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Fake Doctors With Real Drugs: The News From Canada PDF Print E-mail
Swift
Written by Steve Thoms   

Dear Swift Friends:

My name is Steve Thoms and I'm the editor of the new pan-Canadian skeptic blog, Skeptic North. Thanks to some friendly promotional assistance from Phil Plait, Skepchick.org and many other sites to whom our team owes a debt of gratitude, you may have heard of us by now. If not, that's okay, because we've only launched on October 1st. We're a team of skeptical writers, professionals and activists from across Canada, brought together in one place for the first time. Our aim is to be the authority of all things related to skepticism in Canada, and it is with this last point in mind that I come to you all with an urgent call for action and assistance.

As Skeptic North's resident science-based pharmacist reported week, the Ontario legislature is poised to grant prescription rights to naturopaths. I think I hardly need explain to Swift readers how dangerous this is, but please indulge me in a little exposition.

Bill 179 was introduced in the spring of this year as a way of expanding scope-of-practice for health care professionals in Ontario, including (but not limited to) nurses, midwives, pharmacists and radiologists. Such an expansion was recommended by the Health Professions Regulatory Advisory Council (HPRAC), and this organization also recommended further that naturopaths be granted prescription rights. The Bill would have aimed to do this by amending a previous act of the Ontario Legislature, the Naturopathy Act, 2007. In this act, a "naturopath" is defined simply as someone who graduated from one of the two naturopathic colleges in Canada (neither of which are affiliated with any Canadian accredited university, and have extensive courses in homeopathy, Traditional Chinese Medicine, and colonic hydrotherapy). After the first reading of the bill, the HPRAC's recommendation for naturopath prescribing rights were soundly rejected. Before the bill's second-reading, a coalition of naturopathic associations organized a write-in campaign to put the naturopathic amendment back into the bill, and they were successful on Oct 20.

The bill itself has gone through two readings so far, and the third and final reading has been ordered (but not yet scheduled). The current session of the Ontario legislature will likely be over in less than a month, so the bill will likely be presented for it's third reading, at which point it will be enshrined in law. Then naturopaths, homeopaths, acupuncturists, and Reiki practitioners will have the right to prescribe anti-inflammatory, anti-biotic, and narcotic (just to name a few) medications.

Supporters of the naturopath expansion have framed this issue in two disingenuous and/or problematic narratives: one of freedom, and one of access. The former is being presented as allowing Ontario citizens the freedom to seek out alternative health modalities and freedom for naturopaths to prescribe medications that they need to; the latter as a way of dealing with the doctor shortage. Both of these arguments are deeply concerning, because a) there is no law in Canada that prohibits citizens from seeking alternative treatments, and b) if a person who requires legitimate medical attention and feels they are unable to see a doctor in a timely manner, they are far more likely to seek out alternative avenues, potentially finding a dangerously-untrained and under-qualified naturopath.

This is not a matter of freedom of choice, nor is it a matter of helping deal with the doctor shortage. This is about granting political legitimacy to a pseudo-science when it's practitioners are unable to gain legitimacy the way that conventional medicine does: through science, evidence, testing, and peer-review. Most people are not skeptics, and when they hear "Naturopathic Doctor," many are just as likely to see the holder of title as just another primary care provider. Think about that when your mother needs heart medication, or your nephew gets an ear infection.

Defeating a bill in its third reading is rare, but not impossible. I'm asking for all Swift readers (especially the Canadians and Ontarians) to email the Ontario Premier, Dalton McGuinty, and (dmcguinty.mpp.co@liberal.ola.org), as well as the Minister of Long-Term Health and Care, Deb Mattews, (dmatthews.mpp.co@liberal.ola.org). It would also be wise to CC the same email to Andrea Horwath, leader of the New Democratic Party (ahorwath-qp@ndp. on.ca) and Tim Hudak, leader of the Progressive Conservative Party (tim.hudakco@pc.ola.org). The bill is under review by the Standing Committee on Social Policy (for a complete list of the members of the committee, click here), so Ontario residents would do well to email them as well. Remember to CC all correspondences, so that everyone knows who else is reading what.

For further information, visit the above links as well as my own follow-up posts here and here. These links will provide a helpful background and analysis of the practice of naturopathy, its academic standards, the bill itself, and how best to respond. British Columbia has already passed similar legislation, but it's generally the way of things in Canada that however Ontario goes, so-goes the rest of Canada. We really need everyone's help defeating this affront to health care standards and patient safety. If we beat them in Ontario, we just might stop them in their tracks.

If anyone has any questions, feel free to contact me directly at skepticnorth@gmail.com.

Thanks a million
Steve Thoms
Editor-in-Chief,
Skeptic North
www.skepticnorth.com

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in BC
written by Matt_D, November 26, 2009
I work for the Provincial Government in British Columbia - last year the government was considering a similar change, but it seems to have died in the beaurocracy of the Ministry of Health (thank god). Who knows when it will rear its ugly head again, though.

I actually had the opportunity to ask the Minister about the proposed changes, and got a very general answer, but my understanding is that the main reason the provinces are considering these kinds of changes isn't because they want to endorse naturopathy, but that they're trying to reduce the time-waster caseload on real doctors - the hypochondriacs and people who come to their family doctor every time they get a runny nose but a huge and unnecessary burdon on our healthcare system and shrugging these people off on naturopaths who will tell them to go home and take some echenacia or something seems to many people to be a good solution.

I would personally much prefer just spending some money on educating people, and I believe any official recognitian of naturopaths as legitimate doctors is very dangerous; however, there is at least some pragmatic, practical thinking behind these decisions.
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follow-up
written by Matt_D, November 26, 2009
I missed that you mentioned BC at the end of your article - I was under the impression that this was proposed and hadn't passed. Can you cite a source that verifies that it has passed?
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written by KimboJones, November 26, 2009
Re: BC naturopaths, see http://www.cbc.ca/health/story...paths.html and http://en.wikipedia.org/wiki/Naturopathy#Canada

The argument to reduce "burden" on the health care system is a very poor one. There are 1000 or so naturopaths in ON compared to ~ 23000 doctors. What impact could that really have on burden?
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written by Otara, November 26, 2009
"but that they're trying to reduce the time-waster caseload on real doctors - the hypochondriacs and people who come to their family doctor every time they get a runny nose but a huge and unnecessary burdon on our healthcare system and shrugging these people off on naturopaths who will tell them to go home and take some echenacia or something seems to many people to be a good solution."

Thats an insane argument - those kind of people are the people who are most vulnerable to exploitation by 'alternative' practitioners. They're also the people who most need to be seen by professionals so that when real conditions develop they wont just be assumed to be hypochondria related issues.
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Dominos
written by GusGus, November 26, 2009
If Ontario does it, then probably so will the rest of Canada. If Canada does it, will the United States be close behind? I shudder at the thought!!!
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written by MadScientist, November 26, 2009
Dang. OK, I won't say I wish I were Canadian anymore (how aboot that).

For me the primary issue is that naturopaths, homeopaths, quackopaths, etc simply should not be considered as medical practitioners at all until they provide incontrovertible evidence that their quackery does result in correct diagnosis and effective treatment of ailments. Until they demonstrate such competence they should not be eligible for any public health care payments, should not be allowed to make diagnoses of illnesses, and they should have absolutely no authority to prescribe controlled substances. Accepting such quackery debases the entire medical profession and the numerous hard-working folk who've spent a lot of their time and money learning their craft so that they can help the sick and injured. Such legislation will de facto, at least in the public mind, grant legitimacy to the quackery business.
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written by MadScientist, November 26, 2009
@Otara: I agree with you on that one. Hypochondriacs are a nuisance, but occasionally they actually do need some help. Pushing them to the quacks not only does not save any money, but it can be very bad for the hypochondriac too; it is simply unethical. That's one point on which I strongly disagree with Ben Goldacre; quacks do not have a useful purpose to serve.
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Dangerous for other reason
written by MarkEMarkEMark, November 26, 2009
We are just getting across to doctors (in the UK, at least) that anti-biotics should not be prescribed for treatments of viruses like the common cold. Imagine now having to stop a whole new bunch of prescribers doing this. Any drugs that have a knock-on effect to the rest of the population who don't believe in this crap should be removed from the bill as a matter of priority. (That is viruses with increased immunity to anti biotics)
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written by Glen99, November 26, 2009
While the Ontario legislation is clearly ridiculous, the B.C. legislation is positively frightening. And it appears that it has been signed into law (though possibly not yet implemented): http://www.health.gov.bc.ca/le...6_2009.pdf

The list of things they can do in B.C. includes minor surgeries, prescribing mood-altering medications, putting "an instrument or a device or finger" into natural or artificial body openings (whatever that means!), and ordering x-rays and ultrasounds. While they claim certification will be needed to dispense medications, I have little doubt that it won't be difficult to get.

I know a paramedic here in B.C. who thinks that naturopaths are real doctors, and will argue the case, because that's what he was told in his training. That in turn is partly because the law allows naturopaths to refer to themselves as "Doctor Insertname" without qualification. The woo propaganda machine is strong, it seems....
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written by Stargazer9915, November 27, 2009
So am I to understand that if I move to Canada and proclaim myself a homeopathic doctor or a rieki specialist I can write narcotic presriptions? Let me pack my bags right away...and move as far south as I can get and still speak english. I knew the Canadian government was full of stupid people but I didn't think it could be worse than the US. What are they thinking, eh?
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written by Michieux, November 27, 2009
Although we live in Melbourne, Australia, my wife -- who is a native of Edmonton, Alberta, and who holds dual citizenship -- is deeply troubled by this issue. We both would like to know what the medical profession is doing about this: are they just sitting on their hands and remaining silent? Doesn't the HPRAC understand what Naturopathy is?

Rest assured we will be adding our voices to the chorus of outrage this proposal so richly deserves, and welcome to the JREF!
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written by gonut, November 27, 2009
I don't understand why homeopaths want to prescribe real drugs. If they need to give out something stronger, why don't they just dilute their existing panoply of preparations by another factor of ten?
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My email to the Ontario Government....
written by sandiconrad, November 27, 2009
Dear Mr. McGuinty & Ms. Matthews

I am appalled to hear that bill 179 is including Naturopaths, allowing them the opportunity to prescribe drugs. In my opinion, having (foolishly) visited Naturopaths in the past, they do not have the necessary background to be able to offer sound advice nor understand the level of detail required to deal with drug interactions.

In dealing with a family member's H1N1 last week, I was able to consult with a nurse, doctor and pharmacist at various times and was impressed with their knowledge of what the most effective solutions were, while taking into account other health challenges that would have been affected by certain medications. I do not see that same level of knowledge in Naturopaths. Most are currently recommending herbal remedies to combat the flu, rather than the flu shot as recommended by Health Canada & the Ontario Ministry of Health.

Ironically, by granting them power of prescriptions, you are giving them access to the very thing that goes against their business model, and which they have lobbied against up until now. These people have built their business on providing misinformation about the health care industry. Please seriously reconsider this bill.
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MarkEMarkEMark - There is a serious error in your comment
written by Human Person Jr, November 27, 2009
You wrote that: "...anti-biotics should not be prescribed for treatments of viruses like the common cold..." So far, so good, since viruses can't be killed by antibiotics.

You continued: ..."Any drugs that have a knock-on effect to the rest of the population...should be removed from the bill...(That is viruses with increased immunity to anti biotics)

All viruses have (and have always had) complete immunity (sic) to antibiotics. There isn't any "increased immunity" (or decreased immunity, for that matter. I think the word you're looking for is "tolerance," though, not "immunity." Viruses are unaffected by antibiotics.
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Hear, hear.
written by daijiyobu, November 27, 2009
Per: "this is about granting political legitimacy to a pseudoscience when its practitioners are unable to gain legitimacy the way that conventional medicine does: through science, evidence, testing, and peer-review."

When you can't win the game, you move the goalposts.

-r.c.

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This bill will not save money.
written by Mike_M, November 28, 2009
If this bill is passed then it is just a matter of time until it is used to try to get naturopathic treatments covered under the Ontario public health insurance plan. By declaring naturopaths to be just another heath practitioner, the Ontario Government has given them ammunition to use in future lobbying or perhaps a court case.

This is over and above the costs created when people injured by improperly prescribed medication show up at emergency rooms as well as the long term care required to repair the damage (if repair is possible).

MM
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written by PrimevilKneivel, November 30, 2009
I sent my concerns to the Liberal government as well as the leaders of the opposition. The only response i got was from the New Democratic Party that said they support the bill and evidence based health care. I pointed out the irony of that in my reply email right along with my intention to not vote NDP and to spread the work that voting NDP is voting against effective health care.
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written by pxatkins, December 01, 2009
So you'll vote Liberal ... the team that brought it in?
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