Naturopathic Doctor

What naturopathic doctors make

The published median is $115,210 a year, with the bottom tenth at $65,210 and the top tenth at $195,190. Treat the middle of that with caution: the federal survey has no separate code for naturopathic doctors, so these figures come from a residual group called Healthcare Diagnosing or Treating Practitioners, All Other. What you actually earn depends enormously on whether your state licenses the profession at all.

Your first years

Most naturopathic doctors are self-employed. A new practice takes two to four years to fill, and in that time you carry student debt, clinic rent and malpractice insurance on a small patient list.

Insurance is the swing factor

In states that license the profession, some insurers cover visits and some do not. In states that do not license it, patients pay out of pocket for everything, which caps what you can charge and who can afford to see you.

What it costs to get there

Bachelor's degree with science prerequisites, in-state public

4 years, roughly $10,000 to $12,000 a year in tuition and fees

Doctor of Naturopathic Medicine

4 years at a private school, and tuition is comparable to other private graduate health programs

Licensing exams

The NPLEX (Naturopathic Physicians Licensing Examinations) in two parts, plus your state board's fees

Setting up a practice

Rent, equipment, dispensary stock and malpractice insurance, before your first patient

Roughly, all in

$185,000 to $235,000

Tuition, fees, exams and kit. Not rent, food or travel

The low end is a four year bachelor's degree with science prerequisites at in-state public rates of about $10,000 a year, then four years at an accredited naturopathic medical school, where tuition runs near $38,000 a year, plus the two part licensing examinations and your state board's fees. The high end is the dearer end of both. There are no public naturopathic schools in the country, so there is no in-state discount to find and the whole doctorate is charged at private rates. Setting up a practice afterwards costs more again for rent, equipment, dispensary stock and malpractice insurance, and debt in this field tends to be high relative to the income it buys.

File the FAFSA (Free Application for Federal Student Aid) every year. Graduate students can borrow federal loans, but there are no accredited public naturopathic schools, so debt in this field tends to be high relative to the income it buys.

How the money arrives

• Fee for visit

  Longer appointments than a conventional clinic, usually billed by time.

• Dispensary sales

  Supplements and herbal preparations sold through the practice, which is also the part critics scrutinize most.

• Insurance billing

  Possible in some licensed states, and a large part of whether a practice is viable.

• Teaching and writing

  The accredited schools and their clinics employ faculty.

The path

Eight to nine years, and the last four are only available at a handful of private schools.

1. 1

   High school

   Grades 11 and 12

   Biology, chemistry, physics and math, taken seriously. The prerequisites for the doctorate are real science courses.

2. 2

   Bachelor's degree

   4 years

   Any major, with the science prerequisites: general and organic chemistry, biology, physics and psychology.

3. 3

   Doctor of Naturopathic Medicine

   4 years

   Four years at an accredited school. Anatomy, physiology, pathology, pharmacology and diagnosis alongside botanical medicine, nutrition and counseling.

4. 4

   Clinical training

   Included

   Supervised patient care in the school's teaching clinic, built into the final years of the program.

5. 5

   Licensing exams and a state license

   Months

   The NPLEX (Naturopathic Physicians Licensing Examinations), Part 1 in biomedical science and Part 2 in clinical science, then apply to your state board.

High school courses that help

• Chemistry

  Two years of college chemistry are a prerequisite, and it is where people fall down.

• Biology

  Anatomy, physiology and pathology run through the whole doctorate.

• Psychology

  Appointments are long and a lot of the work is behavior change and counseling.

• Business

  Most naturopathic doctors run their own practice, and many fail as businesses rather than as clinicians.

Time and money, at a glance

Years after high school

8 to 9

Tuition

In-state public for the bachelor's, then four years of private graduate tuition

Paid while training?

No

License required

Yes in the states that license the profession, and in the rest it is not available at all

Read this before you commit

Roughly half the states, plus the District of Columbia, license naturopathic doctors, and the rules differ sharply between them: what you may prescribe, whether you may order imaging and whether you may call yourself a physician all change at the state line. Where there is no licensing law there is no route to practice under this title at all. This is also not the same profession as a medical doctor. If your goal is to diagnose and treat disease with the full authority of a physician, look at family medicine, a physician assistant program or nursing instead, and look honestly.

Where people study

Only a small number of schools in the United States are accredited to award the degree. All of them are private.

• Bastyr University

  Campuses near Seattle, Washington and in San Diego, California.

• National University of Natural Medicine

  Portland, Oregon, the oldest naturopathic school in the country.

• Sonoran University of Health Sciences

  Phoenix, Arizona.

• National University of Health Sciences

  Chicago area, Illinois, which also trains chiropractors.

Areas people specialize in

• Residency

  Optional in most states and hard to get, but it is the fastest way to become a competent clinician after graduating.

• Integrative oncology

  Working alongside cancer teams on nutrition, symptoms and side effects. There is a board certification for it.

• Women's health and fertility

  One of the largest sources of patients in private naturopathic practice.

• Environmental and occupational medicine

  Exposure histories and chronic complaints that conventional clinics move through quickly.

Nice-to-haves

• Shadowing a licensed naturopathic doctor

  Do this before you apply. A day in a real practice tells you more than any brochure.

• Nutrition coursework

  Central to the work and useful whichever health career you end up in.

• Small business skills

  Bookkeeping, scheduling, marketing and insurance billing, all of which fall to you.

• A backup plan

  Public health, nutrition and nursing are adjacent fields with broader licensing.

A typical day

Four to six patients rather than twenty. First visits run an hour or more: full history, diet, sleep, stress, family history, medications, then an exam and lab orders. Follow-ups are shorter but still long by conventional standards. Between appointments you review lab results, write plans, call a pharmacy or a physician about a patient you share, and restock the dispensary. Admin, billing and marketing fill whatever is left, because in most practices you are also the owner.

The honest trade-offs

Work life

Typical hours

Clinic hours, and evenings if you own the practice

Remote work

Telehealth is common for follow-ups in licensed states

Physical demand

Low

Unionized

No

Similar paths

• AcupuncturistTreat pain and illness with needles at specific points on the body. A master's degree, a state license, and usually your own practice.
• ChiropractorTreat back, neck and joint pain with your hands. Four years of doctoral school, then usually your own clinic.
• DietitianThe person hospitals call when food becomes medicine. A master's degree is now the entry ticket.

Your state line decides your career

A naturopathic doctor with exactly the same degree can be a licensed primary care provider in one state and legally unable to use the title one state over. No other health profession in the country varies this sharply.

There is no public school for it

Every accredited naturopathic medical school in the United States is private. There is no in-state tuition version of this degree, which is the main reason graduates carry heavy debt into a profession with uneven earnings.

The exam comes in two parts

The NPLEX (Naturopathic Physicians Licensing Examinations) is split into Part 1, biomedical science, taken partway through the program, and Part 2, clinical science, taken at the end. The board that runs it also handles candidates in Canada.