The legal and political identity of Homeopathy.

 

Overview

 

Homeopathy has been practiced for over 200 years, and since its inception has adhered to a basic set of principles and practice as established by Samuel Hahnemann in the late 18^th century.  This extraordinary consistency and identity of homeopathic practice has clearly identified homeopathy as a unique form of medicine.  However, in this time it has never defined itself legally and politically as an independent profession but has existed as a method of treatment within the broader umbrella of general medicine or as a medical art practiced by those outside of medical licensure or by other health professionals.

 

Its lack of recognition within general medicine and the general lack of legal recognition for its practice outside of medicine have led to the relative marginalization of homeopathy within the larger health care movement.  In other countries it has garnered more respect, either in cultures in which scientific materialism does not hold such sway, such as Brazil, Mexico or India, or in countries that allow the practice of homeopathy outside of medical licensure e.g. the UK, Holland, Canada, Israel, Norway, Australia and New Zealand.  The result of this marginalization has been a profession without a clear identity, struggling for recognition as an independent and legal profession.

 

The legality of homeopathy in the United States is an issue that concerns both licensed and unlicensed practitioners of homeopathy.  Whilst it would seem that unlicensed practitioners are more at risk of being accused of practicing medicine without a license, licensed practitioners, including MD’s, take the potential risk of being accused by their own licensing boards of practicing a system of healing outside the scope of practice of their license.  Whilst the specter of illegality has fallen more on the unlicensed professional homeopath, the fact remains that in the United States, many licensed practitioners are also at risk.  The current legal situation can be generally summarized as follows: homeopathy is not medicine when practiced by a medical doctor or other licensed practitioner, but is medicine when practiced by a non-licensed practitioner.

 

Current legal developments.

 

However, there are currently two legislative agendas that potentially impact homeopathic practice:

a)     The Health Freedom Movement that is seeking to define the rights and freedom to  practice many alternative therapies.

b)     The Naturopathic Medicine movement that is seeking to establish licensure for naturopathic doctors in a number of states.

 

Homeopathy has always been part of the scope of practice of naturopathic doctors but the issue of licensure bills brings up several questions.

 

1)     Is the licensure movement in Naturopathic Medicine going to legally subsume homeopathy under the umbrella of Licensed Naturopathic Medicine?

2)     Does restricting the practice of homeopathy in general only to those licensed in another healing art help homeopathy or does it threaten the identity of homeopathy as a unique model of healing?

3)     Does the Health Freedom Movement and practice by dedicated, talented but unlicensed practitioners have a place in promoting, developing and safeguarding the practice of excellent homeopathy?

4)     Should the homeopathic profession seek other legal means to define itself as an independent profession?

 

Who should be able to practice homeopathy in the United States?

 

It should be open to anybody who can safely and competently practice homeopathy.  It should not be restricted to one group or profession or regulated by medical licensure.  A poorly trained licensed practitioner is no compensation for someone who has trained hard and who shows proven competency in homeopathy.

 

There are many dedicated and excellent practitioners who are licensed as naturopaths, medical doctors, nurses, acupuncturists, physician’s assistants, chiropractors, vetinarians and others.  There are also a large and growing number of effective, dedicated non-licensed homeopaths that practice in this and many other countries.  The emergence of professional non-licensed homeopaths as a distinct community and profession in the United States follows the development of homeopathy in other countries, including Canada and the United Kingdom.

 

Given the current diversity of homeopathic “identities” there is a need to develop homeopathy as an independent, legal profession, equal to many others and to employ the institutional and legal means to achieve this.  While the integration of homeopathy into other medical professions makes sense, considering its historical identity as part of medicine and also naturopathic medicine, that is not enough to ensure its survival.  Homeopathy should not be seen as only one specialty amongst many other modalities.  Homeopathic education in medical and naturopathic institutions will not be adequate to guarantee competence.  Recognized full-time homeopathic training programs are the best way to train homeopaths effectively and professionally.  The core criteria for the mandate to practice should only be the ability to practice safely and competently.

 

What are the implications for homeopathy with the passing of scope of practice licensure bills for naturopathic medicine and other medical systems?

 

Licensure bills carve out specific legal domains of practice, ostensibly to protect the public from danger.  When licensure bills are created, they usually define scopes of practice for the profession being licensed, and exemptions and penalties for those practicing any of the modalities within that scope of practice.

 

Most would agree that licensure is necessary when potentially dangerous modalities are being practiced and that educational standards can be enforced through a regulated profession.  However, a problem arises if licensure limits a particular therapy to one specific profession, especially when there is little risk involved in that therapy, one of the main reasons for licensure in the first place.  This issue relates to the definition and practice of homeopathy within naturopathic medicine and also within conventional allopathic medicine.

 

To use the example of naturopathic medicine: most naturopathic students gain a maximum of 150-200 hours of homeopathic training.  Homeopathy is but one of many modalities taught.  One of the criticisms of the naturopathic model is that it is too broad, with no opportunity to truly explore systems as complex as homeopathy.  Most qualifying naturopaths don’t practice homeopathy, or only a little, and in general homeopathy does not hold great sway within Naturopathic Medical Schools, in spite of the committed efforts of homeopathic teachers.

 

There are however some excellent homeopaths that have through come through naturopathic training.  The more relevant issue though is what is the future for homeopathy if it is seen and becomes the exclusive domain of Naturopathic Medicine or medicine in general. It will likely be relegated to being just one modality of many under another legal umbrella, being marginalized once more under an environment that doesn’t fully recognize the energetic paradigms of homeopathic thinking.

 

The history of various health professions once they become licensed and “integrated” into more mainstream medicine is not good.  Osteopathic Manipulation has nearly disappeared since they gained recognition as a medical license, most osteopaths practicing conventional medicine.  Midwifery has suffered greatly whilst under the mandate of conventional medicine.   There is a great challenge to retain the integrity of the philosophy of the practice whilst existing in an allopathic medical orthodoxy.

 

This is the challenge for homeopathy now as it has always been.  Homeopathy is a system of medicine based on holistic principles and guidelines.  The application of these principles is the cornerstone for the survival and health of homeopathy.  Greater social and medical recognition at the expense of these principles is not acceptable.

 

Legislation: This is where the philosophical rubber hits the road.  Where do we stand?

 

Last year, a Naturopathic Medicine Bill passed in Kansas.  Although defined as a registration bill, it is in all but name a licensing bill.  The passage of the Kansas Bill has meant that all practicing naturopaths who are not licensed are not able to practice their craft.  This bill is limiting to professional non-licensed homeopaths as well.

 

There are currently four naturopathic licensing bills under consideration in different states: California, North Carolina, Florida and New York.  Three of them are scope of practice bills, whilst the California bill is defined as a Title Act.  Although each of the bills is different, designed to satisfy the political situation of each state, the scope of practice bills especially are a threat to homeopathy as they seek exclusive rights to much or all of “natural medicine”, which would include homeopathy.

 

Therefore, if these bills pass as written, only licensed practitioners would be able to practice homeopathy.  The Florida bill is particularly aggressive as it is seeking prescribing privileges similar to a medical doctor and also making it a felony offense for the unlicensed practice of naturopathic medicine, including homeopathy.

Both the New York and North Carolina bills are seeking a similar exclusive domain of practice and all these bills have been pushed forward aggressively without any consultation with the homeopathic and other natural medicine community.

 

In California it is a different story.  The Naturopathic bill being proposed is being represented as a Title Act, which in theory means that they are only seeking domain of the title Doctor of Naturopathic Medicine, not trying to carve out an exclusive domain of practice.  However, they still do have scope of practice language in the bill.  They make reference in their bill to the Health Freedom Bill, SB577, which passed the legislature last year, protecting the practicing rights for non-licensed practitioners.  Whether they would have written a bill acknowledging these rights if SB577 had not been passed is an interesting question.  Given the type of other naturopathic bills and the history of licensure in general it is doubtful.  When it comes to legality and licensure, the tendency is to grab as much territory as possible.  However, a Title Act is much more compatible than licensing bills that seek to have exclusive rights and in theory is not inconsistent with the principles behind the Health Freedom Movement.

 

It should be of concern for the homeopathic community that homeopathy could be legally subsumed under the umbrella of naturopathic medicine or any other medical licensure that is not primarily homeopathic.  The huge resurgence of interest in homeopathy in the last few years has come from the non-licensed community.  Most schools training homeopaths are made up of this group.  The financial survival of homeopathic organizations and pharmacies is dependent on this part of the profession.  The largest certification and registration organizations have a majority of professional non-licensed practitioners. It is imperative therefore that we protect the rights of practice for ALL homeopathic practitioners and not limit homeopathic practice to any one profession.

 

There is an onus on the whole homeopathic community now to look at how we want to see homeopathy in 10-20 years.  We need a strong, independent, vital profession that has as great a popularity as any other profession, one that is identifiable as an independent profession, available to all.  We cannot wait and watch homeopathy continue its existence on the margins of legality and acceptability.

 

There is now a huge groundswell away from the limits of allopathic medicine.  People are looking for alternatives and homeopathy is not yet institutionally ready to answer the call.  It is imperative for the profession to acknowledge that homeopathy will only evolve if we can have the vision of homeopathy as an independent profession and one that recognizes the vital contribution of the professional non-licensed community.  Insisting that homeopathy should only be practiced under existing medical and naturopathic licensures will doom homeopathy to insignificance and that would be a tragedy for the profession and for the whole of society.

 

We now have an opportunity to make a difference.  This will only happen if the profession stands behind this vision.   It is unacceptable for professional non-licensed homeopaths that have years of training and experience not to be fully recognized within the homeopathic profession.  The excuse of illegality and apparent lack of medical training is not an acceptable excuse.  The growing Health Freedom Movement is only recognizing what is already happening – thousands of people are out there every day practicing homeopathy and doing it well.