Practising complementary or emerging medicine
BY ASSOCIATE PROFESSOR ANDREW C MILLER, CHAIR, AMA MEDICAL PRACTICE COMMITTEE
The AMA receives both praise and criticism for its policies and positions on the practice of complementary medicine.
When the AMA published its updated Position Statement on Complementary Medicine last year, it elicited support from members for its clear support of evidence-based medicine. But it also drew comments from some members who were offended that the term ‘complementary’ medicine was used to include what they believe is legitimate and medically-indicated treatment. It also drew strong criticism from other members who argued the AMA should oppose any doctors practising complementary medicine.
The complex issue of doctors’ involvement in complementary medicine is also concerning the Medical Board of Australia. The Board is seeking public comments on a proposal to strengthen guidelines for medical practitioners who provide complementary medicine and/or unconventional medicine and/or emerging treatments.
In its consultation paper, the Board details a wide range of activities currently being undertaken by medical practitioners such as: providing ‘alternative’ treatments for cancer in place of conventional therapies; diagnosing and treating Lyme disease in patients who have never left Australia; offering autologous stem cell therapy or providing infusions of platelet rich plasma for conditions where there is little evidence of benefit; and performing ‘anti-ageing’ cosmetic regenerative procedures.
Under the Health Practitioner Regulation National Law, the definition of professional misconduct includes:
- providing a person with health services of a kind that are excessive, unnecessary or otherwise not reasonably required for the person’s well-being;
- referring a person to, or recommending that a person use or consult, another health service provider, health service or health product if the health practitioner has a pecuniary interest in giving that referral or recommendation, unless the practitioner discloses the nature of that interest to the person before or at the time of giving the referral or recommendation.
As all registered medical practitioners must comply with the National Law, there is a clear mechanism for the Medical Board to investigate and take appropriate action against medical practitioners who do not comply.
However, the Board considers that additional guidelines will benefit both medical practitioners and consumers. Medical practitioners will have clear, nationally consistent guidance about the Board’s expectations in relation to complementary and unconventional medicine and emerging treatments. Consumers will have improved safeguards and access to better information while still having choice.
The proposed guidelines would also provide additional support to the Board in investigating reported misconduct because under the National Law an approved registration standard, code or guideline is admissible in proceedings against a practitioner as evidence of what constitutes appropriate professional conduct or practice.
The proposed guidelines cover: discussions with patients; knowledge and skills required by medical practitioners; managing conflicts of interest; informed consent; appropriate diagnostic methods and techniques; appropriate treatment; patient management; advertising requirements; and research requirements.
The Medical Practice Committee is currently examining the content of the Board’s draft guidelines in detail and will provide advice on the AMA’s response. However, overall the draft guidelines are consistent with existing AMA policy. Members views are very welcome and can be forwarded to email@example.com.
Relevant AMA policy can be found in the following position statements and guidelines: Complementary Medicine; Medicines; Advertising and Public Endorsement, Managing Conflicts of Interest; and Doctors’ Relationships with Industry.
The AMA will lodge a submission to the Board, but if you would like to make an individual submission you can find the full public consultation paper and information on how to make a submission at: https://www.medicalboard.gov.au/news/current-consultations.aspx
Submissions are due by 12 April 2019.
Published: 11 Apr 2019