Hospitals adding alternative care also add new risk.

The wellness movement is prompting a small but growing number of hospitals to start separating qualified from not-so-qualified practitioners of treatments, ranging from acupuncture to herbal therapy.

Michael Dwyer, a partner at BDO Seidman LLP in Century City, said the consulting firm has begun a niche service that conducts reviews to ensure that traditional health care providers like hospitals and doctors' groups are enlisting qualified acupuncturists, chiropractors and other practitioners when they add alternative care to their list of health care services.

"In the last 18 months, we've seen a movement toward credentialing the alternative medicine practitioners," Dwyer said.

Much of it has to do with liability. Any organization associated with an unqualified alternative medicine practitioner faces the risk of malpractice lawsuits if the practitioner goofs.

In addition, health care providers who have improperly credentialed personnel risk losing their funding from the federal government, health maintenance organizations and insurance companies.

Dwyer said BDO Seidman recently consulted with Daniel Freeman Hospital on credentialing procedures for acupuncturists, and is working with a Denver area hospital chain called Columbia Health One LLC on credentialing procedures for alternative medical care providers.

"If a physician group or a hospital wants to capture more of the health care dollar by adding alternative medicine... they're going to have to sell the idea to whoever is paying the bills," said Dan Vincent, senior manager of health care consulting for KPMG Peat Marwick LLP. "Proper credentialing is essential to selling the idea."

While traditional and alternative medical care organizations have national groups that set standards for accreditation, each hospital generally has its own set of standards.

That's why, according to Dwyer, the requirements for practicing medicine involve more than obtaining a state license.

Each hospital defines its own "privileging system" that determines what additional criteria a doctor must meet to practice at the hospital. Those criteria typically includes a number of board certifications and other requirements that must be thoroughly checked.

That same privileging system is beginning to be used for alternative medicine at traditional hospitals.

Dr. Steven Rosenblatt, head of a new unit at Cedars-Sinai Medical Center that specializes in alternative medicine, says the facility is "going through an extensive process to devise the credentialing procedures and hone them ourselves in-house."

Rosenblatt says the basic criteria for alternative medical practitioners is that they have a state license, be a graduate of a certified program approved by the national organization that sets the standards for the practitioner's specialty, have a minimum of five to seven years experience (depending on the specialty), and have knowledge of basic procedures to follow in the event a patient suffers a heart attack.

Outside firms are often called in to check such credentials because it is a time-consuming specialty that many hospitals and doctors' groups would rather farm out than perform in-house.

Traditional medical care facilities have only recently begun to ask Sacramento-based HealthCheck Inc. to verify the credentials of alternative medicinal practitioners, according to Mary Ferguson, chief operating officer of the firm.

"We just had our first alternative medicine client earlier this year," said Ferguson.

One of HealthCheck's customers is San Francisco-based Consensus Health Corp., which has formed statewide networks of alternative medical providers who contract with health maintenance organizations and preferred provider organizations in much the same way that traditional doctors' groups contract with HMOs and PPOs.

Vickie Ina, senior vice president of network management for Consensus, said the company's alternative provider networks have contracts with a number of HMOs and PPOs, including Blue Shield of California, which offers alternative medicine under its LifePath program.

Although Consensus does some of its own credential checking, Ina said it calls on HealthCheck to get a second opinion to ensure that network members are properly accredited.