$73,960/year
Bachelor's degree + 4 years
Certification
State licensure (licensed states only)
Job Growth
8% (2022-2032)
Entry Level
No
Work Setting
Private practices, integrative medicine clinics
Last Updated
January 2025
Reviewed by:Sarah Mitchell, PA-C, MPAS – Emergency Medicine Physician Assistant
What is a Naturopathic Physician?
Naturopathic physicians (Doctors of Naturopathic Medicine, ND or NMD) are primary care providers trained in both conventional medical sciences and natural therapeutic approaches. NDs diagnose diseases, treat patients using natural therapies, prescribe medications (in some states), perform minor surgery, and emphasize disease prevention through lifestyle modifications. There are approximately 6,000-8,000 licensed naturopathic physicians in the United States, with numbers growing as more states establish licensure.
Naturopathic medicine is founded on six principles: First, do no harm (use least invasive treatments first); The healing power of nature (support body’s self-healing mechanisms); Identify and treat causes (address underlying disease causes, not just symptoms); Doctor as teacher (educate patients about health); Treat the whole person (address physical, mental, emotional, spiritual aspects); Prevention (emphasize disease prevention and wellness).
NDs complete four-year naturopathic medical schools studying basic medical sciences (anatomy, physiology, biochemistry, pathology) alongside natural therapeutics including clinical nutrition, botanical medicine, homeopathy, hydrotherapy, lifestyle counseling, and physical medicine. Training emphasizes integrating conventional diagnostics with natural treatment approaches.
Scope of practice varies dramatically by state. Twenty-six states plus DC, Puerto Rico, and US Virgin Islands license NDs. Licensed NDs can diagnose diseases, order laboratory tests and imaging, prescribe natural medicines, and serve as primary care providers. Prescribing authority for pharmaceutical medications varies by state, with some allowing full prescribing including controlled substances, others limiting to specific medications, and some prohibiting pharmaceutical prescribing entirely. Unlicensed states don’t regulate naturopathic practice, limiting professional recognition and insurance reimbursement.
Why Become a Naturopathic Physician?
Natural, Integrative Approach:
NDs combine conventional diagnostics with natural therapeutics, appealing to those preferring holistic, patient-centered care minimizing pharmaceutical interventions and emphasizing wellness.
Growing Patient Demand:
Increasing consumer interest in natural medicine, preventive care, and integrative approaches drives demand for naturopathic services. Many patients seek NDs specifically for natural alternatives.
Primary Care Role:
In licensed states, NDs serve as primary care physicians managing acute and chronic conditions, ordering tests, diagnosing diseases, and coordinating specialty referrals.
Practice Autonomy:
Most NDs own private practices or work in integrative clinics, controlling treatment approaches, scheduling, and practice philosophy.
Disease Prevention Focus:
Naturopathic medicine emphasizes preventing disease through nutrition, lifestyle modifications, and early intervention, aligning with current healthcare trends toward preventive care.
Long Patient Visits:
NDs typically spend 60-90 minutes on initial visits and 30-45 minutes on follow-ups, allowing comprehensive patient assessment and therapeutic relationships.
Work-Life Balance:
Most NDs work predictable office hours with minimal call responsibilities, providing excellent work-life balance.
Three Spheres of PHN Influence
What Naturopathic Physicians Do?
In the next section, you’ll learn about the core responsibilities, daily activities, and areas of impact that define a ND—across patient care, nursing practice, and healthcare systems.
Daily Responsibilities and Tasks
Comprehensive Patient Assessment
NDs conduct extensive patient evaluations including detailed medical histories covering symptoms, diet, lifestyle, stress levels, sleep patterns, environmental exposures, and emotional health. Physical examinations are thorough, assessing all body systems. NDs order and interpret laboratory tests (blood work, urinalysis, hormone panels), imaging studies (X-rays, ultrasound), and specialized functional medicine testing (food sensitivity panels, comprehensive stool analysis, nutritional assessments).
Diagnostic approach considers conventional disease classifications alongside functional medicine perspectives identifying nutritional deficiencies, hormonal imbalances, digestive dysfunction, and toxic exposures contributing to symptoms.
Natural Therapeutic Interventions
Clinical Nutrition: NDs develop individualized nutrition plans addressing specific health conditions. Therapeutic diets may include elimination diets identifying food sensitivities, anti-inflammatory protocols, detoxification programs, or disease-specific nutritional approaches (diabetic diets, cardiovascular nutrition, cancer nutrition support).
Botanical Medicine: Prescribing herbal medicines in various forms (tinctures, capsules, teas, topicals) treating infections, inflammation, hormonal imbalances, digestive disorders, and other conditions. NDs understand herb-drug interactions, appropriate dosing, and contraindications.
Nutritional Supplementation: Recommending vitamins, minerals, amino acids, essential fatty acids, and other nutritional supplements correcting deficiencies and supporting physiological functions.
Homeopathy: Some NDs incorporate homeopathic remedies (highly diluted substances) based on homeopathic principles, though this modality remains controversial within medicine.
Physical Medicine: Using hydrotherapy (water therapy), therapeutic exercise, massage, joint manipulation, and physiotherapy addressing musculoskeletal conditions and supporting healing.
Lifestyle Counseling: Extensive patient education about stress management, sleep optimization, exercise programs, environmental toxin reduction, and mind-body practices (meditation, yoga).
Conventional Treatments When Appropriate
Licensed NDs in prescribing states can prescribe pharmaceutical medications when natural approaches are insufficient or conventional treatment is most appropriate. This includes antibiotics for bacterial infections, thyroid medications for hypothyroidism, or diabetes medications when needed.
NDs perform minor office procedures including wound care, laceration repair, skin lesion removal, joint injections, trigger point injections, and IV nutrient therapy.
Preventive Care and Health Promotion
NDs emphasize disease prevention through health screenings, immunizations (where scope permits), nutritional counseling, lifestyle modifications, and early intervention. Annual comprehensive wellness visits address potential health risks before diseases develop.
Collaborative Care
NDs coordinate with medical specialists when patients require conventional medical interventions (surgery, advanced diagnostics, specialty treatments). Integrative practices combine ND care with MDs, DOs, acupuncturists, and other providers creating comprehensive treatment teams.
Chronic Disease Management
NDs manage chronic conditions including diabetes, hypertension, autoimmune diseases, digestive disorders, hormonal imbalances, chronic pain, and mental health conditions. Treatment plans integrate conventional diagnostics with natural therapeutics, often reducing medication needs and improving quality of life.
Patient Education
Extensive time is devoted to educating patients about their conditions, treatment options, self-care strategies, and disease prevention. NDs empower patients to take active roles in their health through informed decision-making and lifestyle changes.
Practice Management
Practice-owning NDs manage business operations including staff supervision, inventory management (supplements, herbal medicines), billing, insurance processing (limited in many states), marketing, and regulatory compliance with state laws.
What’s Next?
Work Environment and Lifestyle
This section covers hospitals, specialty clinics, academic environments, and leadership roles—helping you visualize your future workplace.
Work Environment and Lifestyle
Where Naturopathic Physicians Work
Approximately 75% of NDs operate private practices or work in integrative medicine clinics. Private practice NDs see patients in office settings providing scheduled consultations, physical examinations, and natural treatments. Many NDs integrate retail operations selling supplements, herbal medicines, and health products.
Integrative medicine clinics employ NDs alongside MDs, DOs, acupuncturists, chiropractors, and massage therapists, offering comprehensive natural and conventional care. Some NDs work in naturopathic hospitals (Bastyr University clinic in Washington) or university clinics.
Cancer centers and specialty clinics increasingly hire NDs providing supportive care during conventional cancer treatment, managing treatment side effects, and supporting patient wellness. Some NDs focus on specific populations (pediatrics, women’s health, geriatrics) or conditions (chronic pain, autoimmune disease, mental health).
NDs also work in corporate wellness programs, spas, retreat centers, and teaching positions at naturopathic medical schools.
Work Schedule and Lifestyle
Most NDs work 35-45 hours weekly with flexible, self-determined schedules. Office-based NDs typically work Monday-Friday with occasional evening or Saturday hours. Longer appointment times (60-90 minute initial visits) mean fewer patients daily compared to conventional medical practices.
Call responsibilities are minimal or non-existent. NDs generally don’t manage emergency situations, referring patients to emergency departments when needed.
Work-life balance is excellent compared to conventional medicine. Predictable schedules, practice autonomy, and meaningful patient relationships contribute to high job satisfaction.
Pros
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Holistic, Patient-Centered Care - Long visits, comprehensive treatment approaches
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Practice Autonomy - High ownership rates, treatment philosophy control
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Growing Demand - Increasing consumer interest in natural medicine
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Excellent Work-Life Balance - Regular hours, no call, flexible schedules
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Disease Prevention Focus - Proactive rather than reactive care
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Strong Patient Relationships - Extended visits, collaborative approach
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Diverse Treatment Modalities - Multiple therapeutic options
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Meaningful Work - Helping patients through natural, empowering approaches
Cons
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Limited Licensure - Only 26 states license NDs, restricting practice locations
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Variable Scope - Practice authority varies dramatically by state
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Insurance Limitations - Many insurance plans don't cover naturopathic care
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Lower Income - Median $73,960 versus $200,000+ for conventional physicians
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Professional Skepticism - Some medical providers question naturopathic approaches
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Student Debt - $150,000-$200,000 debt with modest starting incomes
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Evidence Base Debates - Some naturopathic treatments lack robust research support
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Marketing Required - Cash-based practices require strong marketing
What’s Next?
Salary and Compensation
Learn about average salaries, factors that influence compensation, and projected demand for Naturopathic Physician Career Guide.
Salary and Compensation
National Salary Overview
Naturopathic physician salaries vary widely based on licensure status, practice ownership, location, and business success. Estimated median salaries range from $60,000-$90,000, with the midpoint around $73,960 annually. The BLS groups NDs with “Health Diagnosing and Treating Practitioners, All Other” making precise data limited.
Salary by Experience and Practice Type
Experience/Type
Annual Salary
Notes
New Graduate (0-2 years)
$45,000-$60,000
Building practice, associate positions
Early Career (3-5 years)
$60,000-$80,000
Establishing patient base
Mid-Career (6-15 years)
$75,000-$100,000
Established practice
Practice Owner (Successful)
$90,000-$150,000+
High patient volume, retail sales
Employed ND
$60,000-$85,000
Integrative clinics, hospitals
Cash-Only Practice
$80,000-$120,000
No insurance overhead, premium pricing
Income depends heavily on business acumen, location, insurance participation, and retail product sales. Many NDs supplement clinical income through supplement sales, often representing 20-40% of practice revenue.
Salary by State and Licensure Status
Highest-Paying: Dermatology ($140k-$160k+), Cardiothoracic Surgery ($135k-$155k+), Emergency Medicine ($130k-$150k+), Orthopedic Surgery ($130k-$150k), Neurosurgery ($130k-$155k+)
Moderate: Hospitalist Medicine ($120k-$135k), Urgent Care ($115k-$130k), Occupational Medicine ($115k-$135k)
Primary Care: Family Medicine ($110k-$125k), Internal Medicine ($110k-$125k), Pediatrics ($105k-$120k)
What’s Next?
How to Become a Naturopathic Physician
This section outlines education requirements, licensure, certification, and experience needed to become a ND.
Educational Path
Step 1
Complete Bachelor's Degree (4 years)
Earn bachelor’s degree completing naturopathic medical school prerequisites:
- Biology (2 semesters with lab)
- General chemistry (2 semesters with lab)
- Organic chemistry (2 semesters with lab)
- Physics (2 semesters with lab)
- Biochemistry (1 semester)
- Psychology (1 semester)
- English/humanities (varies)
Maintain strong GPA (3.3+ competitive). Volunteer in healthcare settings, shadow naturopathic physicians, and demonstrate understanding of naturopathic philosophy.
Step 2
Take GRE or Medical College Entrance Exams
Most naturopathic medical schools require GRE scores. Some accept MCAT. Average admitted students score 300-310 GRE (combined verbal and quantitative) or 490-500 MCAT.
Step 3
Complete Naturopathic Medical School (4 years)
Apply through Naturopathic Doctor Centralized Application Service (NDCAS). Eight accredited naturopathic medical schools exist in North America (seven in US, one in Canada).
First Two Years (Basic Sciences): Comprehensive study of anatomy (cadaver dissection), physiology, biochemistry, pathology, pharmacology, microbiology, and physical diagnosis. Naturopathic therapeutics training begins including botanical medicine, clinical nutrition, homeopathy, and naturopathic philosophy.
Last Two Years (Clinical Training): Clinical rotations in college clinics and community health centers providing supervised patient care. Rotations include primary care, pediatrics, women’s health, minor surgery, physical medicine, botanical medicine, and clinical nutrition. Students diagnose diseases, develop treatment plans, and manage patient care under supervision.
Required clinical hours: minimum 1,200 supervised patient encounters.
Tuition and Costs: Naturopathic medical school tuition ranges $35,000-$45,000 annually. Total program costs including living expenses average $150,000-$200,000, comparable to chiropractic school but lower than allopathic/osteopathic medical schools.
Step 4
Pass NPLEX Board Examinations
All graduates must pass Naturopathic Physicians Licensing Examination (NPLEX):
- NPLEX Part I: Biomedical sciences (typically taken after year 2)
- NPLEX Part II: Clinical sciences and case management (taken during year 4 or after graduation)
Some states require additional state-specific examinations.
Step 5
Obtain State Licensure (Licensed States Only)
Twenty-six states plus DC, Puerto Rico, and US Virgin Islands license NDs. Requirements typically include:
- Graduation from CNME-accredited naturopathic medical school
- Passing NPLEX Parts I and II
- State jurisprudence examination
- Background check
- Application fees ($300-$800)
In unlicensed states, NDs practice under varying regulations or function as health educators/consultants without legal recognition as physicians.
Step 6
Optional Specialization
After licensure, NDs can pursue specialty board certification through American Board of Naturopathic Specialties (ABNS) in areas including:
- Naturopathic oncology (FABNO)
- Acupuncture and Oriental medicine
- Natural childbirth
- Pediatrics
- Sports medicine
Specialty certification requires additional training, clinical experience, and examination.
Total Timeline
High school to licensed ND: 8 years (4 years undergraduate + 4 years naturopathic medical school).
What’s Next?
Career Advancement
Understand advancement opportunities and long-term growth potential.
Practice Growth
Solo to Group Practice: Expand from single-practitioner to multi-ND group practice increasing patient capacity and revenue.
Specialty Focus: Develop expertise in oncology support, pediatrics, women’s health, autoimmune disease, or other specialties creating niche practices.
Integrative Medicine Partnerships: Join or create multidisciplinary clinics partnering with MDs, acupuncturists, chiropractors, creating comprehensive care centers.
Product Line Development: Create proprietary supplement lines, herbal formulations, or wellness programs sold through practice or online.
Academic and Leadership
Naturopathic Medical School Faculty: Teach at naturopathic colleges in clinical sciences, botanical medicine, nutrition, or other subjects.
Residency Preceptor: Supervise post-graduate residents pursuing specialty training.
Professional Organization Leadership: Serve on state or national naturopathic associations advancing profession and advocacy.
Alternative Paths
Corporate Wellness: Develop and implement employee wellness programs for corporations.
Medical Writing: Write for natural health publications, create online content, author books about natural medicine.
Product Development: Consult for supplement companies developing formulations or marketing natural products.
Retreat Centers: Lead wellness retreats combining naturopathic principles with lifestyle transformation.
What’s Next?
Similar Careers
Understand advancement opportunities and long-term growth potential.
Similar Careers
Integrative Medicine Physician (MD/DO)
Medical school + residency + fellowship
$200,000-$280,000 /year
Conventionally trained physicians incorporating natural therapies. Full prescribing authority and broader scope than NDs.
Acupuncturist (LAc)
Master's degree (3-4 years)
$77,190/year median
Traditional Chinese medicine practitioners specializing in acupuncture and herbal medicine.
Functional Medicine Practitioner
Various (MD, DO, ND, NP, DC) + functional medicine training
Varies by credential
Practitioners using functional medicine approach identifying root causes through comprehensive testing and natural interventions.
Nutritionist/Dietitian
Bachelor's or Master's degree
$66,450/year median
Nutrition specialists providing dietary counseling and medical nutrition therapy.
What’s Next?
Frequently Asked Questions
Still have questions? The final section addresses common concerns and practical questions about becoming and working as a Clinical Nurse Specialist.
Frequently Asked Questions
Is a naturopathic physician a real doctor?
In the 26 states that license NDs, they are legally recognized as physicians with specific scopes of practice including diagnosing diseases, ordering tests, and prescribing treatments. However, NDs hold ND degrees from naturopathic medical schools, not MD or DO degrees from allopathic/osteopathic medical schools. The term “real doctor” is debated—NDs complete doctoral-level training and function as primary care providers in licensed states, though their training differs from conventional physicians.
Can naturopathic doctors prescribe medication?
It varies by state. Some states grant full prescribing authority including controlled substances (Washington, Oregon, Arizona). Others allow limited prescribing excluding controlled substances. Some licensed states prohibit pharmaceutical prescribing entirely. Unlicensed states have no regulatory framework for ND prescribing. All licensed NDs can prescribe natural medicines including herbs, supplements, and homeopathic remedies.
What's the difference between an ND and an MD?
Both complete four-year doctoral programs, but curricula differ significantly. MDs attend allopathic medical schools emphasizing pharmaceutical and surgical interventions, complete 3-7 year residencies, and have full unrestricted practice authority. NDs attend naturopathic medical schools emphasizing natural therapeutics, typically don’t complete residencies (though some exist), and have variable practice authority depending on state licensure. MDs practice conventional medicine; NDs practice natural/integrative medicine.
Is naturopathic medicine evidence-based?
Mixed. Some naturopathic treatments have substantial research support (clinical nutrition, certain botanical medicines, lifestyle interventions). Others lack robust scientific evidence (homeopathy particularly controversial). Naturopathic education includes conventional biomedical sciences and evidence-based practice, but treatment philosophies sometimes conflict with conventional medical standards. Licensed NDs increasingly emphasize evidence-based natural medicine.
Can I practice as an ND anywhere?
No. Only 26 states plus DC, Puerto Rico, and US Virgin Islands license NDs. In unlicensed states, scope is extremely limited or unregulated. NDs cannot use physician titles or practice medicine in most unlicensed states. Geographic limitations significantly affect career options.
How much does naturopathic medical school cost?
Tuition averages $35,000-$45,000 annually for four years. Total debt including living expenses typically ranges $150,000-$200,000. This is comparable to chiropractic school and podiatry school but less than allopathic/osteopathic medical schools.
Do insurance companies cover naturopathic care?
Coverage is limited. Some insurance plans in licensed states provide partial naturopathic coverage, often with visit limitations. Medicare and Medicaid typically don’t cover ND services. Many NDs operate cash-based practices. Coverage is expanding slowly as natural medicine gains acceptance.
How long does it take to become a naturopathic doctor
Eight years after high school: 4 years undergraduate (bachelor’s degree) + 4 years naturopathic medical school (ND degree). Some NDs pursue optional 1-2 year residencies for additional training. This is shorter than conventional physicians (11-15 years) but longer than many allied health professionals.
What’s Next?
Overview
The overview brings together key highlights, role impact, and career context—making it a helpful starting point whether you’re just beginning or refining your decision.
