Speaking Mindfully: The Legal Implications of Health Advice, Part I
Although students often ask yoga teachers and studios for health advice, legal and ethical rules can affect the way such questions can be answered. Here's how to understand some of the legal implications of requests by yoga students for health advice.
By Michael H. Cohen, JD, MBA
Yoga teachers can receive professional credentialing, but no state grants yoga teachers licensure based on specified educational and clinical training requirements. Therefore, even well intended health advice could cross the line into the unlicensed practice of medicine, psychology, or even other disciplines.
Of course, some yoga teachers have licenses in other health care professions, which may give them greater latitude, but there are still complexities when one carries dual licensure and is operating in one sphere (e.g., the yoga studio instead of the acupuncture clinic). Given this environment, the following suggestions may help limit legal trouble and also maintain healthy boundaries around one's current, professional role:
1. Acknowledge the limitations of yoga teaching. It's ok—and often advisable—to tell your students that you simply aren't qualified to give advice about their conditions. When asked for advice, remind them that although in the holistic model of health, the body, mind, and spirit may constitute a seamless whole, our licensing laws do assign different tasks to different providers. Being modest about your knowledge and authority is a great way to smooth over any tension this acknowledgement might create. Less is more; it's better to be humble than to "punt." It would be perfectly acceptable, for example, to admit to students that you do not know whether and how inversions could affect their ongoing chiropractic care for whiplash, medical care for asthma, or heart condition.
2. Emphasize the role of licensed health professionals in dispensing health advice. The 200 or 500-hour yoga teacher training required for certification should and typically does include information about potential contraindications, and it is important to review these with students. At the same time, you can remind your students to consult an appropriate health professional. Saying "I am not a medical doctor, so you should consult your physician regarding your heart condition" would be an appropriate response to the third student. Thus, the corollary to suggestion 1 is to refer students to their licensed chiropractor, medical doctor, acupuncturist, or appropriate health care professional for information and advice regarding their specific condition.
3. Beware of nutritional recommendations, especially involving dietary supplements. It may be tempting to recommend dietary supplements, especially when asked. But scientific evidence for many supplements and their ingredients has been mixed at best and many adverse effects have been reported. In many cases, licensing boards have disciplined health care providers who have offered patients nutritional advice, finding this to exceed their legally authorized scope of practice. Caution pays.
4. Appropriately acknowledge students' health concerns. As a yoga teacher, one of your challenges is making judgment calls when it comes to encouraging students to move past their fears. There is a line between facing one's "edge" and acknowledging potential health concerns and limitations (see "Should Yoga Studios Ask Students to Sign a Liability Waiver?"). "If you feel uncomfortable for any reason, don't do the pose" is a safe suggestion. If, after appropriate medical or other professional health advice, it turns out the student can attempt the pose without any health risk, then it is fine to encourage the student to do so.
Yoga Journal's medical editor, Timothy McCall, MD, gives very cogent advice on this matter in "Can You Prove That Yoga Works?": "When we don't know precisely why something works, it's best to admit it, rather than dress it up in the language of science to make it sound more impressive….The irony is that when we try to explain yoga in scientific terms when the science just isn't there, we risk undermining our attempts to persuade others of yoga's benefits."
I am constantly asked for advice concerning participants issues and what yoga can do for them, I say if it feels good, do it, if it hurts, don't, I tell them this is a good way to get to know your own body's weaknesses and strengths, to be consistent with practice, you never know what comes of it till you gather experience.