IV. CONCLUSION


The foregoing review of legislative developments concerning the alternative health care field reveals a number of significant patterns. First, owing perhaps to the convergence of increasing consumer usage of alternative therapies and the interest of practitioners in securing professional practice rights, statutory activity relating to alternative treatments appears to be intensifying. This phenomenon is particularly apparent in the recent adoption of laws in six states permitting physicians to go beyond conventional forms of treatment and to explore the healing potential offered by the alternative health care paradigm. Legislative intensity is further demonstrated by the recent enactment of provider practice acts that not only solidify the legal foothold already obtained by such well-known alternative therapies as acupuncture, massage, and naturopathy, but also break new ground for less familiar modalities such as art therapy, naprapathy, and reflexology.

Second, the applicable statutes are steadily beginning to reference a variety of lesser known alternative treatments in defining the scope of practice for more prominent therapies. State legislatures have recently felt obliged, for example, to take cognizance of Alexander technique, bioenergetics, Feldenkrais, Hellerwork, polarity therapy, reflexology, reiki, Rolfing, shiatsu, and Trager. The very appearance of the names of these somewhat obscure modalities in the legislative texts is a new development and indicates that the practice and access interests of a growing number of alternative practitioners and their patients and clients increasingly are forming part of state legislative and regulatory agenda.

Third, although overlap in certain procedures and techniques is not uncommon under provider practice acts for allopathic health care professions, the cross-practice rights of alternative practitioners from one alternative modality to another appear to be more prevalent and are formally recognized in many legislative enactments considered in this study. This legislative pattern suggests the existence of a multidisciplinary orientation and fluidity in the practice boundaries for many alternative modalities that may not be matched among allopathic providers.

Fourth, there is an obvious absence of uniformity among the state laws applicable to alternative health care. Even with respect to the same modality, the statutory requirements differ substantially from state to state. While political and fiscal factors in each jurisdiction inevitably mitigate against perfect uniformity, a greater degree of standardization would undoubtedly be helpful in securing interstate reciprocity for alternative practitioners and in rendering access to these modalities by consumers less subject to the circumstance of geographic residence.

Fifth, the legislative response to consumer and professional interest in alternative health care has moved partially beyond the realm of nearly exclusive state concern and into the federal arena where scientific research concerning alternative treatments, as well as issues concerning the use of these therapies and natural substances, will remain the object of Congressional and regulatory attention for some years to come. The investment of federal interest in this field further highlights the significance of alternative health care for the nation as a whole. Moreover, although the 103d Congress accorded scant attention to alternative modalities in the context of the debate concerning reform of the existing health care system, greater legislative interest may well develop as a result of increasing demand by American consumers for access to these relatively safe therapies and the desire of insurers to control the spiraling costs of conventional health care.

Finally, although statutory law constitutes only a portion of the total picture of alternative health care in the United States, legislative developments are particularly significant as formal expressions of public policy in any subject area. Given the synergistic momentum that arises from a high level of consumer usage of alternative therapies, the continuing interest of alternative providers in securing professional practice rights, and other patterns of activity in this field, it seems likely that the legislative arena will experience intense pressure in the coming years to accommodate alternative modes of care. If new enactments are predicated on a patient-centered ideal that accords the individual substantial freedom to select a mode of personal care, the interests of health care in the United States would indeed seem well-served.