Meeting Purpose

This topic was part of a BC-PAN meeting held on January 29th, 2020. The purpose of this part of the meeting was to seek input from public advisors to guide health care regulation on the use of complementary and alternative therapies.

Key message from public advisors

If a registrant is going to provide a complementary or alternative therapy, it is important that the registrant has adequate training, educates the patient, obtains informed consent, and respects the patient’s autonomy.

Complementary and alternative therapies

Shenda introduced the discussion on complementary and alternative therapies. For the purposes of this discussion, complementary and alternative therapies was defined as “any therapy that cannot be demonstrated to be effective through usual scientific means.” Some examples from colleges that are here today are dry needling, cell therapies, therapeutic touch.

Advisor input

If a regulated health professional is offering the therapy, does that make it seem more legitimate?

• No for patients who have experienced mistreatment by HCPs and therefore have a sense of mistrust—these patients are protected from the fallacy that “if my doctor told me to do it, then it’s the right thing”
• Yes, for others it does legitimize a therapy when a regulated HCP promotes or performs it
– Patients presume that regulated HCPs have a code of ethics that will guide the way they treat them

How does the regulator ensure that patients are receiving helpful interventions without being a barrier to progress?

• There needs to be a balance
• HCPs should have to undertake measurable education before offering any new therapy, colleges should prohibit HCPs from performing a therapy they are not trained to do
• Informed consent is important for any therapy
• HCPs need to inform patients about the evidence or lack of evidence so patients can make their own decision about the treatment
• Patients need full disclosure about the risks of a complementary or alternative therapy, more invasive therapies require more disclosure
• Regulators have a duty to help the public make informed decisions by requiring their registrants to educate themselves and their patients
• The validity of a therapy be debatable, but the regulator needs to regulate the way the therapy is provided
• Therapies should be banned when there is quantifiable harm or evidence of unacceptable risk

How to regulate therapies that there might not be science behind? How much science do you need?

• Evidence doesn’t have to come from science, there may be anecdotal evidence from patients who have seen positive outcomes
• Some complementary or alternative therapies are focused on the mind, these are not physically invasive but may provide healing
• Colleges shouldn’t leap forward to prohibit things; they should find a way to honour traditional methods of healing
• What works for one person doesn’t work for everyone
• Even regulated evidence-based therapies may turn out to be harmful
Other comments
• There can be interactions between complementary therapies and proven therapies so it’s important that HCPs make patients should feel comfortable to tell them about the complementary therapies they are using
• The distinction between complementary and alternative is important—foregoing an evidence-based therapy in favour of an unproven one is very different than offering a new unproven complementary therapy in addition to a proven scientific treatment