Because more than half of Americans use complementary and alternative medical (CAM) modalities, such as acupuncture, chiropractic, massage therapy, herbal medicine, naturopathy, homeopathy, Reiki, and energy healing), physicians, hospitals, and health care institutions often find themselves besieged by requests for information about, or delivery of, modalities outside conventional medical care. Such patient demand can pose legal and ethical conflicts for physicians sworn to do no harm, while protecting the health of their patients. Hospitals also face demands to integrate CAM therapies such as acupuncture into their care, or to stock Gingko, St. John's wort, and other dietary supplements in their pharmacies. If you are a clinician or health care organizations, learn how to:
•  Develop a management plan that reduces liability risks by implementing credentialing mechanisms and limiting practitioners’ authorized scope of practice;
•  Create a framework to help contain malpractice liability by assessing the legal risk of different CAM therapies;
•  Address legal issues relating to patient demand for dietary supplements, while maintaining evidence-based criteria and recognized standards of care;
•  Deal with risk of physician discipline for deviation from accepted, conventional practice standards.

Audiences: Clinicians, hospitals, medical clinics, medical societies, healthcare institutions, insurance companies, wellness centers, integrative medicine clinics, medical spas, individual entrepreneurs, and corporations involved in the health care field.

“Even the diehards who still say this is all bunk are being forced to confront these issues,” Michael H. Cohen told Applied Neurology, “because if patients are using these therapies, then a responsible clinician has to know how to converse intelligently, dispassionately, neutrally, and in a way that is mindful of legal and ethical obligations.”

Medical spas are one of the fastest growing businesses, and health care organizations increasingly are moving into adding complementary and alternative medical (CAM) modalities, such as acupuncture, chiropractic, massage therapy, herbal medicine, naturopathy, homeopathy, Reiki, and energy healing, to conventional medical care. The result is a hodgepodge of business enterprises, combining many different kinds of medical, allied health, and CAM providers, and offering patients unique therapeutic combinations. With the global popularity of so-called “traditional medicine” as well as medical tourism, health care consumers are turning toward holistic models of healing, focusing nutritional, exercise and lifestyle choices, and aiming their consumer dollars at prevention and “wellness care.” So-called “retail medicine” is also expanding, with the most basic medical services (such as blood pressure checks) being offered in locations from Walmart to local malls. Business entities seeking to capitalize on these trends, and meet the growing consumer demand for wellness care, must manage their liability risk in this new terrain, whether they are styled as a medical spa, complementary care clinic, integrative medicine center, or holistic health business. This talk provides 5 liability management tips to help organizations stay clear of unnecessary legal entanglement.

Audiences: Entrepreneurs and businesses trying to meet consumer demand for complementary and alternative medical therapies, either by offering these therapies either in hospitals and medical clinics, or in gyms, wellness centers, mind-body health and integrative medicine programs, medical spas, or retail medical services.

“Ethical analysis of CAM and the discussion of informed consent in particular are in their infancy,” Michael told Science & Spirit (July-August 2002). “It's time for the law to expand beyond the narrow focus of biomedicine and embrace the more inclusive holistic model of healing,” Michael told Medical Economics in an interview about medical liability for inclusion of complementary and alternative medical therapies. Michael also told Medical Economics that he would “like to see a duty to refer run both ways between medical physicians and alternative providers.”

Consumer insistence on CAM choices often clashes with doctors' preferences and physician reliance on evidence-based medicine. Understanding your rights as a patient is critical to wise decision-making and navigating your relationship with doctors, hospitals, and other caregivers. Learn:
•  The obscure institutional nooks and crannies through which you might get your hospital to offer you CAM therapies (such as acupuncture for pain relief);
•  The extent of your right to keep your dietary supplements (such as St. John’s wort or gingko) as an in-patient;
•  How to talk your doctor about CAM therapies and address medical and institutional concerns so as to get your needs met;
•  How to enlist the help of professional organizations in your quest for holistic healthcare when dealing with a mainstream medical organization such as a hospital;
•  Ways to overcome liability concerns when you try to coordinate your conventional and CAM caregivers;
•  Special concerns that will arise when you treat your child with CAM therapies such as homeopathy for chronic ear infections, special diets and nutritional protocols, and other treatments;
•  Ways to tap into medical respect for “mind-body” therapies to give yourself a broader array of health care choices.

Audiences: The general public (and anyone who is or has ever been a patient; patients' families).

“To respect the patient as person, the legal system, like medicine, must engage with paradigms beyond mechanism and reductionism and move toward a holistic understanding of the human being's journey toward health on all levels.” — Michael H. Cohen

As consumers’ health care choices shift away from conventional medicine and more toward personal explorations, ranging from colonics to Reiki and Therapeutic Touch, guided imagery to bodywork, acupuncture to nutraceuticals and medical foods, the borderland between medicine and religion becomes increasingly fuzzy. All disciplines must understand the increasingly intricate relationship between medicine, ethics, law, and spirituality in order to assimilate the new paradigm of consumer choice at the border of health care and personal freedom. Learn how therapies in what Michael calls the “Borderland” are changing:
•  Medicine, psychology, and the conventional approach to health;
•  Our ability to reconcile science and religion;
•  Regulatory efforts to accommodate religious pluralism and expand medical pluralism without impinging on patient protection;
•  The implications of complementary and alternative medicine and the holistic health movement for professions outside the health care arena, and disciplines in the humanities

Audiences: Colleges, other university departments, academic medical centers, nonprofit organizations, writers, attorneys and regulators, physicians and nurses, hospitals, medical schools and colleges of acupuncture, chiropractic, and massage therapy; and scholars and professionals of all disciplines.

“Alternative medicine is a huge industry, and there a lot of people wanting a piece of the pie.” -Michael H. Cohen, Los Angeles Times, "Alternative, Conventional Care Forge Uneasy Alliance"

Through yoga, massage and other forms of bodywork, therapeutic touch, Reiki, hands-on and spiritual healing, guided imagery, meditation, and prayer, millions are turning to spirituality as an integral part of self-care. Health and wellness is no longer strictly about medicine. This has enormous implications for the business of health care, as well as for broader social trends toward unity, cohesion, environmental awareness, and even conflict resolution and global peace. Whether considered a "New Age" movement or simply greater reliance on self-empowerment and healing, the upsurge in emphasis on spirituality and consciousness in the new millennium is changing perceptions of health care, wellness, and the link between physical care and care for the soul. Addressing the delicate interface between legal authority, health care, and consciousness, Michael H. Cohen links the thread of technology, business, and spirituality with advice for the new entrepreneur and health care consumer.

Audiences: General public, policymakers and think tanks, lawyers, regulators, judges, universities, bioethicists, hospital ethics committees.

For the future, “I see a trend toward greater respect, greater tolerance and mutual cooperation. I see a team approach with referrals back and forth, but not a duty to refer that is a fear-based model of coercion based on adverse legal consequences. I see is a model based on appreciation, respect, knowledge, wisdom and caring for the patient; where there's greater team involvement in patient care; where each kind of practitioner understands the breadth of the others' knowledge and the limitations of their own discipline; and where they need to reach out and have a common enterprise. The opposing trend, which is also a possibility for humanity and the health care system, is the trend that has dominated health care since its inception in the U.S. That trend is turf battles, waging war, trying to narrow the scope of authority of others, monopolization — that's what we have seen so far. Which path the professions want to take is up to the leaders in the field, but both are possibilities, and they may go on simultaneously.” —Michael H. Cohen, Dynamic Chiropractic

In 2005, the Institute of Medicine convened a study committee to explore scientific, policy and practice questions that arise from the significant and increasing use of Complementary and Alternative Medicine (CAM) therapies by the American public. The study found that greater openness was required on the part of scientific and medical communities, and that legislation and public policy should encourage a new and deeper balance between the goals of empowering health care consumers while protecting the public against dangerous practices.
     Michael H. Cohen served as a Consultant to that report, and has been an important player in legislative, public policy, and organizational debates about the role of CAM in patient life. He has also written about the links between health care policy, environmental awareness, consciousness and spirituality movements, and personal choice in health and wellness. This talk addresses the profound impact of new models of medical pluralism on social change, including larger world trends such as self-determination and democratic values, sustainable development, and economic well-being.

Audiences: Policymakers and think tanks, lawyers, regulators, judges, universities.

Michael told the Los Angeles Times that the controversial Dietary Supplements Health Education Act of 1994 (the DSHEA) “signaled Congressional recognition that there is a whole other branch of healing. ... It made it safe to talk about complementary and alternative medicine for the first time.” “Particularly in the age of the Internet,” Michael H. Cohen told The Integrator Blog, “the whole regulatory structure needs to give more credit to consumers’ ability to make wise choices concerning what goes into their bodies. That stance, as opposed to asserting the long arm of jurisdiction, will help the FDA increase its legitimacy and credibility while providing a negotiated buy-in for manufacturers, practitioners and patients.”