On the Canada Broadcasting Corporation (CBC) program Cross-Country Check-Up May 1st, a discussion on whether tighter regulations for alternative health care ensued. This was prompted on the recent conviction of the parents of Ezekiel Stephan. Ezekiel died when his parents refused to take him to a physician despite life-threatening symptoms and instead administered homeopathic remedies.
You can find the full broadcast at http://www.cbc.ca/radio/checkup/should-alternative-healing-be-more-tightly-regulated-1.3557679
Part of my submission was read on-air (43:06 into broadcast) and my full submission follows below.
re: Should Alternative Health be More Tightly Regulated?
Yes. Yet, there’s a better question, “Do Canadians have access to the most efficacious health care?” The case of Ezekiel Stephan and his parents is a tragic one, and could have been avoided – not by more regulation per se – but better methods at improving user information (and informed choice) and treatment efficacy.
By linking clinical outcomes via technology and reported patient experience to a national database, the public would clearly learn what methods were working and which were suspect. In an age of user experience, it would be health-care users – not political lobbyists – determining what methods were sanctioned based on efficacy.
It’s very difficult for emerging health professions to receive necessary health care funding or research dollars. These emerging professions are not included in the consideration of public health care, even when they are regulated.
Massage therapy, for example, has been regulated for almost 100 years in Ontario, the last quarter century under the Regulated Health Professions Act. Yet despite the rigors of regulation, massage therapy is not funded by Ontario’s health plan, is subject to the HST (because over half of the other provinces are not regulated), and is precluded from hospital patient care, Community Care Access Centres or public health settings. This preclusion despite evidence showing efficacy in the treatment of conditions such as lower back pain, treatment of anxiety and depression.
Massage therapy was overlooked when the Ministry of Health and Long-Term Care announced its Lower Back Pain Pilot Program. The profession was later thrown a bone when the Ministry agreed to inclusion at only one of the test sites (out of seven), and treatment delivered by students at a training school, not seasoned professionals.
Western medicine has a political choke-hold on funding and government support. But medicine didn’t always have the public confidence. Before the Flexner report (1910) commissioned by the Carnegie Foundation, medical schools of varying quality operated in the marketplace. Hospitals were not seen as places of recovery, but of dying. See Patricia O’Reilly’s book “Health Care Practitioners in Canada” to see how politics played heavily in credibility and funding in health care.
People that pursue medical degrees typically come from wealthy families who provide philanthropic donations to hospitals and medical colleges. Pharmaceutical companies also inject millions of dollars into positioning their products in the application of western medicine, ultimately affecting the type of interventions that are endorsed by government.
Proponents of western medicine may cry “where’s the science?” and bemoan a paucity of research for these rival interventions. This detracts from the problem that small professions just don’t have the money.
Small professions are expected to self-fund research to prove efficacy, while western medicine is supplemented from a variety of wealthy sources. It’s a chicken-and-egg outcome for less resourced disciplines to prove themselves.
Western medicine practitioners are already working with chiropractors, massage therapists, naturopathic practitioners and a variety of what is usually termed “Complementary and Alternative Medicine” (CAM) practitioners. I concur, all these professions can and should do more to demonstrate efficacy in their approaches. But the way the system is set up now, these other professions don’t stand a chance.
The National Institutes of Health branch – National Center for Complementary and Integrative Health – is funded by the US Government to explore efficacy in alternative approaches to western medicine. I would like our government to shift from a “prove it to me” stance to a “let’s prove or denounce it together” approach.
The parents of Ezekiel Stephen made a terrible mistake. That mistake could have been avoided if our health care system truly integrated the best of various forms of medicine, funded research in emerging professions that show promise through reported direct user experiences and measurable outcomes, and governments that determine access to services based not on the politically savvy but on efficacy.