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Dose of Their Own Medicine

Integrative doctors battle the ethically conflicted NC Medical Board

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But the board's inquest didn't stop there. When it learned that Great Smokies provides lab results related to alternative therapies for integrative doctors across the state, it sent the laboratory a subpoena demanding a list of all the North Carolina physicians who do business with the lab. The lab did not return Creative Loafing's calls for comment.

Others like Dr. Walter Ward of Winston-Salem are more resigned to the endless inquisition. The use of vitamins is a central part of Ward's practice, one that has caused him to spend endless hours explaining their benefits in treating everything from acne to post nasal drip to medical board investigators with a bottomless supply of pointed questions.

"Every time I turn around they're investigating me about one thing or another," said Ward.

So far, Ward has foregone the attorney fees and taken his chances, betting that he can talk his way out of the board's latest inquest with graphs, charts and stacks of scientific research supporting his methods. In the process he's saved himself tens of thousands of dollars in legal fees, but risked his license and clean record in the process.

Worse yet, when integrative doctors were called before the board to explain themselves in the past, doctors unfamiliar with alternative therapies sat in judgment over them. The board had also barred doctors who were the sole practitioners of an alternative therapy in North Carolina from calling witnesses from other states to help defend them, essentially leaving them defenseless.

It was the equivalent, Buttar and others say, of the board calling in a neurosurgeon to review the work of a gynecologist.

Concern or Harassment?
Last year, according to the National Practitioner Data Bank and an analysis by the group Public Citizen, disciplinary actions (license suspension, revocation, or restriction of clinical privileges) were taken against only 8.1 percent of North Carolina physicians with two or more malpractice payouts. Meanwhile, 17.6 percent of integrative physicians in North Carolina have had to hire attorneys to answer for them in investigations or appear before the Board (compared to 1.1 percent of all physicians).

The trend is not unique to North Carolina, says Neal Pattison, research director for Public Citizen, a group founded by Ralph Nader that, among other things, studies the track record of medical boards nationwide. In states like ours where there's a direct relationship between the physician trade group and the board that disciplines doctors, problems often arise.

In North Carolina, 7 of the 12 members of the medical board are appointed by the North Carolina Medical Society, a powerful private physicians' special interest group with more than 11,000 members statewide. In recent years, various attempts by legislators to rein in the medical society's power over the board, through bills that end its ability to appoint its members, have gone down in flames thanks to the society's proficient lobbyists.

"It's a real conflict," said Pattison. "Being a doctor is a noble calling, but it's also a business and as a bunch of businessmen, these docs are often influencing the conduct of their state medical boards. They are very concerned about something that might be a business threat to the doctors, like a new type of medicine coming to town."

When it comes to integrative medicine, there's much for the mainstream to be financially concerned about. Since 1998, the number of Americans who solicit alternative medical treatment has steadily increased. Last year, a Harvard University study showed that 42 percent of Americans had sought some sort of alternative medicine in the previous six months. Another study by the Duke Center for Integrative Medicine found that there are now more visits annually to alternative care providers than to primary care providers, and that Americans are spending an average of $30 billion a year out of their own pockets for this care. At the same time, insurance providers are increasingly offering employers coverage packages that include alternative therapies like homeopathy, massage, chiropractic medicine, acupuncture and acupressure, which were considered controversial only a decade ago.

According to a state law passed in 1993 after a legislative battle by integrative medical practitioners, the medical board cannot revoke or deny a license to a physician for practicing a therapy that is "experimental, nontraditional, or that departs from acceptable and prevailing medical practices unless, by competent evidence, the Board can establish that the treatment has a safety risk greater than the prevailing treatment or that the treatment is generally not effective."

Dale Breaden, director of public affairs at the NC Medical Board, says it's patently untrue that the board is targeting integrative doctors.

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