wtkchen Posted February 17, 2009 Report Share Posted February 17, 2009 [uPDATE Apr 10, 2009] It has happened! ROLE EXPANDS FOR MIDWIVES, NATUROPATHIC DOCTORS, NURSES For Immediate Release Ministry of Health Services April 9, 2009 http://www2.news.gov.bc.ca/news_releases_2005-2009/2009HSERV0045-000871.htm OFFICIAL Amendment to naturopath regulation (PDF): http://www.health.gov.bc.ca/leg/pdfs/BC_Reg_156_2009.pdf (http://www.health.gov.bc.ca/leg/notice/naturopathic_medicine.html) B.C. gives naturopaths right to prescribe drugs http://www.cbc.ca/health/story/2009/04/10/bc-naturopaths.html Naturopaths can now: 1. prescribe non-controlled medications (eg. they can prescribe Tylenol #3, all antibiotics, all mood altering medications - antidepressants, antipsychotics, mood stabilizers including lithium, immune suppressants such as prednisone, methotrexate), "after completing a certification training". A list of medications they cannot prescribe is attached at the end of the PDF file (seems to be mainly narcotics / sedatives / chemotherapy agents) 2. order Xrays / Ultrasounds. Not CT scan. 3. perform minor surgeries at or below dermis 4. perform allergy challenge testing and desensitization 5. insert finger/instrument/device into any body cavity, whether natural or artificially-created [aside: this was announced one day prior to Easter long weekend] ----------------------------------------------------------------------------------------------- What is your view point? please refer to the Vancouver Sun article below, there are many reader's comments including several from MD's, ND's, pharmacists, and the lay people. Apparently it is still in the discussions stage, but according to a poster who spoke with a MLA, the decision has pretty much already been made. BC Naturopaths will soon get prescribing rights (ALL medications except controlled narcotics), ability to perform minor surgeries with anaesthetic, order lab tests and imaging (X Rays, CT, MRI, U/S, etc), be called "Physician" or "Doctor" without qualifier, be able to form professional corporations, be able to insert fingers and instruments into body orfices, be able to give allergy shots, etc, if the proposed amendment passes. http://www.vancouversun.com/Health/regulations+would+naturopathic+doctors+prescribe+drugs/1293439/story.html Another article on Calgary Herald (Feb 18/09) http://www2.canada.com/calgaryherald/news/theeditorialpage/story.html?id=dd0e40a5-24c7-41a6-b541-19e0e15d340a Full version of naturopaths' proposed changes to the BC Health Professions Act http://www.health.gov.bc.ca/leg/pdfs/Naturopathic_Physicians_Regulation_-_proposed_amendments_Dec_12-2008.pdf BC Naturopathic Association publications / press releases 1. "The BCMA: Misinformed, and spreading deceptive and disingenuous comment not in the interest of patient care." http://www.bcna.ca/documents/WhattheBCMedicalAssociationhasstated.pdf 2. "Naturopathic Doctors & Prescribing Rights: Questions & Answers" http://www.bcna.ca/documents/Pharmacology2008.pdf "Endorsing naturopathic medicine accepts science over spin" - Christoph Kind, ND, president of the B.C. Naturopathic Association (Mar 3) - BCNA's response to the "To endorse naturopathy is to reject science" article http://www.vancouversun.com/opinion/Endorsing+naturopathic+medicine+accepts+science+over+spin/1347334/story.html ________________________________________________________________________________________________________________________________________________ Updated Apr 7 "Naturopath prescribing: The hill to die on" BC Medical Journal, Vol. 51, No. 3, April 2009, page(s) 101—Editorial http://www.bcmj.org/naturopath-prescribing-hill-die Response from Canada Research Chair in Health Law and Policy - Timothy Caulfield, et al. (Feb 26) "To Endorse Naturopathy Is To Reject Science" http://www.vancouversun.com/opinion/op-ed/endorse+naturopathy+reject+science/1330623/story.html College of Physicians and Surgeons of BC response (mass-mailed to MDs on Feb 18) https://www.cpsbc.ca/files/u6/MoHS_Naturopaths_090120.pdf Side note, CPSBC and BCMA was given a ONE month notice by the Ministry of Health to respond to the ND proposed change. The notice was given one week before Christmas vacation, when many MDs are leaving for vacation and when CPSBC/BCMA was likely operating in "holiday mode". Thus, BCMA/CPSBC had to scramble in first week of January to bring the heads together and come up with a response by January 16 (which was then kindly extended to January 19). BCMA - Section of General Practice response to naturopath's proposed changes http://www.sgp.bc.ca/index.php ________________________________________________________________________________________________________________________________________________ Naturopathy: A Critical Appraisal (requires free e-medicine log-in) http://www.medscape.com/viewarticle/465994_2 "Science-Based Pharmacy" - Scott Gavura (pharmacist), Director, Provincial Drug Reimbursement Programs at Cancer Care Ontario http://sciencebasedpharmacy.wordpress.com/ "Naturowatch" - link provided by forum user http://www.naturowatch.org/index.html Thanks A concerned family physician in greater vancouver Link to comment Share on other sites More sharing options...
Halcyon Posted February 17, 2009 Report Share Posted February 17, 2009 Wow, this is really interesting. My thoughts and I'm not from BC: I'm a lowly pre-med; however, I'm not sure how comfortable I am with this. I'd rather see pharmacists get prescribing rights first. Please note, I'm not discounting NDs as they do offer another type of service to patients...and maybe it should stay that way? Thanks for posting this. Link to comment Share on other sites More sharing options...
Jochi1543 Posted February 17, 2009 Report Share Posted February 17, 2009 I don't get it, mostly because I thought the whole point of naturopathy was to stay away from traditional medicine - which, as I imagine, includes surgery and synthetic drugs. Link to comment Share on other sites More sharing options...
wtkchen Posted February 17, 2009 Author Report Share Posted February 17, 2009 Hi Halcyon, Pharmacist already got their prescribing rights in BC few months ago. Pharmacists have been given prescribing rights in AB approx 2 years ago (I think). I agree, I am more comfortable to have pharmacists refilling my patients' prescriptions than Naturopaths, definitely. I'm not a fan of pharmacists changing the dose or altering the prescription though, because whenever they do that, they will just fax to the clinic a "notice of prescription change", thus MD's are then responsible for checking the chart to see if what they did was appropriate (while MD's are NOT paid for this service) But I digress, go read the reader comments on the Vancouver Sun story, you will be amazed by some comments lay-people put down. Some ND's put down interesting comments as well, such as "prescribing medications is no different from prescribing herbs and natural products", etc. A medical resident, a few MDs, a pharmacist have expressed their concerns in the comments section as well. Link to comment Share on other sites More sharing options...
NLengr Posted February 17, 2009 Report Share Posted February 17, 2009 I don't get it, mostly because I thought the whole point of naturopathy was to stay away from traditional medicine - which, as I imagine, includes surgery and synthetic drugs. This is a money making move. They're trying to expand their scope of practice, which will in theory allow them to do more business and therefore earn more. That whole "staying away from traditional medicine" got in the way of the much more important "making lots of cash". Naturopathy is sketchy at best a lot of the time. The science behind it, seems to be based on poorly conducted trails and tests, if there at all. Most of the ones I see are even offering homeopathy, which is a total load of sh*t and anyone with a basic grasp of science should figure that out. In my opinion, this is a dangerous move for public safety. This is a completely different ball game than letting pharmacists or nurse practitioners prescribe medication. But it's a move by the government of BC to try and reduce health-care costs. The hell with the actual health of the citizens. To make things worse, this will further make BC undesirable for physicians to practice in. I've already heard lots of talk about how bad BC treats its MD's (publishing salaries etc.) and how med students/residents should avoid there if they can when they are attendings. Link to comment Share on other sites More sharing options...
medwannabe08 Posted February 17, 2009 Report Share Posted February 17, 2009 What a joke. They're allowing a bunch of wacky pseudo-science nonsense quacks basically do what a physician does. And the guillable public doesn't know any better. Anyone want to start a countdown how long it'll take for the sh!t to hit the fan? Link to comment Share on other sites More sharing options...
wtkchen Posted February 17, 2009 Author Report Share Posted February 17, 2009 To make things worse, this will further make BC undesirable for physicians to practice in. I've already heard lots of talk about how bad BC treats its MD's (publishing salaries etc.) and how med students/residents should avoid there if they can when they are attendings. Alberta urban family physicians can make at least 10-15% more than BC GPs, due to the fee schedule difference. AB at least attempts to compensate MDs who spend extra time with patient, and also offers periodic physical exams to all. While BC docs are rewarded by volume of patient alone (except for certain illness like heart failure, DM, which you get paid a flat fee annually, provided you complete all the paperwork), plus there is no such thing as "routine check up" in BC, it's not covered by MSP. Link to comment Share on other sites More sharing options...
Halcyon Posted February 17, 2009 Report Share Posted February 17, 2009 Hi Halcyon, Pharmacist already got their prescribing rights in BC few months ago. Pharmacists have been given prescribing rights in AB approx 2 years ago (I think). I agree, I am more comfortable to have pharmacists refilling my patients' prescriptions than Naturopaths, definitely. I'm not a fan of pharmacists changing the dose or altering the prescription though, because whenever they do that, they will just fax to the clinic a "notice of prescription change", thus MD's are then responsible for checking the chart to see if what they did was appropriate (while MD's are NOT paid for this service) But I digress, go read the reader comments on the Vancouver Sun story, you will be amazed by some comments lay-people put down. Some ND's put down interesting comments as well, such as "prescribing medications is no different from prescribing herbs and natural products", etc. A medical resident, a few MDs, a pharmacist have expressed their concerns in the comments section as well. Thanks! Pharmacists haven't got them here in ON yet (not unless I missed something haha). Correct me if I'm wrong, but there's simply not enough evidence / research to back up much of the ND practices? Link to comment Share on other sites More sharing options...
A-Stark Posted February 17, 2009 Report Share Posted February 17, 2009 I'm still kinda stunned that this is even being considered. I had a glance at the syllabus of the Naturopath College in Toronto, and while they cover some basic sciences, they do a hell of lot less physiology and pathology than med students, and I'm confident that their "practicum" does not compare to clerkship much less residency. This is ridiculous. Link to comment Share on other sites More sharing options...
NLengr Posted February 18, 2009 Report Share Posted February 18, 2009 I'm still kinda stunned that this is even being considered. I had a glance at the syllabus of the Naturopath College in Toronto, and while they cover some basic sciences, they do a hell of lot less physiology and pathology than med students, and I'm confident that their "practicum" does not compare to clerkship much less residency. This is ridiculous. Here's the course listings for the CCNM http://www.ccnm.edu/?q=prospective_students/course_listings It's short on science/real medicine, but has lots of crap in it like Asian medicine and homeopathy. Link to comment Share on other sites More sharing options...
A-Stark Posted February 18, 2009 Report Share Posted February 18, 2009 Even more ridiculous are their courses in "differential diagnosis", "primary care", and "emergency medicine". Something tells me they don't involve clerkship rotations in family or emergency med (well, they sound like standard lecture-based classes). Do you think they discuss Beta blockers and ACE inhibitors (or digoxin?) in their one class on pharmacology in reference to their one class on physiology? Link to comment Share on other sites More sharing options...
wtkchen Posted February 18, 2009 Author Report Share Posted February 18, 2009 In short, the naturopaths propose to become Family Physician-equivalents. They however "will not propose to obtain power to refer (to specialists) at this time". I suppose all those time spent on GPA / MCAT / medical school / clerkship / residency / LMCC / CCFP will put me head-to-head with a ND, except I can refer patients to specialists and they cannot, yay! Wait, but they can do so much more, colonic hydrotherapy (rinsing out your colon with enemas to detoxify and dislodge impurities), IV chelation therapy ($300 per session, few times a week/month), detox for your severe lead/mercury poisoning. They can even prescribe a bunch of herbal products, vitamins, supplements which they also DISPENSE, and make $ from each prescription (talk about conflict of interest)! A patient pays hundreds of dollars per week for ND while MDs makes $20 per patient (after overhead) by the government. What a job they have! Excuse me for my bitterness. ~ just a young FP in Vancouver Link to comment Share on other sites More sharing options...
A-Stark Posted February 18, 2009 Report Share Posted February 18, 2009 As radical as it may sound, the BCMA may have to take a more... hardline stance on this sort of thing. The S-word, that is. Link to comment Share on other sites More sharing options...
leviathan Posted February 18, 2009 Report Share Posted February 18, 2009 I find it funny that they are considering doing this, when an internationally trained physician cannot practice in BC without huge barriers, even after passing all LMCC exams. Does this make any sense?! Link to comment Share on other sites More sharing options...
leviathan Posted February 18, 2009 Report Share Posted February 18, 2009 Examples of naturopath treatments from various naturopathic journals: Asthma: Hydrogen peroxide bath instead of corticosteroids, beta agonists, etc. HIV/AIDS: St. John's wort, garlic, accupuncture, digestive enzymes Warnings against proven medical and surgical treatments for hypertension, hyperlipidemia, and atherosclerosis, while instead recommending herbs and EDTA chelation.[22] Treatment of the acute stroke patient for at least 20 minutes with an "ice-cold compress ... over the carotid arteries under the jaw bone on the neck" (which "may even abort the stroke") and subtle energy medicine.[25] The author of these recommendations is listed as a "senior editor of the Journal of Naturopathic Medicine, the official publication of the American Association of Naturopathic Physicians." The list goes on...and these people are going to be practicing medicine in BC? Link to comment Share on other sites More sharing options...
A-Stark Posted February 18, 2009 Report Share Posted February 18, 2009 Yep, those HIV patients will certainly benefit from garlic and digestive enzymes (are they taking pepsin pills??) instead of ARVs. It's not April 1st is it? Link to comment Share on other sites More sharing options...
leviathan Posted February 18, 2009 Report Share Posted February 18, 2009 I'll have to let my paramedic friends back home know that the next ischemic CVA patient they have should be redirected to a naturopathic's clinic for cold compresses, and not to Vancouver General for a CT + fibrinolytics. Link to comment Share on other sites More sharing options...
wtkchen Posted February 18, 2009 Author Report Share Posted February 18, 2009 Calgary Herald: Feb 18 / 09 http://www2.canada.com/calgaryherald/news/theeditorialpage/story.html?id=dd0e40a5-24c7-41a6-b541-19e0e15d340a Excerpts: "Bruce Lofting, a naturopathic doctor and vice-president with the Alberta Association of Naturopathic Practitioners, says there's really only a "handful" of medications that are useful to naturopaths, mainly hormones. Antibiotics are also important, in that a patient might have an infection, in which case naturopathic doctors have no choice but to send them to a medical doctor for treatment. That's inconvenient, costly, and unnecessary." -- Which infection? cellulitis? abscess? erysipelas? impetigo? pityriasis rosea? contact dermatitis? viral pharyngitis? Community acquired pneumonia? Aspiration pneumonia? Chlamydia? Molluscum contagiosum? -- ever heard of antibiotic resistance? "Once a college is established, naturopaths could and should be trained to safely prescribe a limited number of useful drugs. Such scope has already been expanded for pharmacists, successfully offering Albertans more cost-effective choice. If British Columbia sets the precedent, Alberta should surely follow." -- What is the logic behind this conclusion Link to comment Share on other sites More sharing options...
NLengr Posted February 18, 2009 Report Share Posted February 18, 2009 I was poking around the ND school in BC's website and found this interesting page linked directly from the main page: http://www.binm.org/princeton.html Apparently it's one of the best MEDICAL schools in North America. Also, it has a part time program (evenings and Saturdays)? What the hell? The whole place seems greasy as hell. The whole profession is greasy as hell. The BCMA, CMA, RCPSC and CCFP is being WAY to quiet about this. Link to comment Share on other sites More sharing options...
Halcyon Posted February 18, 2009 Report Share Posted February 18, 2009 Another thought from a lowly pre-med: This move certainly doesn't help the recruitment efforts of FM. Those med students considering FM, might be put off by the idea that a ND will almost have a similar scope of practice. Not that you want to hear this, wtkchen, but I'm sure you've already had these thoughts. As mentioned, I don't have a problem with NDs, but this is crazy. What action is being taken by BC doctors, such as yourself? Good luck! Link to comment Share on other sites More sharing options...
Halcyon Posted February 18, 2009 Report Share Posted February 18, 2009 I find it funny that they are considering doing this, when an internationally trained physician cannot practice in BC without huge barriers, even after passing all LMCC exams. Does this make any sense?! That's a really good point. Sad, isn't it? Link to comment Share on other sites More sharing options...
NLengr Posted February 18, 2009 Report Share Posted February 18, 2009 Makes sense though. ND's have a nice big lobby group that probably can get the ear of politicians. IMG's are not in a nice big lobby group and additionally, most aren't from here. Much harder to lobby politicians that way. That's how political decisions like this are made. They aren't made based on logic, science or concern for the public. Link to comment Share on other sites More sharing options...
A-Stark Posted February 18, 2009 Report Share Posted February 18, 2009 I was poking around the ND school in BC's website and found this interesting page linked directly from the main page: http://www.binm.org/princeton.html Apparently it's one of the best MEDICAL schools in North America. Also, it has a part time program (evenings and Saturdays)? What the hell? The whole place seems greasy as hell. The whole profession is greasy as hell. The BCMA, CMA, RCPSC and CCFP is being WAY to quiet about this. O_o WTF. I don't know if I should be pleased or very disturbed that Dal is listed right below such fine medical schools as this Boucher Institute or CCNM. Link to comment Share on other sites More sharing options...
wtkchen Posted February 18, 2009 Author Report Share Posted February 18, 2009 The BC Health Ministry gave the College of Physicians and Surgeons & BCMA 1 month notice to come up with a response to the Naturopaths proposal. Conveniently, the notice was given in mid-late December, where most of the physicians are taking a 1-2 week holiday and most offices (including BCMA / CPSBC) are closed or running reduced hours. Therefore the College and BCMA was scrambling in early January to come up with a response within 2 weeks. I wonder how much common interest the politicians and the Naturopath lobby group have. It almost seems like they wanted to sneak this amendment past the MDs by giving them a rediculously tight deadline. Just got the email this morning from the College of Physicians and Surgeons of BC "Message from Registrar re: Naturopathic Physicians Regulation re: Scope of Practice" https://www.cpsbc.ca/files/u6/MoHS_Naturopaths_090120.pdf January 20, 2009 Mr. Daryl Beckett Director, Legislation & Professional Regulation Ministry of Health Services 5-2 , 1515 Blanshard Street Victoria, BC V8W 3C8 Dear Mr. Beckett: We write in follow up to the proposed amendments to the Naturopathic Physicians Regulation regarding that profession’s scope of practice and restricted activities. The Council of the College of Physicians and Surgeons of British Columbia had an opportunity to review the draft Regulation at its meeting of January 16, 2009. Council appreciated the extension of the deadline for its submission to January 19, 2009. We would remind you that the Council is comprised of ten elected physician members and five public members appointed by the Minister. Council was unanimous in its concerns as expressed hereunder. (read on) https://www.cpsbc.ca/files/u6/MoHS_Naturopaths_090120.pdf Link to comment Share on other sites More sharing options...
wtkchen Posted February 18, 2009 Author Report Share Posted February 18, 2009 O_o WTF. I don't know if I should be pleased or very disturbed that Dal is listed right below such fine medical schools as this Boucher Institute or CCNM. It is alphabetically arranged, how convenient for them to numerically label the list because their name is in the beginning of the alphabet. And again, that list just includes schools "featured" in the princeton review book, not because these schools are "one of the best in North America". Talk about misleading marketing. Link to comment Share on other sites More sharing options...
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