HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE March 1, 1993 3:00 p.m. 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 MEMBERS ABSENT None OTHER MEMBERS PRESENT Rep. Jeannette James COMMITTEE CALENDAR Confirmation Hearing: State Medical Board appointments WITNESS REGISTER JOHN FRANKLIN 7121 Chester Court Anchorage, Alaska 99504 Phone: (907) 333-2141 Position Statement: Supported Dr. Rowen's confirmation EDGAR PAUL BOYKO 745 W. Fourth Ave. Anchorage, Alaska 99501 Phone: (907) 279-1000 Position Statement: Dr. Rowen's patient; supported his confirmation REP. JEANNETTE JAMES Alaska State Legislature State Capitol Building Juneau, Alaska 99801-1182 Phone: (907) 465-3743 Position Statement: Supported Dr. Rowen's confirmation JULIA TENISON P.O. Box 3917 Third Judicial District Soldotna, Alaska 99669 Phone: (907) 776-5598 Position Statement: Dr. Rowen's patient; supported his confirmation RUBY GAEDE HC3 Box 907 Soldotna, Alaska 99669 Position Statement: Supported Dr. Rowen's confirmation DR. SANDRA DENTON 4115 Lake Otis Parkway #200 Anchorage, Alaska 99508 Phone: (907) 563-6280 Position Statement: Supported Dr. Rowen's confirmation JIM MILLER P.O. Box 110935 Anchorage, Alaska 99511 Position Statement: Supported Dr. Rowen's confirmation PAT HAYES, R.N. 3331 E. Huffman Road Anchorage, Alaska 99516 Phone: (907) 345-2772 Position Statement: Worked for Dr. Rowen; supported his confirmation JUDY COX 6261 E. 41st Court Anchorage, Alaska 99504 Phone: (907) 333-6363 Position Statement: Worked for Dr. Rowen; supported his confirmation W.C. THOMPSON 3601 Twilight Lane Anchorage, Alaska 99516 Phone: (907) 345-1072 Position Statement: Supported Dr. Rowen's confirmation JOSEF PRINCIOTTA 330 L St. Anchorage, Alaska 99501 Phone: (907) 346-2582 Position Statement: Supported Dr. Rowen's confirmation LINDA NEULS 12845 S. Bragaw St. Anchorage, Alaska 99501 Phone: (907) 345-5482 Position Statement: Supported Dr. Rowen's confirmation DALTRICE BOEHMER 5911 Denali St. Bldg. A1 Anchorage, Alaska 99518 Phone: (907) 563-5782 Position Statement: Supported Dr. Rowen's confirmation CHRISTY ANN ROGERS P.O. Box 221524 Anchorage, Alaska 99522 Phone: (907) 333-0414 Position Statement: Supported Dr. Rowen's confirmation HELENE HENNINGS 1326 LaTouche Anchorage, Alaska 99501 Phone: (907) 279-2919 Position Statement: Supported Dr. Rowen's confirmation DR. PATRICK NOLAN, D.O. Chairman of Internal Medicine Sisters of Providence Hospital 3200 Providence Drive Anchorage, Alaska 99508 Phone: (907) 561-6100 Position Statement: Opposed Dr. Rowen's confirmation SCOTT CROWTHER 1726 Bellevue Loop Anchorage, Alaska 99515 Phone: (907) 349-2198 Position Statement: Supported Dr. Rowen's confirmation 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 031 CHAIR TOOHEY called the meeting of the House Health, Education and Social Services Committee to order at 3:35 p.m. She announced the committee would continue hearing public testimony on the governor's appointments to the State Medical Board, following the earlier adjournment of a joint meeting with the Senate Health, Education and Social Services Committee in the Butrovich Room. Chair Toohey said the committee would not make a decision on the appointments at the meeting, but would only take public testimony. JOHN MICHAEL FRANKLIN, a patient of Dr. Rowen's, testified from Anchorage supporting Dr. Rowen's appointment. Mr. Franklin said he had served the Municipality of Anchorage for years, had been municipal manager and commissioner of public safety, and was on the board of Chugach Electric. He read a letter he had sent to Dr. Rowen, which is on file in the committee room, in which he described the beneficial treatment of his lung cancer through alternative medicine, and the acknowledgement from some traditional doctors of their inability to help him. Mr. Franklin said he is one of many people who cannot wait for traditional medicine to embrace alternative medicine. Number 146 CHAIR TOOHEY noted the committee members present. EDGAR PAUL BOYKO, a patient of Dr. Rowen's and an attorney in Anchorage, testified from Anchorage in support of Dr. Rowen's confirmation. He said orthodox and alternative medicines should be able to work together, and having Dr. Rowen on the medical board would help. Having one alternative medicine representative on the board would help the cause of choice in health care, and rejecting his appointment would be unjustifiable, he said. Number 185 REP. JEANNETTE JAMES testified in Juneau in support of Dr. Rowen's confirmation, saying that as a representative of the board, Dr. Rowen would not represent his profession, but the people of Alaska. She cited public support for Dr. Rowen, his excellent medical education, and his opposition from organized medicine. She said Alaska does not generally consider health care maintenance or prevention, and rejection of Dr. Rowen would further erode consideration of such health care strategies. She supported his activities and his skill as a doctor and asked for his confirmation. Number 216 REP. B. DAVIS asked Rep. James how Dr. Rowen would deal with prevention as a board member. REP. JAMES answered that a board member who supported prevention would be bound to influence others on the board. Number 240 JULIA TENISON, a patient of Dr. Rowen's, testified via teleconference from Soldotna in support of his confirmation, saying his political beliefs differ for other doctors' but he does not belittle other doctors. She added that society should be concerned about insecure doctors who criticize other physicians. Number 261 REP. BUNDE asked Mrs. Tenison if she thought there was a conspiracy of doctors against Dr. Rowen. MRS. TENISON said some individual doctors do take pains to paint Dr. Rowen as a fraud. Number 280 RUBY GAEDE, widow of a Soldotna doctor and a cancer patient, testified via teleconference from Soldotna in support of Dr. Rowen's confirmation, saying she supports freedom of choice in medical care. Number 300 DR. SANDRA DENTON testified via teleconference from Anchorage in support of Dr. Rowen's confirmation, saying there is a growing national interest in alternative medicine, the people of Alaska are entitled to a choice, and it is essential to have a doctor on the board who has studied alternative medicine. Number 327 REP. BUNDE asked if Dr. Denton had read the statutory duties of the board. DR. DENTON answered no. REP. BUNDE said the committee is not judging the validity of alternative medicine. He read the six statutory duties of the board members: to examine and issue licenses to applicants, to develop reasonable licensing guidelines, to issue annual reports to the governor, to discipline violators, to adopt regulations for license renewals, and to contract out treatment for doctors with drug or alcohol abuse or mental health problems. Number 355 DR. DENTON identified herself as the physician reprimanded by the medical board for ordering a glucose insulin tolerance test instead of a glucose tolerance test. The complaint was filed, she said, by a pathologist at an Anchorage hospital laboratory who refused to do the test. She said having a doctor versed in alternative medicine on the board would have afforded her a fairer hearing. REP. BUNDE recalled that Dr. Rowen would be outvoted by the majority of conventional doctors on the board. DR. DENTON said that at least Dr. Rowen could share information with the other doctors on the board. REP. BUNDE asked whether the information was available to all doctors who wanted to see it. DR. DENTON said it was, but doctors might be unwilling to look at it. REP. BUNDE asked whether having Dr. Rowen on the board would force them to look at such information. DR. DENTON said it would not force them to look at the material, but may expose them to information they might not otherwise see. Number 375 JIM MILLER testified via teleconference from Anchorage in support of Dr. Rowen's confirmation. He related the story of how a physician friend of his had gotten angry that Mr. Miller had written a letter of support for Dr. Rowen. Mr. Miller said the incident helped him understand the animosity between the two medical camps. He said Dr. Rowen, as a public figure, is an easy target for criticism, but he would like to see a representative of the AMA (American Medical Association) challenge him directly. Number 400 PAT HAYES, R.N., a nurse for eight years in Dr. Rowen's employ, testified via teleconference from Anchorage in support of Dr. Rowen's confirmation. She said he is an asset to the board, that he is well-schooled in both types of medicine, and that he can help integrate traditional and alternative medicine. She noted the national attention on the appointment. REP. BUNDE asked if she was still working for Dr. Rowen. MS. HAYES said she was. REP. BUNDE said he was glad to get testimony from those with medical experience, as well as from the general public. Number 429 JUDY COX, Dr. Rowen's medical office manager, testified via teleconference from Anchorage in support of Dr. Rowen's confirmation. She said Dr. Rowen is an honest and dedicated physician representing a growing number of Alaskans seeking an alternative to conventional medicine. She said there is a need for more open-mindedness about medicine, especially in light of the nation's economic crisis. She said Dr. Rowen will help protect Alaskans and bring a needed perspective to the board. Number 444 W.C. THOMPSON, a 40-year Alaskan, testified via teleconference from Anchorage in support of Dr. Rowen's confirmation. He said that health care practices not approved by the AMA and the Food and Drug Administration are branded quackery, and the public has no say in the matter. He said the public needs more information on alternative medicine. Number 467 JOSEF PRINCIOTTA testified via teleconference from Anchorage in support of Dr. Rowen's confirmation. He said Dr. Rowen could help bring new information to a board whose members might otherwise be cloistered from such information. He referred to a television program the night before (February 28, 1993) which included information on the medical benefits of shark cartilage in fighting cancers, which has been known in Asian healing arts for centuries, but which is just beginning to be considered by Western medicine. Number 502 REP. BUNDE said the duties of medical board members did not include medical education. MR. PRINCIOTTA said no, but having Dr. Rowen on the board would bring a fresh voice and new outlook to the board because he has a wider vision than other doctors. LINDA NEULS, mother of a 13-year-old son with congenital birth defects, testified via teleconference from Anchorage in support of Dr. Rowen's confirmation. She said that six years of daily antibiotic medication through conventional medicine had caused medical and behavioral problems for her son that Dr. Rowen was able to alleviate with his treatment. She called Dr. Rowen an insightful and caring physician and encouraged his confirmation. Number 535 DALTRICE BOEHMER testified via teleconference from Anchorage in support of Dr. Rowen's confirmation. She said he and his alternative viewpoints would not be a detriment to the board, that he would be the first to recognize whether new alternative doctors in the state were qualified or not, and that the state should remain open-minded about medical care. TAPE 93-25, SIDE B Number 000 CHRISTY ANN ROGERS, a patient of Dr. Rowen's, testified via teleconference from Anchorage in support of his confirmation. She said conventional doctors had failed her through negligence, lack of information, and lack of competence while Dr. Rowen had cured her of back and neck pain with one visit. She expressed anger at doctors who denounced Dr. Rowen's methods when their own were ineffective at doing more than treating symptoms. Number 040 REP. BUNDE asked Ms. Rogers whether she had filed charges with the medical board if she knew of cases of physician negligence. MS. ROGERS said she had not, because while the doctors had not helped her, she felt they should not be punished because their medicine had not helped her. HELENE HENNINGS testified via teleconference from Anchorage in support of Dr. Rowen's confirmation. She said she had undergone chelation treatment for back pain three times in her life. She said she believes in both conventional and alternative medicine, as both have helped her. She said her husband had been successfully treated with shark cartilage for a prostate cancer. Number 130 DR. PAT NOLAN, CHAIR OF INTERNAL MEDICINE AT PROVIDENCE HOSPITAL, AND FORMER MEMBER OF THE STATE MEDICAL BOARD, testified via teleconference from Anchorage in opposition to Dr. Rowen's confirmation. He claimed to speak for the entire staff of his hospital and for that of Humana Hospital in Anchorage (now know as Alaska Regional Hospital). He said he was not questioning the value of alternative medicine, but Dr. Rowen's appointment to the board. He said Dr. Rowen lacked support from most physicians, and Dr. Rowen had called traditional medicine the "sickness industry." He said Dr. Rowen should not be on the board because he is so outspoken on medical issues. Number 168 REP. VEZEY asked Dr. Nolan to clarify his statement concerning Dr. Rowen's statements about the "sickness industry." DR. NOLAN said that Dr. Rowen has said several times that medicine as it is currently practiced is a pro-sickness industry. Dr. Nolan said having a doctor who has his mind made up on the status of the medical industry on the state medical board is a bad idea. Number 180 REP. VEZEY asked Dr. Nolan to explain the statutory requirement that applicants for a medical license in Alaska have a degree from an institution accredited by the AMA. DR. NOLAN said there were about 100 medical and osteopathy schools in the United States, and to practice in Alaska a person must have an M.D. or D.O. degree, and there is a list of domestic and international schools approved by the state. REP. VEZEY asked if a graduate of an AMA-accredited school could be assumed to have been trained according to the association's philosophy. DR. NOLAN stated, "We believe it does in the oath that we take." Number 212 REP. BUNDE said he had seen the television show concerning shark cartilage. He asked Dr. Nolan if he knew of any Alaska law barring Alaskans from receiving such treatment or other natural remedies. He also asked whether Dr. Nolan's view of the board included prevention or encouragement of public acquisition of such materials. DR. NOLAN said he believed there should be a standard of care, which should be set by the medical community. He said those at Providence Hospital did not believe Dr. Rowen adhered to the medical community's standard of care. REP. BUNDE repeated his question about the legality of natural treatments and the board's role relative to such remedies. (Rep. Brice departed at 4:31 p.m.) DR. NOLAN stated, "...to assist necessarily assist or regulate the practice of medicine in these matters of alternative medicine, I don't believe that that's necessary in most cases. I believe people do have some rights and do have rights in obtaining the kind of practice and medical care that they wish. I don't believe that one of the alternative physicians should serve on the board to judge and sit as judge and jury for me or any of my colleagues." Number 246 REP. VEZEY mentioned a recently passed federal law banning the penning of sharks, which might limit the supply of shark cartilage. Number 256 SCOTT CROWTHER testified via teleconference from Anchorage in support of Dr. Rowen's confirmation. He said the standard of care described by Dr. Nolan kept him very sick for years. He described his problem with allergies since 1980, his decade of ineffective treatment from conventional physicians, and the successful treatment at the hands of Dr. Rowen, who advised him to have his amalgam tooth fillings removed, which brought great relief of his allergies and asthma. He said Dr. Rowen wins approval from patients, if not from the medical community. DR. ROBERT ROWEN, APPOINTEE TO THE STATE MEDICAL BOARD, gave a summary statement to the committee members. He suggested committee members see the movie, "Lorenzo's Oil." He disputed Dr. Nolan's statements, saying many doctors at Providence Hospital do support his appointment, but they could not say so publicly for fear of peer reprisals. He described his reference to "the sickness industry" as a reference not to individual doctors, but to the industry as a whole. Dr. Rowen said he was as well schooled in conventional medicine as any physician in Alaska, and could judge other doctors from their own frames of reference. He said the appointment controversy was not about him as an individual, but about rights and symbolism. Dr. Rowen read from a doctor's book, Racketeering in Medicine, in which the author asked whether the medical industry was depriving the public of treatment methods that do not carry the same potential for profit as alternative methods. Dr. Rowen expressed a desire to serve on the medical board as a means to tell other doctors of additional approaches to help patients. He said that if the committee members did not confirm his appointment, they would be mortgaging their health and that of their children. Number 320 REP. BUNDE asked whether Dr. Rowen had hospital staff privileges. DR. ROWEN said all of his practice is out-patient, though he formerly referred patients to surgery and used other medical practices when he worked in the Alaska Native Health Service. He said he was on the staff of Providence Hospital, but he had been dropped from the hospital's courtesy staff because he did not admit patients. He had been on the staff at Humana Hospital, but was removed for not admitting patients. Dr. Rowen said a doctor's membership on a hospital staff was not a proper means for judging competence. He asked the committee members to ask Dr. David McGuire, who was on the staff at Providence (and who was a member of the medical board) his opinion of Dr. Rowen's appointment. REP. BUNDE mentioned Dr. Rowen's indictment of traditional medicine for its profit motive and asked whether alternative physicians were not also motivated by profit. Number 337 DR. ROWEN said that, in speaking of the profit motive, he was not indicting individual doctors, but was referring to the industry as a whole. REP. BUNDE asked whether there was not an industry producing herbs, vitamins and natural products, also driven by a profit motive. DR. ROWEN observed that everyone is motivated by profit, but the alternative medical industry was not in a position to suppress the other side. REP. BUNDE said the profit motive was the basis of the country. He chastised Dr. Rowen for attacking traditional medicine for making a profit. DR. ROWEN said he did not want to prevent anyone from making a profit, but said he did not want one side, with help from the government and regulatory agencies, to annihilate the other side. He said the entire country was watching the nomination process. Number 353 REP. KOTT asked Dr. Rowen whether he was incompetent to perform any of the six duties of the medical board as described in statute. DR. ROWEN said he did not believe so and would not be undergoing hearings on his nomination if he were. Hearing no further questions, CHAIR TOOHEY ADJOURNED the meeting at 4:40 p.m.