A bitter fight over who can be called 'doctor'So, if a naturopath orders an MRI, do payors have to pay for it?
It took 99 years, but Minnesota has finally given official recognition to the practice of naturopathic medicine, which relies on the body's powers to heal itself.
Under a new state law, naturopaths -- who use everything from herbal remedies to biofeedback -- will be allowed to register with the state and call themselves doctors without fear of running afoul of the medical establishment.
... "I didn't realize how much of an issue it was going to be," said Rep. Neva Walker, DFL-Minneapolis, who championed the bill for years before it finally passed and was signed into law in May. "[I] didn't realize somebody who had supported all forms of alternative healing for years was going to be an enemy."
It allows those who qualify to use the title "naturopathic doctor" and expand their "scope of practice" to include such things as ordering blood tests and MRIs, and admitting patients to hospitals....
...The Minnesota Medical Association (MMA), representing conventional doctors, objected to allowing naturopaths to prescribe drugs and perform minor surgery. When those items were dropped, the MMA withdrew its opposition.
I'll ask Mike Paymar that question.
In the meantime the DFL dominated Minnesota legislature has decided that they want to continue to limit medical decision making to "professionals". What's new is that they've decided that medical science is no longer the basis for measuring professional expertise. Social judgment alone is the new criteria.
It's the same sort of reasoning that brings creationism into science classes. People who believe solar variation explains most climate change fall into this category. We're used to this, it's a familiar fight. I don't think there is any alternative to science for making judgments about the natural world, but I accept most of society doesn't agree with me.
So I object to the decision on the basis of using social fashion as the basis for measuring expertise, but that's not my primary objection.
My real problem with this bill is that it doesn't go far enough.
If you abandon science as the basis for expertise, then you shouldn't stop with naturopaths. Certainly nurses should be included, but also teachers, chiropractors, shamans, plumbers, lawyers, accountants, radiology technicians, cab drivers, flight attendants, mothers, fathers and, heck, children too.
Nor should the boundary be artificially set at test ordering. An MRI is not a small procedure, nor necessarily benign.
Let us open up all of medicine and surgery. If Naturopaths are ordering MRIs, then carpenters should be doing hip replacements. If you've every seen a 110 lb orthopedic surgeon rear back to slam the silver hammer down, you'd appreciate the role a good carpenter can play.
If you abandon science as a measure for expertise, then there are no more boundaries. I expect the courts will, in time, agree with me.
Payors and insurance companies will love this. Plumbers are not only much cheaper than neurosurgeons, the follow-up care will also be much shorter and less costly.
Update 6/14/08: Representative Michael Paymar responded promptly by mail. He's guilty - he vote for this sucker. To his credit he doesn't mince words. He's a believer, Mike Paymar is not a rationalist. The Minnesota Medical Association approved the bill, so he felt he had cover to proceed.
Shame on them too.
Paymar is a very good representative, he wins this district by huge margins, and it's not like I'm going to vote for anyone else. On the other hand, it will be much harder now to send him our yearly campaign donations.