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Reviewing the Romanow Report


Our cash-strapped health-care system is by far one of the most talked about issues in Canada. Those in the complementary care field are perhaps even more aware of the cost of getting well, since most patients pay out-of-pocket expenses to visit professionals who aren't covered by government-funded plans.

Not surprisingly, all eyes were on federal health-care commissioner Roy Romanow last year as he gathered information to make his recommendations for the future of our public health system. He heard a multitude of submissions on his cross-country tour, including some arguing for the inclusion of complementary medical coverage by medicare. His final report, which came out last November, has what some would argue are positive implications for complementary medicine in Canada.

In addition to other things, Mr. Romanow recommended a "primary care" medical system, whereby physicians play an increased role in patient care, but within team-based environments. Very simply, doctors and other medical professionals would work in groups, a move expected to improve patient access and services, reduce doctor burnout and save resources since everything is shared.

Many from the natural health field feel hopeful about the future of this team-based approach, which could eventually include complementary health practitioners. Sean O'Rilley from the Canadian Naturopathic Association pointed out in a phone interview that Mr. Romanow's message on the need for better patient education and a wholistic approach is very much in line with naturopathic philosophy.

The proposed primary care system would also increase focus on prevention, another major edict of complementary medicine. On a practical level, however, the two medical philosophies take different approaches to prevention. Whereas orthodox medicine sees vaccines and mammograms as preventive, natural medicine says the same of supplements, herbs, physical therapies and other less technological methods. This difference may make it more challenging to incorporate the two-especially when another of the report's recommendations is to pay doctors bonuses for things such as immunizing the majority of their children patients, hitting targets for flu vaccines and ordering certain numbers of mammograms or Pap smears.

Nevertheless, when it happens, a combined medical approach has been shown to both benefit patients and be cost-effective. When Husky Injection Molding Systems in Bolton, Ont. opened an integrated wellness clinic for its 1,500 employees in 1993, the company saved money. Drug costs dropped 18 per cent, and absenteeism rates decreased to less than two per cent. The centre had a medical doctor, naturopathic physician, chiropractor and massage therapist, who often provided referrals to each other. If this type of scenario occurred on a broad public basis, who knows what could happen?

"Chiropractors treat over four million Canadians annually," said Dr. Greg Stewart, president of the Canadian Chiropractic Association. "Mr. Romanow's report clearly states that patient access to health-care services needs to be undertaken on a team basis. Right now, this doesn't happen. All health-care professionals have a responsibility to their patients to work together in their best interests. A team approach based on evidence-based practices gets Canadians better quicker and often less expensively."

The Green Party of Canada publicized its approval of the Romanow report, but added that his recommendations regarding health services should be considered only the first step. "Essential, future expansions of the health-care system need to include alternative healing and naturopathic practices and remedies into the funding formula" (Nov. 29, 2002 press release).

Thousands of Canadians visit chiropractors, naturopathic physicians, massage therapists, herbalists and other wholistic care providers. We spend more than $3 billion a year on alternative medical services. If you believe the future of Canada's health-care system lies in integration, write to your provincial MP and encourage him or her to support coverage of complementary medical services.



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Matthew Kadey, MSc, RDMatthew Kadey, MSc, RD