When medical progress outpaces the law
Author: Nadia Pröpper-Schwirtzek, Attorney-at-Law, Specialist Lawyer for Medical Law,
Certified Compliance Officer (SHB)
Several years ago, a physician sat across from me—someone I have never forgotten.
A deeply empathetic man, passionate about emerging therapeutic approaches, full of vision for a modern, preventive medicine. His waiting room was busy, his patients trusted him, and he was convinced he was doing everything right.
Until one day a letter arrived.
At first, he thought it was a misunderstanding. Then a mistake. But the allegation was printed in black and white: billing fraud.
He was stunned. He had harmed no one, invented no treatment, diverted not a single cent. His “mistake”? A wording in his fee agreement that did not match the procedures he actually offered — a standard template, amended with a few lines “the way everyone does.”
He later told me that on the night after receiving the letter, he did not worry about himself or his practice.
He worried about his patients.
“What happens if I’m no longer allowed to treat them?”
“Who will look after them?”
These questions — not the legal consequences — weighed most heavily on him.
As we worked through his case, one thing became clear:
He had already brought the future into his practice — yet the legal framework he relied on belonged to the past. This was not a personal failure. It was a structural problem. And one I have encountered with alarming regularity for years.
Together, we were able to limit the damage — a battle fought over many years, through several levels of criminal courts. But where he was fortunate, many others are not.
My mission began long before this — and is far from over
For nearly three decades, I have navigated the intersection of medicine and law. When I enrolled in forensic medicine at Charité during my legal studies, I had no idea it would eventually lead me deep into a field few took seriously at the time: integrative and preventive medicine — and all the legal implications tied to it.
What has accompanied me ever since is a growing realization:
Medicine evolves rapidly — the law lags behind.
And in the widening gap between innovation and regulation, more and more practitioners lose their footing, often without realizing it.
The quiet blind spot in many modern practices
In conversations with physicians, naturopaths, and health coaches, I repeatedly encounter the same moment — the point at which they realize that their consent forms, contracts, or fee agreements do not actually match their treatment methods.
Not because they are careless. Quite the opposite. Many invest enormous time, energy, and passion into new therapeutic approaches, biological treatments, longevity programs, IHHT, infusion therapies, and other innovative concepts. They want to help. They want to heal.
Yet it is precisely this commitment that places them on thin ice — legally speaking.
What begins as a vision often ends as a case file
And it is not about bad actors or fraudsters. In 2024 alone, the Federal Criminal Police Office recorded 20,553 cases of billing fraud — an increase of 847.6 percent. Many of those affected are shocked to learn that they are considered “offenders” under the law, even though they merely filled out a form incorrectly, misapplied a billing code, or used a template never intended for the medical reality of their practice.
Why standard templates are not built for innovation
For years, I have made it my mission to educate physicians, naturopaths, therapists, and coaches that most model contracts were designed for traditional, conventional medical care — and simply cannot meet the demands of modern therapeutic innovation.
They do not address:
- emerging or experimental methods
- limited evidence or off-label settings
- expanded disclosure requirements
- private or hybrid care models
- specialized fee structures
Anyone attempting to “fix” these templates with individual add-ons risks exactly what they seek to avoid: legal vulnerability.
Not due to negligence — but because our system offers almost no legal guardrails for innovation.
The tragedy behind many cases
Too often, I am consulted only after the damage is done.
I have seen practitioners forced to close their practice after decades of excellent work.
Others lost patients, reputation, or years of their professional life. And some still struggle today with the emotional impact of a criminal investigation that never should have occurred.
The painful truth:
All of them acted with the intention to help.
Yet they unknowingly operated in a legal no-man’s-land.
A system in transition
We are in a phase where medicine can do far more than the law is currently capable of regulating. Integrative and preventive healthcare concepts are evolving faster than the legal frameworks meant to govern them.
This is not an accusation — it is an invitation.
An invitation to take responsibility not only for the therapy itself, but also for the framework in which it is delivered.
What drives my work
I advocate for a healthcare landscape in which highly innovative medicine does not fail due to legal formalities.
But I have also learned:
Anyone pioneering new approaches in the health sector must understand the legal dimension.
Not out of fear, but out of respect — for their work, their patients, and their professional path.
Legal certainty is not a technicality.
It is an essential part of medical ethics.
A closing thought
Innovation requires courage.
But courage without protection easily becomes a trap.
Perhaps we are at a turning point — one that will determine whether integrative and preventive medicine remains a niche phenomenon or matures into a recognized, enduring branch of healthcare.
To achieve this, we do not need to think more slowly — only more consciously.
If you are exploring new therapeutic avenues, implementing innovative procedures, or offering integrative, complementary, or preventive concepts, I ask you one thing:
Do not focus solely on the medical aspects.
Also examine the framework that supports them.
Not because legal paragraphs matter more than patients, but because even the best medicine fails when it becomes legally indefensible.
If you are unsure whether your consent forms, treatment agreements, or fee arrangements truly reflect what you do today — not what you offered years ago — then have them reviewed.
By whom is secondary.
That you do it is not.
Innovation is not the risk.
Unawareness is.
I invite your questions:
- Which documents do modern practices truly need?
- Which mistakes do I see again and again?
- And which pitfalls can be avoided with a single sentence?
Write to me, discuss with me, or start simply by looking at your documents with fresh eyes.
The first step toward real future medicine is not the next treatment modality.
It is the awareness that courage only becomes effective when it rests on a secure foundation.
Securing the future of your practice begins today — not tomorrow
If you offer innovative medicine, you also need legally robust structures.
This is exactly where our online courses come in.
In our concise, practice-oriented learning modules, you will discover:
• which documents modern practices truly require
• how to structure consent, contracts, and fee agreements with legal certainty
• how to avoid legal pitfalls before they arise
• how to minimize your risk and safeguard your long-term vision
You do not have to navigate the legal gap between innovation and regulation alone.
Let my decades of experience support you — clearly, pragmatically, and immediately applicable.
👉 Access my online courses and modules here — for real legal certainty, sustainable practice development, and the future you want to build.
Legal certainty begins with your contracts and patient agreements.
👉 Here you will find legally compliant templates you can use immediately in your practice:
Yours,
Nadia Pröpper-Schwirtzek
Attorney-at-Law, Specialist Lawyer for Medical Law
Certified Compliance Officer (SHB)
