We now regularly get asked this question at the front desk: “Couldn’t you offer something holistic here, like acupuncture?” For business owners, this is an uncomfortable question because the answer is rarely as simple as it sounds. There’s a line between what makes professional sense and what German professional law allows—a line that many continuing education brochures fail to draw clearly. Anyone considering an additional qualification in Traditional Chinese Medicine should be aware of this line before paying the first course fee.
1. Why This Issue Is Coming to the Fore in the Industry
The impetus comes from two directions. On the one hand, demand has shifted: members no longer expect just equipment and a class schedule, but offerings that integrate training, recovery, and the stresses of daily life. On the other hand, gyms are looking for features that set them apart from discount facilities and micro-studios. Traditional Chinese Medicine fits into these considerations because, with movement practices, nutrition, and manual techniques, it touches on several areas of everyday gym life. On paper—as soon as specific health complaints are involved—the business is no longer in the realm of fitness training.
2. The Legal Boundary—What a Trainer’s License Allows and What It Doesn’t
The practice of medicine is regulated in Germany. Anyone who identifies, diagnoses, or treats medical conditions requires authorization to do so: a medical license, a license under the Heilpraktikergesetz (Alternative Practitioners Act), or the authority granted to a relevant healthcare profession within its respective scope. A trainer’s license is expressly not included in this, regardless of its level and regardless of how extensive any additional training completed may have been.
Specifically, this means that trainers are not permitted to perform acupuncture, not even in a modified form or with a certificate from a TCM school. Nor may they recommend or dispense Chinese medicines, make diagnoses based on the categories of Chinese medicine, or offer treatment for a specific set of symptoms. A certificate from a private school documents participation; it does not confer any authority. Anyone who crosses this line risks legal proceedings for the unauthorized practice of medicine.
3. What Is Still Possible Without a Medical License
There is still room for maneuver within these limits. Anyone who understands the philosophy of Chinese medicine can structure training and course offerings differently and engage with practitioners as equals. Movement practices such as Qigong and Tai Chi can be offered as courses; however, subsidized prevention courses have their own requirements regarding the qualifications of the course instructors. Nutrition-related content remains permissible within the framework of general nutrition education, as long as it is not directed at a specific clinical condition. And then there’s the intersection: Those who know what happens in a practice can make targeted referrals.
4. What Regulated Qualification Pathways Look Like—A Comparison of Professional Groups
Anyone who wants to understand why a weekend certificate does not confer authorization should look at how the professional groups that are actually permitted to practice acupuncture obtain this authorization. For physicians, this is achieved through additional continuing education in acupuncture: According to the continuing education regulations of the state medical associations, this comprises 200 hours of course-based continuing education, including 60 hours of supervised patient treatment and 20 hours of case seminars. A key prerequisite is certification as a specialist in a field of direct patient care. The 200 hours are added on top of this; they do not come first.
For midwives, the same structure applies on a smaller scale. An acupuncture continuing education program for midwives, aligned with the recommendations of the professional associations, comprises at least 80 training hours—half theory and half practice—spans at least one and a half years, and concludes with an exam that includes written case reports from the midwife’s own practice. But that is not all: At least 16 hours of continuing education are required within two years following completion of the program. The scope of practice remains limited to the profession; it is not expanded by the continuing education.
The situation is different for alternative practitioners: Authorization is not granted through a specific training program, but rather through an assessment by the public health department that tests their knowledge. Across all three groups, the following characteristics can be identified, which trainers can also use as a guide when evaluating a program: a significant amount of supervised practical training, a duration spanning months rather than days, an exam based on documented cases—and, above all, a professional license to which the qualification can be linked in the first place.
5. The Training Landscape and Its Formats
The free market hardly reflects this distinction. Formats range from weekend seminars and modular course series to multi-year, part-time degree programs leading to an academic degree, and the designations in between are largely unprotected. Anyone looking to get started while working should make the number of hours the primary screening criterion before considering price, location, and schedule. A program that claims to turn you into a consultant in 20 hours is clearly on a different scale than the paths mentioned above. An academic degree, on the other hand, is a mark of quality, not a license to practice.
6. How to Identify Reputable Providers
Five points distinguish reliable programs from sales pitches. First, the practical component: Is hands-on practice conducted under supervision, and for how many hours? Second, the exam: Is knowledge tested—ideally using documented case studies—or is the certificate merely awarded for attendance? Third, the instructors: Are they identified by name, along with their qualifications and background, or are they simply referred to as “experienced instructors”? Fourth, the approach to evidence: Those who operate with integrity state that acupuncture is used as a complementary modality and that the body of research is inconsistent depending on the area of application. Fifth, the statement regarding the right to practice: Anyone who fails to clearly state that the training alone does not constitute a license to practice medicine is omitting the crucial point.
7. Economic Context and Unresolved Questions
The question remains whether the effort pays off. Is an additional TCM qualification economically worthwhile for a practice? That depends on who provides the service. This knowledge can pay off as a foundation for developing in-house course formats and ensuring the quality of patient care; however, as a revenue generator in the form of billable treatments, it is only viable if someone with the appropriate license works on-site—for example, through a partnership with a medical practice.
And what if someone wants to go beyond this limit? Then the path leads to a qualification that grants authorization in its own right: a healthcare profession or certification under the Heilpraktiker Act from the public health department. TCM training does not replace this step; it complements it. Those who plan for this early on spare themselves the disappointment of realizing, after two years of coursework, that the desired profession is still not permitted.
So how should we handle members who specifically ask about acupuncture? The most reliable approach is to simply explain that this is a matter for physicians or alternative practitioners, combined with a reference to what the practice is actually permitted to offer. This may sound less impressive than a new certificate on the wall, but in case of doubt, it will hold up to scrutiny.
Image source: #1909238295 Boss / stock.adobe.com
Published on: 19 August 2026