Naturopathic doctors (NDs) are not the first health care providers that come to mind when you think of vaccines, so for some people at Toronto Public Health’s COVID-19 mass immunization clinic, naturopathic doctors are the ones administering the vaccine. I was surprised that they were administering it.
Naturopathic medicine is a unique system of traditional, complementary, and integrative medicine (TCIM) recognized by the World Health Organization. It is often seen as an alternative medical system that opposes science-based practices, so many people would not expect NDs to be involved in vaccinations.
But many people at the clinic, skeptical of widespread public health measures, expressed relief at being able to discuss their concerns about vaccines with a trusted doctor who is well aware of the shortcomings of the medical establishment. Seeing a health care provider who they felt understood their health values gave some hesitant visitors peace of mind. One particularly hesitant girl had compiled a long list of concerns based on information posted online and on social media. The ND listened and answered questions, discussed the risks and benefits of vaccination, and proactively explained side effects. Thankful for the respectful conversation, the hesitant person left the clinic that day, but returned a week later to ask for an ND to administer the COVID-19 vaccine on-site.
ND is a medical profession regulated in six Canadian provinces/territories. Educational requirements for licensure include a bachelor’s degree, graduation from a Council for Naturopathic Medical Education (CNME) accredited program, and completion of an introductory practice exam. The four-year training covers physiology, pathology, and diagnostic skills, as well as areas such as the therapeutic use of herbs and other natural health products, lifestyle management, and traditional Chinese medicine.
Naturopathic doctors emphasize non-drug interventions, primarily dietary and lifestyle modifications, for health promotion and prevention. In addition, ND uses nutritional supplements, herbal medicine, mind-body therapy, manual therapy, acupuncture, and prescription medications. While lifestyle education and motivational counseling are pervasive skills in the command center of many health care professionals, ND is a science-based approach to natural health products, including educating patients about efficacy, dosing, contraindications, and side effects. are uniquely qualified to advise patients regarding the use of and drug-herb interactions. NDs have an advantage when communicating with patients because no other health care provider has the specialized training in natural health products that NDs have. Traditional, complementary and integrative medicine (TCIM) use is high in Canada, with approximately 56% using at least one TCIM therapy, according to a 2015 survey.
NDs have more in-depth knowledge of the wellness industry than other regulated health professionals. As the wellness industry continues to boom and become more mainstream, having a provider with expertise in this particular subject matter in healthcare is invaluable. The ND can advise the patient on how to separate misinformation and disinformation from the available evidence so that the patient can safely incorporate her TCIM into their overall medical care.
Criticisms of naturopathic medicine arise primarily from the perspective that it avoids the use of evidence-based practices. Indeed, individual NDs have been rightly criticized as pseudoscientific practices. While concerns about the need to promote the dissemination of evidence-based practices in naturopathic medicine are legitimate, the view that naturopathic medicine is in opposition to evidence-based practices is inconsistent with research. . Research shows that NDs are increasingly embracing evidence-based attitudes, education, and practices. Research also suggests that multidisciplinary naturopathic medicine may be effective in managing conditions commonly seen in primary care, such as cardiovascular disease, chronic back pain, depression, anxiety, and diabetes. Masu. Indeed, physicians concerned about the harms of pseudoscience should be open to dialogue and partnership with physicians who follow evidence-based approaches, rather than summarily dismissing entire physicians.
The ND’s role in helping patients distinguish between nonsense information and useful wellness industry information, and providing time allocated for patient education, will be particularly helpful in counseling those who are hesitant to receive vaccinations. At the height of the COVID-19 vaccination effort, ND worked in mass vaccination clinics for local public health units in British Columbia and Ontario. In these clinics, NDs provided understanding and validation for hesitations. Provides relevance and authenticity. and built trust in vaccines through understanding, education, and shared values. NDs in British Columbia can administer vaccines as part of their scope of practice, while Ontario has only temporarily amended the Regulated Health Practitioners Act to allow NDs to specifically administer COVID-19 vaccines. . With small regulatory changes, NDs could not only continue to contribute to public health but also become an important part of primary care.
Primary care providers are increasingly burdened by a capacity crisis related to workforce shortages, an aging population, pandemic-specific challenges, and increased rates of chronic disease and multimorbidity. Team-based, multidisciplinary approaches, such as those taken by family health teams, community health centers, and Aboriginal health centers, enable more effective and efficient care for patients with multiple health problems. , thereby reducing the burden on family physicians. Just as social workers, pharmacists, dietitians, and physical therapists do in these interprofessional settings, NDs work together in primary care clinics to increase access to care, support public health measures, and treat chronic illness. It will help prevent and treat disease and reduce unnecessary visits.
Despite standardized training and licensing exams, NDs remain unregulated in some states and territories, and discrepancies in regulatory guidelines between jurisdictions can create friction with other health care providers there is. These factors can exacerbate the idea of an unbridgeable gap between physicians and physicians that only harms patients.
There are significant differences in the regulation and scope of implementation of ND by state. In Ontario, NDs can request laboratory tests, prescribe some prescription drugs, and perform Pap tests. In British Columbia, NDs can prescribe most primary care medications, administer vaccines, insert IUDs, and order ultrasounds and x-rays. Unfortunately, few models currently exist, and research on the opportunities and challenges of integrating NDs into the broader health system, specifically team-based primary care, is limited.
Qualitative research at Anishnawbe Health in Toronto suggests that NDs can contribute to positive health outcomes, patient satisfaction, and improved access to healthcare for Indigenous clients. With more than 2.2 million Ontarians without a family doctor, there is a strong case for leveraging the skills and reach of NDs to address health and workforce shortages, especially in northern and rural communities.
Unless government funding is available to employ NDs on a salary, innovative, solutions-based thinking will be required to work equitably within public and private health care systems and insurance models. . National licensure and equivalence of scope across jurisdictions are important to ensure consistency in standards and guidelines of care and practice. Pilot projects assessing the feasibility of integrating ND into team-based primary care models are needed to determine appropriate staffing and evaluate patient outcomes and experiences.
