A cross-sectional workforce survey of three traditional and complementary medicine professions in Ontario, Canada

BACKGROUND: Workforce studies about traditional and complementary medicine (T&CM) occupations in industrialized countries are scant; and, these occupations’ position within the broader occupational workforce remains unclear. This study aims to address these gaps using a comparative approach. METHODS: Naturopaths, traditional Chinese medicine (TCM) / acupuncture practitioners, and homeopaths in Ontario, Canada were surveyed regarding their demographics, practice characteristics and self-reported income. Results were compared with parallel data from within and outside of Ontario. RESULTS: Study response rate: 23.3% (n = 1205). While predominantly female (57.9%), Ontario’s TCM/acupuncture profession was less feminized than the naturopathic (77.1%) and homeopathic (78.3%) groups. Naturopaths were significantly younger than, and reported fewer years of clinical experience than, the other two groups. About half of TCM/acupuncture practitioners, and almost one-third of homeopaths had trained outside of Canada, predominantly in East and South Asia, respectively. More TCM/acupuncture practitioners (58.9%) and homeopaths (57.6%) had multilingual clinical practices than naturopaths (19.1%). Homeopaths worked fewer hours and saw fewer patients per week than the other occupations. Self-reported mean incomes varied across groups, with naturopaths earning more on average ($63,834, SD $57,101) than did TCM/acupuncture practitioners ($45,624, SD $44,081) or homeopaths ($29,230, SD $41,645). Holding other variables constant, internationally-trained practitioners reported earning one-third less than their Canadian-trained counterparts. DISCUSSION & CONCLUSIONS: Study findings echo occupationally-specific data from other industrialized jurisdictions; and, affirm that different T&CM occupations have distinctive demographic and practice characteristics. The demographic makeup of Ontario’s TCM/acupuncture and homeopathy occupations suggests a role for these groups in delivering culturally-responsive care within Asian ethnic communities. T&CM practitioner incomes, in particular for internationally-trained practitioners, fell below the provincial population income median, and in many cases below the poverty line. T&CM occupations’ relative socio-political marginality may be impacting clinicians’ ability to earn a viable living.