Scope of Practice for Complementary and Alternative Medicine ...

Scope of Practice for ComplementaryandAlternative Medicine (CAM)Health Regulation DepartmentDubai Health AuthorityIntroductionregulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

DHA health regulation is responsible for regulating Complementary and AlternativeMedicine (CAM) practice in the Emirate of Dubai, United Arab Emirates. Scope of Practice(SOP) refers to the activities that CAM personnel are educated, authorized and competentto perform as well as their decision making capacity. Such activities are establishedthrough the legislated definition of licensed CAM practice, complemented by standards,limits, conditions and education and influenced by setting, environment and health needsof the population, and the evolving situation in health care practice.Complementary and Alternative Medicine (CAM) practice include the following practice –in which SOP in outlines in this guidelines-:• Ayurveda• Chiropractic Medicine• Homeopathy• Naturopathic Medicine• Osteopathic Medicine• Therapeutic Massage• Traditional Chinese Medicine• Unani MedicineThe Scope of Practice for the Licensed CAM practitioner is endorsed by DHA healthregulation and should be read in conjunction with DHA health Regulation Code of Conductand Ethics.DHA health regulation upholds that no CAM practitioner should be directed or compelled toundertake any practice that falls short of DHA health regulation standards or code ofconduct requirementsAyurveda Scope of Practice“Ayurveda” is a system of primary health care that originated in India at least severalthousand years ago for the prevention, diagnosis, and treatment of human health conditionsand disease; the promotion and/or restoration of health; and the support and stimulation of apatient’s inherent self-healing processes through patient education and the use of Ayurvedatherapies and therapeutic substances. The Practice of Ayurveda shall not include surgicalprocedures or use of prescription medications. The central principal of Ayurvedic medicineregulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

3. The provisions of this Section are not to be construed to supplant or replace theprivileging requirements and processes that the DHA health regulation requiresLicensed Healthcare Facilities to develop and maintain as they relate to LicensedAyurveda Professionals holding Licenses under these Rules.General Requirements for all Licensed Ayurveda ProfessionalsA Licensee who holds a Ayurveda License must adhere to the following principles andcomply with the following obligations in their practice of Ayurveda. These are in addition tosuch other requirements as are established under these Rules and the General LicensingRules and pursuant to conditions that the DHA health regulation may attach to suchLicensee’s License:1. The Licensee shall have general competence in patient oriented skills, integratingexamination and diagnosis with sensitivity to patient needs and culture. They must beknowledgeable in the basic scientific approach to common illnesses and the seriousor life threatening common diseases and refer when appropriate.2. The decision to employ Ayurveda and its effectiveness in a given case are governedby knowledge of the individual patient in accordance with Ayurveda principles, andwith careful observance of the following specific procedures:a. Individualization of the medical history and physical examination of the patientmust be obtained.b. Employment of diagnostic procedures, supported by laboratory studies, whenappropriate as outlined above.c. Evaluation of the sensitivity of patient to medical treatment and the probablereaction and response of the patient to administration of the treatment chosen.3. The Licensed Ayurveda Professionals is obligated to refer to a general medicalphysician or specialists when there is any doubt about the patient’s diagnosis orresponse to therapy. A referral must not be withheld or discouraged when the patientasks for a second opinion.4. The Licensed Ayurveda Professionals bears the responsibility of maintaining acomprehensive record about their patient, including pursuit of diagnostic tests andconsultations in a timely fashion and collaborating with other medical professionals.In addition to satisfying the above requirements, a Licensed Ayurveda Professionals:1. must fulfill the Continuous Education requirements for licensure, the standards ofProfessional Practice and behavior expected of all Licensees;2. May administer care in the office or the patient’s home.regulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

egulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

Chiropractic Medicine Scope of the Practice‘Chiropractic medicine’ is a system of primary health care concerned with the diagnosis,treatment and prevention of disorders of the neuro-musculoskeletal system and the effectsof these disorders on general health. There is an emphasis on manual techniques, includingjoint adjustment and/or manipulation, with a particular focus on the subluxation. Therelationship between structure, especially the spine and musculoskeletal system, andfunction, especially as coordinated by the nervous system, is central to chiropractic and itsapproach to the restoration and preservation of health. The Practice of ChiropracticMedicine shall not include surgical procedures or the treatment of infectious diseases.The Practice of Chiropractic Medicine may include, activities that involve:1. Physical examination and ordering laboratory examinations consistent withChiropractic education and training, for diagnostic purposes, including, but not limitedto, clinical laboratory tests, and physiological function tests.2. Treatment designed to prevent or correct neurological, skeletal, or soft tissuedysfunction by employing snail and other articular adjustments and manipulations:and3. All diagnostic tests not consistent with naturopathic medical education and trainingmust be referred for performance and interpretation to an appropriately licensedhealth care professional.4. Hot or cold hydrotherapy; Chiropractic Manipulation; trigger point therapy; electrotherapy;and therapeutic exercise.5. Nutritional counseling, extracts of food, nutraceuticals, vitamins, amino acids,minerals, enzymes, botanicals and their extracts, botanical medicines, dietarysupplements and nonprescription drugs.6. Devices including therapeutic devices and durable medical equipment within thescope of training.7. Health education and health counseling.8. Radiological testing must be done by licensed medical doctors (M.D.s) trained inradiology.The Practice of Chiropractic Medicine does not include assistance rendered in emergencysituations by the Licensee.regulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

Patient Safety and Evidence-Based Care in the Practice of Chiropractic Medicine:1. The goal of these Rules and of the General Licensing Rules in addressing the scopeof the Practice of Chiropractic Medicine is to ensure patient safety.2. Licensed Chiropractors shall not be permitted to expand the scope of theirProfessional Practice where they do not have the requisite training or experience topursue such therapeutic approaches.3. The provisions of this Section are not to be construed to supplant or replace theprivileging requirements and processes that the DHA health regulation requiresLicensed Healthcare Facilities to develop and maintain as they relate to LicensedChiropractors holding Licenses under these Rules.General Requirements for all Licensed ChiropractorsA Licensee who holds a Chiropractic License must adhere to the following principles andcomply with the following obligations in his Practice of Chiropractic Medicine. These are inaddition to such other requirements as are established under these Rules and the GeneralLicensing Rules and pursuant to conditions that the DHA health regulation may attach tosuch Licensee’s License:1. The Licensee shall have general competence in patient oriented skills, integratingexamination and diagnosis with sensitivity to patient needs and culture. They must beknowledgeable in the basic scientific approach to common illnesses and the seriousor life threatening common diseases and refer when appropriate.2. The decision to employ Chiropractic and its effectiveness in a given case aregoverned by knowledge of the individual patient in accordance with ChiropracticPrinciples, and with careful observance of the following specific procedures:a. Individualization of the medical history and physical examination of the patientmust be obtained.b. Employment of diagnostic procedures when appropriate as outlined abovec. Evaluate the sensitivity of patient to medical treatment and their potentialreaction and response to administration of Chiropractic treatment with a focuson potential reactions to Chiropractic manipulation.3. The Licensed Chiropractor is obligated to refer to a general medical physician orspecialists when there is any doubt about the patient’s diagnosis or response totherapy. A referral must not be withheld or discouraged when the patient asks for asecond opinion.4. The Licensed Chiropractor bears the responsibility of maintaining a comprehensiverecord about their patient, including pursuit of diagnostic tests and consultations in atimely fashion and collaborating with other medical professionals.regulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

In addition to satisfying the above requirements of, a Licensed Chiropractor:1. Must fulfil the Continues Education requirements for licensure, the standards ofProfessional Practice and behavior expected of all Licensees;2. May administer care in the office or the patient’s home.regulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

Homeopathy Scope of Practice“Homeopathy” A therapy based on the theory of treating likes with likes, which basicprinciples are: law of similarity, direction of cure, principle of single remedy, the theory ofminimum diluted dose and the therapy of chronic diseases. Homeopathic remedies usehighly diluted substances that if given in higher doses to a healthy person would producethe symptoms that the dilutions are being given to treat. In assessing the patienthomeopaths often take into account a range of physical, emotional, and life style factorswhich contribute to the diagnosis. Rather than fighting the disease directly, medicines areintended to stimulate the body to fight the disease.The Practice of Homeopathy shall include, activities that involve:1. engaging in the examination, diagnosis or treatment of a symptoms or humandisease;2. offering or attempting to prescribe or order any homeopathic medicine for the use ofany other person, except as otherwise authorized by law;The Practice of Homeopathy does not include assistance rendered in emergency situationsby the Licensee.Patient Safety, and Evidence-Based Care In the Practice of Homeopathy:1. The goal of these Rules and of the Private Healthcare Standards Rules in addressingthe scope of the Practice of Homeopathic Medicine is to ensure patient safety.2. Licensed Homeopaths shall not be permitted to expand the scope of theirProfessional Practice where they do not have the requisite training or experience topursue such therapeutic approaches.a. Licensed Homeopaths who also have an active physician License may usesterile homeopathic medicinal products for injections.3. The provisions of this Section are not to be construed to supplant or replace theprivileging requirements and processes that the DHA health regulation requiresLicensed Healthcare Facility to develop and maintain as they relate to LicensedHomeopaths holding Licenses under these Rules.General Requirements for all Licensed HomeopathLicensed Homeopaths must adhere to the following principles and comply with the followingobligations in his Practice of Homeopathy. These are in addition to such other requirementsas are established under these Rules and the General Licensing Rules and pursuant toconditions that the DHA health regulation may attach to such Licensee’s License:regulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

1. The Licensee shall have general competence in patient oriented skills, integratingexamination and diagnosis with sensitivity to patient needs and culture. They must beknowledgeable in the basic scientific approach to common illnesses and the seriousor life threatening common diseases and refer when appropriate.2. The decision to employ Homeopathy and its effectiveness in a given case aregoverned by knowledge of the individual patient in accordance with HomeopathicPrinciples, and with careful observance of the following specific procedures:a. Individualization of the total symptom complex of the patient must be obtainedby a detailed history when appropriate.b. Employment of diagnostic procedures, supported by laboratory studies, whenappropriate.c. Evaluation of the sensitivity of patient to medical treatment and the probablereaction and response of the patient to administration of homeopathicmedicinal products, in particular.d. Administration of one or more single or complex homeopathic medicinalproduct, when possible, in the dose that will evoke the desired response in thepatient.e. The Licensed Homeopaths must remember that they are treating a patientwho has a disorder rather than just prescribing for a disease entity3. The Licensed Homeopath is obligated to refer to a general practitioner or specialistswhen there is any doubt about the patient’s diagnosis or response to therapy. Areferral must not be withheld or discouraged when the patient asks for a secondopinion.4. Licensed Homeopath bears the responsibility of maintaining a comprehensive recordabout their patient, including pursuit of diagnostic tests and consultations in a timelyfashion and collaborating with other medical professionals.In addition to satisfying the above requirements of, a Licensed Homeopath:1. Must fulfill the Continues Education requirements for licensure, the standards ofProfessional Practice and behavior expected of all Licensees;2. May administer care in the office or the patient’s home.regulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

Naturopathic Medicine Scope of the Practice‘Naturopathic medicine’ is a system of primary health care for the prevention, diagnosis,and treatment of human health conditions and disease; the promotion or restoration ofhealth; and the support and stimulation of a patient’s inherent self-healing processesthrough patient education and the use of naturopathic therapies and therapeuticsubstances. The Practice of Naturopathic Medicine shall not include surgical procedures,use of prescription medications, and the treatment of infectious diseases.The Practice of Naturopathic Medicine may include, activities that involve:1. Physical and laboratory examinations consistent with naturopathic education andtraining, for diagnostic purposes, including, but not limited to, clinical laboratory tests,and physiological function tests.2. Ordering diagnostic imaging studies consistent with naturopathic training.3. All diagnostic tests not consistent with naturopathic medical education and trainingmust be referred for performance and interpretation to an appropriately licensedhealth care professional.A Licensed Naturopath may administer, order, and prescribe or perform the following:1. Recommendation of food, extracts of food, nutraceuticals, vitamins, amino acids,minerals, enzymes, botanicals and their extracts, botanical medicines, Naturopathicmedicines, dietary supplements and nonprescription drugs.2. Hot or cold hydrotherapy; naturopathic physical medicine; electromagnetic energy;colon hydrotherapy; and therapeutic exercise.3. Devices, including, but not limited to, therapeutic devices and durable medicalequipment within the scope of training .4. Health education and health counseling.5. Musculoskeletal manipulation consistent with naturopathic education and training.The Practice of Naturopathic Medicine does not include assistance rendered in emergencysituations by the Licensee.Patient Safety, and Evidence-Based Care in the Practice of Naturopathic Medicine:1. The goal of these Rules and of the General Licensing Rules in addressing the scopeof the Practice of Naturopathic Medicine is to ensure patient safety.regulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

2. Licensed Naturopaths shall not be permitted to expand the scope of theirProfessional Practice where they do not have the requisite training or experience topursue such therapeutic approaches.3. The provisions of this Section are not to be construed to supplant or replace theprivileging requirements and processes that the DHA health regulation requiresLicensed Healthcare facilities to develop and maintain as they relate to LicensedNaturopaths holding Licenses under these Rules.General Requirements for all Licensed NaturopathsA Licensee who holds a Naturopathic License must adhere to the following principles andcomply with the following obligations in his Practice of Naturopathic Medicine. These are inaddition to such other requirements as are established under these Rules and the GeneralLicensing Rules and pursuant to conditions that the DHA health regulation may attach tosuch Licensee’s License:1. The Licensee shall have general competence in patient oriented skills, integratingexamination and diagnosis with sensitivity to patient needs and culture. They must beknowledgeable in the basic scientific approach to common illnesses and the seriousor life threatening common diseases and refer when appropriate.2. The decision to employ Naturopathy and its effectiveness in a given case aregoverned by knowledge of the individual patient in accordance with NaturopathicPrinciples, and with careful observance of the following specific procedures:a. Individualization of the medical history and physical examination of the patientmust be obtained.b. Employment of diagnostic procedures, supported by laboratory studies, whenappropriate as outlined abovec. Evaluation of the sensitivity of patient to medical treatment and the probablereaction and response of the patient to administration of naturopathictreatment.3. The Licensed Naturopath is obligated to refer to a general medical physician orspecialists when there is any doubt about the patient’s diagnosis or response totherapy. A referral must not be withheld or discouraged when the patient asks for asecond opinion.4. The Licensed Naturopath bears the responsibility of maintaining a comprehensiverecord about their patient, including pursuit of diagnostic tests and consultations in atimely fashion and collaborating with other medical professionals.In addition to satisfying the above requirements, a Licensed Naturopath:regulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

1. Must fulfil the Continues Education requirements for licensure, the standards ofProfessional Practice and behavior expected of all Licensees;2. May administer care in the office or the patient’s home.regulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

Osteopathic Medicine Scope of the Practice‘Osteopathic medicine’ is a system of primary health care based on a holistic approach todiagnose and treat musculoskeletal disturbances that affect other bodily parts and causemany disorders that can be corrected by various manipulative techniques known asOsteopathic Manipulative Medicine (OMM). OMM includes - Cranial osteopathy, Functionaladjustments, balanced ligamentous tension adjustments, Muscle energy adjustments, andother specific adjustment techniques to enhance the body’s healing ability. Osteopathictreatment is used for the prevention, diagnosis, and treatment of human health conditionsand disease; the promotion or restoration of health; and the support and stimulation of apatient’s inherent self-healing processes through patient education and the use ofOsteopathic therapies. The Practice of Osteopathic Medicine shall not include surgicalprocedures or the treatment of infectious diseases.The Practice of Osteopathic Medicine may include, activities that involve:1. physical and laboratory examinations consistent with Osteopathic education andtraining, for diagnostic purposes, including, but not limited to, clinical laboratory tests,and physiological function tests.2. All diagnostic tests not consistent with naturopathic medical education and trainingmust be referred for performance and interpretation to an appropriately licensedhealth care professional.3. Hot or cold hydrotherapy; Osteopathic Manipulative Medicine (OMM); CranialOsteopathy; electro-therapy; and therapeutic exercise.4. Recommendation of food, extracts of food, nutraceuticals, vitamins, amino acids,minerals, enzymes, botanicals and their extracts, botanical medicines, dietarysupplements and nonprescription drugs.5. Devices including therapeutic devices and durable medical equipment within thescope of training.6. Health education and health counseling.The Practice of Osteopathic Medicine does not include assistance rendered in emergencysituations by the Licensee.Patient Safety, and Evidence-Based Care in the Practice of Osteopathic Medicine:1. The goal of these Rules and of the General Licensing Rules in addressing the scopeof the Practice of Osteopathic Medicine is to ensure patient safety.2. Licensed Osteopaths shall not be permitted to expand the scope of their ProfessionalPractice where they do not have the requisite training or experience to pursue suchtherapeutic approaches.regulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

3. The provisions of this Section are not to be construed to supplant or replace theprivileging requirements and processes that the DHA health regulation requiresLicensed Healthcare facility to develop and maintain as they relate to LicensedOsteopaths holding Licenses under these Rules.General Requirements for all Licensed OsteopathsA Licensee who holds an Osteopathic License must adhere to the following principles andcomply with the following obligations in his Practice of Osteopathic Medicine. These are inaddition to such other requirements as are established under these Rules and the GeneralLicensing Rules and pursuant to conditions that the DHA health regulation may attach tosuch Licensee’s License:1. The Licensee shall have general competence in patient oriented skills, integratingexamination and diagnosis with sensitivity to patient needs and culture. They must beknowledgeable in the basic scientific approach to common illnesses and the seriousor life threatening common diseases and refer when appropriate.2. The decision to employ Osteopathy and its effectiveness in a given case aregoverned by knowledge of the individual patient in accordance with OsteopathicPrinciples, and with careful observance of the following specific procedures:a. Individualization of the medical history and physical examination of the patientmust be obtained.b. Employment of diagnostic procedures, supported by laboratory studies, whenappropriate as outlined abovec. Evaluation of the sensitivity of patient to medical treatment and the probablereaction and response of the patient to administration of Osteopathictreatment.3. The Licensed Osteopath is obligated to refer to a general medical physician orspecialists when there is any doubt about the patient’s diagnosis or response totherapy. A referral must not be withheld or discouraged when the patient asks for asecond opinion.4. The Licensed Osteopath bears the responsibility of maintaining a comprehensiverecord about their patient, including pursuit of diagnostic tests and consultations in atimely fashion and collaborating with other medical professionals.In addition to satisfying the above requirements, a Licensed Osteopath:1. Must fulfil the Contentious Education requirements for licensure, the standards ofProfessional Practice and behavior expected of all Licensees;2. May administer care in the office or the patient’s home.regulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

Therapeutic Massage Scope of the Practice“Therapeutic Massage” is a non-medication therapy. It is system of bodywork that includesapplication of soft tissue manipulation techniques to the body generally intended to reducethe stress, fatigue, and pain while improving circulation. Massage therapists work throughthe mobilization of the soft tissue including skin, muscles, tendons, ligaments, andconnective tissue.1. There are many variations of massage that account for several different techniques ,include:a. Acupressure - Acupuncture and acupressure use the same points, butacupuncture employs needles, while acupressure uses the gentle, but firmpressure of hands and feet;b. Alexander technique - The Alexander Technique is movement that reducesphysical stress on the body. Alexander Technique teachers use gentle manualguidance and verbal cues to improve students’ posture and movementpatterns;c. Aromatherapy - The use of essential oils (extracted from herbs, flowers, resin,woods, and roots) in body and skin care treatments;d. Ayurvedic Massage Therapy - An Ayurvedic massage is one part of thetraditional detoxification and rejuvenation program of India calledpanchakarma, in which the entire body is vigorously massaged with largeamounts of warm oil and herbs to remove toxins from the system;e. Bowen technique –light-touch body consists of gentle rolling movements overmuscle bellies and tendons to stimulate the body’s own healing mechanisms.f. Deep tissue massage – Massage techniques that utilize deep-tissue/deepmusclemassage administered to affect the sub-layer of musculature andfascia. The muscles must be relaxed in order to effectively perform deeptissuemassage, otherwise tight surface muscles prevent the practitioner fromreaching deeper musculature. It is generally integrated with other massagetechniques.g. Feldenkrais Method – this method uses hands-on manipulation to guide newmovement patterns. Awareness through movement classes are groupsessions in which the teacher verbally guides students through repatterningand retraining the central nervous system through the musculoskeletal skeletalsystem;h. Lymphatic Massage - Lymph Drainage Therapy (LDT) palpates the lymphaticflow to identify the rhythm, direction, and quality of the lymphatic flow. It maybe used as an adjunctive therapy in patients post-operatively;regulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

i. Reflexology - Reflexology is the application of appropriate pressure to the legand feet, usually on specific points, to bring about physiological andpsychological changes throughout the body;j. Rolfing - Rolfing utilizes physical manipulation and works with the fascia,muscles, and joints to bring head, shoulders, thorax, pelvis, and legs intovertical alignment. It allows more efficient use of the muscles with lessexpended energy by lifting the head and chest and lengthening the body’strunk.;k. Shiatsu – Similar to acupressure, Shiatsu uses a finger-pressure technique ontraditional acupuncture points;l. Sports massage - Sports massage is designed to enhance athleticperformance and recovery;m. Swedish massage - Swedish massage is a vigorous system of massagedesigned to energize the body by stimulating circulation. Five basic strokes, allflowing toward the heart, are used to manipulate the soft tissues of the body;n. Therapeutic Touch - Practitioners, primarily nurses using light touch, aretrained to feel or sense energy imbalances in the client and use light touch tostimulate healing;o. Traditional Chinese Medicine Massage (Tui na) - Tui na techniques rangefrom those that are light and soothing to those that are strong and invigorating.Tui na facilitates healing by regulating the circulation of blood and qi (vitalenergy), combines the names of two of the hand techniques, tui meaning topush and na meaning to lift and squeeze, which are used to represent thesystem; andp. Traditional Thai Massage - Thai massage involves peripheral stimulation andis practiced on a firm mat on the floor instead of on a table. Except for the feet,the client remains fully clothed, and the weight of the practitioner is usedtherapeutically in the massage2. Massage therapists may include adjunctive therapies such as hydrotherapy, mildabrasives, or topical preparations not classified as prescription drugs, mechanicaldevices and tools that mimic or enhance manual actions, and instructed self care.3. Massage therapy may be provided in response to a physician’s prescription or inconjunction with other therapeutic modalities.The Practice of Massage does not include assistance rendered in emergency situations bythe Licensee.Patient safety and Evidence-Based Care in the Practice of Massage:regulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

1. The goal of these Rules and of the General Licensing Rules in addressing the scopeof the Practice of Massage is to ensure patient safety.2. Licensed Massage Therapists (M.T.) shall not be permitted to expand the scope oftheir Professional Practice where they do not have the requisite training orexperience to pursue such therapeutic approaches.3. The provisions of this Section are not to be construed to supplant or replace theprivileging requirements and processes that the DHA health regulation requiresLicensed Healthcare Facilities to develop and maintain as they relate to LicensedMassage Therapists (M.T.) holding Licenses under these Rules.General Requirements for all Licensed Massage Therapists (M.T.)A Licensee who holds a Massage License (M.T.) must adhere to the following principlesand comply with the following obligations in their practice of Massage. These are in additionto such other requirements as are established under these Rules and the General LicensingRules and pursuant to conditions that the DHA health regulation may attach to suchLicensee’s License:1. The Licensee shall have general competence in patient oriented skills, integratingexamination and diagnosis with sensitivity to patient needs and culture. They must beknowledgeable in the basic scientific approach to common illnesses and the seriousor life threatening common diseases and refer when appropriate.2. The decision to employ Massage and its effectiveness in a given case are governedby knowledge of the individual patient in accordance with Massage principles.a. Individualization of the medical history and physical examination of the patientmust be obtained.b. Evaluation of the sensitivity of patient to medical treatment and the probablereaction and response of the patient to administration of the treatment chosen.3. The Licensed Massage Therapists (M.T.) is obligated to refer to a general medicalphysician or specialists when there is any doubt about the patient’s diagnosis orresponse to therapy. A referral must not be withheld or discouraged when the patientasks for a second opinion.4. The Licensed Massage Therapists (M.T.) bears the responsibility of maintaining acomprehensive record about their patient including collaborating with other medicalprofessionals.regulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

In addition to satisfying the above requirements, a Licensed Massage Therapists (M.T.):1. must fulfil the Continues Education requirements for licensure, the standards ofProfessional Practice and behavior expected of all Licensees;regulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

Traditional Chinese Medicine Scope of the Practice‘Traditional Chinese Medicine” is a system of primary health care for the prevention,diagnosis, and treatment of human health conditions and disease; the promotion orrestoration of health; and the support and stimulation of a patient’s inherent self-healingprocesses through patient education and the use of Traditional Chinese Medicine therapiesand therapeutic substances. The Practice of Traditional Chinese Medicine shall not includesurgical procedures or use of prescription medications.The Practice of Traditional Chinese Medicine may include, activities that involve:1. physical examination and requested laboratory examinations consistent withTraditional Chinese Medicine education and training, for diagnostic purposes,including, but not limited to, clinical laboratory tests, and physiological function tests;and2. request diagnostic imaging studies consistent with their Traditional Chinese Medicinetraining; and3. All diagnostic tests not consistent with naturopathic medical education and trainingmust be referred for performance and interpretation to an appropriately licensedhealth care professional.A Licensed Traditional Chinese Medicine Professional may administer, order, and prescribeor perform the following:1. the stimulation of points, areas of the body or substances in the body using qi,needles with or without electrical stimulation (using clean needle technique),moxibustion, heat and cold, color, light, lasers, or suction (cupping); anda. cupping can be done “dry” or “wet”; if the cupping is done wet, steriletechnique must be followed; and2. therapeutic exercises, qi exercises, breathing techniques, and meditation; and3. dietary and nutritional counseling; and education regarding physical, emotional andspiritual balance as it relates or Traditional Chinese Medicine; and4. the prescription of Chinese herbal medicines (single or in combination as patentmedicines, tinctures, granules or raw herbs) as long as it is consistent with TCAMFacility Regulation; and5. musculoskeletal manipulation consistent with Traditional Chinese Medicine training(Tui Na).‘Medical Acupuncture refers to licensed medical doctors practicing acupuncture onlyThey may only practice acupuncture utilizing the stimulation of points using needles ,moxibustion, heat and cold, color, light, or lasers.regulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

The Practice of Traditional Chinese Medicine does not include assistance rendered inemergency situations by the Licensee.Patient safety and Evidence-Based Care in the Practice of Traditional Chinese Medicine orMedical Acupuncture:1. The goal of these Rules and of the General Licensing Rules in addressing the scopeof the Practice of Traditional Chinese Medicine or Medical Acupuncture is to ensurepatient safety.2. Licensed Traditional Chinese Medicine Professionals shall not be permitted toexpand the scope of their Professional Practice where they do not have the requisitetraining or experience to pursue such therapeutic approaches.3. The provisions of this Section are not to be construed to supplant or replace theprivileging requirements and processes that the DHA health regulation requiresLicensed Healthcare Facilities to develop and maintain as they relate to LicensedTraditional Chinese Medicine Professionals holding Licenses under these Rules.General Requirements for all Licensed Traditional Chinese Medicine ProfessionalsA Licensee who holds a Traditional Chinese Medicine License must adhere to the followingprinciples and comply with the following obligations in their practice of Traditional ChineseMedicine. These are in addition to such other requirements as are established under theseRules and the General Licensing Rules and pursuant to conditions that the DHA healthregulation may attach to such Licensee’s License:1. The Licensee shall have general competence in patient oriented skills, integratingexamination and diagnosis with sensitivity to patient needs and culture. They must beknowledgeable in the basic scientific approach to common illnesses and the seriousor life threatening common diseases and refer when appropriate.2. The decision to employ Traditional Chinese Medicine or Medical Acupuncture and itseffectiveness in a given case are governed by knowledge of the individual patient inaccordance with Traditional Chinese Medicine or Medical Acupuncture principles,and with careful observance of the following specific procedures:a. Individualization of the medical history and physical examination of the patientmust be obtained.b. Employment of diagnostic procedures, supported by laboratory studies, whenappropriate as outlined in above.c. Evaluation of the sensitivity of patient to medical treatment and the probablereaction and response of the patient to administration of the treatment chosen.3. The Licensed Traditional Chinese Medicine Professionals is obligated to refer to ageneral medical physician or specialists when there is any doubt about the patient’sregulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

diagnosis or response to therapy. A referral must not be withheld or discouragedwhen the patient asks for a second opinion.4. The Licensed Traditional Chinese Medicine Professionals bears the responsibility ofmaintaining a comprehensive record about their patient, including pursuit ofdiagnostic tests and consultations in a timely fashion and collaborating with othermedical professionals.In addition to satisfying the above requirements, a Licensed Traditional Chinese MedicineProfessionals:1. must fulfil the Continues Education requirements for licensure, the standards ofProfessional Practice and behavior expected of all Licensees;regulation@dha.gov.ae DHA hotline tel. no: 800 DHA (342) www.dha.gov.ae

Unani Medicine Scope of the Practice‘Unani medicine’ is a healthcare system based on the Greece/Arabic philosophywhich consists of four bodily humours: blood, phlegm, yellow bile, and black bile.It encompasses a range of practices, including diet and nutritional therapy, herbalmedicine, life style, stress management, cupping, body detoxification(diaphoresis, diuresis, purging, emesis) and exercise.The Practice of Unani Medicine may include, activities that involve:1. Physical examination and ordering laboratory examinations consistentwith Unani education and training, for diagnostic purposes; and.2. Treatment designed to prevent or correct constitutional dysfunction byemploying Unani medications and above mentioned therapeutictechniques including cupping;a. Cupping can be done “dry” or “wet”; if the cupping is done wet,sterile technique must be followed; and3. All diagnostic tests not consistent with naturopathic medical education andtraining must be referred for performance and interpretation to anappropriately licensed health care professional.4. Hot or cold hydrotherapy; and therapeutic exercise.5. Devices including therapeutic devices and durable medical equipmentwithin the Unani Practitioner’s scope of training.6. Health education and lifestyle counseling.The Practice of Unani Medicine does not include assistance rendered inemergency situations by the Licensee.Patient Safety, and Evidence-Based Care in the Practice of Unani Medicine:1. The goal of these Rules and of the General Licensing Rules in addressingthe scope of the Practice of Unani Medicine is to ensure patient safety.2. Licensed Unani Practitioners shall not be permitted to expand the scope oftheir Professional Practice where they do not have the requisite training orexperience to pursue such therapeutic approaches.www.dhacommunity.com DHA hotline tel.no: 800 DHA (342) www.dha.gov.ae

3. The provisions of this Section are not to be construed to supplant orreplace the privileging requirements and processes that the DHA healthregulation requires Licensed Healthcare Facilities to develop and maintainas they relate to Licensed Unani Practitioners holding Licenses underthese Rules.General Requirements for all Licensed Unani PractitionersA Licensee who holds a Unani License must adhere to the following principlesand comply with the following obligations in his Practice of Unani Medicine.These are in addition to such other requirements as are established under theseRules and the General Licensing Rules and pursuant to conditions that the DHAhealth regulation may attach to such Licensee’s License:1. The Licensee shall have general competence in patient oriented skills,integrating examination and diagnosis with sensitivity to patient needs andculture. They must be knowledgeable in the basic scientific approach tocommon illnesses and the serious or life threatening common diseasesand refer when appropriate.2. The decision to employ Unani and its effectiveness in a given case aregoverned by knowledge of the individual patient in accordance with UnaniPrinciples, and with careful observance of the following specificprocedures:a. Individualization of the medical history and physical examination ofthe patient must be obtained.b. Employment of diagnostic procedures when appropriate as outlinedin abovec. Evaluate the sensitivity of patient to medical treatment and theirpotential reaction and response to administration of Unanitreatment with a focus on potential reactions to Unani manipulation.3. The Licensed Unani Practitioner is obligated to refer to a general medicalphysician or specialists when there is any doubt about the patient’sdiagnosis or response to therapy. A referral must not be withheld ordiscouraged when the patient asks for a second opinion.4. The Licensed Unani Practitioner bears the responsibility of maintaining acomprehensive record about their patient, including pursuit of diagnostictests and consultations in a timely fashion and collaborating with othermedical professionals.www.dhacommunity.com DHA hotline tel.no: 800 DHA (342) www.dha.gov.ae

In addition to satisfying the above requirements, a Licensed Unani Practitioner:1. Must fulfill the Continues Education requirements for licensure, thestandards of Professional Practice and behavior expected of allLicensees;2. May administer care in the office or the patient’s home.www.dhacommunity.com DHA hotline tel.no: 800 DHA (342) www.dha.gov.ae