FAIRBANKS — Whether naturopathic doctors should have the authority to prescribe medicine is at the heart of a new Alaska Supreme Court decision and two bills in the state Legislature.
The state’s highest court said, “No,” in an opinion issued Friday in a lawsuit brought by the Fairbanks-based Alaska Association of Naturopathic Physicians. Two bills that would allow naturopathic doctors prescription privileges are pending.
Naturopathic doctors want to be able to vaccinate patients, provide them with vitamin shots, help wean them off of medications and treat people for some illnesses without having to refer them to medical doctors, according to the court opinion and interviews with naturopathic doctors.
Some medical doctors oppose this. They are concerned about improper treatment by providers with less training than physicians. Nurse practitioners, physician assistants and other medical providers with less training than medical doctors are allowed to prescribe drugs, however, and naturopathic doctors feel marginalized.
“In Alaska, we have some of the highest heath care costs in the country and real high rates of chronic preventable diseases,” said Abby Laing, president of the Alaska Association of Naturopathic Physicians. “We all just want to see people get healthy and get well.”
Fairbanks physician Peter Lawrason is president of the Alaska State Medical Association, which opposes expanding naturopaths’ scope of practice.
“The trouble is, a lot of the groups that want expansion of privileges are not necessarily, in our view anyways, trained for that,” he said.
The issue came to a head with conflicting interpretations of state regulations. Naturopaths were administering treatments such as vitamin B-12 shots, which require a prescription. Some pharmacists refused to fill prescriptions for naturopaths. State investigations were launched of naturopaths who used prescription medicines and of the pharmacists who were the providers, according to the Supreme Court opinion.
The state Division of Corporations, Business and Professional Licensing clarified the rules, stating that naturopaths couldn’t write prescriptions and give vitamin shots. The Alaska Association of Naturopathic Physicians sued, and the case ended up at the state’s high court.
In its decision, the Supreme Court upheld a lower court ruling that the Legislature did not intend to provide prescribing privileges when it set up the licensing structure for naturopaths.
“The bill-drafting process shows the Legislature gradually winnowed the substances for which naturopaths could write prescriptions from some natural substances, to fewer natural substances, to an unconditional ban on prescription drugs,” the opinion stated.
Naturopaths argue that Alaska law is behind the times and needs to be updated. Naturopaths in Alaska face more restrictions than in other states, according to Suzette Mailloux, a naturopathic doctor in Fairbanks.
“We can order lab work and do exams, but we have to refer when people need medications or minor office procedures — stitches or a biopsy,” she said.
Naturopaths have more training than physician assistants and nurse practitioners, yet they have a more limited scope of practice, she said.
Mailloux said the restrictions are driving naturopaths out of Alaska. The state has roughly 50 naturopathic doctors, according to the Alaska Association of Naturopathic Physicians.
House Bill 326 and Senate Bill 120 would expand the privileges of naturopathic doctors.
“A lot of naturopaths coming out of college, they are not interested in practicing here. It just looks like Alaska does not trust them,” said Jane Conway, chief of staff for Sen. Cathy Giessel, R-Anchorage, sponsor of the Senate bill.
No action has been taken on the Senate bill since it was referred to committees. Testimony was taken last week on the House bill, which drew overwhelming support with the exception of the state medical association.
Lawrason said in a letter to the House Labor and Commerce Committee that the best interest of patients is the association’s primary concern, even over workforce shortages.
“We feel that if you are going to be prescribing medications, you need more training than most of the naturopaths have,” he said.
Contact staff writer Amanda Bohman at 459-7587. Follow her on Twitter: @FDNMborough.