Topic: Reporting a US doctor for ethical misconduct.

[vespine]

Firstly I don't live in America, I've done a bit of searching but I thought I'd ask here in case someone has been through the process or at least is familiar with it.

Say you found out that a licensed American doctor was doing something highly dubious, like travelling to a third world contry to conduct trials with a quack medicine officially classed by the FDA as dangerous. This seems highly unethical, if not illegal (Could it be illegal?) What would be the process to formally report this person to have them investigated?

I've found the AMA council on ethical and judicial affairs but they look more like a policy forming body rather then an enforcing body. And it doesn't really seem to fit into the FDA's jurisdiction. I'm guessing it would be a medical licensing body or something.. Federation of state medical boards? National board of medical examiners? It's all a bit confusing...

[Chew]

His/her State Medical Board.

[vespine]

Thanks for that. Illinois is the state I'm looking for. Unlike most states which have dedicated medical boards, Illinois seems to have a "Illinois Department of Financial & Professional Regulation", unfortunately several relevant parts of their website (including the complainds forms) are down for maintenance, I'll report back tomorrow.

[Citizen Skeptic]

As a former medical device industry exec, let me recommend the FDA instead. The AMA is a club of doctors like the Bar Association is a club for lawyers. They don't do a good job of policing themselves. Medical trials, on the other hand, are regulated by the FDA and they won't just go after the doctor. They'll go after everyone involved including the company sponsoring the trials with both civil and criminal charges if applicable. The FDA has agents that carry guns, handcuffs, and padlocks for the doors.

Now is a good time because the FDA is in unfriendly mode more than usual.

[Ice Wolf]

Hi Vespine,

Chew is correct. The appropriate authority is the State Medical Board of the physician. I am unsure whether they have juristiction outside their state however. If he is practising normally in the state and then travelling to the third world for his quackery , there could be an issue. They may not be able to do anything. theoretically the 3rd world country should prosecute him for practicing medicine without a licence in their country but - "You know the situation there".

The Medical boards are not like the lawyers boarsds. Medical boards generally come down hard on nonsense like this. Wakefield in the UK was struck off the regsiter by the GMC for lying in a medical trial. ( and a few other things)

They are hard and will investigate fairly but may not have juristiciation in this case

[vespine]

I understand the jourisdiction thing, but don't they have a code of conduct that members have to abide regardless of where they are?  The thing that surprises me is that the particular doctor I'm talking about isn't doing it very covertly, there's websites about what he's doing.

[Ice Wolf]

Hi Vespine,

No The Medical Boards have jurisiction in their area only. I am registered with the Irish Medical Council and the General Medical Council in the UK.

The IMC find abortion reprhensible and a reason to strike a doctor off. The GMC do not. If i were an obsterician and went to the uk and preformed an abortion there. If juristicition did not apply to the IMC , they might strike me off the Irish register for actions in the uk which were perfectly acceptable to the GMC. The GMC are then also obliged to strike me off their register as I have been struck off a register with which they have an agreement. All because of an action which is completely acceptable to the "Medical Board" in a country in which the action is preformed.

This is the reason why boards must have absolute jurisiction. There are more subtle examples as well. In the 3rd world, resources are very limited. Very difficult ethical decsions must often be made in the context of limited resouces. Some patients may not be savable and giving them expensive and scare drugs will cause future problems for the practice in the 3rd world area. These are difficult ethical decsions that are not faced by doctors or medical boards in the US or UK. A board in the US should not have any juristiction over these decisons. This is only right

If you share some of what this doctor has done I might be able to help you further.

Ice Wolf

[Citizen Skeptic]

I'm sorry to keep harping guys, but it really is the FDA that you need to contact if a medical trial is involved anywhere in the world and an american doctor/drug/device company is involved.

http://www.fda.gov/ScienceResearch/SpecialTopics/RunningClinicalTrials/default.htm

Bioresearch Monitoring
FDA’s bioresearch monitoring (BIMO) program conducts on-site inspections of both clinical and nonclinical studies performed to support research and marketing applications/submissions to the agency.  Links to the compliance programs for each inspection type and contact information for each Center’s BIMO program are also accessible from this site.

http://www.fda.gov/ScienceResearch/SpecialTopics/RunningClinicalTrials/ComplianceEnforcement/default.htm

Notice of Initiation of Disqualification Proceedings and Opportunity to Explain (NIDPOE) letters5
These letters inform the recipient clinical investigator that FDA is initiating an administrative proceeding to determine whether the clinical investigator should be disqualified from receiving investigational products pursuant to FDA's regulations. Generally, FDA issues a NIDPOE letter when it believes it has evidence that the clinical investigator repeatedly or deliberately violated FDA's regulations governing the proper conduct of clinical studies involving investigational products or submitted false information to the sponsor.

The FDA has worldwide reach and the resources. If he is involved in sanctioned trials, he'll be in a heap of trouble.

Medical trials can be quite a money making racket for doctors. While drug companies provide the experimental drug for free, they usually don't pay for the other stuff that you may have to take such as steroids, hormones, blood thinners, etc. that are not being tested plus they get to charge an office fee. My wife had an experimental cancer treatment (fda trials) and the doctor's office was like a frigging clinical trials production factory. I've never seen anything like that and this guy was legit, although he did seem a little slimy personally.

The problem with medical boards is that someone has to birddog the proceeding and while they sometimes take licenses away, it has to be pretty aggregious and obvious. Doctors are given a pretty broad judgement when it comes to how they practice. For example, doctors can prescribe off-label uses for drugs pretty much with impunity. And if kids are involved, there's even more room for judgement because very few drugs are actually approved/tested on kids. This is their world. The FDA has a more black and white view of the world.

[Shadow Of A Doubt]

Hi Vespine,

No The Medical Boards have jurisiction in their area only. I am registered with the Irish Medical Council and the General Medical Council in the UK.

The IMC find abortion reprhensible and a reason to strike a doctor off. The GMC do not. If i were an obsterician and went to the uk and preformed an abortion there. If juristicition did not apply to the IMC , they might strike me off the Irish register for actions in the uk which were perfectly acceptable to the GMC. The GMC are then also obliged to strike me off their register as I have been struck off a register with which they have an agreement. All because of an action which is completely acceptable to the "Medical Board" in a country in which the action is preformed.

Wow, is abortion illegal in Ireland?

[vespine]

Icewolf, never thought of it that way, that makes sense. But, is there NO limitation to that? I mean what if a medical board found out a pediatrician had been convicted of kiddy fiddling in another country, they still can't do anything? That's purely a hypothetical.

I didn't really want to discuss it openly because these forums are google searchable, but what the hell.

It's got to do with that Jim Humble guy, the MMS "bleachgate" thing.. I've actually been investigating MMS for over 2 years now, since before Rhys Morgan "exposed" it. Well, maybe it has waned a bit in the public arena, but it's far from gone away. Jim Humble has a slick new website and there is still a strong internet presence of supporters.

Ok, admittedly they're mostly kooks, which is fine, I accept it will probably never go away completely, and as long as it's just the conspiracy theory nut jobs and cranks drinking the bleach, that's fine. Mission accomplished.

BUT, there is another aspect to it which is not fine.

http://www.m-end.org/

Is a charity affiliated with the seemingly legitimate "Lutheran Church Charities" organization. They claim to be curing people of malaria for the last 5 years using, you guessed it, MMS. They don't call it MMS and don't mention Jim Humble, but one of the founders is none other then Thomas Hesselink MD: Jim Humble's wingman when it comes to "mms research", Hesselink is credited as a contributing author of Jim's first book and he has a big website of Chlorine dioxide "research" (read:hog wash) that Jim Humble frequently cites. Jim Humble and MMS's finger prints are all over the M-End site, only very thinly veiled.

One of the other directors is a Susan Busse MD, another registerd doctor. It looks like she is the one who has actually travelled to Africa and possibly been involved with legitimate aid efforts which are mixed in, to make the matter really convincing or confusing, depending on which way you look at it. There are video testimonials on that site which I find really disturbing once you realize what's really going on.

I haven't found whether Hesselink him self has travelled to Africa.


There are a couple of very lame press relseases talking about how great their progress is going, but of course, no actual publshed results or aything has come of it.

So far, over the past year I have written a letter to the heads of the mother organization "Lutheran Church Charities". I have written to the United Nations Foundation which seems to also be involved somehow (their banner is on the LCC website). I've written to the FBI who I was told investigate charity fraud. I've even written to raising malawi and the gates foudation asking if they could put their clout behind shutting down this scam operation. So far, nada. Not a single reply from anyone.

I'm in the process of writing an open letter to the LCC which i'm going to post on my blog. I've been tryoing to stay anonymous during this time, but I might need to "come out of the closet" if I want to push this further..

Anyone got any other ideas?

[Ice Wolf]

Hi Vespine - I'll answer this in parts.

Every year before my registration is renewed, I'm required to fill in and sign a legal document.

Here it is:

Annual Declaration Questionnaire 2012
 
Please answer each of the following questions
1. Do you practise medicine in the Republic of Ireland? (either permanently or on a temporary / occasional basis)?
2. Have you practised medicine outside the Republic of Ireland in the last 12 months?
3. Do you have medical indemnity cover for all healthcare services you provide? [See paragraph 50.1 of the Council's Guide to Professional Conduct and Ethics]
4. Have you read the current edition of the Medical Council's 'Guide to Professional Conduct and Ethics for Registered Medical Practitioners?

Since your last application with the Medical Council for registration
5. Have any findings been made against you by any other competent authority?
6.Have you given any undertaking to any licensing or registration authority in respect of findings following an investigation or review of your performance?
7. Have any conditions been imposed as a result of these findings on any professional registration or licence held by you?
8. Has any registration or licence held by you been suspended, withdrawn or removed?
9. Has any competent authority refused to grant you registration or a practice licence?
10. Have you had any conviction of a criminal nature whether imposed in or outside the State?

To the best of my knowledge, information or belief all of the above is true. required field  Required

Now - Your question about kiddy fiddling will be covered under 2 sections. Have you ever had a conviction made against you? or Have you ever had findings made against you by another board/medical council?

If a doctor answered yes and filled in an explantion, the  Council would investigate with a fittness to practice enquiry. Kiddy Fiddling would be an easy "stike off" for prosecutors.

It does get difficult in other cases. One doctor was convicted of not having a dog licence. "By the medical council"!! Sense prevailed and nothing happened to him. Other cases can be more diifficult. Driving under the influence of alcohol. Should an entire medical carrer be destroyed by this? I feel this is on the borderline and doctors are humans with frailities and we must look upon this with compassion. It is also unfait that one person might have their driver's licence taken away for this while a doctor has his driving licence and medical licence taken away and the ability to earn a living and pay for his family. Punishmnet should be equal to all. Others argue that your licence should only be taken away if it affect your ability to practice. "Kiddy fiddling " defintiely does that while drunk driving might actually not if it only happened on one or two occasions.

If the doctor answers "no" on the form and is lying and is found out, it is a very serious crime and he will definitely lose his licence.

System is not perfect but it does have to be fair to doctors as well as the public.

[Ice Wolf]

"Wow, is abortion illegal in Ireland?"

Yes , Shadow - It is ! Completely illegal.  Both the doctor and woman would do serious jailtime - about 5 -10 years.

It gets even more complicated however. In the mid 90s, a case called the X case occrurred. X because the girl was not named as she was 14. The girl was raped and her father decided that he would bring her to the UK for an abortion (very common in ireland).

Her father contacted the police involved with the case. He wanted the fetal tissue used as evidence in court to convict the rapist. He wanted to know if they would use the fetal tissue and if it should be kept.

The reaction of the police was incredible. Under Irish law it was apparently illegal to travel abroad for an abortion. An court order was placed to prevent the father and girl leaving the country. This caused huge shock and revulsion.. protest occurred asking if there would be pregnacy tests at ports and airports. An appeal to the Supreme Court did overturn the order. This was on the basis that girl's life was in danger from suicide if the pregnacy was allowed to continue.

It took a referendum of the entire people to overturn this law. Abortion law in ireland is written into the constitution and very difficult to change. It requires all people in the country to vote before any change. It is a deeply devisive issue and no politician wants to touch it with a barge pole in order to avoid annoying the other half of the country.

Nowadays there may be over 50% supprot for a change in the law, but the process is too difficult to have the law changed.

Absolute maddness!

[Shadow Of A Doubt]

That is shocking. But don't worry, organised religion isn't harmful in the West, it must be OK!

[vespine]

Hi Vespine - I'll answer this in parts.
...

Thanks Ice wolf.. That's a great reply, makes sense now. So if they themselves don't get prosecuted for what they are doing, there's no real jurisdiction for the licensing board to do anything.

So, probably the only hope is that the FDA or the FBI eventually take notice and actually bust these shysters.... I haven't had much luck, i even raised it with the  FBI attache in australia, but I got the impression they didn't give a shit, I emailed them 3 times and never got a reply, not even a "thanks for raising your concerns". ..

[Citizen Skeptic]

Hi Vespine - I'll answer this in parts.
...

Thanks Ice wolf.. That's a great reply, makes sense now. So if they themselves don't get prosecuted for what they are doing, there's no real jurisdiction for the licensing board to do anything.

So, probably the only hope is that the FDA or the FBI eventually take notice and actually bust these shysters.... I haven't had much luck, i even raised it with the  FBI attache in australia, but I got the impression they didn't give a shit, I emailed them 3 times and never got a reply, not even a "thanks for raising your concerns". ..

Yeah, the FBI is not really interested in this sort of crime. If there were counterfit drugs involved then maybe the DEA would be interested or Customs if they are coming in and out of the US.