State Medical Board Reform
Integrative Practitioners Working Toward a Level Playing Field
Integrative practitioners have had an uphill battle in protecting their right to practice medicine in a manner that assesses the whole patient—mind, body, lifestyle, and genetics. The right to exercise independent judgment in developing a course of treatment for a patient that exceeds the conventional model of care has been under the microscope by the allopathic community for years and many integrative practitioners have paid the price.
Alternative and complementary medicine has been widely accepted in other countries for centuries and used for decades in our own; however, only within the past 15 (fifteen) years has the conventional medical community in the United States been more accepting of the integrative practice model due in large part to increased public interest and demand.
Since the medical community in the U.S. has historically been conventional in its treatments, the entire health system is designed based on one standard of care. Insurance standards, government reimbursement rates, treatments options and state medical board policies are all structured based on the allopathic model.
Be it the U.S. Food & Drug Administration or the Federal Trade Commission in assessing the validity of health claims or state medical boards in determining if a treatment is acceptable, the automatic default question is, “has the conventional medical community validated the scientific studies or accepted the treatment modality?” and completely dismisses any evidence outside mainstream medicine.
ANH-USA has recently focused efforts on state medical board (Board) reform in attempts to level the playing field to ensure all practitioners, including integrative practitioners, have basic fundamental due process rights during a disciplinary proceeding. What has transpired over the years is complete partiality towards conventional medicine to the detriment of an integrative practitioner’s right to practice medicine under a model outside of mainstream medicine that has tremendous benefit to consumers. To effect this change, articulation of more than one standard of care must be offered to and accepted by Boards.
ANH-USA assisted in efforts to reform Boards this legislative session in Texas and North Carolina. Success was in North Carolina—legislation that included measures towards 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—amongst several others—was never reached for a vote prior to the close of the legislative session.
Additional areas of concern with Board reform are patient privacy rights—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 vested interests 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 the expert is knowledgeable of 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 a complaint against an integrative practitioner and the physician has no recourse. Complaints filed by other licensed practitioners or pharmaceutical companies are rarely based on patient harm or even a patient complaint and are usually filed as an attempt to protect a business financial bottom line, which is wholly unfair to a practitioner and a complete abuse of the Board’s purpose. Finally, the cost to defend a state medical board investigation can be astronomical – ranging from thousands to hundreds of thousands of dollars. Due to the serious ramifications that can stem from an investigation – damage to a professional reputation, financial ruin or even loss of a livelihood – state medical board policies must be fair.
A small number of states have implemented legislation that a physician will not be subject to discipline solely on the basis for practicing alternative or complementary medicine. Other states have implemented ‘safe harbor’ legislation that protects healers and other unlicensed practitioners from state licensing Boards. The integrative medicine community is growing and change is occurring. A true shift from our existing ‘one standard of care’ under the conventional medicine model to include the integrative practice model will require federal and state legislative changes, insurance industry changes, state medical board reform, public education outreach efforts, and ongoing consumer support.