Know your healer

Exberliner's October issue is all about the alternative medicine craze. Get a dose here, as we trudge through the bureaucratic jungle of a Heilpraktiker's existence in Germany. For even more alt-healing, grab October's issue on newsstands now.

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Photo by Charlotte Eberwein
Germans are crazy about alternative therapies – more than any other Europeans. But it’s a poorly regulated jungle out there, with no unified set of rules regarding individual healing methods. Mary Miller, a South African from Kwazulu Natal, always knew she wanted to be a healer. She grew up around Zulu sangomas, witch doctors, and watched them help their patients without conventional medicine. She studied for three years at London’s Westminster University, obtaining a Bachelor of Science and Homeopathy degree, and worked as a practising homeopath for the next seven years. Yet when she decided to move to Berlin in 2008, she found that practicing her profession wasn’t so easy. “Even though I had a degree in homeopathy, it wasn’t recognised in Germany,” Miller says. “I didn’t know that when I moved here and I expected to carry on practising straight away.” After learning German and studying for a year at a private college, she passed an official Heilpraktiker examination in 2010.
The fact that no city official seems to be able to pin down the exact number of alternative healing practitioners, certified or not , speaks for a rather chaotic picture.
One year later, she began working at the Green Room Centre in Friedrichshain as a registered alternative healing practitioner… putting her in the company of at least 20,000 others in the country, many of whom have no degree at all. “You legally have to do this one-year exam,” she says. “After that, if you want to practise homeopathy you could just do a week- end course and call yourself a homeopath.” Getting qualified The rules for becoming a Heilpraktiker have barely changed since their official establishment in the 1930s. Beginning in 1933, all practitioners had to belong to the Heilpraktikerbund Deutschlands (German Healers Association) with new commissar Ernst Kees put in charge of “cleaning the association of useless and unreliable elements”. The result was the Heilpraktikergesetz of 1939, which states that to practise alternative healing in Germany, one must have completed primary school, be at least 25 years old and have a good reputation. Furthermore, the applicant must obtain a medical certificate that proves that there is no indication of physical or mental disability or addiction to drugs. To be a registered Heilpraktiker in Germany today, one must fulfil all these criteria and complete an exam covering basic knowledge of anatomy plus a range of areas such as physiology, hygiene, pathology, sterilisation, disinfection, diagnosis, and health regulations. The examination takes place before a commission of doctors and health officials, who must state that the applicant has sufficient knowledge and ability to practise, and that their treatments do not affect public health in a negative way. Today, according to the Berlin Senate Department of Health and Social Affairs, about 70-80 percent of applicants who take the reputedly difficult examination actually pass it, unlike in the past when the pass rate was closer to 50 percent. The reason for this increase might be that more people are taking the exam seriously, completing courses beforehand at Heilpraktiker training facilities. One such place, the Samuel Hahnemann Schule, has been certified for Heilpraktiker training on behalf of the Bundesagentur für Arbeit (German Federal Employment Agency) since 2007. With two training centres in Berlin, the school offers clinical courses in pathology and anatomy as well as exam preparation and apprenticeships. They also offer more specific courses such as ear acupuncture, chiropractic care, botanical medicine and craniosacral therapy, to name just a few. Students can choose to focus either on Eastern or Western medicine. To join a course there are no actual criteria – students don’t even need a high school diploma to study there. However, having a good CV is important, as well as, naturally, an ability to pay one’s school fees. Before attempting the exam, most students at the school complete a clinical apprenticeship in combination with a therapeutic apprenticeship; this takes three and a quarter years at 25 hours a week and costs about €14,400. What’s in a name? Yet none of this is actually necessary to receive Heilpraktiker certification. Anne Rampacher moved to England from southern Germany in 1989. She studied psychology and biology before attending the Anglo European Chiropractor College (AECC) in Bournemouth. When she moved back to Germany in 2003, settling in Berlin, she found that her qualifications weren’t enough to allow her to practise. Rampacher’s skills, recognised by bodies such as the World Health Organisation, didn’t qualify by German standards for alternative health. Yet with her previous qualification, she managed to pass the Heilpraktiker examination without much problem. To Rampacher’s disappointment, she found that in Germany, becoming a chiropractor – which takes five to seven years of education in England – was just as easy as obtaining that Heilpraktiker certificate. In short, whereas the certification helps protect patients from total amateurs by guaranteeing a minimum degree of medical knowledge, it is nonetheless a blanket exam that doesn’t distinguish between actual methods or specialties – or the actual background and education of practitioners.“Chiropractic is not a regulated profession in Germany. No chiropractic degrees are recognised here, so anybody can call themselves a chiropractor.” Pamphlets at her Friedenau practice – the Berlin Centre for Chiropractic – make the point that “Chiropractors should not be confused with ‘chiropractic therapists.’” With over five years of chiropractic studies under her belt, she’s the only actual Chiropraktikerin on the Berlin market, according to the World Health Organisation’s definition – a point she makes to her patients, many of whom come in with aching backs made worse by less experienced practitioners. Being a Heilpraktiker in Germany, then, is a way to avoid many years of training to be qualified in just one area of alternative medicine. There are limits to what a Heilpraktiker is allowed to do though – for instance, they can’t treat STDs and infectious diseases, perform autopsies or X-ray examinations or practise obstetrics or dentistry. Beyond that, however, possessing the certification gives practitioners licence to perform whatever alternative procedures strike their fancy. The alternative therapy jungle This is not to say that one must pass the Heilpraktiker test to be able to offer some sort of alternative healing. Here, the rules are not just nebulous – they are non-existent. Even people with no medical background or certification whatsoever can open a practice, says Christian Wilms, president of the Association of German Alternative Practitioners, provided that it is a therapy that does not promise to heal the body. “Healing the spirit”, however, is fair game. Though not legally allowed to try curing pain, give diagnoses or pre- scribe treatments, these therapists might offer the exact same therapies as a Heilpraktiker – only they didn’t pass the exam and instead are usually certified by some non-governmental school or healing organisation.  Gabriela Sorge-Wiese, for example, holds a certificate of Foot Reflexotherapy from the Hanne Marquardt School (with centres all over Germany and Europe and courses in Namibia and South Africa), obtained after three four-day courses followed by tests. As a trained physiotherapist with a three-year diploma, she can practice and combine massage/manual therapy with other therapies – reflexology, spiral dynamics – all under the umbrella of this qualification. Yet, she’s anxious to point out: “If I treat someone with foot reflexology, I need a private prescription from a doctor or even a Heilpraktiker. Otherwise as a physiotherapist I am only allowed to do the foot massage as a ‘wellness’ or preventative treatment, which is not reimbursed by health insurance. This is the absolute legal way.” Maria L. (name changed) is in a more shaky situation, as a truly non-conventional healer with few official credentials attesting to her experience. With a post-graduate degree in international relations from a European university and years of experience assisting a famous gerontologist – “Helping people age as best as possible has always been my true calling” – she came to Berlin 10 years ago and opened a practice where she helps a faithful collection of patients through various, mostly self-devised, freestyle therapies including body manipulation, Gua Sha, chiropractic and botanical remedies – whatever she feels can help the patient, body and mind. She describes herself as a natural-born healer, and readily acknowledges she mostly learnt “by doing” thanks to some inborn skills she remembers using since earliest childhood. Neither a doctor nor a Heilpraktiker, she operates under the slim certification of a local institute as a medical massage therapist. “I can’t say I heal or fix anything. It’s just ‘relaxation massage’ – officially.” Although she cooperates with doctors who regularly send patients to her and vice versa, she doesn’t feel comfortable with her situation. “I know of colleagues who have had their practices shut. I’ve been lucky so far: I’ve never had any problems, and I don’t want to have any!” she said after agreeing to talk under strict anonymity. “In a situation like mine, you always run the risk that someone might want to cause you problems. Heilpraktiker are now doing to us what the medical profession have been doing to them for decades,” she says, referring to the ‘witch hunt’ attitude in the natural healing community. She’s now considering taking the Heilpraktiker exam, more as a protection measure than by real interest. “It won’t teach me how to heal my patients, but it can only help with my situation.” Is your healer legit? In short, it’s an alternative therapy jungle out there. Take widespread practices such as acupuncture or reflexology: while some acupuncturists might be licensed alternative healers, others might practice without any formal state recognition, hence control. Still others might be fully fledged medical doctors. One such person is Andreas Müller. A general practitioner, he also offers acupunc- ture and a wide range of alternative treatments, from SCENAR to blood auto-transfusion. “Every weekend I have another alternative therapy course. But I am not a Heilpraktiker.” In fact, as a licensed medical doctor in Germany, he is legally free to practice alternative medicine, no course work or Heilpraktiker certificate needed. How can you tell if your healer is legit? An official from the Department of Health and Social Affairs firmly stated that in Berlin, you must register your establishment if you open up a practice. Registered practitioners may be subject to inspections, in the highly hypothetical case someone has filed a complaint against the practitioner. “Not everyone can claim to treat any kind of sickness or aches,” the official says. “If a patient has doubts about the legitimacy of a practice or Heilpraktiker, they can press charges. And if they are indeed practicing illegally, the sentence is imprisonment.” The legislation, or rather its absence by lack of individual uniform, state-recognised certifications regulating individual therapies, won’t help the Berlin patient choose a practitioner – especially once faced with the startling number of Praxis signs across the city offering a baffling array of alternative treatments. The fact that no city official seems to be able to pin down the exact number of alternative healing practitioners, certified or not, speaks for a rather chaotic picture, as if medical authorities had somehow washed their hands of the matter. “I’ve never even been asked that before,” says the official from the Department of Health and Social Affairs. As an ever-growing number of Germans seem to be turning to these therapies, is it finally time to bring some Ordnung to the alternative health scene? Originally published in issue #120, October 2013.