For over a decade, NAMA has tirelessly worked to create and implement internal regulatory standards for the practice of Ayurveda. These standards were designed to improve and promote the safety, efficacy, recognition and legitimacy of the practice. They were also intended to serve as a framework for state licensing and regulation of Ayurveda in the United States.
NAMA’s regulatory standards recognize three professional practice categories: Health Counselor, Ayurveda Practitioner; and Ayurvedic Doctor. A scope of practice has been defined for each category, as indicated below:
Ayurvedic Health Counselor: Ayurvedic professionals trained to focus on preventive healthcare as well as health promotion, with a specific focus on diet and lifestyle.
Ayurvedic Practitioner: Ayurvedic professionals with additional training in pathology and disease management beyond that of the AHC. These professionals also practice preventive healthcare and health promotion, using diet and lifestyle.
Ayurvedic Doctor: Ayurvedic professionals with additional training and knowledge beyond the AP. Although an AD is not permitted to diagnose a Western disease entity, they are taught to refer out appropriately. They interface with Western medicine, are well versed in all branches of Ayurveda, and possess substantial research skills. The AD has significantly more clinical experience based on a more extensive internship.
These categories and scopes of practice not only represent the current state of Ayurveda in this County; they also represent NAMA’s vision for future growth of the profession. This article addresses legal and practical issues related to the “Ayurvedic Doctor” designation.
The Ayurvedic Doctor designation represents the highest level of professional practice recognized by NAMA. It requires education and training well beyond that required of Ayurvedic Health Counselors and Ayurvedic Practitioners. Ayurvedic Doctors must have extensive, in-depth education, and relevant clinical experience in all eight branches of Ayurvedic medicine. They must also have substantial experience in teaching, demonstrations, panchakarma, and research methods.
In addition to their academic studies, Ayurvedic Doctors must possess clinical experience equal to one-year of supervised clinical practice, and including a minimum of 250 documented patient encounters. Ayurvedic Doctors must understand disease from an Ayurvedic perspective, and have a working knowledge of Western medical pathology, pharmacology, diagnoses, and treatment, sufficient to correlate with the practice of Ayurveda. Ayurvedic Doctors are not required to order western diagnostic tests or prescribe western medicines. Further information regarding the Ayurvedic Doctor category and scope of practice can be found here.
Under the current legal paradigm in the United States, Ayurvedic professionals are not always able to legally practice Ayurveda to the full extent it is practiced in other countries. Each state has laws prohibiting the unlicensed practice of medicine. These laws often restrict the services that Ayurvedic professionals can offer their clients. Violation of these laws can result in both civil and criminal penalties. Some states have laws referred to as health freedom laws, which provide methods, which if followed, help to insulate a professional from liability for violation of the medical licensing laws. For more information regarding these laws and tips for the legal practice of Ayurveda, visit this link here.
Additionally, some states restrict the use of the Doctor title to those that have a medical license in that state or a PhD. Therefore, even if you have graduated from an Ayurvedic Doctor program in the United States or elsewhere, or been approved as an Ayurvedic Doctor member of NAMA, you should not use the Doctor title or Dr. prefix until you confirm the laws of your state allow you to do so.
Furthermore, there are laws that restrict false and deceptive commercial practices. Therefore, if you make any representation that you are a doctor, via use of the suffix A.D., a diploma or certificate hanging on a wall, an advertisement or otherwise, you should be sure to provide a written explanation regarding your certification and disclose the fact that you are not a licensed medical doctor. It is considered best practice to be clear, direct and honest regarding your credentials, scope of practice, and the services you provide. NAMA recommends the use of a written client disclosure form that includes this and other information. You should make sure each client signs the form prior to receiving any of your services.
NAMA considered our country’s current legal paradigm when developing its three professional practice categories. As mentioned previously, these categories were developed with an awareness of the current status of the law, and an eye toward the future. NAMA’s vision is that the future will evolve to allow the full and legal practice of Ayurveda in each state of our country. NAMA is working toward this vision through the development and implementation of its regulatory standards, and by supporting efforts to further health freedom laws and state licensing.
Until NAMA’s vision becomes a reality, it will be more difficult to receive the clinical training and experience required for NAMA’s Ayurvedic Doctor designation. In the United States, there are only a few Ayurveda clinics where students can receive the clinical training and experience required to qualify for the Ayurvedic Doctor designation. Moreover, these clinics have fewer clients than would otherwise be optimal to complete the requirements in a timely manner. As a result, many U.S. Ayurveda schools are offering training in India, where students are able to experience all aspects of Ayurveda and have access to a vast number of clients.
While the available training in India is a positive, there are some hurdles to overcome such as additional administrative demands, increased costs to the schools and students, and all involved having to spend large amounts of time away from home, family and friends. Additionally, as previously mentioned, the Ayurveda practiced in India does not always translate to the Ayurveda that can be legally practiced in the United States. As a result of these hurdles, some schools have chosen not to add an Ayurvedic Doctor program to its current curriculum. Others are choosing to open new schools and clinics in health freedom states. NAMA foresees that in the near future, there will be an expansion of training programs and facilities for Ayurvedic Doctors. In the meanwhile, Ayurvedic professionals will gain additional knowledge and experience as they grow their practices and take part in continuing education to enhance their knowledge base.
The legal and educational issues currently faced by NAMA are not exclusive to Ayurveda. In its early stages, western medicine faced some of the same issues. Even today, in relation to the practice of acupuncture, some state limit the practice to Medical Doctors, Osteopaths and Chiropractors. Other states have not yet enacted laws that license, regulate or prohibit acupuncture.
NAMA seeks your patience and support as it moves forward to expand the role of Ayurveda as an integral part of the United States healthcare system. The need to practice legally and with clarity, honesty and integrity is important not only to you; your actions can affect your fellow practitioners, and the profession of Ayurveda. If even one Ayurvedic professional is prosecuted for practicing medicine without a license or acting in a deceptive manner, it becomes a stain on the entire profession and sets back our efforts to legitimize Ayurveda in the United States. To ensure that Ayurveda maintains a solid and respected reputation within the healthcare field, members are encouraged to be thoughtful and careful in their actions, and to work within the laws of the states in which they practice.
About the Author:
Susan Etheridge is an attorney, Ayurvedic Practitioner and yoga teacher. She is a graduate of Boston University School of Law (J.D.), Florida State University (B.A.), the Ayurvedic Center for Well Being (Guru Kula Program), and Sadhana Healing Arts (Ayur-Yoga 200 Hour Teacher Training Program). Susan is the founder of the Alternative Health Law Firm, which provides legal services that support the expansion, integration and acceptance of alternative healthcare throughout the world.
The information provided in this article is for informational purposes only and should not be considered to be legal advice. The information does not necessarily reflect the opinions of the National Ayurvedic Medical Association or the principal author and is not guaranteed to be correct, complete, or up-to-date. This article may contain links to other resources on the Internet. These links are provided as citations and aids to help you identify and locate other Internet resources that may be of interest, and are not intended to state or imply that the National Ayurvedic Medical Association or the principal author recommends, supports, sponsors, or is in any way affiliated or associated with any person or entity associated with those links, or is legally authorized to use any trade name, registered trademark, logo, legal or official seal, or copyrighted symbol that may be reflected in the links.