Collaboration: Promise and Challenges for NDs
Updated: Feb 9, 2020
As NDs are becoming a larger part of the health care discussion across Canada (for better and for worse), we are learning to work as part of teams under the ‘allied health’ or 'paramedical' umbrella alongside the conventional single-payer system.
This is not always a natural fit; for many years, naturopathic doctors have had to learn to be both independent and self-reliant in their therapeutic approaches. There are complex realities behind this: in most Canadian provinces, we have been locked out of access to diagnostic testing and laboratory medicine. With the move towards allowing ND clinicians access to prescriptive items (including high dose vitamins and botanical medicines), still, this varies considerably from province to province. On an individual level, many NDs have found attempts to communicate—or collaborate--with conventional providers have been met with either ad hominem criticism or stony silence.
We know that patients are not served well by the persistence of these silos. In an environment where many Canadians have limited access to long term relationships with primary care doctors, we can—and should—provide needed support to overburdened provincial health systems. But how do we break through?
In my opinion, this requires patience, persistence, and professional maturity. As NDs, we need to recognize that conventional family doctors and specialists have their own stresses and challenges, and may not have to time to read lengthy reports or requests for collaboration or records. We also need to refrain from using language that is not accessible to conventional understanding, even though it might be commonly used among our colleagues. One of the great strengths of the naturopathic profession is our great diversity in practice and thought; however, this very diversity can pose a communication challenge, as our individual practice philosophy may fall along a very broad continuum. If we wish to have productive collaboration, we need to be honest about what evidence exists for our current treatment programs, or whether we working with more traditional or empiric therapies.
Despite the difference in our models, there is no reason why ND and conventional docs cannot work collaboratively. As NDs, I believe we need to start with whole heartedly supporting our Provincial and National Public Health Agencies, then articulate clearly that we respect the other members of the health care team, even in areas where our opinions might disagree.
After all, we should all be working towards a common goal--which is the long term-health of our patients.
Note: a previous version of this post appeared in Editor's Note: Vital Link Vol. 26, No.2