The Royal Australian College of General Practitioners (RACGP) issued a statement via the Australian Doctor on 23 Feb recommending their members refuse patient test requests from naturopathic practitioners. The rationale underlying this position is based on protection of members from medico-legal and financial risk that may arise from liability, litigation, or test rebate fees, as well as perceptions of patient safety. A template letter has been developed by the RACGP to send to practitioners outlining reasons for the rejection of such requests for patient testing.
Because concepts of disease causation and clinical care can differ between biomedical and complementary medicine practitioners, it is not unusual for testing procedures to have a different focus between the disciplines. All practitioners work for the best patient outcome and each may identify a particular test as warranted within a patient care plan. This situation is non-problematic if those involved in care agree about the reasons for testing using methods that are suitably sensitive and specific with good predictive value.
Such testing takes place within the confines of the private and public healthcare systems, which differ in their range of legalities and procedural requirements. Naturopathic practitioners in Australia are not able to utilise Medicare-funded testing services for their patients and at present their only options are to request these through those that do have access or use non-rebatable services. This is the reason for the testing requests the RACGP refer to in their statement, and it must be noted their concerns have a sound basis.
It is recommended NHAA members carefully consider testing requests that may be made, and proceed with communication in this area in a courteous, reasoned, and professional manner. Requested tests should have relevance to collaborative care and be based in a sound rationale. Patient shared care is very effective, and interdisciplinary relations are important to this success. Therefore any testing should be undertaken in a cooperative manner where practitioners and patients agree on the aim of these within a shared decision-making model.