Monday, October 10, 2005

Throwing Sunshine On the Regulation of Homeopaths

The Arizona Republic has published a fascinating report on the Arizona Board of Homeopathic Medical Examiners. Some of its main points were:
  • Arizona is one of the few states that has a licensing procedure for homeopathy. In Arizona, however, those licensed in homeopathy are not restricted to practicing homeopathy, but are allowed to prescribe medications freely, perform minor surgery, and "practice a wide variety of alternative medicine treatments," including chelation therapy. To be licensed in homeopathy in Arizona, one must have a medical or osteopathic license from another state. The majority of the Board are licensed homeopaths.
  • The board has made it a point to attract physicians from other states "who have been disciplined unfairly in other states and whose skills could benefit patients seeking alternative remedies." The Arizona Homeopathic and Integrative Medical Association sought physicians who had been "'oppressed' by medical boards elsewhere." A former chairman of the Arizona Board of Homeopathic Medical Examiners, "There are doctors that have been enlightened as far as natural cures that have been around for hundreds of years, and their medical boards take them up on charges. These doctors are welcomed here to practice integrative medicine."
  • The Board has only revoked two licenses in its history. It has licensed several homeopaths with felony convictions in other states. These included Dr. Jeffrey Rutgard, an eye doctor from California who served five years in prison for Medicare fraud; Dr. Rick Shacket, and Dr. Robert Rowen, both of California, "convicted in tax cases;" and Dr. Joseph Collins of New Mexico, convicted of securities fraud.
  • The Board dismissed complaints against a homeopath who had a Florida license suspended for "fondling patients;" a Board member who gave "Vitamin C therapy" to a patient with an infected blister who later suffered "acute renal failure;" and a Board member accused of sexual harassment, after the complainant failed to show up at a meeting because of a "family emergency." According to a separate story in the Arizona Republic, the Board dismissed a complaint against a homeopath who injected a patient with "bovine adrenal fluid" for "fatigue," and then, after the patient developed an abscess at the injection site, and complained of pain and swelling, treated it with "acupuncture and message." The patient died of "gas gangrene infection."
  • One former non-homeopath Board member said "There have been doctors that they've licensed that I wouldn't send my worst enemy to. They just want one more boy in the band. They don't care."
The Board has not been audited for 20 years, but now state legislators are calling for an audit before the Board faces a "sunset" review next year.
The Lancet recently published a systematic review of homeopathy [Shang A et al. Are the clinical effects of homeopahty placebo effects? - comparative study of placebo-controlled trials of homeopathy and allopathy. Lancet 2005; 366: 726-732.] whose findings were "compatible with the notion that the clinical effects of homeopathy are placebo effects." An accompanying editorial [Anonymous. The end of homeopathy. Lancet 2005; 366: 690.] put it more strongly,
That homeopathy fares poorly when compared with allopathy in Ajing Shang and colleagues' systematic review is unsurprising. Of greater interest is the fact that this debate continues, despite 150 years of unfavourable findings. The more dilute the evidence for homeopathy becomes, the greater seems its popularity.
For too long, a politically correct laissez-faire attitude has existed towards homeopathy....
Surely the time has passed for selective analyses, biased reports, or further investment in research to perpetuate the homeopathy versus allopathy debate. Now doctors need to be bold with patients about homeopathy's lack of benefit, and with themselves about the failings of modern medicine to address patients' needs for personalised care.
It appears to me that the conduct of the Arizona Board of Homeopathic Medical Examiners provides yet another example of a failing government health care regulatory body. I cannot understand why a license to practice homeopathy should entitle its holder to prescribe the conventional medicines that homeopaths supposedly eschew. If it does, however, the holders of such licenses should be held to the same standards as those with conventional medical licenses. Their misconduct should not be excused by their supposed victimization due to the "oppression" of homeopathy. Certainly, the Board should not be "welcoming" physicians from other states who have had their licenses revoked, or have been convicted of felonies.
While the US can spend money and effort supporting repeatedly discredited alternative medicine systems like homeopathy, we don't seem to have the resources to make enough vaccine for avian influenza, much less cover the 40 million plus uninsured Americans. There is something seriously wrong with our priorities.

1 comment:

Dr. Nancy Malik said...

Homeopathy cures where Conventional Allopathic Medicine (CAM) fails