SB 31 versus “health freedom” in North Carolina

After having been away for four days, it always takes me a little time to get back into the swing of things when it comes to blogging. Actually, it takes some time to get back into the swing of things at work, too. Sometimes it takes starting on something not too difficult and then working my way back up to the more difficult tasks. In terms of blogging, starting out with something not too difficult often means taking on a reliable source of utter nonsense. And what better source of utter nonsense exists in the world of pseudoscientific medicine? Certainly, it’s hard to find a loonier, nuttier purveyor of pseudoscience than Mike Adams, the proprietor of the reliably hysterical alt-med website. Even better, sometimes Mike Adams’ hysteria illustrates a useful point about how quacks think not just about medicine, but about the law and the world, and what their ultimate goals are.

This came to mind when, while I was away in Orlando, readers began sending me this article by Mike Adams entitled NC bill threatens to criminalize naturopaths, homeopaths, herbalists, midwives, aromatherapists as felons. Two days later, he followed it up with North Carolina SB 31 bill seeks to turn healers into felons; but the health freedom backlash has already begun. When I read this, I was intrigued; so, before I get to Mike Adams’ hyperbole about the bill, let’s look at what the bill actually says. Don’t worry. It’s really short, which makes the response to it particularly telling. Here is the current text of the bill:

AN ACT TO CLARIFY THE PENALTY FOR THE UNAUTHORIZED PRACTICE OF MEDICINE.

The General Assembly of North Carolina enacts:

SECTION 1. G.S. 90‑18(a) reads as rewritten:

“§ 90‑18. Practicing without license; penalties.
(a) No person shall perform any act constituting the practice of medicine or surgery, as defined in this Article, or any of the branches thereof, unless the person shall have been first licensed and registered so to do in the manner provided in this Article. Article, and if any Any person shall practice who practices medicine or surgery without being duly licensed and registered, as provided in this Article, the person shall not be allowed to maintain any action to collect any fee for such services. The person so practicing without license being duly licensed and registered shall be guilty of a Class 1 misdemeanor, Class I felony, except that if the person so practicing without a license is an out‑of‑state practitioner who has not been licensed and registered to practice medicine or surgery in this State, the person shall be guilty of a Class I felony. any person who has a license or approval under this Article that is inactive due solely to the failure to complete annual registration in a timely fashion as required by this Article or any person who is licensed, registered, and practicing under any other Article of this Chapter shall be guilty of a Class 1 misdemeanor.”

SECTION 2. This act becomes effective December 1, 2011, and applies to offenses committed on or after that date.

That’s it. Basically, it makes practicing medicine without a license a class I felony, the lowest form of felony. The exception is a practitioner who lets his license lapse through not having renewed it in a timely fashion, in which case it’s a misdemeanor. Pretty inoffensive, right? At least, you would think so. I would think so. Most reasonable people would think so. One might argue whether practicing medicine without a license should be a felony, but I have a hard time arguing against it as long as the penalties are in line with the offense. Not Mike Adams. He sees a dark conspiracy against “alternative” medicine practitioners:

Proponents of the bill say it fixes a loophole in the current law that classifies out-of-state practitioners who practice without a license as Class I felons, while in-state practitioners who practice without a license are only guilty of a Class I misdemeanor. But what the bill actually appears to do is make it even harder for alternative practitioners who literally cannot be licensed in NC because their work is not “approved,” to practice at all. After all, who is going to be willing to provide alternative medical services for consenting patients when doing so makes them a felon?

You know, I almost wish that North Carolina legislators were so Machiavellian in their ways or willing to crack down on quacks in such a strong manner. However, if there’s one thing I know about North Carolina legislators, it’s that they are actually very sympathetic to alternative medicine. After all, the law in North Carolina was such that “alternative” physician Dr. Rashid Buttar has not only survived attempts by the North Carolina State Medical Board to discipline him for using chelation therapy and a panoply of unproven and ineffective treatments on patients with autism and cancer, all the while charging them megabucks for these “therapies,” but he’s gone beyond mere survival. He’s turned these efforts around and used them to work with the legislature to gut any effective enforcement of medical standards by the state medical board. He led an effort, along with the North Carolina Integrative Medicine Society, to get North Carolina legislators to change state law to make it friendlier to “alternative” practitioners.

In essence, the law prevents the state board from disciplining doctors for using “non-traditional” or experimental treatments unless it can demonstrate that they are ineffective or more harmful that prevailing treatments. In essence, this law allows physicians to do practically anything they want in terms of quackery with little to fear, particularly in the cases of patients with diseases for which conventional therapy is toxic–like cancer. All the physician has to do is give some sort of bogus “informed consent,” and it’s a “get out of jail free” card. Now, in such a quack-friendly state, I have a hard time believing that legislators intentionally tried to increase the penalties on “alternative” medicine practitioners. I tend to believe the proffered explanation, namely of harmonizing existing penalties.

To Mike Adams, though, it’s The Man trying to keep The Truth and The Cures from The People:

The State of North Carolina REFUSES to license holistic health practitioners to practice medicine at all! You can’t get a license to treat disease as a homeopath, an herbalist or even as a Chinese Medicine practitioner. Be sure you understand what I’m saying here: YES, you can be “licensed” as a TCM practitioner in North Carolina, but you are NOT licensed to actually treat disease. In fact, if you attempt to tell a patient that you are “treating cancer” (i.e. practicing medicine), then under this new law, you can be arrested and prosecuted for a felony crime.

And Adams says that as though it were a bad thing. Homeopaths, herbalists, and traditional Chinese medicine shouldn’t be treating real diseases. They actually shouldn’t really be treating anyone because their methods are either unproven, disproven, pure pseudoscience, or based on prescientific ideas about how the human body functions and disease disrupts that function. I suppose the least harm is done by letting them wield their placebo effects on people who have benign, self-limited diseases, but even that can result in significant harm because these practitioners don’t know how to differentiate serious diseases that require treatment from the sorts of nonspecific complaints without a clear etiology for which placebo effects are most noticeable.

Of course, to Adams, this is an affront to the freedom of quacks to practice their quackery as they desire and fleece their marks:

This is why this SB 31 bill is an assault on the God-given freedom to practice healing medicine. In fact, state medical boards are, themselves, a symptom of the “disease” of the medical police state. By what right does a state medical board have any authority to tell an herbalist that she cannot treat a heart patient or a diabetic? The huge assortment of herbs that can help reverse diabetes is astonishing, and yet the state medical board in North Carolina (and every other state) insists that degenerative disease can ONLY be treated with drugs and surgery. Anyone even attempting to treat cancer with herbs, for example, can be arrested and charged with a felony crime under this new bill.

This kind of medical police state tyranny has created the situation today where natural healers, herbalists and Chinese Medicine practitioners are scared to death of being hauled off to prison if they accidentally utter a disease name during a patient treatment session. Were you aware that the national certification boards for most holistic modalities even warn healing arts practitioners that they cannot ever, under any circumstances, teach patients about the deadly dangers of prescription medications?

Ah, yes. The “medical police state” rhetoric that we know and love from Adams. Later in the article, he even predicts that after the passage of SB 31 police vans will swoop into Asheville to round up homeopaths and herbalists and throw them in jail. Such an occurrence is, of course, incredibly unlikely. After all, neither the state medical board nor law enforcement officials in North Carolina have shown much, if any, inclination to enforce existing laws that might allow the prosecution of such practitioners for practicing medicine without a license. What makes Adams think that passage of SB 31 would make them any more willing to do so? Only paranoia. Of course, to Adams any law or regulation trying to enforce any sort of science-based standard of care is not an effort to protect the public; it’s fascism, Nazi-ism, and totalitarianism all rolled into one. How dare the state try to protect the public from quackery? It’s an offense to “health freedom,” which is in reality nothing more than the freedom of quacks to do whatever they see fit.

The rest of Adams’ rant is worth reading for its over-the-top rhetoric. Basically, it’s Tea Party anti-government rhetoric on steroids fused with a massive Health Freedom rant. He views Asheville, for instance, not as a center of New Age quackery and woo, but rather as “one of the most famous and abundant healing centers in all of North America.” Of course, this is one of the rare times when Adams might have a germ of a point. Asheville may be famous for its woo, but woo is also big business there, as I’ve mentioned before. Be that as it may, no one brings home the crazy when it comes to “health freedom” the way that Adams does, and the fact that a group called Citizens for Health Care Freedom would team up with Adams does not speak well for its judgment or commitment to good medicine. Of course, if there’s one thing I’ve learned, it’s that any group that has the term “health freedom” in its name is virtually guaranteed to be a promoter of quackery.

On the other hand, Adams might have another germ of a point, although I tend to think it’s completely inadvertent. Adams characterizes SB 31 as a tool to enforce a “medical monopoly” that keeps alternative medicine practitioners out, but that’s not quite true. True, whether intentionally or unintentionally (I tend to vote for unintentionally), SB 31 criminalizes only alternative practitioners who do not have an MD and a medical license. Dubious practitioners like Dr. Rashid Buttar (who is, in my not-so-humble opinion, the biggest quack in North Carolina, certainly the most successful anyway). Maybe Mikey has a point. Maybe the point of this law is to restrict the practice of quackery like homeopathy, much of traditional Chinese medicine, and naturopathy only to state-licensed MDs, who have only to be able to argue that, no matter how pseudoscientific they are or how much quackery they practice, their quackery is no more harmful than “conventional” medicine.

MDs like Dr. Rashid Buttar.

Finally, I urge my readers in North Carolina to contact their legislators and voice support for SB 31. Even though it only impacts non-licensed practitioners, it’s a start. Maybe someday, North Carolina will re-empower its medical board to be able to enforce science-based standards of care. Until then, the citizens of North Carolina have very little protection against quacks.

ADDENDUM: Well, that didn’t take long. True, the source is Mike Adams again, but it looks as though the North Carolina legislature is about to cave, introducing an amendment that changes the text to read:

Representative Weiss

…moves to amend the bill on page 1, lines 13-19, by rewriting the lines to read:

“and registered shall be guilty of a Class 1 misdemeanor, except that if the person falsely
represent himself or herself in any manner as being licensed, registered, and practicing under this Article or any other Article of this Chapter, or any person so practicing without a license is an out-of-state practitioner who has not been licensed and registered to practice medicine or surgery in this State, the person shall be guilty of a Class I felony.”

So, basically, if this version of the bill passes, quacks won’t get into trouble as long as they don’t claim to be licensed health care practitioners in North Carolina. In the state of Dr. Buttar, this isn’t the least bit surprising. All I can say to citizens of North Carolina is that your state legislature appears unconcerned about protecting the public from quacks.