Chinese dragon or toothless tiger? Regulating the professional competence of traditional Chinese medicine practitioners.

The escalation in popularity of complementary and alternative medicine (CAM) has begun to stimulate regulatory responses to ensure the safety and efficacy of different modalities. The Therapeutic Goods Authority in Australia oversees a scheme of listing and registration, said to lead the world. Established CAM courses now confer recognised bachelor degrees. Victoria has recently regulated Traditional Chinese Medicine (TCM) practitioners, through the Chinese Medicine Registration Act 2000 (Vic), modelled on legislation regulating medical practitioners. CAM is being integrated into conventional medical (especially general) practice, and calls for the "mainstreaming" of CAM are increasing. Integrating CAM, however, involves a critical incoherence, well illustrated by the Victorian legislation. Clinical competence can only be properly assessed against standards established through scientific validation. If CAM systems, which purport to offer alternatives to science-based medicine, are regulated through conventional instruments, they may well be relinquishing the very identities which set them apart.