Arizona's homeopathic board is the second chance for doctors who may not deserve one

A California doctor lost his license after he was charged with hiding more than half a million dollars in profits, convicted of tax fraud, and sent to prison.

Another California doctor's license was suspended twice. The first time, he was accused of missing cancer in two patients. The second time, of misprescribing drugs.

Yet another California doctor went to prison and was ordered to pay $15 million in fines after he was convicted of defrauding Medicare by performing unnecessary surgery on the eyes of elderly patients.

And a fourth California doctor had his license suspended, then moved to Arizona and lost a patient. The doctor injected the patient with either cow hormones or sheep DNA (the doctor's given two versions of the story), which caused an infection. The patient died.

In the world of medicine, there are no second chances. A doctor makes a misstep, and a patient can die. That's why the boards that license allopathic and osteopathic doctors — M.D.s and D.O.s, respectively — are so tough, and often criticized for not being tough enough. (See "The Doctor Is Out," John Dickerson, March 6, the first in our "Prescription for Disaster" series.) Lose your M.D. license in one state in the U.S., and you may never practice medicine again. Certainly not in this state.

Unless you know about Arizona's Homeopathic Board of Medical Examiners.

For a few hundred dollars, some extra training (sometimes provided by the board's president himself, for a fee) and a test on the principles of homeopathy, an M.D. or D.O. who likely can't secure another medical license can get a license to practice homeopathic medicine in the state of Arizona. You'll be banned from some procedures, but for the most part, you can go back to practicing medicine — diagnosing patients, prescribing drugs, even performing minor surgeries.

All the doctors listed above — and more — are now homeopathic physicians, licensed to practice by the state of Arizona. (Except for that Utah doctor. He lost his homeopath's license last month after a patient died during a procedure he was not authorized to perform.)

And it's all perfectly legal under Arizona law.

Homeopathy isn't dangerous, per se. The alternative practice began in Germany in 1810. By modern medical and chemistry standards, it's a harmless pursuit because it dilutes chemicals almost to the purity of drinking water before injecting them into the body.

Classic homeopathy uses no prescriptions and is based on a theory that "like cures like" in sick patients. For example, if you're allergic to pollen in the air, a homeopathic physician might take that very pollen, dilute it, and inject you with it. The theory is that a small amount of the problem ingredient will cure you of your symptoms — sneezing, in the case of allergies. Modern chemists say homeopathic injections are so diluted that they have no effect, good or bad.

One popular homeopathic cure, oddly enough, is poison ivy oil. Because poison ivy causes a rash and can cause a fever, homeopathic physicians dilute the oil in alcohol, dilute it again, and use it to treat rashes and fevers. It may seem backward, but that's homeopathy. Homeopathic doctors track which substances help which patients, and then try the same treatments — pollen, poison ivy or otherwise — to treat patients with similar symptoms.

But that hardly matters here, because Arizona's homeopathic license is not always used to practice homeopathy. In fact, none of the doctors in this story were practicing it when they killed or harmed their patients. And, as the Arizona Auditor General found last year, the real problem is that the board is lax when it comes to poor medical treatment, regardless of whether it's considered homeopathic.

Homeopathic doctors can get the D.E.A. authority to prescribe the same drugs an M.D. or D.O. can prescribe, and are allowed to perform "minor" surgeries (for example, a homeopath can perform a vasectomy and administer local anesthesia, but can't perform a breast augmentation or give a patient an epidural) — which have nothing to do with homeopathic medicine. That attracts doctors who can't get, or who are about to lose, their conventional licenses.

Only two other states, Connecticut and Nevada, issue homeopathic licenses. Those states have tighter guidelines for getting a license and give their homeopaths less prescribing and surgical power than Arizona does.

So Arizona's license is a unique opportunity. In effect, the law amounts to a loophole for doctors who've gotten in trouble, or know they'll soon get in trouble, to practice medicine with the initials M.D.h., as homeopathic physicians — even if they don't practice homeopathy.

The requirements for getting an M.D. license in Arizona are strict. You cannot even apply for an M.D. license if you've ever lost an M.D. license in another state. (And that includes California, which can "revoke" an M.D. license, then reinstate it. If your California M.D. license has been revoked, you cannot get an Arizona M.D. license.) You also cannot apply if you have a felony conviction.

It's a little easier to get a D.O. license. If you have lost your D.O. license elsewhere, or you're a convicted felon, you are eligible to apply — but given recent history, it is unlikely Arizona's D.O. board will let you through. An M.D. cannot apply for a D.O. license, or vice versa. The rules for M.D.s and D.O.s are similar in other states.

In order to apply for a homeopathic license in Arizona, you must be either an M.D. or a D.O. in good standing in Arizona or another state. If you have lost a license elsewhere in the past, that's okay. If you are a convicted felon, you're still free to apply. And most significant: Once you are a homeopath, if you lose the license that got you in the door in the first place, you're fine. It doesn't affect your homeopathic license.

(Homeopaths in Arizona aren't even required by law to practice homeopathic medicine. That's a far cry from Connecticut, where the homeopathic license is good for homeopathic treatment and little else.)

Doctors who've committed felonies or have had their licenses revoked in other states need only to listen to a couple audio CDs about homeopathy before applying for a homeopathic license in Arizona. (One $880 correspondence course is actually taught by board president Dr. Todd Rowe.)

A homeopathic license in Arizona costs $975, almost twice as much as a conventional M.D. license ($500). Since a conventional license allows doctors to practice classic homeopathy, there are only two reasons to pay more for the homeopathic license: because you're banned from getting a conventional license or because you want to experiment with treatments the conventional board doesn't allow.

The homeopathic board also fails to discipline the doctors it has already licensed. That's one finding from — amazingly — the first audit of the homeopathic board done since 1985. The report was released in August 2007 by Arizona's Auditor General.

"The Board appears to allow conduct that the other two Arizona physician regulatory boards have determined is unsafe or unprofessional," the auditor general reports.

Auditors concluded there may no longer be a need for the board, which was created in 1981 at the behest of alternative doctors, because many alternative procedures are now allowed with conventional licenses. They also found the board has:

• Sometimes waited for more than a year to look into complaints against doctors.

• Licensed homeopathic doctors who weren't competent in homeopathy.

• Licensed a revoked Arizona D.O. who failed the homeopathy exam three times.

• Dismissed complaints against doctors without considering the accusations.

• Allowed doctors to practice medicine far beyond the scope of homeopathy.

• Failed to explain the difference between an M.D. and an M.D.h. to the public.

Copies of the August 2007 audit were delivered to the 12 state senators and representatives who sit on the Joint Legislative Audit Committee.

And yet, legislation currently being considered by the state House of Representatives would rubber-stamp the homeopathic board for two more years. Another bill attempts to clean up the board, but it fails to plug the loophole that lets doctors with revoked licenses into Arizona. In fact, the second bill solidifies the board's power to license doctors who have had their licenses revoked.

Current homeopathic board members say they are addressing the concerns listed in the audit. But recent board decisions indicate otherwise.

New Times researched the licensing history of all 107 homeopathic physicians in the state and reviewed hundreds of pages of board records. Among the findings: