naturopathydigest.com -- Washington State Expands Scope of Pharmacy Practice for NDs

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Washington State Expands Scope of Pharmacy Practice for NDs

By Tina Beychok, Associate Editor

In a development certain to be welcomed by naturopathic physicians in the state of Washington, lawmakers passed a statute expanding the prescribing rights of NDs.

The new law, which went into effect on Nov. 2, 2007, states:
(1) Naturopathic medical practice includes the prescription, administration, dispensing, and use of:

(a) Nutrition and food science, physical modalities, minor office procedures, homeopathy, hygiene, and immunizations/vaccinations;

(b) Nondrug contraceptive devices;

(c) Nonlegend medicines including vitamins, minerals, botanical medicines, homeopathic medicines, and hormones;

(d) Legend drugs as defined under RCW 69.41.010 with the exception of Botulinum Toxin (commonly known as, among other names, Botox, Vistabel, Dysport, or Neurobloc) and inert substances used for cosmetic purposes; and

(e) Codeine and testosterone products that are contained within Schedules III, IV, and V in chapters 69.50 RCW and 246-887 WAC.

(2) In accordance with RCW 69.41.010(13), all prescriptions must be hand-printed, typewritten, or generated electronically.

(3) Prior to being allowed to administer, prescribe, dispense, or order controlled substances, a naturopathic physician must meet the requirements in WAC 246-836-211 and have obtained the appropriate registration issued by the Federal Drug Enforcement Administration.

(4) Naturopathic physicians may not treat malignancies except in collaboration with a practitioner licensed under chapter 18.57 or 18.71 RCW.

Kasra Pournadeali, ND, immediate past president of the Washington Association of Naturopathic Physicians, presented these changes as a win all the way around when in an interview with John Weeks of the Integrator Blog:

"Implementation of the new law is a win for NDs. It means that the ND scope of practice is now consistent with current ND training. ... The law now only restricts 'controlled substances' (allowing codeine and testosterone preparations) where none were allowed previously. The only broader prescriptive scope is in Arizona where all controlled substances are included.

"The new law sets a precedent for NDs with respect to our injection scope. In Washington, NDs are now able to inject anything within prescriptive authority, including drugs. ... Previously, ND scope in Washington only allowed intramuscular B12 injections (where B12 deficiency existed) and immunizations. The new law removed the exclusion of intrauterine device placement for NDs, and made it allowable for to perform biopsies and take tissue samples.

"The new law is a win for patients. It means the many patients choosing an ND for their primary care will no longer have to undergo a second doctor visit for a simple prescription not on the old ND drug list. It means patients wanting to get off a drug and use effective non-drug treatments now have the option of doing so safely by seeing an ND with training in both pharmacology and non-drug approaches.

"The new law is a win for insurers that provide ND primary care benefit. Because NDs inherently prefer to avoid prescriptions where possible and because NDs are educated in effective non-drug management of chronic conditions, insurers who provide (and promote) ND primary-care benefits will realize savings in prescriptive benefit payout.

"For decades patients have been looking to NDs for their primary care. [This] legislation, based on ND training, represents the next step in facilitating the profession's evolution toward serving a growing need."