Canadian Skeptics Question NDs Prescribing

[Eos of the Eons]

http://www.skepticnorth.com/2009/11/magician-prescriptions-ontario-poised.html

Yeah, plugging the Canadian Skeptic North Blogs, cuz it's awesome!!!

And this is a darn good question:

Naturopath prescribing is also raising questions about the liability of of other health professionals who interact with their clients. A key role of the pharmacist is to double-check the safety and appropriateness of a prescribed drug. When required, the pharmacist resolves drug related problems with the prescriber. This is only possible because pharmacists, physicians, and nurse practitioners work from a common, science-based understanding of drugs and disease. In contrast, naturopaths may not share this science-based approach to illness, and may rely on references that are unknown to, inconsistent with, or directly contradict the medically accepted standard of care. If naturopaths prescribe a drug based on a naturopathic belief system, and a pharmacist determines that the prescription is not appropriate from a scientific and evidence-based perspective, what will the pharmacist's responsibility be? Will pharmacists be held liable for prescriptions written by naturopaths who do not share a science-based view of illness?

[Gord_in_Toronto]

I just did a quick read of the Ontario College of Pharmacists website including their Code of Ethics and the Q&A for pharmacists and could not find anything about science or evidence or efficacy.

The Q&A has a question (about insurance) from a pharmacist who says he dispenses naturopathic medicines. No indication they see anything wrong with this.

In general the pharmacists do what they are told. If a doc insists on dispensing something, they really can't do much about it.

There is a real problem raised in the OP but it extends way beyond pharmacy to the licencing of sCAM "professions" such as homeopathy, chiroquackery and "Natural" Chinese Medicine.

What next? Susan Sommers for Heath Minister? :mad:

[Estellea]

Eos, what prescriptive authority do Canadian naturopaths have?

[Eos of the Eons]

In general the pharmacists do what they are told. If a doc insists on dispensing something, they really can't do much about it.

Not really, if there is a clear contraindication they work with doctors and nurses, as described in the quote. Most ND junk has no contraindications since it it homeopathic, etc. A pharmacist therefore doesn't have much trouble giving it out, but also keeps in mind what isn't a good idea.

Pharmacists are trained for 7 years in things like chemistry, they know more than doctors what substances don't mix, and doctors rely on them for that.

An ND is used to thinking they know more than anyone else, so how willing are they to listen to the pharmacist about evidence that two substances are a bad idea based on the science?

[Eos of the Eons]

Eos, what prescriptive authority do Canadian naturopaths have?
BC (and that is the only province so far that allow this, as stated in the article) naturopaths can currently prescribe, anything they want to (no restrictions from what I last saw when that was passed). Now Ontario NDs want to too, even though they supposedly HATE toxic drugs! Such a bunch of hooey, they want to be called docs, and prescribing rights just lend them more legitimacy, but as in the article... we clearly know why this is a horrible idea.

Also, keep in mind that our "science and technology" minister of Canada is a chiropractor.

It doesn't help the many states in the US allow NDs to prescribe as well. Canada is now following suit (learning how the USAsians managed to get to prescribe).

Canada has provincial and federal laws. This kind of stuff falls under provincial laws, but the federal government is really soft on this stuff too.

[Furcifer]

Eos, what prescriptive authority do Canadian naturopaths have?

Good question. The naturopath my mom took us to when we were kids did his own dispensing. I haven't been since, but the few people I know seem to get theirs dispensed at the clinic they go to, and not Shoppers or WalMart.

(The other question is what about the homeopaths? Aren't they worried? Some poor kid could get his hands on some 100C Belladonna!)

jk, if anyone in Ontario starts taking homeopathy seriously we boot em' out to BC ;)

[Furcifer]

BC (and that is the only province so far that allow this, as stated in the article) naturopaths can currently prescribe, anything they want to (no restrictions from what I last saw when that was passed). Now Ontario NDs want to too, even though they supposedly HATE toxic drugs! Such a bunch of hooey, they want to be called docs, and prescribing rights just lend them more legitimacy, but as in the article... we clearly know why this is a horrible idea.


Hehe, I guess we boot the ND's out to BC too.

I didn't know this was happening out in BC. I mean I expect it, but I didn't know. I hope the pharmacists are insulated from this kind of liability.

[Eos of the Eons]

Good question. The naturopath my mom took us to when we were kids did his own dispensing. I haven't been since, but the few people I know seem to get theirs dispensed at the clinic they go to, and not Shoppers or WalMart.

(The other question is what about the homeopaths? Aren't they worried? Some poor kid could get his hands on some 100C Belladonna!)

jk, if anyone in Ontario starts taking homeopathy seriously we boot em' out to BC ;)
What did they dispense that would have to be prescribed normally?

[Furcifer]

What did they dispense that would have to be prescribed normally?

I don't think anything. If I recall they were mostly extracts and sugar pills. The recent ones (that friends had) were extracts as well.

I didn't know ND's were prescribing medicines! I thought perhaps they took away their extracts and sugar pills and were having to get them dispensed.

Which I could see. Extract, concentrations etc. could certainly be harmful at the wrong levels, or interacting with other extracts etc.

Actually, now that I think about it, maybe the pharmacists do have some liability? Maybe they need to stop dispensing them and demand documentation, studies etc. so they can do their job properly?

[Eos of the Eons]

I don't think anything. If I recall they were mostly extracts and sugar pills. The recent ones (that friends had) were extracts as well.

I didn't know ND's were prescribing medicines! I thought perhaps they took away their extracts and sugar pills and were having to get them dispensed.

Which I could see. Extract, concentrations etc. could certainly be harmful at the wrong levels, or interacting with other extracts etc.

Actually, now that I think about it, maybe the pharmacists do have some liability? Maybe they need to stop dispensing them and demand documentation, studies etc. so they can do their job properly?
NDs want prescribing rights so they can prescribe real drugs that are tested for safety and efficacy first. If it is not tested with certain protocols and found to have an effect that you can claim about it, then it is not a drug.

Pharmacists know more than anyone else what is in the more useless junk, because most of it has been tested, and anyone can get on the net and pull the studies from pubmed, and of course see no problem handing out sugar pills or useless magic water laced with alchohol since they know there are no contraindications.

Ginseng has specific low amount of chemicals in it, and a pharmacist would know if that chemical will render another drug useless, but since ginseng has these chemicals in such low quantity (they are mostly sugar too, and fiber), and most tested supplement show they have little to no active ingredient in them, so most people can take it with heart medicine or aspirin with no worries.

I would suggest quizzing a pharmacist. Ask him if taking ginseng with aspirin or some common med (Lipitor) would be a problem.

Also, most people having problems with supplements are the ones who bought them online, or from an acquaintence hawking MLM supplements, but not from a pharmacist. Not that you can trust every pharmacist out there to not get counterfeit drugs or not know if some supplement is laced with drugs or things like arsenic. It is just better to go ask a pharmacist for junk instead of getting it online.

[Gord_in_Toronto]

Not really, if there is a clear contraindication they work with doctors and nurses, as described in the quote. Most ND junk has no contraindications since it it homeopathic, etc. A pharmacist therefore doesn't have much trouble giving it out, but also keeps in mind what isn't a good idea.

"Work with" is fine but my humble understanding is that the doctor calls the shots. And although "Most ND junk has no contraindications since it it homeopathic, . . .", some of it is not distilled water and has "chemicals" in it, vidé Susan Sommers' bio-equivalents. Now the poor pharmacist is supposed to know all naturopathic crap as well?

Pharmacists are trained for 7 years in things like chemistry, they know more than doctors what substances don't mix, and doctors rely on them for that. And if the doctor has "more recent data" he will and does overrule the pharmacist.

An ND is used to thinking they know more than anyone else, so how willing are they to listen to the pharmacist about evidence that two substances are a bad idea based on the science?

Beats me. And that's my concern. :scared:

[Gord_in_Toronto]

NDs want prescribing rights so they can prescribe real drugs that are tested for safety and efficacy first. If it is not tested with certain protocols and found to have an effect that you can claim about it, then it is not a drug.

Pharmacists know more than anyone else what is in the more useless junk, because most of it has been tested, and anyone can get on the net and pull the studies from pubmed, and of course see no problem handing out sugar pills or useless magic water laced with alchohol since they know there are no contraindications.

Ginseng has specific low amount of chemicals in it, and a pharmacist would know if that chemical will render another drug useless, but since ginseng has these chemicals in such low quantity (they are mostly sugar too, and fiber), and most tested supplement show they have little to no active ingredient in them, so most people can take it with heart medicine or aspirin with no worries.

I would suggest quizzing a pharmacist. Ask him if taking ginseng with aspirin or some common med (Lipitor) would be a problem.

Also, most people having problems with supplements are the ones who bought them online, or from an acquaintence hawking MLM supplements, but not from a pharmacist. Not that you can trust every pharmacist out there to not get counterfeit drugs or not know if some supplement is laced with drugs or things like arsenic. It is just better to go ask a pharmacist for junk instead of getting it online.

I have called out two pharmacists here in the Toronto area about having homeopathic "remedies" on their store shelves. I can't remember what the first one was but the pharmacist said he had been to a "conference" and "there was something to it". In the second case the local Shoppers here sells a homeopathic teething remedy. I suggested to a pharmacist (but not THE pharmacist) that is was useless. She said, "people buy it so it must work".

You can teach people seven years of science but that does not mean that they have been taught to think. :mad:

[Eos of the Eons]

I'm not sure bio-identicals are ND junk... but I heard of pharmacists selling it without prescriptions.. no prescription needed for hormones? Fraccin insane.

I'm pretty sure if a doctor prescribed something that would kill the patient because the patient is already taking something prescribed by another doctor... the doctor wouldn't overrule it. The pharmacist is required to tell doctors about contraindications.

Although I don't condone homeopathy, at the very least a pharmacist knows what is in it, and even skeptical ones will make excuses to you... they do cater to their customers whims (and it is harmless if not replacing real treatment for something, not that a pharmacist can tell a patient what to do, they can only advise and sell).

[Corsair 115]

I have called out two pharmacists here in the Toronto area about having homeopathic "remedies" on their store shelves. I can't remember what the first one was but the pharmacist said he had been to a "conference" and "there was something to it". In the second case the local Shoppers here sells a homeopathic teething remedy. I suggested to a pharmacist (but not THE pharmacist) that is was useless. She said, "people buy it so it must work".


It shouldn't be that surprisng. The CP24 program, Wylde on Health, features a host who is a homeopathic doctor. (Though in fairness CP24 also runs On Call with Dr. Karl, which features an actual medical doctor.)

[Gord_in_Toronto]

It shouldn't be that surprisng. The CP24 program, Wylde on Health, features a host who is a homeopathic doctor. (Though in fairness CP24 also runs On Call with Dr. Karl, which features an actual medical doctor.)

Does not surprise me in the least. CP24 has a history of cluelessness with respect to science in general. They undoubtedly think Christian Scientists are scientists. :scared:

[Corsair 115]

Does not surprise me in the least. CP24 has a history of cluelessness with respect to science in general.


Heh, it's fun if you watch how the rotate their news anchors around. Whenever one gets assigned to do the weather updates, they become a "weather specialist." Almost everyone on-air at CP24 is apparently a weather specialist.

Whenver they bill someone that way, I always think, wait, if they're a weather specialist, that means they specialize in the weather. So really all they ought to be doing is the weather, since that's they're speciality. I mean, you don't take a specialist and waste that specialized knowledge and skill on other matters, do you?

Anyway, all that said, I still think I'd rather watch CP24 than the new Newsworld, er, I mean CBCNN.