naturopathydigest.com -- Swimming Upstream

Since the 1980s, Ontario NDs have fought to be included in Canada's Regulated Health Professions Act (RHPA). Has their time finally come?

As the number of naturopathic doctors in Ontario continues to soar, and as naturopathic medicine across North America works to establish a solid identity and scope of practice in the realm of primary care, the Ontario Association of Naturopathic Doctors (OAND) and naturopathic physicians province-wide are expectantly awaiting crucial regulatory changes by Ontario's Minister of Health and Long-Term Care.

Naturopathic doctors in Ontario, currently regulated under the Drugless Practitioners Act, have sought regulation under the Regulated Health Professions Act (RHPA) for years. The RHPA regulates 23 health professions, including medical doctors, nurses, nurse practitioners and psychologists; and establishes regulatory bodies called "colleges" to govern and hold professionals accountable. Since the 1980s, naturopathic doctors in Ontario have sought regulation of their profession under RHPA. Currently, naturopathic physicians in Ontario must be registered with The Board of Directors of Drugless Therapy - Naturopathy (BDDT-N), which is governed under the antiquated Drugless Practitioners Act of 1925.

Although the efforts of Ontario's NDs toward regulatory change historically have been met with disappointment, the results of a spring 2006 survey of more than 600 Ontario residents provided renewed motivation and useful ammunition in the decades-old battle for improved regulation.

The results of the survey,¹ prepared for the Coalition for Naturopathic Medicine (i.e., OAND, the BDDT-N, the Canadian Association of Naturopathic Doctors and the Canadian College of Naturopathic Medicine) revealed that approximately 40 percent of Ontario residents (5 million potential patients) say they are likely to see a naturopathic doctor sometime in the next few years. And the likelihood of seeing an ND in the future rises significantly, to nearly 70 percent, as patients learn more about NDs' rigorous education, training and mandatory, standardized board exams.

"With that many Ontarians wanting to use the services of a Naturopathic Doctor, it is absolutely essential that the province bring in effective regulation of the profession," said Ruth Ann Barron, ND, chair of the OAND and spokesperson for the Coalition for Naturopathic Medicine.² Dr. Barron echoes more than 25 years of dissatisfaction with the regulation of the profession in Ontario.

The history of the regulation of naturopathic medicine in Ontario is an extensive one. In Canada, naturopathic practice is regulated under provincial law in four provinces: British Columbia, Manitoba, Ontario and Saskatchewan. The profession was first regulated in Ontario in 1923, following an amendment to the Ontario Medical Act. And, since 1925, NDs have been licensed under the Drugless Practitioners Act, and governed by the BDDT-N. At present, naturopathic doctors are the only health professionals in Ontario still regulated under the Drugless Practitioners Act.

Starving for change, members of the profession have actively participated in the Health Professions Legislative Review (HPLR). The Health Professions Regulatory Advisory Council (HPRAC), an organization providing independent policy advice to the Minister of Health and Long-Term Care on matters related to the regulation of health professions in Ontario, undertook two such reviews, in 1996 and 2001, respectively, both of which strongly recommended that naturopathic medicine be regulated under RHPA, ultimately to no avail.

As spring approached, HPRAC was preparing its 2006 report to the Minister of Health & Long-Term Care on regulatory issues and matters respecting health care practitioners, patients and clients. And on March 17, the OAND, partnering with the Coalition of Naturopathic Medicine, sent a written submission to HPRAC, outlining the need for regulation of the profession under RHPA and citing the results of the April 2006 survey.³ The information was once again acknowledged and included on May 19, 2006, in a document titled Regulation of Health Professions in Ontario: New Directions.⁴ HPRAC once again advised Ontario's Minister of Health that naturopathic doctors and the practice of naturopathic medicine should be regulated under RHPA, as are most other regulated health care professions in Canada.

"We have been functioning under legislation that was written in 1925, so the current regulation is simply too antiquated and toothless for the 21st century." said Dr. Barron. "If the province adopts [RHPA regulation of naturopathic medicine], the HPRAC recommendation will provide real protection to both the public and our profession."

According to the HPRAC report, many positive and foreseeable changes are anticipated if naturopathic medicine is regulated under RPHA. Among other expected changes, improved regulation would:

The official submission by HPRAC to the Minister of Health and Long-Term Care, Hon. George

Smitherman, includes a 45-page discussion of the status of naturopathic medicine in the province; the previous recommendations (1996 and 2001) that the profession be RPHA-regulated; reasons why such regulation is crucial, including deficiencies of the current regulating body (Drugless Practitioners Act); the scope of practice for naturopathic doctors; and a transition prospectus.

The document also contains a recommendation regarding the co-regulation of homeopathy and naturopathy (i.e., the creation of a joint college of homeopathy and naturopathy), citing "clear links between the principles and practices of naturopathy and homeopathy."⁴

"As we told both HPRAC and the Minister of Health, we have some reservations about the practicality of the recommended joint college with homeopaths, but NDs are pragmatic people," said Barron, in response to the notion of co-regulation. "Right now, a joint college seems to be the quickest, most efficient means of achieving the regulation that NDs have been requesting for years so we will make every effort to make the proposed college a success."²

There is no question that improved regulation is a goal for most, if not all, naturopathic doctors in Ontario. An Internet survey⁴ of NDs, regulated by the BDDT-N and undertaken by the Coalition for Naturopathic Medicine, indicated that:

The HPRAC's report, Regulation of Health Professions in Ontario: New Directions, was released by the Minister of Health and Long-Term Care for public comment and closed on June 30, 2006. Whereas the Drugless Practitioners Act is unequipped with adequate public safety and accountability provisions to properly address the risk of harm or ensure the protection of public interest, the RHPA promises a more comprehensive framework for the regulation of the naturopathic profession.

Survey prepared by Innovative Research Group, April 2006.
"5,000,000 Ontarians Expect to Visit..." Press Release.
"OAND Submission to HPRAC."
Click to download PDF.
Survey conducted Feb. 21-March 3, 2006.