Introduction

As part of its strategic plan for 2023-2027, the Council of the College of Naturopaths of Ontario (the College) established as a strategic objective that Naturopathic Doctors are trusted because they are effectively regulated. The Council set out several priorities in support of this objective, including that “the College examines the regulatory model to maximize the public protection benefit to Ontarians”.

As a part of this review, the College may consider both changes to the existing regulations made under the Naturopathy Act, 2007, as well as enacting new regulations under its regulation making authority.

In line with these considerations, the College of Naturopaths of Ontario (the College) is undertaking a preliminary consultation on the potential development of a new prospective regulation that sets out the therapies that are included within the naturopathic profession in Ontario, any limitations on the use of those therapies and those therapies that might be prohibited.

The College recognizes that the therapies used within the naturopathic profession may not necessarily be unique to Naturopathic Doctors and may be used in the direct treatment of conditions, i.e., with the intent of “curing” a disease, disorder or dysfunction, or may be used as part of an adjunctive or supportive treatment for other treatments a patient may be undergoing. As such, a preliminary consultation will allow the College to garner views of all system partners, including registrants of the College, about this prospective regulation.

At this time, the College is seeking the input of its registrants, the general public, and system partners on the idea of creating a regulation that establishes the therapies used within the profession, as well as what therapies might be included and/or excluded if the College were to proceed. A decision to proceed with such a regulation has not yet been made, and all feedback will be brought forward in any subsequent decision-making process by the Council of the College.

Background

The College receives numerous inquiries each year from the public and other regulated health professionals about whether a Naturopathic Doctor can treat various conditions. Answers to such questions vary depending on whether the condition can be diagnosed using tools available to NDs, whether the therapies used to treat the conditions involve the performance of a controlled act that is authorized to the naturopathic profession and whether NDs have access to the necessary tests to be able to effectively monitor a treatment plan over time.

Furthermore, recent investigations conducted by the Inquiries, Complaints and Reports Committee and matters that have been referred to the Discipline Committee have identified that there may be a lack of understanding of the treatments that may be provided by registrants of the College to their patients.

Adding to the complexity in these situations, NDs as individual health care practitioners may have the necessary competencies to treat a condition that the profession, as a whole, may not be able to do by working in collaboration with other regulated health professionals and using approaches such as delegation.

A general understanding of the therapies used within the practice of naturopathy might move the bar forward in terms of increasing the understanding and acceptance of the naturopathic profession by members of the public as part of their circle of care, and by members of other regulated health professions.

Regulation Making Authority

If the Council of the College, in consultation with the Ministry of Health, were to propose a regulation that sets out the therapies used within the practice of naturopathy, the authority to do so rests in section 11(b) of the Naturopathy Act, 2007 which states:

Regulations

11 Subject to the approval of the Lieutenant Governor in Council and with prior review by the Minister, the Council may make regulations, …

(b)  prescribing therapies involving the practice of naturopathy, governing the use of prescribed therapies and prohibiting the use of therapies other than the prescribed therapies in the course of the practice of naturopathy;

Such a regulation would allow the Council of the College to prescribe the therapies that are used within the profession, how some or all those therapies are to be used and prohibit therapies that the Council determines are outside of the practice of the profession, represent a risk of harm to patients or which provide insufficient evidence of efficacy.

In addition to providing valuable information about the profession to the public, creating this regulation could add an important tool in the regulatory framework for the College by providing another set of criteria for practise evaluation and accountability. It would also provide valuable context to the naturopathic profession in Ontario.

Supporting Documentation

In line with the intent of this consultation, several supporting documents have been created, providing greater context to what any such regulation might contain and rationale for the categorizations of the therapies set out. As this is a preliminary consultation on this topic, these documents have not been vetted or approved by the Council of the College. The documents include:

Name	Description
Doc 1 – Overall Intent of the Prospective Draft Naturopathic Therapies Regulation	This document sets out the intention of this regulation, what the provisions drafted say, and explanations about the selection of the therapies set out.
Doc 2 – Draft Naturopathic Therapies Regulation	This document is a preliminary draft that could establish the basis on which a registrant would determine whether a therapy is permitted for use and identifies the therapies that might be authorized for use, potential conditions for their use, and therapies that could be prohibited.
Doc 3 – Detailed Description of Therapies	This document provides information that describes the current understanding available to the College of the use of the various therapies.
Doc 4 – Similar Regulations from other Ontario Regulated Health Professions	This document sets out the known similar regulations established by other regulated health profession regulatory Colleges in Ontario.

Consultation Areas

Through this consultation, the College is seeking feedback in several areas. In support of this, there are several online forms being used to collect feedback from individuals and organizations, as follows.

A. General Feedback on the Intent of the Regulation

The initial area of consultation is on the intent and impact of the prospective regulation. The document titled “Overall Intent of the Regulation Approach” is the primary background document for this aspect of the consultation. The College is inviting interested parties to review this document and provide feedback on the concept of creating this regulation.

Key questions to be considered:

• Is the intent of this prospective regulation clear?
• What benefit is inherent in creating such a regulation for the public, other professions and registrants of the College?
• Are there risks or harms inherent in creating such a regulation for the public, other professions and registrants?
• Does this regulation enhance public protection?
• Can you identify any unintended consequences of putting such a regulation in place?

Feedback on the general intent of the Regulation can be provided through this online form.

B. Draft Naturopathic Therapies Regulation

The second area of consultation relates to the specific wording of the draft prospective Naturopathic Therapies Regulation. In support of this area of feedback, the College invites interested parties to review three documents.

The first is the document entitled “Draft Naturopathic Therapies Regulation”. This document provides specific potential wording on this prospective regulation. The second document is titled “Overall Intent of the Regulation Approach” which is the primary background document for this consultation. It also provides explanations for the specific wording in the proposed regulation and what the College would intend for each of these provisions to do. The third is the document entitled “Detailed Description of Therapies” which will allow interested parties to understand what each therapy is and the rationale for its inclusion or exclusion from the practice of the profession.

Key questions to be considered relate to the wording of the draft prospective regulation and the list of therapies set out in each section, including:

• Section 1, Standard of Practice re therapies.
  • Any comments on the wording of the standard?
  • Any elements of the standard that should be excluded?
  • Any elements that should be included in the standard but are not appearing?
• Section 2, therapies authorized to the profession,
  • Any comments on the wording of the section itself? The wording is intended to ensure that the list of authorized therapies is not exclusive and other therapies that meet the standard might be included in a registrant’s practice.
  • Are there any therapies that are proposed to be authorized that should be removed?
  • Are there any therapies that are prohibited that should be authorized?
• Section 3, limitations or conditions on the use of the therapies.
  • Any comments on the wording of the section itself? Is it clear?
  • Are there any therapies listed where the limitation is not accurate or should be modified or removed?
  • Are there any therapies on the proposed authorized therapies list that should have a limitation placed on their use?
• Section 4, prohibited therapies.
  • Any comments on the wording of the section itself?
  • Are there any therapies that are proposed to be prohibited that should be authorized, with or without limitations?
  • Are there any therapies that are proposed to be authorized that should be prohibited?
  • Are there any therapies not listed in the regulation that should be added to the proposed prohibited list?

Feedback on the wording of the draft prospective Regulation can be provided through this online form.

C. Detailed Description of Therapies

The third area of consultation relates to the description of the therapies provided as reference. Although every effort has been made to provide accurate summaries of the purposes of the therapies, errors may occur. Through this feedback process, interested parties can make submissions to change or amend the wording as well as to add new therapies not listed.

Feedback on the descriptions of therapies can be provided through this online form.

D. Similar Regulations from Ontario Regulated Health Profession Colleges

The College is aware that there seem to be no similar regulations governing the use of naturopathic therapies in other Canadian jurisdictions. There are any number of reasons why that might be the case, including the regulatory authority not having the legislative authority to make such a regulation.

The College has reviewed similar regulations for other health professions in Ontario and provides that information in the document titled “Similar Regulations from other Ontario Regulated Health Professions”. While every effort has been made to be fully accurate, none of the other Colleges were involved in the creation of this document. As such, the identification of any errors or omissions would be helpful.

Key questions to be considered relate to the information provided:

• Has the College understood the regulation correctly?
• Are there any other professions with similar regulations that have not been included.

Feedback for correcting any errors or omissions within the ‘Similar Regulations from Other Regulated Health Professions’ document can be provided through this online form.

Feedback

The College is seeking feedback from all stakeholders, including registrants, the public, naturopathic organizations and other regulatory bodies. Feedback must be provided through the College’s online submission forms, the links for which are noted under Consultation Areas section above.

All feedback may be published by the College on the College’s website. Feedback from organizations will be published such that a reader can identify the individual and the organization. Feedback from individuals within the profession, other professions or members of the public will be published anonymously.

Regardless, all feedback must include the name of the individual submitting the feedback for validity purposes. Anonymous submissions will not be considered and will not be retained by the College.

Timeframe

The College will be providing the opportunity for feedback. Consultation will begin on November 6, 2024, and will conclude on or about December 20, 2024.

Our Thanks

The College wishes to thank everyone for taking the time to review these consultation materials, and for providing any feedback.

Andrew Parr, CAE
Chief Executive Officer