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A Guide to Naturopathic Doctors and Their Practice


A naturopathic doctor (ND) is a medical professional who practices naturopathic medicine.

Naturopathic medicine is an alternative medicine approach that emphasizes the use of natural medicine and a “whole person” approach to preventing, diagnosing and treating health problems.

NDs primarily focus on addressing the underlying causes of illness and disease – rather than treating the symptoms alone – to help promote the well-being of the body and mind as a whole.

All naturopathic doctors respect the six principles of naturopathic medicine. These are:

  • First, do no harm. NDs focus on using medications, procedures, and other treatment approaches that are as minimally invasive as possible. However, in cases where natural treatment methods are not effective, an ND may refer for additional care.
  • The healing power of nature. Naturopathic medicine emphasizes the healing power of the natural world as well as the body’s ability to heal. NDs help the patient use this power by helping to create a healthy environment, both internally and externally.
  • Identify and treat the causes. NDs work to identify the physiological, biochemical, structural, and psychospiritual contributor underlying the symptoms. By addressing the underlying root cause, naturopathic medicine aims to treat the cause of the symptoms rather than improving the symptoms.
  • Doctor as teacher. NDs function not only as practitioners of natural medicine, but also as teachers for their patients. As part of their practice, NDs teach patients everything they need to know to take care of their bodies.
  • Treat the person as a whole. Naturopathy emphasizes the idea that there are multiple factors – physical, mental, genetic, environmental, etc. – which have an impact on health. During treatment, NDs focus on all of these factors, rather than just one.
  • Prevention. While NDs diagnose and treat health issues, the primary focus of naturopathic medicine is the prevention of disease and illness.

Using the six principles of naturopathic medicine, NDs aim to help patients recover from acute and chronic health conditions while using the most natural and minimally invasive approaches possible.

NDs begin the journey to licensure with a 4-year doctoral program and must follow the following path to licensure:

  • Education. Licensure for a Naturopathic Doctor (ND) or Doctor of Naturopathic Medicine (NMD) includes a 4-year doctoral program from an accredited naturopathic medical school. According to the Council on Naturopathic Medical Education (CNME), there are nine programs in the United States that currently qualify graduates for licensure.
  • Exam. After completing an accredited 4-year program, NDs must pass the Naturopathic Physician Licensing Examination (NPLEX). During the NPLEX, candidates are tested on a variety of topics, including biomedical topics and medical diagnoses, treatment modalities, and interventions.

Once an ND has obtained their license, they must continue to follow all state guidelines for naturopathy while practicing medicine. Although requirements vary from state to state, they generally include meeting annual continuing education requirements and adhering to that specific state’s scope of practice.

Physicians begin their journey by passing an exam called MCAT, which grants them admission to medical school. After passing the MCAT, students must complete a 4-year doctoral program before being accepted into a residency program.

Residency training can last from 3 to 7 years, depending on the program and specialty. The student can then take an exam to become a state-licensed, board-certified Doctor of Medicine (MD).

A physician can become a holistic physician by specializing in holistic medicine, which is a type of alternative medicine that focuses on promoting wellness of mind, body, and soul. Unlike naturopathic medicine, holistic medicine is not a separate branch of medicine. Instead, it’s an approach to medicine that uses both conventional medicine and alternative medicine.

Although naturopathic medicine has been practiced as a form of alternative medicine since the early 1900s, people still question the legitimacy of NDs.

Regulations vary around the world, but in the United States, licensed naturopathic physicians are true medical professionals who can provide many of the same services as physicians.

In the healthcare world, many NDs choose to go into private practice. But many also work alongside other healthcare professionals in a variety of healthcare settingsincluding:

  • hospitals
  • clinics
  • health centers
  • the universities
  • other private care facilities

In the United States, there are strict regulations surrounding the practice of naturopathic medicine. Although anyone can go to school to become an ND, not all states allow naturopathic physicians to practice medicine.

As of 2022, NDs can obtain a license to practice in only 22 states:

  • Alaska
  • Arizona
  • California
  • Colorado
  • Connecticut
  • Hawaii
  • Idaho
  • Kansas
  • Maine
  • Maryland
  • Massachusetts
  • Minnesota
  • Montana
  • New Hampshire
  • New Mexico
  • North Dakota
  • Oregon
  • Pennsylvania
  • Rhode Island
  • Utah
  • Vermont
  • Washington

In addition to the states listed above, three jurisdictions in the United States offer naturopathic licenses:

  • District of Colombia
  • Porto Rico
  • US Virgin Islands

In other jurisdictions in the United States that do not license naturopathic physicians, there are three states in which it is actually illegal for anyone to practice naturopathic medicine:

  • Florida
  • Caroline from the south
  • Tennessee

Whether an ND is covered by insurance depends entirely on the type of insurance plan you have.

In most cases, NDs are not covered by insurance. Some plans even specifically exclude NDs from their coverage. However, some of the services that NDs can provide may be covered by some insurance plans.

As for Medicare, it does not cover services provided by NDs. In fact, Original Medicare will only cover the services of a Doctor of Medicine (MD), Doctor of Osteopathic Medicine (DO), or other specialist, such as:

  • assistant doctor
  • nurse practitioner
  • clinical social worker
  • podiatrist
  • chiropractor
  • physiotherapist or occupational therapist
  • Oral language pathologist
  • clinical psychologist
  • dentist or optometrist, depending on your plan

If you live in a state that allows licensed NDs to practice, you can consult your insurance plan’s coverage and benefits booklet for information about coverage for this type of care.

NDs can treat a wide range of health conditions, including acute and chronic illnesses.

According to a 2020 survey by the Association of Accredited Naturopathic Medical Colleges (AANMC), the most common conditions treated by practicing NDs include:

Most NDs focus on the most common health issues listed above. But some NDs also specialize in other areas of health, such as men’s health, autoimmune diseases, and oncology.

A licensed naturopathic physician can prevent, treat, and diagnose a wide variety of acute and chronic health conditions, including many of the conditions listed above.

But, like the types of diagnoses a doctor can make, many health conditions require the intervention of a specialist for an accurate diagnosis.

If an ND is unable to accurately diagnose a specific health condition, a referral may be made to an outside specialist for additional diagnostic testing and an official diagnosis.

Although there are 25 jurisdictions that allow licensed naturopathic physicians to practice medicine, only the following 13 states allow NDs to order lab tests for patients:

  • California
  • Colorado
  • Idaho
  • Massachusetts
  • Maryland
  • Maine
  • Minnesota
  • Montana
  • North Dakota
  • New Hampshire
  • New Mexico
  • Utah
  • Vermont

Outside of these states, NDs are not permitted to order lab tests for patients. Instead, the patient can be referred for any lab tests they may need.

Many states that allow licensed naturopathic doctors to practice medicine also allow those doctors to prescribe drugs — with restrictions.

Under most national regulations, NDs are not permitted to prescribe controlled substances or substances highly controlled by government regulations due to their potential for misuse. However, in New Hampshire, New Mexico, and Washington, an exception is made for certain controlled drugs based on specific ingredients.

Naturopathic doctors are only licensed to practice in the 25 jurisdictions listed above.

If you live in the United States and reside in one of the places mentioned above, one of the best ways to find a list of licensed NDs in your area is to use the American Association search tool. of Naturopathic Physician. With this tool, you can search for licensed NDs using a variety of parameters, including practice direction, treatment modalities, and insurance.

It is important to remember that some people may call themselves naturopaths or naturopathic physicians without ever being licensed. If you live in a state that allows NDs to be licensed, be sure to check your ND credentials to confirm that they have met all licensing requirements.

If you are wondering if an ND is right for you, it might be helpful to determine what your treatment goals are and, in turn, this can help you determine how naturopathic medicine might benefit you.

In many cases, naturopathic medicine is more beneficial for people who appreciate a more natural, less invasive approach to the prevention and treatment of chronic disease. This can be especially helpful for those with multiple health conditions because often these conditions are linked in ways that an ND can recognize and treat.

However, even outside of using naturopathic medicine as a primary approach, many people with chronic conditions can also benefit from having a naturopathic doctor as part of their healthcare team. And in some cases, an ND may already be part of your team. In fact, in 2018, there were 28 medical centers in the United States that employed one or more naturopathic physicians.

Naturopathic medicine is a branch of medicine that focuses on using a whole-body approach to prevent, diagnose, and treat medical conditions.

Although naturopathic medicine is banned in more than half of the United States, there are still 25 jurisdictions that allow licensed naturopathic physicians to practice medicine.

If you want to learn more about other types of alternative medicine, check out our Healthline Natural hub or the Natural Medicine Journal.