Skip to main content
Top
Published in: BMC Complementary Medicine and Therapies 1/2015

Open Access 01-12-2015 | Research article

Complementary medical health services: a cross sectional descriptive analysis of a Canadian naturopathic teaching clinic

Authors: Deborah A Kennedy, Bob Bernhardt, Tara Snyder, Viviana Bancu, Kieran Cooley

Published in: BMC Complementary Medicine and Therapies | Issue 1/2015

Login to get access

Abstract

Background

Historically, alongside regulatory and jurisdictional differences in scope of practices, practice patterns of naturopathic doctors (NDs) have varied widely to promote holistic or whole-person treatment using a variety of therapies including: controlled substances, minor surgery, a variety of complementary therapies, as well as both novel and conventional assessments. However, little is known about the observed practice patterns of NDs, the services provided to their patients, or the type of conditions for which patients of NDs are seeking treatment. In order to address this gap, a cross-sectional descriptive analysis of the largest Canadian teaching clinic for NDs was undertaken to better understand the services provided to the community and increase the knowledge regarding the use of naturopathic medicine.

Methods

Data stemmed from two sources at the Toronto, Ontario clinic: a passive patient satisfaction survey, and the clinic’s point-of-sale (POS) system. Data included patient demographics, postal codes, health services utilization, ICD-10 codes, therapies employed, along with other data relating to the financial transactions associated with the visit. Simple descriptive statistics and the Kruskal-Wallis test were used to compare different age-based groups and examine health services use between years. This study was approved by the Research Ethics Board of the Canadian College of Naturopathic Medicine.

Results

13,412 patients were treated in 76,386 patient visits spanning three clinic years. Median age of patients was 37; females outnumbered males (2.6:1) in all age-based groups except the pediatric population. In the patient satisfaction survey, there were 1552 potential survey respondents; with 118 responses received (response rate: 7.6%). Obtaining health education, health prevention and help with chronic health conditions were the primary motivators for patient visits identified in the patient survey.

Conclusion

The clinic attracts people from a wide area in the metropolitan Toronto and surrounding region with health concerns and diagnoses that are consistent with primary care, providing health education and addressing acute and chronic health conditions. Further explorations into health services delivery from the broader naturopathic or other complementary/alternative medical professions would provide greater context to these findings and expand understanding of the patients and type of care being provided by these health professionals.
Appendix
Available only for authorised users
Literature
1.
go back to reference Litchy AP. Naturopathic physicians: holistic primary care and integrative medicine specialists. J Diet Suppl. 2011;8(4):369–77.CrossRefPubMed Litchy AP. Naturopathic physicians: holistic primary care and integrative medicine specialists. J Diet Suppl. 2011;8(4):369–77.CrossRefPubMed
4.
go back to reference Seely D, Szczurko O, Cooley K, Fritz H, Aberdour S, Herrington C, et al. Naturopathic medicine for the prevention of cardiovascular disease: a randomized clinical trial. CMAJ. 2013;185(9):E409–16.CrossRefPubMedPubMedCentral Seely D, Szczurko O, Cooley K, Fritz H, Aberdour S, Herrington C, et al. Naturopathic medicine for the prevention of cardiovascular disease: a randomized clinical trial. CMAJ. 2013;185(9):E409–16.CrossRefPubMedPubMedCentral
5.
go back to reference Szczurko O, Cooley K, Mills EJ, Zhou Q, Perri D, Seely D. Naturopathic treatment of rotator cuff tendinitis among Canadian postal workers: a randomized controlled trial. Arthritis Rheum. 2009;61(8):1037–45.CrossRefPubMed Szczurko O, Cooley K, Mills EJ, Zhou Q, Perri D, Seely D. Naturopathic treatment of rotator cuff tendinitis among Canadian postal workers: a randomized controlled trial. Arthritis Rheum. 2009;61(8):1037–45.CrossRefPubMed
6.
go back to reference Herman PM, Szczurko O, Cooley K, Mills EJ. Cost-effectiveness of naturopathic care for chronic low back pain. Altern Ther Health Med. 2008;14(2):32–9.PubMed Herman PM, Szczurko O, Cooley K, Mills EJ. Cost-effectiveness of naturopathic care for chronic low back pain. Altern Ther Health Med. 2008;14(2):32–9.PubMed
7.
go back to reference Szczurko O, Cooley K, Busse JW, Seely D, Bernhardt B, Guyatt GH, et al. Naturopathic care for chronic low back pain: a randomized trial. PLoS One. 2007;2(9):e919.CrossRefPubMedPubMedCentral Szczurko O, Cooley K, Busse JW, Seely D, Bernhardt B, Guyatt GH, et al. Naturopathic care for chronic low back pain: a randomized trial. PLoS One. 2007;2(9):e919.CrossRefPubMedPubMedCentral
8.
go back to reference Cooley K, Szczurko O, Perri D, Mills EJ, Bernhardt B, Zhou Q, et al. Naturopathic care for anxiety: a randomized controlled trial ISRCTN78958974. PLoS One. 2009;4(8):e6628.CrossRefPubMedPubMedCentral Cooley K, Szczurko O, Perri D, Mills EJ, Bernhardt B, Zhou Q, et al. Naturopathic care for anxiety: a randomized controlled trial ISRCTN78958974. PLoS One. 2009;4(8):e6628.CrossRefPubMedPubMedCentral
9.
go back to reference Bradley R, Oberg EB. Naturopathic medicine and type 2 diabetes: a retrospective analysis from an academic clinic. Altern Med Rev. 2006;11(1):30–9.PubMedPubMedCentral Bradley R, Oberg EB. Naturopathic medicine and type 2 diabetes: a retrospective analysis from an academic clinic. Altern Med Rev. 2006;11(1):30–9.PubMedPubMedCentral
10.
go back to reference Habib C, Gowan M, Podgrabinski S, Grodski T, Leung B, Seely D, et al. Treating type 2 diabetes: a Cross-sectional Audit of Naturopathic Standards of Care Using the Naturopathic Patient Database. J Evid Based Complement Alternat Med. 2012;17(2):108–16.CrossRef Habib C, Gowan M, Podgrabinski S, Grodski T, Leung B, Seely D, et al. Treating type 2 diabetes: a Cross-sectional Audit of Naturopathic Standards of Care Using the Naturopathic Patient Database. J Evid Based Complement Alternat Med. 2012;17(2):108–16.CrossRef
11.
go back to reference Bradley R, Kozura E, Kaltunas J, Oberg EB, Probstfield J, Fitzpatrick AL. Observed Changes in Risk during Naturopathic Treatment of Hypertension. Evid Based Complement Alternat Med. 2011;2011:826751.CrossRefPubMedPubMedCentral Bradley R, Kozura E, Kaltunas J, Oberg EB, Probstfield J, Fitzpatrick AL. Observed Changes in Risk during Naturopathic Treatment of Hypertension. Evid Based Complement Alternat Med. 2011;2011:826751.CrossRefPubMedPubMedCentral
12.
go back to reference Walji R, Weeks L, Cooley K, Seely D. Naturopathic medicine and aboriginal health: an exploratory study at Anishnawbe Health Toronto. Can J Public Health. 2010;101(6):475–80.PubMed Walji R, Weeks L, Cooley K, Seely D. Naturopathic medicine and aboriginal health: an exploratory study at Anishnawbe Health Toronto. Can J Public Health. 2010;101(6):475–80.PubMed
13.
go back to reference Oberg EB, Bradley R, Hsu C, Sherman KJ, Catz S, Calabrese C, et al. Patient-reported experiences with first-time naturopathic care for type 2 diabetes. PLoS One. 2012;7(11):e48549.CrossRefPubMedPubMedCentral Oberg EB, Bradley R, Hsu C, Sherman KJ, Catz S, Calabrese C, et al. Patient-reported experiences with first-time naturopathic care for type 2 diabetes. PLoS One. 2012;7(11):e48549.CrossRefPubMedPubMedCentral
19.
go back to reference Hollenberg D, Lytle M, Walji R, Cooley K. Addressing provider shortage in underserviced areas: the role of traditional, complementary and alternative medicine (TCAM) providers in Canadian rural healthcare. Eur J Integr Med. 2013;5(1):15–26.CrossRef Hollenberg D, Lytle M, Walji R, Cooley K. Addressing provider shortage in underserviced areas: the role of traditional, complementary and alternative medicine (TCAM) providers in Canadian rural healthcare. Eur J Integr Med. 2013;5(1):15–26.CrossRef
20.
go back to reference Leung B, Cooley K, Flower G, Habib C, Podgrabinski S, Gowan M, et al. Assessing the utility of an electronic research database to capture whole systems practice at two naturopathic outpatient teaching clinics. Evid Based Complement Alternat Med. 2012;18(3):170–5.CrossRef Leung B, Cooley K, Flower G, Habib C, Podgrabinski S, Gowan M, et al. Assessing the utility of an electronic research database to capture whole systems practice at two naturopathic outpatient teaching clinics. Evid Based Complement Alternat Med. 2012;18(3):170–5.CrossRef
21.
go back to reference Coulter ID, Khorsan R. Is health services research the Holy Grail of complementary and alternative medicine research? Altern Ther Health Med. 2008;14(4):40–5.PubMed Coulter ID, Khorsan R. Is health services research the Holy Grail of complementary and alternative medicine research? Altern Ther Health Med. 2008;14(4):40–5.PubMed
22.
go back to reference Wardle J, Oberg EB. The intersecting paradigms of naturopathic medicine and public health: opportunities for naturopathic medicine. J Altern Complement Med. 2011;17(11):1079–84.CrossRefPubMed Wardle J, Oberg EB. The intersecting paradigms of naturopathic medicine and public health: opportunities for naturopathic medicine. J Altern Complement Med. 2011;17(11):1079–84.CrossRefPubMed
23.
go back to reference Verhoef MJ, Boon HS, Mutasingwa DR. The scope of naturopathic medicine in Canada: an emerging profession. Soc Sci Med. 2006;63(2):409–17.CrossRefPubMed Verhoef MJ, Boon HS, Mutasingwa DR. The scope of naturopathic medicine in Canada: an emerging profession. Soc Sci Med. 2006;63(2):409–17.CrossRefPubMed
25.
go back to reference Park J. Use of Alternative Health Care. Health Rep. 2005;16(2):39–42. Park J. Use of Alternative Health Care. Health Rep. 2005;16(2):39–42.
26.
go back to reference Roth M, Kobayashi K. The use of complementary and alternative medicine among Chinese Canadians: results from a national survey. J Immigr Minor Health. 2008;10:517–28.CrossRefPubMed Roth M, Kobayashi K. The use of complementary and alternative medicine among Chinese Canadians: results from a national survey. J Immigr Minor Health. 2008;10:517–28.CrossRefPubMed
27.
go back to reference Millar W. Patterns of use–alternative health care practitioners. Health Rep. 2001;13(1):9–21.PubMed Millar W. Patterns of use–alternative health care practitioners. Health Rep. 2001;13(1):9–21.PubMed
28.
go back to reference Wiles J, Rosenberg M. ‘Gentle caring experience’: Seeking alternative health care in Canada. Health Place. 2001;7:209–24.CrossRefPubMed Wiles J, Rosenberg M. ‘Gentle caring experience’: Seeking alternative health care in Canada. Health Place. 2001;7:209–24.CrossRefPubMed
29.
go back to reference McFarland B, Bigelow D, Zani B, Newsom J, Kaplan M. Complementary and alternative medicine use in Canada and the United States. Am J Public Health. 2002;92(10):1616–8.CrossRefPubMedPubMedCentral McFarland B, Bigelow D, Zani B, Newsom J, Kaplan M. Complementary and alternative medicine use in Canada and the United States. Am J Public Health. 2002;92(10):1616–8.CrossRefPubMedPubMedCentral
30.
go back to reference Metcalfe A, Williams J, McChesney J, Patten S, Jette N. Use of complementary and alternative medicine by those with a chronic disease and the general population - results of a national population based survey. BMC Complement Altern Med. 2010;10:58.CrossRefPubMedPubMedCentral Metcalfe A, Williams J, McChesney J, Patten S, Jette N. Use of complementary and alternative medicine by those with a chronic disease and the general population - results of a national population based survey. BMC Complement Altern Med. 2010;10:58.CrossRefPubMedPubMedCentral
31.
go back to reference Chamberlin S, Oberg E, Calabrese C, Hanes DA. Naturopathic Practice at North American Academic Institutions: description of 300,483 visits and comparison to conventional primary care. Integr Med Insights 2014, in press. Chamberlin S, Oberg E, Calabrese C, Hanes DA. Naturopathic Practice at North American Academic Institutions: description of 300,483 visits and comparison to conventional primary care. Integr Med Insights 2014, in press.
32.
go back to reference Wilson K, Busse JW, Gilchrist A, Vohra S, Boon H, Mills E. Characteristics of Pediatric and Adolescent Patients Attending a Naturopathic College Clinic in Canada. Pediatrics. 2005;115(3):e338–43.CrossRefPubMed Wilson K, Busse JW, Gilchrist A, Vohra S, Boon H, Mills E. Characteristics of Pediatric and Adolescent Patients Attending a Naturopathic College Clinic in Canada. Pediatrics. 2005;115(3):e338–43.CrossRefPubMed
33.
go back to reference Hawk C, Ndetan H, Evans Jr MW. Potential role of complementary and alternative health care providers in chronic disease prevention and health promotion: an analysis of National Health Interview Survey data. Prev Med. 2012;54(1):18–22.CrossRefPubMed Hawk C, Ndetan H, Evans Jr MW. Potential role of complementary and alternative health care providers in chronic disease prevention and health promotion: an analysis of National Health Interview Survey data. Prev Med. 2012;54(1):18–22.CrossRefPubMed
34.
go back to reference Williams A, Kitchen P, Eby J. Alternative health care consultations in Ontario, Canada: a geographic and socio-demographic analysis. BMC Complement Altern Med. 2011;11(1):47.CrossRefPubMedPubMedCentral Williams A, Kitchen P, Eby J. Alternative health care consultations in Ontario, Canada: a geographic and socio-demographic analysis. BMC Complement Altern Med. 2011;11(1):47.CrossRefPubMedPubMedCentral
36.
go back to reference Meyer S. A geographic assessment of ‘total’ health care supply in Ontario: complementary and alternative medicine and conventional medicine. Can Geogr. 2010;54(1):104–22.CrossRef Meyer S. A geographic assessment of ‘total’ health care supply in Ontario: complementary and alternative medicine and conventional medicine. Can Geogr. 2010;54(1):104–22.CrossRef
37.
go back to reference Leung B, Verhoef M. Survey of parents on the use of naturopathic medicine in children—characteristics and reasons. Complement Ther Clin Pract. 2008;14(2):98–104.CrossRefPubMed Leung B, Verhoef M. Survey of parents on the use of naturopathic medicine in children—characteristics and reasons. Complement Ther Clin Pract. 2008;14(2):98–104.CrossRefPubMed
38.
go back to reference Canadian Institute for Health Information (CIHI). Health Care in Canada, 2011: a focus on seniors and aging. Toronto: Canadian Institute for Health Information (CIHI); 2011. Canadian Institute for Health Information (CIHI). Health Care in Canada, 2011: a focus on seniors and aging. Toronto: Canadian Institute for Health Information (CIHI); 2011.
39.
go back to reference Rozga M, Stern J, Stanhope K, Havel P, Kazaks A. Dietary supplement users vary in attitudes and sources of dietary supplement information in East and West geographic regions: a cross-sectional study. BMC Complement Altern Med. 2013;13(1):200.CrossRefPubMedPubMedCentral Rozga M, Stern J, Stanhope K, Havel P, Kazaks A. Dietary supplement users vary in attitudes and sources of dietary supplement information in East and West geographic regions: a cross-sectional study. BMC Complement Altern Med. 2013;13(1):200.CrossRefPubMedPubMedCentral
Metadata
Title
Complementary medical health services: a cross sectional descriptive analysis of a Canadian naturopathic teaching clinic
Authors
Deborah A Kennedy
Bob Bernhardt
Tara Snyder
Viviana Bancu
Kieran Cooley
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2015
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/s12906-015-0550-6

Other articles of this Issue 1/2015

BMC Complementary Medicine and Therapies 1/2015 Go to the issue