Transforming and Supporting Patient Care - Health Professions ...

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260Chapter 11 – Profession of Naturopathy• Enabling competencies established in other year one courses include:Physiology, Anatomy, Histology, Biochemistry, Clinical Nutrition,Principles in Research and Botanical Medicine.• In addition to the year two course in Pharmacology, students aretaught about the safe and effective therapeutic use of botanicals inBotanical Medicine and drug-food interactions in Clinical Nutrition. Alarge component of the curriculum is devoted to four courses in thefundamentals of diagnosis. These courses include and cover both thetheoretical and practical aspects of diagnosis. At the end of the year,students are expected to be competent in reaching a physical andclinical diagnosis; able to use standard medical laboratory tests toassist them in this process; and able to generate a diagnosis bymeans of differential reasoning.• In year three, courses related to prescribing competencies include:Primary Care, Botanical Medicine, Clinical Nutrition, Venipunctureand Parenteral Therapy, Pediatrics, Obstetrics, Emergency Medicineand Men’s and Women’s Health. The Primary Care course integratespreviously learned competencies into the program by increasingstudents’ knowledge of first-line pharmacotherapy, current guidelinesand best practices. This course also investigates how to criticallyevaluate therapeutic options through evidence-based risk-benefitassessment, modifiable disease factors and harm reduction in clinicalpractice. Students serve a twelve-month clinical internship duringtheir fourth year. This internship allows them to apply their skillsunder the supervision of a licensed ND to patients in the RobertSchad Naturopathic clinic and at five satellite clinics in CommunityHealth Centres in Toronto. All students are evaluatedcomprehensively as part of an assessment of their clinical skills.Graduates of CCNM are eligible for licensure in jurisdictions such asArizona where the prescribing of drugs is already part of the scope ofpractice of the profession. 27NDs indicate that regulation of the profession under the antiquated DPA andthe increase in the number of substances placed on restricted scheduleshas negatively impacted the natural evolution of the naturopathicprofession. For many years, ND students have been taught about theindications, contraindications and use of drugs in the curriculum ataccredited naturopathic colleges. In Ontario, what has been missing is theclinical experience of using drugs in the teaching clinic and in clinicalpractice. Pharmacology has been part of the NPLEX, the licensingexaminations used by all regulated jurisdictions in North America, since1994. Graduates from all of the accredited colleges of naturopathic medicinecurrently practice in jurisdictions that have prescribing authority. 2827Ibid: 26-27.28Ibid: 46.HPRAC Critical Links January 2009
261Chapter 11 – Profession of NaturopathyRequest for Change: Dispensing and CompoundingThe proponents requested the authority to compound naturalsubstances for individual patients, for use in clinics, or fordispensing and selling when they are not available through apharmacy. Proponents said that it is expected that NDs would onlybe authorized to dispense categories of natural substancesdesignated by regulation (i.e., those which they are authorized toprescribe) and in compliance with a standard of practice for conflictof interest.NDs are not currently restricted under the DPA from dispensing andcompounding naturopathic substances but these controlled acts have notbeen included in the Naturopathy Act, 2007. Under BDDT-N, NDs haveestablished practice standards in place for the compounding, storage anddispensing of naturopathic medicine. 29Proponents’ RationaleThe controlled act of dispensing is key to the practice of naturopathicmedicine because the substances used on a regular basis by NDs may notbe readily available from other sources. For example, communitypharmacies may not encounter sufficient demand for these substances andmay also be unfamiliar with their use. As a result, pharmacies often do notstock substances that NDs use as part of their regular course of practice.This issue is particularly prevalent in smaller and remote communities. NDswould not compound, dispense or sell Schedule I drugs.Compounding of restricted therapeutic natural substances, aswell as dispensing and selling, is necessary in order to continueto provide the individualized preparations that are integral tonaturopathic care. NDs are not seeking to dispense, sell and/ orcompound pharmaceuticals. 30Request for Change: SellingThe proponents are requesting the authorized act of selling to ensure thatpatients have access to natural substances (Schedule I and II natural healthproducts) not typically available from local pharmacies, especially in smalltowns and rural areas.NDs state that they seek to be authorized to sell categories of naturalsubstances designated by regulation that they are authorized to prescribeand in compliance with a standard of practice for conflict of interest.29Ibid. Policy on In-Office Preparation and Compounding of Naturopathic Medicines (Appendix 3).30BDDT-N, OAND, CCNM and CAND.Review of Non-Physician Prescribing and Administration of Drugs.November 2008: 17.HPRAC Critical Links January 2009
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Table of ContentsCritical Links:Tra
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5Chapter 1 - An Introductionprofess
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20Chapter 2 - Excellence in Health
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56Chapter 3 - A New Drug Approvals
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164Chapter 7 - Professions of Chiro
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186Chapter 8 - Profession of Dental
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310Chapter 13 - Profession of Optom
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340Chapter 14 - Profession of Pharm
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366Chapter 15 - Profession of Physi
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378Chapter 16 - Profession of Respi
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394Chapter 17 - Conclusionscontinui
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396Chapter 17 - Conclusionsincluded
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398Chapter 18 - Summary of Proposal
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