Practitioners List: Regulations and Code of Ethics

In these regulations the following terms have the following meanings:

'AEN'

shall mean Allergy Environmental and Nutritional.

'AENM'

shall mean AEN Medicine.

'BSEM'

is the British Society for Ecological Medicine.

'The Board'

means the Board of Registration of the BSEM, responsible for this Register.

'Complementary Medicine' and 'complementary'

mean diagnostic or therapeutic methods, traditional or new, which are neither part of mainstream Western medicine nor are currently accepted by the Board as acceptable AEN methods.

'Registration' and 'Registrants'

pertain to the Register of AEN Physicians.

'He', 'him' and 'his'

include their feminine equivalents.

Regulations

All Registrants have demonstrated to the Board's satisfaction their competence in the diagnosis and treatment of patients using the methods of AEN Medicine. Specifically, the Board has been satisfied as to their
1.  Proficiency in allergy aspects, and
2.  Proficiency in environmental aspects, and
3.  Proficiency in nutrition aspects, and
4.  Continuing education in AENM, and
5.  Completion of long and short case histories to a satisfactory level, and
6.  Clinical outcome audit showing clinical improvement of treated patients comparable to that achieved by other Registrants, and
7.  Performance in all related matters as determined by a clinic visit or other appropriate assessment.

Furthermore, in order to register they have
8.  signed and submitted the Statement attached to the Code of Ethics (below), and
9.  either been recommended by two existing Registrants in writing to be a fit and proper person for registration,
      or in the absence of such written recommendations, they have been included in the Register by a majority unopposed ("nem con") vote of the Board.

Registrants who use AENM methods as their primary approach to the conditions that respond, backing these up with conventional medicine if appropriate, are on List A. Registrants who use AENM methods as their primary approach, backing these up with complementary medicine if appropriate, are on List B. Desensitisation methods currently considered by the Board to be acceptable AENM methods are listed, for each Registrant using them.

The Board is not competent to express opinions on Complementary Medicine. Complementary methods used by Registrants are noted if volunteered, and inclusion of such methods implies neither approval nor disapproval by the Board. Methods of diagnosis or treatment purporting to be AEN methods but for which there exists, in the Board's opinion, insufficient current supporting evidence are also noted, for practitioners professing to use them, and such inclusion implies neither approval nor disapproval by the Board.

Each Registrant has supplied a list of conditions he considers himself to be good at treating, and these are noted.

Although every care is taken in assessing physicians for registration, the responsibility for medical treatment always lies with the individual doctor and patient and not with the Register.

All Registrants are also on the Medical Register or the Dental Register. Dentist Registrants are noted as such. The Board of Registration will express views or take action on matters falling within the area of AEN medicine notwithstanding that the General Medical or Dental Councils may also have jurisdiction.

Registration is limited to members practising in the UK. Overseas members may apply for the category of Correspondent, to be listed under a separate heading. Correspondents have satisfied the Board as above but are not regulated by the Board.

Code of Ethics

Every Registrant shall at all times so order his conduct as to uphold the dignity and reputation of the speciality of Allergy Environmental and Nutritional Medicine and to safeguard the interests of patients and public in matters of safety, efficacy, costs and otherwise. He shall exercise his professional skill and judgement to the best of his ability and discharge his professional responsibilities with integrity and compassion. Each Registrant shall sign and deliver to the Board of Registration a written undertaking to the effect set forth herein, and this shall be an essential condition for registration. If any Registrant becomes aware of infringements of this code by any other Registrant it is his duty to report it to the Board which, in cases of severe violation, may remove practitioners from the Register. An appeals procedure is in place.

A.  Methods of Treatment The Board accepts AEN treatment methods if they have been validated by adequate peer-review publications using conventional levels of statistical significance (p>0.05), or are supported by basic science and by regular and effective custom and usage. The Board currently considers the treatment methods advocated in the textbook "Environmental Medicine in Clinical Practice" (1997), obtainable from BSEM Publications, to be acceptable by these criteria as AEN methods. The Board recognises the need for research into the basic science of AEN medicine, and the need for expanding and improving the methods available for diagnosis and treatment, and expects Registrants to play their part in this, keeping the Board informed about developments.

Registration will not be granted to or renewed for practitioners who habitually use methods not supported as above, unless the applicant demonstrates that he is engaged in current audit of the methods (either when using a method on its own or in combination with other methods), and preferably research to provide the required scientific evidence, the results of which must be made available on demand to the Board for inspection. Patients must be informed whether the treatment methods proposed for them are currently accepted by the Board or not.

B.  Safety The Board recognises that although adverse effects of AEN medicine are uncommon, no effective health intervention can be entirely free of risk. All Registrants must be prepared for acute allergic reactions, must keep up to date with methods of resuscitation, and must be equipped with all drugs and equipment appropriate to their type of practice. It will be the duty of all Registrants to keep records of all adverse treatment outcomes both short term and long term among their patients, and to submit them on request to the Board, which will collect and analyse them from time to time to see if evidence of genuine side-effects emerges.

C.  Methods of Diagnosis Registrants using tests, either clinical or laboratory-based, are required to explain honestly to the patient what can be expected of the test(s), and must be prepared, if asked, to give all available objective data on the tests' validity, sensitivity and specificity. If regularly using diagnostic tests for which, in the Board's opinion, there is insufficient evidence of validity, sensitivity or specificity, Registrants and applicants for registration must either (a) furnish such evidence on request to the Board, or (b) demonstrate that they are at least engaged in their own audit of the utility value of the test. Patients must be informed whether diagnostic tests proposed for them are currently accepted by the Board or not. It will not be sufficient to rely on utility values or testimonials quoted by the test purveyors.

D.  Fees Registrants charging fees for their services are expected to charge the normal market rate, as determined from time to time by the Board by surveying the fees charged for similar services by other practitioners of similar standing. Registrants and applicants for registration about whom any complaint of excessive charges has been received must be prepared to justify their fees and other charges to the Board's satisfaction. If associated with a private facility that charges its own fees, the Board requires Registrants and applicants for registration to demonstrate to the Board's satisfaction that the private facility's fees are also reasonable.

Appeals Procedure

To satisfy Human Rights legislation an independent Appeals Panel of four members has been appointed, namely a Chairman who will have the casting vote and two others, all three independent of the BSEM, plus one member of the BSEM committee. The Appeals Panel currently comprises an academic lawyer, an immunologist and a senior member of the BSEM committee, under the chairmanship of a Professor of Mathematics. All have either personal or family experience of AEN Medicine. They have agreed to serve and agree that they will not receive payment for their work other than reasonable expenses. New members of similar standing may be appointed to the Panel by the Board as necessary to replace retiring members.

Complaints against Registrants, and applications to the Register which are rejected by the Board, will be confidential to the Board unless the defendant appeals against the decision. In the event of an appeal the appellant will be entitled to nominate up to three sympathetic referees with whom the Panel may discuss his case and the Panel may also consult its own referees. An essential condition for an appeal is that the Panel at its discretion may discuss confidential details of the case with the referees, provided these are not disclosed by the referees to others. The appellant will be required at the outset to deposit funds to be determined from time to time (currently £500) to cover the expenses of the appeal process, returnable if the appeal succeeds, in which case the whole process will remain confidential. No legal representation will be allowed but the appellant may be accompanied at the hearing(s) by a friend who may speak if requested to do so by the Chairman. Neither the Board nor the Appeals Panel will be responsible for any costs incurred by the appellant, his friend or by any of his referees. If the appeal fails, all expenses of the appeal will be deducted from the deposit and the remainder returned. Failed appeals will be reported to the Board, the BSEM Committee, and if the Board considers appropriate in the Society's Newsletter.