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Integrative Practitioners—Still Far From a Level Playing Field

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Integrative practitioners face an uphill battle in protecting their right to practice medicine in a manner that assesses the whole patient—mind, body, lifestyle, and genetics.  The entire U.S.  health system is designed based on a single standard of care.  Insurance rules, government reimbursement rates, treatment options, FDA and FTC regulations and enforcement, and state medical board policies are all structured based on a very narrow allopathic model.

Imagine what it is like to invest so many years and so much money into a medical education and residency– and then to lose your license because you used safe and effective natural remedies that have caused no harm and much good. This happens all too often. And the mere threat of it can and is used to intimidate doctors.

For many years, but also in recent months, we have worked for state medical board  reform. We want to be sure that all practitioners, including integrative practitioners, have fundamental due process rights during a disciplinary proceeding.
This legislative session, we assisted in efforts to reform Boards in Texas and North Carolina.  We had success in North Carolina. Legislation there included measures ensuring basic fundamental due process rights such as timely notice of the complaint, full disclosure of the alleged charges, a six (6) month time limit to complete an investigation, and a right to appeal any public disciplinary action.  The bill in Texas had great momentum but, due to a filibuster, the bill never reached a vote prior to the close of the legislative session.
Board reform is also needed with respect to patient privacy rights, conflicts of interest, and other problems with disciplinary hearings.  Boards should not have full access to patient records without patient consent.  Board members should sign under oath a financial disclosure form to ensure there are no relationships between a Board member and a medical practice, medical device company, or a pharmaceutical company that may influence the decision-making process.
The physician under investigation should have full disclosure of the experts the Board consulted in assessing medical competency to ensure that the expert is knowledgeable about the treatment modality under investigation and to ensure the expert has no financial ties that may influence his/her opinion.  Anonymous complaints prevent the physician from preparing a complete answer and defense.  By allowing anonymous complaints, competitors and pharmaceutical companies can file any complaint against an integrative practitioner and the physician has no way of confronting his accusers.

A small number of states have implemented legislation that protects a physician from being disciplined for practicing alternative or complementary medicine.    The integrative medicine community is growing and change is occurring.  But a true shift from the existing conventional “one standard of care” model to a more integrative practice model will require federal and state legislative changes, insurance industry changes, state medical board reform, public education, and ongoing consumer support.

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