Wednesday, March 7, 2012

Maryland State Law and CAM Providers

I am lucky enough to be able to afford to be treated by a massage therapist either before or after each REALLY long race that I run. (For me, I classify anything longer than a half marathon as a REALLY long race.) My practitioner brought the Maryland 2012 HB0238 and SB0337 to my attention. These are laws that involve the Nursing Board and who needs to be licensed. The synopsis of the bill on the state House website reads:

Exempting individuals who provide gratuitous care for specified individuals from the requirement that an individual must be licensed or certified before practicing specified health occupations; exempting individuals who respond to a disaster situation in the State from the requirement that an individual must be licensed before practicing registered nursing or licensed practical nursing under specified circumstances; authorizing the Board to grant specified licenses by endorsement; etc.

That seems to focus on exceptions to the rule of being licensed.

My practitioner is concerned about the language that refers to the licensed practical nurses. The language reads that a practitioner

" a team relationship an act that requires specialized knowledge, judgment, and skill based on principles of biological, physiological, behavioral, or sociological science to:

(1) Administer treatment or medication to an individual;

(2) Aid in the rehabilitation of an individual;

(3) Promote preventive measures in community health;

(4) Give counsel to an individual;

(5) Safeguard life and health;

(6) Teach or supervise; ..."

Now, these are specifically applied to licensed practical nurses in the language of the bill. However, practitioners like "breathworkers, midwives, doulas, herbalists, life coaches, sound/music therapists, art and poetry therapists, movement, dance, and eurythmy therapists, samyama healing practitioners, meditation teachers, acupuncturists, massage therapists, bodyworkers (reiki, zero balancing, rolfing, etc.) yoga therapists, ayurvedic consultants, counselors and other practitioners of alternative healing arts" might be interpreted as falling under this regulation and then be required to get new licensing that is controlled by the Nursing Board.

I don't know whether there is a hidden underlying intent here. However, consider the following:

(A) a history of conflict among health professions when it comes to scope of practice and control;

(B) an increasing number of nurse practitioners who have to compete for patients;

(C) people having to struggle with insurance and pay more out of pocket despite health care reform; and

(D) a growing number of non-medical providers interested in health and well being.

I think there might be an incentive for nurses (perhaps in collaboration with physicians) to limit the entry of others' into the market for providing services to maintain and improve health and there may be a close relationship between at least some nurses/physicians and both legislators and regulators within the executive branch. Perhaps there is an argument that consumers lack information about providers who are not regulated by the state's Nursing Board (or the equivalent for physicians) but it is not clear that there is a market failure here that needs regulating.

It's worth your consideration--regardless of what state you are in.   

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