Why Naturopathic Doctors Aren't Recognized as Primary Care Pediatricians

... with one important exception

In the evolving landscape of integrative medicine, naturopathic doctors (NDs) play a vital role in supporting families with holistic, patient-centered care. Yet, despite their expertise in nutrition, lifestyle medicine, botanical therapies, and preventative health, NDs are not legally recognized as primary care pediatricians in most U.S. states.

Let's unpack the distinctions, regulations, and philosophical differences that shape this reality - and highlight one notable exception.

What is a Allopathic Primary Care Pediatrician?

An allopathic primary care pediatrician is a licensed medical doctor (MD or DO) who specializes in the care of infants, children, and adolescents. They are trained to:

• Diagnose and treat a wide range of childhood illnesses

• Administer vaccinations and manage infectious diseases

• Monitor developmental milestones and behavioral health

• Provide urgent and emergency care

• Coordinate with specialists for complex conditions

Pediatricians complete:

• 4 years of medical school

• 3+ years of pediatric residency

• Obtain board certification through the American Board of Pediatrics

This training is designed to prepare them for high-acuity care, hospital privileges, and full-scope medical management.

What is a Naturopathic Primary Care Doctor?

A naturopathic primary care doctor is a licensed medical doctor who specializes in preventative medicine, nutrition and lifestyle counseling, root-case medicine, and chronic disease management. They are trained to:

• Diagnose and treat and wide range of illnesses

• Administer homeopathy, nutraceuticals, botanical medicine, and nutritional IV therapy

• Monitor symptomatology and treatment process

• Provide urgent and primary care

• Coordinate with specialists for complex conditions

Naturopathic doctors complete:

• 4 years of medical school

• 1,200 hours of primary care rotations

• 1+ year specialized residency

• Obtain state-approved medical licensure upon successful completion of the NPLEX board exam

Legal and Regulatory Barriers

Here's why NDs aren't recognized as primary care pediatricians under U.S. law:

*may not apply to Washington State NDs

Barrier	Explanation
Lack of Pediatric Residency	NDs do not complete ACGME-accredited pediatric residencies
Vaccine Administration Limits*	Many states restrict NDs from administering or managing full vaccine schedules
State Scope of Practice	Many states do not define NDs as eligible for primary care pediatric roles
Insurance & Medicaid Restrictions*	NDs are rarely reimbursed as PCPs under Medicaid or commercial insurance plans
Hospital Privileges	NDs typically lack hospital admitting rights or emergency pediatric training

The Exception: Fellows of the American Board of Naturopathic Pediatrics (ABNP)

These NDs have completed:

• Rigorous postdoctoral training in pediatric medicine

• Extensive clinical experience with pediatric populations

• Board certification through the American Board of Naturopathic Pediatrics

While ABNP Fellows are not recognized as primary care pediatricians under conventional medical law, they represent the highest level of pediatric training within the naturopathic profession. In states with a full-scope of practice, FABNP-certified NDs may offer comprehensive pediatric care including well-child visits, chronic condition management, and vaccine counseling - within their legal limits. You can find a board-certified ABNP Fellow here.

The Role NDs Can Plan in Pediatric Care

While NDs aren't primary care pediatricians, they can be powerful allies in family medicine:

• Complimentary Support: NDs can offer integrative care alongside pediatricians especially for chronic conditions

• Preventative Guidance: Families often turn to NDs for nutrition, sleep, immune support, food intolerance, and lifestyle modifications

• Gentle Advocacy: NDs are equipped to help parents navigate medical decisions with clarity and compassion

It's important to remember, in states with full-scope licensure, some NDs do offer pediatric care - but always within their training and legal scope.

Considerations in Navigating Integrative Pediatric Care

Step 1: choose a licensed pediatrician (MD or DO) for emergencies and hospital support

Step 2: work with a licensed ND for preventative care and chronic health concerns

Step 3: complete a Release of Information for your child's medical team to ensure open communication between providers to avoid gaps in care

Final Thoughts

Naturopathic doctors bring invaluable insight to pediatric wellness. They offer a uniquely holistic lens for your child's health - supporting with gentle, individualized care that emphasizes prevention, nutrition, and emotional well-being. While they are not typically recognized as primary care pediatricians, they can play a vital role in your child's healthcare journey.

By understanding and respecting the boundaries imposed on NDs, families can create integrative care teams that blend the best of both worlds: the clinical depth of emergency medicine in conventional pediatrics and the nurturing, root-cause approach of naturopathic medicine. When these disciplines collaborate, children receive care that is not only safe and comprehensive - but truly whole.