In California, the term naturopath can legally be used by individuals who have not attended an accredited naturopathic medical school and who are not eligible for a California naturopathic medical license. The title naturopathic doctor or ND can only be used by a provider licensed by the state of California. This is an unfortunate and confusing situation that does not exist in other states where NDs are licensed. Naturopaths, or traditional naturopaths, as many refer to themselves, receive diplomas from online programs that are not accredited by the US Department of Education. They cannot diagnose or treat medical conditions, are not trained in the interactions of pharmaceuticals and natural therapies, and cannot call themselves doctors. As unlicensed individuals, naturopaths do not have a regulatory agency, nor are they held to any standard of safety. Indeed, numerous cases of patient harm have been ascribed to such unregulated practitioners. Naturopathic doctors, on the other hand, are licensed as primary care doctors, complete the rigorous training program described above, complete two national board exams before being eligible for a license, and are subject to the same standards for patient safety as a medical or osteopathic doctor.