The Naturopathic Physicians Board of Medical Examiners regulates approximately 195 active naturopaths. The scope of practice for these physicians has expanded substantially since 1992, when a seemingly minor statutory wording change eliminated the requirement that naturopaths use only drugless and nonsurgical methods. Now, Arizona’s scope of practice appears to be the broadest of the 11 states that regulate naturopathic physicians. Because the intent behind this change is unclear, the report recommends that the Legislature review the Board’s statutes and clarify the scope of practice as needed. The report also recommends that the Legislature consider establishing a separate body to oversee development of the Board’s formulary, or list of drugs that naturopaths are allowed to prescribe. Currently, the formulary lists more than 460 drugs, including some controlled substances. Unlike other states, a separate body did not oversee Arizona’s formulary development, and it has not been adopted in administrative rule.
The report also contains three additional findings relating to the Board’s performance in areas such as licensing, complaint processing, and management oversight:
Licensing examination: The Board has not shown that its three-part examination was developed, scored, and maintained appropriately, which raises questions about whether it can be used to measure licensing applicants’ competency to practice naturopathy. The Board also has not maintained adequate records to show that all licensed naturopaths have taken all required parts of the examination.
Complaint processing: The Board has been slow to process some complaints and, at the time of this review, had developed a backlog of cases. Although the Board has begun to act on these complaints, additional efforts are needed in two areas. First, to ensure that the public has access to naturopaths’ complaint histories, the Board needs to improve recordkeeping. Second, to ensure that Board decisions do not appear biased, the Board needs to separate its investigation and adjudication functions.
Management oversight: Board operations suffer from numerous problems that either have not been recognized or adequately addressed. Specifically, numerous recordkeeping deficiencies exist, and the Board has had difficulty adhering to its personal services budget. The Board has also not responded to 1992 and 1998 legislative directives to develop and implement rules. Many of these problems are compounded by the Board’s failure to adequately oversee its executive director. In addition, the Board has allowed open meeting law violations to occur, and has not ensured that its members avoid participating in decisions where conflicts of interest may exist.