Toronto Star to CPSO: Don’t Muzzle Our Doctors

From the College of Physicians and Surgeons of Ontario’s consultation on “Non-Allopathic” therapies comes a revised policy [PDF, starts page 249]. It’s a significant improvement (gone are references to “allopathic”), but it’s still muddled and equivocal when it comes to advocating for a single treatment standard. The Toronto Star is unimpressed with the revision:

Alternative medicine is booming even without much proof it works. A record 20,000 people are expected at Toronto’s Whole Life Expo at the downtown convention centre next weekend. Three-quarters of Canadians regularly use some form of natural health product, opening their wallets to spend at least $4.3 billion yearly. And the herbs and homeopathic tinctures they buy are just one facet of unconventional medicine — a thriving sector encompassing everything from acupuncture to zone therapy (supposedly stimulating the body’s organs through hand or foot massage).

Ontario’s College of Physicians and Surgeons is bending to the trend with a new policy inhibiting doctors’ criticism of unconventional therapies. In doing so it risks encouraging even broader use of dubious and potentially harmful treatments.

The editorial calls it exactly right:

The college shouldn’t seek to accommodate that trend or retreat to a neutral corner. Rather it should leave doctors free to punch hard against those peddling dubious cures and to challenge people’s comforting, but irrational, beliefs. Science-based medicine serves patients best. If doctors can’t vigorously defend it, who will?

(Emphasis added)

See the full editorial here. The CPSO is poised to ratify the revised policy at their council meeting on November 28 and 29.

Medical Doctors, Unproven Treatments, and Professional Standards

Taking a closer look at how physicans deal with alternative medicine

If there’s one group that you’d expect would take a dim view of physician provision of unproven or ineffective treatments, it’s the regulatory colleges that determine medical standards of practice. And that’s why it’s concerning and surprising the College of Physicians and Surgeons of Ontario (CPSO) has published the following draft policy paper, Non-Allopathic (Non-Conventional) Therapies in Medical Practice. The policy as written is unclear with respect to physician expectations. It also appears to significantly diminish the requirement for physicians to provide medical care and advice based on established scientific standards.

To start, let’s look at the CPSO’s role. From their own description:

Doctors in Ontario have been granted a degree of authority for self-regulation under provincial law. The College of Physicians and Surgeons of Ontario is the body that regulates the practice of medicine to protect and serve the public interest. This system of self-regulation is based on the premise that the College must act first and foremost in the interest of the public. All doctors in Ontario must be members of the College in order to practise medicine.

Now let’s take a look at the policy, and its congruence to the CPSO’s role. There’s already been a strong reaction online. Both The Committee for the Advancement of Scientific Skepticism (CASS), as well as  Dr. David Gorski, at the Science-Based Medicine Blog have posted detailed analyses. Each identifies multiple shortcomings in the policy that put the public interest into question. Here are some additional thoughts on the policy itself [PDF]. Continue reading