Alberta Government Should Approach "Alternative Medicine" With Trepidation

My latest Calgary Herald column looks at the Alberta government's recent decision to regulate naturopaths:

It's commendable that Health Minister Fred Horne wishes to respect choice in health care.
However, acknowledging that various health options exist need not lead to an endorsement - tacit or otherwise - of those options.
Last week, the Alberta government announced changes to the Health Professionals Act to officially recognize naturopaths and to establish the College of Naturopathic Doctors of Alberta. The changes also spell out which procedures naturopaths are licensed to perform.
The government's news release pledges that "Albertans can be assured they are receiving safe, effective services from qualified professionals."
It also offers a definition of naturopathy that could have been written by the industry itself: "focus(es) on health promotion, illness prevention and treating disease using natural therapies and substances that promote the body's ability to heal."
However, this branch of so-called alternative medicine is viewed with much apprehension by those who adhere to a belief in evidence-based medicine.
For example, Dr. Kimball Atwood, an assistant clinical professor at the Tufts University School of Medicine in Boston and associate editor of the Scientific Review of Alternative Medicine, says naturopathy stems from a 19th-century health movement espousing "the healing power of nature."
He writes that present-day naturopathy is "replete with pseudo-scientific, ineffective, unethical and potentially dangerous practices."
At some level, the Alberta government concurs, because the health system does not cover naturopathic services or treatments, and the government made it clear that the status quo in that regard is not changing.
Therefore, the government's position appears contradictory. If indeed naturopaths offer "safe and effective" treatment, then why wouldn't they be covered? However, if these services do not meet the evidentiary standard laid out by our health-care system, then why is the government giving what surely amounts to tacit approval of naturopathy?
The health minister has a broader duty, I dare say, to uphold the integrity of the health-care system and to ensure that his department's decisions are doing nothing to undermine important public health initiatives.
Take, for example, the importance of vaccines. Alberta Health Services has been advancing this cause on a number of fronts recently, with respect to pertussis, HPV and chickenpox. The AHS website devotes an ample amount of space to providing information about the importance of vaccination and some of the myths around vaccines.
A study last year from researchers in Toronto found that parents who rely primarily on naturopaths were more likely to have a partially vaccinated or unvaccinated child. Do we now risk exacerbating this problem here in Alberta?
Vaccination is a choice, just as visiting a naturopath is, but it serves to illustrate how the Alberta government can respect the existence of choice, while at the same time taking a stance in favour of the scientific evidence.
To speak of "traditional medicine" and "alternative medicine" is to offer a meaningless and useless distinction. The only distinction that ought to concern us is the distinction between that which works (medicine) and that which does not (hooey).
A recent study by University of Alberta researchers Tim Caulfield and Christen Rachul found that naturopaths in Alberta and B.C. are regularly offering services that are "of questionable value and have no scientific evidence of efficacy beyond placebo."
Those include chelation therapy, colon cleanses and homeopathy.
Homeopathy, which posits that "like cures like" and the more diluted a substance, the more powerful it is, may be shunned by some naturopaths, but all are trained in it. Even the website of the Canadian Association of Naturopathic Doctors lists homeopathy as an example of a naturopathic treatment.
If naturopaths are offering treatments with little or no scientific basis, it seems to me that rather than weeding out such practices, the Alberta government's decision only further entrenches them and ensures more Albertans receive them.
Homeopathy, for example, may be "safe" in the sense that there's nothing in it to cause harm, but the danger arises when unsound practices becomes a substitute for medically sound and medically proven treatments.
The Alberta government may have a role to play in ensuring the safety of so-called alternative health products and services, but it should be careful about not undermining the health-care system in the process.