October 29th, 2009 by Peter Lipson, M.D. in Better Health Network, Quackery Exposed
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Dr. Weil is often seen as the smiling “mainstream” of alternative medicine. He’s a real doctor (unlike, say, Gary Null), and much of what he advocates is standard and uncontroversial nutritional advice. But Weil illustrates the two biggest problems with so-called alternative medicne: once you’ve decided science is dispensible, the door is open to anything, no matter how insane; and no matter how altruistic you may start, sooner or later you start selling snake oil. Most doctors out there are working hard to help their patients prevent and overcome disease use the available evidence. Others decide that science is too constraining and start practicing at the periphery of knowledge, throwing plausibility and ethics to the wind.
The fact that Weil claims to donate to charity all of his ill-gotten gains does not mitigate the harm he causes. Read more »
*This blog post was originally published at Science-Based Medicine*
September 24th, 2009 by David H. Gorski, M.D., Ph.D. in News, Quackery Exposed
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Although I have criticized state medical boards for not doing enough to protect patients from physicians who practice pseudoscientific medicine and quackery, they do nonetheless serve a purpose. Moreover, critical to medical boards doing even the limited amount of enforcement that they do is the ability of health care providers or other citizens to submit anonymous complaints against physicians who are not practicing up to the standard of care or who may be in other ways taking advantage of patients.
Unfortunately, the other day I found out about a very disturbing case in Kermit, Texas. Two nurses who were dismayed and disturbed by a physician peddling all manner of herbal supplements reported him to the authorities. Now, they are facing jail:
In a stunning display of good ol’ boy idiocy and abuse of prosecutorial discretion, two West Texas nurses have been fired from their jobs and indicted with a third-degree felony carrying potential penalties of two-to-ten years’ imprisonment and a maximum fine of $10,000. Why? Because they exercised a basic tenet of the nurse’s Code of Ethics — the duty to advocate for the health and safety of their patients.
The nurses, in their 50s and both members of the American Nurses Association/Texas Nurses Association, reported concerns about a doctor practicing at Winkler County Memorial Hospital in Kermit. They were unamused by his improperly encouraging patients in the hospital emergency department and in the rural health clinic to buy his own herbal “medicines,” and they thought it improper for him to take hospital supplies to perform a procedure at a patient’s home rather than in the hospital. (The doctor did not succeed, as reportedly he was stopped by the hospital chief of staff.)
How can this be? This is how:
The nurses Vicki Galle, RN, and Anne Mitchell, RN, say they were just trying to protect patients when they anonymously reported their concerns April 7 to the Texas Medical Board (TMB). The RNs believed a physician wasn’t living up to ethical practice standards at the 15-bed county hospital where they worked.
The report indicated Rolando Arafiles, MD, one of three physicians on contract with the hospital, improperly encouraged patients at the Winkler County Memorial Hospital emergency department and the county’s rural health clinic to buy herbal supplements from him.
However, because the two nurses worked for a county hospital – and included medical record numbers of the patients in their letter to the TMB in April – the county attorney’s office indicted them on “misuse of official information” – a third-degree felony that carries potential penalties of 2-10 years’ imprisonment and a maximum fine of $10,000. Additionally, the prosecution asserts the nurses used patient records as part of the evidence they offered to the TMB to “harass or annoy” Arafiles.
Part of what’s so disturbing about this is that complaints to the medical board are supposed to be confidential. Indeed, this sort of retaliation is exactly why such complaints are confidential. Why do I say “retaliation”? Well, certainly there is the suspicious timing of how they were arrested:
Mitchell and Galle, both long-time nurses at the facility, were fired from their positions and were subsequently arrested June 12, just 5 days past the 60-day window that could have been part of the defense to prove retaliation. The two nurses are free on bond of $5,000 each.
Gee, you don’t think that timing was intentional, do you? If that’s not enough, take a look at this account:
The nurses went up their chain of command with their complaints. They got nowhere with their 25-bed rural hospital. So they anonymously turned the doctor into the Texas Medical Board using six medical record numbers of the involved hospital patients .
When the medical board notified the physician that he was under investigation for mistreatment and poor quality of care, he filed a harassment complaint with the Winkler County Sheriff’s Department.
To find out who made the anonymous complaint, the sheriff left no stone unturned. He interviewed all of the patients whose medical record case numbers were listed in the report and asked the hospital to identify who would have had access to the patient records in question.
At some point, the sheriff obtained a copy of the anonymous complaint and used the description of a “female over 50″ to narrow the potential complainants to the two nurses. He then got a search warrant to seize their work computers and found a copy of the letter to the medical board on one of them.
So let’s get this straight. Two nurses, alarmed that a physician was inappropriately peddling herbal remedies that he sells to patients in the emergency room of a small rural hospital in the middle of Nowhere, Texas, try to report him through the chain of command. From here on out, I’m going to try to read between the lines a bit, but I bet my speculation is not too far from the truth. My guess is that Dr. Arafiles is probably either popular or desperately needed in Kermit–or both–and that he’s well-connected in the town. Well, actually, that last part is almost certainly true, as apparently Dr. Arafiles is buddies with the Sheriff (Robert Roberts) and–who knows?–probably Winkler County Attorney Scott Tidwell as well for all we know. The Sheriff, tipped off by his buddy that someone at the hospital was complaining about his questionable choice of venue to peddle his herbal woo, went after Mitchell and Galle as though they had gone on a four county shooting spree and and then, after he figured out who they were, threw the book at them, even though they had no justification in doing so:
The Texas Medical Board sent a letter to the attorneys stating that it is improper to criminally prosecute people for raising complaints with the board; that the complaints were confidential and not subject to subpoena; that the board is exempt from federal HIPAA law; and that, on the contrary, the board depends on reporting from health care professionals to carry out its duty of protecting the public from improper practitioners.
Excerpts from this letter include:
- Information provided by an individual to the board… is information used by the Board in its governmental capacity as a state agency…Information provided triggering a complaint or furthering and investigation by the Board is information provided for a governmental purpose – the regulation of the practice of medicine.
- …under federal law, the TMB is exempt from the [HIPAA] requirements; therefore, the provision of medical documentation with patient names on them to the Board is not a violation of [HIPAA].
And it’s true. In order to encourage whistleblowing and minimize the chances of retaliation, HIPAA rules don’t apply to complaints to state medical boards. Regardless of the merit of Mitchell and Galle’s complaint, they were well within their rights to report Dr Arafiles to the Texas Medical Board. It doesn’t matter whether they had first gone through the chain of command or not, regardless of what hospital flunkies or apologists for the sheriff say.
This case is bad. Real bad. Nurses and other health care professionals are reluctant enough as it is to report a bad doctor or a doctor peddling dubious therapies as it is. What makes this case particularly outrageous is not only because it appears to be a horrible abuse of power by Sheriff Roberts, but, even worse, it sends the clear and unmistakable message to nurses in Texas: Don’t get out of line or the medical powers that bewill make you pay. They will find out who you are, no matter what it takes to do so, and then they will do everything in their power to retaliate. They’ll even try to throw you in jail if they can figure out a rationale to do so, legal or not. It’s hard enough to go against a doctor as it is, particularly in small towns, where doctors are often considered pillars of the community, making it hard enough to risk the disapproval that would be likely to be directed at any whistleblower. Without legal protections against prosecution for reporting a doctor to the board, confidentiality means nothing if there is someone in a position of power who is determined enough to shred the confidentiality of the complaint (like a county sheriff) and apparently ready to abuse his power to retaliate against the nurses making the complaints.
Even though I’m a bit late to the game, it disgusted me to read about this case. If we are to protect the public from physician misconduct, be it quackery, breaches of ethics, inappropriate sexual behavior, fraud, or whatever, there must be protections for the complainants against retaliation by hospitals or whomever. Quite correctly, the Texas Nurse’s Association is fully backing Mitchell and Galle, and Mitchell and Galle are also filing a civil lawsuit in federal court against the hospital (Winkler County Memorial Hospital), the county attorney, and the sheriff. The complaint alleges:
Specifically, Winkler County had a policy to prohibit any adverse report without first getting the approval of the Board of Control of Winkler County Memorial Hospital and the Medical Staff. This discouraged employees from publicly reporting matters of public concern regarding patient safety and patients’ health and welfare as to how they were being treated that would cast Winkler County or Winkler County Memorial Hospital or Rolando G. Arafiles, Jr. in a negative light.
This sort of miscarriage of justice should not be allowed to stand. TheTexas Nurses Association has set up a legal defense fund for these nurses (a link is on the TNA home page), and I urger SBM readers to contribute. I have. I also encourage SBM readers to write polite letters of protest to the Winkler County District Attorney’s Office. It is a travesty that this retaliation against nurses just trying to do their duty for their patients has been allowed to continue this long and this far. We should do whatever we can to make sure that this pure power play to put a couple of uppity nurses back in their place does not stand.
May 3rd, 2009 by admin in Better Health Network
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I have said it before and I will say it again. Diet pills do not work and can be dangerous. For proof of the dangerous part, check out the Food and Drug Administration (FDA) notice of the recall of Hydroxycut.
In all, there are 14 products that have been recalled including:
- Hydroxycut Regular Rapid Release Caplets
- Hydroxycut Caffeine-Free Rapid Release Caplets
- Hydroxycut Hardcore Liquid Caplets
- Hydroxycut Max Liquid Caplets
- Hydroxycut Regular Drink Packets
- Hydroxycut Caffeine-Free Drink Packets
- Hydroxycut Hardcore Drink Packets (Ignition Stix)
- Hydroxycut Max Drink Packets
- Hydroxycut Liquid Shots
- Hydroxycut Hardcore RTDs (Ready-to-Drink)
- Hydroxycut Max Aqua Shed
- Hydroxycut 24
- Hydroxycut Carb Control
- Hydroxycut Natural
Why the recall?
The FDA says there have been 23 reports of liver damage, elevated liver enzymes, or liver damage requiring transplant. Other reported problems include seizures, muscle damage, and cardiovascular problems. One death of a 19 year old man is also thought to be associated with using Hydroxycut.
If you are using Hydroxycut currently, throw it away or return them to where you purchased them. There are numerous ingredients in the 14 different products recalled and right now it is not clear which ingredients are thought to be the most dangerous and cause problems.
Diet and exercise
I know you are tired of hearing it, but I am not tired of saying it. 🙂
Reducing calories and increasing calorie burn by moving more are the best way to lose weight. Many dietary supplements on the market are safe. But some can have dangerous consequences. use caution and when in doubt, don’t use something you think may be dangerous.
*This post, Hydroxycut Recall, was originally published on Healthline.com by Tara Gidus, MS, RD.*
November 12th, 2008 by Dr. Val Jones in Audio, Expert Interviews
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Penny Kris-Etherton, Ph.D., R.D., Distinguished Professor of Nutrition (Department of Nutritional Sciences, Penn State University) about what she learned at the American Dietetic Association Food & Nutrition Conference & Expo in Chicago.
Please listen to the podcast here: [audio:http://blog.getbetterhealth.com/wp-content/uploads/2008/11/pennykrisetherton.mp3]
Penny’s take home messages:
1. Corn is not evil. The vegetable itself can be quite nutritious, though high fructose corn syrup is an empty calorie food additive.
2. There is no magic food that will melt your fat away.
3. There is no magic pill that will help you lose weight. You must decrease your calorie intake and increase your exercise.
4. Increasing protein a little bit can increase satiety.
5. Omega-3 fatty acids and iron can improve brain health.
6. Regular fatty fish consumption can reduce the risk of heart disease (2 servings/week).
7. Food first – try to get all your nutrients from the foods you consume. Consider vitamins and supplements only after you’ve been unable to get your dietary needs met from food.
8. Fish oil supplements are safe and pure. There are differences in the amount of omega-3 fatty acids that the supplements deliver, so read the label carefully.
9. A healthy diet is about eating a broad range of nutritious food (don’t scrimp on your veggies), it’s not about supplementing a poor diet with some supplements.
10. Accurate nutrition information is really important. Two trusted sources are: MyPyramid.gov and the American Heart Association
**Listen to the podcast**
