Thriving in an Unlicensed State

Dos and Don'ts
Written by Rhonda Steinke, ND
Practicing in unlicensed states can be a rewarding experience especially since these areas are lacking integrative healthcare. The key to creating a thriving practice is to plan carefully. The following recommendations on starting a successful career in an unlicensed state are based on my experience.

Do: Hire an Attorney and Accountant
Don't: Use Inappropriate Terminology
Consider hiring an attorney and accountant to discover the legal and accounting framework that your business will have to operate under. This initial investment will save you time and money in the long run. Have the attorney look at state regulations that can affect your practice. They can be found in various areas such as Medical Practice Acts, Higher Education Acts, and Health Codes. Understanding regulations can prevent costly mistakes. For example, I've seen practitioners have to waste marketing materials after finding it necessary to change their title from "physician" to "doctor" and others forfeit inventory after discovering they could not compound botanical extracts in office. Some attorneys may recommend you avoid words such as "clinic, plan, patient, treat". They might suggest alternatives such as "office, recommendation, client, and support." Accountants will be able to differentiate important tax information for example some states do not tax supplements as they are considered food instead of retail items.

Do: Join Your State Association
Be involved with the state association and get in touch with as many Naturopathic Physicians as you can to get their opinion and perspective. I find most state associations are extremely supportive and have a strong peer network to discuss similar struggles and fears of working in an unlicensed state. It is also a good idea to find a mentor that has been working in an unlicensed state that is willing to assist as you begin the process of starting your business.
Do: Invest in Business Insurance
Find out what type of insurance best suits your practice. Business liability insurance will protect your entity and its assets from civil litigation. Malpractice insurance is available for ND's in unlicensed states but is questionable if truly protective. Some attorneys believe malpractice insurance in these states could be used against you since it is intended for those who "practice" medicine.

Do: Build a Trusting Referral Network
Don't: Practice beyond Your Scope
Build relationships with other practitioners whom diagnose and prescribe and others specializing in practice such as IV nutrients, hormone prescription, acupuncture, etc. These contacts will be an asset for building your patient base and can provide supporting documentation that you are referring for medical diagnosis and treatment. In my practice, I chose to work with “clients” already diagnosed by conventional practitioners and referred out others until a diagnosis was established.