Why Do Doctors Hate Naturopaths? What the Criticism Is About and How to Choose Well

Most of what gets called "hate" is public, organized criticism from medical associations such as the American Medical Association (AMA) and the American Academy of Family Physicians (AAFP). It comes down to four points:

• Training. Naturopathic doctors (NDs) complete a four-year program, and residency is usually optional. Physicians must complete a residency to be fully licensed.
• Evidence. There are few well-designed studies of naturopathic care, and some treatments common in naturopathic practice have no good evidence behind them.
• Scope of practice. Medical groups oppose bills that would let NDs prescribe more drugs or be treated as primary care physicians.
• Unlicensed practice. In about half of US states, no law controls who can call themselves a naturopath.

The last point matters most for patients. A licensed ND has finished an accredited four-year program and passed national board exams. A "traditional naturopath" has done neither. If you are considering a naturopath, find out which kind you are dealing with and keep your doctor informed. Below is what each side argues and how to choose well.

Licensed ND or traditional naturopath: who the criticism is aimed at

"Naturopath" covers two very different groups. The National Center for Complementary and Integrative Health (NCCIH) separates them:

• Licensed naturopathic doctors graduate from a four-year doctoral program accredited by the Council on Naturopathic Medical Education (CNME), pass the national board exams (NPLEX), and hold a state license where one exists.
• Traditional naturopaths train in programs that are not accredited and are not eligible for a license.

Some criticism applies to both groups and some applies only to unlicensed practitioners. The AAFP, for example, opposes licensing naturopaths at all, so its objections cover licensed NDs too. Concerns about practitioners with no accredited training apply mainly to the unlicensed group. California's naturopathic board reports that most of its enforcement cases involve unlicensed activity.

Where NDs stand legally depends on the state:

• Licensed or registered: 23 states, plus Washington, D.C. and Puerto Rico, by our count of state statutes (Wyoming Legislative Service Office, 2025). The AMA (2024) says at least 24 states and D.C. license or regulate naturopathic doctors. Sources differ, so check your state board.
• Banned: Florida, South Carolina and Tennessee prohibit the practice. In Florida, practicing or using an ND title without a license is a third-degree felony, and the state has issued no new licenses since 1959. A 2026 bill to restore licensing was vetoed in June 2026.
• Unregulated: the remaining 24 states, including New York. In unregulated states, practitioners may generally use titles such as "naturopath" or "traditional naturopath" as long as they don't claim a state license (Connecticut OLR, 2023).

Some history helps explain the split. Benedict Lust adopted the term "naturopathy" in 1902 (Naturopathic Medicine review). The 1910 Flexner Report, which reshaped US medical schools, reviewed homeopathic, eclectic and osteopathic schools but does not mention naturopathy (Flexner Report, full text). Bastyr University, a naturopathic school in Seattle, was founded in 1978 (Bastyr history).

Licensing is not new either. Florida's law dates to 1927, and NPLEX has been the national licensing exam since 1986 (California board, 2026). Massachusetts, which has a Board of Registration in Naturopathy, began licensing NDs in 2022. For the full state list, see which states license naturopathic doctors.

How ND training compares with medical training

Training is a central objection. The table below compares the main training steps.

Sources: California Board of Naturopathic Medicine, 2026; CNME; CNME Handbook of Accreditation, September 2025; Utah Code 58-71-302; American Board of Family Medicine.

Two claims about training circulate widely and are wrong:

• "NDs have no national licensing exam." They do. NPLEX is used across the licensing states and Canadian provinces.
• "NDs get only 1,200 hours of patient contact." The 1,200 hours is the minimum supervised clinical training inside a program of at least 4,100 hours. It is not a count of patient contact.

For more on degrees, titles and residency, see whether a naturopathic doctor is a real doctor.

What doctors' organizations say

AMA. In its April 5, 2024 advocacy update, the AMA reported that one of its trustees testified against bills in Connecticut and Alaska that would have let NDs prescribe. The reasons given were that NDs lack residency training and broad clinical exposure, and that their pharmacology is taught alongside botanical medicine and homeopathy. The AMA also describes NDs as seeking broader scope, including the power to prescribe controlled substances. We could not confirm a formal AMA policy number on naturopathy.

AAFP. The AAFP's naturopathic practice policy (page dated December 2019) opposes licensing naturopaths and opposes scope expansion where they are licensed. It also says NDs should never use the title "physician" or be considered primary care physicians, and that insurers should not be required to cover naturopathic services.

State medical societies. They often lead the fight in individual states. The North Carolina Medical Society, for example, said in June 2024 that it helped halt legislation to license naturopaths in Senate Bill 607, calling the proposed scope undefined and expansive. The session law that SB 607 became contains no naturopathy text (S.L. 2024-45), and North Carolina still does not license naturopathic doctors.

How naturopaths see the conflict

Naturopaths and their supporters argue that licensing protects patients by separating trained NDs from people with no accredited training. The sponsor memo for New York's 2026 licensing bill, S8714, makes this point. It notes that because New York does not regulate NDs, "anyone may lay claim to the title." A June 2025 issue brief from ND advocates to Wyoming lawmakers proposes licensing on similar grounds.

The profession describes its approach through six stated principles, including "first do no harm," "identify and treat the causes" and "treat the whole person." The full list of six also includes prevention (AANMC). These are professional principles, not research findings. Both sides say they treat the causes of illness. Where they really disagree is on what counts as evidence.

What the evidence shows

The evidence on naturopathic care is thin rather than clearly negative:

• The Merck Manual says there are few well-designed studies of naturopathy.
• A 2019 scoping review found 33 studies with 9,859 participants, mostly on chronic conditions, and its authors concluded that naturopathic care was effective for several of them. The review also counted case series of five or more patients, which weakens that conclusion.
• A 2012 conference abstract by Calabrese and colleagues, reporting a systematic review in progress, had identified 12 studies of whole-practice naturopathic care, six of them randomized trials, and said the findings merit further investigation. It is an abstract, not a full paper. The full review, published in 2015, reported benefit in its included studies but noted the limits of their observational designs (Oberg et al., 2015).
• NCCIH does not rate whether naturopathy as a whole works.

For a fuller look at the research, see whether naturopathy is legit.

Treatments that draw the most criticism

Much of the criticism targets specific practices, not the profession as a whole:

• Homeopathy, chelation and colon cleansing. A 2011 analysis by Caulfield and Rachul of 53 naturopathic clinic websites in Alberta and British Columbia found these commonly advertised treatments had no evidence beyond placebo. The study looked at marketing claims, not patient outcomes.
• Colon cleansing and "detox." NCCIH says there is limited evidence for detoxes and cleanses and that colon cleansing can cause serious side effects. A 2009 systematic review found no rigorous controlled trials supporting colon cleansing for general health, described adverse effects in case reports and case series, and concluded that the practice "cannot be recommended at this time."
• Vaccines. The Merck Manual notes that some naturopaths discourage childhood vaccination.

Patient safety

Doctors' main safety concern is about diagnosis and prescribing. The AMA argues that NDs lack the training to do both safely. How often naturopathic care actually harms patients is not well measured. We found no systematic review of harms from naturopathic care in PubMed (searched October 2026). The specific harms that are documented come from particular treatments, such as colon cleansing (see above).

NCCIH's practical advice is simple: tell all your health care providers about any complementary approaches you use, so they can coordinate your care.

Where doctors and NDs already work together

In several licensing states the law requires NDs to work with physicians (Connecticut OLR, 2023, and state statutes):

• Maine: NDs can prescribe only after a 12-month collaboration with an MD or DO.
• Maryland: a collaborative agreement is a condition of the license.
• New Mexico: licensed NDs practice primary care in collaboration with a physician (NM Naturopathic Doctors' Practice Act).
• California: apart from hormones, NDs prescribe only under a procedure set up with a supervising physician (California board, 2026).

Prescribing rules vary widely. See which states let naturopathic doctors prescribe.

How to choose a naturopath your doctor can work with

1. Check the license. In a licensing state, look the ND up on the state board's website. New York has no ND license, so check what license the person does hold (MD, DO, NP, RN or other) with the NYSED license verification search.
2. Ask about training. Ask which CNME-accredited school they attended and whether they passed NPLEX. A weekend or online "certification" is not the same thing.
3. Tell your doctor. Bring a written list of every supplement, herb and treatment the naturopath suggests.
4. Ask the naturopath to coordinate. Ask whether they will send visit notes or lab results to your doctor.
5. Don't stop prescribed treatment on your own. Talk to the prescriber before stopping or changing any medication, screening or vaccine.
6. Be wary of the practices above. Ask what evidence supports any colon cleanse, "detox" or homeopathic product before you pay for it.

If you aren't sure how to raise it, something like this works:

I'm seeing a licensed naturopathic doctor for [concern]. Here is the list of supplements and treatments they suggested. Could you check them against my medications and tell me if anything concerns you?

Our guide on how to find and vet a naturopathic doctor covers the questions to ask in more detail. To compare practices, browse naturopathic doctors in our directory or see naturopathic doctors in New York.

When to see a medical doctor

• Emergencies, and any new, severe or fast-worsening symptoms.
• Anything that needs a prescription drug an ND can't prescribe in your state.
• Care you want Medicare to pay for. NDs are not on Medicare's list of physician types.
• Before you stop or change any prescribed medication.

Last reviewed: October 2026