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The Importance of Professional Organizations in Integrated Medicine
listed in integrated medicine, originally published in issue 52 - May 2000
What are Professional Organisations?
For as long as there have been complementary therapists, there have been organisations formed by individuals or groups to promote that therapy. Frequently, early professional organisations were highly conservative and did little to bring together those practising a particular therapy, and little to promote educational and training standards. Registers were sometimes seen as a way to exclude those from other training establishments and therefore operated as little more than graduation lists for a particular course or group of institutions. In many cases the identification of such 'registered practitioners' would not necessarily be of value to the public who would be seeking access to practitioners widely recognized as being competent. For other therapies, where the numbers practising were small, professional organisations were formed to try to bring widely differing therapies together. Some such organisations have had success in guiding the development of educational provision and maintaining a register.
More recently, professional organisations in complementary therapies have evolved to a level in which they have endeavoured to put individual differences to one side to bring together those practising a particular discipline. In many cases attempts have been made to facilitate the development of the education and training standards, promote public awareness and recognition of the therapy as well as to provide a monitored register of practitioners. In addition, the definition of codes of ethics and the provision of an effective complaints procedure in cases of malpractice have been vital for the protection of the patient and credibility of the organisation. The difficulty for the public has been how do they know whether a professional organisation operates effectively.
These developmental stages may sound as if they have been unique to complementary therapies, but they have occurred several times throughout the history of health care provision. More recently this has occurred with the disciplines now grouped under the Council of Professions Supplementary to Medicine i.e. physiotherapists, dieticians, podiatrists and biomedical scientists.
The Current Development of Professional Organisations
Over the past decade, in response to demands from practitioners, the public and encouragement from government, professional bodies have been established in complementary therapies. Initially some organisations have tended to be established by a limited cross section of those practising a therapy. More recently there have been genuine attempts to encourage unification; sometimes this has occurred even with those practising very different approaches to the same therapy.
These initiatives at unification have in some cases lead to the formation of National or even European-wide organisations.
The current process for the formation of a professional organisation is to bring together individual practitioners and members of current institutions under the umbrella of a lead body or council. Once formed, the priority of the professional organisation has been to define the minimum standards for the education and training for future practitioners. This has sometimes meant that national occupational standards have been developed which represent the minimum standards required to practise. National occupational standards have been defined for aromatherapy, reflexology, hypnotherapy and homoeopathy, and other therapies are already setting up lead bodies to commence this process. Therapies such as acupuncture, herbal medicine and homoeopathy have worked towards self-regulation after the formation of a unifying professional organisation. For those disciplines that have sought and been granted statutory self-regulation (i.e. osteopathy and chiropractic), the councils established have set up committees to define the education and training standards to be adhered to. Course providers have to then submit their provision for scrutiny before accreditation may be awarded.
The issue that then arises after having established a unified national organisation is the problem of what do you do about those already practising in the therapy. How do you ensure that they are competent and have had an acceptable level of education and training? The newly formed General Osteopathic Council adopted an approach which gave all those who wished to practise as an 'osteopath' two years to complete a portfolio to provide evidence of their education, training, case history taking and problem solving skills. This task has proven arduous for many busy osteopathic practitioners who may not have had to apply themselves to such theoretical exercises since their training many years or even decades ago. In February, with only three months remaining before the deadline, only just over half of those who applied have returned the required documentation. Some osteopaths have expressed concern that many highly experienced practitioners will be excluded from the register despite their valuable contribution to the establishment of the standards of the current profession.
Professional organisations have a vital role to play to ensure the public access to competent practitioners. There is no doubt that the current situation of the large number of organisations for some of the smaller therapies is very confusing for the public. The formation of genuinely unifying lead bodies or councils accomplishes much by simplifying the situation.
Wielding Power Wisely
Once formed, a single professional body for a particular therapy has considerable powers which include refusing accreditation of a course provider. With the history of division in some therapies, the members of accreditation panels have to rise above past or even current prejudices to operate impartially.
Will Integrated Medicine be promoted by the New Professions?
One of the weaknesses of the past that may materialize in the newer professional organisations is their tendency towards being exclusive and conservative in pursuit of establishing clear boundaries for their therapy. This may lead to the guideline syllabus becoming prescriptive, and aspects that may have facilitated links with other health care professionals being discouraged to maintain the 'purity' of the syllabus. Perhaps once professional organisations have consolidated their positions, syllabi will be developed that will enable those that wish, the opportunity to contribute to the development of integrated medicine in the twenty-first century.
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