Regulating practice at the margins: Türkiye’s sequential policy response to unlicensed traditional, complementary, and independent health service provision, 2025–26
European Journal of Public Health, cilt.36, sa.5, 2026 (SCI-Expanded, SSCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 36 Sayı: 5
- Basım Tarihi: 2026
- Doi Numarası: 10.1093/eurpub/ckag150
- Dergi Adı: European Journal of Public Health
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, ABI/INFORM, Abstracts in Social Gerontology, CINAHL, Educational research abstracts (ERA), EMBASE, Index Islamicus, MEDLINE, Political Science Complete, Psycinfo, Public Affairs Index, Directory of Open Access Journals, Political Science Abstract (IPSA), Academic Search Ultimate (EBSCO), Natural Science Collection (ProQuest), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest), Sociology Source Ultimate (EBSCO)
- Karadeniz Teknik Üniversitesi Adresli: Evet
Özet
Türkiye’s foundational health-professions law (1928) concentrates clinical authority in licensed physicians. A 2014 regulation moved traditional and complementary medicine (T&CM) from prosecutable practice into lawful, certified-physician-only provision, centralizing supply. Demand—reported by 14.7%–60.5% of patients nationally—has outgrown this framework. Physicians hold exclusive T&CM authority yet face structural disincentives to exercise it: the public performance-payment system values a 30-minute T&CM session the same as a 2-minute prescription renewal. Unmet demand migrated to unlicensed providers. Interviews with 58 T&CM service providers across Türkiye’s seven regions, completed just before these reforms, documented provider-reported harms in unlicensed provision, including scarring from improper cupping, reuse of unsterile instruments (including using a leech across multiple clients), and deaths caused by thermal sulphur gas, as well as a reactive, complaint-driven inspection system. In response, the Ministry issued three sequential regulations: licensed Health Professional Service Units (March 2025), licensed medicinal herbal teas restricted to pharmacies (2 July 2026), and licensed Wellness Centres encompassing T&CM as explicitly non-curative services (4 July 2026). All share one logic: new licensed, traceable channels for contested activity rather than tightening enforcement or deregulating. Early signals include active licensing uptake among allied health professionals; the wellness framework is only weeks old; this article is an early policy analysis, not an impact evaluation. The case offers a transferable instrument for health systems facing tension between physician-centred scope-of-practice law and rising demand at the margins of clinical practice, while suggesting that legal permission without financing reform may leave the underlying supply gap intact.