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Legislation of acupuncture is “on the table” in parliament. The upcoming law requires all future courses in acupuncture to be recognised as an academic bachelor’s degree. Today there are approximately 1500 active practitioners in Israel, of them about 300 are medical doctors. All treatments are privately funded. All major hospitals and health organisations have private out-patient clinics for Alternative Medicine, partially subsidised for their members. Private health insurance programs offer partial reimbursement for private treatments as well.
Israeli Association for Traditional Chinese Medicine
Read more
There are at present no restrictions or laws towards practicing acupuncture in Iceland other than the sanitary license given by the Surgeon General to open office and practice with needles. National insurance covers part of the acupuncture treatment done by medical doctors and physiotherapists. Treatments carried out by non-medical acupuncturists are not covered.
Icelandic Acupuncture Association
Read more
In Austria acupuncture and chinese herbal medicine is generally in the hand of physicians. The law says that you have to have the right to “assault a patients body”, just as you do when giving an injection or taking blood or giving an Infusion, that you are allowed to insert a needle (means acupuncturing). Therefore there are only two Job profiles allowed to use acupuncture: -physicians that have a “jus practicandi”-means have permission to work on their own-they then are allowed to treat any indication with acupuncture -midwifes: are allowed to use acupuncture -only for pregnancy and obstetrical indications! Chinese herbal medicine is regulated similarily-chineses prescriptions to pharmacies that cook decoctions or do granules, need to asure, the prescription is by an physician with the right to prescribe any kind of medicine -so it doesn´t matter wether one wants to prescribe western or chinese medicine, you need to have a prescribing permission (=physicians) Interestingly as soon as you are a physician with permission to practise (jus practicandi), you are allowed to use acupuncture or herbal medicine, you don´t have to prove finished education in TCM. The only thing is, that if you can´t prove graduation of acupuncture education and are not listed at the Austrian medical association as educated acupuncturist, your patients will not get any Money refunded from the insurances.
Österreichische Ausbildungsgesellschaft für Traditionelle Chinesische Medizin
Austrian Educational Society for Traditional Chinese Medicine
Read more
Belgium has almost thirty years of history with the acceptance and legality of Traditional Chinese Medicine. In 1987 research into complementary medicine (Sermeus 1987) had promising results regarding the effect of complementary medicine. Despite those results it took almost twenty years to change the very closed medical profession. In 1999 Belgium passed an important an progressive law: Colla’s Law that foresees the installation of four commissions for the following therapies (homeopathy, acupuncture, osteopathy and chiropractic). The law aims to protect patients by standardising education and discriminate qualified from unqualified practitioners. A commission sets the standard and the profession will be protected by law. The law also requires federations to help organise scientific research. Since 2005 the commission is installed and starts the necessary work to establish a law and legalise the four professions. Now, approximately one in two Belgians visits a complementary practitioner.
Association Belge Des Acupuncteurs Diplomés de Chine
Belgian Association of Acupuncturists graduates of China
Read more
Belgian Acupunctors Federation
Belgian Acupunctors Federation
Read more
EUFOM federation for acupuncturists
EUFOM federation for acupuncturists
Read more
Belgium has almost thirty years of history with the acceptance and legality of Traditional Chinese Medicine. In 1987 research into complementary medicine (Sermeus 1987) had promising results regarding the effect of complementary medicine. Despite those results it took almost twenty years to change the very closed medical profession. In 1999 Belgium passed an important an progressive law: Colla’s Law that foresees the installation of four commissions for the following therapies (homeopathy, acupuncture, osteopathy and chiropractic). The law aims to protect patients by standardising education and discriminate qualified from unqualified practitioners. A commission sets the standard and the profession will be protected by law. The law also requires federations to help organise scientific research. Since 2005 the commission is installed and starts the necessary work to establish a law and legalise the four professions. Now, approximately one in two Belgians visits a complementary practitioner.
Association Belge Des Acupuncteurs Diplomés de Chine
Belgian Association of Acupuncturists graduates of China
Read more
Belgian Acupunctors Federation
Belgian Acupunctors Federation
Read more
EUFOM federation for acupuncturists
EUFOM federation for acupuncturists
Read more
Belgium has almost thirty years of history with the acceptance and legality of Traditional Chinese Medicine. In 1987 research into complementary medicine (Sermeus 1987) had promising results regarding the effect of complementary medicine. Despite those results it took almost twenty years to change the very closed medical profession. In 1999 Belgium passed an important an progressive law: Colla’s Law that foresees the installation of four commissions for the following therapies (homeopathy, acupuncture, osteopathy and chiropractic). The law aims to protect patients by standardising education and discriminate qualified from unqualified practitioners. A commission sets the standard and the profession will be protected by law. The law also requires federations to help organise scientific research. Since 2005 the commission is installed and starts the necessary work to establish a law and legalise the four professions. Now, approximately one in two Belgians visits a complementary practitioner.
Association Belge Des Acupuncteurs Diplomés de Chine
Belgian Association of Acupuncturists graduates of China
Read more
Belgian Acupunctors Federation
Belgian Acupunctors Federation
Read more
EUFOM federation for acupuncturists
EUFOM federation for acupuncturists
Read more
Acupuncture is legal by the Czech law published by the ministerial order in 1981. The therapy can only be given by doctors who graduated in western medicine and are clinically attested before following and pass a government authorised acupuncture course of about 100 hours. According to Czech law, acupuncture has no clinically proven effect and therefor cannot replace common western treatment. The Czech Law does not recognise the herbal therapy as used in traditional Chinese Medicine. Herbs are provided as special food supplements, must meet specific conditions and be registered as a food product. Subscription of herbs is registered as a lifestyle advice or a sale of products.
Komora Tradicní cínské medicínyr
Czech Chamber of Traditional Chinese Medicine
Read more
Currently we have no restrictions on the practice of TCM in Denmark. The Danish Health Authorities have made an approval system (RAB) that ensures that the practitioner meets a minimum level of education (250 hours of education in acupuncture and 300 hours of education in Western Medicine). Acupuncturists can only become a member of an ETCMA Association if they meet the “Minimum Educational Criteria for Membership of the ETCMA”.
Association of Acupuncture Practitioners
Praktiserende Akupunktører
Read more
Health Professional Acupuncturist
Sundhedsfaglige Akupunktoerer
Read more
Currently we have no restrictions on the practice of TCM in Denmark. The Danish Health Authorities have made an approval system (RAB) that ensures that the practitioner meets a minimum level of education (250 hours of education in acupuncture and 300 hours of education in Western Medicine). Acupuncturists can only become a member of an ETCMA Association if they meet the “Minimum Educational Criteria for Membership of the ETCMA”.
Association of Acupuncture Practitioners
Praktiserende Akupunktører
Read more
Health Professional Acupuncturist
Sundhedsfaglige Akupunktoerer
Read more
There is no law concerning practitioners of Traditional Chinese Medicine (TCM) in Finland. With adequate training any practitioner can use acupuncture, moxa, cupping, herbal therapy or other TCM modalities. Currently, the Finnish Social and Health Ministry is creating a law for all alternative medicine practitioners. National insurance covers part of the acupuncture treatment done by medical doctors and physiotherapists. Some private insurances occasionally cover treatments done by non-medical acupuncturists.
Suomen perinteisen kiinalaisen lääketiteteen yhdistys
Finnish Traditional Chinese Medicine Society of Acupuncture and Herbs
Read more
Only medical doctors can legally diagnose and use acupuncture. Practitioners of Traditional Chinese Medicine (TCM) who are not medical doctors are however tolerated. Some private insurance companies reimburse TCM in part.
Confédération française de Médecine Traditionnelle Chinoise
Confédération française de Médecine Traditionnelle Chinoise
Read more
Medical treatment, including Traditional Chinese Medicine TCM, may only be given by a medical doctor or Heilpraktiker. Medical doctors have an academic degree. Heilpraktikers passed a specialised exam at the Health Office that is on par with the first state exams at university. Heilpraktikers treat almost all conditions, excluding only certain infectious diseases, gynaecological problems and dentistry. Treatment is only covered by private insurance and mostly charged privately.
Arbeitsgemeinschaft für klassische Akupunktur und Traditionelle Chinesische Medizin
Arbeitsgemeinschaft für klassische Akupunktur und Traditionelle Chinesische Medizin
Read more
The practice of Chinese medicine has not been regulated by law in Greece yet. Only several government administration circulars have been issued on the matter (1980, 1996) which characterized acupuncture as a medical action. However such circulars are not regulatory acts, their nature simply being advisory or interpretative. It must be noted that the constitutional right to professional freedom to which Chinese medicine practitioners are entitled, cannot be restricted but any kind of act other than specific law voted by the parliament as well as acts of public administration issued following specific delegation and guidelines provided by such law. Furthermore, the Ministry of Finance-tax authorities provide the possibility to start a business in acupuncture, herbal therapy or alternative medicine in general, without any restriction, under the category “other services concerning human health”.
Ελληνικός Σύλλογος Κινέζικης Ιατρικής
Hellenic Society of Chinese Medicine
Read more
All acupuncturists operate under common law. There are 5 professional associations federating into one over arching council. At present all regulation is voluntary but the Dept of Health facilitated talks between the associations since 2007. A Health Professionals Council (CORU) has been formed to gain Statutory Self Regulation. Patients pay for treatment privately but up to 50% of this is reimbursed by healthcare insurers.
Acupuncture Council of Ireland
Read more
Acupuncture Foundation Professional Association
Read more
Irish Register of Chinese Herbal Medicine
Read more
All acupuncturists operate under common law. There are 5 professional associations federating into one over arching council. At present all regulation is voluntary but the Dept of Health facilitated talks between the associations since 2007. A Health Professionals Council (CORU) has been formed to gain Statutory Self Regulation. Patients pay for treatment privately but up to 50% of this is reimbursed by healthcare insurers.
Acupuncture Council of Ireland
Read more
Acupuncture Foundation Professional Association
Read more
Irish Register of Chinese Herbal Medicine
Read more
All acupuncturists operate under common law. There are 5 professional associations federating into one over arching council. At present all regulation is voluntary but the Dept of Health facilitated talks between the associations since 2007. A Health Professionals Council (CORU) has been formed to gain Statutory Self Regulation. Patients pay for treatment privately but up to 50% of this is reimbursed by healthcare insurers.
Acupuncture Council of Ireland
Read more
Acupuncture Foundation Professional Association
Read more
Irish Register of Chinese Herbal Medicine
Read more
Even if there’s still no first level (approved by Italian parliament) law regulating CAM in Italy, a few lawsuits outcomes in recent years state that Acupuncture and Phytotherapy in Italy can only be practiced by MDs. These pronouncements are based on second level rules (Regional Councils agreements) regulating the minimal educational standards for MDs to be inscribed in the regional registry of acupuncturists (400 hours in three years), held by regional physicians boards. Other TCM fields (tuina, anmo, qigong) can be practiced by anyone, after a theoretic and practical training that is not standardized by law; provided their practice doesn’t overlap on what is considered MDs or paramedics field of competence. Having no specific regulating law at a national level, different interpretations are often given about the right of non sanitary members to practice even simple anmo. Tuina (and complementary techniques such as moxa, cups, hammer etc.) and Qigong in Italy are mainly considered as DBN (Bio-Natural Disciplines), at the same level of Shiatzu, Yoga, Feldenkrais, Pranopractices etc. However, only local level registers are provided and not in every region. At the beginning of last year a new law (L.4/14) was issued but it is not yet fully applied. This new law (“Prevision of law concerning non- organised Professions”) is meant to regulate the so called ‘Professioni non Ordinistiche’, which means any profession that doesn’t require compulsory admission to ”professional orders”, as for Medical Doctors, Lawyers, Architects, Engeneers, Accountants. ETCMA’s member OTTO is presently the only national association enabled to issue tuina/qigong professional quality certificates by this law.
Operatori Tuina-Qigong e Tecniche Orientali
Tuina-Qigong Operators and Oriental Techniques
Read more
There are neither legal recognition nor restrictions to practice Traditional Chinese Medicine (TCM) or acupuncture in the Netherlands. In general TCM therapy is charged privately; some health insurers reimburse (part of) the treatment if the practitioner is member of a TCM organisation. The rules for reimbursement vary per insurer. Chinese herbs and herbal products are classified as foods and food supplements and can be imported and marketed without registration or notification. These products are, however, not reimbursable.
Nederlandse Vereniging voor Acupunctuur
Dutch Acupuncture Association
Read more
Nederlandse Vereniging voor Traditionele Chinese Geneeskunde
Dutch Association of Chinese Traditional Medicine
Read more
There are neither legal recognition nor restrictions to practice Traditional Chinese Medicine (TCM) or acupuncture in the Netherlands. In general TCM therapy is charged privately; some health insurers reimburse (part of) the treatment if the practitioner is member of a TCM organisation. The rules for reimbursement vary per insurer. Chinese herbs and herbal products are classified as foods and food supplements and can be imported and marketed without registration or notification. These products are, however, not reimbursable.
Nederlandse Vereniging voor Acupunctuur
Dutch Acupuncture Association
Read more
Nederlandse Vereniging voor Traditionele Chinese Geneeskunde
Dutch Association of Chinese Traditional Medicine
Read more
There are at present no restrictions towards practising acupuncture in Norway. The Law of Alternative Treatment of Disease draws attention to serious health risks with regard to therapeutic modalities performed by unauthorised health professionals. Therapeutic modalities such as acupotomology, warming needles and intramuscular stimulation fall into this category of caution. An estimate of between 900-1300 authorised health professionals practice acupuncture in Norway today. Acupuncture is not reimbursed by the National Health Insurance Office in Norway today. Clients can get tax reduction for expenditure in complementary and alternative medicine on their annual income taxes. Private health insurance sometimes cover expenditure in complementary and alternative medicine such as acupuncture.
Norwegian Acupuncture Association
Norwegian Acupuncture Association
Read more
Acupuncturist is an officially recognised paramedical job, to be practiced by both medical doctors and non medical therapeutics. There are recommendations about program, teaching hours, conditions of certification et cetera. Other Traditional Chinese Medicine practices such as herbalist of phtyoteraoeutist are not recognised by law. Western medicine acupuncture in the treatment of pain is funded by National Health Fund (NFZ) only if done in Pain Management Clinic.
Polskie Towarzystwo Tradycyjnej Medycyny Chinskiej
Polish Society of Traditional Chinese Medicine
Read more
TCM, Acupuncture and Herbal Therapy are legalized and regulated by Portuguese Law number 45/2003 and 71/2013 (along with 4 other CAM’s). There are other ordinances that regulate specifics issues, mostly regarding technical aspects such as advertising, offices, and fees to be paid. To work in Portugal, the provider is obliged to have a Professional Certificate which is given by the HealthCare System Central Administration (ACSS) and also needs to be registered as a CAM provider in the Portuguese Health Regulation Entity (ERS). CAM providers are obliged to have an insurance that covers both his (professional) and patients risks. According with Portuguese law number 1/2017 CAM treatments performed by a licensed provider are VAT free. CAM providers have technical and deontological autonomy. Almost all private health insurance companies reimburse TCM and Acupuncture treatments. Nowadays Portugal is in a transition period as it progresses from an unregulated scenario (where providers still can get the Professional Certificate without a recognized bachelor’s degree) to a highly regulated reality, where TCM and Acupuncture providers need to have a recognized bachelor’s degree to get the mandatory Professional Certificate to practice. This transition period will end in 2025. Herbal medication has no specific regulation and is sold under the label of dietary supplements.
Associação de Medicina Energética
Association for Energy Medicine IVN Portugal
Read more
Sociedade Portuguesa de Medicina Chinesa
Portuguese Society of Chinese Medicine
Read more
Associação Profissional de Acupunctura e Medicina Tradicional Chinesa
Professional Association of Acupuncture & Traditional Chinese Medicine
Read more
TCM, Acupuncture and Herbal Therapy are legalized and regulated by Portuguese Law number 45/2003 and 71/2013 (along with 4 other CAM’s). There are other ordinances that regulate specifics issues, mostly regarding technical aspects such as advertising, offices, and fees to be paid. To work in Portugal, the provider is obliged to have a Professional Certificate which is given by the HealthCare System Central Administration (ACSS) and also needs to be registered as a CAM provider in the Portuguese Health Regulation Entity (ERS). CAM providers are obliged to have an insurance that covers both his (professional) and patients risks. According with Portuguese law number 1/2017 CAM treatments performed by a licensed provider are VAT free. CAM providers have technical and deontological autonomy. Almost all private health insurance companies reimburse TCM and Acupuncture treatments. Nowadays Portugal is in a transition period as it progresses from an unregulated scenario (where providers still can get the Professional Certificate without a recognized bachelor’s degree) to a highly regulated reality, where TCM and Acupuncture providers need to have a recognized bachelor’s degree to get the mandatory Professional Certificate to practice. This transition period will end in 2025. Herbal medication has no specific regulation and is sold under the label of dietary supplements.
Associação de Medicina Energética
Association for Energy Medicine IVN Portugal
Read more
Sociedade Portuguesa de Medicina Chinesa
Portuguese Society of Chinese Medicine
Read more
Associação Profissional de Acupunctura e Medicina Tradicional Chinesa
Professional Association of Acupuncture & Traditional Chinese Medicine
Read more
TCM, Acupuncture and Herbal Therapy are legalized and regulated by Portuguese Law number 45/2003 and 71/2013 (along with 4 other CAM’s). There are other ordinances that regulate specifics issues, mostly regarding technical aspects such as advertising, offices, and fees to be paid. To work in Portugal, the provider is obliged to have a Professional Certificate which is given by the HealthCare System Central Administration (ACSS) and also needs to be registered as a CAM provider in the Portuguese Health Regulation Entity (ERS). CAM providers are obliged to have an insurance that covers both his (professional) and patients risks. According with Portuguese law number 1/2017 CAM treatments performed by a licensed provider are VAT free. CAM providers have technical and deontological autonomy. Almost all private health insurance companies reimburse TCM and Acupuncture treatments. Nowadays Portugal is in a transition period as it progresses from an unregulated scenario (where providers still can get the Professional Certificate without a recognized bachelor’s degree) to a highly regulated reality, where TCM and Acupuncture providers need to have a recognized bachelor’s degree to get the mandatory Professional Certificate to practice. This transition period will end in 2025. Herbal medication has no specific regulation and is sold under the label of dietary supplements.
Associação de Medicina Energética
Association for Energy Medicine IVN Portugal
Read more
Sociedade Portuguesa de Medicina Chinesa
Portuguese Society of Chinese Medicine
Read more
Associação Profissional de Acupunctura e Medicina Tradicional Chinesa
Professional Association of Acupuncture & Traditional Chinese Medicine
Read more
In Romania the practice of acupuncture and phytotherapy is restricted to doctors, although the law governing the practice of alternative medicine is unclear and contradictory in places, and hence those who do not have a medical training background can also find legal ways to practice. Acupuncture as a treatment has had periods in which it has been reimbursed by the national health insurance system, even if with only the equivalent of 3 euros per treatment. Herbal treatment is recognised by law and restricted to doctors, but the commercialisation of herbs is subject to a law that makes individualised treatment with herbs legally almost impossible, as each bundle of herbs should have a legal approval from the ministry of health.
Taoist Association for Holistic Healing
Taoist Association for Holistic Healing
Read more
The overall management of alternative medicine including TCM is weak. The Slovenian government requires an exam in the Slovene language in order to obtain the license to legally practice but the exam has completely no content of TCM. Even so, practising TCM as a “service” is a legitimate business for more than 20 years. Traditional Chinese medicine is written in the law as a recognized form of medicine even though there are no details at all regarding the definition and training syllabus as in other medical specialities. Medical doctors who have 200 hours of training could claim themselves as acupuncturists and acupuncture treatment is provided in public hospitals.
Slovensko združenje za kitajsko medicino in akupunkturo
Slovensko združenje za kitajsko medicino in akupunkturo
Read more
To date, there is no regulation in Spain, beyond what is regulated by Decree 1277/2003, for health professionals, the heading for the high tax and the labour agreement of the sector for non-health professionals (paramedic services) who practice them. There is also no specific regulation on the training or certification of people who practice TCI. For health professionals, Decree 1277/2003 establishes, in its classification of health centers, the U101 health care unit (unconventional therapies), which requires that the director of the Centre must be a Western physician. As a result, health professionals who are not doctors must exercise TCIs as paramedics or be under the direction of a Western physician. The non-health professionals of the TCI are registered in the corresponding Social Security regime and obtain the registration of economic activity, as well as the municipal license as paramedical professionals related to paramedical activities (naturopaths, acupuncturists and other paramedical professionals), under the protection of Royal Decree 1175/1990, of September 28.
European Foundation of TCM
European Foundation of TCM
Read more
Sweden knows two acupuncture systems: Traditional Chinese Medicine (TCM), and a Swedish invention of stimulating the afferent sensory nervous system. TCM acupuncture and Chinese herbal medicine are classified as Complementary and Alternative Medicine (CAM) and are not used within the official healthcare system. The afferent sensory nervous system acupuncture is used in the Swedish healthcare system – the technique can be learned in 14 days of training. This method is for pain relief only.
Svenska Akupunkturförbundet Traditionell Kinesisk Medicin
Swedish Acupuncture Association for Traditional Chinese Medicine
Read more
Legal situation in Switzerland In Switzerland healthcare professionals are regulated by the laws of each individual canton or region (Switzerland has a total of 26 cantons). Licenses for the practice of acupuncture and Tuina as well as Chinese drug therapy are granted by the cantons, currently very different conditions apply. The laws regarding the practice of acupuncture and Chinese medicine by therapists range from prohibitions to legal practice of all modalities to no regulations at all. The situation now is changing to stronger regulations: Since the year 2000, the TCM association Switzerland, together with other associations of complementary medicine, began to strive for federal professional regulation. In the year 2015, the State Secretary for Education, Research and Innovation (SBFI) approved the Higher Professional Examination in order that TCM practitioners obtain a federal diploma as “Naturheilpraktiker” with specialization in TCM. The practice of Chinese herbal medicine today isn’t regulated in most cantons. Since January 2001, herbal substances have been regarded as medicines by the federal government medicines agency Swissmedic. Thus, in theory, only therapists with legal permission to prescribe and administer Chinese medicines can legally practice Chinese herbal medicine. With the new national health law coming in 2019, the prescription will soon only be allowed for therapists with the national title and for therapists, that already have an existing permission in one of the cantons, with a few exceptions. Doctors (MD) can practice acupuncture and Chinese herbs in all cantons. If they want to be reimbursed for acupuncture by the compulsory health insurance they need to have an ASA-Fähigkeitsausweis, a certificate which requires a minimum education time of 360 hours in acupuncture and Chinese herbal medicine.
Association Professionnelle Suisse de MTC
Associazione professionale svizzera di MTC
TCM Fachverband Schweiz
TCM Association Switzerland
Read more
At present there is no government legislation in the United Kingdom (UK) covering the practice Traditional Chinese Medicine (TCM) such as acupuncture or Chinese herbal medicine. Professional associations such as BAcC wish to achieve statutory regulation of acupuncture; until then, voluntarily self-regulation with the Professional Standards Authority is applied. Most people who choose to have acupuncture consult independent practitioners and pay for their treatment privately. There are some health insurance plans that reimburse the cost of such treatment, however many will only cover the cost of treatment provided by practitioners who also have western medical qualifications (medical doctors, physiotherapists etc).
British Acupuncture Council
British Acupuncture Council
Read more
There are at present no restrictions or laws towards practicing acupuncture in Iceland other than the sanitary license given by the Surgeon General to open office and practice with needles. National insurance covers part of the acupuncture treatment done by medical doctors and physiotherapists. Treatments carried out by non-medical acupuncturists are not covered.
Icelandic Acupuncture Association
Read more
Legislation of acupuncture is “on the table” in parliament. The upcoming law requires all future courses in acupuncture to be recognised as an academic bachelor’s degree. Today there are approximately 1500 active practitioners in Israel, of them about 300 are medical doctors. All treatments are privately funded. All major hospitals and health organisations have private out-patient clinics for Alternative Medicine, partially subsidised for their members. Private health insurance programs offer partial reimbursement for private treatments as well.
Israeli Association for Traditional Chinese Medicine
Read more
Legal situation in Switzerland In Switzerland healthcare professionals are regulated by the laws of each individual canton or region (Switzerland has a total of 26 cantons). Licenses for the practice of acupuncture and Tuina as well as Chinese drug therapy are granted by the cantons, currently very different conditions apply. The laws regarding the practice of acupuncture and Chinese medicine by therapists range from prohibitions to legal practice of all modalities to no regulations at all. The situation now is changing to stronger regulations: Since the year 2000, the TCM association Switzerland, together with other associations of complementary medicine, began to strive for federal professional regulation. In the year 2015, the State Secretary for Education, Research and Innovation (SBFI) approved the Higher Professional Examination in order that TCM practitioners obtain a federal diploma as “Naturheilpraktiker” with specialization in TCM. The practice of Chinese herbal medicine today isn’t regulated in most cantons. Since January 2001, herbal substances have been regarded as medicines by the federal government medicines agency Swissmedic. Thus, in theory, only therapists with legal permission to prescribe and administer Chinese medicines can legally practice Chinese herbal medicine. With the new national health law coming in 2019, the prescription will soon only be allowed for therapists with the national title and for therapists, that already have an existing permission in one of the cantons, with a few exceptions. Doctors (MD) can practice acupuncture and Chinese herbs in all cantons. If they want to be reimbursed for acupuncture by the compulsory health insurance they need to have an ASA-Fähigkeitsausweis, a certificate which requires a minimum education time of 360 hours in acupuncture and Chinese herbal medicine.
Association Professionnelle Suisse de MTC
Associazione professionale svizzera di MTC
TCM Fachverband Schweiz
TCM Association Switzerland
Read more
Belgium has almost thirty years of history with the acceptance and legality of Traditional Chinese Medicine. In 1987 research into complementary medicine (Sermeus 1987) had promising results regarding the effect of complementary medicine. Despite those results it took almost twenty years to change the very closed medical profession. In 1999 Belgium passed an important an progressive law: Colla’s Law that foresees the installation of four commissions for the following therapies (homeopathy, acupuncture, osteopathy and chiropractic). The law aims to protect patients by standardising education and discriminate qualified from unqualified practitioners. A commission sets the standard and the profession will be protected by law. The law also requires federations to help organise scientific research. Since 2005 the commission is installed and starts the necessary work to establish a law and legalise the four professions. Now, approximately one in two Belgians visits a complementary practitioner.
Association Belge Des Acupuncteurs Diplomés de Chine
Belgian Association of Acupuncturists graduates of China
Read more
Belgian Acupunctors Federation
Belgian Acupunctors Federation
Read more
EUFOM federation for acupuncturists
EUFOM federation for acupuncturists
Read more
Acupuncture is legal by the Czech law published by the ministerial order in 1981. The therapy can only be given by doctors who graduated in western medicine and are clinically attested before following and pass a government authorised acupuncture course of about 100 hours. According to Czech law, acupuncture has no clinically proven effect and therefor cannot replace common western treatment. The Czech Law does not recognise the herbal therapy as used in traditional Chinese Medicine. Herbs are provided as special food supplements, must meet specific conditions and be registered as a food product. Subscription of herbs is registered as a lifestyle advice or a sale of products.
Komora Tradicní cínské medicínyr
Czech Chamber of Traditional Chinese Medicine
Read more
Currently we have no restrictions on the practice of TCM in Denmark. The Danish Health Authorities have made an approval system (RAB) that ensures that the practitioner meets a minimum level of education (250 hours of education in acupuncture and 300 hours of education in Western Medicine). Acupuncturists can only become a member of an ETCMA Association if they meet the “Minimum Educational Criteria for Membership of the ETCMA”.
Association of Acupuncture Practitioners
Praktiserende Akupunktører
Read more
Health Professional Acupuncturist
Sundhedsfaglige Akupunktoerer
Read more
There is no law concerning practitioners of Traditional Chinese Medicine (TCM) in Finland. With adequate training any practitioner can use acupuncture, moxa, cupping, herbal therapy or other TCM modalities. Currently, the Finnish Social and Health Ministry is creating a law for all alternative medicine practitioners. National insurance covers part of the acupuncture treatment done by medical doctors and physiotherapists. Some private insurances occasionally cover treatments done by non-medical acupuncturists.
Suomen perinteisen kiinalaisen lääketiteteen yhdistys
Finnish Traditional Chinese Medicine Society of Acupuncture and Herbs
Read more
Only medical doctors can legally diagnose and use acupuncture. Practitioners of Traditional Chinese Medicine (TCM) who are not medical doctors are however tolerated. Some private insurance companies reimburse TCM in part.
Confédération française de Médecine Traditionnelle Chinoise
Confédération française de Médecine Traditionnelle Chinoise
Read more
The practice of Chinese medicine has not been regulated by law in Greece yet. Only several government administration circulars have been issued on the matter (1980, 1996) which characterized acupuncture as a medical action. However such circulars are not regulatory acts, their nature simply being advisory or interpretative. It must be noted that the constitutional right to professional freedom to which Chinese medicine practitioners are entitled, cannot be restricted but any kind of act other than specific law voted by the parliament as well as acts of public administration issued following specific delegation and guidelines provided by such law. Furthermore, the Ministry of Finance-tax authorities provide the possibility to start a business in acupuncture, herbal therapy or alternative medicine in general, without any restriction, under the category “other services concerning human health”.
Ελληνικός Σύλλογος Κινέζικης Ιατρικής
Hellenic Society of Chinese Medicine
Read more
Medical treatment, including Traditional Chinese Medicine TCM, may only be given by a medical doctor or Heilpraktiker. Medical doctors have an academic degree. Heilpraktikers passed a specialised exam at the Health Office that is on par with the first state exams at university. Heilpraktikers treat almost all conditions, excluding only certain infectious diseases, gynaecological problems and dentistry. Treatment is only covered by private insurance and mostly charged privately.
Arbeitsgemeinschaft für klassische Akupunktur und Traditionelle Chinesische Medizin
Arbeitsgemeinschaft für klassische Akupunktur und Traditionelle Chinesische Medizin
Read more
All acupuncturists operate under common law. There are 5 professional associations federating into one over arching council. At present all regulation is voluntary but the Dept of Health facilitated talks between the associations since 2007. A Health Professionals Council (CORU) has been formed to gain Statutory Self Regulation. Patients pay for treatment privately but up to 50% of this is reimbursed by healthcare insurers.
Acupuncture Council of Ireland
Read more
Acupuncture Foundation Professional Association
Read more
Irish Register of Chinese Herbal Medicine
Read more
Even if there’s still no first level (approved by Italian parliament) law regulating CAM in Italy, a few lawsuits outcomes in recent years state that Acupuncture and Phytotherapy in Italy can only be practiced by MDs. These pronouncements are based on second level rules (Regional Councils agreements) regulating the minimal educational standards for MDs to be inscribed in the regional registry of acupuncturists (400 hours in three years), held by regional physicians boards. Other TCM fields (tuina, anmo, qigong) can be practiced by anyone, after a theoretic and practical training that is not standardized by law; provided their practice doesn’t overlap on what is considered MDs or paramedics field of competence. Having no specific regulating law at a national level, different interpretations are often given about the right of non sanitary members to practice even simple anmo. Tuina (and complementary techniques such as moxa, cups, hammer etc.) and Qigong in Italy are mainly considered as DBN (Bio-Natural Disciplines), at the same level of Shiatzu, Yoga, Feldenkrais, Pranopractices etc. However, only local level registers are provided and not in every region. At the beginning of last year a new law (L.4/14) was issued but it is not yet fully applied. This new law (“Prevision of law concerning non- organised Professions”) is meant to regulate the so called ‘Professioni non Ordinistiche’, which means any profession that doesn’t require compulsory admission to ”professional orders”, as for Medical Doctors, Lawyers, Architects, Engeneers, Accountants. ETCMA’s member OTTO is presently the only national association enabled to issue tuina/qigong professional quality certificates by this law.
Operatori Tuina-Qigong e Tecniche Orientali
Tuina-Qigong Operators and Oriental Techniques
Read more
There are neither legal recognition nor restrictions to practice Traditional Chinese Medicine (TCM) or acupuncture in the Netherlands. In general TCM therapy is charged privately; some health insurers reimburse (part of) the treatment if the practitioner is member of a TCM organisation. The rules for reimbursement vary per insurer. Chinese herbs and herbal products are classified as foods and food supplements and can be imported and marketed without registration or notification. These products are, however, not reimbursable.
Nederlandse Vereniging voor Acupunctuur
Dutch Acupuncture Association
Read more
Nederlandse Vereniging voor Traditionele Chinese Geneeskunde
Dutch Association of Chinese Traditional Medicine
Read more
There are at present no restrictions towards practising acupuncture in Norway. The Law of Alternative Treatment of Disease draws attention to serious health risks with regard to therapeutic modalities performed by unauthorised health professionals. Therapeutic modalities such as acupotomology, warming needles and intramuscular stimulation fall into this category of caution. An estimate of between 900-1300 authorised health professionals practice acupuncture in Norway today. Acupuncture is not reimbursed by the National Health Insurance Office in Norway today. Clients can get tax reduction for expenditure in complementary and alternative medicine on their annual income taxes. Private health insurance sometimes cover expenditure in complementary and alternative medicine such as acupuncture.
Norwegian Acupuncture Association
Norwegian Acupuncture Association
Read more
Acupuncturist is an officially recognised paramedical job, to be practiced by both medical doctors and non medical therapeutics. There are recommendations about program, teaching hours, conditions of certification et cetera. Other Traditional Chinese Medicine practices such as herbalist of phtyoteraoeutist are not recognised by law. Western medicine acupuncture in the treatment of pain is funded by National Health Fund (NFZ) only if done in Pain Management Clinic.
Polskie Towarzystwo Tradycyjnej Medycyny Chinskiej
Polish Society of Traditional Chinese Medicine
Read more
TCM, Acupuncture and Herbal Therapy are legalized and regulated by Portuguese Law number 45/2003 and 71/2013 (along with 4 other CAM’s). There are other ordinances that regulate specifics issues, mostly regarding technical aspects such as advertising, offices, and fees to be paid. To work in Portugal, the provider is obliged to have a Professional Certificate which is given by the HealthCare System Central Administration (ACSS) and also needs to be registered as a CAM provider in the Portuguese Health Regulation Entity (ERS). CAM providers are obliged to have an insurance that covers both his (professional) and patients risks. According with Portuguese law number 1/2017 CAM treatments performed by a licensed provider are VAT free. CAM providers have technical and deontological autonomy. Almost all private health insurance companies reimburse TCM and Acupuncture treatments. Nowadays Portugal is in a transition period as it progresses from an unregulated scenario (where providers still can get the Professional Certificate without a recognized bachelor’s degree) to a highly regulated reality, where TCM and Acupuncture providers need to have a recognized bachelor’s degree to get the mandatory Professional Certificate to practice. This transition period will end in 2025. Herbal medication has no specific regulation and is sold under the label of dietary supplements.
Associação de Medicina Energética
Association for Energy Medicine IVN Portugal
Read more
Sociedade Portuguesa de Medicina Chinesa
Portuguese Society of Chinese Medicine
Read more
Associação Profissional de Acupunctura e Medicina Tradicional Chinesa
Professional Association of Acupuncture & Traditional Chinese Medicine
Read more
In Romania the practice of acupuncture and phytotherapy is restricted to doctors, although the law governing the practice of alternative medicine is unclear and contradictory in places, and hence those who do not have a medical training background can also find legal ways to practice. Acupuncture as a treatment has had periods in which it has been reimbursed by the national health insurance system, even if with only the equivalent of 3 euros per treatment. Herbal treatment is recognised by law and restricted to doctors, but the commercialisation of herbs is subject to a law that makes individualised treatment with herbs legally almost impossible, as each bundle of herbs should have a legal approval from the ministry of health.
Taoist Association for Holistic Healing
Taoist Association for Holistic Healing
Read more
The overall management of alternative medicine including TCM is weak. The Slovenian government requires an exam in the Slovene language in order to obtain the license to legally practice but the exam has completely no content of TCM. Even so, practising TCM as a “service” is a legitimate business for more than 20 years. Traditional Chinese medicine is written in the law as a recognized form of medicine even though there are no details at all regarding the definition and training syllabus as in other medical specialities. Medical doctors who have 200 hours of training could claim themselves as acupuncturists and acupuncture treatment is provided in public hospitals.
Slovensko združenje za kitajsko medicino in akupunkturo
Slovensko združenje za kitajsko medicino in akupunkturo
Read more
To date, there is no regulation in Spain, beyond what is regulated by Decree 1277/2003, for health professionals, the heading for the high tax and the labour agreement of the sector for non-health professionals (paramedic services) who practice them. There is also no specific regulation on the training or certification of people who practice TCI. For health professionals, Decree 1277/2003 establishes, in its classification of health centers, the U101 health care unit (unconventional therapies), which requires that the director of the Centre must be a Western physician. As a result, health professionals who are not doctors must exercise TCIs as paramedics or be under the direction of a Western physician. The non-health professionals of the TCI are registered in the corresponding Social Security regime and obtain the registration of economic activity, as well as the municipal license as paramedical professionals related to paramedical activities (naturopaths, acupuncturists and other paramedical professionals), under the protection of Royal Decree 1175/1990, of September 28.
European Foundation of TCM
European Foundation of TCM
Read more
Sweden knows two acupuncture systems: Traditional Chinese Medicine (TCM), and a Swedish invention of stimulating the afferent sensory nervous system. TCM acupuncture and Chinese herbal medicine are classified as Complementary and Alternative Medicine (CAM) and are not used within the official healthcare system. The afferent sensory nervous system acupuncture is used in the Swedish healthcare system – the technique can be learned in 14 days of training. This method is for pain relief only.
Svenska Akupunkturförbundet Traditionell Kinesisk Medicin
Swedish Acupuncture Association for Traditional Chinese Medicine
Read more
Legal situation in Switzerland In Switzerland healthcare professionals are regulated by the laws of each individual canton or region (Switzerland has a total of 26 cantons). Licenses for the practice of acupuncture and Tuina as well as Chinese drug therapy are granted by the cantons, currently very different conditions apply. The laws regarding the practice of acupuncture and Chinese medicine by therapists range from prohibitions to legal practice of all modalities to no regulations at all. The situation now is changing to stronger regulations: Since the year 2000, the TCM association Switzerland, together with other associations of complementary medicine, began to strive for federal professional regulation. In the year 2015, the State Secretary for Education, Research and Innovation (SBFI) approved the Higher Professional Examination in order that TCM practitioners obtain a federal diploma as “Naturheilpraktiker” with specialization in TCM. The practice of Chinese herbal medicine today isn’t regulated in most cantons. Since January 2001, herbal substances have been regarded as medicines by the federal government medicines agency Swissmedic. Thus, in theory, only therapists with legal permission to prescribe and administer Chinese medicines can legally practice Chinese herbal medicine. With the new national health law coming in 2019, the prescription will soon only be allowed for therapists with the national title and for therapists, that already have an existing permission in one of the cantons, with a few exceptions. Doctors (MD) can practice acupuncture and Chinese herbs in all cantons. If they want to be reimbursed for acupuncture by the compulsory health insurance they need to have an ASA-Fähigkeitsausweis, a certificate which requires a minimum education time of 360 hours in acupuncture and Chinese herbal medicine.
Association Professionnelle Suisse de MTC
Associazione professionale svizzera di MTC
TCM Fachverband Schweiz
TCM Association Switzerland
Read more
At present there is no government legislation in the United Kingdom (UK) covering the practice Traditional Chinese Medicine (TCM) such as acupuncture or Chinese herbal medicine. Professional associations such as BAcC wish to achieve statutory regulation of acupuncture; until then, voluntarily self-regulation with the Professional Standards Authority is applied. Most people who choose to have acupuncture consult independent practitioners and pay for their treatment privately. There are some health insurance plans that reimburse the cost of such treatment, however many will only cover the cost of treatment provided by practitioners who also have western medical qualifications (medical doctors, physiotherapists etc).
British Acupuncture Council
British Acupuncture Council
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In Austria acupuncture and chinese herbal medicine is generally in the hand of physicians. The law says that you have to have the right to “assault a patients body”, just as you do when giving an injection or taking blood or giving an Infusion, that you are allowed to insert a needle (means acupuncturing). Therefore there are only two Job profiles allowed to use acupuncture: -physicians that have a “jus practicandi”-means have permission to work on their own-they then are allowed to treat any indication with acupuncture -midwifes: are allowed to use acupuncture -only for pregnancy and obstetrical indications! Chinese herbal medicine is regulated similarily-chineses prescriptions to pharmacies that cook decoctions or do granules, need to asure, the prescription is by an physician with the right to prescribe any kind of medicine -so it doesn´t matter wether one wants to prescribe western or chinese medicine, you need to have a prescribing permission (=physicians) Interestingly as soon as you are a physician with permission to practise (jus practicandi), you are allowed to use acupuncture or herbal medicine, you don´t have to prove finished education in TCM. The only thing is, that if you can´t prove graduation of acupuncture education and are not listed at the Austrian medical association as educated acupuncturist, your patients will not get any Money refunded from the insurances.
Österreichische Ausbildungsgesellschaft für Traditionelle Chinesische Medizin
Austrian Educational Society for Traditional Chinese Medicine
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Belgium has almost thirty years of history with the acceptance and legality of Traditional Chinese Medicine. In 1987 research into complementary medicine (Sermeus 1987) had promising results regarding the effect of complementary medicine. Despite those results it took almost twenty years to change the very closed medical profession. In 1999 Belgium passed an important an progressive law: Colla’s Law that foresees the installation of four commissions for the following therapies (homeopathy, acupuncture, osteopathy and chiropractic). The law aims to protect patients by standardising education and discriminate qualified from unqualified practitioners. A commission sets the standard and the profession will be protected by law. The law also requires federations to help organise scientific research. Since 2005 the commission is installed and starts the necessary work to establish a law and legalise the four professions. Now, approximately one in two Belgians visits a complementary practitioner.
Association Belge Des Acupuncteurs Diplomés de Chine
Belgian Association of Acupuncturists graduates of China
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Belgian Acupunctors Federation
Belgian Acupunctors Federation
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EUFOM federation for acupuncturists
EUFOM federation for acupuncturists
Read more
Belgium has almost thirty years of history with the acceptance and legality of Traditional Chinese Medicine. In 1987 research into complementary medicine (Sermeus 1987) had promising results regarding the effect of complementary medicine. Despite those results it took almost twenty years to change the very closed medical profession. In 1999 Belgium passed an important an progressive law: Colla’s Law that foresees the installation of four commissions for the following therapies (homeopathy, acupuncture, osteopathy and chiropractic). The law aims to protect patients by standardising education and discriminate qualified from unqualified practitioners. A commission sets the standard and the profession will be protected by law. The law also requires federations to help organise scientific research. Since 2005 the commission is installed and starts the necessary work to establish a law and legalise the four professions. Now, approximately one in two Belgians visits a complementary practitioner.
Association Belge Des Acupuncteurs Diplomés de Chine
Belgian Association of Acupuncturists graduates of China
Read more
Belgian Acupunctors Federation
Belgian Acupunctors Federation
Read more
EUFOM federation for acupuncturists
EUFOM federation for acupuncturists
Read more
Belgium has almost thirty years of history with the acceptance and legality of Traditional Chinese Medicine. In 1987 research into complementary medicine (Sermeus 1987) had promising results regarding the effect of complementary medicine. Despite those results it took almost twenty years to change the very closed medical profession. In 1999 Belgium passed an important an progressive law: Colla’s Law that foresees the installation of four commissions for the following therapies (homeopathy, acupuncture, osteopathy and chiropractic). The law aims to protect patients by standardising education and discriminate qualified from unqualified practitioners. A commission sets the standard and the profession will be protected by law. The law also requires federations to help organise scientific research. Since 2005 the commission is installed and starts the necessary work to establish a law and legalise the four professions. Now, approximately one in two Belgians visits a complementary practitioner.
Association Belge Des Acupuncteurs Diplomés de Chine
Belgian Association of Acupuncturists graduates of China
Read more
Belgian Acupunctors Federation
Belgian Acupunctors Federation
Read more
EUFOM federation for acupuncturists
EUFOM federation for acupuncturists
Read more
Acupuncture is legal by the Czech law published by the ministerial order in 1981. The therapy can only be given by doctors who graduated in western medicine and are clinically attested before following and pass a government authorised acupuncture course of about 100 hours. According to Czech law, acupuncture has no clinically proven effect and therefor cannot replace common western treatment. The Czech Law does not recognise the herbal therapy as used in traditional Chinese Medicine. Herbs are provided as special food supplements, must meet specific conditions and be registered as a food product. Subscription of herbs is registered as a lifestyle advice or a sale of products.
Komora Tradicní cínské medicínyr
Czech Chamber of Traditional Chinese Medicine
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Currently we have no restrictions on the practice of TCM in Denmark. The Danish Health Authorities have made an approval system (RAB) that ensures that the practitioner meets a minimum level of education (250 hours of education in acupuncture and 300 hours of education in Western Medicine). Acupuncturists can only become a member of an ETCMA Association if they meet the “Minimum Educational Criteria for Membership of the ETCMA”.
Association of Acupuncture Practitioners
Praktiserende Akupunktører
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Health Professional Acupuncturist
Sundhedsfaglige Akupunktoerer
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Currently we have no restrictions on the practice of TCM in Denmark. The Danish Health Authorities have made an approval system (RAB) that ensures that the practitioner meets a minimum level of education (250 hours of education in acupuncture and 300 hours of education in Western Medicine). Acupuncturists can only become a member of an ETCMA Association if they meet the “Minimum Educational Criteria for Membership of the ETCMA”.
Association of Acupuncture Practitioners
Praktiserende Akupunktører
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Health Professional Acupuncturist
Sundhedsfaglige Akupunktoerer
Read more
There is no law concerning practitioners of Traditional Chinese Medicine (TCM) in Finland. With adequate training any practitioner can use acupuncture, moxa, cupping, herbal therapy or other TCM modalities. Currently, the Finnish Social and Health Ministry is creating a law for all alternative medicine practitioners. National insurance covers part of the acupuncture treatment done by medical doctors and physiotherapists. Some private insurances occasionally cover treatments done by non-medical acupuncturists.
Suomen perinteisen kiinalaisen lääketiteteen yhdistys
Finnish Traditional Chinese Medicine Society of Acupuncture and Herbs
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Only medical doctors can legally diagnose and use acupuncture. Practitioners of Traditional Chinese Medicine (TCM) who are not medical doctors are however tolerated. Some private insurance companies reimburse TCM in part.
Confédération française de Médecine Traditionnelle Chinoise
Confédération française de Médecine Traditionnelle Chinoise
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The practice of Chinese medicine has not been regulated by law in Greece yet. Only several government administration circulars have been issued on the matter (1980, 1996) which characterized acupuncture as a medical action. However such circulars are not regulatory acts, their nature simply being advisory or interpretative. It must be noted that the constitutional right to professional freedom to which Chinese medicine practitioners are entitled, cannot be restricted but any kind of act other than specific law voted by the parliament as well as acts of public administration issued following specific delegation and guidelines provided by such law. Furthermore, the Ministry of Finance-tax authorities provide the possibility to start a business in acupuncture, herbal therapy or alternative medicine in general, without any restriction, under the category “other services concerning human health”.
Ελληνικός Σύλλογος Κινέζικης Ιατρικής
Hellenic Society of Chinese Medicine
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Medical treatment, including Traditional Chinese Medicine TCM, may only be given by a medical doctor or Heilpraktiker. Medical doctors have an academic degree. Heilpraktikers passed a specialised exam at the Health Office that is on par with the first state exams at university. Heilpraktikers treat almost all conditions, excluding only certain infectious diseases, gynaecological problems and dentistry. Treatment is only covered by private insurance and mostly charged privately.
Arbeitsgemeinschaft für klassische Akupunktur und Traditionelle Chinesische Medizin
Arbeitsgemeinschaft für klassische Akupunktur und Traditionelle Chinesische Medizin
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All acupuncturists operate under common law. There are 5 professional associations federating into one over arching council. At present all regulation is voluntary but the Dept of Health facilitated talks between the associations since 2007. A Health Professionals Council (CORU) has been formed to gain Statutory Self Regulation. Patients pay for treatment privately but up to 50% of this is reimbursed by healthcare insurers.
Acupuncture Council of Ireland
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Acupuncture Foundation Professional Association
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Irish Register of Chinese Herbal Medicine
Read more
All acupuncturists operate under common law. There are 5 professional associations federating into one over arching council. At present all regulation is voluntary but the Dept of Health facilitated talks between the associations since 2007. A Health Professionals Council (CORU) has been formed to gain Statutory Self Regulation. Patients pay for treatment privately but up to 50% of this is reimbursed by healthcare insurers.
Acupuncture Council of Ireland
Read more
Acupuncture Foundation Professional Association
Read more
Irish Register of Chinese Herbal Medicine
Read more
All acupuncturists operate under common law. There are 5 professional associations federating into one over arching council. At present all regulation is voluntary but the Dept of Health facilitated talks between the associations since 2007. A Health Professionals Council (CORU) has been formed to gain Statutory Self Regulation. Patients pay for treatment privately but up to 50% of this is reimbursed by healthcare insurers.
Acupuncture Council of Ireland
Read more
Acupuncture Foundation Professional Association
Read more
Irish Register of Chinese Herbal Medicine
Read more
Even if there’s still no first level (approved by Italian parliament) law regulating CAM in Italy, a few lawsuits outcomes in recent years state that Acupuncture and Phytotherapy in Italy can only be practiced by MDs. These pronouncements are based on second level rules (Regional Councils agreements) regulating the minimal educational standards for MDs to be inscribed in the regional registry of acupuncturists (400 hours in three years), held by regional physicians boards. Other TCM fields (tuina, anmo, qigong) can be practiced by anyone, after a theoretic and practical training that is not standardized by law; provided their practice doesn’t overlap on what is considered MDs or paramedics field of competence. Having no specific regulating law at a national level, different interpretations are often given about the right of non sanitary members to practice even simple anmo. Tuina (and complementary techniques such as moxa, cups, hammer etc.) and Qigong in Italy are mainly considered as DBN (Bio-Natural Disciplines), at the same level of Shiatzu, Yoga, Feldenkrais, Pranopractices etc. However, only local level registers are provided and not in every region. At the beginning of last year a new law (L.4/14) was issued but it is not yet fully applied. This new law (“Prevision of law concerning non- organised Professions”) is meant to regulate the so called ‘Professioni non Ordinistiche’, which means any profession that doesn’t require compulsory admission to ”professional orders”, as for Medical Doctors, Lawyers, Architects, Engeneers, Accountants. ETCMA’s member OTTO is presently the only national association enabled to issue tuina/qigong professional quality certificates by this law.
Operatori Tuina-Qigong e Tecniche Orientali
Tuina-Qigong Operators and Oriental Techniques
Read more
There are neither legal recognition nor restrictions to practice Traditional Chinese Medicine (TCM) or acupuncture in the Netherlands. In general TCM therapy is charged privately; some health insurers reimburse (part of) the treatment if the practitioner is member of a TCM organisation. The rules for reimbursement vary per insurer. Chinese herbs and herbal products are classified as foods and food supplements and can be imported and marketed without registration or notification. These products are, however, not reimbursable.
Nederlandse Vereniging voor Acupunctuur
Dutch Acupuncture Association
Read more
Nederlandse Vereniging voor Traditionele Chinese Geneeskunde
Dutch Association of Chinese Traditional Medicine
Read more
There are neither legal recognition nor restrictions to practice Traditional Chinese Medicine (TCM) or acupuncture in the Netherlands. In general TCM therapy is charged privately; some health insurers reimburse (part of) the treatment if the practitioner is member of a TCM organisation. The rules for reimbursement vary per insurer. Chinese herbs and herbal products are classified as foods and food supplements and can be imported and marketed without registration or notification. These products are, however, not reimbursable.
Nederlandse Vereniging voor Acupunctuur
Dutch Acupuncture Association
Read more
Nederlandse Vereniging voor Traditionele Chinese Geneeskunde
Dutch Association of Chinese Traditional Medicine
Read more
There are at present no restrictions towards practising acupuncture in Norway. The Law of Alternative Treatment of Disease draws attention to serious health risks with regard to therapeutic modalities performed by unauthorised health professionals. Therapeutic modalities such as acupotomology, warming needles and intramuscular stimulation fall into this category of caution. An estimate of between 900-1300 authorised health professionals practice acupuncture in Norway today. Acupuncture is not reimbursed by the National Health Insurance Office in Norway today. Clients can get tax reduction for expenditure in complementary and alternative medicine on their annual income taxes. Private health insurance sometimes cover expenditure in complementary and alternative medicine such as acupuncture.
Norwegian Acupuncture Association
Norwegian Acupuncture Association
Read more
Acupuncturist is an officially recognised paramedical job, to be practiced by both medical doctors and non medical therapeutics. There are recommendations about program, teaching hours, conditions of certification et cetera. Other Traditional Chinese Medicine practices such as herbalist of phtyoteraoeutist are not recognised by law. Western medicine acupuncture in the treatment of pain is funded by National Health Fund (NFZ) only if done in Pain Management Clinic.
Polskie Towarzystwo Tradycyjnej Medycyny Chinskiej
Polish Society of Traditional Chinese Medicine
Read more
TCM, Acupuncture and Herbal Therapy are legalized and regulated by Portuguese Law number 45/2003 and 71/2013 (along with 4 other CAM’s). There are other ordinances that regulate specifics issues, mostly regarding technical aspects such as advertising, offices, and fees to be paid. To work in Portugal, the provider is obliged to have a Professional Certificate which is given by the HealthCare System Central Administration (ACSS) and also needs to be registered as a CAM provider in the Portuguese Health Regulation Entity (ERS). CAM providers are obliged to have an insurance that covers both his (professional) and patients risks. According with Portuguese law number 1/2017 CAM treatments performed by a licensed provider are VAT free. CAM providers have technical and deontological autonomy. Almost all private health insurance companies reimburse TCM and Acupuncture treatments. Nowadays Portugal is in a transition period as it progresses from an unregulated scenario (where providers still can get the Professional Certificate without a recognized bachelor’s degree) to a highly regulated reality, where TCM and Acupuncture providers need to have a recognized bachelor’s degree to get the mandatory Professional Certificate to practice. This transition period will end in 2025. Herbal medication has no specific regulation and is sold under the label of dietary supplements.
Associação de Medicina Energética
Association for Energy Medicine IVN Portugal
Read more
Sociedade Portuguesa de Medicina Chinesa
Portuguese Society of Chinese Medicine
Read more
Associação Profissional de Acupunctura e Medicina Tradicional Chinesa
Professional Association of Acupuncture & Traditional Chinese Medicine
Read more
TCM, Acupuncture and Herbal Therapy are legalized and regulated by Portuguese Law number 45/2003 and 71/2013 (along with 4 other CAM’s). There are other ordinances that regulate specifics issues, mostly regarding technical aspects such as advertising, offices, and fees to be paid. To work in Portugal, the provider is obliged to have a Professional Certificate which is given by the HealthCare System Central Administration (ACSS) and also needs to be registered as a CAM provider in the Portuguese Health Regulation Entity (ERS). CAM providers are obliged to have an insurance that covers both his (professional) and patients risks. According with Portuguese law number 1/2017 CAM treatments performed by a licensed provider are VAT free. CAM providers have technical and deontological autonomy. Almost all private health insurance companies reimburse TCM and Acupuncture treatments. Nowadays Portugal is in a transition period as it progresses from an unregulated scenario (where providers still can get the Professional Certificate without a recognized bachelor’s degree) to a highly regulated reality, where TCM and Acupuncture providers need to have a recognized bachelor’s degree to get the mandatory Professional Certificate to practice. This transition period will end in 2025. Herbal medication has no specific regulation and is sold under the label of dietary supplements.
Associação de Medicina Energética
Association for Energy Medicine IVN Portugal
Read more
Sociedade Portuguesa de Medicina Chinesa
Portuguese Society of Chinese Medicine
Read more
Associação Profissional de Acupunctura e Medicina Tradicional Chinesa
Professional Association of Acupuncture & Traditional Chinese Medicine
Read more
TCM, Acupuncture and Herbal Therapy are legalized and regulated by Portuguese Law number 45/2003 and 71/2013 (along with 4 other CAM’s). There are other ordinances that regulate specifics issues, mostly regarding technical aspects such as advertising, offices, and fees to be paid. To work in Portugal, the provider is obliged to have a Professional Certificate which is given by the HealthCare System Central Administration (ACSS) and also needs to be registered as a CAM provider in the Portuguese Health Regulation Entity (ERS). CAM providers are obliged to have an insurance that covers both his (professional) and patients risks. According with Portuguese law number 1/2017 CAM treatments performed by a licensed provider are VAT free. CAM providers have technical and deontological autonomy. Almost all private health insurance companies reimburse TCM and Acupuncture treatments. Nowadays Portugal is in a transition period as it progresses from an unregulated scenario (where providers still can get the Professional Certificate without a recognized bachelor’s degree) to a highly regulated reality, where TCM and Acupuncture providers need to have a recognized bachelor’s degree to get the mandatory Professional Certificate to practice. This transition period will end in 2025. Herbal medication has no specific regulation and is sold under the label of dietary supplements.
Associação de Medicina Energética
Association for Energy Medicine IVN Portugal
Read more
Sociedade Portuguesa de Medicina Chinesa
Portuguese Society of Chinese Medicine
Read more
Associação Profissional de Acupunctura e Medicina Tradicional Chinesa
Professional Association of Acupuncture & Traditional Chinese Medicine
Read more
In Romania the practice of acupuncture and phytotherapy is restricted to doctors, although the law governing the practice of alternative medicine is unclear and contradictory in places, and hence those who do not have a medical training background can also find legal ways to practice. Acupuncture as a treatment has had periods in which it has been reimbursed by the national health insurance system, even if with only the equivalent of 3 euros per treatment. Herbal treatment is recognised by law and restricted to doctors, but the commercialisation of herbs is subject to a law that makes individualised treatment with herbs legally almost impossible, as each bundle of herbs should have a legal approval from the ministry of health.
Taoist Association for Holistic Healing
Taoist Association for Holistic Healing
Read more
The overall management of alternative medicine including TCM is weak. The Slovenian government requires an exam in the Slovene language in order to obtain the license to legally practice but the exam has completely no content of TCM. Even so, practising TCM as a “service” is a legitimate business for more than 20 years. Traditional Chinese medicine is written in the law as a recognized form of medicine even though there are no details at all regarding the definition and training syllabus as in other medical specialities. Medical doctors who have 200 hours of training could claim themselves as acupuncturists and acupuncture treatment is provided in public hospitals.
Slovensko združenje za kitajsko medicino in akupunkturo
Slovensko združenje za kitajsko medicino in akupunkturo
Read more
To date, there is no regulation in Spain, beyond what is regulated by Decree 1277/2003, for health professionals, the heading for the high tax and the labour agreement of the sector for non-health professionals (paramedic services) who practice them. There is also no specific regulation on the training or certification of people who practice TCI. For health professionals, Decree 1277/2003 establishes, in its classification of health centers, the U101 health care unit (unconventional therapies), which requires that the director of the Centre must be a Western physician. As a result, health professionals who are not doctors must exercise TCIs as paramedics or be under the direction of a Western physician. The non-health professionals of the TCI are registered in the corresponding Social Security regime and obtain the registration of economic activity, as well as the municipal license as paramedical professionals related to paramedical activities (naturopaths, acupuncturists and other paramedical professionals), under the protection of Royal Decree 1175/1990, of September 28.
European Foundation of TCM
European Foundation of TCM
Read more
Sweden knows two acupuncture systems: Traditional Chinese Medicine (TCM), and a Swedish invention of stimulating the afferent sensory nervous system. TCM acupuncture and Chinese herbal medicine are classified as Complementary and Alternative Medicine (CAM) and are not used within the official healthcare system. The afferent sensory nervous system acupuncture is used in the Swedish healthcare system – the technique can be learned in 14 days of training. This method is for pain relief only.
Svenska Akupunkturförbundet Traditionell Kinesisk Medicin
Swedish Acupuncture Association for Traditional Chinese Medicine
Read more
Legal situation in Switzerland In Switzerland healthcare professionals are regulated by the laws of each individual canton or region (Switzerland has a total of 26 cantons). Licenses for the practice of acupuncture and Tuina as well as Chinese drug therapy are granted by the cantons, currently very different conditions apply. The laws regarding the practice of acupuncture and Chinese medicine by therapists range from prohibitions to legal practice of all modalities to no regulations at all. The situation now is changing to stronger regulations: Since the year 2000, the TCM association Switzerland, together with other associations of complementary medicine, began to strive for federal professional regulation. In the year 2015, the State Secretary for Education, Research and Innovation (SBFI) approved the Higher Professional Examination in order that TCM practitioners obtain a federal diploma as “Naturheilpraktiker” with specialization in TCM. The practice of Chinese herbal medicine today isn’t regulated in most cantons. Since January 2001, herbal substances have been regarded as medicines by the federal government medicines agency Swissmedic. Thus, in theory, only therapists with legal permission to prescribe and administer Chinese medicines can legally practice Chinese herbal medicine. With the new national health law coming in 2019, the prescription will soon only be allowed for therapists with the national title and for therapists, that already have an existing permission in one of the cantons, with a few exceptions. Doctors (MD) can practice acupuncture and Chinese herbs in all cantons. If they want to be reimbursed for acupuncture by the compulsory health insurance they need to have an ASA-Fähigkeitsausweis, a certificate which requires a minimum education time of 360 hours in acupuncture and Chinese herbal medicine.
Association Professionnelle Suisse de MTC
Associazione professionale svizzera di MTC
TCM Fachverband Schweiz
TCM Association Switzerland
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At present there is no government legislation in the United Kingdom (UK) covering the practice Traditional Chinese Medicine (TCM) such as acupuncture or Chinese herbal medicine. Professional associations such as BAcC wish to achieve statutory regulation of acupuncture; until then, voluntarily self-regulation with the Professional Standards Authority is applied. Most people who choose to have acupuncture consult independent practitioners and pay for their treatment privately. There are some health insurance plans that reimburse the cost of such treatment, however many will only cover the cost of treatment provided by practitioners who also have western medical qualifications (medical doctors, physiotherapists etc).
British Acupuncture Council
British Acupuncture Council
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