As a practitioner of “alternative medicine” I have often questioned what exactly is alternative, from the conventional system, about the medicine I am practicing. While there are differences in the therapies I use and some differences in the principles of practice, the most consistent difference I see, for a naturopathic doctor practicing in Canada, is the distinction between public and private health care.

For readers abroad, Canada has a socialized health care system whereby all residents have provincial health insurance provided by a single government agency. In Ontario this is called the OHIP (Ontario Health Insurance Plan). Provincial health insurance covers the cost of almost all conventional medical services and most in-patient treatments, including surgery and drugs, but generally not outpatient prescriptions. No resident is denied coverage irrespective of their medical condition or family history. This public system ensures that every person, rich or poor, has access to life-saving interventions and can be assured of equal and fair treatment regardless of their financial status. This is without a doubt one of greatest benefits of being Canadian!

As Canadians, we pay a lot for our socialized medical system and, for some, paying for private health care may seem like a luxury. However while the public system ensures a minimum level of health for all, it is unreasonable to expect that it could afford to provide an optimal level of health for everyone. This, I believe, is not the responsibility of a socialized medical system and should therefore be the responsibility of the individual. 

This is where the concept of private medicine becomes relevant. People deserve the right (and in my in opinion, owe it to themselves) to seek a higher level of health than the standard set by the public health care system. And so, in increasing numbers people are seeking personalized, private health care to improve their health and wellbeing. This is where I believe alternative medicine fits into the picture. Alternative health care practitioners offer a service: providing private health care for people who seek a different approach than the one provided publicly.

The challenge I find as a new practitioner is that many people are not accustomed to allocating monetary value to the time spent with a doctor. From the patient’s perspective, whether you see your family doctor or your cardiothoracic surgeon, it is all free. Of course, it isn’t really free; given the high level of taxation residents of Ontario enjoy, the term “pre-paid” would be more accurate. Nevertheless, patients have the privilege of seeing a highly trained medical professional (who has invested hundreds of thousands of dollars and many years into their training) and walking out of the office without even knowing how much the visit cost the health care system. So is it any surprise that these same people are reluctant to spend money on time with an “alternative doctor”?

Now this point requires clarification because the concept of time is key. People are willing to pay alternative practitioners for “natural” solutions to their problems; and they are willing to spend money on pills, liquids, needles and physical modalities because they are used to having to pay for treatments (most often prescriptions). I see many patients who will eagerly spend hundreds of dollars on laboratory tests like food allergy sensitivity who would never spend $100 for 1 hour with a professional to address the stressors in their lives that are likely the biggest cause of their issues.

It is the merit of time spent with the provider that I find is undervalued. If you bring your car to a mechanic you pay for $60 -$90 per hour for diagnostics and labor in addition to parts. If you see a psychologist you pay around $100-150 per hour to speak to another human being. In 2009the average hourly rate to speak to a lawyer was over $450! So why do patients baulk at the concept of paying for medical advice? Not medical procedures or treatments, advice?

The irony is that the time we spend with our patients is one of our greatest strengths. It is exactly this that sets private medicine apart from public medicine: the freedom to spend more time assessing, empathising, educating, and encouraging our patients. And patients do, without a doubt, appreciate these things but most don’t seem to value them. In fact, that by virtue of their appreciation one might infer that patients feel they are getting something extra, a courtesy perhaps, for which they did not pay. This perception undermines the value of what we do.

In order for patients to begin to value these services, patients need to start thinking of OHIP as life insurance instead of health insurance. Health insurance needs to be a personal investment, through health promoting choices, into our own present and future wellbeing and vitality. Sadly, most people invest more per year in auto insurance than this kind of health insurance. As practitioners we need to shift this perception, first acknowledging to ourselves the value of the time we invest in patient care, and next by communication and demonstrating the importance of our time to patients through our words and our actions.