(2001; 200 pages)
The complementary/alternative treatments most used by the Danish population are reflexology, acupuncture, massage, natural medicine, homeopathy, natural healing, kinesiology, and chiropractic (172).
A 1994 study (172) reported that 33% of the adult population of Denmark had used complementary/alternative medicine during the previous year, women used it more frequently than men, and the average age of patients of complementary/alternative medicine decreased in the period from 1970 to 1994. The study also found that of those who used complementary/alternative treatments, 77% considered themselves cured, 17% experienced no effect from the therapy, and 1% considered their health problems to have worsened as a result of their treatment. People most often sought complementary/alternative therapies for joint and muscular problems.
Approximately 700 physicians are members of the Danish Society for Medical Acupuncture; 116 of these are newly certified (172). There are 265 chiropractors practising in Denmark (45). The Danish Chiropractic Association has 300 members. There are 16 000 allopathic medical doctors in Denmark. There are also several associations of non-allopathic physician providers.
In Denmark, allopathic physicians holding an academic degree in medicine, having taken the Hippocratic oath before a faculty of medicine, and authorized by the National Health Service are not restricted as to the medical techniques they may use. The title of "Physician" is protected and only licensed allopathic physicians may call themselves such. Public-sector medical positions are reserved for authorized doctors (172).
Two laws (172) regulate the practice of complementary/alternative medicine. The Medicine Act legislates the making and marketing of natural remedies and includes criteria for packaging, providing information to patients, and advertising. The Practice of Medicine Act of 1970 permits non-allopathic physicians to practise medicine regardless of their training and without previous authorization. However, non-allopathic physicians are not recognized as official health care providers, their titles are not protected, and they are not integrated into the national health care system.
By Articles 23-26 of Order 426 of the Practice of Medicine Act of 1976, issued by the Minister of the Interior on 19 August 1976, non-physicians may not perform specific medical acts that are reserved for licensed allopathic physicians, nor are they permitted to use needles except under the supervision of an allopathic physician. The medical acts reserved for licensed physicians are the following: treating persons for venereal diseases, tuberculosis, or any other infectious disease; performing surgery; administering general or local anaesthetics; providing obstetric aid; applying medicines that may be dispensed only with a physician's prescription; using X-ray or radium treatments; or practising therapies using electric machines. Violation of this limited monopoly is punishable by up to 12 months in prison. However, non-allopathic practitioners are only prosecuted for selling harmful products, otherwise exposing patients to a provable danger, or causing the serious deterioration or death of their patients. Sentencing is particularly severe in cases where the patient is mentally ill or handicapped, under 18 years of age, or considered incapable of managing his/her own affairs. Ancillary staff, by contrast, may practice complementary/alternative medicine without restriction.
Chiropractors are the exception to this law. They are regulated by a 1992 law (65). Whenever patients consult a chiropractor without an allopathic physician's referral, the chiropractor must inform the patient's practitioner of the diagnosis and treatment, whether the practitioner is an allopathic physician or not.
A Danish study on complementary/alternative treatments concluded that current legislation in this field is sufficient and further regulations are not necessary.
Education and training
The Danish Society for Medical Acupuncture offers a 120-hour diploma course in acupuncture for allopathic physicians (172). The Danish Chiropractic Association (172) provides training for non-allopathic physicians. Membership in the Danish Chiropractic Association is restricted to those persons trained at a college accredited by the American Council on Chiropractic Education who have completed a six-month apprenticeship with a member of the Association and have passed the Association exam.
The Danish Chiropractic Association (172) is working to obtain official recognition and full social insurance reimbursement for chiropractic treatments. In the meantime, reimbursement is determined by a 1975 agreement between public insurance schemes and chiropractors. Under this agreement, public insurance covers one-third of the costs of up to five chiropractic consultations and one X-ray examination per year, on the condition that these are provided by chiropractors recognized by the Danish Chiropractic Council. When patients are referred by licensed allopathic physicians, some acupuncture and osteopathic treatments are also reimbursed (172).