Scope of Practice: What Naturopathic Doctors and Unlicensed Naturopaths May and May Not Do

Urgent first

Chest pain, signs of a stroke, a severe allergic reaction, trouble breathing, thoughts of suicide or any sudden serious symptom need emergency care, not an appointment with any kind of practitioner. In the US call 911 (or 988 for the Suicide and Crisis Lifeline). This page is general information about who may do what under the law. It does not replace care from a doctor, and no title on this page implies that naturopathic care replaces medical care.

What "scope of practice" means

A scope of practice is the list of things a practitioner is allowed to do. In the US there is no single national system: the National Center for Complementary and Integrative Health (NCCIH) says states decide what credentials practitioners need, and that requirements vary widely from state to state and discipline to discipline. [1]

Three words are often mixed up. NCCIH describes licensure (a government requires it to provide a service), title licensure (a credential is needed to use a title) and registration (a practitioner files details of training and experience with a state agency). [1] These are different legal tools, so "regulated" can mean different things in different places.

Licensed naturopathic doctors and unlicensed naturopaths, side by side

NCCIH describes the groups this way for the United States. It also notes that other providers, such as chiropractors and physicians, may offer some care that overlaps with naturopathy. [2] This table states only what the sources say about training, regulation and scope. It does not rank anyone.

The profession's own accrediting and school bodies describe the picture this way: the CNME is recognized by the US Department of Education to accredit doctoral programs in naturopathic medicine, [4] and only graduates of CNME-accredited schools are eligible to obtain licensure or sit the NPLEX/CONO licensing exams. [3] The same school association says both scope and regulatory status vary from state to state and province to province. [3]

Where licensing exists, and where it does not

NCCIH's credentialing page says only 17 states and the District of Columbia license naturopathic physicians. [1] That count comes from one page and can change as laws change, so check the current rule in your own state. For a state-by-state view see naturopathic doctor licensing in the United States. For other countries see naturopathic regulation in Canada, the UK, Australia and elsewhere.

What happens to people who use the title in a state with no licensing law is not described in the sources we read, so we do not state it. Ask your state health department or licensing board.

What two state laws actually say

Because scope is set state by state, the wording of the law is the best guide. Two examples, both read on the legislature or statute pages:

• Washington. The law says naturopathic medicine includes "minor office procedures, homeopathy, naturopathic medicines, hygiene and immunization, contraceptive devices, common diagnostic procedures". [5] The same sentence excludes "the treatment of malignancies" (cancers) from that list of prescribed, administered or dispensed items. [5]
• Oregon. The statute defines "minor surgery" as including repair of "superficial lacerations and abrasions", [6] and defines a naturopathic physician as a person who holds a Doctor of Naturopathic Medicine degree and is licensed under the chapter. [6] We read only the definitions section, not the rules on prescribing, so we do not summarize prescribing authority.

These are two examples, not a national rule. Other states differ, and laws change.

What a license does and does not tell you

In the US, government agencies grant and monitor licenses, while professional organizations certify practitioners. [1] NCCIH adds that being licensed or certified is not always a guarantee of being qualified, [1] and that regulations, licenses or certificates do not guarantee safe, effective treatment from any health care provider, conventional or complementary. [2]

Limits worth knowing

• Cancer. In a study of 281 people with cancers that had not spread, choosing alternative medicine as the only cancer treatment was associated with a greater risk of death than conventional treatment. [7] Do not use any practitioner in place of cancer treatment. See naturopathic and integrative care in cancer.
• Vaccines. Get vaccine information from health authorities such as the CDC and WHO, and see vaccines and naturopathic care.
• Medicines. Never stop or change a prescribed medicine because of any practitioner's advice without talking to the prescriber.

How to check scope before you book

• Ask which license, if any, the person holds, and in which state or province.
• Look the license up with the licensing agency (see how to verify a credential).
• Ask what they are allowed to diagnose, order or prescribe where they practice.
• Ask whether they will share records with your own doctor.

Pregnant people, children, older adults, people with cancer, kidney or liver disease, and people taking several medicines or blood thinners should check with their own clinician before starting any new treatment.

Related reading

Credentials, titles and scope of practice is the overview, and ND, MD, DO, NP and PA: what each credential means compares training and licensing in parallel.