Naturopaths are alternative medicine practitioners who claim to provide primary care, like medical doctors. This is despite that fact that they use a hodgpodge of unproven or disproven therapies, sometimes alongside conventional medical treatments. Among naturopathy’s advocates, it’s repeatedly claimed that naturopathy offers something that “conventional” medicine does not: naturopaths are described as “doctors plus”, using unconventional approaches to coax the body to “heal itself” with methods that are claimed to be safer and more effective than conventional drugs and medical interventions.
Naturopathy, as a profession, seeks the same legislative credentials and status as medical doctors. And as Jann Bellamy has pointed out, they have been fairly successful in both Canada and the United States in obtaining legislative credentialling that implies scientific legitimacy to this practice. In what looks like a modest pushback, one Canadian province has declared that naturopaths cannot position themselves as medical doctors or claim that they are “medically trained”.
In November, a column at CBC news from Dr. Michelle Cohen, a family doctor, noted:
The College of Physicians and Surgeons of New Brunswick recently conducted an investigation and found that 41 per cent of the province’s naturopaths were using restricted terms like “physician” and “medical practitioner” in contravention of New Brunswick’s Medical Act.
To be sure, naturopathic education does involve basic science and clinical skills, but it’s unquestionably false advertising to claim that this represents “medical training.” Many health professionals complete multi-year programs where students memorize anatomy, see patients in supervised settings and get tested on clinical skills. That’s not “medical” training — it’s the essential background for almost everyone in health care. And just like “dentistry” and “nursing” are clear and unambiguous ways to describe one’s background, so too should “naturopathy” be a sufficient descriptor. The only reason to start throwing the term “medical” around is to deliberately sow confusion about your education.
Five provinces (B.C. Manitoba, Alberta, Saskatchewan and Ontario) have naturopathic colleges that regulate the profession and are mandated to protect the public. This past summer, Alberta surgeon Dr. Carrie Kollias contacted the College of Naturopathic Doctors of Alberta about a naturopath claiming to have “recently graduated from medical school.” They replied that this was “not in any way misleading” because his website listed the naturopathic school he attended. But patients shouldn’t be required to fact check their provider’s background. Using the terms “naturopathic” and “medical” as if they are interchangeable is a bait and switch designed to confuse. Condoning this behaviour as a regulator is a dereliction of duty.
Naturopathic medicine is marketed as a “distinct form of primary health care.” This phrase is ubiquitous: it appears on the websites of naturopathic medical schools, on materials published by practicing naturopaths, and on lobbying documents to promote the unfettered licensure of naturopaths and to expand eligibility for federal loan repayment programs. Based on my educational and professional experience as an accomplished member of the naturopathic community, I can say that naturopathic medicine might be a distinct form of something, but it is not any form of primary health care. I am saddened to report that not only was I misled, but so were hundreds of legislators, thousands of students, and tens of thousands of patients.
The reality is that naturopathic education is profoundly unscientific and isn’t comparable to a medical education. So when naturopaths make claims that could be misleading, it’s not surprising that they will be called out.
New Brunswick physicians sought an injunction
Earlier this month, a New Brunswick judge issued an injunction prohibiting naturopaths (who are unlicensed in that province) from making specific claims about their credentials:
Naturopaths are not medical practitioners and naturopaths are not allowed to use words to suggest that they are.
– Court of Queen’s Bench Justice Hugh McLellan
The CBC noted:
In an oral decision, Justice Hugh McLellan said the justification for naturopaths using terms such as “doctor” and “family physician” are based on the assumption that “people are attuned to the meaning of words like “naturopathy.”
Many patients might read a website or a Facebook ad out of context, he said, and fail to pick up on the difference between “a doctor listing his or her qualifications as ‘Dr. So-and-So, B.Sc., MD,’ as opposed to the listing that might include ‘B.Sc., ND [naturopathic practitioner].'”
“I see a risk here,” McLellan said, “that the words … could, in fact, imply or be designed to lead the public to believe these various naturopaths are entitled to practise medicine.”
ND = Not a Doctor
In an unrelated but also related story, a newly elected city councillor in British Columbia is also being criticized for misrepresenting her naturopathic background during the election campaign.
Coun. Allison Patton, who was voted in last month as part of Mayor Doug McCallum’s Safe Surrey Coalition slate, used her profession as a selling point during the campaign. Patton described herself as “a community physician for over 17 years” in the biography on her campaign website, without noting that she is a naturopath. She also referenced her “medical practice” in a campaign video, but did not mention that she practices naturopathy.
The story notes:
A member of the public filed a complaint on Thursday with the College of Naturopathic Physicians of B.C., alleging that Patton’s campaign materials breached the college’s advertising policy. College policy says naturopaths can describe themselves as physicians or doctors, but “the designation naturopathic physician must be used each time.” According to the policy, “Physician, as a stand alone term, could imply another type of physician, for example an MD, even in a naturopathic setting.”
Seeking primary care? Check credentials
Naturopaths lack the qualifications of medical doctors, yet may position themselves as “medically trained” and capable of providing primary care. These claims are not backed by convincing evidence. While naturopaths can offer reasonable, science-based advice, naturopaths may also offer health advice that can be at odds with medical evidence and sometimes even basic laws of physics. To date, there have been few attempts worldwide to hold naturopaths to any particular objective standard of care. Given the variety of practices that encompass “naturopathy”, some of which may have disasterous consequences, this remains a practice where the consumer must be very cautious. If you’re seeking primary care grounded in science and evidence, there’s really only one provider you should be seriously considering: a medical doctor.