Boon H
University of Toronto, Ontario, Canada.
Complement Ther Med. 2002 Mar;10(1):14-9. doi: 10.1054/ctim.2002.0499.
Increased use of complementary/alternative medicine (CAM) therapies by Canadians combined with increasingly forceful lobbying from both practitioner groups and the public have made the regulation of CAM practitioners an important issue for Canadian policy makers. A variety of challenges (including regulatory structures that are difficult to change, fear of adding costs to an already under-funded healthcare system and the lack of internal cohesion of some CAM practitioner groups) are currently hindering attempts to implement new policy. However, an environment of health regulation review and renewal as well as public support for regulation may have created a window of opportunity for investigating policy options. Currently in Canada, health care providers are regulated by individual provinces. This means that although some CAM practitioners are either regulated (e.g. chiropractors) or not regulated (e.g. herbalists, homeopaths) in all provinces; others (e.g. naturopathic practitioners, acupuncture/TCM practitioners) are regulated in some provinces, but not others. Harmonization of regulations and scopes of practice for CAM practitioners across Canada is one of the biggest future challenges.
加拿大人对补充和替代医学(CAM)疗法的使用增加,再加上从业者团体和公众越来越强烈的游说,使得对CAM从业者的监管成为加拿大政策制定者面临的一个重要问题。目前,各种挑战(包括难以改变的监管结构、担心给本就资金不足的医疗体系增加成本以及一些CAM从业者团体缺乏内部凝聚力)阻碍了实施新政策的尝试。然而,健康监管审查与更新的环境以及公众对监管的支持,可能为研究政策选项创造了一个机会窗口。目前在加拿大,医疗服务提供者由各个省份进行监管。这意味着,虽然一些CAM从业者在所有省份要么受到监管(如脊椎按摩师),要么不受监管(如草药师、顺势疗法医生);但其他从业者(如自然疗法医生、针灸/中医从业者)在一些省份受到监管,在其他省份则不受监管。在加拿大实现CAM从业者监管规定和执业范围的统一,是未来最大的挑战之一。