Bill 179 - the end of Ontario??

[Incrimin8]

Originally Posted by MOD ONE

How are NDs hippies?

The ones I have meet are far from it.

agreed...we had a few ND's over at the house this weekend for dinner and I couldn't get any of them to spark up a j with me. squares

[Wiseman]

Originally Posted by praktik

Hey the "have you read the bill?" line is now officially a tribe-meme. I haven't been the only one!
For instance, that isn't my tag at the bottom.

Not mine either!

[Wiseman]

Originally Posted by maphi

Have you read my other posts?

read them? I'm scoring them to music as we speak!

[acheron]

Have You Read The Bill?
a new musical starring Tyra Banks as maphi
words and music by Wiseman
seven performances nightly at the Jon Stewart Center for Truthiness
Tickets available at Patrick's Shop

[derek]

lol...nice won

[Wiseman]

hah!

[Lysistrata]

<3

[praktik]

Originally Posted by acheron

Have You Read The Bill?
a new musical starring Tyra Banks as maphi
words and music by Wiseman
seven performances nightly at the Jon Stewart Center for Truthiness
Tickets available at Patrick's Shop

<opening number, curtain up, spotlight on Tyra as she slinks onstage to a stirring orchestral score>

"Of your trash I've had my fill,
For you sir have not read the bill!

You have not that much is clear,
for then you'd see I'm right my dear!"

[Eclectic]

Originally Posted by maphi

Have you read my other posts?

Can we use this too?

Like the "I know someone who _____, I hope they're ok."

But "Have you read ___?"

I submit this to the Tribe Elders™.

[Flashy_McFlash]

Originally Posted by praktik

<opening number, curtain up, spotlight on Tyra as she slinks onstage to a stirring orchestral score>

"Of your trash I've had my fill,
For you sir have not read the bill!

You have not that much is clear,
for then you'd see I'm right my dear!"

I do declare I resent your hate
Just because I choose to vaccinate

Why sir I'm only asking questions
I didn't mean to cause you tension

THE BILL!
THE BILL!
You haven't read the bill!

THE BILL!
THE BILL!
To my ears you sound mighty shrill!

[Lysistrata]

have you read my other posts
have you read the bill
i dont' mean to brag or boast
but of you all i've read the most
only i have taken the red piiiiiiill.......

[derek]

the bill i have read
canada is all finished
five-O at the door

[judge wopner]

this isnt anything too radical.

there have been a host of changes over the years to allow chiro's to order x-rays, pharmacists and Nurse Practitioners to make certain calls that were previously the domain of MD's.

i think this is happening the same way certain meds that were at one time required scripts are now over the counter. they reach a critical mass and eventually are trusted to be sold by pharmacies, even if taking too much of them or allergies to certain ingredients could be deadly, we still seem to have a good system going.

its an admission that prescribing antibiotics isnt a lofty of a call as it used to be, and that so long as certain diagnostic procedures are followed, its safe to entrust the ability to people with sufficient training like nurses or ND's.

a whole host of tasks that only doctors used to perform are now done by other medical professionals, i dont see this bill as threatening unless you believe that ND's by trade are quacks, which may only apply to some of their modalities (homeopathy)

[Bass-Invader]

Originally Posted by Incrimin8

-public opinion on western medicine is driving the change, why else would ND's be in business and growing?
Again, medicine is not a field predicated on public opinion. I'm sure if a naturopathic practitioner was being compelled to accept a treatment he disagreed with merely on the basis that lots of people wanted it, he would cite the same point. Treatments are based on treating disease, not satisfying whatever lay people emotionally have been convinced. Please expand on why the lay public's (supposed) want of more natural medicine justifies moving the prescription of standard medicine to non standard practicioners.

-I couldn't agree more with her comment that ND's have similar school training, if not better. Just speaking recently with a couple of our MD and ND friends (recent grads), we were all surprised that ND's had more class hours and clinical hours than the MD's did. So the training and schooling is there.
Training to do what though? Complexity does not beget truth. The mere fact that they might log more hours does not mean that they are more qualified than standard doctors at curing disease. More to the point, it surely doesn't make them experts at prescribing standard medicine's pharmaceuticals. Given that, please elaborate on how this particular point leads us to to a justification for having NDs prescribe standard medicines.

- in short, malpractice insurance is cheaper in ontario for ND's as well.
My point was that the fact that malpractice insurance is cheaper has absolutely no cognitive bearing on whether they should prescribe standard drugs. It also speaks nothing to whether they are safe, or effective. Praktik posted a link which gives some explanation if 30 seconds of critical thought do not make it obvious.

[Bass-Invader]

Originally Posted by judge wopner

this isnt anything too radical.

there have been a host of changes over the years to allow chiro's to order x-rays, pharmacists and Nurse Practitioners to make certain calls that were previously the domain of MD's.

i think this is happening the same way certain meds that were at one time required scripts are now over the counter. they reach a critical mass and eventually are trusted to be sold by pharmacies, even if taking too much of them or allergies to certain ingredients could be deadly, we still seem to have a good system going.

its an admission that prescribing antibiotics isnt a lofty of a call as it used to be, and that so long as certain diagnostic procedures are followed, its safe to entrust the ability to people with sufficient training like nurses or ND's.

a whole host of tasks that only doctors used to perform are now done by other medical professionals, i dont see this bill as threatening unless you believe that ND's by trade are quacks, which may only apply to some of their modalities (homeopathy)

While I agree that prima facie, the drugs themselves which seem to be within this list are probably not going to cause gross harm in the hands of NDs, particularly if the province mandates appropriate training in their use, my main concern is the blurring of the lines between standard medicine and naturopathy.
When naturopaths are willing to go on public record citing skewed, misleading, and irrelevant statistics to sell their profession (see the malpractice example), I don't doubt that their next port of call will be something to the effect of:
"if you are still apprehensive about naturopathy, our practicioners are already licensed by the government to prescribe the same drugs that normal doctors do. Obviously this level of trust by the same authorities that regulate standard medical doctors implies a vote of confidence in naturopathy as a whole"

Second, I expect hybrid treatments to be developed and introduced. Have a really bad sore throat and a fever? Well we will prescribe this regime of complex homeopathic treatments. Also, take this bottle of amoxcillin. On look you are cured. Tell all your friends.
I'm sure you can see what is wrong there.

[Incrimin8]

Originally Posted by Bass-Invader

standard medicine to non standard practicioners

-The all too common occurrence of failure within the current 'standard' is the reason for change

- The first 2 years of schooling for ND's and MD's are identical. Many of the teachers at U of T are also teaching the same courses at CCNM (Canadian College of Naturopathic Medicine). Both are registered and federally recognized by an accredited regulatory board. Courses such as pharmacology, radiology, lab diagnosis, clinical diagnosis (ie physical exams) and differential diagnosis taken by both ND's and MD's gives both parties more than enough training to prescribe basic pharmaceuticals.

Keep in mind the ND's prescribing rights will be limited to within their scope of practice. (ie they won't be handing out treatment for lupus or prednisone)

Also note, standard doctors do not cure disease. Their specialty is, for the most part, band-aid solutions.

- On the note of malpractice insurance I stand corrected...ND's insurance rates have actually gone down over the last few years. So if you are seeing something the insurance companies are not, please enlighten us. Prakits link was obvious... 1 in 5 doctors are sued in the US. I've heard new MD's in Ontario don't even pay their premiums, the government does through some credit program? Where's the accountability with their all important prescribing powers in that?

I welcome the change this bill could introduce. It can do nothing but help the current health care crunch we are in now. Besides, I'd much rather spend an hour with my ND talking about whats wrong with me, then wait an hour for 2 mins of an MD's time.

[Bass-Invader]

Originally Posted by Incrimin8

-The all too common occurrence of failure within the current 'standard' is the reason for change

Yes, medical science has gotten us nowhere.

- The first 2 years of schooling for ND's and MD's are identical. Many of the teachers at U of T are also teaching the same courses at CCNM (Canadian College of Naturopathic Medicine). Both are registered and federally recognized by an accredited regulatory board. Courses such as pharmacology, radiology, lab diagnosis, clinical diagnosis (ie physical exams) and differential diagnosis taken by both ND's and MD's gives both parties more than enough training to prescribe basic pharmaceuticals.

I don't know enough about this. If it is true that NDs go through the exact same training/curriculum as MDs where that intersection of training relates to whatever drugs are being prescribed then I can accept competence for those drugs. I still don't agree with the process, nor where I assume naturopathy intends to go with it - to a hybrid naturopathy/standard medicine approach.

Also note, standard doctors do not cure disease. Their specialty is, for the most part, band-aid solutions.

This is rubbish. Doctors cure diseases they have cures for, they attempt to treat the ones they don't until a cure is found.

- On the note of malpractice insurance I stand corrected...ND's insurance rates have actually gone down over the last few years. So if you are seeing something the insurance companies are not, please enlighten us. Prakits link was obvious... 1 in 5 doctors are sued in the US. I've heard new MD's in Ontario don't even pay their premiums, the government does through some credit program? Where's the accountability with their all important prescribing powers in that?

Why the hell would you use insurance company premiums as a metric for medical efficacy and/or safety. As for accountability, doctors can lose their license to practice.

I welcome the change this bill could introduce. It can do nothing but help the current health care crunch we are in now. Besides, I'd much rather spend an hour with my ND talking about whats wrong with me, then wait an hour for 2 mins of an MD's time.

Um, you can already do that.

[Incrimin8]

um, yeah I know that thanks

[maphi]

You all owe me hefty royalty for unauthorized usage of my lyrics. I am calling my constitutional lawyer at this moment. (note: all royalties will be donated directly to Praktik's mental health assessment fund and the new Praktik Right Wing at CAMH)

[maphi]

Originally Posted by Wiseman

read them? I'm scoring them to music as we speak!

Okok... I'll mix it for you if you want. Shall I mix it on the studio's vintage Neve, the SSL 9000J, or in the box with Pro Tools HD?

[judge wopner]

Originally Posted by Bass-Invader

my main concern is the blurring of the lines between standard medicine and naturopathy.

i think its a recognition that they posses much of the same basic training in rudimentary aspects of medicine that they can make the call if these drugs are in order.

osteopaths in the US operate under similar circumstances.

i suspect part of the idea is the same reason chiro's can order x-rays to save a trip to the doctor, people can come to an ND and save a trip to the MD by just getting a scrip for antibiotics if they find that their Oil of Oregano and Arnica Tinticure doesnt stimulate their humors sufficiently...
i joke, i love ND's!!

Originally Posted by Bass-Invader

When naturopaths are willing to go on public record citing skewed, misleading, and irrelevant statistics to sell their profession (see the malpractice example), I don't doubt that their next port of call will be something to the effect of:
"if you are still apprehensive about naturopathy, our practicioners are already licensed by the government to prescribe the same drugs that normal doctors do. Obviously this level of trust by the same authorities that regulate standard medical doctors implies a vote of confidence in naturopathy as a whole"

Second, I expect hybrid treatments to be developed and introduced. Have a really bad sore throat and a fever? Well we will prescribe this regime of complex homeopathic treatments. Also, take this bottle of amoxcillin. On look you are cured. Tell all your friends.
I'm sure you can see what is wrong there.

i think your making some sweeping generalizations then stepping back from them as if to say "hey im just sayin' can we really trust these people?"... citing examples of malpractice and bullshit modalities while true for each specific situation is difficult in context of any evidence-based practice, we cant operate from the standpoint that MD's as a profession are a monolith.

in any given specialty there are conflict opinions about treatment and a host of contradictory studies with suspect fiduciary backing by pharmaceutical interests.

you can find at any given times doctors who disagree with chiro vs. those who find value in its use, the same for ND's.

shit there isnt even agreement on ice vs. heat. ive heard a million different variations from surgeons, doctors, chiro's, physio's and RMT's. all have had allegedly several hundred hours in basic physiology and science, and should be able to provide an evidence-based narrative to their stance, yet we dont see that. we generally see opinions formed on the basis of a mix of training, studies and experience. something that ND's are somehow held under a microscope for more than say physiotherapists who employ a host of similar modalities that dont always hold up to scrutiny (accupuncture, laser therapy, Alexander technique, active release therapy)

there is a reason why physio treatment was mostly discontinued under our health care plan accept for very specific situations. id say ND's are simply catching up.

the issue surround training hours is secondary in my consideration of the issue because nurses get considerable training in physiology and toxicology but require a masters degree and a few thousand clinical hours before they are conferred diagnostic capacity at all. its inconsistent.

i wonder how much of a hand drug companies had in the drafting of this legislation, anything to increase the ability of people to prescribe their product can only help them.

______________________

[Bass-Invader]

Originally Posted by judge wopner

i think its a recognition that they posses much of the same basic training in rudimentary aspects of medicine that they can make the call if these drugs are in order.

osteopaths in the US operate under similar circumstances.

i suspect part of the idea is the same reason chiro's can order x-rays to save a trip to the doctor, people can come to an ND and save a trip to the MD by just getting a scrip for antibiotics if they find that their Oil of Oregano and Arnica Tinticure doesnt stimulate their humors sufficiently...
i joke, i love ND's!!

What's wrong with making those people go to a real doctor when their tincture doesn't work?

i think your making some sweeping generalizations then stepping back from them as if to say "hey im just sayin' can we really trust these people?"... citing examples of malpractice and bullshit modalities while true for each specific situation is difficult in context of any evidence-based practice, we cant operate from the standpoint that MD's as a profession are a monolith.

in any given specialty there are conflict opinions about treatment and a host of contradictory studies with suspect fiduciary backing by pharmaceutical interests.

Don't do this. You're equivocating the degree of disagreement within medical science in order to paint naturopathy as just another one of those opinions. You know this isn't true and for it to be the case you would essentially need to discount the whole of medical science because you feel all studies contradict themselves.

you can find at any given times doctors who disagree with chiro vs. those who find value in its use, the same for ND's.

Oh so that means that the number is 50%, and that the general view in the scientific community measuring treatment/result etc is that at least 50% of studies are pro chiro? So what if you can find a doctor that likes chiros?

[Sal De Ban]

Ontarians are MONSTERS

[Incrimin8]

Originally Posted by Bass-Invader

What's wrong with making those people go to a real doctor when their tincture doesn't work?

please define in your own words what you feel a 'real doctor' is?

[judge wopner]

Originally Posted by Bass-Invader

What's wrong with making those people go to a real doctor when their tincture doesn't work?

no one is suggesting theres anything wrong, only that it saves time and money to circumvent the usual process of going to see an MD for something that ND's are considered qualified to prescribe.

the Chiro example given before stands as a reasonable efficiency added to our system, they specialize in back injuries and despite varying opinions on the efficacy of chiropractic, the powers that be are satisfied with the level and standard of diagnostic training they receive and consider them competent enough to order an x-ray. it avoids the hassle of people having to see an MD just for an x-ray before being treated by a DC

again as noted before Osteopaths operate under similar circumstances in the US where a D.O. degree is in some states considered almost equivalent to a medical degree, in spite of the patchy efficacy of osteopathic treatment.

Originally Posted by Bass-Invader

Don't do this. You're equivocating the degree of disagreement within medical science in order to paint naturopathy as just another one of those opinions. You know this isn't true and for it to be the case you would essentially need to discount the whole of medical science because you feel all studies contradict themselves.

never said all studies contradict themselves, your trying to paint my opinion in a corner,

what i am saying is that your sweeping generalizations about both ND's and MD's are flawed. MD's are not monolithic in their interpretation and practice of medicine. there are a host of treatments and approaches that are far from uniform in the medical community. the very fact that some doctors approve of Chiropractic treatment for some injuries vs. some that do not suggests that "Medical science" while still the gold standard in care is not a simple black and white counter balance to "alternative" therapies.

again i think the examples i gave before put the issue in perspective. we know that many doctors agree physiotherapy is beneficial after an injury, yet we also know many physio's use certain modalities that ND's and DC's use such as acupuncture, active-release and laser therapy that are either unproven or have a host of conflicting efficacy studies.

within this grey area is a considerable amount of medical practice to which MD's themselves are far from uniform in their approval of.

i agree the standard should be for evidence based medicine, but ive already addressed that, we have MD's who prescribe drugs sometimes that in clinical trials have suspect or minimal benefits over placebo's, or worse are shown years later to have been harmful (Vioxx)

Originally Posted by Bass-Invader

Oh so that means that the number is 50%, and that the general view in the scientific community measuring treatment/result etc is that at least 50% of studies are pro chiro? So what if you can find a doctor that likes chiros?

i have no idea what youre talking about here.

i get the impression you think im making a sort of middle-ground appeal using the lack of uniform opinion towards ND's as justification for their existence in clinical practice. not the case, i am suggesting qualified MD's can make the call if they wish to refer patients to an ND, the same way they do with a host of other health care practitioners, but it seems as though you are calling for a standard they be held to simply because elements of their practice lack scientific validation.

it would be a reasonable requirement if it was applied across the board to other health care professionals which have similar issues but its not. far from it, and because of that, the Province goes bit by bit in how they extend treatment capacity to each body. The fact that elements of ND's training include sham treatments no different from chiro's, physio's, RMT's, and occupational therapists isnt sufficient to bar their ability to perform other functions and in this case give out AB scripts any more than a chiro's ability to order an x-ray.

if you advocate that all powers conferred on non-MD health practitioners should be removed the moment they as a profession engage in non evidence based medicine, then we are off on a different issue.

interesting example: Science-Based Medicine Neti pots ? Ancient Ayurvedic Treatment Validated by Scientific Evidence
use of nasal irrigation a treatment modality from Ayurvedic medicine is used widely by MD's and has proven effective (for short term use) after controlled trials and a Chochrane meta-analysis. a great example of MD's taking the working bits of an otherwise unproven modality (Ayurvedic).

Who is to say that ND's cant do the same. we cite their class subjects as if to disparage them (they take classes in homeopathy and ayurvedic medicine!!!!!!) but fail to appreciate how they might employ elements of each treatment to achieve a given result. the additional capacity to prescribe AB's provides them with an additional tool when less invasive treatment fails, and of any other health care professional next to MD's, the ND has the training to do it.

now excuse me as my phrenologist proceeds with a cranial leeching,