Top 5 Complaints and How to Avoid Them: ND-patient communication and Informed Consent

Every year the College receives various complaints about naturopaths’ conduct, practice, and behaviour. The College is legally obligated to investigate each complaint that it receives. Although complaints differ, there are five areas of commonality that stand out and are most often investigated by the Inquiries, Complaints and Reports Committee (ICRC). This 5-part blog series will explore the top five areas of complaints and tips on how NDs can avoid them. 

3. ND-patient communication and Informed Consent

Complaints that are received about patient care often revolve around a ND’s communication with a patient. In many instances, a patient who submits a complaint about the naturopathic care they received, did not completely understand the reasons for the ND’s diagnosis and/or the recommended course of action.  

NDs should recognize that patient care isn’t just about diagnosing and treating health conditions, but rather a collaboration with the patient to help them make informed decisions about their health care and that patient-centred care is key. Communicating and explaining all aspects of the care that is being provided is the best approach to ensuring the patient has a clear understanding of the care they are receiving.  

NDs should remember that the naturopathic doctor-patient relationship requires an ongoing exchange of information between themselves and the patient to ensure the patient’s concerns are being appropriately addressed. 

All aspects of care provided by any health care professional, including NDs, must occur in an environment where informed consent is given by the patient. This does not mean that having a patient sign a singular form at the start of the relationship is sufficient. Consent is on-going and not a singular event. What does informed consent actually mean? Under Ontario law, it means that the ND has explained the nature of the procedure to be provided, the anticipated benefits, the material risks, the possible side effects, alternative courses of action and the likely consequences of not having the treatment. Informed consent is required for every element of the patient encounter, from initial assessment and examination, to performing treatments and to follow-up encounters.  

It is critical for every health care professional to understand that informed consent can be withdrawn at any time. If during a procedure the patient becomes visibly uncomfortable or begins to ask questions, NDs should stop the procedure to allow the patient to ask questions, to answer those questions and reconfirm that the patient continues to consent to the treatment. 

Tips for avoiding patient care complaints: 

• Ask the patient questions to ensure you understand their concerns and expectations. 

• Encourage patients to ask you questions throughout their appointment and ensure that patients are aware of the nature of the treatment suggested, its benefits, potential side-effects, available alternatives and associated costs.  
• Monitor your patients verbal and non-verbal cues for any suggestion that they might be uncomfortable or questioning the procedure being performed or treatment being offered and check-in with that patient to ensure consent remains in place.  
• Recognize the patient’s right to accept or reject any health care recommended, and respect their request for a second opinion. 
• Document all verbal discussions had with the patient in their patient record. 
• Remember that you hold a position of power over the patient and always communicate in a transparent, ethical and patient-centred manner. 

• Be clear about expectations of the treatment. 

Would you like to learn more about the Inquiries, Complaints and Reports Committee? Join us for our next edition of our In Conversation With townhall series, featuring the Inquiries and Complaints team.