Tuesday, July 21, 2009

Arizona's homeopathic medical board

Dr. Kimball Atwood's presentation at the Science-based Medicine conference included some observations about the overwhelming evidence against homeopathy being a valid or even remotely plausible treatment for anything. During one of the Q&A sessions at that conference, someone made an observation that Arizona is a terrible state for all kinds of quackery, and even has a State Board of Homeopathic Medical Examiners.

The homeopathy board was created in 1982 by a law written and lobbied for by Dr. Harvey Bigelson, a homeopath who was indicted in 1992 by a federal grand jury on 63 counts of Medicare fraud, 44 counts of mail fraud, and eight counts of obstruction of justice. He plea-bargained his way down to three counts and five years of probation, and lost both his medical and homeopathic licenses, making him one of only two homeopaths to lose their licenses by action of the board. He subsequently opened a cancer clinic in Mexico to continue his quackery.

There was an opportunity for Arizona to dispose of its Homeopathy Board in 2006, when the law that created it would have expired under its sunset provisions, but our legislature foolishly renewed it despite overwhelming evidence that it not only gives an unmerited credence to nonsense, but doesn't even do anything to keep criminals from practicing homeopathy. An October 9, 2005 story in the Arizona Republic pointed out several cases of convicted felons from other states permitted to obtain homeopathic licenses and practice in Arizona. It also pointed out that complaints brought against homeopathy board members for malpractice and sexual harassment were simply dismissed:
The homeopathic board has dismissed at least five complaints against its own members over the past five years, including one in which a patient suffered kidney failure after treatment, as well as an alleged incidence of sexual harassment.

The complaint involving kidney failure was lodged against board member Dr. Annemarie Welch in March 2003. The woman who lodged the complaint fell ill after seeking treatment from Welch for an infected blister on her toe. Welch treated the infection with "vitamin C therapy," according to board meeting minutes.

After the woman suffered "acute renal failure," she filed a complaint against Welch with the Arizona Medical Board, which also licenses Welch.

The homeopathic board argued for primary jurisdiction of the Arizona Medical Board complaint against Welch, arguing that she had primarily used homeopathic procedures. Once the homeopathic board had control of the case, it dismissed the complaint.

According to meeting minutes, board members did not believe there was a correlation between the vitamin C therapy and the patient's kidney failure. They also noted that the patient didn't comply with Welch's treatment recommendations. Welch pointed out the Medical Board also found no wrongdoing in its investigation.
That's crazy--the judgment shouldn't have been whether the vitamin C therapy caused the problem, but whether the LACK of a real treatment of the infection caused by the quack treating her with vitamin C caused the kidney failure. The story goes on:
A Phoenix woman lodged a sexual harassment complaint against board member [Dr. Gary] Gordon in May 2001. The woman said he had spontaneously kissed her on the mouth after she stopped to speak with him at his booth at a medical trade show.

The homeopathic board dismissed the woman's complaint because she did not show up to the May 2001 meeting at which her complaint was scheduled to be heard. She apparently had a family emergency and wrote to the board that she could not make it. Board members questioned Gordon about the allegation, which he denied. The woman did show up at the next board meeting and asked to refile her complaint, but board members voted 2-2 against it.
Nice way to uphold ethical standards, there, homeopathy board. And their permissive behavior with regard to conduct appears to extend beyond members of the board to the licensed homeopaths they're supposed to be regulating:
Troubled physicians licensed by the board include Dr. Charles Crosby, who obtained his Arizona homeopathic license in May 2004 despite revealing to the board that he had been ordered to have counseling for a "perceived loss of social inhibition" in his home state of Florida. It later became known that Crosby had been accused of fondling patients and of having a breast fetish. A report on the case in Florida said Crosby had developed "a special technique of manipulating women's breasts to treat pain in other areas of their body."

The suspension of Crosby's license in Florida triggered a inquiry before the Arizona homeopathic board in July. At the meeting, Schwengel, the board president, said he did not find any specific examples that showed Crosby had acted unprofessionally, according to meeting minutes.

Other members expressed concern about Crosby's behavior, but they did not suspend his license, instead giving him until November to undergo an independent mental evaluation to determine if he is competent to practice here.
Board member Gordon defended this action on the grounds that in the U.S. we assume that doctors in trouble who have "paid their debt to society" have been rehabilitated, and that taking away a license is a severe punishment:
"What we look at is, do we want to try and resurrect a troubled physician and keep them under control, or do we want to throw them away and let them dig ditches?" Gordon said. "Once you take a doctor's license away, they don't really have a particular skill that they're qualified to do."
And what are homeopaths qualified to do in Arizona, besides dispense bottles of overpriced water falsely claimed to be medicine? The board's website gives the answer:

The scope of the license includes the practice of acupuncture, chelation, homeopathy, minor surgery, neuromuscular integration, nutrition, orthomolecular therapy and pharmaceutical medicine (see A.R.S. § 32-2901(22)).
The one that jumps out at me the most is "minor surgery." Yikes!

Here's a list of approved continuing education courses for homeopaths in Arizona:

Learn Oxidative Therapy AHIMA/Westbrook 1/22/09 7 hours
Ethics & Boundaries Dr. Jodi Decker Flexible 3 hours
Professional Ethics Dr. Jodi Decker Flexible 4 hours
Lyme-Autism Connection LIA Foundation/CHOICE 6/25/ - 6/28/09 12 hours

The middle two courses on ethics would seem to me, if taught honestly and accurately, to completely undermine the enterprise. Homeopathy is a bogus practice, and I'd think using bogus practices as medical treatment should be near the top of the list of unethical things that health practitioners should avoid. The other two courses sound like the promotion of quackery; oxidative therapy has been a quack treatment for cancer, and the latter is about a link between two conditions, each of which is already surrounded by rampant nonsense, that is being promoted by the "Lyme-Induced Autism Foundation" in advance of supporting research or data. There was some research being done at Columbia University's Lyme and Tick-Borne Diseases Research Center a few years ago by Dr. Brian Fallon about a possible misdiagnosis of some cases of Lyme disease as autism, but that apparently has not demonstrated any connection and there is nothing about autism currently on their website. About.com compares Fallon's description of his research to a press release from the L.I.A. Foundation:

In our work with children who have developed Lyme disease, we have encountered a few children who had developed autistic-like disorders which were eventually also diagnosed as having Lyme Disease due to other concomitant symptoms; when the child received intensive antibiotic therapy, the autistic syndromes dramatically improved and, in some cases, resolved. We hypothesize: a) that a small subpopulation of children with autism in Lyme endemic areas may have an antibiotic responsive disorder due to a spirochete-induced autistic syndrome...
L.I.A. Foundation press release:
New reports indicate up to 90% of children with autism are infected with Lyme disease. With autism at a staggering 1 out of 166 children, parents are questioning this new finding.
Can you tell which organization is using scientific methodology? The L.I.A. Foundation's list of its own activities puts "awareness" and "education" ahead of "research," which is putting the cart before the horse. (Of course, if they did research as a priority, that could cause problems for their chosen acronym--the L.I.A.R. Foundation probably wouldn't get as many donations.)

It should be noted that Welch and Gordon are not on the state homeopathy board today. But next time we have the opportunity, I suggest we Arizonans get rid of this board completely.

UPDATE (February 9, 2011): I recently came across this April 10, 2008 New Times story that shows how Arizona's homeopathic board certification has effectively been an invitation to doctors who've lost their licenses in other states to come to Arizona and become M.D.h.'s.

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