Last updated: 03/03/2022
Why I adopted a professional code of ethics
In the state of North Carolina, Naturopathic Doctors are not licensed. Because of this, there is a much greater risk of infringing on state-licensed modalities, such as medical doctors, chiropractors, osteopaths, physical therapists, massage therapists, and dietetics. In order to stay protected from infringing on state law and to protect my patients and clients, I have adopted an extensive, however not exhaustive, definition of what I can and can’t do as a Naturopathic Doctor. I will continue to update this page to better clarify my professional responsibility to the public.
(Adapted from North Carolina Association of Naturopathic Physicians)
Naturopathic Medicine is a distinct health care profession, emphasizing prevention, treatment, and optimal health through the use of therapeutic methods and substances that encourage individuals’ inherent self-healing process.
The practice of Naturopathic Medicine includes modern and traditional, scientific, and empirical methods. The following principles are the foundation of Naturopathic Medical practice:
First Do No Harm (Primum Non Nocere): Naturopathic Doctors follow three guidelines to avoid harming the patient:
Utilize methods and medicinal substances which minimize the risk of harmful side effects, using the least force necessary to diagnose and treat
Avoid when possible the harmful suppression of symptoms
Acknowledge, respect, and work with individuals’ self-healing process
Identify and Treat the Causes (ToIle Causam): The Naturopathic Doctor seeks to identify and remove the underlying causes of illness rather than merely eliminate or suppress symptoms.
Doctor as Teacher (Docere): Naturopathic Doctors educate their patients and encourage self-responsibility for health. They also recognize and employ the therapeutic potential of the doctor-patient relationship.
Treat the Whole Person (Tolle Totum): Naturopathic Doctors treat each patient by taking into account individual physical, mental, emotional, genetic, environmental, social, and other factors.
The Healing Power of Nature (Vis Medicatrix Naturae): Naturopathy recognizes an inherent self-healing process is ordered and intelligent people. Naturopathic doctors act to identify and remove obstacles to healing and recovery and to facilitate and augment this inherent self-healing process.
Prevention: Naturopathic Doctors emphasize the prevention of disease by assessing risk factors, heredity, and disease susceptibility and making appropriate interventions in partnership with their patients to prevent illness.
Naturopathic treatments include the following modalities:
(1)Public health measures
(2)Education on current natural treatment theory
(6)soft tissue manipulations that are not protected within the scope of a licensed professional in the state of North Carolina
(7)diet and lifestyle modification (excluding meal plans)
What is a Naturopathic Doctor?
Naturopathic Doctors educate and provide treatments that encourage the human body’s restoration to its natural processes, which unnatural sources have altered. Naturopathic Doctors focus on holistic, proactive prevention and comprehensive evaluations and recommendations. By using protocols that minimize the risk of harm, Naturopathic Doctors help facilitate the body’s inherent ability to restore and maintain optimal health. In addition, it is the Naturopathic Doctor’s role to assess and correct the origin of health disorders.
Scope of Pratice:
(Adapted from Maryland state law)
A. Order physical and laboratory examinations under the direct supervision and authorization by an active state-licensed professional for diagnostic purposes consistent with the education and training of naturopathic doctors, including:
(2) Clinical laboratory tests;
(3) Orifical examinations;
(4) Electrocardiograms with over read by a cardiologist; and
(5) Physiological function tests;
B. Order diagnostic imaging studies under the direct supervision and authorization of an active state-licensed professional, interpret the diagnostic imaging reports, and access the images from these studies.
C. Never prescribe, dispense, order, or administer natural medicines, including, but not limited to, food, extracts of food, nutraceuticals, vitamins, amino acids, minerals, enzymes, botanicals, and their extracts, and botanical medicines, homeopathic medicines, and all dietary supplements and nonprescription drugs as defined by the Federal Food, Drug, and Cosmetic Act;
D. Administer or perform hot or cold hydrotherapy, naturopathic physical medicine, electromagnetic energy, and therapeutic exercise to provide restorative care services, except that if a referral to another licensed provider is appropriate for ongoing rehabilitation or habilitation services, the naturopathic doctor shall make the referral;
E. Provide health education and health counseling; and
F. Perform naturopathic musculoskeletal mobilization.
Code of Ethics
(Adapted from Maryland state Law)
A. Naturopathic doctors shall concern themselves primarily with the welfare of the patient.
B. A naturopathic doctor who suffers from a physical, mental, or emotional impairment, including substance abuse, that impacts the individual’s ability to practice naturopathic medicine shall seek professional treatment and refrain from the practice of naturopathic medicine until the impairment no longer exists or reasonable accommodations can be made.
C. A naturopathic doctor shall:
(1) Use professional discretion and integrity in relationships with a member of the health care community;
(2) Be professional in conduct, with honesty, integrity, self-respect, and fairness;
(3) Remain free from conflict of interest while fulfilling the objectives and maintaining the integrity of the naturopathic doctor profession;
(4) Provide accurate fee information to the patient, the individual responsible for payment for treatment, and the insurer;
(5) At all times, respect the patient’s dignity, autonomy, and privacy;
(6) Practice naturopathic medicine only as defined in the scope of practice outlined in this document
(7) Cooperate with any lawful investigation by government agencies
D. A naturopathic doctor may not:
(1) Misrepresent credentials, qualifications, or affiliations and shall attempt to correct others who misrepresent the naturopathic doctor’s credentials, qualifications, or affiliations;
(2) Knowingly engage in or condone behavior that is fraudulent, dishonest, or deceitful, or involves sexually stimulating services;
(3) Engage in a commercial activity that conflicts with the duties of a naturopathic doctor;
(4) Perform naturopathic medicine on a patient if a contraindication against naturopathic doctor treatment exists;
(5) Discriminate against a patient or a health care provider based on race, religion, age, gender, sexual orientation, national origin, or disability;
(6) Intimidate, threaten, influence, or attempt to influence any person regarding any violation of law or regulation; or
(7) Aid or abet any individual violating or attempting to violate any provision of law or regulation.
E. A naturopathic doctor shall:
(1) Use professional judgment in the use of evaluation and treatment procedures;
(2) Decline to administer treatment if the naturopathic doctor believes that treatment is contraindicated or unjustified;
(3) Terminate a professional relationship with a patient in an appropriate manner, such as:
(a) Providing the patient with sufficient notice to permit the patient to obtain the services of another professional;
(b) Assisting the patient by providing referrals if appropriate; or
(c) Continuing to provide emergency treatment to the patient if treatment is required before a reasonable time has passed to allow the patient to obtain the services of another health care provider;
(4) Maintain a written record of treatment of the patient under the naturopathic doctor’s care for at least five calendar years
(5) Make the written records of treatment available to the patient upon request, in compliance with applicable laws for disclosure of medical records;
(6) Make arrangements for another professional to provide for the needs of the patient during anticipated absences when the naturopathic doctor is unavailable to the patient;
(7) Make referrals only to other qualified health care providers;
(8) Accurately inform the patient, other health care professionals, and the public of the limitations of the practice of naturopathic medicine;
(9) Adequately assess the patient to determine if contraindications against naturopathic medical treatment exist and refer the patient to an appropriate health care practitioner;
(10) Exercise independent professional judgment in the treatment or evaluation of the patient regardless of whether the patient was referred by another health care provider;
(11) Ensure clear and concise professional communications with patients regarding:
(a) Nature and duration of treatment;
(b) Assessments and treatment plans;
(d) Billing; and
(e) Insurance; and
(12) Administer fair and equitable fees to patients regardless of status or insurance.
F. A naturopathic doctor may not:
(1) Accept a client for treatment, or continue unnecessary treatment, when the patient cannot be reasonably expected to benefit from the treatment;
(2) Receive remuneration from, or provide remuneration to, or split a fee, for either making or accepting a referral of the patient to or from another health care provider;
(3) Make a guarantee or promise about the efficacy of a particular treatment, the naturopathic doctor’s practice, or the result of treatment unless supported by scientific principles accepted by profession; or
(4) Exploit the professional relationship by:
(a) Continuing treatment unnecessarily; or
(b) Charging for a service:
(i) Not provided; or
(ii) Different from those provided.
G. A naturopathic doctor shall:
(1) Maintain professional boundaries, even when the patient initiates crossing the boundaries of the professional relationship; and
(2) Respect and maintain professional boundaries and respect the patient’s reasonable expectation of professional conduct.
H. A naturopathic doctor may not:
(1) Exploit a relationship with a patient, staff member, or student for the naturopathic doctor’s personal advantage including, but not limited to, a personal, sexual, romantic, or financial relationship;
(2) Engage in a sexually intimate act with a patient; or
(3) Engage in sexual misconduct, which includes, but is not limited to:
(a) Therapeutic deception;
(b) Non-bona-fide treatment; and
(c) Sexualised behavior at the office; and
(d) Sexualised communication or behavior with anyone classified as a “Patient” or “Client” within three months after ending the professional relationship.
I. A naturopathic doctor may not engage in inappropriate behavior with other practice staff, including sexual advances, harassment, discrimination, exploitation, retaliation, and other unprofessional conduct.
J. A naturopathic doctor shall:
(1) Respect and maintain the privacy and confidentiality of the patient;
(2) Disclose the patient’s records or information about the patient only with the patient’s consent or as required by law;
(3) Adequately safeguard confidential patient information, including storage and disposal of records;
(4) Provide sufficient information to a patient to allow the patient to make an informed decision regarding treatment, including:
(a) The purpose and nature of an evaluation or treatment regimen;
(b) Alternatives to treatment;
(c) Side effects and benefits of a treatment regimen proposed and alternatives to that treatment;
(d) The estimated cost of treatment and alternatives to treatment;
(e) The right of the patient to:
(i) Withdraw from treatment at any time, including the risks associated with withdrawing from treatment;
(ii) Decline to participate in treatment if an aspect of the treatment will be recorded, documented, photographed, observed, or otherwise used in an educational program; or
(iii) Terminate any treatment contract at any time, for any or no reason, with no fee or penalty incurred;
(5) Obtain the full informed consent of a patient participating in a human research program, without communicating a direct or implied penalty for the patient’s refusal to participate in the program and with due regard for the patient’s autonomy and dignity;
(6) Comply with applicable federal and state laws for human research programs; and
(7) Promptly and efficiently obey any request for patient records from:
(1)The individual being treated, and;
(2)A healthcare professional who has been provided written consent from the patient for records to be shared; and
(3)Court-ordered subpoena for patient records.
K. A naturopathic doctor shall:
(1) Only provide treatments within the scope of professional training received, and has proven competency in, and;
(2) Be current in the qualifications to practice.
L. The naturopathic doctor may not perform a treatment or provide a service that the naturopathic doctor is not qualified to perform or which is beyond the scope of the naturopathic doctor’s education, training, capabilities, experience, and scope of practice.
M. A naturopathic doctor may not construe any failure to specify a particular ethical, legal, or professional duty as a denial of the existence of other ethical, legal, or professional duties or responsibilities that are equally as important and generally recognized in the naturopathic profession.