CAMLAW: Complementary and Alternative Medicine Law Blog : Complementary, Alternative, & Integrative Medicine Law, Regulation, Ethics & Policy (Alternative and Complementary Medicine, Medical Spa Information, Holistic Health Attorney, and Legal Resources)

Keith L. Martin has written a lengthy piece for Physicians Practice outlining some of the issue as follows:

Many CAM approaches — encompassing everything from use of probiotics, meditation, acupuncture, massage therapy, and energy medicine — have long histories, but their use alongside mainstream medicine is still evolving, especially when it comes to physician acceptance.

"Physicians are appropriately, I believe, thinking hard about which of these practices are useful to people and which are dangerous," says Josephine P. Briggs, NCCAM's director. "Our goal at the NIH is to make sure there is good science being done so that these distinctions can be made and so people can base this on real evidence."

Originally called the Office of Alternative Medicine when established in 1992, NCCAM's creation, Briggs says, was based on "heavy use by the American public" and "a feeling there were some health practices the public wanted to know about."

With those practices have also come rules, in the form of state laws and licensure about who is able to perform CAM treatments. CAM credentialing varies from state to state and by method. For example, all 50 states and the District of Columbia require licensure for chiropractic practitioners, while only 42 states and D.C. have licensure rules for acupuncture, according to NCCAM. Then you have licensure for homeopathic physicians, present in only three states.

Martin quotes from our interview:

Michael H. Cohen, an attorney specializing in legal issues for physicians and CAM practitioners based in California, says that the growing number of state laws and licensure does legitimize the use of CAM. But he also notes practitioners still need to be wary of "broadly drafted medical licensing laws" and the threat of regulatory and legal sanctions for unlicensed medical practice. "Ignorance of the law is not a defense," Cohen says...

Know your state laws. Cohen, who authors a blog on complementary medicine (www.camlawblog.com), advises a thorough review of state and local laws regarding CAM and perhaps consulting with an attorney who specializes in CAM law.

He notes several states that have "corporate practice of medicine doctrines," prohibiting nonphysicians from creating partnerships with physicians. In California, he notes, the state medical board also openly opposes arrangements between doctors and "medi-spas," with the threat to sanction physicians involved in such relationships.

"The best tip is not to enter into a business arrangement without legal advice, naively assuming that it will all work out for the best," he says.

I would just add that the legal issues surrounding medical spas are complex.  State medical boards do not necessarily oppose such arrangements, but they are concerned about potential violations of the corporate practice of medicine doctrine that essentially result in rent-a-license arrangements between medical spas and doctors.  For more information, see the Spa Legal Issues section of this blog.