Open Access Research article

Practice patterns of naturopathic physicians: results from a random survey of licensed practitioners in two US States

Heather S Boon1*, Daniel C Cherkin2, Janet Erro2, Karen J Sherman2, Bruce Milliman3, Jennifer Booker4, Elaine H Cramer5, Michael J Smith6, Richard A Deyo7 and David M Eisenberg8

Author Affiliations

1 Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada

2 Center for Health Studies, Group Health Cooperative, Seattle, Washington, USA

3 Bastyr University, Naturopathic Medicine Program, Kenmore, Washington, USA

4 Private Practice, Olympia, Washington, USA

5 Centers for Disease Control, Vessel Sanitation Program, Atlanta, Georgia, USA

6 Natural Health Products Directorate, Health Canada, Ottawa, Ontario, Canada

7 University of Washington Departments of Medicine and Health Services, Seattle, Washington, USA

8 Beth Israel-Deaconess Center for Alternative Medicine Research and Education, Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA

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BMC Complementary and Alternative Medicine 2004, 4:14  doi:10.1186/1472-6882-4-14

Published: 20 October 2004



Despite the growing use of complementary and alternative medicine (CAM) by consumers in the U.S., little is known about the practice of CAM providers. The objective of this study was to describe and compare the practice patterns of naturopathic physicians in Washington State and Connecticut.


Telephone interviews were conducted with state-wide random samples of licensed naturopathic physicians and data were collected on consecutive patient visits in 1998 and 1999. The main outcome measures were: Sociodemographic, training and practice characteristics of naturopathic physicians; and demographics, reasons for visit, types of treatments, payment source and visit duration for patients.


One hundred and seventy practitioners were interviewed and 99 recorded data on a total of 1817 patient visits. Naturopathic physicians in Washington and Connecticut had similar demographic and practice characteristics. Both the practitioners and their patients were primarily White and female. Almost 75% of all naturopathic visits were for chronic complaints, most frequently fatigue, headache, and back symptoms. Complete blood counts, serum chemistries, lipids panels and stool analyses were ordered for 4% to 10% of visits. All other diagnostic tests were ordered less frequently. The most commonly prescribed naturopathic therapeutics were: botanical medicines (51% of visits in Connecticut, 43% in Washington), vitamins (41% and 43%), minerals (35% and 39%), homeopathy (29% and 19%) and allergy treatments (11% and 13%). The mean visit length was about 40 minutes. Approximately half the visits were paid directly by the patient.


This study provides information that will help other health care providers, patients and policy makers better understand the nature of naturopathic care.