The collaboration between Traditional Health care sector and modern western Health care system
Traditional and complementary medicine according to the World Health Organization (WHO) may be defined as the comprehensive understanding of multiculturality based. This knowledge stems from the ingenuity, invention, creativity, faith and experiences. Which is used to improve and sustain health, help in diagnosis, prevention, and curative process whether it is physical or mental illness. (1)
The essential turning point in the long story of the fraught if not hostile link between traditional and recent treatment systems occurred in late 70s. The official stamp of approval from WHO (World Health Organization) has been given for the use of traditional domestic practitioners in recent western health care organizations. It has become a share part of the systematics policy of the WHO and other national and international agencies.
The 30th World Health Assembly of the WHO in 1977 decided to encourage and support the development of the traditional medicine in health care system.
In Alma-Ata 1978, the international conference on primary health care under supervision of the WHO and UNICEF passed an additional decision to support the use of traditional medicine in the government health care system. A short time later, other universal granter organization approved identical policy to finance the health programs using the traditional physician. (2)
Integration and collaboration between the CAM and the conventional medicine is beneficial for future potential growth and development in health care system. (3)
The latest strategy that has been announced via WHO is the WHO Traditional Medicine (TM) Strategy 2014–2023, targeting:
- Efforts for contribution of TM to the health care system
- Safety, effectiveness of the TM by systemic regulation
- Strengthen the role of TM to keep the community healthy (4)
In spite of the rise in benefits and interest of the traditional medicine from many developed countries, the conjunction of the two systems are still not an easy mission. It seems to be a cohabitation rather than integration. (5)
Due to the large diversity multicultural group inside Canada, it has been found many old Chinese immigrants represent the main minority group that they use the Traditional Chinese Medicine as well as natural health products inside Canada. Also the Aboriginals Canadian people have their own (Traditional Aboriginal Medicine) in North America. (6) Broadly speaking it is about 73% of the residents that utilize the CAM during their life. (7)
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This paper will discuss briefly the conventional medicine in Canada, the second part of the paper will examine the current regulations to get the license for the practitioners with most of the challenges from province to other, finally the recommendation part will consist of benefit of integration and collaboration between CAM and health care that may achieve as well as some proposal and suggestion for implication of the policy.
Issue and Context
The increasing of the demand and publicity of utilizing the complementary and alternative medicine (CAM) is the main cause of creation of a regulatory framework to adopt those treatment and products; however the actual fact shown that rising in number of Canadian were utilizing those products and medicine are convenient even when there was a few regulations. Furthermore the CAM practitioner examples are many for instance, Traditional Chinese Medicine (TCM) practitioners, midwives, pharmacists, naturopathic doctors.
In addition, (CAM) practitioner also has its own regulations; generally there are three following models of occupational arrangements:
- Certification. (8)
“In 2001, about 20% of Canadians worked in regulated occupations” (9)
The least rigorous one of three above forms is the registration, yet the rest two are the most common in health fields. For the registration model, the person need only to fill a set of information for examples, name, address, and level of the training that obtained from government agency and paying fees with few particular qualification
Upon the government requirements, certain tests, examination or others requirements should be done to certify the person and show his knowledge, ability and skills to reserve the title .getting the license is the best one to achieved the particular rights to practice
The health care system, there is a provincial code that has been created to address the accumulated of the experience and protect the use of the particular title ,for instances, medical doctor and chiropractor ; practitioner that has passed particular requirements ,yet each province is differ in the documentation process ,accreditation of the license ,in addition to process of assessments. There is some provincial efforts has been taken to facilitate the acceptance of the mutual professions standard that permit the practitioner to practice freely from one province to other.
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The licensing process in Canada is different from profession to other, for example the Chiropractors had to get the license since early ninetieth, meanwhile in 2004 a new legislation had issued to obligate all dietitians to be registered as a major condition to practice and get the tilt of (registered dietitian). In Ontario, 1994 became the first province that approved to license the midwives, followed by rest provinces and territories.
Ontario, Alberta, Manitoba, British Columbia, Quebec, Saskatchewan and Northwest Territories, have licensed Midwifery, those provinces create the Canadian Midwifery Regulators Consortiums well as formed the Multijurisdictional Midwifery Bridging Project, this plan is to help the licensed midwives who were educated outside Canada to get licensed and practice inside Canada.
Most of CAM practitioner are licensed in particular provinces, for instance the naturopath and naturopathic physician are licensed, British Columbia, Alberta, Ontario, Saskatchewan, Nova Scotia and Manitoba, while in Quebec they have their high standard regulation. Another example is the message therapy are licensed in three provinces Ontario, British Columbia, and Newfoundland ,the rest provinces have their own association to handle the license.
Ontario and BC licensed the acupuncture and traditional Chinese medicine together; however Alberta and Quebec licensed only acupuncture.
In certain provinces that do not have the regulation for certain professions, the employees need to be a member in the provincial association. In spite of those regulations in Canada, it is still very restrictive of mobility of CAM practitioners inside Canada, not only provincial barriers but also the cost of the various regulations from province to another.
In addition to that, another challenge facing the provider, getting the license with strict changeable requirements, raise in the prices, and limited access to the health care, can lead to negative effect on health consequences.
In the last couple decades, numbers of TM practitioners have got licensed, however there is no proof of a progress or improvement in the health care outcome of the patient. The elevation in the number of licensed practitioners has seems to be only practitioners higher wages and decrease in the provision of heath care to Canadians. (8)
Recommendations and Suggestions
In order to elaborate the function and advantages of the integration between the TM and conventional medicine, we need to analyze the potential incorporation of TM directly to heath care system, and how develop a feasible programs that address the main challenge and difficulties that may face the policy –maker as well as the decision maker and try to find a rout to simplify those challenges, with outline the risk and benefit of TM and establish a fair access to health system inclusive the participation pathways.
To ensure the success of the integration with optimum health outcomes, we need to:
- Allocation fund for the research projects exclusively for TM and natural health products.
- Create a single provincial guideline to make sure the flexible labor force mobility between provinces within Canada.
- Provision of cost effective programs to facilitate the regulations process for the practitioners, with respect to the safety and efficacy.
- Develop an active communication between the provincial health authority and the TM practitioners to share information and prompt reporting by professional network.
- Facilitate the global coordination with international agencies such as WHO to achieved the universal data base and gather information.(4)
- Replace license with certificates since the cost of CAM practitioners regulations for example high rate wages for practitioners are far outweigh the advantage and services, so the replacement of license to certificate is suitable .(8)
- Encourage collaboration between CAM and health authority for example ministry of health to create the skeleton of the strategy for running the health care system.(3)
- Initiate a promotion program and workshops to fill the gap between the General practitioners and TM practitioners, and open a discussion in between to encourage the convergence of thoughts and acceptance each other’s.
The purpose of the above recommendations is to illustrate how important is the incorporation of TM and modern medicine that may have a positive health outcomes in Canada health care system, and to help the stakeholders ,decision makers to regulate a frame work for such integration and facilitate the implantation of it.
- (Policy and evaluation perspectives on traditional health practitioners in national health care systems. Pillsbury, B L.1982 ,volume 16,issue21)
- Traditional medicine and primary health care among Canadian aboriginal people, Brenda Shestowsky ,1991-1992.
- Traditional, W. H. O., & Strategy, M. (n.d.). WHO Traditional Medicine Strategy.
- Integrating traditional medicine into modern health care systems: examining the role of Chinese medicine in Taiwan. Chi, C
- Lai, D., & Chappell, N. (2007). Use of Traditional Chinese Medicine by older Chinese immigrants in Canada. Family Practice, 24(1), 56–64. doi:10.1093/fampra/cml058
- Deveau, D. 2010. Alternative health care ï¬nally getting its due; physicians referring patients to complementary practitioners, medical schools integratingcare. Vancouver Sun March 15, D2.).
- Ramsay, C. (2009). Unnatural Regulation: Complementary and Alternative Medicine Policy in Canada, (September).
- Sobkow, Jo-Ann (2001). Formal Occupational Barriers. Human Resources and Skills Development Canada.
Course code: MHA 6360
Date: October 8th ,2014
By: Yasmin Al-Ani
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