No, I don't read it that way. To me it says "the method shall be (a) a gastronomy tube, or (b) any other means a licensed physician might deem appropriate."
Thus, if a doctor determines no other means is appropriate, then the method SHALL BE the gastronomy tube.
That should read "gastroTomy tube." Surely Felon is hammering on the misspelling, if this is an electronic transmission of the original EO.