Consumer Health Digest #12-14

Your Weekly Update of News and Reviews
April 19, 2012

Consumer Health Digest is a free weekly e-mail newsletter edited by Stephen Barrett, M.D., with help from William M. London, Ed.D., M.P.H. It summarizes scientific reports; legislative developments; enforcement actions; news reports; Web site evaluations; recommended and nonrecommended books; and other information relevant to consumer protection and consumer decision-making.

More action against Dr. Mark Geier. Following hearings by an administrative law judge, the Maryland State Board of Physicians issued an order extending the suspension of Mark R. Geier, M.D. In April 2011, the Board of Physicians issued an emergency suspension order which stated Geier had misrepresented his credentials, operated an institutional review board that did not meet state and federal regulations, and rendered substandard care to nine patients with autism. In six of the patients, the board charged, he inappropriately diagnosed precocious puberty (a rare condition) and administered Lupron, a drug that reduces the body's production of the male hormone testosterone and is used to castrate sex offenders. Shortly afterward, following a hearing, the Board issued formal charges against Geier, continued his suspension, and also charged his son David with practicing medicine without a license. In November 2011, The administrative law judge dismissed the charges that Dr. Geier had misrepresented his credentials and improperly operated an institutional review board, but she found ample evidence of substandard care. Concluding that allowing Geier to continue to practice while formal charges are pending raised a "substantial likelihood of risk of serious harm to the public health, safety, or welfare," she recommended that the suspension should continue until the board rules on the formal charges. The Geiers had been operating ASD Centers LLC, a chain of clinics that advertises "a new combined genetic, biochemical, heavy metal, and hormonal evaluation/treatment for patients diagnosed with autism spectrum disorder (ASD)."

In response to the Maryland action, at least seven states that had licensed Geier have suspended his license until the Maryland proceedings are completed. In February 2012, the Maryland Board issued an Amended Cease and Desist Order based on information it had received that Dr. Geier had authorized drug refills for at least three patients even though his license was suspended. David Geier has had an administrative hearing, but the board will probably not take further action for at least three months.

Link between gum disease and cardiovascular disease doubtful. An American Heart Association expert panel has concluded that gum disease is has not been demonstrated to be a factor in causing cardiovascular disease and treating gum disease does not appear to prevent or influence the course of atherosclerotic vascular disease. A link between the two disorders has been proposed for more than a century, and patients and providers have been increasingly presented with claims that gum treatment strategies offer cardiovascular protection. Both disorders share several common risk factors (cigarette smoking, age, and diabetes mellitus) but the most likely reason they are found together is that people who have good oral hygiene also tend to have a healthy lifestyle that helps protect against cardiovascular disease. [Lockhart PB and others. Periodontal disease and atherosclerotic vascular disease: Does the evidence support an independent association? A scientific statement from the American Heart Association. Circulation doi: 10.1161/CIR.0b013e31825719f, April18, 2012]

Texas appeals court nixes two procedures done by chiropractors. A Texas court of appeals has ruled that chiropractors are barred from performing manipulation under anesthesia and doing needle electromyography tests. In 2006, after the Texas Board of Chiropractic Examiners decided that chiropractors could perform needle electromyography and that its rules did not prohibit manipulation under anesthesia (MUA), the Texas Medical Association (TMA) filed suit to challenge these policies and also whether chiropractors have the right to "diagnose" any medical conditions. A district court judge sided with the TMA, but the appeals court ruling permits chiropractors to diagnose spinal and musculoskeletal illnesses but not other conditions. MUA has some respectable use for treating frozen shoulder, knee, or jaw (TMJ) problems, but spinal MUA has none. Aetna's Clinical Policy Guide provides a detailed discussion.

Chiropractic schools facing financial trouble. The Chronicle of Higher Education has reported that many of the nation's 16 chiropractic programs are struggling to stay in business. According to the journal's analysis:

Source: Fuller A. Chiropractic colleges seek legitimacy amid financial woes. The Chronicle of Higher Education, April 1, 2012.

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