BC Naturopaths imminent to be granted prescribing power/minor surgery/lab/imagi

[UBCmed09]

Here is an article in the Vancouver Sun on the issue. (just sent out to the listserve by the BCMA)

 

*To endorse naturopathy is to reject science*

 

***The issues between medical doctors and naturopaths go beyond a turf war

*

*The Vancouver Sun* Thu 26 Feb 2009 Page: A15 Section: Issues & Ideas

 

Timothy Caulfield (*Canada Research Chair in Health Law and Policy at the

University of Alberta)*

Allan Becker (*professor in the department of pediatrics, University of

Manitoba)*,

Susan Elliott (*professor of geography at McMaster University)*,

Susan Waserman (*rofessor of medicine at McMaster University)*

Judah Denburg(*professor of medicine, McMaster University)*

 

 

Do vaccines cause autism? Is there enough evidence to justify the public

funding of chiropractics? Do homeopathic remedies work?

 

These are questions that trigger tough health policy questions and, more

broadly, touch on the very nature of evidence and knowledge. And they are

all issues that have, over the past few weeks, been topics of public debate

and substantial media coverage.

 

In Alberta, there has been much public disquiet about the delisting of

chiropractics. In the United States, a recent court decision, examining

years of scientific evidence, rejected the idea that there is any connection

between the measles, mumps, & rubella (MMR) vaccine and childhood autism.

 

And, in British Columbia, a debate is brewing around the idea of expanding

the scope of practice of naturopaths to allow the prescription of drugs and

the diagnosis and treatment of allergies, including potentially

life-threatening food allergies.

 

From a health policy perspective, this latter issue is of particular

interest, especially since the prevalence of food allergies has doubled in

the past 10 years.

 

The naturopath issue is not, as it has often been framed, just a "turf" war

among professions. It is not, for example, one set of health care

professionals (medical doctors) trying to exclude another group from helping

patients. It is also not solely about choice (if it were, why not open up

the health system to every type of practitioner?)

 

A much bigger issue is at play: What type of evidence are we as individuals,

and as a society, going to consider in making health policy decisions?

 

Do we want a system based on scientific principles that can be counted on to

be reproducible and predictable, or one based on anecdote and belief (in

this case, the belief being, as The American Association of Naturopathic

Physicians states, the "dependable orderliness" of nature that is "guided by

a kind of inner wisdom that everyone has")?

 

To be clear, we are not claiming that all naturopathy is bunk. As research

progresses, some naturopathic remedies may be found, through scientific

methods, to be effective and safe. Also, naturopathy seems to be inching

toward a more evidence-based approach, as illustrated by the inclusion of

traditional science courses in the curriculum of accredited naturopathic

schools.

 

But, on the whole, naturopathy still resides on the fringes of conventional

scientific inquiry. In fact, it is often held up as the archetypical

anti-science practice -- giving primacy to a philosophical ethos over what

available evidence reveals about effectiveness. It is a field that has

embraced practices that remain, to put it mildly, scientifically

questionable -- such as homeopathy, chelation and colonic irrigation. And

many of these practices contradict what the available evidence tells us

should be done. Remarkably, a survey of American naturopaths found that only

20 per cent would recommend to parents that they vaccinate their children.

 

By highlighting the ambiguous scientific foundations of naturopathy we do

not mean to imply that conventional health care is perfect. The practice of

medicine must improve. Some therapies used by doctors are yet unproven or

understudied. And the busy, business-like approach of too many doctors has

caused patients to seek more holistic and attentive practitioners -- such as

naturopaths. But this is no reason to discard or question the tremendous

advances that modern medicine has brought us to enrich and improve the

quality of our lives.

 

And the use of unproven therapies by one group of health care providers is

not a justification for supporting the use of unproven therapies by another

group. All health care decisions should be informed by the best available

evidence. This seems particularly so when we are seeking to make our health

care system ever more efficient, safe and cost-effective.

 

The medical profession has also been pushing toward a more evidence-based

approach. There are continuing efforts to figure out what works, what works

best and what doesn't work. The practice of medicine is based on science,

not on a particular immutable faith or worldview. Yes, there are issues with

the practice of medicine, but since it is based on science it is capable of

changing, evolving and defining best practice for all of our benefit.

 

If naturopathy were held to the same generalizable scientific principles

would naturopathic schools be teaching homeopathy and naturopathic

manipulation? No.

 

Of course, Canadians have a right to choose alternative approaches to their

health; for some, the use of naturopathic therapies fits with a personal

philosophy. But leaving room in society for a plurality of health

philosophies is different from officially endorsing and legitimizing a

practice via government action.

 

Here, we don't need to engage the age-old debate about the value of science

as compared to other forms of knowledge ("traditional" or otherwise.) We

simply need to ask if the B.C. government has made an explicit decision to

drift further from the use of scientific principles in its assessment of

health care. If so, it should be explicitly explained to the public how and

why this is being done. We should also consider the specific, practical,

issues associated with the proposed expansion of scope in practice.

 

Will children with life-threatening food allergies be poorly managed? How

many who do not really have food allergies will be misdiagnosed? What public

anxiety and burden on the health system will eventuate? Will this add health

care costs -- for the extra, perhaps unproven, naturopathic care and for

additional care by physicians who may be needed to resolve urgent problems

or confusion?

 

Will naturopathic advice result in falling vaccination rates and the real

threat of increased rates of infectious disease, as happened in the United

Kingdom when the autism question was widely embraced?

 

Has the B.C. government considered these issues and, if so, what evidence

was used?

 

Finally, it is a great paradox that at a time of fiscal restraint, when we

are spending billions of dollars on science to define the best

evidence-based health care, the government is preparing to endorse a largely

unproven and untested alternative approach.

 

Is the potential impact on our children worth this public experiment?

 

Is this really the direction the Victoria wants to go?

[xyz]

It's about time reasonable people started responding. Is there no one in the B.C. government that has a background in science? Is there not one MLA that understands or respects the scientific method?

[NLengr]

It's about time reasonable people started responding. Is there no one in the B.C. government that has a background in science? Is there not one MLA that understands or respects the scientific method?

 

99% of politicians have little respect for anything beyond their own image and getting re-elected.

[wtkchen]

Here is an article in the Vancouver Sun on the issue. (just sent out to the listserve by the BCMA)

 

*To endorse naturopathy is to reject science*

 

***The issues between medical doctors and naturopaths go beyond a turf war

*

*The Vancouver Sun* Thu 26 Feb 2009 Page: A15 Section: Issues & Ideas

 

 

 

Thank you for the link. It is good to finally have some publicised response from the health policy researchers / academia. It would be nice to find the link to the actual article on Vancouver Sun. Too bad it's in section A15, this issue probably belongs in the frontpage, or at least frontpage of Health section. All eyes have been fixated on finance and crime in this city of late.

 

*Update: link to above article is http://www.vancouversun.com/opinion/op-ed/endorse+naturopathy+reject+science/1330623/story.html

[wtkchen]

March 3, 2009

Christoph Kind, ND, President of BC Naturopathic Association. Response to the "To endorse naturopathy is to reject science" article:

 

"Endorsing naturopathic medicine accepts science over spin"

http://www.vancouversun.com/opinion/Endorsing+naturopathic+medicine+accepts+science+over+spin/1347334/story.html

 

Some quotes:

 

The op-ed article about naturopathic medicine published in The Vancouver Sun on Feb. 26 is misinformation of the worst kind, bundled in a false aura of "expertise."

 

Despite their efforts to appear objective, the authors of the article are perpetuating a professional "turf war" and misleading the public with spin. The scientific education and training that naturopathic physicians receive is no different than the scientific training medical doctors receive.

 

Naturopathic physicians are highly educated, highly trained and highly competent health professionals. Naturopathic physicians' education includes at least three years of pre-medical training followed by four years of full-time study at an accredited naturopathic college.

 

Naturopathic students receive more training in basic and some clinical sciences at accredited naturopathic colleges than that offered at some standard medical schools.

 

It is time that all health professions embraced a multidisciplinary model for health care delivery to ensure that patients receive quality, science-based health care.

 

- Post #1 of this thread updated

[Daemos]

So have they gotten rights yet? The vancouver sun's opinion page of Christoph Kind, seems to indicate they obtained the rights.

 

They make many bold claims, but have YET to back any of them up.

 

If NDs can do all what they want safely I see NO reason to prevent this from happening, but as of right now, they have not shown this would be something they can safely do. Why do they try to put a spin that this is a turf war, why don't they instead put efforts in gathering facts to prove to everyone that they really can do everything they ask safely, and that everything they do is scientifically valid.

[da_birdie]

So have they gotten rights yet? The vancouver sun's opinion page of Christoph Kind, seems to indicate they obtained the rights.

 

I don't think they got what they asked for yet. According to the BC Ministry of Health website http://www.news.gov.bc.ca/?organisation_obj_id=0b00921e8000057b, the most recent news is March 1 re: changes of regulations of chiropractors and optometrists. Optometrists can now prescribe eye meds and remove foreign bodies etc, with proper training.

[smile]

I don't think they got what they asked for yet. According to the BC Ministry of Health website http://www.news.gov.bc.ca/?organisation_obj_id=0b00921e8000057b, the most recent news is March 1 re: changes of regulations of chiropractors and optometrists. Optometrists can now prescribe eye meds and remove foreign bodies etc, with proper training.

 

the optometry thing doesn't seem very intrusive upon ophthalmologists' turf, but what additional responsibilities did chiropractors pick up?! things are getting scarier! I don't know very much about chiropractors, but apparently their "tension detecting" instruments were developed to detect spirits in the body! (no joke!) I've simply chosen to ignore those with chiro/naturo diplomas, but things seem to be getting out of hand!

[da_birdie]

I wonder how optometrists feel with naturopaths encroaching on their "turf"

 

http://north-west-news.whereilive.com.au/news/story/keep-an-eye-out/

 

Naturopath Neville Hartley has introduced iridology to the holistic options at Keperra Chemmart Day & Night Pharmacy.

 

Mr Hartley said the practice of iridology had been around since the 1800s and looked at the correlation between health and discolouration of the iris.

 

Besides Arcus senilis, Kayser-Fleischer rings, and certain ocular infections, I wonder what else they can find there. Wonder what new claims will be made if a ND gets his/her hand on a slit-lamp or retinal imaging equipment.

[smile]

I wonder how optometrists feel with naturopaths encroaching on their "turf"

 

http://north-west-news.whereilive.com.au/news/story/keep-an-eye-out/

 

 

 

Besides Arcus senilis, Kayser-Fleischer rings, and certain ocular infections, I wonder what else they can find there. Wonder what new claims will be made if a ND gets his/her hand on a slit-lamp or retinal imaging equipment.

 

I don't understand this. who else is lobbying for naturopaths and chiros? surely MDs have stronger political ties, plus they definitely outnumber the naturos/chiros.

[NLengr]

I wonder how optometrists feel with naturopaths encroaching on their "turf"

http://north-west-news.whereilive.com.au/news/story/keep-an-eye-out/

Besides Arcus senilis, Kayser-Fleischer rings, and certain ocular infections, I wonder what else they can find there. Wonder what new claims will be made if a ND gets his/her hand on a slit-lamp or retinal imaging equipment.

 

Wow...what a load of BS. Then again, I can hardly say I'm surprised. It's not like science has been the strong suit of the profession.

 

Here's the iridology wiki for anyone interested: http://en.wikipedia.org/wiki/Iridology

[youngdad]

http://www.mather.infomedia.com/reality/confessions.html

 

Very interesting

[astrokitty]

this is crazy.

 

 

a girl i knew went to naturopathic school few years ago with no mcat & average around 65%. no medical/healthcare related extra curricular either.

 

once she got in, she kept telling people how she is a "doctor" and how she goes to med school for "four years" just like other med students.

 

 

 

many pre-meds and med students know how quality of education NDs receive is not even similar to what one would receive as an allopathic medicine student. but people who are not familiar with the field of medicine might think that there really isn't much difference between primary care given by allopathic & naturopathic med. people are thrown off by the terms like "doctor", "4 years", and "medicine"

 

it really doesn't matter how long they study. it's quality, not quantity that matters.

 

 

i just think that allopathic physicians must work together and stop this non-sense!!!!!!

[shaka84]

Smile

 

I am not sure which orifice you are talking out of. You admit that you don't know much about chiropractors but then make some outlandish claims about "tension-instruments" and detecting spirits. I have a chiropractic degree. I do not know of any chiropractor in BC using a tension detecting instrument. I do not know of any chiropractor who looks for spirits in the body. This is just plain old misinformation with a side of BS. I certainly don't agree with some chiropractors and their practice choices but this is nonsense.

 

Ignoring those with ND/DC degrees is a great strategy for patient management. What would you do if someone asked about seeing a chiropractor? Tell them that you simply ignore that type of practitioner and move on? I can tell you from experience that the patient in many cases will shrug you off and seek care elsewhere. BTW, there is plenty of evidence to support manipulation in low back pain. There are also chiropractic research chairs in universities across Canada including UBC, U of A, U of C and U of T.

 

The BC government has incorporated a number of health professions into the Health Act. Chiropractors did not pick up any new responsibilites they got reorganized.

 

shaka

[Mourning Cloak]

BTW, there is plenty of evidence to support manipulation in low back pain.

 

True enough.

 

 

http://www.cochrane.org/reviews/en/ab000447.html

 

The bottom line is that spinal manipulation was better than placebo, and was no more nor no less efficient than "medication for pain, physical therapy, exercises, back school or the care given by a general practitioner".

 

So really, it comes down to the patient's individual preferences.

 

(Cochrane reviews are your friend)

 

New review pending (results not out yet)

http://www.cochrane.org/reviews/en/protocol_266305021509500923.html

[smile]

Smile

 

I am not sure which orifice you are talking out of.

 

my mouth. do you know how to talk out of your ass? teach us wise one.

 

You admit that you don't know much about chiropractors but then make some outlandish claims about "tension-instruments" and detecting spirits.

 

I plainly admit I don't know much. what's wrong in that?

 

I have a chiropractic degree. I do not know of any chiropractor in BC using a tension detecting instrument. I do not know of any chiropractor who looks for spirits in the body. This is just plain old misinformation with a side of BS. I certainly don't agree with some chiropractors and their practice choices but this is nonsense.

 

congratulations on your accomplishments. I didn't mean to insult your profession. I was simply stating what I knew. the chiropractic 'measuring' instruments detects some sort of voltage imbalance or something. I'm referring to EMF meters that chiropractors use. here's the article that concludes that there are no proven mechanisms in their use: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1840038 - years ago they were used to detect 'negative energy' or 'spirits' in the body. google it. again, I'm not sure if it's true or not.

 

Ignoring those with ND/DC degrees is a great strategy for patient management.

 

DC and ND in ontario are NOT accredited degrees. they are awarded diplomas. they have NO post-secondary affiliation. this I know for a fact because I checked the schools' websites.

[NLengr]

BTW, there is plenty of evidence to support manipulation in low back pain. There are also chiropractic research chairs in universities across Canada including UBC, U of A, U of C and U of T.

 

And there is very little evidence to support many other treatments offered by DC's .

 

Although I do recognize that there has been a push for more evidence based practice in the profession which I commend. That's a good step toward becoming more integrated into the medical system.

[leviathan]

I have a chiropractic degree. I do not know of any chiropractor in BC using a tension detecting instrument. I do not know of any chiropractor who looks for spirits in the body.

LOL, check out this story from the heroic chiropracter who uses chiropractic manipulation and activators to help a pregnant woman and cure a myocardial infarction while on a flight.

 

 

http://www.chiroweb.com/mpacms/dc/article.php?id=37125

 

It's so bizarre I almost thought it was a joke at first.

[AndrewB]

LOL, check out this story from the heroic chiropracter who uses chiropractic manipulation and activators to help a pregnant woman and cure a myocardial infarction while on a flight.

 

 

http://www.chiroweb.com/mpacms/dc/article.php?id=37125

 

It's so bizarre I almost thought it was a joke at first.

 

He sounds like a pretentious d-bag.

 

BTW...a quick search of his name proved it. He's a quack.

 

http://www.drbrucehagen.com/

[pharmdude]

LOL, check out this story from the heroic chiropracter who uses chiropractic manipulation and activators to help a pregnant woman and cure a myocardial infarction while on a flight.

 

 

http://www.chiroweb.com/mpacms/dc/article.php?id=37125

 

It's so bizarre I almost thought it was a joke at first.

 

 

LOL ! Who here thinks he heard the S4 while listening to the heart with his ear... on a flying aiplane ?

[shaka84]

You were talking out of your ass.

There is certainly nothing wrong with being uninformed about chiropractic or naturopathy etc... There is a problem when you make uneducated comments that have no value. As far as the paper you pulled, that is a technique used by an incredibly low number of chiros and it is not legal in Canada as far as I am aware. It is fringe at best. I have never seen that instrument before nor do I know anyone who has ever used it.

 

The english speaking chiro college grants degrees. It used to be a diploma.

 

CMCC graduates Doctors of Chiropractic

In 2005, CMCC became the first private institution to offer a professional health care degree under the Government of Ontario’s Post-Secondary Education Choice and Excellence Act 2000. This program is offered under the written consent of the Ontario Minister of Training, Colleges and Universities for the period from March 23, 2005 to March 23, 2010. Prior to the expiry date of this consent, CMCC will apply to the Postsecondary Education Quality Assessment Board for renewal of degree granting status.

 

You were trying to insult the profession. That was very clear in your posts.

 

There are some crazy as hell chiropractors out there. There is also some very good ones just like any other profession. It is not that hard to find a terrible MD.

 

Chiropractors get a very good MSK education. Better than MD's. I know this because I am a med student as well. If chiros stuck to MSK conditions I am sure their existence would be much less complicated. It's too bad many don't.

 

Peace.

 

shaka

[A-Stark]

Fair enough - I'm not sure how this is relevant to naturopaths pretending to be doctors, though. And it's false to suggest that critics here are "uninformed" about naturopathy. Just the opposite - hence the opposition.

[smile]

You were talking out of your ass.

There is certainly nothing wrong with being uninformed about chiropractic or naturopathy etc... There is a problem when you make uneducated comments that have no value. As far as the paper you pulled, that is a technique used by an incredibly low number of chiros and it is not legal in Canada as far as I am aware. It is fringe at best. I have never seen that instrument before nor do I know anyone who has ever used it.

 

The english speaking chiro college grants degrees. It used to be a diploma.

 

CMCC graduates Doctors of Chiropractic

In 2005, CMCC became the first private institution to offer a professional health care degree under the Government of Ontario’s Post-Secondary Education Choice and Excellence Act 2000. This program is offered under the written consent of the Ontario Minister of Training, Colleges and Universities for the period from March 23, 2005 to March 23, 2010. Prior to the expiry date of this consent, CMCC will apply to the Postsecondary Education Quality Assessment Board for renewal of degree granting status.

 

You were trying to insult the profession. That was very clear in your posts.

 

There are some crazy as hell chiropractors out there. There is also some very good ones just like any other profession. It is not that hard to find a terrible MD.

 

Chiropractors get a very good MSK education. Better than MD's. I know this because I am a med student as well. If chiros stuck to MSK conditions I am sure their existence would be much less complicated. It's too bad many don't.

 

Peace.

 

shaka

 

I was talking out of my ass despite quoting a credible article. Wow. Anyway, I guess you're right about the degree bit - sorry about that.

 

By the way, I'm not insulting you or other chiropractors per se. (You could definitely be a very bright person). I simply don't agree with the chiropractic approach.

[cindersley]

Hey guys,

Whether or not the government will go ahead with this legislature will be influenced by public reaction. You guys made some good points in these posts so why not trying to submit them to the Vancouver Sun Opinions page? Balance out some of the misinformation out there.

 

Check out the 2001 BC Health Professions Councils conclusions on the regulation of Naturopathic medicine if you can. The competency and limits of a ND are quite clearly stated here.

 

http://www.health.gov.bc.ca/leg/hpc/review/part-i/update-naturopath.html

[da_birdie]

Hey guys,

Whether or not the government will go ahead with this legislature will be influenced by public reaction. You guys made some good points in these posts so why not trying to submit them to the Vancouver Sun Opinions page? Balance out some of the misinformation out there.

 

Check out the 2001 BC Health Professions Councils conclusions on the regulation of Naturopathic medicine if you can. The competency and limits of a ND are quite clearly stated here.

 

http://www.health.gov.bc.ca/leg/hpc/review/part-i/update-naturopath.html

 

Wow interesting read, I wonder what has changed in naturopath education that will sway the decision the other way this year. The only thing I see changed is the appointment of a new Health Minister and perhaps the intensity of the Naturopath lobby.

 

The Vancouver Sun article's comment page seems to be monitored, some comments submitted weren't posted (this seems to be a prevalent issue in this kind of news comment sections; I've read about this other Canadian media's website that disable/remove unfavorable user comments in response to news stories (written by realtor agencies) spreading (falsely) favorable news regarding real estate)

 

Good thing is if you google "BC Naturopath Prescribing", this thread is #1 ! So hopefully the public / naturpaths will partake in this discussion here, provided they know what the largest artery in the body is called! (part of the sign-up process to this forum)

 

Oh, I just found the admission criteria for one of the ND schools in BC:

 

Academic Admissions Requirements

The completion of a bachelors degree in any field of study

from a recognized post-secondary institution is required prior

to entry into the program....

 

The following specific courses are required prerequisites with

a final grade of 60 percent or better. Prerequisite courses must

be taken at a recognized post-secondary institution, either onsite

or on-line.

• Biology: one full-year (6 credit hours).

• Psychology: half-year (3 credit hours)

• English / Humanities: one full-year (6 credit hours). The

courses must include an essay component. Applicants may

be required to write a short essay at the time of interview.

• General Chemistry: one full-year (6 credit hours)

• Organic Chemistry: half-year (3 credit hours)

• Biochemistry: half-year (3 credit hours)

 

In addition, prospective students would benefit by completing

additional courses in some or all of the following areas:

• Anatomy• Cell Biology• Genetics• Human Physiology• Microbiology• Physics• Sociology• Statistics

 

A cumulative grade-point average of 3.0 on a four-point scale

(75 percent) is recommended in order for the applicant to be

competitive for the limited seats available. However, students

with lower GPAs can also be accepted.

 

http://www.binm.org/docs/AcademicCalendar.pdf

http://www.binm.org/Admission_Criteria.html

 

I wonder what the "actual" average entrance GPA for ND schools are, didn't someone here say a person with average in the 60s got in? In light of the ND's continuous insistence that their education is "at least equivalent" to MDs, it would be nice to have a chart comparing the admission criteria/curriculum/hours of clinical training etc between medical school + family medicine residency / nursing+nurse practitioner school / pharmacy school / chiropractor school / "naturopathic medical schools", and see if ND's education and training justifies their claim of such versatile capabilities. (Again, even this might not prove much, as the actual ND curriculum is nowhere as "science-based" and "intensive" as they claim, and as it was quoted in a post above: "Those who believe that regulation is a substitute for evidence will find that even the most meticulous regulation of nonsense must still result in nonsense".)