After over 60 years, Florida is moving to once again license “naturopathic doctors.” It’s a move critics warn will permit the use of unproven and potentially dangerous treatments, but supporters say could help alleviate the state’s worsening doctor shortage and give patients a choice about their care.
“Naturopathy” was developed in the 19th century as a philosophy of treating disease through natural therapies. The holistic approach to healthcare focuses on working with a patient mentally, spiritually and physically, through using food, herb therapy, psychotherapy, electrotherapy, physiotherapy, minor surgery and other methods.
The bill, which has been passed by the Legislature but not yet sent to Gov. Ron DeSantis, creates a state board of Naturopathic Medicine to assist the Department of Health in overseeing naturopathic doctors in the state. It prohibits naturopathic physicians from prescribing drugs, performing surgery, and using anesthesia. Administering chiropractic care and acupuncture are also barred under the bill, unless the naturopathic doctor is also licensed in those fields.
Lawmakers in support of relicensing believe it gives people alternative options for healthcare and can also help combat the physician shortage in Florida, one of the worst in the country.
“In a state with a severe shortage of healthcare providers, Floridians are asking for choices and availability,” said state Sen. Colleen Burton, R-Winter Haven, in a Senate Fiscal Policy committee meeting earlier this year. “This isn’t a mandate that Floridians seek the care of a naturopath, but gives them an alternative.”
Opponents argue naturopathy is not supported by science.
Jann Bellamy said there is a lack of medical literature backing naturopathic care. He is a Tallahassee attorney who has been writing about the licensure of alternative medicine providers for 20 years and who testified about the bill before the Senate Fiscal Policy Committee.
“The bill permits the use of homeopathic remedies, and not one of which has ever received FDA approval, the safety and effectiveness required by federal law,” Bellamy told state lawmakers. “Naturopathic doctors would have a broad authority to diagnose and treat any disease with largely unproven remedies, inadequate education and training, and no insurance coverage.”
Florida recognized naturopaths in the Medical Act of 1921, and the state first licensed them to practice in 1927. The legislature abolished naturopathic licensing in 1959, and only naturopathic practitioners who had been licensed for two years at the time could renew their licenses.
There are currently no licensed naturopathic physicians in Florida, as the last licensed naturopathic doctor, Dr. Robert Geldner, died in 2010. Twenty-four states currently allow the licensing of naturopaths, including California, Massachusetts and Pennsylvania.
Naturopathic schools are four-year programs that are accredited through the Council on Naturopathic Medical Education, the only naturopathic education accrediting body recognized by the U.S. Department of Education. There are currently six accredited naturopathic medicine programs across eight campuses in Arizona, California, Oregon, Washington, Illinois, Puerto Rico and Canada.
Most insurers and Medicare do not cover naturopathic care, leaving many patients to pay out-of-pocket for treatment.
The measure passed the state Senate on a 33-3 vote, with all votes against coming from Republicans. In the House, the bill passed 85-22, with a majority of Democrats, 18 of the 25 present, voting in opposition, along with four GOP votes against.
Lawmakers opposed to licensing are concerned it could allow naturopathic doctors to administer treatments outside of their area of training and expertise and injure patients.
“My responsibility has to be my constituents, and I don’t want them led down a path that isn’t scientifically proven to where they might be harmed,” said Sen. Ralph Massullo, Jr., R-Inverness, in a Senate Health Policy committee meeting.
If the bill becomes law it would take effect on Dec. 31. It also would reduce the penalty for practicing naturopathy without a license from a felony to a second-degree misdemeanor, drawing criticism from some lawmakers.
Naturopaths maintain that an important focus of their training and practice is determining when to send patients to higher levels of care if they identify a patient as having a disease or other serious health problem.
“It is a key portion of our training to recognize the limitations of what we do and make a proper referral, whether that’s back to their medical primary care provider, or to a specialist within the field,” Todd Robinson, a naturopathic doctor and the founder of Wellness Working Group in Jacksonville Beach, told lawmakers during a Senate Fiscal Policy Committee hearing.
“This bill is not about replacing or undermining physicians,” said bill sponsor Sen. Ana Maria Rodriguez, R-Doral, “nor is it about undermining the very real structural problems in our healthcare system today. It is to ensure that naturopathic practitioners are operating with clear standards, accountability, and transparency.”
In Tallahassee, Teegan and Sarah Fiedler both have degrees in naturopathy and they named their practice “North Florida Naturopathic.” Teegan Fiedler is licensed in chiropractic medicine and Sarah Fiedler is licensed in acupuncture.
Their website includes a disclaimer for Florida residents:
“North Florida Naturopathic operates in the state of Florida as a Chiropractic Clinic. As Florida has not issued licenses to Naturopathic Doctors since 1959, Teegan and Sarah Fiedler are not licensed NDs in Florida. Teegan Fiedler is a licensed Chiropractic Physician in Florida and is licensed to practice chiropractic medicine only. Sarah Fiedler is a licensed Acupuncture Physician in Florida.”
In 2018, the state Department of Health opened an investigation into their practice. Sarah Fiedler said there was no problem with how she and her husband were treating patients, but “they (FDOH) just didn’t like our name.”
“It was awful, expensive and exhausting,” Sarah Fielder said. “It was so ridiculous, and I don't want anybody to go through what we went through to practice here.”
Supporters also believe that the licensing requirements established by the legislation will make naturopathy safer for patients. Because new naturopaths haven’t been licensed in Florida for decades, they believe people were seeking care elsewhere that was potentially dangerous.
“One of my patients went to someone who advertised themself as an accredited doctor who did online school. The patient got injured, and I had to help them with that,” said Dr. Phuong Thach, who runs Thach Acupuncture and Functional Medicine in Pensacola. Dr. Thach said that she plans to add “naturopathy” to the name of her practice if the bill becomes law.
Robinson, the naturopathic doctor in Jacksonville Beach, focuses on using natural medicine to supplement the care of patients who have been diagnosed with cancer. He learns about his patients’ personal history, goals and lifestyle to develop a list of literature that he believes will be helpful to patients and possibly their other medical care providers in order to augment their treatment. For example, if a patient is being treated with a particular drug for their cancer, Robinson will research lifestyle practices to enhance the drug’s efficacy and diminish any long-term side effects.
“All the information I provide my clients is written down, fully referenced, and is intended to be shared with anyone else on their team,” Robinson said in an interview.
This story was produced by Fresh Take Florida, a news service of the University of Florida College of Journalism and Communications. The reporter can be reached at elizabethmaguire@ufl.edu.
