Editorial

Editorial: Refocusing on Inclusion

Marianne Trevorrow,1 MA, ND


This edition will be published on the first anniversary of our digital transition, two and a half years into the COVID-19 pandemic. While many of our practices and social lives are returning to a new kind of normal (including mask wearing at work and indoor public settings), as of yet, there still seems to be no clear pathway towards saying the pandemic is well and truly over. We are also hearing warnings from the Public Health Agency of Canada (PHAC) and provincial Public Health agencies to be mindful of a 7th—and potentially an 8th—wave of infections later this fall, driven by sub-variants of COVID-Omicron.

What is also becoming apparent is that our public healthcare system is in crisis. Our patients are dealing with backlogs for surgeries, diagnostic testing, specialty or even primary medical care, and patients are increasingly feeling abandoned, as many family physicians are leaving practice either to retire or due to burnout.

This situation should be calling out for increased awareness of naturopathic doctors and the need for our services to support these gaps in the public system. However, while many private benefit providers and government departments are recognizing the value of our care with increased coverage (including, most recently Veteran Affairs Canada), it seems that movement on many crucial scope expansion issues is mired in provincial health bureaucracies, which are scrambling to manage fallout from years of underfunding and added costs associated with the COVID pandemic.

Still, at CANDJ, we continue to encourage public engagement, such as supporting CAND’s “Better Health, Together” communication strategy, and with social media support for CAND on multiple platforms. Recently, your CANDJ editor was accepted for a year-long planetary health leadership course with the Canadian Association of Physicians for the Environment (CAPE) and will be working to build partnerships with other regulated healthcare providers on issues regarding health and environmental advocacy.

Another project we have been working on over the past few months, and which we are unveiling with this issue, is an update of our author submission and citation guidelines to include recognition, at a fundamental level, of the respectful use of traditional Indigenous medicines, Knowledge Keepers, and ways of knowing that underlie much of our naturopathic therapeutics. While their editorial will describe this project in greater depth, I’d like to recognize how deeply grateful we were for the thoughtful commentary and discussions on this project by colleagues Nicole Redvers, Johanne McCarthy, Jamie van Erkelens, and Sarah Connors, and of course the crucial coordinating work of our Associate Editor, Cyndi Gilbert. This truly is a step forward for our publication, and for the profession in North America.

In our Commentary section, we have an article discussing a recent controversy in Washington State over regulatory changes to their continuing education requirements to specify naturopathic association–supported content. From this vantage point, and a poll they carried out of with their members in 2020, they argue for a larger discussion around conflicts of interest (COIs) in ND professional continuing education. As our readers know, CANDJ adopted strict International Committee of Medical Journal Editors’ (ICMJE) competing disclosure standards for all of our submissions in 2019; nevertheless, we are encouraged to see these discussions taken up across the profession. We think it is a conversation whose time has definitely come.

Our second commentary is a thought-provoking examination of a social science “multiple-models” approach for teaching naturopathic therapeutics in undergraduate clinical education. As the author points out, the various lenses of naturopathic medicine (evidence-based, Traditional and Complementary Medicine, or Vitalistic) need not be considered in exclusion of one another, but each can be taught as having its own particular strengths, weaknesses, and biases. In many ways, we think that having cognitive flexibility, critical thinking, and tolerance for ambiguity in practice is one of the great strengths of the naturopathic approach, especially as we integrate more into conventional health settings.

Rounding out this edition is a fascinating case study on female sexual dysfunction in a young adult patient from a student/faculty team at the Canadian College of Naturopathic Medicine (CCNM) that will highlight the use of such a “multiple models” approach in clinical practice. It also offers thoughts about appropriate clinical communication around the sensitive topic of human sexuality and trauma-informed practice.

Once again, we hope you enjoy another lively edition of CANDJ and engage with our publication as we grow and evolve.


AUTHOR AFFILIATIONS

1Editor in chief, CAND Journal

ACKNOWLEDGEMENTS

Not applicable.

CONFLICTS OF INTEREST DISCLOSURE

I have read and understood the CAND Journal’s policy on conflicts of interest and declare that I have none.

FUNDING

This research did not receive any funding.


Correspondence to: Dr. Marianne Trevorrow, MA, ND, Canadian Association of Naturopathic Doctors, 20 Holly Street, Suite 200, Toronto, ON M4S 3B1, Canada. E-mail: drmtrevorrow@cand.ca

To cite: Trevorrow M. Editorial: Refocusing on Inclusion. CAND Journal. 2022;29(3):1-2. https:/doi.org/10.54434/candj.126

Received: 11 August 2022; Accepted: 11 August 2022; Published: 22 September 2022

© 2022 Canadian Association of Naturopathic Doctors. For permissions, please contact candj@cand.ca.


CAND Journal | Volume 29, No. 3, September 2022

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