HPRAC Recommends Larger Role for NDs in Primary Care
Full Scope of Practice for Naturopathic Doctors:
Prescribing, Dispensing, Selling and Compounding
February 2, 2009
Ontario’s Naturopathic Doctors (NDs) are a highly trained and provincially regulated health profession. The regulation of the profession is in transition from the Drugless Practitioners Act to the Regulated Health Professions Act. This transition is expected to be completed in the next two years. As part of this transition, NDs require the controlled act of prescribing, dispensing, selling and compounding a drug in order to maintain patient care they are currently able to provide, and take on an expanded role in improving access to primary health care.
The Health Professions Regulatory Advisory Council (HPRAC), which advises the Ontario Ministry of Health and Long-Term Care, has a clear vision of the importance of all regulated health professions being able to make their maximum contribution by working to the full scope of their training and capability. They envision a health care system:
“…where all health professions can function to the fullest extent of their training and capability as part of an integrated and collaborative health care team is key to improving access to seamless, effective, patient-centred care. To deliver this kind of care, health care professionals must be able to practice to the maximum extent of their respective scopes of practice.”
HPRAC supports full scope of practice for NDs, including the limited ability to prescribe drugs. HPRAC’s January 2009 report, Critical Links: Transforming and Supporting Patient Care, recommends that NDs be able to prescribe restricted natural substances that are integral to Naturopathic Medicine, as well as specific pharmaceuticals that would allow NDs to play a larger role in primary care.
NDs are one of only three health professions that provide primary health care for patients in the province, along with medical doctors and nurse practitioners. In fact, NDs have been regulated in Ontario since 1925. Science-based, safe and effective, patient-centred care are at the heart of all ND care.
NDs have the high level of training required to prescribe medicine. The minimum seven years of training includes pre-med studies plus a four-year program from an accredited Naturopathic College with extensive training and testing in pharmacology.
Naturopathic Doctors require the ability to prescribe therapeutic natural substances that are integral to Naturopathic Medicine but are currently on restricted schedules because they are not suitable for consumer self-selection. Examples include some vitamins, minerals and amino acids in higher dosages or administered by injection, as well as restricted botanical medicines and bio-identical hormones. NDs are the experts in the use of these substances. Loss of access would severely impact patient care and take away patient choice.
NDs will also be able to improve patient care by having access to key drugs used in primary care. For example, prescribing authority would allow NDs to immediately treat a diagnosed case of strep throat with antibiotics as indicated by best practices, improving patient care and patient safety while reducing pressure on other providers and emergency rooms. Being able to practise to their full scope will also make NDs more effective members of inter-professional teams.
Prescribing authority will not change the fundamental approach to Naturopathic Medicine to treat the whole person, with a focus on identifying the underlying causes of a health concern, rather than just treating symptoms.
Ensuring that all health professions are able to make their full contribution will improve patient care, respect patient choice of care provider, improve access to safe and effective care, and improve the effectiveness of inter-professional teams.
