History of No. Carolina Medical Practice Act Changes
‘Those who cannot remember the past are condemned to repeat it.’ (George Santayana – 1905). In a 1948 speech to the House of Commons, Sir Winston Churchill changed the quote slightly when he paraphrased it: ‘Those who fail to learn from history are condemned to repeat it.’
Following is a transcript of a recording by John Wilson, MD of Asheville, North Carolina documenting the history of the changes to the Medical Practice Act of North Carolina. My most grateful thanks go out to him for taking the time and effort to record these events. His detailed memory of the dates and times and people involved gives us an invaluable resource moving into the future of Biological and Integrative Medicine.
Around 1980, there was an MD practicing classical homeopathy in Asheville, North Carolina. His name was Dr. George Guess. The North Carolina Medical Board brought charges against Dr. Guess claiming that he was not practicing within the usual and acceptable standards of the practice of medicine at that time. They initiated legal action to revoke Dr. Guess’ license.
Dr. Guess challenged the NCMB at the district court level. The court upheld Dr. Guess’s right to practice homeopathy. The Medical Board however challenged that decision and appealed to the state appellant court that also upheld the lower court decision. The Medical Board further challenged it to the State Supreme Court. In July of 1991, the North Carolina Supreme Court reversed the two lower court decisions and claimed that the Medical Board had the right to establish the standards of practice for medical doctors in North Carolina. The majority court decision stated that whether the practice of homeopathy is effective is an interesting but irrelevant question. The dissenting justice, stated: “It’s a good thing penicillin wasn’t discovered in North Carolina.”
Now that set the stage for the Medical Board to go after any other practicing physician who was practicing outside of the usual and acceptable standards of practice. This of course involved Dr. Laird who in 1980 started practicing Chelation Therapy and he was informed by the Medical Board that he should cease and desist this activity as it was probably unethical. He wrote back to them and told them that he would not stop because it was helping people. This set up a series of ongoing communications between the Board and Dr. Laird. Action against Dr. Laird was postponed because there were several academic studies that were pending to test the veracity of Chelation Therapy for vascular disease. For various reasons these studies all fell apart. The more definitive study was going to be done at Walter Reed Hospital, but the Gulf war came along and sabotaged that by diverting the personnel and the funds that had been allocated to do the study.
After the Guess decision came down, the Medical Board scheduled a practice revocation hearing for Dr. Laird in September of 1991, one week after I arrived to join him in practice. We determined that it was obviously not going to be successful to challenge the Medical Board’s opposition to Chelation Therapy in the courts and so we became active politically to see of we could successfully change the wording of the Medical Practice Act. This was obviously a huge challenge for which we did not have a full scope of understanding of all that would be involved. We hired a political organizer who had run the successful campaign of a US Senator in Virginia. We also hired a hands-on local husband of a physician to manage telephone trees and communications (remember that the internet was not available in 1991). In addition, we contracted the services of a lobbyist who had been working for years with legislature and hired by the Chiropractic Association in North Carolina. We gathered approximately 15 people from around the state who had an interest in integrative health including health food store owners, other physicians and nurses, etc. They put together a telephone tree to communicate with various committee members in the legislature when certain bills would come up before them so that we could let them know our opinion.
We even had two individuals who were so committed to this task that they moved to Raleigh to meet with legislators who were favorable to our desire to change the wording in the Medical Practice Act making it more open for integrative medical practitioners.
We were fortunate in getting help for fundraising through an organization we founded calling it Carolinians for Healthcare Access. We were able to enlist numerous patients including the top producers in Amway as well as many others. All in all, I believe we had to raise a quarter of a million dollars to pay for this political effort.
Of interest, is that our lobbyist, who was very familiar with and skilled in dealing with the legislators who served on the committees that would hear our proposed bill, was able to hand select the committees and influence the wording of the changes we wanted to make in our Bill. There were seven lobbyists opposing her that were hired by the North Carolina Medical Society who were initially opposing our bill. However, through skillful discussion, at the end of the day we were able to enlist their help with this bill. When we finally succeeded, they claimed that it was their idea, reminding us all that if you don’t have to take credit for something, you can probably accomplish a lot more. We were happy to let them have the credit in exchange for their support.
Our Bill was introduced into legislature during an “off year”. During this time the legislature cannot introduce or vote on a new bill, only those that had been previously introduced. Knowing that, our lobbyist arranged to have the bill referred to the committee for a study. She was able to influence which committee would be most favorable to hearing our bill.
Once the study commission was formed, she was able to influence who served on the committee to make sure they were favourable to our changes. Actually, as part of the introduction of the bill, we proposed that the North Carolina legislature create a Board of Integrative Medicine. We knew if that were introduced the Medical Society would be violently opposed to the bill. We anticipated this, and this is exactly what happened. During the peak of their irritation over this proposal, we slipped in a compromise which was basically the wording of the bill we wanted to have. They were so relieved to be rid of the idea of a separate board, the legislature embraced it as did the Medical Society and thus their claim that it was their idea.
The following year, an even numbered year, the study committee forwarded the bill to the legislature and it was heard in the Senate and the State House. There was a massive phone calling campaign through a telephone tree that was established. Our telephone trees connections were so effective that the numerous legislators would call our clinic (Great Smokies Medical Center in Asheville – GSMC) and beg us to “call off the troops”. We of course told the legislators that we had no control over the feelings that people had that motivated them to call to make this change.
Also of interest, during the committee hearings on the changes to the Medical Practice Act, Dr. Laird was brought before the committees to testify. He explained the rationale for Chelation Therapy. Following his testimony, three state representatives and one senator called GSMC to schedule and receive chelation therapy.
When our bill was finally heard and passed the actual wording of the change in the Medical Practice Act stated that: “The Medical Board may not deny nor restrict the licensure of a physician merely because the type of practice he or she is engaged in differs from the usual and acceptable standards of practice except by competent evidence, the Medical Board must prove that such a therapy is inherently more dangerous than the conventional therapy it replaces or is generally ineffective.”
Seems like a lot of work for just a couple of sentences, but it did open the door!
Following this passage, the Medical Board published it’s first “position statement”. This stated that in their opinion, the practice of Chelation Therapy was unethical. They were of course afraid there would be a massive influx of Chelation practitioners in the state of North Carolina. I think there was some success on their efforts as Great Smokies was the only clinic for years in the state following this that provided Chelation Therapy.
Following this effort, we were so exhausted from the fight, that we let all of our efforts just rest and did not maintain any vigil.
The culture of the Medical Board did not change of course following this, and in 1998 went after one of the practitioners for their use of hair analysis and giving vitamin B12 shots to patients. He was brought before the board and had to face that challenge. In 2003 the Medical Board attacked an integrative physician in Raleigh for using ozone and intravenous peroxide. They actually suspended his licence and this gave him time to reorganize and revitalize the Carolinians for Healthcare Access. We ended up going back to the legislature in 2003 and were successful in passing a Due Process for Physicians’ Bill, which significantly changed the playing field for integrative doctors.
This in essence stated that a physician called before the board could bring as his witnesses, doctors who had the same specialty. The idea here being that a family practice doctor could not review the case of a neuro surgeon, nor visa versa. But an integrative physician who is brought before the board could bring as his supporting witnesses a physician of the same specialty. This also eventually gained the support of the North Carolina Medical Society and this bill was passed.
However, the Medical Board continued their attack against integrative physicians in 2008. But this time, we were able to gain the support of the most powerful person in the legislature, Senator Sam Nesbitt who happened to be the senator from my district. I often wonder if he was paying attention when I was treating his granddaughter for asthma, the 6th (sixth) physician to do so. She did respond nicely to the treatment that I provided. Through the power of his influence Senator Nesbitt was able to get passed some sweeping changes to the Medical Practice Act that made it more accommodating for integrative physicians. Since the passage of the Medical Practice Act changes in 2008, there have been no further unfair attacks on integrative physicians in North Carolina.
I’m reminded of the words of Thomas Jefferson, that “the price of freedom is eternal vigilance.”
In 2003, a group of approximately 8 (eight) of us physicians formed what we called the North Carolina Integrative Medical Society (NCIMS). This group was originally founded with the purpose of fundraising for:
- paying for a lobbyist
- paying for vigilance
- and, watching for what is going on in the legislature
But eventually we became an educational organization and three times a year we now have an Integrative Grand Rounds. Once a year we also hold an annual meeting in Asheville which brings in over a hundred attendees from across the South East region. It’s one of the few, if not the only state that has its own Integrative Medical Society which is a vibrant and exciting group to be part of and sharing knowledge and comradery.