Patients are asking physicians and hospitals to provide specific CAM therapies as part of their conventional care. How should hospital administrators and staff respond? How can they meet patient interests while maintaining patient safety (and managing liability concerns)?

Hospitals venturing into CAM therapies need to be concerned about malpractice on two theories: direct liability and vicarious liability. Direct liability, which is also known as corporate negligence, means that the institution has been directly negligent to the patient. Vicarious liability means that the institution has not necessarily done or failed to do something, but rather, becomes liable for the acts of its employees and other considered its agents.
Institutions are the ultimate “deep pockets” for injured patients and thus would benefit from careful consideration of strategy in integrating CAM therapies. I offer some risk management strategies and suggestions in the books, and also under the Malpractice and Risk Management topic on this blog.
A second important concern is credentialing, as a strong program to credential providers of CAM therapies facilitates overall quality assurance and risk management, and negligent credentialing can be a grounds for malpractice liability. Again, turn to the books or the articles linked under the Licensure and Credentialing topic for more information.
Another helpful resource will be a forthcoming book funded by the National Library of Medicine, in which Mary Ruggie, PhD (a professor at Harvard’s Kennedy School of Government) and I interviewed over twenty-five integrative care centers across the U.S. about strategies they used to overcome social and legal obstacles to integrative care. We summarized some of these strategies and our findings in Cohen MH, Ruggie M. Integrating complementary and alternative medical therapies in conventional medical settings: legal quandaries and potential policy models. Cinn L Rev 2004;72:2:671-729.
In our article, we noted that strategies to gain institutional acceptance included: gradual educational and public relations efforts within institutions; building on existing credentialing processes for allied health providers; reviewing national standards for providers lacking licensure (for example, yoga therapists); involving key players within the institution, including key skeptics and critics, in the process; drawing on existing models within the human resources department; and carefully negotiating authorized scope of practice.