Legislature(1993 - 1994)
03/01/1993 01:30 PM House HES
| Audio | Topic |
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
JOINT HOUSE AND SENATE
HEALTH, EDUCATION AND SOCIAL SERVICES
STANDING COMMITTEES
March 1, 1993
1:30 p.m.
HOUSE MEMBERS PRESENT
Rep. Cynthia Toohey, Co-Chair
Rep. Con Bunde, Co-Chair
Rep. Gary Davis, Vice Chair
Rep. Al Vezey
Rep. Pete Kott
Rep. Harley Olberg
Rep. Bettye Davis
Rep. Irene Nicholia
Rep. Tom Brice
HOUSE MEMBERS ABSENT
None
SENATE MEMBERS PRESENT
Sen. Steve Rieger, Chair
Sen. Bert Sharp, Vice Chair
Sen. Loren Leman
Sen. Mike Miller
Sen. Jim Duncan
Sen. Johnny Ellis
SENATE MEMBERS ABSENT
Sen. Judy Salo
OTHER MEMBERS PRESENT
Rep. Curt Menard
Sen. Randy Phillips
COMMITTEE CALENDAR
Confirmation Hearing: State Medical Board appointments
Joint meeting with Senate HESS
WITNESS REGISTER
NOEL DEVRIES
P.O. Box 1027
Palmer, Alaska 99645
Phone: (907) 745-3362
Position Statement: Appointee
DR. JOAN JELINEK, M.D.
1305 21st Ave.
Fairbanks, Alaska 99701
Phone: (907) 452-7524
Position Statement: Appointee
DR. GARY JOHNSON, M.D.
P.O. Box 80606
Fairbanks, Alaska 99708
Phone: (907) 479-3235
Position Statement: Appointee
EILEEN BECKER
P.O. Box 109
Homer, Alaska 99603
Phone: (907) 235-7526
Position Statement: Appointee
DR. ROBERT ROWEN, M.D.
615 E. 82nd Ave. #300
Anchorage, Alaska 99518
Phone: (907) 344-7775
Position Statement: Appointee
ACTION NARRATIVE
TAPE 93-25, SIDE A
Number 000
CHAIRMAN RIEGER called the meeting to order at 3:03 p.m. and
noted members present. He stated that the Senate members
had to return to a floor session at 3:00 p.m. He said the
committee would consider the appointees in the following
order: Noel DeVries, Joan Jelinek, Gary Johnson, Eileen
Becker and Robert Rowen. He brought NOEL DEVRIES'
nomination to the table and asked if members had any
questions.
NOMINATION OF NOEL DEVRIES
Number 028
REP. TOOHEY asked Mr. DeVries how he would feel about making
decisions about physicians who performed abortions.
MR. DEVRIES said he would follow applicable Alaska statutes.
He said the medical board did not usually deal with that
issue, but did deal often with impaired physicians,
disciplining those with drug or alcohol problems. He did
not see it as an issue. Mr. DeVries remarked, "I can say
this, I guess. I might may have a problem if there were
lesser medical procedures and lesser-qualified people
applied to, say, an abortion with other comparable surgery.
I don't know as that's the case."
REP. TOOHEY said she heard Mr. DeVries say his judgement
would not be pre-clouded by a physician's involvement in
providing abortions and asked if that were correct.
Number 084
MR. DEVRIES said the medical board has been very lenient in
terms of working with drug and alcohol problems. He said
that his vote on suspension of a physician who performs
abortions would not be swayed by that fact.
CHAIR BUNDE referred to the case of Dr. Ake, an Anchorage
physician convicted of sexually abusing patients, and how
difficult it was for women to lodge protests. He asked what
might have been done to speed the process of investigating
Dr. Ake and what might be done to prevent continued sexual
abuse.
Number 109
MR. DEVRIES stated that he is not a physician, but a public
member of the medical board. He said it was a little
frustrating to sit on the board and go through a long,
laborious process, but due process takes time. While he
might like to see the process speeded up, he did not know if
it was realistic. He did not think the board had a mandate
to get involved in sexual harassment issues, but was
mandated to look at medical competency. He said such
complaints might better go to the Human Rights Commission or
another commission.
CHAIR RIEGER asked if the medical board had been too lenient
and should be stricter in removing doctors from practice
than it has been in the past.
MR. DEVRIES answered that Dr. McGuire (a member of the
medical board) was decisive, and other doctors on the board
knew the need to vigorously discipline other doctors when
necessary. He said such discipline was especially necessary
when a doctor was abusing drugs or alcohol.
(Rep. Nicholia arrived at 1:43 p.m.)
NOMINATION OF DR. JOAN JELINEK, M.D.
Number 174
SEN. RIEGER brought the confirmation of Dr. Joan Jelinek to
the table and noted that she was on-line via teleconference
from Fairbanks.
REP. TOOHEY asked whether the knowledge that a physician
performed abortions would influence her judgement of that
physician in matters coming before the medical board.
DR. JELINEK answered no, it would not. She said the duties
of medical board members are well-defined, and any personal
or religious preferences regarding abortion should be
excluded from their judgement as board members.
Number 192
SEN. RIEGER asked her opinion of the medical board's level
of strictness in disciplining doctors.
DR. JELINEK answered that it was a complex question. She
said the medical board was effectively investigating the
complaints brought to it, but there was often an excessive
delay before the board could render an opinion and impose a
sanction if necessary. That could be a function of the
number of complaints, the level of support, and the limited
attention which each board members could bring to a case.
She said medical board sanctions had been appropriate,
though she was frustrated at the size of the caseload and
the delays before rendering decisions. She said the board
was not lenient, but said the board sometimes lacks specific
guidelines in dealing with imprecise areas of human and
medical judgement. She said the medical board has drawn
attention for its many disciplinary actions against doctors,
though it might not be excessive, given the number of
doctors in the state.
Number 230
REP. BUNDE asked whether Dr. Jelinek felt the public was
well-informed about how to file complaints against doctors
and whether more information was necessary.
DR. JELINEK answered that the medical board served the
public, and while the public may need more education, it
would probably greatly expand the board's caseload. Once
the board hears of complaints, the investigators are prompt
and thorough, she said, but there is often subsequent delay
before action by the board.
Number 255
SEN. LEMAN said he had received several comments from
medical doctors on Dr. Robert Rowen's appointment, and asked
Dr. Jelinek to comment on Dr. Rowen's performance on the
medical board in the time she had been appointed to the
board.
DR. JELINEK responded that she could take no issue with Dr.
Rowen's performance during the one or two board meetings
since his appointment. She said she was familiar with the
concerns from doctors and laymen that Sen. Leman had
mentioned. She said the medical board would continue to
operate under its governing statutes and said she hoped no
individual nomination would alter the board's course.
Number 279
REP. BUNDE invited Dr. Jelinek to share her opinions on Dr.
Rowen's appointment.
Number 280
DR. JELINEK said she was not offering specific information
on Dr. Rowen's appointment, but recognizing the controversy
over his alleged practice of unconventional medicine in
Alaska. She said she felt that legislators, physicians and
laymen must consider American medical practice, and offered
to provide a recent JAMA (Journal of the American Medical
Association) article which reviewed the prevalence, cost and
patterns of use of unconventional medical practices, and
judged that the nation was probably underutilizing them.
The article suggested one in four Americans seek
unconditional therapy in addition to other medical
attention, often surreptitiously. She said the National
Institute of Health was establishing an office to do
research into unconventional medical practices, but in the
interim the medical profession must continue to practice
conventional medicine.
Number 321
REP. NICHOLIA asked whether Dr. Jelinek believed the medical
community was responding adequately to the problems of Fetal
Alcohol Syndrome (FAS).
DR. JELINEK said she had no sense of that and could not
answer the question, as she practiced internal medicine, not
pediatrics, obstetrics or gynecology.
Number 337
NOMINATION OF DR. GARY JOHNSON, M.D.
SEN. RIEGER brought the nomination of DR. GARY JOHNSON to
the table, noted that Dr. Johnson was on-line via
teleconference in Fairbanks, and invited committee members
to question him.
REP. TOOHEY asked Dr. Johnson if he could be an impartial
judge of a peer professional if he knew that physician
performed abortions.
DR. JOHNSON answered yes.
Number 345
SEN. RIEGER asked Dr. Johnson under what conditions he would
consider suspending the license of a doctor in Alaska.
DR. JOHNSON answered that he would do so if a physician was
causing potential harm to patients, practicing unethical
medicine, or breaking the law.
SEN. RIEGER asked Dr. Johnson's opinion of the medical
board's level of strictness or leniency in investigating and
licensing.
DR. JOHNSON said that, though he had been at only one board
meeting, he shared Dr. Jelinek's desire that the process
could be done faster, though he acknowledged it probably
could not. He said the medical board was fairly balancing
the interests of the public with the leeway needed for
different styles of medical practice, and it must allow due
process, which can be lengthy.
Number 372
REP. BUNDE asked if the public needed more information about
ethical medical practice.
DR. JOHNSON said everyone, including physicians, needed more
education on ethical medical practice. He said there was a
lot of room for debate as to what constituted ethical
practice.
REP. BUNDE asked if he knew how to more clearly delineate
what constituted ethical practice to improve the accuracy of
such complaints.
Number 385
DR. JOHNSON said it would take a massive public education
campaign to do so. The effort would have to include
determination of guidelines concerning ethics, including
sexual harassment, consensus on which is now developing
across the nation.
Number 404
SEN. LEMAN noted that Dr. Johnson had signed a letter
opposing Dr. Rowen's appointment. Sen. Leman invited him to
express his displeasure in greater detail and to give his
opinion of Dr. Rowen's work on the board to date.
DR. JOHNSON said he felt it was inappropriate for appointees
to comment on the appointments of others. As president of
the Alaska Medical Association, Dr. Johnson said, he has
obligations to communicate the members' feelings on issues
of medical ethics, including appointments to the State
Medical Board. He said he signed a letter from the state
association's board expressing concerns about the
appointment to the medical board of a doctor whose methods
of practice were not scientifically proven. Dr. Johnson
said ethics are debatable. Some might argue that a doctor
should perform treatment he knew to be beneficial whether
scientifically proven or not, while others might say doctors
should use only treatment methods proven to be effective and
safe. He said the AMA had outlined its concerns to
legislators. Dr. Johnson said he had no basis of judging
Dr. Rowen's performance on the medical board.
Number 451
NOMINATION OF DR. EILEEN BECKER, M.D.
SEN. RIEGER brought the nomination of DR. EILEEN BECKER to
the table, noted that she was testifying via teleconference
from Homer, and invited members to question her.
REP. TOOHEY asked Dr. Becker if she could be an impartial
judge of a physician if she knew that physician performed
abortions.
DR. BECKER said she would have no problem with that; she
valued life, and she would consider all the factors involved
in a case before making any judgement.
(Sen. Rieger noted that Rep. Olberg, Rep. Kott, Rep.
Nicholia, Sen. Ellis and Sen. Miller had joined the meeting.
Number 462
REP. BUNDE asked if the medical board needed to play a role
in educating the public on what constituted unethical
behavior.
DR. BECKER said she was not sure, as she had not looked at
the materials she had received, was only appointed early in
the year, and had been involved only in one short
teleconference. But she said that, as a broadcaster
involved in communications, she would be interested in
working toward that sort of thing. If the board decided it
needed to work toward that end, she would be willing to work
toward that end, she said. She said she wanted to avoid
disseminating so much knowledge as to encourage a witch-
hunt, but she said it would be wise to make sure everyone
knew how to get information to the authorities if necessary.
There is always room for improvement of communications, she
stated.
REP. BUNDE said he was not criticizing, but asking for a
layman's impressions.
Number 480
NOMINATION OF DR. ROBERT ROWEN, M.D.
SEN. RIEGER brought the nomination of DR. ROBERT ROWEN to
the table, invited Dr. Rowen to testify before the committee
in Juneau, and invited the committee members to question
him.
Number 486
REP. TOOHEY asked Dr. Rowen if his judgement of a physician
before the medical board would be clouded by the knowledge
that the physician performed abortions.
DR. ROWEN answered no.
REP. B. DAVIS asked how many meetings Dr. Rowen had attended
since his appointment in July, 1992; what action he had
taken as a board member; and how comfortable he felt in such
action considering the controversy over his appointment.
Number 492
DR. ROWEN said he had attended two board meetings, which
dealt mostly with physicians impaired by addiction to drugs
or alcohol. He said the board had taken no action on
physicians for reasons other than drugs or alcohol.
REP. B. DAVIS asked if he was comfortable on the medical
board.
DR. ROWEN said he was very comfortable. He offered an
example of how he felt he had contributed to the board,
saying he had helped the board develop a policy on the use
of narcotic pain relief medication following complaints by
patients about some physician's reluctance to administer
strong pain medication. He suggested inclusion of a
paragraph in the policy reminding doctors that there are
philosophies outside of the medical profession, such as
chiropractic and acupuncture, that should be considered.
Number 513
SEN. LEMAN asked Dr. Rowen for his response to the feeling
expressed by some in the medical profession who were leading
the charge against his confirmation to the medical board.
DR. ROWEN said the allegations had been that he is unethical
because he did not practice "scientific medicine." He
referred to books containing 3-4,000 references on
nutritional therapy, including some stating that up to 80
percent of cases of a specific ear condition were due to
allergies to milk or other substances. He read the abstract
of an article dealing with chelation therapy, which showed
the therapy brought marked improvement in 77 percent and
good improvement in 16 percent. He cited other studies
showing that bypass surgery is dangerous, ineffective, and
in most cases, overdone. He said a letter from the medical
association to members of the committee regarding a
presentation he made on mercury, and accusing him of being
unethical, contained knowing falsehoods. He asked what the
association might have meant by conveying knowing
falsehoods.
Number 544
DR. ROWEN referred to an incident in which a nurse's error
during an ultraviolet irradiation of blood treatment brought
an allergic reaction from a patient. He said that in 10
years he did not know of any patient who suffered
significant injury at his hands. He said few doctors have
such a record. He said a 1942 article on the treatment
showed the treatment brought complete recovery to 17
patients with only one treatment. He said 90 percent of his
practice was related to nutrition and asked what he did that
was unscientific. He said he felt it would be bad practice
not to use vitamins, herbs or minerals before using
petrochemical pharmaceutical because they pose no risk, have
shown documentation in peer-reviewed medical literature, and
are cheap.
Number 573
DR. ROWEN said he does use drugs and prescribe surgery in
his practice, but infrequently. He referred to the case of
Mrs. Coghill, who had severe back pain and was scheduled for
surgery despite negative back scans. He said he relieved
her pain with injections of anesthetic into her root canals
and sent her to a dentist for extraction of two teeth and a
pus pocket, which brought relief of her back pain. He cited
that treatment as a way to cut costs and treat patients
without dangerous surgery.
TAPE 93-25, SIDE B
Number 000
SEN. LEMAN said he had read Dr. Rowen's health care cost
containment proposal, called it an interesting proposal
placing more responsibility on the individual, and invited
him to comment further on why health care costs were high.
DR. ROWEN said there were several reasons. The first was
that third-party payment eliminates the incentive not to
spend. The second is that the medical industry was a
profit-making industry that obscures symptoms with expensive
drugs, but does not cure disease. He cited his standing
offer of $100 to anyone who could prove a drug cured a
disease, except for antibiotics. He said many ailments can
be helped through better nutrition. He said there is no way
to contain health costs until the medical system paid more
attention to the causes and prevention of diseases, not
their symptoms. The third was the international
pharmaceutical industry's efforts to eliminate alternatives
to its methods, he said, citing cases in which doctors have
lost their licenses and been harassed for their treatment
philosophies. He said he spends up to 1,000 hours on
research into his methods and decried doctors who refuse to
consider them.
Number 082
REP. BUNDE asked if Dr. Rowen's criticisms of conventional
medicine would bar him from working with conventional
doctors on the medical board, even though he did not respect
their medicine.
DR. ROWEN disputed that statement. He said he did respect
their medicine, felt there was a place for drugs and
surgery, and had directed such treatment for his patients.
He said he did not want to judge other doctors for
practicing conventional medicine. His interest in serving
on the medical board was not to butt heads, but to
contribute ideas or offer suggestions, such as while
considering the case of a doctor performing a large number
of back surgeries, that there may be more cost-effective
treatments.
Number 113
REP. BUNDE asked if Dr. Rowen viewed his role on the board
as educating other doctors and encouraging them to follow
his view of medicine.
DR. ROWEN said he did not see his role as encouraging other
physicians to follow his views. He said many doctors are
terrified of straying from the party line for fear of losing
their licenses or being reprimanded. He said many doctors
are afraid to voice public support for him for fear that if
they did so, "they would be taken out." Dr. Rowen said
patients of his who had told other doctors of the results
they had gotten with Dr. Rowen were dropped as patients by
those doctors. He cited the "Annals of Internal Medicine,"
which has indicated that 40 percent of Americans would
choose alternatives over conventional medicine. He said his
natural medicine is not better than other doctors' medicine,
or vice versa. He said doctors should serve their patients,
not dogmas.
Number 138
REP. BUNDE said he was implying no value judgement by the
terms conventional and alternative medicine. He noted Dr.
Rowen's criticism of the profits conventional doctors make
from pharmaceutical, and asked whether Dr. Rowen did not
make a profit from natural medicines he sold his patients.
DR. ROWEN responded that he did not think that was a fair
criticism. He said he and other natural doctors have
homeopathic pharmacies for the convenience of their patients
and direct patients to health food stores. He said he is
motivated by concern for his patients. Other doctors, such
as dermatologists, sell medicines, and surgeons make money
from surgeries, he said.
REP. BUNDE said he had not intended criticism in calling
attention to the profit in selling herbs.
Number 181
DR. ROWEN cited saw palmetto, an herb proven safe and
effective in treating prostate enlargement and which cost
pennies, but which the Food and Drug Administration (FDA)
did not recognize for that purpose. But when Meurck
pharmaceutical developed a more expensive, less effective
and more dangerous synthetic analogue of the herb, it got
FDA approval, he said. He noted the system works to make
money. He cited the drug Halcion, banned in Great Britain
as dangerous, but left on the U.S. market while tryptophan,
a safe sleep aid is under pressure to be taken from the U.S.
market because a contaminated batch made it to the market.
If the nation does not look to such ways to lower medical
costs, the nation will go bankrupt, he said.
SEN. RIEGER asked if Dr. Rowen considered himself an
advocate of alternative medicine.
DR. ROWEN responded that he was an advocate for the patient.
DR. ROWEN was asked if he practiced both alternative and
conventional medicine.
DR. ROWEN answered yes, but said not everything he did was
alternative. He said providing nutrients was more
scientific than prescribing drugs to cover up a symptom. He
said he did not like the term "alternative."
SEN. RIEGER asked if there were alternative medicines Dr.
Rowen considered dangerous.
DR. ROWEN asked him to define dangerous.
SEN. RIEGER asked if he did anything dangerous.
Number 214
DR. ROWEN answered that anything used to excess or
improperly, even oxygen or water, was dangerous. Chelation
therapy has a good safety record, though the medical
community calls it dangerous.
SEN. RIEGER asked if there were any medical practices that
he would consider a generally dangerous practice.
DR. ROWEN answered that all drugs or herbs are good if used
correctly and are bad if used incorrectly.
SEN. RIEGER asked if there were such a thing as experimental
medicine, and asked his opinion on the level of scientific
proof required before a practice should be permitted in the
medical community.
Number 232
DR. ROWEN responded, "Our statute added the word
experimental medicine. And the reason why that was done was
not for me. Unconventional was good enough. Chemotherapy
and radiation are as experimental as they come. That's true
human experimentation. And the studies have shown that
chemotherapy and radiation usually gives people worse
quality of life than if they did nothing at all..." He said
The Lancet has published an article saying mammograms have
no screening value for women under 50, but the legislature
was bamboozled into getting insurance companies to pay for
them. Experimental involves anything not proven, he said.
A 1978 survey done for the Office of Technology Assessment
by the McGovern Committee found that up to 80 percent of
practices in orthodox medicine have no scientific basis, he
said.
Number 243
SEN. RIEGER asked Dr. Rowen under what conditions he would
vote to pull another doctor's license.
DR. ROWEN answered that, as he had been persecuted by the
profession, he said he would bend over backwards to be fair
and already has in one vote on a physician. If a doctor is
harming patients, the medical board must take action, he
said. He said he would like to educate other doctors about
other philosophies, on behalf of the patients, and noted
that he is but one of seven board members, and all would
have to follow the statutory obligations in considering such
action. He said the medical board should take action if a
doctor were incompetent within the scope of his practice, if
a physician were harming his patients or performing
unethically according to the medical regulations.
Number 278
REP. TOOHEY commented that the committee was not considering
Dr. Rowen's competency and said she believed he had a place
in the community and, as long as he was competent, was glad
he was practicing. But his service on the medical board was
another question. She said the board's function was to help
doctors maintain a standard of practice to protect the
public, not to further any individual physician's medical
philosophy. She expressed displeasure that he evidently had
a medical agenda and was inappropriately using his position
on the medical board to pass judgement on other doctors.
DR. ROWEN said he had spent a good deal of time in his
testimony defending himself against medical association
attacks as being allegedly too unethical to serve on the
board and he was trying to present a different view of those
types of ethics. He said differences of opinion and dissent
are beneficial to making progress, denied trying to further
any agenda, but to share ideas. He asked if it were proper
for other doctors who might be prejudiced against his type
of practice to sit in judgement of other physicians like
him.
SEN. RIEGER asked if there were a problem with alternative
medical practitioners being harassed or persecuted by the
medical boards.
DR. ROWEN answered that in other states, many of his
colleagues had been de-licensed at the complaints of other
physicians, not patients' complaints. Three years ago, Dr.
Rowen said he anticipated the trend would reach Alaska. He
said the medical association brought a "quack-buster" to
Alaska, Dr. Jennifer Christian, went on a "witch-hunt," and
the association began a drive to purge the state. He said
Russ Hoffman, M.D., past president of the association and
now working in Bethel, could offer corroboration. He said
the medical board was above that and recalled its obligation
to serve the people, not the profession. A public outcry
concerning a bill arising from that effort, plus Dr. Rowen's
appointment to the board, indicated public desire for
plurality of thought in the medical profession, he said.
Number 336
REP. B. DAVIS asked what legislation Dr. Rowen had referred
to.
DR. ROWEN answered that Sen. Pat Rodey had introduced in the
House, and Reps. Dave Donley, Max Gruenberg and Johnny Ellis
carried forward legislation stating that the medical board
could not base a finding of professional incompetence solely
on the basis that a licensee's basis was unconventional or
experimental. Dr. Rowen said he agreed to add the words,
"in the absence of demonstrable physical harm to a patient."
He said he was being held to a higher standard than orthodox
doctors, but that was okay.
Number 344
REP. BUNDE asked how many Alaska doctors practiced
alternative medicine.
DR. ROWEN answered there were five, though there may be six
or seven.
REP. BUNDE asked if he knew of any that had been brought up
before the medical board.
Number 358
DR. ROWEN answered that one doctor who performed an insulin
tolerance test was reprimanded several years ago. He said
the doctor thought the test was a good indicator of a
patient's risk for coronary artery disease, but at another
doctor's complaint, the issue went before the medical board,
where the doctor in question was reprimanded. Dr. Rowen
said several medical articles said the test was valid, but
the medical board did not look at them.
REP. BUNDE asked whether Dr. Rowen would have voted for
censure if he had been on the board.
DR. ROWEN said that he would have called the medical board's
attention to those articles and not to the opinion of the
complaining doctor.
Number 364
REP. VEZEY referred to Dr. Rowen's standing $100 wager to
find a drug that cured a disease and asked whether the
doctor excluded vaccines or antibiotics that prevented
disease.
DR. ROWEN said he did not consider vaccines to be disease
curing compounds, but disease preventing compounds.
REP. VEZEY asked whether Dr. Rowen had criticisms of using
vaccinations to prevent disease.
DR. ROWEN said there was a controversy over vaccinations, in
which he did not get involved.
REP. VEZEY asked Dr. Rowen if he practiced alternative
medicine or practices not taught in medical schools.
DR. ROWEN said it depended on how the question was viewed.
He cited his degree from the University of California, San
Francisco, considered the nation's first- or second-best
medical school, and said while he respected the value of
that education and was utilizing it, he has added to it.
Number 400
REP. VEZEY referred to the high cost of malpractice
insurance and asked how the insurance industry viewed
unorthodox physicians such as Dr. Rowen.
DR. ROWEN answered that such doctors generally paid lower
rates, as the insurance industry recognizes that such
doctors do not injure people. He said his insurance rates
as of two years ago were at least $3,000 lower than if he
was a conventional doctor. He said his insurance company is
geared to physicians practicing his kind of medicine.
Number 409
REP. VEZEY asked if the insurance company had a name for
that type of medicine.
DR. ROWEN answered that they call it "preventative"
medicine.
Number 400
REP. VEZEY said the confirmation process was to judge Dr.
Rowen's suitability for service on the medical board, not
for his worth as a physician. He asked what Dr. Rowen felt
the duties of the board were.
Number 418
DR. ROWEN answered that his duties are prescribed by
statute, the most important of which is to protect the
public. The medical board achieved this aim by removing
from practice physicians who are hurting people, or
directing physicians impaired by drugs or alcohol to seek
rehabilitation. The board must make sure that physicians,
above all, do no harm.
REP. VEZEY said the doctor and others view the function of
the medical board differently. He said the board is, by
statute, a licensing board that must determine competency,
deal with rehabilitation of substance-abusing doctors and
other charges, he said. He said the underlying
qualification for licensure is a degree from a school
accredited by the American Medical Association (AMA), of
which Rep. Vezey said he believed Dr. Rowen was critical.
He said the issue was who should sit on the medical board in
judgement of other doctors.
Number 448
DR. ROWEN agreed that the medical board is governed by
statutes and regulations, not philosophies. He said he was
not on the board to criticize, but to say there are
shortcomings everywhere, and that there is a need for new
approaches and new ideas, and, in the area of cost-
containment, some bold and novel approaches. If the medical
establishment, which admits it has established a system that
is not working well, continues to dictate rules and
practices, the public will continue to get more of the same.
He did not mean to be critical but to point out that neither
side had all the answers, and that neither should be held to
different standards.
Number 466
REP. VEZEY said he was confused because the statutes
authorized licensing of physicians only according to
standard medical practice as sanctioned by the AMA.
DR. ROWEN objected to Rep. Vezey's statement. He said the
statute did not say in accordance with the AMA, but listed
specific requirements.
REP. VEZEY said the statute specifically said a doctor must
have a degree from an AMA certified school.
DR. ROWEN asked whether the statutory requirement was for a
degree from an accredited school, or a school accredited by
the AMA.
REP. VEZEY said there was another agency mentioned in the
statutes, as well as the Council of Medical Education of the
AMA.
DR. ROWEN said he accepted the statutory requirement and he
had gone to such an accredited school.
REP. TOOHEY said the statute concerning the State Medical
Board did not deal with medical costs, and she believed it
was not the duties of the board to deal with such an issue,
or many others that Dr. Rowen had raised.
DR. ROWEN said he agreed that cost containment and licensing
were separate issues, and that issuing and regulating
licenses had to be done according to statute.
REP. NICHOLIA asked whether Dr. Rowen had a malpractice suit
pending against him.
DR. ROWEN answered that a patient had an allergic reaction
to the mistake of a nurse in his office, but he had not seen
any papers filed. He said many physicians acknowledge that
a doctor is lucky to get through a career without ever being
sued for malpractice. He said it was well-known that the
mistake was not his, that even medical people make mistakes,
and that he had not fired his nurse for doing so.
Number 500
SEN. RIEGER asked if the medical board has been too strict
or lenient in censuring or de-licensing other physicians.
DR. ROWEN said it was hard to answer, as he had only been
with the board for two meetings.
Number 520
REP. B. DAVIS asked Dr. Rowen whether he would be more
concerned about patient rights or doctor's rights as a
medical board member. She also recalled his statement that
he would be less interested in judging doctors than in
helping them see alternative treatments, and asked him to
reconcile this statement with his professed concern for
patients.
DR. ROWEN said the medical board must work with physicians
to make them better doctors; for example, when doctors were
harming patients or were abusing drugs or alcohol. He said
it was hard to answer her question as he had not seen the
issue arise during his time on the board. He said he could
see his role on the board as trying to educate physicians
that approaches other than surgery, invasion or drugs might
be used in treatment. But if a doctor was injuring
patients, the board would have to take action as it saw fit.
REP. B. DAVIS said she believed Dr.Rowen was qualified, and
that she had once considered seeing him herself. But she
said that did not affect his suitability as a medical board
member. She said her main concern was that he might have to
come before the board and therefore be removed from it, and
that his serving on the board was a set-up for such a
situation because a case against him was pending.
Number 540
DR. ROWEN contradicted her, saying that the case in question
(presumably the case concerning the nurse's mistake and
subsequent patient's allergic reaction) had been
investigated by the board, which had exonerated him. A
negligence case against his nurse, in which he was a co-
factor, was a totally different case.
REP. B. DAVIS said there was more than a normal chance that
he or the five or six other doctors practicing a similar
type of alternative medicine might be brought up before the
same medical board on which he served. She asked whether he
might be more vulnerable than other doctors.
DR. ROWEN said that was not true; he had only a couple of
complaints filed against him in ten years. One of those,
which was tossed out, was from a patient who did not want to
pay her bill. Another was due to his nurse's error, in
which case he was exonerated. Two other complaints came
from medical doctors who did not like what he did, he said.
He described a case in which he diagnosed a bowel
obstruction in a female patient from Fairbanks, but the two
Anchorage gastro-enterologists he asked to treat the patient
said they were too busy to do so. The patient went to the
Providence Hospital emergency room, where Dr. Merchant saw
her and said he would take care of it, but could not get a
surgeon to come to the hospital to treat her. The patient
languished in the emergency room for hours and Dr. Merchant
acknowledged to the patient's daughter that doctors were
refusing to treat the patient because she had been seeing
Dr. Rowen. As a result of the lack of treatment at the
hospital, the woman developed a gangrenous bowel which had
to be removed and which led to general bad health for the
woman, Dr. Rowen said.
REP. B. DAVIS asked why he did not attend to his own
patient.
DR. ROWEN answered that the woman needed surgery and the
matter was out of his hands.
TAPE 93-26, SIDE A
Number 000
DR. ROWEN said he wanted to see the politics of medicine
change to consider more the needs of patients.
REP. TOOHEY said she was an emergency room nurse who has
worked with Dr. Merchant and said that if Dr. Merchant felt
it was an emergency he would have taken action and would not
have let the patient become gangrenous.
DR. ROWEN answered that the woman was admitted to the
hospital at the emergency room, but did not see an
appropriate specialist. Dr. Merchant was the emergency room
physician and did a good job, Dr. Rowen said.
SEN. RIEGER asked Dr. Rowen to leave the two books he had
introduced into the record with the committee for committee
members to peruse at their will. (The two books were,
Encyclopedia of Natural Medicine by Michael T. Murray, N.D.,
and Joseph E. Pizzorno, N.D., from Prima Publishing,
Rocklin, CA; and Nutritional Influences on Illness by Melvyn
R. Werbach, M.D., from Third Line Press, Inc., Tarzana, CA.
The two articles were "EDTA Chelation Therapy in Chronic
Degenerative Disease" by Effrain Olszewer and James P.
Carter in Medical Hypotheses, 1988; and "Ultraviolet Blood
Irradiation Therapy" by George Miley, M.D., in the Archives
of Physical Therapy, Sept. 1942. The articles, and the
title pages of the books, are on file in the committee
room.)
SEN. RIEGER referred to the statutes concerning the State
Medical Board, to which Rep. Vezey had earlier referred, and
said they were contained in AS 08.64.200, paragraph one,
concerning physician applicants and medical school
graduation requirements. Sen. Rieger announced that the
House Health, Education and Social Services Committee would
continue to hear public testimony on Dr. Rowen's
appointment, starting at 3:30 p.m. on the same day, March 1,
1993, in Room 104 (106) of the Capitol Building. Sen.
Rieger then ADJOURNED the joint meeting at 3:05 p.m.
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