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OVERVIEW
Historically, medical practice in the U.S. originated as a pluralistic model, licensing regular, Homeopathic, and often, eclectic medicine. As new methods evolved, some were relegated to limited licenses, such as drugless practitioners from which many chiropractic boards evolved. In most states however, Homeopathy maintained its domain as a "school of medicine" equal to and freely competitive with allopathic medicine through the turn of the century. In the early 1900s, most medical boards were inclusive and tolerant of competing ideas and methods. Most licensing exams provided for differences in therapeutics and materia medica for Homeopathic, eclectic, and regular medicine. State supreme courts ruled repeatedly that if one could pass the muster of the medical license one could then practice as one wished.
By the 1920's Abraham Flexner's architecture for a new medical education begot the paradigm of modern medicine - chemicals and surgery had been installed as the prevailing means of treating illness. Europe remained untouched by Flexner's influence and Homeopathy continued to grow there as a profession and as a system for home care as well. In America, the newer generation of medical students was funneled into "regular" schools. With Homeopathic physicians disappearing, the legacy was kept alive by the lay people, thanks to the foresight of the American Foundation for Homeopathy's Layman's League begun in the Sixties.
The living legacy of the American Foundation was inherited by its educational off-shoot, the National Center for Homeopathy in 1974. Through study groups and yearly symposia, through the library and the publications, the people of Homeopathy have brought its science and art into the later part of this Century despite the odds that it would be lost forever.
However, the nature of this rebirth results in awkward moments and this is one of them. At this time in America, often the finest Homeopaths, with the greatest learning and understanding, are not licensed physicians. And those physicians who do use Homeopathy often face bias and unequal privilege, if not downright punishment in their professional lives. Lay experts bridle that physicians have any privileges, no matter how limited by bias, that the unlicensed cannot have at all - especially considering that many physicians who practice Homeopathy are not as highly trained in this art as they.
WHAT IS LEGAL PRACTICE?
Beginning in the summer of 2001, unlicensed practice of Homeopathy, free from physician referral or supervision, will be legalized in Minnesota. A first in the nation.
As for the rest of the country, one might argue that if the current licensing laws are silent upon the subject of Homeopathy, then it is not illegal to hang out a shingle as a professional Homeopath and tend your patients happily ever after. Considering that prosecutions of lay Homeopaths are rare, they may be on to something. But before one takes comfort in this theory one should take a closer look: The most decisive way to determine the status of Homeopathy in a given state is to look in the past for signs if the profession was ever licensed there. Then, one should look at the licensing requirements in those early laws and follow them through their evolution over the years until one comes to the point where the significant references are repealed. That is the crucial moment that determines Homeopathy's place as a licensed modality.
We know that in 1919, the American Institute of Homeopathy counted six states with separate Homeopathic medical boards, and 30 states with blended boards. The blended boards held all licensees to the same educational standards excepting the subjects of therapeutics and materia medica, both of which were taught and examined according to the differing schools of practice.
From there, the 1910 Flexner Report has taken its toll socially and Homeopathic practice goes abroad. But, the statutes are generally slow to change, with archaic references lasting into the later part of this century -- references to long gone four year schools and county Homeopathic medical societies still exist in New Jersey law.
The significant point here is that the repeal of most of the old laws regarding Homeopathy were not made in timely response to Flexner or any other trend. Rather, they were made later, as general housekeeping long after the Homeopaths and their sons had left the stage the laws were not silenced in order to de-professionalize the practice. When this is the case, the practice of Homeopathy lands squarely within the practice of medicine whether one considers the Homeopathic assessment to be a diagnosis or not. See selected state histories.
But, landing squarely within the Practice of Medicine does not mean that a method itself is approved or will be tolerated. Currently, eight states have laws which protect the medical doctor's use of alternative therapies including Homeopathy. New Jersey's references, although outdated, would probably still qualify Homeopathy as tolerable. Three states (AZ, CT, NV,) offer an additional Homeopathic license to already licensed physicians. Nevada is unique in that it offers a professional status for "Advanced Practitioners of Homeopathy" who may work in supervised collaboration with an MD or DO Homeopath. Homeopathy may or may not fall within the scope of practice for Chiropractors or Acupuncturists depending upon a combined reading of each states' professional practice, food and drug, and other relevant laws. Pharmacists are licensed to recommend over the counter medications and homeopathic remedies.
OTHER CURRENT CONUNDRUMS
Meanwhile, the Homeopathic pharmacopoeia has been getting short shrift as some states have reformed their drug laws. In Pennsylvania, the definitions of "Drug" and "Official Compendium" were amended in 1972 to no longer include the Official Homeopathic Pharmacopoeia unlike most other states and the Federal Act, which do. The same occurred in Texas in 1985, affecting TFDCA. As a result, a Texas physician was harshly disciplined in 1995 for providing a Homeopathic injection with the patient's informed consent! Legislative campaigns are underway in both states to correct the "oversight."
The most ironic situation is probably in New York, where as a result of the 1994 Alternative Medical Practice Act, two Homeopaths have been appointed to that state's medical discipline board, the OPMC. Nonetheless a physician was denied equal opportunity to be retrained for practice deficiencies because, "Since she primarily maintains a Homeopathic practice, practice supervision or monitoring by an allopathic practitioner would not address those deficiencies which the hearing committee felt needed to be resolved." Instead, her license was entirely revoked. |
