Supportive but “worried”: perceptions of naturopaths, homeopaths and Chinese medicine practitioners through a regulatory transition in Ontario, Canada

Abstract

BackgroundIn line with recent World Health Organization recommendations, many jurisdictions are taking steps to regulate practitioners of traditional, complementary and alternative medicine (TCAM). Previous studies have examined TCAM practitioners’ generally-supportive views about professional regulation; however, little research has been conducted on TCAM practitioners’ experiences and perspectives amidst an active regulatory process. In 2006 and 2007, the province of Ontario, Canada announced it would grant self-regulatory status to three TCAM practitioner groups - homeopaths, naturopaths and Chinese medicine practitioners/acupuncturists.MethodsIn 2011 and 2012, part-way through each group’s regulatory process, we surveyed all practitioners from these three groups (n = 1047) that could be identified from public registries and professional associations. The data presented here are derived from the sub-sample of homeopaths (n = 234), naturopaths (n = 273) and Chinese medicine practitioners/acupuncturists (n = 181) who provided answers to an open-ended question about their opinions of the regulatory process at the end of the survey. An inductive, thematic analysis of qualitative survey responses was conducted.ResultsSurvey responses affirmed a pro-regulatory stance across all groups, but revealed considerable ‘worry’ amongst practitioners as to how the regulations might be implemented. Four primary ‘worry-related’ themes emerged: a) regulation’s potential administrative and financial burden on practitioners; b) scope-related concerns; c) implementation of fair registration standards; and d) whether regulation might erode the groups’ distinctive worldviews. Some occupationally-specific concerns appeared related to each group’s particular stage of professionalization. Other ‘worries’ may be related to the relative marginality of TCAM practitioner groups within biomedically-dominant national health care systems, and the possibility that inter-professional hierarchies may be emerging between particular TCAM groups. Specific concerns around overlapping practice scopes between TCAM and other professions raised questions about the implementation of non-monopolistic regulatory models such as Ontario’s.ConclusionsOverall, this study will help inform regulators and TCAM practitioner groups to navigate the unique challenge of regulating health care providers long excluded from national health care systems, who frequently work from within paradigms distinct from mainstream biomedicine.

Statutory Regulation of Traditional Medicine Practitioners and Practices: The Need for Distinct Policy Making Guidelines

“…T&CM professional regulations worldwide are most often implemented at the national/federal level, but in some countries are governed at the regional/provincial/state level. 4 , 5 …”

“…In some jurisdictions, particular groups of T&CM practitioners may be eager to “earn” professional regulatory status from the state, hoping to increase their sociopolitical power and economic status. 5 , 31 , 43–46 As scholars of professionalization have long observed, occupational self-interest and competing claims to authority over knowledge are common issues with which regulators are faced across a range of professions. 23 , 30 The state, it has been widely argued, should carefully subordinate such self-interest and competing knowledge claims to the interests of the public (represented in the healthcare field as patients).…”

Medical Pluralism and the State: Regulatory Language Requirements for Traditional Acupuncturists in English-Dominant Diaspora Jurisdictions

“…In Canada, the United States, and Australia, where traditional acupuncture practitioners have been increasingly regulated, East Asian immigrants commonly represent a significant proportion of practitioners (Chiu, 2006;Ijaz et al, 2015;Zhou et al, 2012). Survey data from the province of Victoria, Australia, in 2012 showed 38% of registered Chinese medicine practitioners have Chinese as their first language, a proportion that increased substantially with age, up to 80% in the above-65 age group.…”

“…Critical scholarship that addresses equity-related issues surrounding medical pluralism in the global North represents an emerging area of research (e.g., Baer, 1989;Cant & Sharma, 1999;Green et al, 2006;Hollenberg & Muzzin, 2010;Marian, 2007aMarian, , 2007b. In such settings, it is not only biomedicine's dominance in the health care sector and the health care needs and preferences of immigrant ethnic minority patients (e.g., Han, 2000;Rochelle & Marks, 2011) that increases complexity but also the potential for immigrant TM practitioners to be systemically disadvantaged (e.g., Chiu, 2006;Ijaz, Boon, Welsh, & Meads, 2015;Shroff, Hlaing, & Wu-Lawrence, 1997).…”

El Debate Político Sobre Las Terapias Alternativas Y Complementarias en España en La Interfaz Entre Ciencia, Política Y Sociedad (1979-2018)

“…). Como ha demostrado la literatura sobre las TAC(Ijaz et al, 2015), este tipo de exploración permite una mejor comprensión de los términos en que se desarrolla y construye el debate político al tiempo que identifica qué partidos políticos contribuyen al debate. Se trata, por tanto, de una fórmula para mapear las narrativas hegemónicas de las TAC y sus promotores en la esfera política.Durante los 39 años del periodo analizado se tramitaron 80 expedientes parlamentarios sobre las TAC en las Cortes Generales del Estado español con una media de dos iniciativas por año, distribuidos como se puede ver en la Figura 1.…”