From the Department of Health Policy and Management, Harvard School of Public Health (Drs Studdert and Brennan); the Center for Alternative Medicine Research, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School (Drs Eisenberg and Kaptchuk); Boston University School of Law (Ms Miller); and Harvard Law School (Mr Curto), Boston, Mass.
Health Law and Ethics section editors: Lawrence O. Gostin, JD, the
Georgetown/Johns Hopkins University Program on Law and Public Health, Washington,
DC, and Baltimore, Md; Helene M. Cole, MD, Contributing Editor, JAMA.
Although use of alternative therapies in the United States is widespread
and growing, little is known about the malpractice experience of practitioners
who deliver these therapies or about the legal principles that govern the
relationship between conventional and alternative medicine. Using data from
malpractice insurers, we analyzed the claims experience of chiropractors,
massage therapists, and acupuncturists for 1990 through 1996. We found that
claims against these practitioners occurred less frequently and typically
involved injury that was less severe than claims against physicians during
the same period. Physicians who may be concerned about their own exposure
to liability for referral of patients for alternative treatments can draw
some comfort from these findings. However, liability for referral is possible
in certain situations and should be taken seriously. Therefore, we review
relevant legal principles and case law to understand how malpractice law is
likely to develop in this area. We conclude by suggesting some questions for
physicians to ask themselves before referring their patients to alternative
Studdert DM, Eisenberg DM, Miller FH, Curto DA, Kaptchuk TJ, Brennan TA. Medical Malpractice Implications of Alternative Medicine. JAMA. 1998;280(18):1610–1615. doi:10.1001/jama.280.18.1610
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