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News from the British Columbia Naturopathic Association V O L . 9 / N O . 1 / WINTER 2 0 0 3 NATUROPATHIC MEDICINE WEEK: MARCH 22-29, 2003 A NATIONAL CELEBRATION PROMOTING WELLNESS Join naturopathic physicians (NDs) across BC this spring as they participate in a national celebration promoting health, disease prevention and wellness.
NMW is a national event celebrated in communities across Canada, with mayors proclaiming NMW, doctors providing lectures, speaking on radio, clinic open houses and a host of other community events. In BC, NDs focus on providing free medical testing.
sure, blood sugar and urine dip,although you should call your Testing is one way to support patient wellness. Many people are unaware that NDs are licenced primary care physicians in BC and that they provide standard diagnostic testing. Free testing is an opportunity for new patients to find out more about health prevention as well as the patient-focussedcare NDs provide.
your area. This is an excellentopportunity to meet your localnaturopathic physician and to Participating BC doctors will mostly be providing three standard diagnostic tests (although tests offered may vary—call your local participating ND foran appointment and to find out which tests they will be offering). Most NDs will be performing free blood pressure, urine dip (kidney function) and bloodsugar testing. Many NDs will also be providing zinc tally tests, an immunemeasurement test. Participating doctors will also have general informationon naturopathic medicine for free distribution. For a list of participating doctors and contact numbers, surf to our website at: www.bcna.ca As NDs are primary care physicians, practicing family medicine, they treat a broad range of conditions ranging from common ailments such as coldand flu, food allergies, chronic fatigue, and childhood illnesses, to chronicdegenerative conditions such as arthritis, asthma, heart, immune system, This is the fourth year BC NDs have joined NMW. The event is listed on
Health Canada’s website: http://www.hc-sc.gc.ca/english/
calendar.html#mar
NMW is a perfect opportunity for prospective patients to find out moreabout doctors in their area, and for existing patients to get more information As outlined in the media release at right (distributed nationally in mid-February), the Liberals are set to seriously alter thedelivery of naturopathic medical care. If you have ever relied on an ND for care, see an ND now or expect to in thefuture, the care you’ve received is about to be compromised. We are urging past and present patients to write a shortletter to the Premier. The issues are outlined in the news release, and you can get more details from the documents on-line. We’ve also captured some of the major issues in short paragraphs below to help delineate the problem. Yourwriting time is much appreciated. Send letters to: Dear Premier:I receive primary healthcare from a naturopathic doctor. My naturopathic doctor has helped me in ways where thegovernment system has failed. I also save the government money—I pay the government money for healthcare whichI don’t use, pay again for care from my naturopathic doctor, and I don’t put pressure on our regular health system.
Despite all this the provincial government has refused to recognize the value and credibility of naturopathic medicalcare. I urge the minister of health to please step forward and recognize naturopathic doctors as primary healthcareproviders. I would appreciate a response to my letter.
Dear Premier:I don’t understand why naturopathic doctors can’t access provincial medical labs. The labs are privately owned andpublicly funded. Naturopathic doctors are licenced doctors providing primary healthcare. It doesn’t make sense to mewhy the government allows this to happen—you have the power to allow licenced healthcare professionals access yetyou haven’t acted on this. Why should I have my naturopathic doctor have to send my bloodwork out of province? It’smy understanding that as far back as the Royal Commission report in the 1980s there has been a recommendation toallow naturopathic doctors lab access. What’s taking so long? I would appreciate a letter from your ministry explainingwhy there is delay in taking action on this.
Dear Premier:Why can’t the government put more emphasis on preventative healthcare? My naturopathic doctor emphasizes dietimprovement, healthy lifestyle changes and health education. All of these things are integral to having a healthy societythat does not drain our government health system. But the government doesn’t recognize this value. My naturopathicdoctor can’t even access provincial labs for standard diagnostic tests! In fact she can’t even get some of the integralnon-drug items she needs to do her job as a doctor simply because the government won’t recognize her as a primaryhealthcare provider. I would like to know why the government refuses to act on behalf of licenced naturopathic doctorsserving British Columbians. Please respond to my letter.
Dear Premier:I consider my naturopathic doctor to be my sole healthcare practitioner. At present if I were to need a prescription, Iwould need to go to the “walk in clinic”, or the emergency ward to see a medical doctor. My naturopathic doctor tellsme that although she is trained to use prescriptions, your government is denying her the ability to treat me accordingto my needs. I would appreciate a response to my letter.
Dear Premier:As a patient, why can I not get a copy of my medical records sent to my ND? My medical doctor refused to release myrecords to my naturopathic doctor, even after I have signed a Release of Records form. I would like to know why yourgovernment is allowing this to happen?Dear Premier:If I need a referral to a specialist, my naturopathic doctor tells me that she cannot make that referral, even though sheis my primary care provider and has made the diagnosis. It seems to me that this must be costing me, as a taxpayer,a lot of money. This requires at least two visits to my medical doctor, that the health budget should not be paying for.
Dear Premier:I see both a medical doctor and a naturopathic doctor. My medical doctor has been very open about the fact thathe does not support naturopathic medical care. This antagonism has made me feel very uncomfortable and that Icannot be open and up front with my medical doctor because I fear that my level of care may be jeopardized. Iwould like to know why your government is not advocating better acceptance of naturopathic medicine by themedical profession.
MEDIA RELEASE
BC Liberals Poised to Limit Patient Choice Kelowna, BC - The British Columbia Liberal Government is preparing to reduce the scope of practice fornaturopathic physicians based on the government’s document entitled Safe Choices: a New Model for RegulatingHealth Professions in British Columbia.
Dr. Garrett Swetlikoff, ND, President of the British Columbia Naturopathic Association (BCNA) said, “SafeChoices represents a huge, backwards step for naturopathic medicine and health care in British Columbia.” Ina recent letter to Dr. Penny Ballem, Deputy Minister of Health Services, Dr. Swetlikoff went on to say, “Theproposed changes will only serve to limit access for hundreds of thousands of existing patients seekingcomplementary medical care from qualified professionals.” Naturopathic physicians have been providing safe, effective, valid health care for over a century. Safe Choicesignores this history, obliterates the current reality of naturopathic medical care, education and skill, and theLiberal Government has not acted in good faith.
“The entire review process has resulted in recommendations that are a radical departure from what naturopathicmedicine has been and it is deeply offensive to both doctors and the patients naturopathic physicians carefor,” said Dr. Swetlikoff.
The Liberal Government claims to believe in the necessity of quality preventative health care, yet they accepta scope document that will: Limit patient choice and decrease health care options; Eliminate safe, effective, and economical preventative health care options for residents of BC thatconventional allopathic medicine does not provide; Disregard the precedents and past agreements regarding scope of practice for naturopathicphysicians; and Legitimize a dubious double standard contrary to the spirit of a shared scopes of practice model.
Safe Choices: A New Model for Regulating Health Professions in British Columbia is a sham. All BritishColumbians should ask their MLA why the Liberals (whose political platform encourages freedom of choiceand free enterprise) want to restrict a health care profession which it does not support financially (i.e., MSP),whose safety record is impeccable, and is in high demand by the public.
http://www.healthplanning.gov.bc.ca/leg/hpc/review/part-i/update-naturopath.html Find the names and addresses of MLAs in BC at: http://www.legis.gov.bc.ca/mla/3-1-1.htm Prescription Drug Interactions Atenolol and Lipitor are effective drugs when used appropriately, but they both have a number of warnings, adverse side effects and precautions. As a licenced pharmacist and naturopathic physician, it surprised me that these two drugs were sowidely prescribed. My concern as a primary care provider is that some patients taking these prescriptions may not befully aware of all the negative side-effects. Below I have attempted to highlight these concerns.
Atenolol, also sold as Tenormin®
What this drug does: It’s prescribed for mild to moderate hypertension. It’s often used in combination with other drugs,particularly a thiazide diuretic (e.g., hydrochlorothiazide). Atenolol may be used in combination with diuretics and/orvasodilators in patients with severe hypertension. Atenolol is not recommended for the emergency treatment ofhypertensive crisis nor for patients suffering from angina.
Some of the many contraindications include sinus bradycardia; sick sinus syndrome; right ventricular failure secondaryto pulmonary hypertension; cardiogenic shock; hypotension; severe peripheral arterial disorders; anesthesia withagents that produce myocardial depression; metabolic acidosis; and known hypersensitivity.
Atenolol can in some cases cause cardiac failure—special caution needs to be exercised when patients with a historyof heart failure are prescribed this drug. Further, it can be more difficult for doctors to treat patients on beta-blockerswho suffer anaphylaxis (an allergic type reaction). Other patients who should be administered this drug with cautioninclude diabetics and those suffering from hypoglycemia. When I’m attending a patient on beta blockers I monitorblood sugar levels with regularity. New mothers should be aware that there is significant accumulation of atenolol inbreast milk.
In short, Atenolol users may experience a number of adverse reactions, the most severe being congestive heart failure,and bronchospasm, while the most common are slow heart-rate, dizziness, vertigo, fatigue, diarrhea and nausea.
Lipitor is a synthetic lipid-lowering agent. Doctors prescribe it primarily to patients with high cholesterol with or withouthigh triglycerides. However, a prescription for this medication shouldn’t be given until after a doctor has establishedthat dietary measures to reduce total cholesterol are ineffective, and/or where response to diet and other non-pharmacological measures have proven to be inadequate. Contraindications include hypersensitivity to any componentof this medication. Lipitor may impact Co-Enzyme Q10 levels, cause hypersensitivity, renal insufficiency, and shouldnot be taken with antacids. This drug negatively interacts with niacin, oral anticoagulants, gemfibrozil and other drugs.
My professional opinion is to seek qualified advice before starting any drug regime—whether pharmaceuticalprescriptions, over-the-counter drugs or supplements. All of us have different health concerns, unique health histories,and our age, sex, weight and other factors can play a role in how we metabolize drugs.
Naturopathic physicians will work with patients to develop non-drug regimes and/or to provide information on alternativeswhen and where possible. As NDs have an education in both pharmacology and pharmacognosy (the interaction ofbotanical medicines) they are the experts to consult for valid non-drug alternatives. For example, there are manybeneficial vitamins, minerals and anti-oxidants which can support heart health without a negative interaction. In addition,there are naturally derived botanicals and Traditional Chinese Medications to help lower cholesterol. In order to makean informed decision on drug regimes, consider a second opinion from your licenced ND.
This article written by registered pharmacist and naturopathic physician Dr. Deborah Phair The latest Fortune 500 analysis shows that the drug industry is still by far the most profitable in America on all three counts: return on revenue (18.5 percent), return on assets (16.3 percent) and return on shareholders’ equity (33.2 percent). These are three to eight times the medians of all On this and the facing page, two naturopathic physicians address the serious side-effects and contraindications of commonly prescribed pharmaceuticals as well as alternatives to standard drug therapy.
(based on number of prescriptions dispensed): Naturopathic physicians are the only licenced primary health care provid- ers in BC who complete education, training and take board exams in bothpharmacology and pharmacognosy (the interaction of botanical medicines).
Natural menopause is known with certainty only in retrospect 12 Premarin & HRT Alternatives consecutive months without a period. Perimenopause primarily refersto the years preceding this event, as the cycle begins to change andsymptoms arise. There are two primary considerations that need to be made with respect to hormone replacement.
The first is to treat the symptoms that are interfering with the quality of a woman’s life. Symptoms of course will varyfrom woman to woman, and each individual will need to decide if her situation warrants treatment. In such cases,replacement is done for a short period of time. The second consideration is the historical argument for the preventionof heart disease and osteoporosis. Estrogen has never been FDA approved for heart disease and though it is approvedfor the prevention of osteoporosis, it’s worth noting that prevention of bone loss is not the same thing as fractureprevention. As documented from the Women’s Initiative, when menopause is natural we really do not know to whatextent hormone replacement can accomplish such prevention. However, women who undergo surgically-inducedmenopause and take estrogen, may have some benefit in terms of bone loss.
Though Premarin continues to be the primary prescribed form of estrogen replacement in North America, it’s importantfor patients to recognize that when it comes to hormone replacement, there is wide choice and the decision makingprocess should be individualized. When describing hormone replacement, the term “natural” is used to refer to hormonesthat are indistinguishable from human hormones, that is, bio-identical. Generally, these hormones are derived from soy,wild yam and the calabar bean. Some examples of conventional prescribed bio-identical estrogen replacement includeEstrace, Estraderm, Climara, Estrogel and Vivelle. Compounded formulations can include any combination of bio-identical/natural hormones in various percentages. Although not commonly used by conventional medical practitionersin Canada and the US, estriol or estriol mixtures are favored by a number of naturopathic physicians. Typically, mixturesof estrogens are usually administered in combination with oral natural progesterone. Natural hormone replacement canbe dispensed in many forms, the most popular are oral, transdermal creams, vaginal/rectal suppositories and sublingualdrops. Other “friendly” forms of natural replacement include DHEA, melatonin, natural progesterone and pregnanalone.
Non-hormonal options are also effective and most commonly include the phytoestrogens Black cohosh, Chaste-treeberry, Dong quai, Ginseng, Gingko biloba, Black current, Kava, Licorice, Sage, St. Johns wort, Isoflavones and lignans.
Eating a nutritious diet, exercising regularly, stress-management and nutritional supplementation are all effective adjuvantoptions for symptom relief and addressing disease prevention.
This article written by Dr. Tasnim Adatya, a licenced naturopathic physician who practices on Vancouver’s west side.
The Canadian Naturopathic Association and naturopathic medicine approachesappear well placed to play an important role in advancing health livingstrategies, preventing illness and improving health.
Honourable A. Anne McLellan, Minister of Health A recent study at the University of Toronto showed that family physicians and walk- in clinic doctors spend an equal amount of time with patients—on average 12 minutesper patient.
Serzone under review by Health Canada: Serzone, a commonly prescribed anti-depressant is under review by Health Canada. The drug has been linked to severe liver damage that hascaused at least 18 deaths worldwide. The drug has also resulted in some patients requiringliver transplants—including two in Canada. More than 100 Canadians are known to have suffered liver damage resultingin enzyme imbalances, cell death, inflammation and bile in the blood. Serzone may also cause fatigue, malaise, abdominal pain, nausea, vomiting, discoloured stools, dark urine, weight loss, jaundice, confusion and brain swelling.
There are many valid, science-based alternatives to drug therapy for depression: Speak to your ND, a specialist incomplementary medicine, about what’s right for you.
Cipro, the antibiotic that became a household word during the 2001 anthrax scare, isbecoming increasingly ineffective against other dangerous germs because of overuse, a study found. In 1994, Cipro was effective against 86 percent of the bacteria samplesanalyzed, but that dropped to 76 percent by 2000, the researchers found. Resistance can develop when a drug isused repeatedly against the same germ, which may eventually mutate to outwit the drug. Overuse and inappropriateuse of antibiotics can also cause bacteria that normally live in the body to mutate and become infectious. Theincreasing resistance found in the study came at a time when doctors increasingly prescribed Cipro and similar drugsfor common ailments, including respiratory infections caused by viruses, which are unaffected by antibiotics, theresearchers said.
Yet more research, conducted in Chicago, confirms that “good fats” (e.g., Omega-3 andOmega-6 oils commonly found in fish), are beneficial not only as a preventative measure against heart disease but as an aid in preventing Alzheimer’s. The research also showedthat “bad” fats (e.g., partially-hydrogenated vegetable oils) are a risk factor for Alzheimer’s. The “heart brain” connectionhas long been established in naturopathic medical protocols. Ask your ND for more information on good fats versusbad fats.
CBS’ 60 Minutes II ran a fascinating expose in February on Eli Lilly’s attempt toregain its share of the anti-depressant marketplace. With generic Prozac eclipsing brand sales, Lilly has introduced a new patented drug: “Once a Week Prozac.” In aningenious attempt to capture new users, Lilly reps contacted doctors for patient files, then, through a pharmacy and ondoctor’s letterhead, sent correspondence to patients advising them to “change” their prescription. Each advice letterincluded free weekly Prozac. Ingenious, yes, but illegal. And many patients who had never taken anti-depressants andnever suffered from depression received the “new” prescription. Lawsuits to follow… Sources: Victoria Times Colonist; correspondence from the federal health minister to the CNA; Maclean’s; Yahoo;JAMA; Vancouver Sun; CBS Left: Excerpt from the Vancouver Sun,Saturday, February 22, in a full-page profileregarding Mike Harcourt’s rehabilitationprogram with Vancouver ND Dr. LawrenceChan; at right, an excerpt from the PentictonHerald following our February press release(reprinted page 3).
Other media events: Will BC healthcarechoices become even more limited? Thatwas the theme of Rafe Mair’s Feb 24 CKNWprofile on naturopathic medicine. Rafe spokewith BCNA President, Dr. Garrett Swetlikoff,on the Liberal’s plan to restructure andradically restrict the practice of naturopathicdoctors in BC. For more on this issue see acopy of our February press release on page3. Rafe’s show led to follow-up segmentson BCTV, CBC and CTV news.
Dr. Nigma Sciortino recently appearednationally on CTV’s Vicki Gabereau show.
Prior to that she appeared on Breakfast TVhere in Vancouver. You can view her BTVspots on-line at www.bcna.ca—choose thearticle tab (each video segment will open ina new window as an mpeg file).
Notes on the current status of federal health care in Canada: Did you know that the Canadian Alliance is in the process The Canada Health Act does not compel the government of re-examining its health policies? Carol Skelton, the to provide any sort of complementary or alternative Official Opposition Deputy Health Critic is specifically medicine whatsoever. Because of this, there is no tax looking at revisions to their policies regarding naturopathic allocation required for any services other than those medicine. At present the Alliance supports and encourages provided by MDs and in a hospital. Further, the Act does Canadians to have greater freedom in their choice of not focus on or promote preventative medicine. There is complementary treatments and natural products. You can no fee code for any practitioner offering complementary voice your concerns regarding the present limitations of or alternative medicine; thus, even if an MD chooses to the Canada Health Act, health dollars which you, as a become educated in and provide alternative therapies, patient, have no say in controlling or accessing, and there will be a patient fee. The federal government does restrictive Revenue Canada rules regarding tax refunds on not recognize naturopathic doctors (despite provincial legitimate medical expenses outside of those in a hospital.
recognition). What this means is that even if a province Your input and concerns are welcomed by the Alliance.
wants to support naturopathic medicine (and policies affecting the actual delivery of health care are a provincial jurisdiction) the federal government can intervene or The prompts for your input are easy to follow.
T a x C o u r t C o n f u s i o n
Across the country Canadians are going to Tax Court to appeal restrictive and unrealistic tax decisions byRevenue Canada. What is at stake is the legitimate provision of health care from licenced doctors—yet withoutthe use of prescription drugs.
In general, Revenue Canada only allows medical expenses for drugs when they are pharmaceuticals. It arrivesat this decision by a rather circuitous route however. The paragraph in the Income Tax Act regarding medicalexpenses reads, in section 118.2(2): …a medical expense of an individual in an amount paid…for drugs, medicaments or other preparations orsubstances…manufactured, sold or represented for use in the diagnosis, treatment or prevention of adisease…purchased for use by the patient as prescribed by a medical practitioner or dentist and as recorded by apharmacist.
The problem lies not with the ND’s skill, expertise or the fact that an ND’s medicaments differ from those usedby an MD, but simply the phrase “as recorded by a pharmacist.” If an ND uses natural therapeutics that don’trequire a pharmacist’s prescription Revenue Canada refuses a tax credit.
However, recent tax cases have queried the government’s rationale. How can the government force a patient totake a drug when a non-drug therapy may be more effective and in some cases life-saving? In a recent tax case, Frank v. The Queen, the judge held that a receipt for natural medications was sufficient;there did not have to be a prescription. However, that was an individual case. Other judges (e.g., Dunn v. TheQueen and Melnychuk v. The Queen) actually wanted to allow the credit, but noted they could not ignore thewording. A judge can only interpret they law; he or she cannot write the law.
In Ray v. The Queen, Judge O’Connor found that the non-prescription medications in question were required tosustain the life of the Appellant. He wrote: With respect, the ambiguity in the provision has resulted in judicial acrobatics with the purpose of fitting a taxpayer’ssituation within the provision. It is my opinion that common sense should prevail. If the medications are prescribedby a doctor and they make the difference between life and death or functioning or not functioning, they should fallunder paragraph 118.2(2).
In a November 2002 ruling, Claussen v. The Queen, Judge E A Bowie re-emphasized the inadequacies of the Act: I would not want to leave this case without expressing my agreement…that sooner or later the government will haveto consider an amendment to this legislation to extend the tax credit to cover the natural remedies and alternativeforms of treatment that are becoming prevalent, and are proving to be effective in certain cases. The present caseis demonstrative of the need for some reform of the law…The distinction made by the law has no apparent medicalbasis. The situation cries out for reform. However, it is only Parliament that can act… We will keep you up to date as a host of similar tax cases unravel. In the meantime, express your discontent withthis prejudicial and nonsensical legislation by writing to your MP. Letters to the PM or your MP do not require astamp.
Your Health is published quarterly by the British Columbia to advance the scientific, educational and professional aspects Naturopathic Association, the professional association for naturopathic physicians in the province. It is compiled and edited The public is welcome and encouraged to join the BCNA. An by Glenn Cassie. The information provided herein is annual membership fee of $25 assists the BCNA in for educational and reference purposes only; it is its efforts to increase government recognition and not intended as a substitute for consultation and heighten the profession’s profile. Membership diagnosis nor treatment from a qualified doctor.
entitles you to a one-year subscription to Your Your Health is provided free to BCNA members.
Health and other news and information bulletins.
The BCNA offers patients, across the province, Contact us online at www.bcna.ca, e-mail us at referrals to licenced naturopathic doctors (NDs) in bcna@bcna.ca, call us at 604/736-6646 or 1-800/ their area, as well as student information to persons interested in the profession. It is the BCNA’s purpose

Source: http://bcna.ca/files_3/pdf/YHWinter2003.pdf

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