Doctors Free to be Alternative

Last year, BC MLA Steve Orcherton proposed a private member's bill in the British Columbia legislature that would free doctors to practise complementary medicine. The bill is intended to "allow medical practitioners to use their own judgment to diagnose and treat patients."

The real target of Bill M212-200 is the BC College of Physicians and Surgeons (BCPS) which, according to Orcherton, "has a long history of interfering with the public's right to choose medical doctors who incorporate complementary medicine into their practices." The attitude of the College towards complementary medicine fluctuates between grudging tolerance and outright hostility.

According to the BC College policy manual, complementary and alternative therapies "are generally unproven." Dr VanAndel, the College's Registrar, insists the College is willing to classify any medication as "conventional" as soon as it's proven to be effective. He notes hypnosis and acupuncture as examples.

Orcherton became interested in complementary medicine because of meetings with British Columbians who belonged to organizations such as Citizens Supporting Complementary Medicine. He sensed a need to find different ways to approach health care since every province is having difficulties providing medical care for citizens and complementary medicine may be cheaper or more effective than conventional treatments. Orcherton believes that with skyrocketing costs doctors have to look at alternatives in vitamin and mineral supplementation, homeopathy, chelation and acupuncture. But he says that provincial colleges are more concerned about protecting their turf and the financial health of their doctor-members than the health of their patients.

"Doctors have the strongest closed shop union in the world," he stated.

VanAndel called this claim "nonsense." He stated that the College is a regulatory body, not a union.

We Need Choice Not Bias

Apart from missing the point of Orcherton's union analogy it doesn't answer the question of how the College can fairly and without bias investigate alternative therapies. VanAndel describes how advice is obtained from two or three doctors recognized by the college as experts in the field. This advice is supplemented by what is currently considered to be "acceptable" in peer-reviewed literature. But what happens when cardiologists are asked to review chelation therapy, for example, something that, if effective, could significantly reduce the number of heart operations?

When faced with the suggestion that perhaps even the most expert cardiologists might be motivated to protect their incomes, VanAndel told me to "do the math" and I would figure out for myself that cardiologists would make much more money from giving a large number of chelation treatments than they currently make from a smaller number of hugely expensive heart operations.

VanAndel claims that Orcherton's bill is far too broad. If passed, every doctor who got hauled in front of the College for harming patients would simply claim that they were practising an alternative medicine and get off the hook!

Total freedom to choose does not come without a price. At present many Canadians expect to be able to walk into a doctor's office whenever they have a health problem. They happily believe that one doctor can give unbiased treatment advice from all "legitimate" areas of medicine and if not, he or she will be sent to see a "specialist." If given choices, Canadians will need to educate themselves at least enough to choose the modalities that apply to their current health problems. They should rely on medical regulators only to feel confident that all practitioners of their chosen modality meet minimally acceptable standards. Perhaps a large part of the problem is that many only think about their health when it has gone and don't spend enough time planning how to keep the good health that most of us are born with.

Orcherton's Bill M212-2000, the Medical Practitioners Amendment Act 2000, passed first reading in the BC legislature in July 2000. It is scheduled for second reading in the spring 2001 session. But private members' bills are rarely successful in Canada's parliamentary government system. Even if this bill fails however, another will rise from its ashes. Eventually British Columbians will have a wide choice of health interventions, as achieved by similar legislation in both Alberta and Ontario.