Vanessa Lindsay, a naturopathic doctor in Vancouver, has been treating high blood pressure in her patients for years through nutrition and exercise.
“She’s lost weight. She’s gotten stronger. She’s eating better, she’s hydrating, she’s sleeping better,” Lindsey said.
However, the patient is still taking two types of blood pressure medication. And since naturopathic doctors in British Columbia are allowed to prescribe medications, Lindsey also works with patients on those medications.
“I can monitor her and support her in safely weaning when appropriate,” said Lindsay, who is also president of the BC Naturopathic Doctors Association.
“So we use complementary care when appropriate, but we also need to integrate traditional tools when necessary.”
British Columbia, along with the Northwest Territories, has the widest scope of practice for naturopathic doctors in Canada, including certifying to prescribe medications and administer vaccines.
The Canadian Association of Naturopathic Physicians would like to see doctors with similar training allowed to practice the same scope of practice across the country, said executive director Sean O’Reilly.
She touted a four-year training program that includes science and said it distinguishes “naturopathic doctors” from unregulated practitioners who call themselves naturopaths without standardized training.
With a shortage of family doctors in Canada, many naturopathic doctors are positioning themselves as the solution, claiming they are trained to be a patient’s primary care provider.
This has fueled concerns among doctors and medical professionals that they are not equipped to serve as the primary source of care for patients.
“We have to be really 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 as well, treat them as if they were just another form of family medicine. It’s about introducing them,” Cohen said.
“That’s not true,” she said.
”They’re learning anatomy and physiology, but there’s a lot they’re not doing. ”
To become a naturopathic doctor in Canada, students must complete a bachelor’s degree and then undergo four years of training at the Canadian College of Naturopathic Medicine. O’Reilly said the training will include “biomedical and clinical sciences,” including learning about pharmacy and immunization.
“What sets naturopathic doctors apart from other medical professionals is precisely their philosophy and approach to patients,” O’Reilly said.
“Their approach is to look at the whole person, not just the physical, but also the mental, emotional, social and environmental aspects,” she says.
“They also focus on educating patients about things like lifestyle and diet.”
O’Reilly said naturopathic doctors are regulated in British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, the Northwest Territories, and are becoming regulated in Nova Scotia.
O’Reilly said many people who call themselves “naturopathic doctors” are unlicensed and unregulated in some states. These practitioners give the profession a bad name and are likely to be the most anti-vaccine, she said.
But Cohen challenged the idea that naturopathic doctors, even those with university degrees, could be considered a type of family physician.
“They have a completely different type of training and are on a different path.”
Cohen said a “fairly thorough” review of the training of naturopathic doctors found that neither the curriculum nor the clinical training requirements equipped them to diagnose and treat serious illnesses. Ta.
Although naturopathic doctors claim to do the same four-year programs as doctors, “the way they present it is deceptive,” she says.
After completing four years of medical school, doctors must complete at least two more years of training before they can practice, he said.
And while naturopathic doctors must have at least 1,200 hours of clinical training, family physicians have closer to 10,000 hours of clinical training, Cohen said.
The type of clinical training is different because trainees training to become family physicians see a variety of patients, many of them seriously ill, through hospital rotations, she said.
Without such experience, doctors may miss “red flags” that could indicate serious illness in patients with certain symptoms, which could lead to misdiagnosis, she said. .
Still, Cohen believes that the role of naturopathic doctors is to work collaboratively with primary care physicians and nurses as “part of a team that provides specialized care.” This may include lifestyle and dietary consultation, and providing evidence-based information about supplements and interactions with other medications.
Cohen noted that naturopathic doctors have participated in Ontario’s COVID-19 vaccination campaign, making them uniquely qualified to provide science-based counseling about vaccines to people who are hesitant and don’t trust the health care system. He said some people may have it.
Dr. Tahmina 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 welcomes their contributions.
“They are often more educated about preventive and more holistic dietary and lifestyle aspects when it comes to health promotion, prevention, and healing. I think it needs to be ‘both’, not ‘both’,” Ali said. .
He emphasized that communication and coordination among healthcare providers is essential to patient health and to avoid ordering duplicate diagnostic tests and treatments.
But other medical experts are more skeptical.
Dr. Sarah Bates, acting president of the Family Medicine Division of the Alberta Medical Association, said: “It is misleading at the very least for naturopathic doctors to claim that they are the solution to the current crisis, and from a family physician’s perspective. , it’s very frightening.”
“Now, I fundamentally believe that primary care is a team sport, 100 percent. They should complement each other, but that’s not the case.” That’s where the naturopathic doctor comes in,” Bates said.
“A lot of it is essentially pseudoscientific rhetoric,” she says. “It could cause harm.”
Bates still remembers a patient from about 15 years ago who suffered from rectal bleeding, so he referred her for diagnostic tests, including a colonoscopy.
However, her patient did not undergo the surgery.
“She went to see a naturopath instead, but came back to me a year and a half later with worse bleeding and weight loss. She looked very unwell. “Bates said.
The naturopathic doctor was treating a patient with the yeast Candida, a fungal infection, she said.
“She died of colon cancer about six months later.”
Bates said she knows it may sound like she’s trying to protect her “turf,” but she’s just trying to protect her patients.
“There are enough jobs here,” she said. “But the solution is not to refer people to practitioners who are not properly trained to provide a certain level of care.”
Blake Murdoch, a senior research fellow at the University of Alberta Health Law Institute, agreed.
“Many natural remedies are based on the principle that modern medicine only treats symptoms rather than the underlying cause, but this is not the case unless there is no scientifically known effective treatment. This is clearly false,” Murdoch said in an email.
“This is where alternative medicine ‘fills in the gap’ with something that is probably ineffective or untested and potentially unsafe.”
This report by The Canadian Press was first published March 25, 2024.
Canadian Press health coverage is supported through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
Nicole Ireland, Canadian Press
