Ordem dos Médicos and Ordem dos Nutricionistas Move to Force Practitioners to Choose Between Medicine and 'Integrative' Therapies — Both Bodies Confirm Deontological-Code Revisions and Push for a Legislative Crackdown on Pseudoscience

The two professional bodies that license Portuguese clinical practice are revising their deontological codes in parallel, and the language they are using around the revision is sharper than anything either body has put on record before. Both the Ordem dos Médicos and the Ordem dos Nutricionistas told Público on 27 April that they will rewrite the rules governing what their members can market and practise alongside conventional medicine, and both are pushing for a legislative complement that would let the State act where the orders cannot.

The proximate cause is what the orders describe as a fast-growing market for «integrative medicine», «functional medicine», «anti-aging medicine», and the corresponding «functional» or «integrative» nutrition labels. None of those designations corresponds to a recognised specialty. None has been validated by the State. And practitioners who use them, or who run clinics under those banners, are mostly not breaking any law that the orders can enforce against, which is the heart of the problem.

What the new codes will say

The Ordem dos Médicos is preparing to revise its deontological code to require physicians, in effect, to pick a lane. The framing comes from Luís Cunha Miranda, coordinator of the order's Observatory of Medical Practice, who told the paper that practitioners «will have to choose» between practising medicine and offering pseudoscientific therapies. The revision, once adopted, will turn what is currently an ambiguous overlap — a doctor with a valid cédula running an «integrative» clinic on the side — into a disciplinary matter inside the order.

The Ordem dos Nutricionistas is at an earlier stage of the same process. Vice-president Carla Pedrosa told Público the order is starting work on its own deontological-code revision, with a tighter focus: only the legally recognised specialty designations may be used by registered nutritionists. Pedrosa was blunt about the unvalidated-supplements market that often travels with «functional nutrition» branding. The safety of those products, she said, is «zero».

Neither body has set a public date for adoption. Code revisions inside the Portuguese ordens go through the general-assembly route and typically take months, sometimes longer, between draft and final text. The signal value of the parallel move is more important than the calendar: two regulators that share an underlying enforcement problem have decided to move on it at the same time.

The legislative ask

Cunha Miranda is also pressing for a legislative change that the orders themselves cannot deliver. The order wants what he calls an «absolute clarification» of the designations clinics and professionals are allowed to use, alongside heavier fines and stronger inspection powers for whichever State entity ends up doing the policing. His framing of the current enforcement vacuum is direct: «crime continues to pay».

The current legal architecture splits the work badly. Internal complaint procedures inside the ordens require a patient to file a formal grievance, which is a high bar in a market where the patient often paid out of pocket for a service they wanted in the first place. Criminal referral to the Ministério Público is available for usurpation of credentials — a non-medic running a clinic under medical branding — but it is rarely used and slower still. Neither route catches the larger universe of registered professionals using non-recognised designations to market services around the edges of their cédula.

The complaint numbers tell the story

Both orders have received almost no complaints in the relevant categories. The Ordem dos Médicos logged fewer than ten complaints over the past year specifically related to integrative-medicine practices. The Ordem dos Nutricionistas received three complaints across two years, and none of those was against a registered nutritionist — meaning the targets of those few complaints sat outside the order's reach to begin with.

Those numbers are the cleanest measure of the regulatory gap. They are not a measure of low prevalence. The orders' position is that the market is large and growing fast on social media and through influencer channels, but the formal-complaint route is structurally unsuited to catching it. A patient who feels they were oversold supplements does not typically file with the order; a patient who recovered well does not file at all. The complaint inventory captures, at best, the catastrophic outliers.

Where the social-media question fits

Both orders flagged the same secondary problem: oversight of social-media and influencer channels. Practitioners who post under their cédula on Instagram or YouTube are operating in a regulatory zone the orders have only begun to map. Cunha Miranda's reference to «hardening of fines and inspection» reads in that context as a request for the State to give somebody — ASAE, ERS, or a new body — clear authority to police medical and nutrition content posted by registered professionals. The orders can discipline their members, but cannot remove a post. The legislative ask would close that gap.

What this means for patients in the SNS and the private sector

The most immediate practical change, once the new codes are adopted, will be visible in the language clinics use to advertise themselves. A clinic branded as «Medicina Integrativa» with registered Ordem dos Médicos physicians on staff will face a choice: either drop the integrative-medicine branding, or risk those physicians being subject to disciplinary action under the new code. Equivalent pressure will reach the nutritionists' market once the second code is finalised.

For SNS patients, the change is largely indirect. The SNS does not currently fund integrative or functional medicine, and the regulatory pressure points sit in the private out-of-pocket market that has been growing in Lisbon, Porto and the Algarve. For private patients, the practical effect will depend on how aggressively the orders use their new disciplinary tools and whether the legislative complement actually arrives. Without it, the orders' reach stops at their own members — and the unregistered «integrative» market will continue to operate beside them.

What to watch

Three signals. First, the publication date of each order's revised deontological code — the Ordem dos Médicos is further along, and a draft text could surface in the second half of 2026. Second, whether the Government engages on the legislative side; Cunha Miranda's ask is on the record, and the Ministry of Health has not yet publicly responded. Third, whether complaint volumes change after the new codes land. A jump in complaints would be the cleanest sign that the orders' new tools are reaching the market they have spent the last few years describing as out of their reach.

Source: Público, «Ordens dos Médicos e dos Nutricionistas preparam-se para apertar o cerco à pseudociência», 27 April 2026.

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