Jonathan Collin, MD
Washington State Medical Association Opposes Washington State Naturopathic Association’s Effort to Expand Scope of Practice
Naturopathic physicians in Washington have requested the Department of Health to conduct a sunrise review of their scope of practice. Senate Bill 5411 would make broad updates to the naturopathic practice act. The Washington State Medical Association opposes the expanded scope of practice claiming that the act does not require additional education and training. SB 5411 would permit naturopathic physicians to prescribe all controlled substances included in schedules II-V. Currently, naturopathic physicians are limited to codeine and testosterone–they are not allowed to prescribe other controlled substances. Of note, NDs in Washington can prescribe all legend drugs that are not considered controlled substances.
SB 5411 also would expand the definition of “minor office procedure” to include primary care services and treatment of minor injuries. However, the WSMA believes that this change in definition will permit a wider range of surgical procedures. The MDs object to the act allowing naturopathic physicians carrying out reproductive surgeries such as vasectomies and abortions. Additionally, the medical association does not want the naturopaths to have the authority to sign certification forms such as death certificates.
Medical doctors are worried that they will lose “business” to naturopathic physicians. The MDs are pressuring the Department of Health to disallow the act based on fears that public safety would be endangered. Among themselves, surgeons and family doctors don’t want naturopathic doctors to be able to do surgeries and procedures. The naturopathic association counters that naturopathic physicians do have the education and training to prescribe controlled drugs and conduct minor surgeries and procedures.
Over the years naturopathic education has expanded to match what is offered at the medical college. Pharmacology has become an integral part of the naturopathic curriculum. Minor surgery and procedures are also included in the four-year naturopathic program. However, a hospital-based residency is generally not availed to most ND graduates. Still many NDs do undertake post-graduate educational and training programs, including residencies. The MDs’ claim that naturopathic physicians are not qualified to prescribe controlled drugs appears unfounded. It is unclear about naturopathic physician proficiency for undertaking surgeries and procedures in the office; it may be necessary for the Washington State naturopathic board to establish a residency and examination for surgery certification.
As difficult as it may be, there should be a liaison between the NDs and MDs to work out the expansion of ND scope of practice. One also needs to ask about the future of naturopathic medicine. What happens when natural healing methods, including herbal medicine, homeopathy, hydrotherapy, fasting/diet, and functional medicine are no longer the focus of naturopathic practice? If the naturopathic physician is primarily prescribing drugs and performing surgery, is it still naturopathy?
How to Build a Biocivilisation by Predrag B. Slijepčević
Over the past seventy-five years the miracle treatment for infection has been penicillin or a newer antibiotic, anti-parasitic, or anti-viral medication. Natural-minded practitioners have argued that it is the terrain that has been upset and deserves attention, not the infective organism. But what exactly is the terrain? We think of nature, land and sea, as the greater earthly terrain, particularly nature that we inhabit locally. It is our internal terrain, our overall body, that we focus on to assess the imbalances that provide opportunity for symbiotic organisms to become pathologic.
A growing number of biologists conjecture that thinking about terrain from a human-centered viewpoint is not only very limiting but incorrect. How life has existed for at least 3.5 billion years remains an unfolding mystery but assuredly it evolved well before human-like existence 600,000 years ago. What has enabled the earliest organisms, presumably bacteria and viruses, to form eons ago and, more importantly, what has ensured their existence for these billions of years? Biologist/philosophers like Gregory Bateson claim that survival of the organism is dependent on the organism’s ability to interact intelligently with its environment. Bateson asserts that the “mind is the essence of being alive” and that all organisms participate and contribute to the biosphere that serves as a mind communicating between individual organisms and the biosphere as a whole.
Predrag Slijepčević’s book, How to Build a Biocivilisation, examines the intelligence of the biosphere and its applications that precede and supercede human’s more recent artistic and scientific development. Slijepčević looks at the existence of technology, communication, engineering, science, doctoring, artistry, and farming that the biosphere developed eons before current human history. He considers our future participation in building a biocivilisation must include, indeed, emphasize the contribution of nature’s biosphere in its entirety and abandon the false idea of human dominance and superiority.
An excerpt of Slijepčević’s book appears in two parts starting in this issue.
Because of Winn-Dixie by Kate DiCamillo
I don’t usually write about fiction, novels, but given this is the gift-giving season I would like to give a plug to writer, Kate DiCamillo, who has written many children’s books particularly for the pre-teen and teen. Because of Winn-Dixie is her first book and the first book I have read of hers. It is very easy reading although it may be a tough read for a child under ten. I’m hoping my seven-year-old granddaughter, Jackie, can follow it, but it will assuredly be too much for her four-year-old brother, Quinn. It is true that the title harkens to the supermarket chain but the book is about a dog and its young girl owner—she named the dog Winn-Dixie after she found the stray dog in the supermarket.
DiCamillo grew up in the South but relocated to Minnesota where she wrote Winn-Dixie. The story takes place in a small town in Florida at an unspecified time around the 1950s. There is sufficient plot for Hollywood to have picked it up and made it into a movie. Opal, the protagonist, is the daughter of a preacher of a small church; her mother moved out years earlier, leaving Opal with no memories of her mom. Opal is a confident, strong, forthright, buoyant, hopeful youngster who does not let mishaps or stubbornness or laziness get in her way. While she does have a certain level of shyness and loneliness and sadness, she is quite accepting of what life offers her and takes on those opportunities with gusto. When the dog first appears, disheveled and lost, he smiles fully and latches onto Opal. The adventures that the two share are not quite like Huckleberry Finn but they are of a quiet, wholesome quality to which the reader can fully empathize.
Before you gift wrap this for your grandchild take a moment to read it for yourself. It’s not a long read, and you’ll feel good all over right through to the end.
Published December 2, 2023