Barriers and Facilitators to the Inclusion of Naturopaths in Interprofessional Health Care Teams: A Scoping Review.

Abstract

Objective: The growing population of individuals with chronic pain presents a challenge to a globally overburdened health care workforce. Naturopaths are trained as primary health care providers who manage patients with chronic pain and, yet, are often overlooked in health care teams. This scoping review aims to identify barriers and facilitators affecting naturopathic inclusion into interprofessional health care teams managing patients with chronic pain. Methods: This study protocol was registered a priori through Open Science (https://doi.org/10.17605/OSF.IO/2G3JT). A search was conducted using databases AMED, CINAHL, MEDLINE, SCOPUS, Web of Science, APA PsycInfo, and Health Business Elite. Search limits included English language from 2012 to 2023. Included publications were from academic and gray literature. Search terms used included the following: "Naturopath*" OR "Integrative medicine" AND "Health care system*" OR "Health system*" OR "Models of health care" OR "Professional autonomy" OR "Professional regulation" OR "Professional govern*" OR "Interprofessional practice (IPP)" OR "Multidisciplinary communication." The scoping review utilized Covidence software and was analyzed using thematic analysis. Themes were identified following Arksey and O'Malley's (2005) framework to inform a narrative approach. Results: Five themes emerged that relate to the inclusion of naturopaths in health care teams as follows: (1) perceptions of naturopathy, (2) practice standards, (3) legitimacy, (4) resources, and (5) shifting power dynamics and cooperation. Conclusions: Barriers for naturopathic inclusion into health care teams are influenced by perceptions of naturopathy, naturopathic education standards, regulations, research, and patient equity and access. Facilitators for inclusion include the growing shift toward person-centered care, greater interprofessional education, and shared assets, including colocation.