I found out yesterday the largest insurer in my state is allowing naturopathic doctors to be PCP's and is reimbursed under the same quasi-captitation plan that MD's in primary care are. They are paid based on performance metrics like smoking cessation counseling and adolescent well visits just like the MD's (medical home like 'quality' metrics).
The formulary that they are allowed to prescribe is basically everything except controlled substances and can request to do outpatient procedures as well.
So they are functioning as primary care physicians in my state.
From my point of view, I have seen multiple patients now where I had to correct the completely wrong diagnoses or treatments started by ND's.
I just saw a patient who had a history of a TIA from atrial fibrillation. His ND stopped his Factor Xa inhibitor and started him on Boluoke. Boluoke is earthworms (or an enzyme in earthworms)
Of course there is no good research on this and the best I could find was a small study of 60 patients in china but they did not study anything to do with stroke prevention in atrial fibrillation.
So what is their thought process? Do they have a secret set of studies that I dont have access too? Is it just a matter of picking anything as long as it is not a traditional medication? If they have full prescribing access to Factor Xa inhibitors what about their training says to stop that treatment and start up an earthworm pill?
This is one of many examples and I feel like Im a bit in lala land here with ND's are being paid as equal peers in primary care but their treatments are completely wrong. Obviously if I stopped a factor Xa inhibitor and started to have the patient take earthworms that would be malpractice and I'd probably lose my license at the same time
Did I miss something?
Source: Original link