The following rebuttal is written by Stephen Carter on behalf of Pure North in response to the July 20 column, “Behind the Curtain” by Ricardo Acuna.
The story, Pure North Case exposes the depths of cronyism and influence by wealth in Alberta by Ricardo Acuna was, unfortunately, just a summary of old CBC stories. Regrettably, Acuna imported all of the errors from the original series.
It is correct that Pure North health professionals often prescribe vitamin D in quantities greater than Health Canada guidelines. Health Canada provides a one-size-fits-all recommendation for people who are not necessarily under medical supervision. The TOP guide (Toward Optimized Practice), which provides direction to Alberta physicians about medical treatments, advises that higher “booster” amounts in weekly or monthly doses are perfectly safe; and that patients may require higher doses due to vitamin D insufficiency or circumstances such as obesity, older age, dark skin, or restricted exposure to sunlight. Pure North and Precision Health treat individual patients. Health Canada does not.
Pure North also knows that the appropriate measure for adequate vitamin D is not intake (because the largest contributor is sun exposure), but blood serum 25(OH)D concentration with a target of 125 to 250 nmol/L. TOP specifies that side effects are not expected unless blood level routinely exceeds 500 nmol/L.
In short, Pure North’s recommendations for vitamin D are individualized to the patient, consistent with Alberta medical guidelines, prescribed and monitored by health professionals, and measured regularly to ensure safe blood levels. The allegation that this treatment may put patients at risk is flat out wrong.
Pure North does not prescribe any other vitamins or minerals in excess of Health Canada’s recommendations.
The stories further allege there is no peer-reviewed research showing vitamin D therapy does any good. A high school student with Google could correct that error. Dozens of international studies show measurable correlations between vitamin D and chronic diseases such as diabetes, metabolic syndrome, cancer, depression and multiple sclerosis. A hospital program in South Carolina is proving that vitamin D reduces premature births by 60 percent. Vitamin D’s promise results in scientists undertaking new research regularly and over 70,000 scientific publications. Simply, vitamin D is a safe and inexpensive therapy with some proven and other potential benefits for a range of health issues.
The allegation that the provincial government rushed Pure North funding inappropriately is also wrong. This so-called rushed decision took 16 months, involving extensive discussions with health bureaucrats to work out the program’s optimal design. The fact that officials like Carl Amrhein encouraged the program is a positive: senior, experienced health bureaucrats recognized the potential for lowering health costs through prevention. Amrhein’s personal participation in Pure North is proof that he believes it works. Why would he subject himself to a therapy he believed was harmful, experimental or ineffective?
Claims that the seniors’ program was not subject to ethics screening is also wrong. Medical practitioners at Pure North are subject to oversight by their professional colleges, as is the case for doctors all over Alberta. Pure North is not a research institute. Pure North and the government agreed to provide aggregate, anonymized data (with patients’ explicit permission) to the University of Calgary so that the government would have an objective measure of the program’s outcomes. University scientists obtained ethical approval for their research.
The analysis, by the way, published by U of C economist Dr. Herbert Emery, found that for every dollar invested in the seniors’ program, $2.36 was saved in health care costs such as hospital stays.
The Precision Health clinic, for which additional government funds were later provided, is completely separate from Pure North and its seniors’ program. Precision Health offers what every clinic in the pilot project offers—the ability for Nurse Practitioners to see patients, diagnose, treat and prescribe. The objective of this pilot is to reduce medical costs by allowing nurse practitioners to perform many of the duties currently limited to doctors. It is a good program. It is unfortunate the government terminated funding for Precision Health because CBC’s reporters, with no medical training, disagreed with a nurse practitioner’s prescribed treatment. It is a poor way to make decisions about public health funding.
Both Pure North and Precision Health are programs of merit. That can be proven with facts in evidence. Allan Markin should be applauded for his philanthropy. He has spent over $250 million of his own money to ensure at-risk patients receive adequate nutritional counselling and supplements, populations that otherwise would have no access to such services. Preventive health programs help people feel better and live longer, and save the health system millions in treatment costs.