Is yoga therapy unlicensed practice of medicine?

Yoga therapy brings the art of yoga to therapeutic issues and is a natural extension of yoga for wellness and general health; but when does yoga therapy cross the line into unlicensed practice? In The Search for Regulatory Recognition of Yoga Therapy: Legal and Policy Issues, I wrote about yoga not just as a spiritual discipline, but as a therapeutic approach to treat underlying ailments.

The reality is that we still have this epistemological chaos – or language confusion – about the separation between wellness care on one hand, and disease care on the other.

Legally, disease care is considered the practice of medicine, and practitioners who are not licensed can run afoul of prohibitions against unlicensed practice of medicine (or psychology) and be subject to prosecution.

On the FDA side, disease claims are considered to turn a product into a new drug; dietary supplement manufacturers and distributors are limited to structure/function claims (which they must substantiate), or claims of general well-being. FDA laws track state practice of medicine laws in terms of the distinction between disease on one hand, wellness on the other.

Yoga is really about something deeper. However, to the extent practitioners make claims, they tread on this nuanced distinction. Historically, the practice of “medicine” has been defined quite broadly in the law, leaving practitioners in jeopardy. Non-MD (or non-DO) practitioners such as chiropractors, acupuncturists, and massage therapists, have a more limited scope of practice which is typically defined by statute, or by regulations, and refined by case law. Malpractice laws weigh into the fray.

We can have credentialing for yoga therapy and yoga therapists, and this can work well as an effort to create standards for practice. Medical licensing statutes still loom large, though.

One possible legislative solution, which I offered in the article on yoga therapy legal and policy issues, is title licensure for yoga therapists. There would still be issues about claims, though – for example, can yoga therapy alleviate depression, insomnia, or obesity? The epistemological chaos creates legal peril, even though there is a fine line between, for example, mood, difficult falling asleep, and weight issues and the diseases mentioned a moment ago.

The notion that yoga therapy dissolves the mental and spiritual suffering at the root of many illnesses brings us back to more of an “energy medicine” definition in which consciousness is primary.

Where the legal rubber meets the road of practice, though, is the territory in which practitioners make claims for what they do. Claims consist of language, but they are also a form of advertising to the consumer as to what the practice can do. For this reason, enforcement authorities can search the Web for disease terms, and pick off practitioners.

The most helpful legal defense is to think proactively before opening a practice, and have the website and all marketing materials reviewed for unlicensed practice issues. In states such as California, where “SB 577” – now codified into the Business & Professions Code – provide some umbrella for non-licensed practice, practitioners may be on safer ground.

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