Integrated Medical PracticeNon-Allopathic (Non-Conventional) Therapies in Medical Practice in OntarioActing on behalf of the TTNO, Pat Tamosetis and Gail Lafortune led a group response to the draft policy for Complementary Medicine prepared by the The College of Physicians and Surgeons of Ontario. Here is the follow up letter from the College, in response to their request for feedback from stakeholder community partners this past summer. The policy is good news for Therapeutic Touch! We know that Therapeutic Touch works! It is backed by solid research and respected worldwide for the way it may be integrated with the high tech medicine of today to provide a safe, nurturing environment for the patient. Dear Stakeholders,Re: Complementary Medicine: Final Policy Approved by Council On behalf of the College of Physicians and Surgeons of Ontario, we thank you for participating in our recent consultation on the Non-Allopathic (Non-Conventional) Therapies in Medical Practice (formerly, Complementary Medicine) draft policy. We received close to 700 responses from stakeholders, and we considered all of the feedback very carefully. A number of revisions were made to address stakeholder concerns, and to clarify important messages contained in the document. Key revisions include a change in the policy’s title, removal of the requirement to consider patients’ socio-economic status, and clarification of the expectation that all physicians practise the profession in a manner that is informed by evidence and science, and that is in keeping with their legal, professional and ethical obligations. The final policy, re-named Complementary/Alternative Medicine has been approved by Council. It is available on the College’s website at the following link: http://www.cpso.on.ca/policies/policies/default.aspx?ID=1532 Thank you again for your contribution to the College’s policy development process. Policy Department
College of Physicians and Surgeons of Ontario Some Highlights of the Policy Health Care Decisions
Patients have the right to make health care decisions that accord with their own values, wishes and preferences. This includes decisions to pursue complementary/alternative medicine either as an adjunct to conventional medicine, or instead of conventional medicine. The Medicine Act, 1991 states that physicians shall not be found guilty of professional misconduct or incompetence solely on the basis that they practice a therapy that is non-traditional or that departs from the prevailing medical practice. Diagnosis
Physicians providing CAM must reach a conventional diagnosis. If physicians also reach a CAM diagnosis, that diagnosis must be based on the clinical assessment conducted and other relevant information, be supported by sound clinical judgment and informed by evidence and science. CAM diagnoses that do not satisfy these requirements are not acceptable diagnoses. Therapeutic Options
Any CAM therapeutic option that is recommended by physicians must be informed by evidence and science, and it must: - Have a logical connection to the diagnosis reached;
- Have a reasonable expectation of remedying or alleviating the patient’s health condition or symptoms; and
- Possess a favourable risk/benefit ratio based on: the merits of the option, the potential interactions with other treatments the patient is receiving, the conventional therapeutic options available, and other considerations the physician deems relevant.
Physicians mustnever recommend therapeutic options that have been proven to be ineffective through scientific study. Patient Use of CAM and Documentation
In order to provide safe, high quality conventional medical care, physicians must have complete, accurate information about their patients. This includes information about any CAM that patients may be pursuing or may wish to pursue. The College advises physicians to inquire about patient use of CAM on a regular basis. This might involve incorporating questions about CAM into annual health exams, and/or patient assessments for specific health conditions or ailments. Where patients are pursuing CAM, physicians should note this fact in the patient’s medical record, along with any details of the therapy the patient is able to provide. Discussing CAM
When asked for information about CAM, physicians must respond in a professional manner, within the limits of their knowledge, skill and judgment. Physicians may wish to consider whether they can assist patients in obtaining reliable and accurate information about the CAM modality or intervention in question. This may involve suggesting potential resources, or referring patients to other practitioners where doing so is in the best interests of the patient, and will support informed decision making.
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