Slipping Through the Net

"Internet Internist" caught in web of investigations

It's small consolation to Debbie Knight that Pietr Hitzig, the self-proclaimed "father of Fen-Phen," surrendered his license to practice medicine in Maryland last week.

The Phoenix native is convinced that, had Maryland authorities acted sooner, her brother, Alvin Chernov, might still be alive. Chernov committed suicide at his father's Glendale home in September 1995. He was 25.

"I'm happy that that particular battle has been won," says Knight, who now lives north of Sacramento. "But Hitzig should never be allowed to practice medicine again anywhere. This guy has preyed on more desperate people than anyone can say. I'm sure we haven't seen the end of him in the medical field."

Though he's banned from practicing medicine in his home state, it's uncertain if Hitzig will continue a practice for which he's become infamous--dispensing advice and prescriptions over the Internet.

A New Times story ("The Internet Internist," March 19, 1998) told of Chernov's downward spiral after Hitzig had prescribed him the diet-drug combination widely known as Fen-Phen. (The "Fen" refers to the appetite depressant fenfluramine, the "Phen" to phentermine. Both are amphetamines.)

Chernov, a recent Arizona State University graduate, had been suffering from severe depression. Trouble was, he never met Hitzig in person, and communicated with his doctor solely by e-mail or phone. Hitzig told New Times last March that his unorthodox protocol could cure depression in a matter of hours:

"If you use my technique, you'll stop all psychoneuroses. So why should the doctor have to worry what the psychoneuroses are? You just fix the people. . . . I've got lots of Alvin Chernovs who are still alive because of what I do."

The doctor added, "If they--the medical board or the cops--had a good charge against me, don't you think they would have shut me down?"

Hitzig's actions in the Chernov case raised many questions, including whether tweaking the brains of virtual strangers through cyberspace constitutes criminal behavior.

Federal prosecutors in Baltimore confirm that they've been investigating Hitzig for more than a year. But the doctor hasn't been charged with any crimes.

One charge could be that Hitzig prescribed Fen-Phen and other drugs "outside the ordinary course of accepted medical practice," which is a federal crime.

A problem is that state legislatures enacted laws for disciplining doctors before there was an Internet. No state yet prohibits treating patients over the Internet, and the feds don't have such laws on the books, either.

Finally, authorities in most states--including Arizona--say their jurisdictional limits end where the doctor, not the patient, is based.

Debbie Knight wrote to the Arizona Board of Medical Examiners (BOMEX) about a week before her brother died. She informed them of Hitzig's practices, and of a recent conversation she'd had with the doctor.

From her September 1997 letter:
"[Hitzig] told me, 'Right now, I am everything to him.' I asked Hitzig if he had seen Alvin in person. He said no, that he did not need to--he had given Alvin a very thorough psychological test via the mail. . . . Dr. Hitzig then told me I, too, should be on his protocol because I had the sniffles, and the meds would clear it right up."

She wrote again to BOMEX shortly after Chernov's death:
"In my first letter I asked for your help in stopping Dr. Pietr Hitzig. . . . I know there is nothing anyone can do to help my brother at this point, but for others like him, I ask you: Please do not let this happen again."

Knight says a BOMEX investigator promised her that the doctor would soon be arrested in Maryland. He wasn't.

In December 1998, the Maryland Board of Physician Quality Assurance finally ordered Hitzig to explain why he shouldn't lose his license for wrongdoing allegedly committed against Maryland-based patients.

A 60-page report issued by the board last December cited several examples of Hitzig's dubious practices. The litany included a patient who committed suicide in the doctor's driveway after being put on an extensive Fen-Phen regimen in 1994--almost three years before Alvin Chernov became Hitzig's patient.

Also in December, the Maryland agency temporarily suspended Hitzig's license until a committee considered the allegations. A hearing was scheduled for this week, but was preempted by Hitzig's decision to surrender his license.

Hitzig could not be reached for comment. But in a written four-page statement to the board, he said in part:

"I admit that I have engaged in unprofessional conduct, including sexual misconduct with my patients. I acknowledge that I misused my position as a physician and betrayed the trust placed in me."

In his heyday from 1994 to late 1997, Hitzig bragged on his Web site that he'd "successfully treated over 8,000 patients" with Fen-Phen for a variety of ailments. His list included obesity, alcoholism, methamphetamine abuse, migraines and even Gulf War Syndrome.

Dispensing large quantities of Fen-Phen proved lucrative. Court records indicate Hitzig drew a salary in 1995 of $269,000. His business took a hit, however, in September 1997. Two days after Alvin Chernov killed himself, the federal Food and Drug Administration coincidentally ordered the recall of fenfluramine and dexenfluramine, after studies linked the drugs to possible heart-valve disorders. (Hitzig is a defendant in a class-action suit filed by Baltimore-area patients claiming they developed heart problems after taking Fen-Phen.)

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