The Atlanta Journal-Constitution’s investigation of the alternative medicine industry uncovered a pattern of practitioners across Georgia pushing legal limits on what they’re allowed to do and presenting confusing information about their credentials.
That why experts say it’s important for patients to understand those limits and to ask about the qualifications of those providing care.
“The biggest red flag for me would be if there’s not a match between the training of the people who are caring for you and the services that are being offered,” said Leslie Wolf, a professor of law at the Georgia State University College of Law.
Patients need to be on guard at med spas and IV clinics, she said. If a clinic is offering an IV treatment without first taking a patient’s medical history, she said that puts the patient at risk.
“Some things to look for are whether there is a physician overseeing care, who is offering the treatment and also how are they offering the services. Are they actually asking about your medical information?” she said.
Patients also should ask about treatments they are offered, especially those not backed by research or not approved by the Food and Drug Administration.
“I think a good question is, ‘What’s the evidence behind what you’re recommending or what you’re offering?’” Wolf suggested. “‘What’s the alternative?’ And, always, ‘What’s the risk?’”
Concerned that some IV clinics were not following the law, the Georgia Composite Medical Board in May issued a statement on IV therapies that spells out legal requirements.
Here’s a look at the limits on various types of practitioners who may be promoting alternative medicine in Georgia.
State-licensed professionals
Physicians: They can legally use a prescription drug for conditions not approved by the FDA and administer it in different dosages and different ways. However, physicians can run afoul of federal law if they advertise or promote what’s called off-label uses of prescription medicine.
Physicians also can run afoul of state laws banning false, deceptive or misleading advertisements, promotions and social media claims, such as falsely claiming expertise or the ability to cure incurable conditions.
Physicians and most other licensed healthcare providers must adhere to what’s called the standard of care, meaning they should provide medical advice and treatment with the skill and care the average practitioner in that specialty should provide. It they don’t, they can be subjected to discipline or risk malpractice lawsuits.
Some states, though not Georgia, also require that physicians inform patients in writing that they are recommending an alternative therapy that is considered outside of conventional medicine, inform them of potential risks and obtain the patients’ signature on an informed consent document.
Physician assistants: In Georgia, a physician assistant must work under supervision of a state-licensed physician to carry out healthcare tasks, such as prescribing medications or running diagnostic tests, that the physician has delegated. An assistant also must be in the supervising physician’s scope of practice. However, the physician assistant does not have to be in presence of the physician to provide the medical services, so in some situations physician assistants may open their own clinics or practices.
In any interaction with patients, they must clearly identify themselves with words such as “physician assistant” and not use or be addressed by the title Dr. And a 2023 Georgia law (SB 197) requires physician assistants with doctoral degrees to state in a clinical setting that they are not medical doctors.
Advanced practice registered nurses: In Georgia, APRNs must have a supervising physician whose principal place of practice is either in Georgia or, if out of state, within 50 miles of the patient’s location at the time services are rendered. APRNs can only provide the medical tasks, such as prescribing medications, evaluating patients and ordering medical scans, that are in a protocol agreement with that doctor. State law also requires that APRNs must work in a specialty or field that is comparable to their supervising physician’s.
The supervising physician or another physician who is designated must be available for consultation. To monitor quality of care, the delegating physician generally must review medical records at least quarterly and must conduct an on-site observation of the APRN’s practice at least once a year. Any patient prescribed a controlled substance by an APRN must be evaluated in person or virtually by the delegating physician every three months.
State law requires an advanced practice registered nurse and others who hold doctorate degrees and who identify themselves with the title “doctor” to clearly state while in a clinical setting that they are not a medical doctor or physician.
Registered nurses: They can provide direct patient care, administer medications and monitor patients in ways consistent with evidence-based guidelines and authorized by a valid order. RNs may, for example, perform prescribed or ordered IV hydration and nutrient therapies and medications, if authorized by a valid individualized order prescribed by a physician, nurse practitioner or physician assistant with prescriptive authority acting within their legal scope of practice.
If a nurse works in a facility where clients may come for IV hydration, the nurse must ensure there is an individualized prescription or order and a client history and physical for appropriateness. Standing orders are not a substitute for the individualized order/prescription and history and physical for IV wellness treatments or for cosmetic procedures such as Botox or collagen injections.
Nurses must have the knowledge and skills to safely carry out treatments and recognize side effects and allergic reactions. It is not within an RN’s scope of practice to make a medical diagnosis, identify medical problems or develop medical or cosmetic treatment plans
Chiropractors: In Georgia, chiropractors can use chiropractic methods to adjust the spine or adjust articulations of the human body. Those methods may include adjustments by electrical and mechanical devices and use of heat, cold, noninvasive light, ultrasound and other modalities.
Chiropractors are not allowed to prescribe drugs or administer medications or perform surgery on patients. They cannot administer injections, do colonic irrigation or use any other technique invasive of the human body. They cannot make unsubstantiated claims about treatments.
While chiropractors cannot prescribe medicines, they may recommend the use of nutritional and dietary supplements but must stay within the scope of chiropractic practice.
Under Georgia law, they are not allowed to call themselves “chiropractic physician”; they may only use the title chiropractor or doctor of chiropractic (D.C).
Paramedics: Emergency medical services personnel are authorized to perform only the skills for which they have received proper training and certification and that have been credentialed by their local EMS agency’s medical director. However, a licensed paramedic may also perform those skills in settings such as medical facilities or physician offices under the direct supervision of a licensed physician. Direct supervision requires the supervising physician to be present in the same physical location and be readily available to help the EMS provider throughout the patient encounter.
Podiatrists: Their practices are limited to diagnosis and treatment of the human foot and leg. In that context, they may provide dietary advice related to improving foot health.
Acupuncturists: In Georgia, they are not allowed to diagnose disease and they do not have authority to write prescriptions.
Unlicensed individuals
Naturopaths: Georgia does not set education or training standards, license or oversee those who call themselves naturopaths. State law prohibits those who are not otherwise licensed in Georgia as physicians from calling themselves physicians or purporting to diagnose or treat conditions or diseases. The Georgia Composite Medical Board can obtain cease and desist orders to stop those offering such services or misidentifying their credentials.
Medical assistants: Because they are not licensed in Georgia, the state does not set standards for the education or training of medical assistants, even as the medical board acknowledges that physicians are using them for more and more tasks. However, physicians can face lawsuits related to the tasks they assign. In early 2026, a Georgia physician and the facility he owns agreed to pay $2.18 million to settle allegations that it used unlicensed medical assistants to infuse patients with chemotherapy chemicals. State law does not allow unlicensed individuals to do that.
About the Author
Keep Reading
The Latest
Featured
