What are
complementary and alternative therapies?
Complementary and alternative therapies, also referred to as CAM
(Complementary/Alternative Medicine), include therapies outside
the realm of allopathic (drugs/surgery/radiation) medicine. These
therapies include but are not limited to homeopathy, herbal therapies,
exercise/movement, vitamins, relaxation methods, lifestyle, diet,
imagery, energy healing, biofeedback and folk remedies (remember
your mother’s chicken soup for a cold?). CAM emphasizes preventive
and natural practices. Natural practices include healing modalities
that work with and enhance the body's inherent ability to heal.
Healthcare activities that involve a real danger of significant
harm are regulated and licensed by the state, and for that reason
are prohibited under this Act.
CAM may be used with allopathic medical care or used as an alternative
to allopathic medicine, such as massage instead of a sleeping pill,
hypnotherapy instead of a nicotine patch or homeopathy instead of
anti-histamines.
CAM practitioners
are currently practicing in Georgia. Why is this law needed?
Under the current law, most CAM practitioners can be found to be
in technical violation of the law because state licensing boards
might consider their activities to be the “practice of medicine”
or the "practice of another licensed modality. Georgia does
not recognize unlicensed healthcare professions and may use the
full force of the state's police power to suppress these healthcare
practices. In fact, CAM practitioners can be prosecuted even if
their practices have nothing to do with medicine in the conventional
sense and they have caused no physical or mental harm.
This policing action
has had a chilling effect on the growth of healthcare choice in
Georgia - at a time when more people than ever are seeking preventive
and natural, non-toxic, non-invasive healthcare. These state policies
curtail consumer freedoms by putting all natural practitioners,
as well as those doctors and institutions that would hire them,
at risk of closure and prosecution.
There are hundreds of
natural healthcare providers practicing in Georgia with thousands
of clients. The studies of use of alternative healthcare by the
National Institutes for Health and Harvard infer that millions of
otherwise law-abiding citizens may be being pushed outside of the
law by outdated public policy when they choose an unlicensed practitioner
in Georgia.
Because of this legal
threat of prosecution, CAM practitioners have been inhibited and
the public has been deprived of important information. CAM practitioners
are reluctant to hold themselves out to the public, to develop practitioner
standards and to disclose their credentials to clients. Thus, the
public is denied access to information that would allow them to
make informed choices about CAM practitioners and the theories on
which their modalities are based. Existing laws discourage many
individuals from training to become CAM practitioners and slows
the development of CAM practices. These same laws discourage clients
of CAM practitioners, who are also patients of licensed healthcare
providers, from having their licensed providers and their CAM practitioners
communicate with each other. This inhibits integrated care for consumers.
Almost 80% of CAM clients do not tell their licensed provider that
they are consulting CAM practitioners.
Medical licensing laws
in the United States were developed because conventional medical
care utilizes high-risk therapies such as surgery, radiation and
pharmacology.
In Georgia, OCG 43-34-26,
the definition of medicine states:
“If any person shall hold himself out to the public as being
engaged in the diagnosis or treatment of disease or injuries of
human beings, or shall suggest, recommend, or prescribe
any form of treatment for the palliation, relief, or cure
of any physical or mental ailment of any person, with the
intention of receiving therefor, either directly or indirectly,
any fee, gift, or compensation whatsoever … shall be deemed
to be practicing medicine ...” (emphasis mine)
It is this broad language
that is the problem. Under this definition, recommending an herb
is viewed as the practice of medicine. To put it another way, our
current laws do not distinguish between brain surgery and non-invasive
practices that hold no demonstrable risk of harm.
If a CAM
practitioner has formal training and is certified in his/her healing
art, doesn’t that mean s/he can practice legally?
CAM practitioners who have formal training and are certified have
met certain requirements that demonstrate proficiency in their healing
modality. However, certification exams are administered by healing
art organizations themselves and not by the state. For example,
National Guild of Hypnotists certifies hypnotherapists. Whether
or not the State of Georgia licenses a profession is a completely
separate issue … and a business license is yet another issue.
Having a “license”
means that a practitioner is approved by the State to legally practice
within the scope of his/her license. Some CAM practitioners such
as chiropractors are licensed by the state. However, many CAM practitioners
are not licensed, even though they may be well trained, experienced
and certified in their modality. Under the Act, CAM practitioners
who are not licensed by the state will be allowed to practice their
healing arts as long as they do not perform activities that create
a real danger of significant harm to their clients. Of equal importance,
for the first time they will be required to give information to
their clients about their training and experience, including certification
in their modality.
How will
the State
Planning for Increased Community Access Act
benefit Georgia citizens?
The Act frees CAM practitioners to practice openly, while specifying
that they cannot perform certain medical activities or put their
clients at a true risk of significant harm. For example, CAM practitioners
will not be allowed to perform surgery, prescribe legend drugs,
recommend that clients discontinue drugs that were prescribed by
a licensed provider or use or prescribe radiation. For the benefit
of consumers, the Act requires CAM practitioners to disclose to
clients their training and experience, to explain the rationale
behind their method of treatment, to make absolutely clear to their
clients that they are not “licensed” by the state and
to keep records showing that they have disclosed this information
to their clients.
The Act creates an atmosphere
that will improve public safety. (1) the Act explicitly prohibits
CAM practitioners from treating clients in a way that causes or
creates a genuine risk of significant harm and it explicitly forbids
certain medical activities; (2) it requires CAM practitioners to
disclose their training and experience and the rationale behind
their treatment; (3) by allowing CAM practitioners to practice openly,
the Act facilitates the development and growth of organizational
societies for practitioners of those therapies, which will improve
the training and monitoring of their practitioner members; (4) by
bringing CAM practitioners out of the shadows and giving their clients
written information about themselves and their CAM therapy, the
Act encourages and facilitates consumers communication between their
licensed healthcare professionals and their CAM practitioners.
Since some licensed healthcare providers in Georgia can use CAM
in conjunction with their standard treatments, why isn’t that
enough?
Licensed providers are not always trained in CAM modalities, most
are not intimately familiar with the range of modalities and some
do not recognize or approve of CAM modalities. Individuals trained
in CAM modalities are an important source of healthcare to members
of the public. 69% of Americans use CAM modalities, most often for
minor ailments or serious conditions for which conventional medicine
can offer little in the way of therapeutic help. These problems
include chronic pain, anxiety, chronic fatigue syndrome, sprains
and muscle strains, addictive problems, arthritis and headaches.
Over 95% of consumers who now use CAM modalities do so in conjunction
with and not as a replacement for licensed healthcare.
While many physicians
recognize and approve of CAM modalities, 60% of surveyed physicians
referred their patients to CAM practitioners rather than performing
those therapies themselves. Only 23% actually performed CAM modalities
themselves.
What if
a consumer has a problem with a CAM practitioner?
First, the consumer should talk to their practitioner and try to
work out any problem with him or her. If that proves unsatisfactory,
they can contact the practitioner’s certifying/professional
organization. As a last resort, the Act does nothing to stop a consumer
from seeking civil relief against a CAM practitioner or, depending
on the nature of the problem, asking for action by the Georgia Department
of Health, Solicitor General or Composite Board of Medical Examiners.
As always, responsibility
ultimately rests with the consumer, for wisely choosing a practitioner
who has good training, experience and skills. The disclosure and
disclaimer mandates of this Act facilitate this process.
What can
happen if a CAM practitioner practices in a prohibited area, creates
a real risk of significant harm to a client or doesn’t give
a client the written information required?
Any CAM practitioner who practices in a prohibited area (such as
performing surgery) or who creates a real risk of significant harm,
is denied the protections of the Act and may be treated in the same
way they could have been before the Act was passed. The offending
practitioner may be criminally prosecuted, subjected to civil fines,
be ordered by a court to stop the forbidden practices and obliged
to reimburse the State for the costs of legal proceedings against
them.