Dr. Alethea Fleming, ND

The intersection of Medicare and Naturopathic Medicine

If you are in your Medicare years (or getting close) you may have noticed a disturbing trend of not being able to find a primary care physician that accepts Medicare, or one that can see you in the next six months. One solution that is highly desirable by many patients is to allow naturopathic physicians to be primary care physicians under Medicare. A 2014 study of 384 people over the age of 65 indicated that 96% would see an ND if it was covered by their insurance compared to only 23% if they had to pay out of pocket.1 The desire is there, but NDs are currently not covered by Medicare.

There is a distinct trend in medicine of fewer primary care docs (30% of all physicians, compared to 70% fifty years ago in the United States, or in most other countries globally) because our current medical model encourages medical students to pursue specialty or subspecialty practices to achieve better salaries and recognition. According to the 2013 Medscape Report on Physician Compensation fewer than half of all family care docs are satisfied with their career and if they had to do it all over again only 28% of them would choose primary care again. The hours are long, the amount of individual patient contact is limited to an average of 15 mins, and the education and accompanying student loans are daunting.

There is a predicted shortage of up to 45,000 primary care physicians in the next decade and naturopathic physicians are trained and ready to help alleviate that shortage in a way that is immediately helpful to the medical system as well as satisfying to patients. The Affordable Health Care Act (ACA) stipulated that commercial insurers may not discriminate against licensed health care practitioners, which includes naturopathic physicians, and yet there is a federal inconsistency with Medicare which denies patients the right to continue seeking care with a naturopath once they reach mandatory Medicare enrollment.

The best way to achieve the goal of having naturopathic care be one of the options in Medicare is to write your representative and ask for it. Let’s make health care more accessible and realistic for all patients in the Medicare system.

Fleming,-Alethea_resizedDr. Alethea Fleming, ND is a passionate advocate for naturopathic geriatric medicine. A 2007 Bastyr University graduate, she also earned a certificate in Gerontology from the University of Washington. Dr. Fleming is the owner and lead physician of the Vital Aging Clinic in Anacortes, Washington where she provides primary care to all adults as well as adjunctive geriatric care. Dr. Fleming is active in multiple community organizations as well as a member of WANP, AANP and OncANP. In her off hours, Dr. Fleming can be found hiking the beautiful trails of Fidalgo Island, spending time with her wonderful husband and son, or with her nose firmly in a good book.


  1. Older American’s Views on Naturopathic Physicians in Medicare 2014 Infoserv.
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