Right now we, as holistic nutritionists, are in the lowest category for lawsuits. This is good for us and keeps our liability rates low. There are a lot of lawsuits happening in the alternative profession currently and one of the biggest issues is the use of supplements. Now there are two reasons for this:

1: Therapeutic dosing - which involves exceeding the dosage recommended by the supplement company on the bottle. We, as holistic nutritionists,  are not authorized to do this and still be within our scope of practice and if a practitioner should do this, and he/she were sued, the insurance company would cancel the insurance. If too many of us did this - it would cause the rates for all of us to go up, assuming they ever allowed it as part of our policy. Most holistic nutritionists should be professionally educated enough to know this is not in our scope so this is unlikely to occur.

 2. Supplements Not Registered With Health Canada: This is a more likely occurrence. Insurance companies will cover us for the use of supplements if they are regulated by Health Canada and have their NPN numbers or are at least in the process of getting them as it well known there is a backlog of processing applications. The companies that are more than likely not going for their NPN number are MLM companies and professional lines from the US often sold only in practitioners clinics and not sold at health food stores and pharmacies. These products are easy to spot as they usually do not have proper ingredient labels, again something else that could put a practitioner at risk of being sued.

Politics notwithstanding, the reason the insurance companies value the NPN process is that the applications involve verifying manufacturing quality of a product and validating the research involved in making the product. Health Canada does not verify that a product is effective. They are only granting NPN numbers to verify safety of use for the product and this is what insurance companies care about. We may debate whether they are erring on the side of caution too far but this is who the insurance companies have chosen to rely on and that is what we need to know.

What are the legal implications?

First let's be clear. If  a practitioner recommends  a supplement and the client has a reaction to it, as long as the practitioner has not exceed the amount recommended on the bottle, a  good quality supplement company will have liability coverage that protects practitioners who are their customers. If you are not sure if a company that you use in practice has this type of coverage, call them and ask. We have spoken with several and they all do but they are all companies that either have NPN numbers for all their products or are in the process of getting them. If you exceed bottle recommendations, their coverage may not cover you.

However, if a company does not have an NPN number for the product you are recommending or is not in the process of getting one for the product, and you are sued, even if they have coverage for you as a practitioner, your liability insurance could be cancelled your coverage or your rates could go up and it could have bigger implications for the profession causing the rates to go up for the entire profession, if it starts happening often enough.

What are your best options?    

1. Check to see if the supplements you recommend have NPN numbers or ask if the company is in the process of obtaining them. As a general rule, if a supplement is sold at a health food store or pharmacy, it is more than likely either for them to have an NPN number or be in the process of getting it. This includes professional lines such as Metagenics, product lines from distributors such as Preferred Nutrition, individual supplement companies like Trophic, Garden of Life and New Roots Herbal and even small companies like Nova Scotia Naturally and many others are all submitting product applications to Health Canada and have obtained or will obtained their NPN numbers. They are taking this process seriously and we should respect the time and cost it takes for them to do this and understand this represents their commitment to make a quality product.
2. Some companies are starting to post the NPN numbers for their products as part of the product information on their website or at the very least having more of a general discussion as to how they are proceeding with obtaining them. You are supposed to be able to look up who is registered on the Health Canada web link but it difficult to do so without product specifics but you can learn more about the process and why you should respect the companies who take the time and expense to go through it
3. If you are going to sell supplements, make sure this is covered under the general liability coverage of your policy as this is a part of business coverage and not practitioner coverage. Check with the company that their policy covers you both as a seller and as a practitioner.
4.  And finally, do not underestimate the benefit of food. One of the reasons therapeutic dosing is needed by other practitioners is that they do not do enough to work with clients and their diet. They, at best, hand them a list of what to eat or avoid. We have protocols that are much more food -based. This takes pressure off the supplements to do all the healing. As a profession, the more we understand this and focus on improving our ability to have compliance with food for clients, the more we can show other practitioners how to work with us and give us referrals and build our place in the healthcare field. In the meantime please be aware of the legal realities of recommending supplements. If you are going to sell supplements, make sure this is covered under the general liability coverage of your policy as this is a part of business coverage and not practitioner coverage. Check with the company that their policy covers you both as a seller and as a practitioner.