BACKGROUND: Questions about the risks and regulatory requirements of naturopathy and western herbal medicine (WHM) in Australia prompted research by the Department of Human Services Victoria. This article offers findings from a survey of education providers, which was one of several studies carried out for the report. (The full report can be found at http://www.health.vic.gov.au/pracreg/naturopathy.htm.) METHOD: Questionnaires were sent to 43 Australian providers of naturopathy and WHM education. RESULTS: Unsustainable variation was found in award types, contact hours, clinical education, length of courses, and course content. CONCLUSIONS: Naturopaths and WHM practitioners are primary contact health professionals but educational standards vary widely, with some practitioners not likely to be adequately prepared. The degree of risk in their practice, and the need for better integration of complementary care with mainstream healthcare, require education at least to the level of a bachelor degree. Courses should be subject to independent external accreditation. However, attempts to determine appropriate minimum educational standards are unlikely to succeed without the support of a regulatory system that can mandate those minimum requirements.

McCabe P. School of Public Health, La Trobe University, Bundoora 3086, Victoria, Australia. Complement Ther Clin Pract. 2008 Aug;14(3):168-75.

OBJECTIVES: To compare outcomes in perception of pain and disability for a group of patients suffering with chronic low-back pain (CLBP) when managed in a hospital by either a regional pain clinic or a chiropractor. DESIGN: The study was a pragmatic, randomized, controlled trial. SETTING: The trial was performed at a National Health Service (NHS) hospital outpatient clinic (pain clinic) in the United Kingdom. SUBJECTS AND INTERVENTIONS: Patients with CLBP (i.e., symptom duration of >12 weeks) referred to a regional pain clinic (outpatient hospital clinic) were assessed and randomized to either chiropractic or pain-clinic management for a period of 8 weeks. The study was pragmatic, allowing for normal treatment protocols to be used. Treatment was administered in an NHS hospital setting. OUTCOME MEASURES: The Roland-Morris Disability Questionnaire (RMDQ) and Numerical Rating Scale were used to assess changes in perceived disability and pain. Mean values at weeks 0, 2, 4, 6, and 8 were calculated. The mean differences between week 0 and week 8 were compared across the two treatment groups using Student's t-tests. Ninety-five percent (95%) confidence intervals (CIs) for the differences between groups were calculated. RESULTS: Randomization placed 12 patients in the pain clinic and 18 in the chiropractic group, of which 11 and 16, respectively, completed the trial. At 8 weeks, the mean improvement in RMDQ was 5.5 points greater for the chiropractic group (decrease in disability by 5.9) than for the pain-clinic group (0.36) (95% CI 2.0 points to 9.0 points; p = 0.004). Reduction in mean pain intensity at week 8 was 1.8 points greater for the chiropractic group than for the pain-clinic group (p = 0.023). Conclusions: This study suggests that chiropractic management administered in an NHS setting may be effective for reducing levels of disability and perceived pain during the period of treatment for a subpopulation of patients with CLBP.

J Altern Complement Med. 2008 Jun;14(5) Wilkey A, Gregory M, Byfield D, McCarthy PW. Private Practice, Oldham, United Kingdom.