A Utah doctor lost his license after he illegally prescribed drugs over the Internet.
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:
• One-fourth of Arizona's homeopaths have lost their conventional M.D. or D.O. licenses.
• The homeopathic board has licensed at least five convicted felons, whose crimes range from tax fraud to mail fraud. Four are now practicing. The other is on parole.
• The board dismissed a complaint against a homeopath after a patient died. Although a county medical examiner determined that the homeopath caused the death, the board ruled that the procedure did not violate the rules of homeopathy.
• One-fourth of the homeopaths licensed in Arizona don't live or practice in Arizona. Some practice with their Arizona M.D.h. in states where their M.D. license has been revoked. That is illegal in some states and legal in others.
• Other state medical boards pay professional investigators to study complaints against doctors. The homeopathic board uses volunteer alternative doctors to investigate their colleagues.
• Some doctors use their Arizona homeopathic licenses to perform face lifts, breast augmentations, liposuctions, and other surgeries that homeopaths aren't allowed to perform.
• Doctors who claim an interest in homeopathy need little training in the field to get an Arizona license.
Anna Prassa was a public member of the homeopathic board from 2000 to 2006. She says the board is flawed beyond repair.
"There's a reason why another state revokes a doctor's license," Prassa says. "For that to happen — and then they can waltz right into our state and get a license — that's a problem. It's a crime."
DR. GARY PAGE
In 2004, Dr. Gary Page, a dermatologist and M.D. from Utah, sent an application to the Arizona Medical Board. The Arizona Medical Board sent Page's application right back. Because his Utah license had been surrendered for Internet prescribing (and his California license revoked, as a result), Page wasn't eligible by law to apply for an M.D. license in Arizona.
If Arizona didn't have a Homeopathic Board of Medical Examiners, Page's story would likely have ended there.
Unable to practice medicine as a conventional M.D., Page sent an application to Arizona's homeopathic board.
Even though Page had no history of practicing homeopathic medicine, and though he'd been previously stripped of his medical licenses, Arizona's homeopathic board welcomed Page into the state.
Page was issued a homeopathic M.D.h. license. He moved to Gilbert with his wife and five kids — supposedly to practice alternative medicine.
But on July 3, 2007, Page was not practicing homeopathy, or any form of alternative medicine. He was performing a standard liposuction — a surgery not allowed under a homeopathic license.
According to records from the homeopathic board and the Arizona Medical Board, Page's patient, a 53-year-old woman, prepaid for liposuction on her thighs. Page injected the patient with anesthesia, which was allowed by his M.D.h. license, and then performed the liposuction, which wasn't.
The patient died shortly after surgery. The Maricopa County Medical Examiner cannot release the cause of death because board documents have concealed the victim's name.
That death — the third fatality at the Anthem cosmetic surgery clinic — was reported by the media. What wasn't reported is that Page walked right through the homeopathic board's loophole, securing an Arizona M.D.h. even after he'd lost his M.D. licenses in other states.
On March 18 of this year, Page surrendered his homeopathic license as the board was preparing to revoke his license because liposuction falls outside the scope of "minor" surgery homeopaths are allowed to perform.
He never could have practiced in Arizona, if not for the loophole that lets previously revoked doctors practice here as homeopaths.
Page did not return phone calls and e-mails seeking comment.
DR. GABRIEL COUSENS
In 1998, Charles Levy, 57, booked a flight to Arizona. Levy, an insurance agent, told his family he was in good health and planned to visit the Tree of Life Spa for a time of rejuvenation with a homeopathic doctor.
He looked forward to the live organic vegan diet and spiritual rest described by Dr. Gabriel Cousens, whose Web site promotes him as an M.D. and M.D.h.
Cousens is not eligible for an M.D. license in Arizona because his license was once taken away (but reinstated) in California and remains censured in New York. According to Arizona Medical Board spokesman Roger Downey, that makes a doctor ineligible for an Arizona medical license. If Cousens were a D.O., he would be eligible. But he's not. He's been practicing here as a homeopath for 15 years.
According to court records from a civil suit filed by Levy's family, Levy showed up at Cousens' secluded campus in the green hills of Patagonia, Arizona. He was hoping for a time of physical and spiritual rest. Cousens told him that injections of cow adrenaline and/or sheep DNA could energize his body. Levy agreed to five injections, which aren't a homeopathic treatment but are allowed by Arizona's homeopathic board.
Unfortunately, the injection site — on Levy's right buttock — grew infected, so he went to see Cousens about it. Cousens didn't recommend an antibiotic. Instead, he treated the growing abscess with acupuncture and massage.
The infected area became green and black. It spread down Levy's thigh, and on March 1, 1998, Levy did not wake up in his dorm room at the Tree of Life Spa. Cousens found Levy unconscious and attempted CPR, with no success.
Cousens did not call 911. Instead, he called an air ambulance, and arranged for a helicopter pickup on the football field of a nearby high school.
Cousens and a nurse carried Levy — draped in a bathrobe, bleeding from his mouth and groin — to a car and drove him five minutes to the field.
A Patagonia police officer was driving by the school when he saw Cousens and a number of spa guests gathered around an unclothed body lying on the grass.
Levy's buttock and thigh were black and swollen. His eyes were wide open. He was dead. After the helicopter took the body, Dr. Cousens told the officer that he'd injected Levy with sheep DNA. Later, Cousens contradicted his statement, saying the injection was actually cow hormones.
Whether the injection was cow or sheep didn't matter to Santa Cruz County Medical Examiner Dr. Cynthia Porterfield. She examined Levy's body and ruled that the injection and subsequent infection killed him. Specifically, she found that Levy died from Clostridium perfringens, a bacteria that grows in gas gangrene. During the Civil War, that bacteria claimed thousands of soldiers' lives when it grew in their battle wounds. Modern antibiotics can kill the bacteria easily when used.
"I spoke with him the day before. The next day, I got a phone call that he was gone," Levy's son, Howard, says. "I pretty much haven't recovered since. He was not on any medication, didn't have high blood pressure, or a weight problem. He could go out and run three miles on the boardwalk."
Levy filed a lawsuit against Cousens, and Cousens paid an undisclosed amount to settle the suit after the medical examiner pinned the death directly on him.
The osteopathic medical board also examined the autopsy and ruled that the medical examiner was right to name the injection and infection as the causes of death.
But when Cousens' dead patient came up before the homeopathic board in 2001, the board dismissed the complaint — despite the medical examiner's findings.
The board ruled that, though a patient did die, the doctor did not violate any laws of homeopathic medicine.
In his October 11, 2000 court deposition, board member Dr. Garry Gordon says he served as the board's lead investigator into Cousens, but he also worked as an expert witness for Cousens in court.
Because the homeopathic board dismissed the complaint, the medical board in California — where Cousens holds his M.D. — has no way of knowing Cousens injected a patient with animal hormones. It has no way of knowing he treated a growing infection with acupuncture or that a county medical examiner named his treatment as the causes of a patient's death.
The Arizona board has since destroyed audio records from that meeting (technically, it did so legally).
"I think it's a travesty that he's still practicing in Arizona," Howard Levy says from his home in New York. "Those people who are allowing this to continue to happen are just as guilty. The simple fact that he can continue to practice medicine in any way, shape, or form shows that the system is failing the general public."
Today, Cousens still practices at his spa in Patagonia. He says he has "28 cubic feet of scientific literature" that disprove the medical examiner. He says Levy died of an extremely rare syndrome that strikes suddenly and kills in hours. Cousens also says Levy was sick when he arrived at the spa and had the gas gangrene infection long before his cow adrenaline injections.
"Dr. Porterfield, the pathologist, really was neglectful," says Cousens, who also says he thinks he would have won the case in court. (He says his insurance company forced him to settle.) "I believe that if we were in front of the medical board, they would have cleared me just as well."
DR. CHARLES CROSBY
In 2002, the Florida Department of Health forced Dr. Charles Crosby, a D.O., into the state's impaired-physician program. Crosby had been kissing and groping female patients and staff, according to Florida records.
Crosby was diagnosed with a narcissistic disorder and with Frottuerism, a disorder "characterized by intense sexually arousing fantasies, sexual urges, or behaviors involving touching or rubbing against the body of a non-consenting person."
The surgeon and pain-management specialist's bedside manner included "touching patients' breasts in a way they found offensive (example, stroking their nipples) . . . kissing patients and staff . . . and using crass and sexual remarks that others found offensive."
Crosby told a psychiatrist he had "developed a special technique of manipulating women's breasts to treat pain in other areas of their body." That psychiatrist diagnosed Crosby with a breast fetish and ruled him unfit to practice medicine.
In June 2003, Crosby was still practicing medicine when he was caught manipulating the breasts and ribs of a woman at a medical trade show in Norfolk, Virginia.
On March 17, 2004, Florida's physician intervention program warned Crosby that it was restricting his practice and might suspend his Florida license.
Two months later, Crosby was standing before Arizona's homeopathic board, petitioning for a homeopathic license. Crosby didn't have enough homeopathic training, but the board voted to give him a license, as long as he took 40 hours of homeopathic courses. The homeopathic board licensed Crosby in Arizona — even as the Florida board was investigating him for groping his female patients.
Two months after Crosby secured his Arizona homeopathic license, the Florida board suspended his license. Crosby apparently never moved to Arizona. He lives and advertises in Florida, and his license is still suspended there. His Arizona homeopathic license is active, though he's on probation, which means Crosby has to submit reports that confirm he's seeing a psychiatrist.
Crosby declined comment for this story.
DR. MURRAY SUSSER
Dr. Murray Susser, 73, has been practicing alternative medicine for decades. The California Medical Board has taken his license away twice.
The first time was in 1997. According to California Medical Board records, Susser failed to identify some conventional cases of cancer. He failed to diagnose colon cancer in one patient, even though the patient had blood in her stool and complained of rectal bleeding.
For another patient, Susser prescribed natural vitamins in dangerous quantities, including "tannic acid, which is carcinogenic," and testosterone, which boosted blood pressure to unhealthy levels. According to California Medical Board records, Susser failed to see bowel cancer in that patient, too.
Susser's discipline culminated when he advised a patient who was jaundiced and experiencing severe abdominal pain to not go to the emergency room. Paramedics forced the patient to go to the ER, where she was diagnosed with severe liver and pancreas damage, due to the all-natural injections.
After two years of community service at 25 hours a week, Susser's California medical license was restored in 2000. His New York license is still surrendered.
In 2002, Susser secured a homeopathic license in Arizona. He's been practicing in Scottsdale ever since. In 2005, the California Medical Board again took away Susser's license (he's on probation again) for prescribing ketamine, an anesthetic and animal tranquilizer.
In 2006, Arizona's homeopathic board examined the same charges and dismissed them.
Known as "Special K" in the club scene, ketamine is similar to PCP. It can cause hallucinations along with extreme detachment from reality. The homeopathic board concluded that Susser was not in the wrong to prescribe ketamine to fibromyalgia patients — even though it falls outside the conventional standard of care.
In an interview for this story, Susser calls ketamine the pain reliever of the future for patients with chronic pain.
The U.S. Food and Drug Administration begs to differ. The FDA approves ketamine only as an anesthetic and veterinary tranquilizer.
Susser also says the details in the California Medical Board's paperwork are charges and not facts. He says they weren't proved and that he signed the agreements only to avoid court fees.
DR. ELLIOTT SCHMERLER
On January 9, 2007, a physician stood before Arizona's homeopathic board and told his personal story of redemption. Too bad it wasn't all true.
It had been five years since Dr. Elliott Schmerler pleaded guilty to felony tax fraud. According to IRS documents, Schmerler funneled more than $500,000 through a corporation in the Bahamas and then used the money for personal expenses. He was sentenced to 15 months in prison and stripped of his Nevada medical license.
Two of Schmerler's cosmetic surgery patients had poor results, and he paid out money in lawsuits to two others, according to his homeopathic application and records from the Nevada Medical Board.
By December 2006, Schmerler had served his time in prison and finished his probation for the tax fraud case. He wrote the IRS a check for $96,533 to settle the score. That month, the Nevada Medical Board issued Schmerler a restricted medical license that specifically banned him from performing cosmetic surgery in the state.
Because of his revocation and felony conviction, Schmerler could not perform cosmetic surgery as an M.D. in Arizona.
One month after Nevada issued him a restricted license, Schmerler was in Arizona, petitioning for his homeopathic license. Standing in the basement boardroom at the state building for regulatory boards, Schmerler told the board a big lie.
"Since our previous meeting, I was issued a new, unrestricted license by the Nevada Allopathic Medical Board," he said.
None of the board members mentioned that Schmerler's printed license restricted him from ever performing any kind of cosmetic surgery.
Instead, the discussion focused on giving doctors second chances, particularly when their history involves felonies.
"I fully recognize we may take a little heat from the media because 'that homeopathic board is back to licensing felons again,'" then-board president Dr. Garry Gordon said as he made a motion to accept Schmerler's application. "But I take the full responsibility of recognizing everything I've seen and read about this doctor going forward."
The board members didn't ask Schmerler why Nevada banned him from cosmetic surgery. They didn't ask about the liposuction patient who ended up with an infected, oozing stomach or the breast augmentation patient who woke up with a lopsided chest — both documented in his own application and in Nevada Medical Board records.
Nobody asked Schmerler why the Nevada Medical Board disciplined him for "intent to deceive" or whether he would attempt to practice his specialties — liposuction and breast augmentation — in Arizona. Those procedures aren't allowed with a homeopathic license.
Instead, the board took Schmerler at his word. Gordon asked his fellow members to give Schmerler another chance at honesty.
"Physicians are really not well suited to digging ditches, but they don't have a lot of other things they're good at doing," he said. "They shouldn't be used car salesman. When I was in California, I was astonished how everyone who serves their time and does their probation is finally re-licensed."
Arizona law doesn't let the conventional board give M.D.'s such second chances. The only way Schmerler could bring his services to Arizona would be through the homeopathic board's loophole.
The board voted 5-0 to grant Schmerler a homeopathic medical license.
So how has Schmerler used his shot at redemption?
Schmerler advertises himself on the Web and at his Scottsdale office as an M.D. He is not a licensed M.D. in Arizona. Homeopathic board president Dr. Todd Rowe says it's illegal for a homeopathic doctor to advertise as an M.D. if the doctor isn't licensed in Arizona.
According to Schmerler's office staff at A Surgical Art: A Cosmetic Surgery Group in downtown Scottsdale, Schmerler doesn't specialize in homeopathic medicine. He specializes in cosmetic surgeries — also illegal because his homeopathic license limits him to minor surgery.
A call to Schmerler's office confirms he specifically performs tummy tucks, breast augmentations, liposuctions, and facelifts, none of which is minor and none of which is legal to perform with only a homeopathic license.
There's no evidence Schmerler has harmed anyone in the year he's practiced here. But it's clear that he walked right through the homeopathic loophole to perform cosmetic surgery — the very thing he's banned from practicing in his home state of Nevada, and the very thing Arizona's conventional medical boards are designed to regulate.
Schmerler did not return phone calls requesting an interview for this story.
DR. RICK SHACKET
In 2003, Dr. Schmerler's partner in practice, Dr. Rick Shacket, shared the same page of an IRS press release, long before he shared the same office suite in Scottsdale. The press release detailed the felony convictions of both doctors.
Shacket secured his homeopathic license in 2001, before his conviction. The next year, he was sentenced to 33 months in prison after he pleaded guilty to creating a false identity so that he could hide $540,000 in profits, according to IRS documents.
A standard practice for nearly every medical board in the country, the California Osteopathic Board revoked Shacket's license. But Arizona's homeopathic board didn't. Shacket's Arizona license remained intact even while he was in prison and on probation. His profile on the Arizona Homeopathic Board Web site shows no discipline or letters of concern since his licensing in 2001.
In 2005, the osteopathic board also gave Schmerler an Arizona license.
Shacket did not return calls for comment.
DR. JEFFREY RUTGARD
In 1995, Dr. Jeffrey Rutgard, a San Diego ophthalmologist, was found guilty of talking senior patients into unnecessary eye surgeries, so he could pocket the Medicare payments. He was sentenced to 11 years in prison and ordered to pay $15 million to Medicare. The California Medical Board revoked his license during the 1994 trial.
Rutgard was out of prison by 2004. He promised the Arizona homeopathic board he would move to the state to learn alternative medicine. A chiropractor even testified that he'd take Rutgard under his wing to keep an eye on him.
Four years later, Rutgard apparently has yet to relocate to Arizona. The board hasn't penalized him, and Rutgard's license is intact. Despite his revoked California M.D. license, he practices part time in California with his Arizona M.D.h. and under the supervision of another homeopath, according to Homeopathic Board records.
California Medical Board spokeswoman Candace Cohen says Rutgard is breaking the law in that state if he is diagnosing patients or prescribing drugs, regardless of the Arizona license.
New Times could not confirm whether Rutgard has broken the law in California. He has paid his annual renewal fee of almost $1,000 for five years.
Rutgard did not return a message left on his home answering machine, requesting an interview.
Dr. Todd Rowe has served on Arizona's homeopathic board since 2005. He took over as president a month after state auditors released their report in the fall of 2007. Rowe, a psychiatrist, holds a valid Arizona M.D. license in addition to his homeopathic license.
Rowe says he and his board members are working to fix the problems outlined in the audit.
"I do feel like there's cleaning to do, and we have been working on that. We thought the auditors did an excellent job and really listened to the issues," he says.
But Rowe disagrees with the audit's statement that the homeopathic board may not serve a purpose. He and others in the alternative medicine community say Arizona holds the unique position of protecting alternative medicine.
As for the audit finding that licensed homeopaths aren't practicing homeopathic medicine, Rowe says the board wants to change its name to the board of "homeopathic and integrative medicine." That way the board can continue licensing alternative treatments outside the scope of homeopathy.
Rowe adds that the board is prepared to protect and regulate alternative medicine and that it's cracking down. "We've been tightening our discipline, at least since I've come onboard," he says. "All of our disciplinary actions have been at least if not more stringent than other boards."
He says the board is speeding up its investigations, too, by using volunteer homeopathic doctors to investigate complaints against their colleagues. Though that's a far cry from the professional, independent investigators the conventional medical board uses, it may be better than the recent system, in which board members investigated complaints themselves.
"We've made significant changes in the last year. There's a flow chart now that mandates we investigate every matter, at least since I've been president," Rowe says.
But three months ago, on January 9, the board failed to see an apparent violation of law right under its nose. Dr. Elliott Schmerler, the doctor banned from practicing cosmetic surgery in Nevada, stood before the board. It had been one year since the board voted to license Schmerler, a convicted felon.
The American Board of Cosmetic Surgeons had filed a board complaint that Schmerler was using their acronym, ABCS, on his business card and Web site — implying he's still board-certified, which he's not.
Schmerler showed the homeopathic board a new business card and said he had pulled the misleading acronym off his Web site. The board didn't discipline him, writing him a non-disciplinary letter of concern instead.
With that, Schmerler was off the hook.
The board had just been reminded, by the death of Dr. Gary Page's liposuction patient in July 2007, that it's illegal to use a homeopathic license for major cosmetic surgery in Arizona.
Still, none of the board members asked Schmerler why he's advertising as a cosmetic surgeon and M.D., when he isn't licensed as either in Arizona.
Rowe tells New Times he is aware that it's illegal for a homeopath to perform breast augmentations and tummy tucks in Arizona without an M.D. or D.O. license. He also confirms that "it's against the law for a doctor who isn't an M.D. in Arizona to advertise himself as an M.D."
So why didn't either issue come up in January, when Schmerler was before the board?
"We are only allowed to focus, as a board, on the complaint. We're limited in what we can explore outside of the initial complaint," Rowe says. But he adds that the board could open its own complaint, if it wanted. He says he's not sure why it didn't.
If Arizona lawmakers did disband its homeopathic board, it wouldn't be the first time that's happened in this country. In 1957, the state of Maryland disbanded its 80-year-old homeopathic board amidst controversy surrounding the doctors it was licensing. Other states have followed suit, forcing homeopaths to get licensed with the conventional board.
Some of Arizona's lawmakers say they have higher hopes for the largest homeopathic board in the nation. Despite last year's less-than-favorable audit, the state Senate voted last month to continue the board for two years.
The Senate also passed another omnibus bill that addresses a few of the problems highlighted in the audit. Both bills are expected to pass the House this month. But they don't plug the biggest loophole.
Barbara Leff, a Republican from Paradise Valley, and Paula Aboud, a Tucson Democrat, are members of the Senate Health Committee. Leff did not return calls for this story, but Aboud says she knows about the audit and that she and Leff sponsored amendments to the omnibus bill that would affect the homeopathic board. One amendment touches more on the concerns of activist doctors than the concerns of the audit.
One new clause in the bill confirms the board's power to license doctors who've been kicked out of other states.
Aboud — who has sought treatment from homeopaths — says she's concerned about that very problem.
"If you're doing classical homeopathy, which is merely a spiritual practice of working on the level of the spirit or the body, there are not too many ways a person can be harmed," Aboud tells New Times.
"But this homeopathic board is allowing a homeopathic doctor to do surgery and acupuncture and treatments that do harm the public."
The bill passed by the Senate in March and pending in the House as of press time does take a step toward closing the loophole. It would require doctors who've been revoked to wait five years before applying for their homeopathic license. That doesn't stop doctors from applying months or weeks before their licenses are revoked in their home state.
Dr. Charles Crosby, the Florida sex addict, illustrates why the new legislation wouldn't close the loophole. The intent behind the new line is that a doctor like Crosby couldn't apply for a homeopathic license until five years after he lost his Florida license.
But Crosby didn't apply for his homeopathic license after Florida suspended him. He applied for it two months before they suspended him.
In all states, doctors know when a medical board is investigating them. If doctors think they may lose their conventional licenses, they can secure an Arizona homeopathic license during the months of investigation in their home state.
Then, if their conventional license is stripped, they retain a homeopathic license. The bill that passed the Senate would not stop shrewd doctors from walking through the loophole. It still would allow them to keep a homeopathic license, even if they were stripped of the M.D. or D.O. license two months later — as Crosby was.
Conventional medical boards across the country rubber-stamp revocations. For example, when Dr. Gary Page surrendered his Utah license, California automatically revoked his license there.
Arizona's homeopathic board, however, doesn't have to follow suit.
The new legislation wouldn't affect the homeopathic board's ability to ignore revocations in other states — or even here in Arizona.
In fact, the proposed fixes would have let every single one of the problem doctors in this story into Arizona, though it would have delayed one doctor for two years.
If the House passes a bill that doesn't close the loophole, the governor could still veto it. Governor Janet Napolitano's spokeswoman, Jeanine L'Ecuyer, says she's surprised to hear the homeopathic board has licensed convicted felons.
"The governor has a general policy of not commenting on legislation until it's before her for her signature or veto," L'Ecuyer says. "But what you've described is of tremendous concern. We will begin the process of working with the board to see what's going on because public safety is paramount to the governor."
Dr. Kathleen Fry is one homeopath who doesn't think the new legislation would do enough. Fry is also an M.D. in good standing with the Arizona Medical Board. She testified before the Senate Health Committee in February that the homeopathic board is broken.
"I ask you not to continue this corrupt system because more people may end up maimed or dead." Fry said, then referring to Page's patient.
"It is this careless language that I believe led to the death of the unfortunate woman in Anthem last summer who underwent liposuction under local anesthesia. This language in this bill does not preclude another such tragedy occurring."
Chris Springer, executive director of the Arizona Board of Homeopathic Medical Examiners, is also the board's only employee. And she's a part-time employee. For 30 hours a week, Springer wears the hats of application reviewer, phone answerer, initial complaint investigator, liaison between other boards and spokeswoman, among others. Before this job, she was the director of the state's board of nursing home administrators.
Springer has a few things to say about the audit and the potential new laws that would affect the board. She says there will be no more second chances for doctors who've lost their licenses elsewhere, regardless of what the Legislature does this session. Her board is getting tough, Springer says. "The second chance isn't going to happen anymore."
As if the fallout from last year's audit weren't enough, Springer is fighting not just to keep the homeopathic board in existence, but also to keep her job in existence. This year, Napolitano is combining the staffs of several tiny boards. In Arizona, the concern seems to be more with consolidating office equipment and jobs than with regulation — at least, the regulation of homeopathic medicine.
In a lot of ways, Chris Springer represents the homeopathic board's six members. Down in the basement boardroom, cleaning up agendas after a recent board meeting, Springer gives her opinion of Dr. Gary Page.
She doesn't see Page as a formerly revoked doctor who found a loophole to practice in Arizona. She doesn't see him as a man whose patient died hours after a liposuction he wasn't licensed to perform.
"He has five kids and wife. Now he doesn't have a job," she says quietly. "It's sad."
Correction (posted April 24, 2008): It should have been stated that Dr. Rick Shacket surrendered his California medical license after a felony conviction for tax fraud.
