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Reality check: New rules for naturopaths fail to ensure safety

Eben Byers was a rich American steel industrialist and amateur golfer who fell and injured his arm during a train ride in 1927. All of these facts would be unremarkable, except for what Byers's doctor prescribed as a cure: radioactive water.

In those days, radium drinks were extremely popular, mostly among those with discretionary money to spend, to treat any and all sorts of physical ailments. Byers became a fervent believer in the healing powers of radioactive water, guzzling bottles a day until, less than five years later, most of his teeth fell out, his lower jaw was removed and holes started to form in his skull.

After his death in 1932, the U.S. government gave new, expanded powers to the Food and Drug Administration to crack down on snake oil salesmen and other peddlers of "medicines" that had no proof behind them and plenty of evidence of harm.

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More than 80 years later, the world is a much different place. To sell a prescription drug, pharmaceutical companies must first spend millions of dollars on development and clinical trials and subject themselves to the (usually) rigorous approval processes used by agencies such as the FDA and Health Canada.

But in other ways, you would think that we were back in the 1920s.

For the past eight years, Ontario has been promising to implement new regulations governing the activities of naturopaths. The rules, which could come into force any day now, would give naturopaths the power to order dozens of lab tests, treat chronic diseases and prescribe a number of medications, even though it is unclear what, if any, formal pharmacologic training they receive. In British Columbia, naturopaths already have many of these powers, part of a growing trend toward legitimizing the offerings of these so-called alternative-health practitioners.

It might seem as if the Ontario government has adopted a sound approach, cracking down on the most questionable practices of naturopaths while still giving them the authority to practise as licensed health professionals.

In reality, the new regulatory system is all over the map and creates a confusing picture. Naturopaths will still be allowed to prescribe herbal remedies and therapies that have absolutely no evidence to back their use. They will also be able to prescribe prescription drugs, which groups such as the Ontario Medical Association have openly warned about. Naturopaths can continue to promote (as many do) ineffective nosodes, referred to by many in the field as "homeopathic vaccines."

Across the province, naturopaths are up in arms. No, they are not celebrating their vastly expanded powers; they are protesting against the fact the new regulations will place some limits on their authority, something naturopaths say is unjustified and will pose a deadly threat.

Specifically, naturopaths are rallying against restrictions on their ability to order lab tests outside Ontario, prescribe certain intravenous therapies and collect some specimens from patients in their offices. Among the prohibited tests and treatments are certain forms of chelation therapy, a controversial and risky procedure promoted by naturopaths as a way to treat heavy-metal exposure; some infertility therapy; screening for various sexually transmitted infections; as well as tests to monitor some cancer patients.

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The proposed regulations "will undoubtedly jeopardize the continuity of care and safety of the more than one million Ontarians," the Ontario Association of Naturopathic Doctors says in a letter sent in May to Ontario Health Minister Eric Hoskins.

In reality, there is no imminent public-health threat posed by prohibiting naturopaths from ordering questionable blood tests from U.S.-based labs to "diagnose" food sensitivities or determine how many environmental "toxins" a person may be carrying.

So why are naturopaths positioning themselves as individuals who should hold authority in these matters, considering their lack of specialized training to treat those diseases and the fact that our publicly funded health system is already set up to provide those services?

Profit, for one. According to the Canadian Association of Naturopathic Doctors, a patient can expect to pay up to $180 an hour to see a naturopath.

There are cases in which naturopathy can help people take control of their health – say, when it comes to nutrition and dietary counselling. But unfortunately many of the services they offer have not been backed up by clinical trials or any real, credible evidence.

The government has created a new system to regulate naturopaths, but has failed to implement any measures that would ensure the services they offer are legitimate and safe and offer real benefit. Instead of focusing on a checklist of lab tests or setting arbitrary limits on the types of IV therapy they can offer, Ontario should have created a regulatory system based on the principle of evidence first. That would dramatically reduce the number of services naturopaths are able to offer, and charge for, but would ensure that patients get care based in fact, not a persuasive argument or anecdotal report.

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There is no danger of radium water making a comeback. But as more provincial governments move to legitimize health professionals who promote unproven, ineffective treatments, it seems we have forgotten the lessons Byers and a legion of snake oil salesmen taught us. Primarily, there is a reason evidence – from numerous large, well-designed trials – is now the standard used to determine which treatments work and which procedures should be offered.

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About the Author

Carly Weeks has been a journalist with The Globe and Mail since 2007.  She has reported on everything from federal politics to the high levels of sodium in the Canadian diet. More

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