In April 2011, North Dakota became the 16th state to license naturopathic doctors, just six months after a group including two Bastyr alumnae and two current Bastyr students began a concerted push for state licensure.
"I think it's going to be amazing," says Bastyr alumna Faye Johnson, ND, LAc (03), who has a thriving practice in North Dakota. "In addition to giving the practice more exposure, the bill also eliminates any gray areas in practicing naturopathic medicine."
Fellow alumna Elizabeth Allen, MS, ND ('09), led the effort along with Johnson and Bastyr ND students Elizabeth Allmendinger and Sara Christopherson, who both are graduating June 20.
"We were not expecting the bill to pass the first time it was introduced," Dr. Allen admits, adding that she's aware of just one other licensing bill that went through the state Legislature in one attempt. "It was really surprising — we really thought the bill would be dead after that first hearing."
But her tireless efforts and the targeted lobbying by the North Dakota Association of Naturopathic Doctors helped not only to keep Senate Bill 2271 (pdf) alive, but also to secure an approval that was unanimous in the Senate and 80-10 in the House.
Spreading the Word Beyond Naturopaths
Christopherson says North Dakota's size, with a population of less than 650,000, worked in their favor.
"I think it has to do with the state being small, and that many people know elected officials personally," she says. "It was just easier to reach out to a lot of the legislators on a personal level."
Christopherson says many of her own connections are from her days growing up in Fargo, the largest city in North Dakota. And it doesn't hurt that both of her parents grew up in the state: Her mom has been a nurse for 30 years in North Dakota's biggest hospital system, while her dad is a loan officer for farmers and is on a first-name basis with many of the state's legislators.
"Prior to this, I've been educating a lot of my friends and family on what I'm doing, what naturopaths are and what they do, and I'm constantly sharing the inspiring stories of healing," Christopherson says. So when it came time to ask all of these contacts to help her with the email lobbying effort, they were ready to join the effort and to enlist the additional support of their own family and friends.
"I think it helps that it wasn't all just naturopaths contacting the legislators," Christopherson explains. "Support was coming from farmers, business owners, nurses and MDs."
Dr. Allen reiterated that a scope of support is important for any other natural medicine providers pursuing state licensure.
"You have to build relationships with legislators, and you also have to build relationships with business people and with those in the medical profession," she says.
Dr. Allen secured many of those relationships in an earlier career clerking for the 1993 state Legislature, in addition to eight years working for the state government.
"Many of the freshmen legislators I got to know while I was clerking are now experienced, long-term senators," she says. "Now they're the ones who the freshmen legislators listen to."
Are You Ready to Pursue Licensure?
Allmendinger learned first-hand how the system works when she flew to North Dakota during winter quarter to testify at the licensure hearing.
"I've done a lot of public speaking in my life," she says," but that was the most nerve-wracking. I just felt so strongly about it that I didn't want to make any mistakes, especially since saying the right thing would have such a positive impact."
Dr. Allen adds that a successful attempt at pursuing state licensure has a lot to do with the details.
"There are a lot of little miscellaneous things you need to know," she says, "like how many copies to make, how to prepare for questions, and just knowing where to get information to stay on top of your bill's status."
She adds that following your bill's progress on a daily basis is a must, which can make it hard for practitioners to lead these efforts.
Dr. Allen actually worked full time on the bill from around Thanksgiving of 2010 until the first hearing ended Jan. 31, then she continued working 10 to 30 hours a week until the bill was signed into law April 26. And although her tireless efforts led to the bill's passage, they also took a toll. She recently decided to close her practice.
The Future for North Dakota's Naturopathic Doctors
With new doors opening up for naturopathic physicians in the state, Dr. Allen is looking forward to opportunities that better meet her goals.
"I'd like to try to find a position where I can use all three of my degrees," she says, listing a bachelor's degree in social work and a Master of Science in Public and Human Service Administration in addition to her Doctor of Naturopathic Medicine. And she's confident passage of SB2711 will help her find that ideal position.
"Having licensure will legitimize what we're doing and make it a lot easier for agencies to consider creating new positions," Dr. Allen says, offering as an example a job share with a nurse practitioner. "There are things that a nurse practitioner can do and there are things that I can do, so it'd be a way of creating a position and expanding holistic care."
Allmendinger, who's also studying acupuncture and Oriental medicine in a dual track, says the bill's passage couldn't have come at a better time for her own plans to move back to Bismarck, N.D. Previously, she was considering practicing just over the border in Montana or Minnesota, both of which also license NDs, so she could still be close to family and serve North Dakota residents.
"This enables me to go exactly where I want to be," Allmendinger says.
And she's likely not the only one. As part of her testimony at the licensure committee, Allmendinger brought up North Dakota's declining population, explaining that the bill's passage could help convince educated young people such as herself to move back to the state to practice.
Attracting more naturopathic doctors to the state also could help alleviate the shortage of rural health providers. "I think the bill had a big pull because it's hard to get practitioners to move to North Dakota and to live in the rural areas," Christopherson says.
Although she's not one of those practitioners who plans to move to rural North Dakota, Christopherson does admit that the idea of practicing in the state is much more appealing to her now because of the licensure.
Meanwhile, Dr. Johnson is looking forward to the competition licensure will bring, as well as to the opportunities that await naturopathic doctors in North Dakota.
"We're excited to be 'Sweet Sixteen,'" she says. "I'm excited to go back to the Legislature in two years and ask for more. With this experience under our belts, I'm not afraid of the process. I know we can get more the next time around."