Study Committee Minutes – March 22, 2006
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North Carolina Legislative Health Watch
Volume 8, Number 18
Posted: March 23, 2006
BARRIERS TO ALTERNATIVE MEDICINE DISCUSSED
The House Select Committee on Complementary and Alternative Medicine held its first meeting on March 22nd.
ALTERNATIVE MEDICINE PRACTICES ON COMMITTEE’S AGENDA The House Select Committee on Complementary and Alternative Medicine (Committee) met on March 22nd to begin its work by looking at complementary and alternative medicine (CAM) terminology and practices. Chairperson Rep. Earline Parmon (D-Forsyth) announced that the Committee would be “studying the pros and cons of and barriers that limit access to CAM for citizens who want it.” Although the House Health Committee considered a bill relating to CAM in 2005 (H 1303, Consumer Health Freedom Act – sponsored by Rep. Paul Luebke, D-Durham), Rep. Parmon emphasized that “there is no bill currently before this Committee.”
CAM availability in North Carolina and ways to improve consumer access
Mike Causey, lobbyist for a pro-CAM group called Citizens for Healthcare Freedom, pointed to H 1303 as an example of the type of legislation his client supports. He said that at least 18 states have introduced “healthcare freedom” legislation that “protects people’s right to choose alternative health care” and that 6 states have enacted “some sort of health freedom” law. He cited CIGNA
and Blue Cross Blue Shield of North Carolina as examples of carriers that are “leading the charge” to cover CAM services. He estimated that 2-3 million North Carolinians use or are affected by CAM and described what he called the high demand for “natural products” and organic foods.
Mr. Causey yielded some of his time before the Subcommittee to Margaret Bennett, an unlicensed homeopath from Asheville. Ms. Bennett said that there should be exemptions in the Medical Practice Act for “healing arts that are low risk and proven effective here and around the world.” She claimed that access to CAM is “limited” because CAM providers are “threatened with prosecution for practicing without a license.” She said that there was “no safe harbor in North Carolina” for CAM providers “even though there is no risk of harm to the public.” She added that, once legalized in the state, the “marketplace can provide information to patients” about CAM services. To show the effectiveness of homeopathy, Ms. Bennett gave the example of the Spanish flu outbreak of 1918. She said that the mortality rate during that epidemic was 1.05% for people treated with homeopathic remedies and over 28% for people who received conventional
Integrating CAM with conventional medical care
Dr. Douglass Mann, a University of North Carolina (UNC) School of Medicine neurologist, reviewed the history, structure and goals of the UNC Program on Integrative Medicine (Program) – where he is the Director of Clinical Services. He told the Committee that it was important to distinguish between “complementary medicine” which is “used together with conventional treatments such as acupuncture, aromatherapy, and massage” and “alternative medicine” which “refers to the choice made by a consumer to use something other than conventional care.”
Dr. Mann explained that the National Institutes of Health divides CAM “healing strategies” into five major categories:
1) Supplements, vitamins and other dietary strategies.
2) “Mind-body therapies” like biofeedback and hypnosis.
3) “Body therapies” which involve physical contact with the patient like
chiropractic, massage and osteopathy.
4) “Energy therapies” like acupuncture and the use of magnets.
5) “Whole systems of healthcare that are independent of conventional care
systems” like Chinese medicine and homeopathy.
Dr. Mann said that CAM is taught in around 75% of all medical schools in the United States. The UNC Program, which began in 1997, includes teaching, research and patient care. CAM is integrated with conventional care in three UNC clinics: The University Headache Clinic, the Family Medicine Clinic (where acupuncture is practiced), and the Physical Medicine and Rehabilitation Clinic.
Rep. Larry Womble (D-Forsyth) asked about the position of the American Medical Association (AMA) on CAM. Dr. Mann responded that the AMA has supported studying the “efficacy and safety” of CAM services but has not commented on specific therapies.
Rep. Rick Eddins (R-Wake) asked about oversight of CAM services in North Carolina. North Carolina Medical Board’s (Board) Legal Director and Legislative Liaison Thomas Mansfield said that the Board has the statutory authority to seek an injunction from a superior court judge to stop the unauthorized practice of medicine by non-medical providers and may refer cases to the North Carolina Attorney General (to be assigned to a district attorney) for criminal prosecution, particularly under circumstances where people are being harmed. Mr. Mansfield said that the Board has pursued this option two times in the last five years. Mr. Mansfield emphasized that the Board has and exercises more oversight authority over physicians and other licensees who practice CAM.
Dr. Michael Sharp, who was on the UNC School of Medicine faculty for 25 years and started the family medicine clinic in the Integrative Medicine Program, opened his Plum Spring Clinic in 2001 to practice medicine using CAM. He said that he was converted from “believing that only conventional modalities are effective” and noted that while he used to write 50 prescriptions a week when he practiced conventional medicine alone, he now writes fewer than five. He added that he only rarely refers people for surgery any more.
Dr. Sharp described himself as a “fan of Practice Acts” because it is important to define the scope of practice. He thinks that the “vagueness” in how CAM diagnosis and treatment is defined creates an “enforcement problem” for the Medical Board. He supports a CAM Practice Act as a way to help regulate CAM by defining the scope of practice for CAM providers, imposing adequate licensure requirements, and mandating continuing education.
In response to a question from Rep. Susan Fisher (D-Buncombe), Dr. Sharpe estimated that “80% of what he does” in his clinic is covered by insurance – he gave massage therapy as an example.
House Select Committee on Complementary and Alternative Medicine:
Rep. Earline Parmon (D-Forsyth), Chair
Rep. Russell Tucker (D-Duplin), Vice Chair
Rep. Alice Bordsen (D-Alamance)
Rep. Rick Eddins (R-Wake)
Rep. Bill Faison (D-Orange)
Rep. Susan Fisher (D-Buncombe)
Rep. Pricey Harrison (D-Guilford)
Rep. Louis Pate (R-Wayne)
Rep. Fred Steen (R-Rowan)
Rep. Larry Womble (D-Forsyth)
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A Word From Our
I am involved in CHF because of my burning desire for the public to become more educated in natural health, and have the freedom to choose whatever form of healthcare they believe is best. Most importantly, I want to see The Health Freedom Act, House Bill 1303, passed this year to make my above desires attainable.
- Brenda J. Rohrer
ND, MH, CNHP, CST
Links of Interest
Certified Natural Health Professionals of NC
The Coalition for Natural Health
Health Freedom Expo
The American Association of Nutritional Consultants
The Health Action Center
Click HERE for Additional Links