The Texas Medical Board is cracking down on doctors of pastoral medicine—some of whom are not doctors at all, Lauren Silverman reports for NPR's "Shots."

The Texas-based Pastoral Medical Association (PMA) issues "pastoral provider licenses" in 50 U.S. states and 30 countries. But the meaning of such a license is unclear. According to the group, applicants must meet "rigid standards," but NPR asked what those standards were and got no reply.

What is clear is that some doctors of pastoral medicine market themselves as medical professionals—claiming to treat conditions such as neuropathy and thyroid issues—yet do not have medical degrees or, in other cases, make promises beyond the scope of their medical training.

For instance, Karl Jawhari, a chiropractor, founded the HealthCore Center in Texas, where he says he practices "functional medicine" under his PMA license.

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"We've seen people with an array of issues: thyroid issues, diabetes, blood pressure, cholesterol," he tells NPR—and he claims to have had "great success." But the Texas Medical Board in June issued a cease and desist order to Jawhari, demanding that he no longer offer to treat conditions beyond the scope of his chiropractic training.

Jawhari says he has complied with the order, but insists he is far from the worst offender. "I've heard of a few people that are practicing that aren't even doctors," he explains.                                                                                         

Mari Robinson, the board's president, says Jawhari is just one example of people attempting to practice under a pastoral medicine license in recent years. "Folks are purporting to treat and diagnose illness using that term," she explains. "It's not a degree; it's not a license." The board in recent years has issued about a dozen cease and desist orders to individuals touting pastoral provider licenses.

Such licenses may be mostly marketing, says Stephen Barrett, a former psychiatrist and founder of the consumer website Quackwatch.org. "There are lots of credentials you can buy, and this is just one of many," he explains.

According to Barret, many doctors of pastoral medicine have their patients sign confidentiality agreements that prohibit them from suing if something goes wrong. Instead, they insist that an ecclesiastical tribunal settle all disputes because—supposedly—any advice they give is pastoral in nature. "In other words, 'If I give you health advice that's not health advice, that's pastoral advice'" (Silverman, "Shots," NPR, 4/25).