Naturopathic doctors are not the solution to the primary care crisis: doctors, health experts

Vancouver naturopathic doctor Vanessa Lindsay has been treating a patient’s high blood pressure for a long time through nutrition and exercise.

“She’s lost weight. She’s stronger. She’s eating well. She’s hydrated. She’s sleeping better,” Lindsay said.

But the patient is still on two blood pressure medications, and since naturopathic doctors in British Columbia can prescribe medications, Lindsay works with her patient on those as well.

“I can support you in monitoring and safely weaning one when appropriate,” said Lindsay, who is also the president of BC Naturopathic Doctors.

“So using complementary care when appropriate, but also integrating these conventional tools when necessary.”

British Columbia, along with the Northwest Territories, has the most extensive scope of practice for naturopathic doctors in Canada, including the ability to prescribe medications and be certified to administer vaccines.

The Canadian Association of Naturopathic Physicians wants the same scope of practice to be allowed for similarly trained professionals across the country, said executive director Shawn O’Reilly.

He touted a four-year training program that he said includes science and distinguishes “naturopathic doctors” from unregulated practitioners who call themselves naturopaths without any standardized training.

Amid the shortage of family doctors in Canada, many naturopathic doctors are positioning themselves as a solution, arguing that they are trained to be a patient’s primary care provider.

This is raising alarm among doctors and health experts who say they are not equipped to be a patient’s primary source of medical care.

“We have to be very careful,” said Dr. Michelle Cohen, an assistant professor of medicine at Queen’s University and a physician at Lakeview Family Health Team in Brighton, Ont.

“When it comes to naturopathic doctors, my concern is that many of them and some of their organizations will also present them as a different form of family doctor,” Cohen said.

“They’re not,” he said.

They’re learning a little bit of anatomy and a little bit of physiology, but there’s a lot they’re not doing.”

To become a naturopathic doctor in Canada, students must have a bachelor’s degree and then complete four years of training at the Canadian College of Naturopathic Medicine. That training involves “biomedical and clinical sciences,” including pharmacology and learning about immunization, O’Reilly said.

“It’s really the philosophy and approach that naturopathic doctors take with their patients that sets them apart from other health professionals,” O’Reilly said.

“Their approach is to look at the whole person. So not just their physical aspects, but also the mental, emotional, social and environmental (factors),” he said.

“They also really focus on educating their patients about things like lifestyle and diet.”

Naturopathic doctors are regulated in British Columbia, Alberta, Saskatchewan, Manitoba, Ontario and the Northwest Territories, O’Reilly said, and are in the process of being regulated in Nova Scotia.

O’Reilly said that in some provinces, many people who call themselves “naturopaths” are unqualified and unregulated. These professionals give the profession a bad name and are the most likely to be anti-vaccine, he said.

But Cohen questioned any notion that naturopathic doctors, even those who come through college, can be considered a type of family doctor.

“They have a completely different type of training and follow a different path.”

Cohen said he has studied the training of naturopathic doctors “very thoroughly” and found that neither the curriculum nor the clinical practice requirements equip them to diagnose and treat serious illnesses.

Although naturopathic doctors argue that they do a four-year program like a doctor does, “the way they present it is misleading,” he said.

Doctors must do at least two more years of residency after four years of medical school before they can practice, he said.

And while naturopathic doctors must have at least 1,200 hours of clinical training, family doctors do closer to 10,000 hours, Cohen said.

The type of clinical training also differs, he said, as those training to be family doctors see a wide variety of patients, many of them very sick, through hospital rotations.

Without that kind of experience, a doctor can miss a “red flag” that could indicate a serious illness in a patient with certain symptoms, leading to a misdiagnosis, he said.

Still, Cohen sees the role of naturopathic physicians as working in cooperation with family physicians and nurse practitioners, as “part of a team that provides care along their line of expertise.” This could include consultation about lifestyle and diet and providing evidence-based information about supplements and how they may interact with other medications.

Some may also be uniquely qualified to provide scientific advice about vaccines to people who are skeptical and distrustful of the medical system, Cohen said, noting that naturopathic doctors participated in COVID-19 vaccination campaigns in Ontario.

Dr. Tahmeena Ali, president of BC Family Doctors, agreed that naturopathic doctors can play a specific role as part of a patient’s primary care team and said she appreciates their contributions.

“They’re often more educated about preventative and more holistic diet and lifestyle aspects for health promotion and prevention and healing. And I don’t think there should be an ‘all or,’ but “both,” said Ali.

He emphasized that communication and coordination among providers is essential for patient well-being and to avoid ordering duplicate diagnostic tests or treatments.

But other health experts are far more skeptical.

“Naturopaths touting themselves as a solution to our current crisis is misleading to say the least. And from a family physician’s perspective, it’s pretty horrifying,” said Dr. Sarah Bates, acting president of the section of family medicine from the Alberta Medical Association.

“Now, I fundamentally believe that primary care is a team sport. One hundred percent. We should be working collectively with nurses, with nurse practitioners and pharmacists and psychologists and complementing each other’s practice, not competing with it. But there is no place for naturopathic doctors,” Bates said.

“A lot of (this) is essentially pseudoscience rhetoric,” he said. “There is harm that can be done.”

Bates still remembers a patient from about 15 years ago who had rectal bleeding, so he referred her for diagnostic tests, including a colonoscopy.

But his patient did not attend the procedure.

“Instead, she went to her naturopathic doctor, and a year and a half later, she came back to me with more bleeding and weight loss. She looked terribly sick,” Bates said.

The naturopathic doctor had been treating the patient for yeast candida, a fungal infection, he said.

“He died like six months later from colon cancer.”

Bates realizes it may seem like he’s trying to protect his “turf,” but he said he’s just trying to protect patients.

“There’s enough work here to go around,” he said. “But the solution is not to bring in a professional without the proper training to provide a certain level of care.”

Blake Murdoch, senior research associate at the University of Alberta’s Health Law Institute, agreed.

“Much of naturopathy is based on the principle that modern medicine only treats symptoms rather than (the) underlying cause, which is patently false, except when there is no effective treatment known to science,” Murdoch said in an email.

“This is where alternative medicine supposedly ‘fills in the blanks’ with things that don’t work or are unproven and potentially unsafe.”


#Naturopathic #doctors #solution #primary #care #crisis #doctors #health #experts
Image Source : vancouver.citynews.ca

Leave a Comment