Regulating practice at the margins: Türkiye's sequential policy response to unlicensed traditional, complementary, and independent health service provision, 2025-26.

Abstract

Türkiye's foundational health-professions law (1928) concentrates clinical authority in licensed physicians. A 2014 regulation moved traditional and complementary medicine (T&CM) from prosecutable practice into lawful, certified-physician-only provision, centralizing supply. Demand-reported by 14.7%-60.5% of patients nationally-has outgrown this framework. Physicians hold exclusive T&CM authority yet face structural disincentives to exercise it: the public performance-payment system values a 30-minute T&CM session the same as a 2-minute prescription renewal. Unmet demand migrated to unlicensed providers. Interviews with 58 T&CM service providers across Türkiye's seven regions, completed just before these reforms, documented provider-reported harms in unlicensed provision, including scarring from improper cupping, reuse of unsterile instruments (including using a leech across multiple clients), and deaths caused by thermal sulphur gas, as well as a reactive, complaint-driven inspection system. In response, the Ministry issued three sequential regulations: licensed Health Professional Service Units (March 2025), licensed medicinal herbal teas restricted to pharmacies (2 July 2026), and licensed Wellness Centres encompassing T&CM as explicitly non-curative services (4 July 2026). All share one logic: new licensed, traceable channels for contested activity rather than tightening enforcement or deregulating. Early signals include active licensing uptake among allied health professionals; the wellness framework is only weeks old; this article is an early policy analysis, not an impact evaluation. The case offers a transferable instrument for health systems facing tension between physician-centred scope-of-practice law and rising demand at the margins of clinical practice, while suggesting that legal permission without financing reform may leave the underlying supply gap intact.