NonAllopathic(NonConventional)TherapiesinMedicalPracticeDraftPolicy (Formerly,ComplementaryMedicine) Consultation TheNonAllopathic(NonConventional)TherapiesinMedicalPracticedraftpolicyhas beenapprovedforexternalconsultation.Proposedrevisionstothepolicy,formerly calledtheComplementaryMedicinepolicy,havebeendevelopedbyaWorkingGroup followingapreliminaryexternalconsultation. TheCollegeisinvitingfeedbackfromtheprofession,thepublicandotherstakeholders onthereviseddraftpolicy.AllofthefeedbackreceivedwillbereviewedbytheWorking Group,theCollegesExecutiveCommitteeandCouncilbeforemakinganydecisions aboutwhatisincludedinthefinalversionofthepolicy.Deadlinetoprovidecommentis September1,2011.

11. Moreinformationfollows,including: BriefBackground ProcessUsedinDevelopingtheRevisedDraftPolicy KeyFeaturesoftheRevisedDraftPolicy NextSteps HaveYourSay SeeRevisedDraftPolicyhere BriefBackground TheCollegesComplementaryMedicinepolicyiscurrentlyunderreviewinaccordance withourregularpolicyreviewprocess.Thepolicywasoriginallydevelopedinthe mid1990s,andarticulatedbroadstatementsofexpectationfortheprofessionrelated tothreecorecomponents:assessingpatients,treatingpatients,andadvancing knowledge. SincethedevelopmentoftheComplementaryMedicinepolicy,theenvironmenthas changedsignificantly.Thepopularityofnonallopathictherapiesamongstpatientshas increasedandthetypeofavailabletherapieshasincreased.Nonallopathictherapies arebeingprovidedbyabroadrangeofindividuals:physicians,otherregulated professionals,andsomeunregulatedprofessionals,andnewregulatoryCollegeshave beenformedforNaturopathy,HomeopathyandTraditionalChineseMedicineand Acupuncture.

ProcessUsedinDevelopingtheRevisedDraftPolicy AWorkingGroup,composedofbothphysicianandpublicmembersofCouncil,was strucktoreviewtheComplementaryMedicinepolicy.Anumberofpreliminarysteps wereundertakenbytheWorkingGrouptoensureitwasinformedofthepertinent issuesandhadengagedwithrelevantstakeholders,by: Invitingstakeholderstopresenttheircommentsontheexistingpolicyandonthe fieldofcomplementarymedicineataWorkingGroupmeetinginthespringof2010; Holdingapreliminaryconsultationontheexistingpolicyoverthespringand summerof2010; Conductingapublicopinionsurveyonrelatedissues; ReviewingtherelatedpoliciesandpositionsofCanadianandinternational jurisdictions; Researchingarangeoftopics,includingevidencebasedmedicineandpatientuseof therapies. Throughthepolicyreviewprocess,theWorkingGrouphasalsocriticallyassessedthe existingpolicy.Itconsideredwhetherthepolicywassufficientlycomprehensiveor whetheritshouldaddressotherphysicianrolesbeyondthedirectprovisionofnon allopathictherapies.Inaddition,theWorkingGroupconsideredwhetherthe expectationsintheexistingpolicycouldbemadeclearerforphysicians,andwhether policyrevisionscouldbemadetohelppreventpatientharm. Aftercarefulconsiderationofalltheinformation,feedback,andresearchgathered duringtheearlystagesofthepolicyreviewprocess,theWorkingGrouphasdeveloped thereviseddraftpolicy,NonAllopathic(NonConventional)TherapiesinMedical Practice,whichhasbeenapprovedforexternalconsultation. KeyFeaturesoftheRevisedDraftPolicy TheCollegesupportspatientchoiceinsettingtreatmentgoalsandinmakinghealth caredecisions,andhasnointentionorinterestindeprivingpatientsofnon allopathictherapiesthataresafeandeffective.Asamedicalregulator,theCollege does,however,haveadutytoprotectthepublicfromharm. Thus,theobjectofthisdraftpolicyistopreventunsafeorineffectivenonallopathic therapiesfrombeingprovidedbyphysicians,andtoprohibitunprofessionalor unethicalphysicianconductinrelationtothesetherapies. Differentoperativetermshavebeenadoptedthatweredeemedtobevalueneutral: Allopathicmedicinereferstotraditionalorconventionalmedicine(astaughtin medicalschools)andnonallopathictherapiesrefertocomplementaryor alternativemedicine.

 Thedraftpolicyappliestophysicianswhoprovidenonallopathictherapies; physicianswhosepatientspursuenonallopathictherapies;andphysicianswhoform professionalaffiliationswithnonallopathicclinics,therapies,ordevices. Thedraftpolicyisfoundedonthegeneralpropositionthatthetenetsofgood medicalpracticeapplytoallopathicandnonallopathiccareequally. Thedraftpolicysetsmoreexplicitexpectationsofphysiciansandgreaterprotections ofpatients,by: o Explicitlyprohibitingtheexploitationofpatients; o Requiringthatclinicalassessmentsanddiagnosesmeetthestandardsof allopathicmedicine; o Requiringareasonableconnectionbetweenthepatientsconditionand thediagnosisANDbetweenthediagnosisandthetherapeuticoption proposed; o Explicitlystatingthatpatientconsentwillnotdischargethesumtotalof physiciansobligationswhenrecommendingtherapeuticoptions; o Requiringthattherapeuticoptionsmusthaveareasonablerisk/benefit analysis,reasonableexpectationsofefficacysupportedbyevidence,and takeintoaccountthepatientssocialeconomicstatus; o Prohibitingphysiciansfrominflatingorexaggeratingtheexpected outcomefromnonallopathictherapiesorfrommisrepresentingthe benefitsofallopathiccare. NextSteps TheWorkingGroupisseekingfeedbackfromtheprofession,thepublicandother stakeholdersonthereviseddraftpolicy.Yourfeedbackwillhelpustoassessthedraft policybeforeitisfinalizedbyCouncil.Toensuretransparencyandencourageopen dialogue,thefeedbackwereceiveispostedonourwebsiteinaccordancewithour postingguidelines.Seepostingguidelines. AllofthefeedbackreceivedwillbereviewedbytheWorkingGroup,theColleges ExecutiveCommitteeandCouncilbeforemakinganydecisionsaboutwhatisincludedin thefinalversionofthepolicy.Allfeedbackiscarefullyconsidered,eventhatwhichisnot reflectedinthefinalpolicy.Whenfinalizingthepolicycontent,theCollegewillconsider theextenttowhichyoursuggestionsorcommentsrepresenttheexpectationsofthe profession,andareconsistentwithourmandateasamedicalregulator. HaveYourSay CompleteaBriefSurvey AND/OR Email:ComplementaryMedicine@cpso.on.ca

 OR CollegeofPhysiciansandSurgeonsofOntario 80CollegeStreet Toronto,ONM5G2E2 Attention:PolicyDepartmentComplementaryMedicine DeadlineforcommentisSeptember1,2011