WHAT IS CAM?

Complementary and Alternative Medicines (CAM) are health services that are not considered to be part of conventional medicine, and include modalities and practices that extend beyond the dominant health system of a particular society or culture.  Traditionally, CAM encompasses four domains: (1) whole medical systems, such as homeopathy; (2) mind-body medicine, including music; (3) energy-medicine, including therapeutic touch; and (4) bioelectromagnetic-based therapies, such as pulsed fields.

State professional licensure boards typically become involved in CAM under the following circumstances:

1. Licensed Medical Professionals: A licensed medical professional who elects to utilize CAM therapies by integrating them into conventional medicine may attract the attention of the licensure board if the practice violates licensure standards for acceptable or appropriate treatment;
2. Unlicensed CAM Practitioners: Licensure boards may take action against an unlicensed CAM practitioner for violating the state’s prohibition against the unlicensed practice of a licensed health care profession; and
3. Licensed CAM Practitioner: Where a CAM provider is licensed, the practitioner is subject to restrictions on their scope of practice.  Providing services beyond that scope may result in discipline.

LICENSURE

If you are involved in providing CAM services to your patients, it is important to understand the legislation in your state that regulates the grounds for discipline in the health care profession.  Some states, such as North Carolina and Georgia, have passed legislation that generally accommodates the use of CAM by licensed physicians, while other states take a practice-by-practice approach, authorizing particular CAM interventions on an individual basis.  A few states have taken a more welcoming approach to alternative treatments by passing legislation that requires CAM practitioners to be represented on licensure boards.  While states take differing approaches in their treatment of CAM services, courts will likely give deference to any applicable state rules, regulations, or statutes.  Therefore, when a malpractice claim is brought against a CAM provider, the court will strictly apply state law in determining whether the licensure board took appropriate action against a provider’s license.

Criminal sanctions

It is important to remember that an unlicensed provider who is providing CAM treatments may be at risk for criminal sanctions, as is any physician who aids and abets the unlicensed provider.  Additionally, a physician who facilitates the unauthorized practice of medicine is at risk for license revocation.  Before a licensed provider is quick to dismiss the risk, he or she should consider whether his or her staff members affiliated with the provider’s practice may be performing duties that fall outside of their approved scope of practice, which may result in a malpractice claim being brought against the physician.  It is well worth the time and effort to ensure that staff are acting within the scope provided by state rules, regulations, and any applicable statutes, especially when someone in the practice is providing CAM treatments to patients.

NO CLEAR BOUNDARIES

CAM treatments do not have clear boundaries, and there is no sharp line of when practices move from non-traditional to conventional.  It is wise to think carefully about how and when to incorporate CAM into your practice, and to ensure that in so doing, you are complying with the laws of your state.  Unconventional methods may have valuable results for your patients, and a quick check with your legal advisor will provide peace of mind while providing those treatments.

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^{Content of this article is based largely on information provided in Barry R. Furrow, et al., Law and Health Care Quality, Patient Safety, and Medical Liability 82-110 (West ed., 7th ed. 2013).}

Ariane Sowa, a summer associate at Lewis Thomason in 2018, contributed to this article.