June, 2011 |188
Arizona Medical and Natural Health Clinic
The power of scope of practice
Naturopathic medicine in Canada has undergone an exponential magnitude of progress in just a handful of years. The country has welcomed its second institution granting the ND diploma (Boucher Institute of Naturopathic Medicine in British Columbia), the province of British Columbia has secured legislative standing and subsequent scope of practice privileges unparalleled by any other jurisdiction in the country, Ontario has initiated the process of legislatively placing the profession into the Regulated Healthcare Practitioners Act likewise accompanied by revisions to scope of practice, and several other provinces are simultaneously making major regulatory strides. During this key time in the evolution of the profession in Canada, we at IHP felt it appropriate to showcase the work of a Canadian- trained ND practicing in Arizona. We hope the individuals charged with shaping the future of our profession in Canada take a moment to reflect on the Arizona Medical and Natural Health Clinic and recognize the power of scope of practice.
Dr Erika Sykes- McKeen graduated from the Canadian College of Naturopathic Medicine in 2004, and before long had successfully integrated herself in a facility of 20+ MD’s at the Westmount Community Health Centre in Hamilton, Ontario. Her passion, integrity, and mastery of naturopathic systems saw her practice build quickly. Her unparalleled mastery of pharmacology, laboratory diagnosis, differential diagnosis, and physical exam made the transition of practice alongside conventionally- trained physicians an easy one. Before long, the desire to begin a family saw her pack- up her Hamilton facility and move to Phoenix Arizona, never to see the snow again!
Erika comes from a long line conventionally- trained physicians. When asked why she chose to pursue naturopathic medicine, she beams a huge smile and replies “well, MD’s are kind of limited in what they can do. As a naturopathic doctor, I can do everything an MD can, AND a whole bunch of other stuff that they never even learn about!” The state of Arizona has the most progressive legislative environment for ND’s of any jurisdiction in North America. They are recognized as primary healthcare providers, and provided a full formulary of prescription medications that is virtually unlimited. The title of a practicing naturopath in Arizona is not ND, but NMD, or Natural Medical Doctor.
The first impression of entering the Arizona Medical and Natural Health Clinic is that you have arrived at the facility of a neurosurgeon. 50” plasma televisions line almost any wall you encounter, running a series of health tips, recipe ideas, and the occasional profile of a product offered at the facilities adjacent natural health product dispensary. The floors are gleaming stone, the ambiance that of a modernized home of luxury. The 5000sqft facility houses 12 treatment rooms. Team members include four NMD’s, two chiropractors, a registered nurse, and two massage therapists.
The facility serves as a one- stop shop of wellness, offering services to the severely ill seeking solutions for chronic, debilitating illness, yet also providing a thriving selection of beauty and cosmetic services. Value- added offerings of the clinic include an infrared sauna, cold laser therapy, and an elegant IV lounge offering services of prescription medications, chelation therapy, vitamin/ mineral cocktails, and prolotherapy/ mesotherapy. Preservativefree immunizations are also made available.
A well- developed array of integrative diagnostic tests are routinely implemented by the team, including IgG food sensitivity testing, salivary cortisol profiles, salivary hormone testing, urinary metabolic profiles, and complete stool analysis. The facility has established a highly successful beauty and cosmetic platform offering services that include botox and filler (juvederm) injections, laser hair removal, accent laser, and microdermabrasion. The massage team offers a highly diversified selection of offerings, including sport massage, pregnancy massage, deep tissue massage, Swedish massage, hot stone massage, and reflexology.
Arizona represents a rare opportunity to observe the impact to community of ND’s afforded their full scope of practice. As Christoph Kind, president of the BCNA told IHP shortly after the province of British Columbia secured prescription rights for ND’s, “the right to prescribe legitimizes the decision not to prescribe”. When allowed to exercise the full skill set an ND is trained in, practitioners of naturopathic medicine quickly, effectively, and successfully integrate themselves into their respective communities as primary healthcare providers of unquestioned quality. It is not surprising to witness a preference of the general public to visit an ND in favour of an MD when there does not exist a fiscal incentive to visit the MD, or more appropriately the fiscal burden of visiting an ND.
The NMD’s of the Arizona Medical and Natural Health Clinic are quick to highlight their need for access to prescription medications. They are necessary and required tools of practice. But as the majority of ND’s would agree, systems of practice alter when tools other than pharmacotherapy are added to a practitioner’s medicine bag. If you think a prescription is the only possible thing that can help a patient, you are going to prescribe. When you are trained to recognize the impact diet, lifestyle, nutritional, nutraceutical, and botanical agents can have on health, you are likely to try them first, and defer to a prescription medication only if evidence- based natural treatments have failed.
IHP is grateful to Dr Erika Sykes- McKeen and the Arizona Medical and Natural Health Clinic for allowing us to showcase their facility to you. The clinic has surpassed expectations and set the bar of an outpatient primary care facility. During this period of rapid evolution of the profession, regulators and those charged with writing new legislation would be well served to take the time to investigate the success with which ND’s operate under more appropriate scope of practice regulation. In times of physician shortages reaching almost panic levels, awarding a thriving profession deserved ability to deliver safe, effective, and costeffective medical care must be made a top priority.