In Canada, more naturopaths and homeopaths are being regulated in a manner similar to doctors, nurses and other health professionals. Earlier this year, Ontario became the first province to start regulating homeopaths, while naturopaths are regulated in B.C., Alberta, Saskatchewan, Manitoba and Ontario, with discussions about regulation ongoing in several other provinces.
Naturopathy combines modern science with traditional and natural forms of medicine to "stimulate the healing power of the body and treat the underlying cause of disease," according to the Canadian Association of Naturopathic Doctors.
Homeopathy, on the other hand, "recognizes that all symptoms of ill health are expressions of disharmony within the whole person," according to the Canadian College of Homeopathic Medicine. Homeopathic remedies are made by diluting substances in liquid to the point that none of the original substance remains. Proponents claim the liquid has a memory of the substance, which produces healing.
According to the Canadian College of Homeopathic Medicine, the difference between the two disciplines is that naturopathy focuses on lifestyle and diet modifications, which may include homeopathic remedies, whereas homeopaths specialize solely in homeopathy.
For years, naturopaths and homeopaths practised in a grey area. But as more provincial governments create self-regulatory frameworks, naturopaths and homeopaths will be expected to follow standards set by regulatory colleges. (Self-regulation means that health professionals are responsible for setting standards and abiding by them. Problems are typically handled on a complaints basis.)
Regulation is "an issue partly of public safety, to provide … a standard of care and guidelines under which they are expected to practise," Ontario Health Minister Eric Hoskins said this year when asked about the move to regulate homeopaths.
Given that, it is reasonable to expect that regulation will usher in more accountability and assurance that services offered by naturopaths and homeopaths are of high quality and safe.
But this isn't the case with one of the most important public-health issues we face today: vaccines. And it's unclear who, if anyone, is holding these regulated health professionals to account.
Promoting anti-vaccine myths
Nosodes are homeopathic preparations touted by many homeopaths and naturopaths – including those licensed by provincial colleges – as safer, more effective versions of publicly funded traditional vaccines offered in doctors offices and pharmacies. This, despite the fact nosodes have never been approved by Health Canada for the prevention or treatment of illness. And despite the fact some regulatory colleges have clear policies that restrict members from advising on vaccines or promoting so-called alternatives. It's bad enough that Health Canada still allows nosodes to be sold (even though labels must state that nosodes are not vaccines).
But a few minutes of searching online yields numerous examples of regulated and unregulated homeopaths and naturopaths who promote nosodes as vaccine alternatives or who spread inaccurate information about the supposed dangers of traditional vaccines. (While vaccination can cause serious side effects, this is extremely rare. A report from Public Health Ontario found that, of the 8.4 million vaccine doses given in the province in 2014, there were 568 adverse event reports, 23 of which were serious.)
For instance, the website of the Calgary-based Gaia Naturopathic Health Clinic says nosodes can treat all childhood illnesses, including whooping cough, measles and mumps. They work by harnessing "the pure energetic state of disease administered on a sugar pill." Marnie Wachtler, a naturopath at the clinic, is licensed by the provincial naturopathy college. The clinic did not respond to an interview request and the college declined to answer questions. (In a CBC interview last year, former college president Alissa Gaul said the organization does not have a clear vaccination policy and that people should "make the choice that's best for them.")
In August, Aylmer, Ont., homeopath Sheryl Cloes shared a picture of her registration certificate with the College of Homeopaths of Ontario on her clinic's Facebook page. A week later, she shared a photo stating that claiming vaccines are safe because your child was not harmed by one is like smokers claiming cigarettes are safe because they do not have cancer. In October, she shared a photo of shot glasses filled with a kale-based smoothie with a caption saying: "This is the only kind of flu shot we should be getting. Come on into the clinic and get your homeopathic cold and flu prevention."
The clinic's website states that homeopathic remedies can prevent and treat the flu. The page states the clinic supports the right to choose and includes a link to an anti-vaccination video.
College policy states that "vaccination is not within the homeopathic scope of practice" and that "a registrant shall not advise his or her patient against vaccination."
Another serious problem is the fact that, in Ontario, many practitioners call themselves homeopaths despite not being licensed. Doing so is against provincial regulations, but no one is stopping any of the people from doing so.
Earlier this month, the College of Homeopaths of Ontario participated in the National United Professional Association of Trained Homeopaths (NUPATH) annual conference in Toronto. One of the conference's guest speakers was Neil Miller, director of the anti-vaccination group called the Thinktwice Global Vaccine Institute. According to the conference website, Miller started his "crusade" against mandatory vaccines after his son was born and he discovered "numerous studies warning medical practitioners that vaccines are often unsafe and ineffective."
A representative with the College of Homeopathy of Ontario spoke at the conference and had an exhibitor booth. Registrar Basil Ziv said the college chose to participate in the conference so that it could present its views about vaccination and highlight the fact it is outside the homeopathic scope of practice.
But Michael Kruse, chair and interim executive director of Bad Science Watch, which campaigns against nosodes, says the presence of a regulatory college at the same conference as an anti-vaccination speaker represents a systemic problem and that the Ontario government needs to speak out.
It's important to remember that many unregulated naturopaths and homeopaths promote false information about vaccines and nosodes. But in those provinces where regulations have been adopted, what has been achieved by regulation other than offering an added layer of legitimacy to some of the health professionals who undermine the importance of vaccines?
After all, it's one thing when a co-worker retweets an article about homeopathic vaccination, or an aunt e-mails to tell you actor Jim Carrey says mandatory vaccination causes heavy-metal poisoning. But it's quite another when the people spreading fear-mongering, inaccurate information are licensed medical professionals authorized by the province to practise.
A better standard of care?
It's difficult to get answers from the naturopathic and homeopathic community about these issues.
None of the clinics mentioned responded to an interview request. Beverly Huang, president of the College of Naturopathic Doctors of Alberta, declined to answer questions. So did Ontario Health Minister Eric Hoskins.
Basil Ziv, registrar of the College of Homeopathy of Ontario, said in an interview that the college is working to make sure members know that vaccinations are outside their purview. But he said the college does not have enough resources to find out which members are breaking the rules. He asked instead that I give him the names of any individuals I had identified through Google searches.
Over the past few weeks, federal and provincial ministers of health have been fanning out to flu shot clinics across Canada, telling members of the public to get vaccinated. But what about the messages Canadians are hearing from those naturopaths and homeopaths who continue to spread dangerous, false information? It was one thing when those professions were unregulated, with no professional guidelines or standards. Now, in many parts of Canada, that has changed. If the purpose behind regulation was to level the playing field, it's clear that there remains a long way to go.