Naturopathic physicians (NDs) are not the first health care providers that come to mind when we think of vaccines. Many people at a Toronto Public Health COVID-19 mass vaccination clinic were therefore surprised that an ND was administering vaccines.
Naturopathic medicine is a distinct system of traditional, complementary and integrative medicine (TCIM) recognized by the World Health Organization; it is often seen as an alternative health system in opposition to science-based practices and, as such, many would not expect MNs to be involved in vaccinations.
However, many people attending the clinic expressed relief at being able to discuss their vaccine concerns with an ND, someone they trusted, skeptical of broad public health measures and familiar with the flaws of the medical establishment. Seeing a provider who they felt understood their health values reassured some of the more hesitant visitors. One particularly hesitant person had a long list of concerns based on information posted online and on social media. The ND listened, answered questions, reviewed the risks and benefits of vaccination, and proactively explained side effects. Grateful for the respectful conversation, the hesitant person left the clinic that day, but returned a week later to request that the ND be on site to administer a COVID-19 vaccine.
NDs are a regulated health profession in six provinces/territories of Canada. Educational requirements Eligibility for licensure requires possession of a bachelor’s degree, graduation from a program accredited by the Council for Naturopathic Medicine Education (CNME), and successful completion of entrance exams to practice. The four-year course covers physiology, pathology and diagnostic skills as well as the therapeutic use of herbs and other natural health products, lifestyle management and disciplines such as traditional Chinese medicine.
Naturopathic physicians emphasize non-pharmaceutical interventions, primarily diet and lifestyle modification for health promotion and prevention. Additionally, NDs use nutritional supplements, herbal remedies, mind-body therapies, manual therapies, acupuncture, and prescription medications. While lifestyle education and motivational counseling are general skills available to many healthcare workers, NDs are particularly qualified to advise patients on the evidence-based use of natural health products , including patient education regarding effectiveness, dosage, contraindications, and adverse effects. and drug-herb interactions. No other healthcare workers have specific training in natural health products like that of MNs, which places them at an advantage in communicating with patients. The use of traditional, complementary and integrative medicine (TCIM) is high in Canada, with approximately 56 percent use at least one CIMT therapyaccording to a 2015 survey.
NDs have extensive knowledge of the wellness industry, more than any other regulated healthcare professional. As the wellness industry continues to grow and become more mainstream, it is especially valuable to have a provider with this particular content expertise in healthcare. NDs can advise patients on how to separate misinformation and disinformation from available evidence so that they can safely integrate CIMT into their overall health care.
Criticism of naturopathic medicine This approach stems largely from the fact that it avoids the need for evidence-based practices. Indeed, individual NDs have been rightly criticized for pseudoscientific practices. Even if we worry about need for increased adoption Although evidence-based practice in naturopathic medicine is justified, the perspective that naturopathic medicine is opposed to evidence-based practice is not consistent with research. Studies show that NDs have increasingly adopted evidence-based attitudes, education And practical. Research also suggests that multimodal naturopathic medicine may be effective in managing conditions commonly seen in primary care, including heart disease, chronic low back pain, depression, anxiety And diabetes. Certainly, physicians concerned about the harms of pseudoscience should be open to dialogue and partnership with NDs who follow evidence-based approaches rather than summarily dismissing the entire profession.
The role of NDs in helping patients differentiate between nonsense and useful information from the wellness industry, as well as the time they can devote to patient education, is particularly useful in advising those who might be hesitant to get vaccinated. At the height of the COVID-19 vaccination effort, NDs worked for local public health units in British Columbia and Ontario. in mass vaccination clinics. In these clinics, NDs offered understanding and validation of hesitation; provided relatability and credibility; and built confidence in vaccines through understanding, education and shared values. Although BC NDs are able to administer vaccines within their scope of practice, Ontario has only temporarily changed the Regulated Health Professionals Act to enable NDs to specifically administer COVID-19 vaccines. With minor regulatory changes, NDs could not only make a continued contribution to public health, but could also become an important part of primary care.
Primary care providers are increasingly burdened with capacity crisis linked to labor shortages, an aging population, pandemic-specific challenges and the increased prevalence of chronic illness and multimorbidity. Interdisciplinary team approaches, such as those employed by family health teams, community health centers and Aboriginal health centers, allow for greater effective and efficient care for patients with multiple health problems, thereby reducing the workload of family doctors. Just as social workers, pharmacists, dietitians, and physical therapists do in these interprofessional settings, NDs could collaborate in primary care clinics to increase access to health care, support public health measures, prevent and treat chronic diseases and reduce unnecessary visits.
Despite standardized training and licensing exams, NDs remain unregulated in a few provinces and territories, which can lead to friction with other health care providers due to inconsistencies in regulatory guidelines between jurisdictions. These factors can exacerbate the idea of an unbridgeable divide between physicians and NDs that only serves to harm patients.
The differences in provincial ND regulation and scope of practice are vast. In Ontario, NDs can order lab tests, prescribe certain prescription medications, and perform Pap tests. In BC, NDs can prescribe most primary care medications, administer vaccines, insert IUDs, and order diagnostic ultrasounds and x-rays. Unfortunately, few models currently exist and research is limited on the opportunities and challenges to integrate MNs into the health system in general and into team-based primary care in particular.
Qualitative research at Anishnawbe Health in Toronto suggests that NDs can contribute to positive health outcomes, patient satisfaction and improved access to health care for Indigenous clients. With over 2.2 million Ontarians who do not have a family doctor, there is a strong case for leveraging the skills and scope of NDs to help address health and human resource shortages, particularly in northern and rural communities.
Innovative, solutions-based thinking will be necessary to work equitably within public and private health systems and insurance models unless government funds are made available to hire paid ND physicians. National licensure and equivalence of scope across jurisdictions are important to ensure consistency in standards and guidelines for care and practice. A pilot to assess the viability of integrating ND into team-based primary care models is needed to determine appropriate staffing, as well as to evaluate outcomes and patient experiences.
