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Naturopathic doctors aren’t solution to primary care crisis: doctors, health experts

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8 months ago

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Vancouver naturopathic doctor Vanessa Lindsay has been treating a longtime patient’s high blood pressure through nutrition and exercise.

“She’s lost weight. She’s stronger. She’s eating well. She’s hydrated. She’s sleeping better,” said Lindsay.

But the patient is still on two blood pressure medications — and because naturopathic doctors in British Columbia are allowed to prescribe drugs, Lindsay works with her patient on those, too.

“I can support her in monitoring and safely weaning off one when it’s appropriate,” said Lindsay, who is also the president of BC Naturopathic Doctors.

“So using the complementary care when it’s appropriate, but also integrating those conventional tools when necessary.”

British Columbia, along with the Northwest Territories, has the most extensive scope of practice for naturopathic doctors in Canada, including the ability to prescribe drugs and be certified to administer vaccines.

The Canadian Association of Naturopathic Doctors wants to see the same scope of practice allowed for similarly trained practitioners across the country, said executive director Shawn O’Reilly.

She touted a four-year training program that she said includes science and distinguishes “naturopathic doctors” from unregulated practitioners who call themselves naturopaths without any standardized training.

Amid a family doctor shortage in Canada, many naturopathic doctors position themselves as a solution, arguing that they have the training to be a patient’s primary care provider.

That’s raising alarm among medical doctors and health experts who say they are not equipped to be a patient’s principal source of medical care.

“We’ve got to be really careful,” said Dr. Michelle Cohen, assistant professor of medicine at Queen’s University and a physician on the 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 — will present them as though they are just a different form of family doctor,” said Cohen.

“They’re not,” she said.

“They’re learning some anatomy and they’re learning some physiology, but there’s a lot that they don’t do.”

To become a naturopathic doctor in Canada, students must have a bachelor’s degree and then take four years of training at the Canadian College of Naturopathic Medicine. That training involves “biomedical and clinical sciences,” including pharmacology and learning about immunization, said O’Reilly.

“It’s really the philosophy and approach that naturopathic doctors take with their patients that differentiates them from other health-care professionals,” O’Reilly said.

“Their approach is to look at the whole person. So not just their physical aspects, but mental, emotional, social, environmental (factors),” she said.

“They also really focus on educating their patients on such things as lifestyle and diet.”

Naturopathic doctors are regulated in British Columbia, Alberta, Saskatchewan, Manitoba, Ontario and the Northwest Territories, O’Reilly said, and are in the process of becoming regulated in Nova Scotia.

O’Reilly said that in some provinces, many people calling themselves “naturopaths” are unqualified and unregulated. Those practitioners give the profession a bad name and are the most likely to be anti-vaccine, she said.

But Cohen disputed any notion that naturopathic doctors — even those who go through the college — can be considered a type of family doctor.

“They have a completely different type of training and they follow a different path.”

Cohen said she has looked “pretty thoroughly” into the training of naturopathic doctors and found neither the curriculum nor the clinical practice requirements equip them to diagnose and treat serious illnesses.

Although naturopathic doctors argue they do a four-year program like a medical doctor does, “it’s deceptive the way they present that,” she said.

Medical doctors must do at least two more years of residency after their four years of medical school before they can practice, she said.

And while naturopathic doctors must have at least 1,200 hours of clinical training, family doctors do closer to 10,000 hours, Cohen said.

The type of clinical training also differs, she said, as those training to be family doctors see a wide variety of patients — many of them very sick — through hospital rotations.

Without that kind of experience, a practitioner can miss a “red flag” that could indicate serious illness in a patient with certain symptoms, leading to misdiagnosis, she said.

Still, Cohen sees a role for naturopathic doctors to work in co-operation with family doctors and nurse practitioners, as “part of a team providing care that’s along their line of expertise.” That could include consulting on lifestyle and diet and providing evidence-based information about supplements and how they might interact with other medications.

Some may also be uniquely qualified to provide science-based counselling on vaccines to people who are hesitant and may not trust the medical system, Cohen said, noting that naturopathic doctors took part in COVID-19 vaccination campaigns in Ontario.

Dr. Tahmeena 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 often have more education on the preventive and more holistic diet and lifestyle aspects to health promotion and prevention and healing. And I don’t think that there has to be an ‘either or,’ but a ‘both,'” Ali said.

She emphasized that communication and co-ordination between the providers is essential for the patient’s well-being and to avoid ordering duplicate diagnostic tests or treatments.

But other health-care experts are much more skeptical.

“Naturopaths presenting themselves as a solution to our current crisis is at the very least misleading. And from the perspective of a family physician, it’s quite horrifying,” said Dr. Sarah Bates, acting president of the Alberta Medical Association’s family medicine section.

“Now, I do fundamentally believe that primary care is a team sport. One hundred per cent. We should be working collectively with nurses, with nurse practitioners and pharmacists and psychologists and complementing each other’s practice, not competing with it. But there is no place in there for naturopathic physicians,” Bates said.

“A lot of (it) is essentially pseudoscience rhetoric,” she said. “There is harm that can be done.”

Bates still remembers a patient from about 15 years ago who had rectal bleeding, so she referred her for diagnostic tests, including a colonoscopy.

But her patient didn’t go for the procedure.

“She went to her naturopathic physician instead, and a year and a half later, she returned to me with further bleeding, weight loss. She looked terribly sick,” Bates said.

The naturopathic practitioner had been treating the patient for yeast Candida, a fungal infection, she said.

“She died like six months later from colon cancer.”

Bates realizes that it might sound like she’s trying to protect her “turf,” but said she’s just trying to protect patients.

“There’s enough work here to go around,” she said. “But the solution is not to introduce a practitioner without the appropriate training to provide a certain level of care.”

Blake Murdoch, a senior research associate with the Health Law Institute at the University of Alberta, agreed.

“Much of naturopathy is based on the principle that modern medicine only treats symptoms rather than (the) underlying cause, which is patently false other than when there is no effective treatment known to science,” Murdoch said in an email.

“This is where alternative medicine supposedly ‘fills the gaps’ — with things that don’t work or are untested and potentially unsafe.”

This report by The Canadian Press was first published March 25, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

Nicole Ireland, The Canadian Press

 

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

Published

2 weeks ago

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October 31, 2024

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.
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Here is how to prepare your online accounts for when you die

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3 weeks ago

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October 24, 2024

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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3 weeks ago

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October 23, 2024

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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