The Medical Board of Australia (Board) is considering introducing new guidelines to establish clearer regulation of medical practitioners who provide complementary or unconventional medicine or emerging treatments (Proposed Guidelines). The Proposed Guidelines would supplement the Board’s current Code of Conduct, similar to the Sexual Boundaries Guidelines introduced by the Board late last year.
The Proposed Guidelines address the need to support safe practice and ensure safeguards for patients. The Board cites cases involving the diagnosis of Lyme Disease, and unconventional uses of stem cell therapy, chelation therapy, alternative cancer treatment and anti-ageing treatments as some of the driving forces behind this wave of regulation.
The current working definition defines ‘complementary and unconventional medicine and emerging treatments’ to include any assessment, diagnostic technique or procedure, diagnosis, practice, medicine, therapy or treatment that is not usually considered to be part of conventional medicine, whether used in addition to, or instead of, conventional medicine. This includes unconventional use of approved medical devices and therapies (e.g. off-label prescriptions).
The Proposed Guidelines do not restrict access to complementary medicine, but guide practitioners on how to discuss the topic with patients to ensure that they are providing an acceptable level of care. From the outset, the Proposed Guidelines confirm that practitioners should respect their patients’ right to make informed decisions about their health, including to choose complementary and unconventional medicine and emerging treatment.
Areas of particular concern and guidance include:
- conflicts of interest – considering pecuniary interests and best interests of the patient;
- practitioner knowledge and skill - only offering treatments within the knowledge, skill and scope of practice;
- patient assessment - ensuring that any assessment and examination is comprehensive, considers all relevant information, and that recommendations for further investigations are based on best current available information;
- informed consent - ensuring that patients have enough information to make informed decision about their choice of treatment;
- treatment - not discouraging the use of conventional treatment options when clinically appropriate;
- patient management - ensuring strict follow up for both patient wellbeing and contribution to medical knowledge and taking precautions to avoid delay or missed diagnosis); and
- advertising - ensuring that any advertising complies with current restrictions and does not create unreasonable expectations regarding the benefits of certain treatments.
The Board is accepting written submissions on the Proposed Guidelines until close of business on 12 April 2019.