Legislative Alchemy: “Naturopathic Doctor” licensing is bad medicine for Florida

Florida banned naturopathic practice in 1959, and despite numerous attempts over the years to pass a licensing law, with varying scopes of practice proposed, all bills have ended in defeat.

Will 2026 be different? Sadly, I think this is their year.

Bills licensing “naturopathic doctors” are making their way through the current Florida legislative session.  Given an armamentarium of unvalidated testing, pseudoscientific diagnoses, and quack remedies, naturopathic practitioners would be allowed to call themselves “doctors”, with the authority to diagnose and treat any patient of any age with any disease or health condition, all without consultation with the patient’s physician.

Bad laws

But first: Hello, again. Good to be here. As some of you may recall, I was a regular SBM contributor from 2010 to 2022.  As an attorney, I was particularly disturbed by the incorporation of rank pseudoscience into the law, a phenomenon I dubbed “Legislative Alchemy”, the subject of many of my posts.

A distinctly insidious form of Legislative Alchemy is healthcare practitioner licensing. Grounded in the states’ constitutional authority to protect the public’s health, safety, and welfare, at their best licensing laws set education and training standards, define scope of practice, and impose a regulatory framework to protect the public from harmful practices. 

Unfortunately, licensing laws have been co-opted by practitioners of pseudoscience, like chiropractors, acupuncturists, and naturopaths. Diagnoses and treatments based on fabricated human physiology unknown to medical science (chiropractic subluxations, acupuncture points, naturopathic vitalism) are given the imprimatur of legitimacy. Patients fill the waiting rooms of these state-licensed practitioners, deceived by the credentials their legislators have carelessly bestowed. Perversely, licensing becomes a vector for harm.

I had been thinking recently of returning to blogging.  The dogged determination of a couple of legislators to impose “naturopathic medicine” on the good citizens of Florida, and my alarm as I watched this unfold, finally lit the fire that led me back to SBM, where I’ll post monthly (and maybe more).

Bad bills

There’s no better exemplar of Legislative Alchemy than the naturopathic licensing bills threatening to become law in my home state.

Senate Bill 688 and House Bill 223 would give naturopathic doctors the authority to call themselves, well, “doctor”, “ND”, or “NMD” (naturopathic medical doctor), along with a broad scope of practice: the authority to diagnose and treat any patient of any age (including children) for “any deformity, disease, pain, or other physical or mental condition”. This is almost exactly the same language used to describe a medical doctor’s scope of practice in Florida law, the only difference being that MDs can do surgery and have full prescription privileges.

Their practice would be based on “Principles of naturopathic medicine”, an amorphous list that includes vitalism, rebranded here as “the healing power of nature”.

Self-regulated system

Like other health care licensing legislation, the bills default to a self-regulated system to establish credentials for practice, including education and testing.  In the case of naturopathic licensing standards, the nomenclature of medical doctor licensing has been brilliantly co-opted, just without the rigor required for the real thing.  

The proposed legislation would allow naturopaths who’ve graduated from an “accredited naturopathic medical school” and passed the
Naturopathic Physicians Licensing Examinations (NPLEX) to practice. That all sounds nice, unless you know some background.

NDs are educated in small, private schools that operate outside the mainstream American university system.  Unlike real medical school, there is no entrance exam and the acceptance rate for U.S. schools is 65%-100% (2015 analysis).

These schools are accredited by an agency run by naturopaths. Unfortunately, while the U.S. Department of Education imposes administrative and financial standards in approving accreditation agencies, it does not require a science-based education, making the Department yet another vector for the introduction of pseudoscience into the healthcare system.

Pseudoscientific curriculum and inadequate clinical training

Their curriculum includes pseudoscience, like homeopathy.  Clinical training takes place, for the most part, in small, school-based clinics where they see patients with a limited range of health problems.  Upon passing the NPLEX, the rigor and scientific basis of which have never been fully evaluated, they can go straight into practice.

No residency is required. The three to seven years of additional clinical training that medical doctors undergo before practice (plus additional exams) is simply whitewashed away.

Thus, according to the American Academy of Family Physicians (AAFP):

the scope and quality of naturopathic education do not prepare the practitioner to properly and accurately diagnose illness or provide appropriate treatment. Government endorsement of naturopaths through licensure will jeopardize the health and safety of patients.

Their inadequate education and training obviously show in their practice, which is, again according to the AAFP:

not based upon the body of basic knowledge related to health, disease, and health care that has been accepted widely by the scientific community.

Bad practices

Yet, despite these deficiencies, Florida would give NDs the authority to order any and all lab tests (some of which are poorly regulated) and diagnostic imaging, including unnecessary pediatric labs and scam tests like IgG testing for food “sensitivities”, hair testing for “toxicities”, and secretory IgA testing, which “are often accompanied by extensive clinical interpretations which may recommend, or be used to justify, unnecessary or harmful treatments.”

If what we know about naturopathic practice in other areas holds true in Florida, and we have no reason to expect otherwise, NDs, fresh from graduation, will be able to diagnose fake diseases, like adrenal fatigue and run “detox” scams or treat real health issues with bogus remedies, like treating cervical dysplasia with escharotics or HPV with “immune boosting” herbs.

In fact, they can treat any health condition with dietary supplements and herbs which (except for true vitamin or mineral deficiency) for the most part have a poor record of safety and effectiveness. They could employ “environmental medicine” and “natural substances”, neither of which is defined.

(For a more complete discussion of bogus diagnoses, misuse of testing, and other dangers of naturopathic practice, see Scott Gavura’s “Naturopathy v. Science” series and Naturopathic Diaries.)

Homeopathic remedies

They can also treat any disease or condition (again, real or imagined) with homeopathic remedies, which is both medically and legally problematic. Medically, homeopathic remedies can’t, and don’t work, for anything, unless you’re maybe looking to induce the placebo effect. (Here’s one example of how their use by a licensed naturopathic doctor resulted in tragedy.)

Legally, federal law requires all homeopathic remedies to have FDA approval before going on the market. But, as the FDA itself has said, none of them (that’s right, none) has ever met this requirement. So, it’s not legal to sell them.  Unfortunately, however, the FDA (apparently due to a lack of resources) is turning a blind eye to the whole mess. For its part, the Federal Trade Commission has warned that, if you’re going to claim a homeopathic remedy is effective for anything, you basically have to tell consumers it doesn’t work right there on the label.

And where will patients get these nostrums? From the ND who prescribed them. So convenient! As ex-naturopathic doctor Britt Hermes points out, sales of dietary supplements, homeopathic remedies, and the like to patients are a significant source of ND income. (We would go ballistic if MDs routinely wrote prescriptions for drugs, then sold those drugs to their patients.)

Prescribing “substances”

As for prescription drug privileges, last year’s failed licensing bill included a naturopathic formulary (a list of drugs they could prescribe). This year (solely as a matter of political expediency, in my view) there’s a more modest ask. NDs would be able to prescribe “natural, non-pharmacologic substances”, another term that is undefined.

 Whatever that means, I believe it’s there so they have the legal authority to inject these “substances”. (Drug law is complicated, but a substance that is a dietary supplement in oral form, e.g., a vitamin, can become, legally, a prescription drug when injected, requiring prescription privileges.)

This could lead to a whole lot of mischief, such as IV infusions of vitamin mixtures (including high-dose Vitamin C for cancer). Or, prior to the FDA telling the American Association of Naturopathic Physicians they couldn’t do it anymore, infused compounds of substances like cesium chloride (also for cancer) or curcumin.

Self-regulating

NDs could do all of this without any obligation to consult with the patient’s MD. And without access to the patient’s medical records, unless the state plans to force the entire health care system (hospitals, doctors, ARNPs, and the rest) to let NDs access their EHRs. (There’s no such provision in the bills.)

A Board of Naturopathic Medicine will regulate their practice, consisting of four naturopathic doctors, two medical doctors, and a layperson. In other words, the foxes will guard the henhouse, applying a naturopathic, not a medical, standard of care.

Most of the rest of the bills’ verbiage consists of impressive-looking boilerplate incorporating “naturopathic doctors” into the vast web of laws governing health care in Florida, firmly embedding them in the system like malware.

And who will pay for this? Medicare and most health insurance policies (unless forced to by a state) don’t cover naturopathic doctors and, even when they do, they don’t pay for fake diagnoses and ineffective treatments. This will leave Floridians to pay hundreds, perhaps thousands, of dollars out of pocket.

Bad choice

You’d think all of this would give the legislators pause, but you’d be wrong. I testified against naturopathic licensing in four committee meetings, raising the same concerns I catalog here. Not one legislator asked a follow-up question. The Florida Medical Association opposed the bills but waived appearance before some committees. At others, including the one I attended yesterday, they didn’t even bother. I was the sole person to actually appear in opposition before any House or Senate committee. (Fun Fact: For some unknown reason, Americans for Prosperity, the Koch brothers-funded libertarian/conservative advocacy group, is also behind naturopathic licensing in Florida.)

HB 223’s sponsor, Rep. David Smith, a central Florida Republican, has told his colleagues that naturopathic doctors will practice “lifestyle medicine”, giving examples like treating allergies, high or low blood pressure, skin problems, and “ED”.  He’s said that they won’t treat cancer and that having two medical doctors on the naturopathic board will provide “medical supervision”.

This is baloney! Let me be clear: There is absolutely nothing in these bills that would limit naturopaths to “lifestyle medicine” (not that they should be doing that anyway). Once again, they will have the authority to diagnose and treat any disease or health condition.

Cancer is most certainly a “disease” and there is the so-called “specialty” of “naturopathic oncology”, which, most disturbingly, includes “pediatric naturopathic oncology”.

And about that “medical supervision”? There are four naturopathic doctors and two medical doctors on the Board, each with one vote. You do the math.

The head of the Florida Naturopathic Physicians Association testified yesterday that there were “hundreds”, which he amended to “thousands”, of articles in the medical literature attesting to the safety and effectiveness of naturopathic care. (That name should give you a hint of their real intentions: full physician scope of practice, just like an MD.) Actually, there aren’t.

Sen. Ana Maria Rodriguez, a Miami-Dade Republican, the sponsor of SB 688, for her part, simply repeats the naturopathic talking points and defends her bill as giving Floridians “choices” in her committee appearances.

Yep, it’s a choice alright.  A really bad choice. And very likely to become law.