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Why NDs Must Use Extra Care When Prescribing

Several of the tenets of naturopathic medicine – treat the whole person and the role of the patient in the healing journey – often result in a different relationship between naturopathic doctors and their patients.

While the underpinning of these tenets is good, there are instances where the patient essentially begins dictating their care against the better judgment of the provider. For example:

  1. If you do not “normally” prescribe certain drugs, be careful about making exceptions for individual patients. Do you have sufficient information about their condition, the prescription, guidelines related to it, and are you willing to take on the long-term management of that condition?
  2. Many states have specific guidelines or requirements for prescribing controlled substances; make sure you are up to date with the latest education and regulation. Ignorance of the law will not save you from discipline.
  3. Coordination of care with other providers is a successful way of making sure that your patient is following through with their care plan and getting the care they need. You can create this expectation and requirement in your care plan. If a patient is unwilling to identify (or doesn’t remember) their other providers or sign a release for you to obtain their records that is a red flag.
  4. The Prescription Drug Monitoring Program (called by different names depending on the state) is a rich tool for providers and often prescribers are required to check it before prescribing controlled. Sign up for it and obtain each patient’s prescription history so you know who their prescribing providers are and whether patient remembered to report all their medications.
  5. If you have a contract with a patient, it is ineffective if you do not enforce it.

Be aware that some patients may feign interest in pursuing naturopathic treatment. Watch for signs that a patient is disengaged and uncooperative when it comes to following non-pharmacologic treatment regimens. As an ND, it is essential you protect yourself against drug-seeking patients.

About the Author

Adina Matasaru, principal at Matasaru Law, PC, is an experienced attorney representing clients in complex malpractice defense and prevention, medical ethics and professional license defense. Matasaru has represented naturopathic physicians for more 17 years and is dedicated to the expansion and protection of the profession. She frequently volunteers as a speaker on risk management and medical ethics and advises various alternative healthcare institutions and associations. She is vice chair of the NUNM board of directors. Rebecca Tobias, senior paralegal at Matasaru Law, provided invaluable assistance

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