As crossover approaches at the North Carolina General Assembly it is possible that SB 118/HB 913 – Naturopathic Doctors Licensing Act may be debated. This legislation proposes to create a third classification of physician in North Carolina.
Current law permits the licensure of Medical Doctors (MD) and Doctors of Osteopathy (DO) – both regulated by the North Carolina Medical Board. SB 118/HB 913 propose to license Naturopathic Doctors (ND) under their own licensing board.
Only 18 states currently license naturopaths, none of which are in the Southeast.
Allowing practitioners without medical training to refer to themselves as doctors is confusing to the public and poses a risk to safety. Use of the initials ND is especially confusing when compared to MD (medical doctor) and NP (nurse practitioner) titles.
SB 118/HB 913 would allow naturopaths to order tests and manage chronic disease as a primary care provider. The bills allow naturopaths to treat infants and children, diagnosis and treat mental health conditions, even diagnosis and treat cancer.
If naturopathic treatment is endorsed by the legislature as adequate treatment of life-threatening and chronic disease, patients are put in harms way. Ineffective naturopathic treatment could delay much needed medical services, leading to complications and even death.
Finally, in states where naturopaths have been licensed, there appears to be an immediate and constant push for expanded scopes of practice to include the ability to prescribe controlled substances. The American Association of Naturopathic Physicians notes on its website, “… seven more states are pursuing scope modernization, particularly expanded prescribing authority” this year alone.
For these reasons the Coalition opposes SB 118 and HB 913.
North Carolina’s OB/Gyn doctors and Certified Nurse Midwives work side-by-side as partners to ensure that their patients – women and soon-to-be-born children – get the best and safest care possible. Cooperation and high standards of care are only enhanced by flexible, but necessary, physician supervision of nurse midwives. Physician OB/Gyns complete twice as many years of education and over ten times as many clinical training hours as nurse midwives.
Nurse midwives are an essential part of a team approach to ensuring the safety of thousands of mothers and children in our state. As with any team, leadership by those with the most experience and education is necessary.
Every mother and child deserves the best and safest care. Lowering standards of care – reducing safety – to increase access to care is a false choice that no woman or family should face. That’s why NCCPP opposes reducing safety standards such as eliminating the requirement that nurse midwives work supervised by a physician.
Passage of SB 695 or HB 807 would allow lesser qualified providers to direct the care of patients with the highest risk. It could also leave those providers unprepared to handle complications that arise in even the healthiest patients. Passage of this legislation will give women and their families a false sense of security that midwives can do everything necessary to keep mothers and their newborns as safe as possible.
Every pregnant woman and every newborn in our state deserves the best and safest care – because problems during labor and delivery can come at any moment, without warning, for even the healthiest women. Eliminating physician supervision of nurse midwives is simply not worth the risk.
Did you know that physician supervision provides greater flexibility to the way nurses practice in our state?
North Carolina law is unique from many other states in that it is accommodating to both nurses and physicians – resulting in better patient care. While other states limit nurses to the skills acquired during 1-2 years of training, North Carolina law allows nurses to expand their expertise well beyond their formal education. This broadening of their responsibilities is achieved by working side by side with a supervising physician.
Physician supervision allows nurses to achieve additional on the job training from someone with over a decade of medical education, thereby practicing well beyond what was learned in nursing school.
In fact, advanced practice nurses in North Carolina can perform any medical act approved by a supervising physician.
Supervision allows nurses to practice to the fullest extent possible, while
maintaining the safety net of physician expertise vital to patient safety.
As the needs of our state change, physician supervision allows nurses to maximize their skills and practice without the limitations of their training. Otherwise, nurses simply do not have the training necessary to safely and independently practice medicine.
Senate Bill 695 proposes to allow nurses to independently provide neonatal care, mental health services and any other medical care across the life span of a patient – despite very limited training.
Two years of education prepares nurses to follow pre-approved protocols, but it does not prepare them to independently diagnose and treat complex disease.
Nurses play a vital role in the patient care team, but
two years of training is no substitute for the expertise of a physician.
For these reasons the Coalition supports physician supervision of nurses and opposes SB 695.
Doctors can train for as long as 15 years before they are allowed to treat patients without supervision – because extra years of training can mean the difference between life and death. A nurse’s’ training is considerably shorter – which makes their supervision by a physician critical to patient safety.
For this reason the Coalition supports continued physician supervision of nurses and opposes SB 695.
Medical school is a rigorous, full-time, four-year program consisting of classroom work as well as thousands of hours of clinical training. After graduation, MDs enter into a residency program that ranges from 3-7 years of additional training. In some instances, fellowship training may also follow, adding 1-2 more years to the process.
Physicians train for at least a decade – some for much longer – before
they are permitted to practice without supervision.
The years required to become a physician are essential, ensuring that physicians of all specialties – from primary care to neurosurgery – obtain the knowledge and skills necessary to safely practice.
Nurses obtain their certifications in a variety of ways. However, no matter their training pathway, nurses do not undergo the level of training necessary to independently diagnose and treat complex medical conditions.
Even advanced practice nurses may only complete an additional
2 years of education and training after college.
The extra years of training that physicians receive can mean the difference between life and death. For this reason the Coalition supports continued physician supervision of nurses and opposes SB 695.
The North Carolina Board of Electrolysis Examiners have filed proposed rules to take effect on August 1, 2015. Among other regulations, these proposed rules would make changes to the requirements for physician supervision of electrolysis providers.
PUBLIC HEARING: Sunday, April 26, 2015, 9:30 a.m.-1:30 p.m.
Trinity Oaks, 728 Klumac Road, Salisbury, NC 28144
The North Carolina Board of Electrolysis Examiners will accept public comment regarding proposed rules changes found here. The rule change proposes to clarify provisions regarding applications for licensure, school and instructor certifications, fee increases, continuing education, and agreements with Supervisory Physicians.
New language would specify that agreements with supervising physicians include an acknowledgement that current guidance from the North Carolina Medical Board with respect to laser hair removal and laser surgery by non-physicians will be observed and monitored. The new rules would also require attestation that the supervising physician will be readily available and able to respond quickly to patient emergencies and questions by those performing electrolysis procedures under the physician’s supervision.
Comments can be directed to:
Susan Magas, 2 Centerview Drive, Suite 60, Greensboro, NC 27407, phone (336) 856-1010, or firstname.lastname@example.org.
Comment period ends: June 1, 2015