Voluntary self-regulation of complementary and alternative medicine practitioners.

The taxonomy of health providers is contested. Allopaths (practitioners of scientific medicine) construct a universe in which there are physicians and non-physicians. That dichotomy is grossly simplistic, since the world of non-physicians covers all types of medicine since time began except for the scientific medicine in the west of the last 130 or so years, and it covers all non-MD practitioners. Scientific physicians began to dominate the regulatory space in each of the states in the late 19th century, and by about 1930 they had succeeded in eradicating in the public mind almost all authority in other forms of medicine and in non-MD health workers. Scientific non-physician health providers (aka allied health workers) have carved out a regulated space, but many other non-physician providers practice in a gray regulatory world, neither regulated or unregulated, or, in other states, their practices could be constructed as illegal because of the breadth of the exclusive physician scope of practice. Some non-scientific practitioners are trained in non-scientific schools of medicine. The main comprehensive non-scientific schools of medicine are Traditional Chinese Medicine, Ayurveda and Homeopathy. These schools have their own languages and theories, theoretical and practical literatures, medicines, schools, professions, and histories that date into pre-scientific times. From a philosophical point of view they are on par with allopathy (scientific medicine), but with different identities. I explore homeopathy, and discuss its regulatory status and the sociological problems that contribute to its institutional weakness, even though it is and was primarily practiced by physicians. I suggest the homeopathic community should seek state sanction of their profession using a model of voluntary self-regulation. My analysis will be useful to anyone seeking to understand problems in regulating non-physician health providers; and for anyone who wants to understand how the physician monopoly works (through scope of practice laws).