Liability in the Naturopathic world is very different from the malpractice system that allopathic providers operate under. This stems from a radically different philosophical approach to health, the low risk experienced by patients, and a radically different type of healing interaction than most people are accustomed to.
In Allopathic Medicine, patients are diagnosed, treated with medications and surgery, and maintained in that state indefinitely – 'under' a physicians care. There is a clear differential in power, with the physician having authority over the patient – and the expectation that the patient does as directed. Because of this, an elaborate system of liability protection and malpractice has been created. Physicians, because they are human, have oversights and make mistakes. But because they are the sole authority in the therapeutic relationship – they also assume all responsibility. Since errors will always occur; allopathic physicians would be unable to practice if they were actually held responsible for their decisions. The two systems that have developed to address this are standards of care – community standards created by physicians of how patients under certain conditions should be treated and applied to all – and a medical malpractice system that essentially pays for any mistakes just as car insurance covers accidents in driving.
The Naturopathic community functions very differently. Our primary form of liability protection is based on a relationship between the patient and physician. Naturopathic physicians spend considerable time creating a relationship of trust, as evidenced by the length of their visits, accessibility of care, and the personal nature of their interactions. Naturopathic physicians are teachers. They don't tell their patients what to do, they instead educate their patients with respect to their options and support them with their decisions. The responsibility for health lies with the patient who is advised and supported by the physician with the ultimate aim being independence and self sufficiency.
Although most Allopathic providers do not disclose issues of liability or standards of care – the basis of much of the care provided has more to do with standards protecting the physicians liability than the best interest of the patient. But Naturopathic physicians actively promote medical consumerism... educating patients about different philosophies of care, stressing their rights and role in their own care, providing basic education about health issues, and generally equipping patients with respect to their rights as consumers.
For this reason Naturopathic Physicians do not frequently encounter liability issues, have different requirements for malpractice, jurisprudence and standards of care that vary from state to state based on regulations and laws. All Naturopathic physicians who have graduated from accredited universities have lines of authority under which they practice.
In a practical world, liability issues are consistent with professional demeanor and social standards. The best way to address concerns about a provider is the same way you would address any person -air your concerns directly. Lawsuits, liability and other legal misunderstandings are often quickly settled with basic information and communication. When patients go instead to others to air their complaints or use public forums – they engage in slanderous behavior, that is essentially professional gossip. Just as gossip is damaging to the reputations of individuals in the world, professional gossip is much more serious because it doesn't just hurt feelings... it damages a person's professional reputation and therefore their livelihood.
So how do patients protect themselves? In the state of Idaho anyone can call legally call themselves a Naturopathic Physician and practice. Licensure is NOT required. This is a buyer beware state – but physicians who have graduated from accredited schools are easily identified and will usually make a point of discussing their education. Secondly look for basic characteristics that identify a good physician – do they promote education, do they spend adequate time with you to establish a relationship and answer questions, and are they accessible at odd times or in case of emergency? Lastly evaluate your own appropriateness for this style of healthcare. Do you take responsibility for your own care, do you want to be more educated about your health, do you want to learn to be a good medical consumer and become more self sufficient? If you want to know who a physician is, ask for patient referrals and ask the questions that concern you the most.
How do Naturopathic Physicians protect themselves? Naturopathic Physicians protect themselves by following professional and ethical standards; creating relationships with their patients; and conducting themselves with integrity. Our biggest challenge is practicing in a community where there is a huge discrepancy between different providers who may call themselves by the same titles. While the term Naturopathic Physician in Washington State refers to a physician who has graduated from an accredited university with a doctoral degree in medicine and is formally trained as a primary healthcare provider; in Idaho anyone can practice and call themselves a Naturopathic Physician - no training required.
In summation, genuine safety in healthcare varies markedly between the various healing professions based on the risks to the patients. Rules for protecting oneself from a poor outcome follow the boundaries of common sense and social standards. Shop around, ask questions, and be a good consumer. Communicate with your provider. And if you encounter challenges, follow professional and ethical standards. These simple tips protect the therapeutic relationship that is essential for genuine healing.
The right to make decisions about your own health care is a tenuous one. There are many people who support the concept of a medical monopoly, denying patients the right to choose their own care.... there has never been a time where this choice is more at risk. Consumers who access and support medical alternatives promote that right for all people. But the success of the system is dependent on NOT falling into the constraints that insurance, malpractice, professional associations, and legislation has imposed on our ability to make choices about our own care. In my humble opinion and with respect to my faith; maintaining exceptional and professional Naturopathic care is the way I choose to protect the rights of my patients.