic physicians. She explained that in
Oregon, Naturopaths have had prescription endorsement for 50
years, 20 years in Arizona, and 30 years in Washington State,
which is a long track record.
4:25:30 PM
DR. KANE explained that most NDs do not use pharmaceuticals.
She remarked some patients often see multiple doctors, who are
not always aware of the prescriptions other medical providers
have prescribed. Thus, case management is an important
component of her job. She referred to a recent letter from the
pharmacists' association that relates they support the
establishment of the Alaska Naturopathic Medical Board with the
purpose of regulation of the practice of naturopathic doctors in
Alaska. She related the concept of a two-tier prescription
provision came from a bill introduced in the Senate about four
years ago. The idea was to have prescription endorsement
including a federal Drug Enforcement Agency (DEA) number. She
commented that NDs are already set up to participate with the
DEA, but she does not request a number since it is only
necessary when prescribing schedule I-V drugs. Schedule VI
drugs are for antibiotics and anti-hypertensive diuretics, while
Schedule VII drugs are over the counter drugs. The way the
schedule was developed the smaller the number the more dangerous
the drugs, in terms of addiction and abuse. She suggested that
NDs only need Schedule VI drugs. However, if the legislature
would feel more comfortable with federal oversight by the DEA,
she believed that would be acceptable, as well. She offered her
belief that her colleagues, the medical doctors, and physicians
would likely be opposed to prohibit NDs from having access to
all the drugs. She pointed out that some NDs specialize in
oncology and one practices in Anchorage. She explained that his
practice also includes a nurse practitioner, who has the ability
to prescribe. However, while she has some cancer patients, she
co-manages and helps them offset the side effects of
chemotherapy. She said she wants to present a picture that the
NDs are not trying to use substances they do not know how to
use. NDs have deep and thorough training in pharmacology and
pharmacology interaction, the interaction with nutrients,
supplements, and over the counter herbs. She remarked that NDs
are the only level of medical practitioners specifically trained
in supplement, nutrient, and herb interaction with
pharmaceuticals.
4:29:52 PM
REPRESENTATIVE BUCH asked for her title.
DR. KANE answered that she is a Naturopathic Doctor (ND) and a
licensed acupuncturist (LAC). In further response to
Representative Buch, she related that she is referred to as
"Doctor."
4:30:28 PM
REPRESENTATIVE BUCH referred to page 6 and to the prescription
drug types, type I and type II schedules, referenced in that
provision of the bill.
DR. KANE explained the two-tier designation for NDs in the bill.
She explained this is a tier developed in this bill as a point
of negotiation. Thus, Tier I would not require a federal DEA,
or federal oversight so Naturopaths could not prescribe Schedule
I - V drugs. Some nurse practitioners have a federal number,
while others do not want "drug hounds" calling them at home.
The second type, Tier II, would refer to Naturopaths that choose
not to have a DEA number, and only have access to Schedule 6
drugs, or Schedule VII drugs, which are over the counter drugs.
4:33:43 PM
REPRESENTATIVE BUCH asked about the effective date of the bill,
which is two parts, with most sections effective on July 1,
2010. According to this bill, the state would improve the scope
of medications, but will authorize more types of surgeries, and
another section creates a proposed Naturopathic Medical Board
(NMB). He related that the enhancements would go into effect
prior to the NMB being established.
DR. KANE thinks the language should be clarified, that it would
not be appropriate for NDs to have an expanded scope without a
NMB board. She offered her belief that the purpose of the NMB
is to provide ongoing appropriate opportunities for the
professionals who would fall under the purview of the proposed
NM board. Currently NDs have a national organization that gives
them continuing education opportunities. The DCCED's Division
of Corporations, Business, and Professional Licensing, as an
agency, currently does not have the ability to provide
continuing educational opportunities. The other reason is to be
certain professionals are not going beyond their scope of
practice. She suggested that the NMB would oversee the
professionals.
4:35:41 PM
REPRESENTATIVE LYNN stated that he is fortunate to be covered by
three types of insurance: state, Medicare, and military. He
asked if his health insurance would cover her services.
DR. KANE related that he could only use his Alaska Care, which
has recognized Naturopathy since 1986. Medicare is a federal
decision and NDs are working to have this addressed at the
federal level. TRICARE is a component of the government and is
linked to federal funding for military health care.
4:37:04 PM
REPRESENTATIVE LYNN asked for the typical annual income.
DR. KANE was unsure. She speculated that the specialty doctor
would likely earn a lot more than a general practitioner, who
probably earns on average about $250,000 per year and an average
ND would earn from $50,000 - $60,000 per year.
4:38:12 PM
DR. KANE, in response to Representative Lynn, stated she sees
about eight patients on a busy day, but more typically would see
five to six patients per day.
4:38:43 PM
CHAIR OLSON asked what types of minor surgery would be
contemplated.
DR. KANE related that the minor surgeries would cover items such
as wart removal for pathology reports, skin tags, and sutures.
She related that she specializes in women's health care and
sometimes an endometrial biopsy is necessary. The types of
surgeries contemplated would not be anything in a body cavity or
the eyes, and is typically limited to growths.
4:40:14 PM
DAVID OTTOSON, Juneau, Alaska, explained that he and his family
uses Naturopaths. He has seen a number of Naturopaths for
numerous ailments, including sinus infections, earaches, urinary
tract infections, and insomnia. He has found all the
Naturopaths he has seen to be highly professional and competent.
He has been very satisfied with the quality of care he has
received. He said, "To me, it is amazing that this is
controversial, this legislation at all, because what the
Naturopathic community is looking at is just an expansion of the
scope of practice, in accordance with what they are trained to
do." They may wish to prescribe an antibiotic for an earache,
which made sense to him. He asked the reason he should go to
another doctor or nurse practitioner if my child has an ear
infection. It is not cost effective to see a second physician.
This idea that somehow Naturopaths will work outside their area
of competence is totally at odds with his experience. He
related his own experience of five years ago when he returned
from Africa and was sick. He initially did not think it was
serious, but he contracted chills and a fever.
4:43:38 PM
MR. OTTOSON continued to relate his personal experience with Dr.
Kane. He said that she stopped by his house, remarking that
house calls are something NDs will perform. She drew a blood
sample and had it tested. She discovered he had malaria and
sent him to the hospital for treatment since it was beyond her
experience. The Bartlett Regional Hospital in Juneau could not
treat him as the drugs were not available in Juneau. He was
Medivaced to Seattle. The type of malaria he had contracted is
often fatal, so he was very fortunate to be treated by expert on
malaria at the University of Washington facility. He emphasized
from his experiences that he has found that Naturopaths will
refer something they are not qualified to treat; they know their
limitations. He has found NDs work with people to improve their
own health. He suggested that society needs to move to a system
in which people take responsibility for their own health to
control health care costs. Some people need to be encouraged
and helping people is one thing NDs do best. He offered his
belief that Naturopaths represent the medicine of the future.
He urged members to support HB 282.
4:46:34 PM
REPRESENTATIVE BUCH stated he appreciated Mr. Ottoson's personal
testimony. He explained that legislators need to be assured
that there are not unintended consequences, but he supports the
concept.
4:47:51 PM
CHAIR OLSON related that the ramifications are more serious with
medical issues.
[HB 282 was held over.]
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB282 Letter Dr Emily Kane 3-3-10.pdf |
HL&C 3/10/2010 3:15:00 PM |
HB 282 |
| HB282 USDOL Definition of Naturopathic Physician.pdf |
HL&C 3/10/2010 3:15:00 PM |
HB 282 |
| HB282 Comparison of Naturopathic and Major Medical Schools.pdf |
HL&C 3/10/2010 3:15:00 PM |
HB 282 |
| HB282 ND Curriculum Book List.pdf |
HL&C 3/10/2010 3:15:00 PM |
HB 282 |
| HB282 Letter DCCED 3-1-10.pdf |
HL&C 3/10/2010 3:15:00 PM |
HB 282 |
| HB282 AANP AMA summary Statement.pdf |
HL&C 3/10/2010 3:15:00 PM |
HB 282 |
| HB282 Letter AOA 3-8-10.pdf |
HL&C 3/10/2010 3:15:00 PM |
HB 282 |
| HB282 AANP AMA Summary Statement (2).pdf |
HL&C 3/10/2010 3:15:00 PM |
HB 282 |
| HB282 Email from Suzette Mailloux 2-12-10.pdf |
HL&C 3/10/2010 3:15:00 PM |
HB 282 |
| HB282 Email Jessica McCord 3-9-10.pdf |
HL&C 3/10/2010 3:15:00 PM |
HB 282 |
| HB282 Letter AANP Karen Howard 3-9-10.pdf |
HL&C 3/10/2010 3:15:00 PM |
HB 282 |
| HB282 Letter Wayne Aderhold 3-10-10.pdf |
HL&C 3/10/2010 3:15:00 PM |
HB 282 |