Netherlands

Legislation
In 1993 the law “Wet Beroepen Individuele Gezondheidszorg (BIG)” allowed anyone to provide medical care. However only medical professionals registered in the BIG register could carry out certain procedures (e.g. prescription of medication, surgery).

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A penal provision was included in the act: damaging a person’s health would be punished. Complementary and alternative practitioners are not registered in the BIG register, unless they also have a medical background.

Since 2009, it is obligatory to have your practice registered with the regional Chamber of Commerce. A VAT number and registration with the Tax Authorities (VAT = 21%) are also required. You are obliged to file tax returns. In 1992, it became obligatory for all businesses to have company liability insurance.

Reflexologists often have their own practice, many of them in their own homes. The majority of them are female.

Reflexology and conventional medicine
Reflexology in hospitals is not common yet. We know of a VNRT-reflexologist who is allowed to give people treatment during chemo therapy, but only on the initiative of the patient. We also know of a nurse who gave post-operative patients treatments of 10 minutes in order to avoid a catheter. So it is only in rare cases and also not very official or made public. Hospitals don’t advertise with it.
Some GP’s refer their patients to a reflexologist, but again this is only in individual cases. In the south of the Netherlands some midwifes work together with reflexologists.

Attitude research on Integrative Medicine
The Louis Bolk Institute is conducting various studies on the attitude and knowledge of healthcare managers, nurses and pediatricians regarding Integrative Medicine (IM), the combination of conventional medicine and complementary or alternative therapies (CAM). The project runs from 2009 to 2012, and is funded by various healthcare organisations.

Nurses are more positive about Integrative Medicine than managers
The first results indicate that higher managers and administrators have a somewhat skeptical attitude toward IM, whereas nurses have a positive opinion of complementary treatments. Pediatricians are also positive, with a significant number using CAM therapies themselves. The results of these studies have been published in specialist journals; scientific articles are currently in preparation. The survey among pediatricians was concluded in the spring of 2011 (source: http://www.louisbolk.org/health-nutrition/integrative-medicine-3/attitude-research-on-integrative-medicine).(external link)

Organizations that promote integrative medicine and promote research on complementary therapies are:
NIKIM: Nationaal informatie- en kenniscentrum integrative medicine (National knowledge and data centre for Integrative Medicine) (www.nikim.nl)
IOCOB: Innovatief Onderzoek en Onderwijs van Complementaire Behandelsvormen (Innovative research and education of complementary therapies) (www.iocob.nl)

Although reflexology is still considered to be outside the medical establishment, it is becoming more and more known to the public.

PR
There are no specific marketing rules. Reflexologists can inform the public about who they are and what they do. However on July 2012 a new law was passed that says that it’s not allowed to claim on packaging and leaflets of homeopathic medication for which it can be used if it is not evidence based by clinical trials. So in that perspective it is wise to be careful about what reflexologists claim on their websites and advertisements and only speak from their own experience.

Title and registration
The title reflexologist is not protected, meaning that everybody can call themselves reflexologists and start a practice.

However, in order to be recognized by private health insurers the following is necessary:

– Membership of an association that has been accredited by these health insurers;
– An AGB-code: AlgemeenGegevensBeheer zorgverleners (General Registration for Health practitioners).This registration code is necessary for health insurers to recognize any health practitioner and you can only receive one as a member of an approved association.

Without recognition from the private health insurer, reflexologists can still have a practice but clients cannot reclaim the costs of treatment from their insurer.

Education and associations
There are a number of reflexology training programmes in the Netherlands. Reflexology associations have recognized eight of these. Now, each association has their own requirements and standards.
There are three associations, which are exclusively for reflexologists, and four that deal with several complementary disciplines of which reflexology is one.
RIEN members are:
– S.V.R; Stichting Vakgroep Reflexzonetherapeuten
– B.E.R; Bond van Europese Reflexologen
– V.N.R.T ;Vereniging van Nederlandse Reflexzone Therapeuten
– L.V.N.G; Landelijke Vereniging Natuurlijke Geneeswijzen (for several complementary disciplines).

Reimbursement of reflexology treatments by health care insurers
In the Netherlands, everyone must have basic health insurance. The government sets standards for what should be included. Private health insurers execute this and one can choose between a number of companies. Basic insurance can be extended by paying for extra coverage: i.e. dental care but also alternative therapies. If your extra insurance covers alternative therapies, reflexology treatments and/or other complementary therapies will be paid for up to a total amount of €300-€500 (±6 to 10 treatments) a year, provided that the therapist is recognized by these health insurers.

Research
Research into reflexology is still rarely carried out. But interest in CAM research is growing. The Louis Bolk Institute conducts research into the implementation and efficacy of Integrative Medicine techniques, such as guided visualizations, mindfulness, yoga and Tai Chi, and supplementary care programs, for the treatment of pain, anxiety, stress and life style related illnesses(www.louisbolk.org).

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Oktober 2015: An alternative doctor is also a doctor.
Three years after the introduction of the VAT tax (21%) on alternative medicine is approaching the end of this ( by the Dutch Association against Quackery motivated) measure. After several processes in the Tax Court and the Supreme Council is the conclusion: the tax authorities cannot discriminate between conventional medicine and alternative therapies of doctors and therapists. Based on the judgment of the Supreme Court, the Tax has changed its course and one is in discussions with several industry associations about the implications of this ruling.

Source: NRC Handelsblad

Erkenning dat alternatieve genezers volwaardige beroepsbeoefenaars zijn