Practicing Yoga Therapy Unlicensed in Maine
Does Regulation Affect Accessibility?
Many conditions of the body or mind cause people who are suffering to seek complementary and alternative (CAM) health care. Oftentimes people find relief with these practices that they do not find with mainstream medical care alone. In some states, however, this means consumers are seeking and receiving services that are unregulated by state oversight, certification, registration, or licensure.
Lack of state oversight and licensure causes some practitioners to offer their services under the threat of practicing medicine without a license. Under this threat, practitioners may choose not to advertise, may not offer their services at all, or may offer services in a limited way. The result is limited consumer access to complimentary and alternative healthcare to alleviate suffering.
What Is Safe Harbor?
Safe Harbor exemption laws protect consumer access to the broad range of health care and healing practitioners, such as herbalists, body workers, culturally specific healing practices, and yoga therapy. Safe Harbor laws also protect practitioners from the threat of being shut down or charged with practicing medicine without a license. Here you’ll find a Safe Harbor guide in the form of a downloadable PDF (see below).
No License Required?
In June of 2019, Maine passed into law LD 364, “An Act to Establish the Right to Practice Complementary and Alternative Health Care Act.” Maine’s Right to Practice CAM Law recognizes that some complimentary and alternative health practices are required to be licensed, such as acupuncture, naturopathic medicine, midwifery, and auricular acupuncture. The Safe Harbor provided by this law exempts practitioners who are not required to be licensed, like yoga therapists.
According to Maine’s Right to Practice CAM Law, “A person who provides complementary or alternative health care services in accordance with the [law] who is not required to be licensed, certified or registered in the state as a health care professional or practitioner, does not violate any law relating to the licensing of health care professionals under this law as long as the person complies with the requirements of [the law].” The law affirmatively states that the law itself cannot be used to stop exempted practitioners from offering their services or force them to be licensed.
Moving Toward Acceptance?
Detractors from laws like this, such as Jann Bellamy from “Science-Based Medicine,” argue, “Quacks who misrepresent the safety and effectiveness of their treatments or cause physical or financial injury to patients will be protected from accountability for their harms under [the law].” Other detractors like The Maine Nurse Practitioners Association have argued that the bill “provides no recourse or protection to the public and undermines the basic idea of why licenses are required.”
But Andrew MacLean, interim chief executive officer of the Maine Medical Association, suggests that the bill wouldn’t change much, because alternative practitioners are already barred from practicing medicine without a license, just like everyone else. He said, “I see the bill as somewhat nonsensical, but I don’t see it as threatening to physicians or medicine.”
The law’s sponsor, Democratic Sen. David Miramant, of Camden, counters that Maine’s Right to Practice Law was largely crafted to prevent practitioners of alternative therapies from being accused of practicing medicine without a license. Camden defends the the law stating,
Concerns that Maine’s Right to Practice CAM Law will actually harm consumers seem to ignore the law’s plain language. The law does not exempt unlicensed practitioners from anything but “any law relating to the licensing of health care professions.” Practically speaking, this means that the lack of state licensure cannot be used to stop exempted practitioners from offering their services nor can it be used to charge them with practicing without a license. To protect consumers, the law contains certain prohibitions and requirements. And it explicitly provides for civil relief should any injury occur.
6 Practitioner Don’ts
A person providing unlicensed CAM health care services under Maine’s Right to Practice Law may not —
Perform surgery, set fractures or perform any other procedure on a person that punctures the skin;
Administer or prescribe radiation, including x-ray radiation;
Prescribe or administer medications, drugs or devices that require a prescription from a licensed health care professional;
Recommend the discontinuance of medications or drugs or the use of devices prescribed by a licensed health care professional;
Perform chiropractic adjustment of joints or spine; or
Act in any way that suggests, advertises or implies that the person providing complementary or alternative health care services is licensed as a health care professional under any other chapter of this Title.
3 Practitioner Dos
Under Maine’s Right to Practice CAM Law, a person who provides unlicensed CAM health care services and is advertising or charging a fee for those services must, before providing services, do three things:
Give written disclosures;
Get written statement that the disclosures were provided and understood;
Keep the signed statement for two years.
4 Disclosure Musts
Under Maine’s Right to Practice CAM Law, a person who provides unlicensed CAM health care services must disclose —
The name, business address and telephone number of the person providing complementary or alternative health care services;
The fact that the person providing complementary or alternative health care services is not a licensed health care professional;
The nature of the complementary or alternative health care services to be provided; and
The degrees, training, experience, credentials or other qualifications of the person providing complementary or alternative health care services. A written copy of the disclosures required under this subsection must be posted in a prominent location on the premises where the complementary or alternative health care services are being provided.
Right To Practice Guide
Civil Liability?
If you follow these rules can you still be subject to negligence or other civil claims? Yes.
The law does not limit the right of any person to seek relief for negligence or other civil remedy against a person providing CAM health care services.
What Does It Mean For Maine Yoga Therapists?
At the time of this writing, there are approximately 19 certified yoga therapy practitioners in Maine according to the International Association of Yoga Therapy (IAYT). Maine’s Right to Practice CAM Law assures these practitioners that they will not be shut down or charged with practicing medicine without a license if they follow its provisions. It also clarifies what is prohibited and what is required by the state.
More specific guidance for yoga therapists comes from the IAYT. In the interest of professionalizing the field of Yoga Therapy and providing safety for Yoga Therapists and clients, IAYT devised a Scope of Practice and Code of Ethics and Professional Responsibility in 2016. These are applicable to IAYT-certified yoga therapists, and provide a clear professional paradigm that can support all Yoga Therapists pioneering the field, necessary steps for professionalization Yoga Therapy.
Legislation and professional certification benefit both Yoga Therapists and consumers by providing protection and assurance. Legislation protects practitioner and consumers thereby broadening consumer access. IAYT certification provides assurance that Yoga Therapists are meeting certain professional standards.
If you are practicing Yoga Therapy in Maine,
Be educated about Maine’s Right to Practice CAM Law, follow it; and
Consider becoming IAYT certified and following its Scope of Practice and Code of Ethics.