Sunday, November 15, 2009

Ontario Bill 179: New Powers for Magician-Clinicians

Currently moving through Ontario legislature is Bill 179, "An Act to amend various Acts related to regulated health professions and certain other Acts." This bill received it's second reading back in May, with third reading and ultimately royal assent expected in the coming months. Part of the bill is an amendment to the 2007 Naturopathy Act as follows:
The Naturopathy Act, 2007 is amended to provide for the prescribing, dispensing, compounding and selling of drugs and to deal with transitional disciplinary issues during the transition from regulation under the Drugless Practitioners Act to regulation under the Regulated Health Professions Act, 1991 and the Naturopathy Act, 2007.
Yes, similar to a bill that passed in BC, the amended Bill 179 would grant prescribing power to naturopathic practitioners. What is naturopathic medicine? The Canadian College of Naturopathic Medicine (CCNM), one of two schools in Canada that offer a doctor of naturopathic medicine program has the following definition:
Naturopathic medicine is a distinct system of primary health care that addresses the root causes of illness, and promotes health and healing using natural therapies. It supports your body's own healing ability using an integrated approach to disease diagnosis, treatment and prevention that includes: acupuncture/Asian medicine, botanical medicine, physical medicine (massage, hydrotherapy, etc.), clinical nutrition, homeopathic medicine [and] lifestyle counseling.
So naturopathic doctors (NDs) who could be granted prescribing powers include acupuncturists and homeopaths among other non-evidence based practitioners. Call me skeptical, but allowing, for example, a homeopath - somebody whose idea of sound medicine is prescribing a dilution that likely doesn't contain a single molecule of the "therapeutic" compound (i.e. just water) - to prescribe drugs seems like a bad idea. (Hmm. Will they follow homeopathic protocols for prescribed drugs? "Take this antibiotic, but dilute 1060 times first") I'm not alone in being concerned.

Furthermore, granting prescription powers to naturopaths will blur the line between naturopathic doctors and their evidence-based counterparts. Prescribing drugs will give NDs an air of legitimacy, making them look like traditional MDs despite not having the same training. What do you prescribe for blocked chi flow? And with different standards for evidence, approach to disease, and diagnosis and treatment philosophy, how do you properly prescribe a drug that has been discovered, tested and approved in the 'traditional' regime. Nevermind the tension this places on pharmacists, whose jobs include evaluating the safety and appropriateness of a prescription (again, from a standard medicine point of view).

If there's a silver lining to this legislation, it's a faint one. Is the ability to prescribe drugs, a privilege several naturopath organizations lobbied to have included in the revised Bill 179, an admission of defeat by NDs? After all, if their methods and treatments are supposed to be effective or even better than 'harmful' standard care why the need to prescribe their 'toxic' drugs? Surely they can't be more effective than botanicals, acupuncture needles and tap water!

And maybe this will put an end to the Pharma Shill Gambit. The Pharma Shill Gambit, in short, is the dismissal of arguments supporting mainstream medicine because the people making them are no doubt on the payroll of the big, bad pharmaceutical industry (for some fine examples, check out a few of the comments here). Since naturopaths will be prescribing drugs, we won't have to deal with that anymore. After all, they'll be in the pockets of Big Pharma too, right? ... Right?

If you have something to say about these changes to the Naturopathy Act, let your MPP know before it passes.

[h/t: Skeptic North via Greg Laden]