Naturopath Steven MacPherson
Charged with Unprofessional Conduct

Stephen Barrett, M.D.


The Washington Department of Health's Board of Naturopathy has charged Steven MacPherson, N.D. with unprofessional conduct. The statement of charges, shown below, indicates:

There is no scientific evidence that hCG is safe and effective for losing weight.

STATE OF WASHINGTON
DEPARTMENT OF HEALTH
BOARD OF NATUROPATHY

In the Matter of:

STEVEN PAUL MACPHERSON
Credential No. NATU.NT.00000643

Respondent


|
|
|
|
|
|

No. M2013-1225

STATEMENT OF CHARGES

The executive director of the Board of Naturopathy (Board), on designation by the Board, makes the allegations below, which are supported by the evidence contained in case no. 2012-5553. The patients referred to in this Statement of Charges are identified in the attached Confidential Schedule.

1. ALLEGED FACTS

1.1 On September 5, 1991, the State of Washington issued Respondent a credential to practice as a naturopathic physician. Respondent's credential is currently active.

1.2 Tanya Hunter operated a business called "Belle-Petite" which advertised, marketed, and sold a weight loss program utilizing human chorionic gonadotropin (hCG). Ms. Hunter stated that she utilized Respondent as her consulting physician who prescribed hCG for "clients" via Skype. On or about July 18, 2012, a health law judge signed an agreed cease and desist order finding that Ms. Hunter had engaged in the unlicensed practice of medicine in violation of RCW 18.71.011 through her operation of Belle-Petite.

1.3 On or about September 12, 2012, Respondent stated that he took on the responsibility of prescribing hCG for clients of Belle-Petite after reviewing "a health history intake form and interviewing the clients for approximately 15 minutes" via Skype. Respondent also stated that "Tanya [Hunter] was responsible for educating the clients on the details of the diet in conjunction with the hCG and providing the guidance and support throughout the weight loss process." The client would purchase and receive the hCG from Belle-Petite.

1.4 Respondent did not maintain adequate contact or follow-up with these patients after the initial Skype exam. All subsequent patient interactions including advising the patient about side effects were conducted by Ms. Hunter. Respondent failed to ensure safety or oversee chain of custody of the hCG that was dispensed to patients.

1.5 Patient records received and reviewed as follows:

Patient A: Patient A's intake form reported current and past medical problems that may have been exacerbated by hCG treatment including allergies, constipation/diarrhea, bloating, pain, and headaches. Patient A's progress note does not address any of these potential interactions. There is no physical examination noted in the chart. The treatment plan consists of hGG plus vitamin B 12. However, there is no copy of an actual prescription in the chart. Patient A's evaluation did not meet the standard of care for a naturopathic physician practicing in Washington State because:

(i) Patient was not informed that hCG use has a minimal chance of helping with weight loss based on available evidence.

(ii) Patient was not queried, advised of, or cleared for potentially serious side effects from combining hCG with past and present health issues.

(iii) Patient interview was conducted by Skype which is not HIPAA compliant.

(iv) Patient was not seen in person and there was no physical examination. The objective portion of the chart note includes weight but there is no indication how it was obtained if the patient was not present.

(v) Respondent inappropriately delegated patient oversight and contact to an unlicensed person during their use of hCG, and contributed to the unlicensed practice of medicine.

Patient B: Patient B's intake form was blank. Respondent's notation lists "no health conditions". However, there is no physical exam recorded in Patient B's charting. The treatment plan consists of hCG injections and he diet. There is no copy of an actual prescription. Patient 8's evaluation did not meet the standard of care for a naturopathic physician practicing in Washington State:

(i) Patient B was not informed that hCG use has a minimal chance of helping with weight loss based on available evidence.

(ii) Patient 8 was not queried, advised of, or cleared for potentially serious side effects from combining hCG with past and present health issues.

(iii) Patient B's interview was conducted by Skype which is not HIPAA compliant.

(iv) Patient 8 was not seen in person and there was no physical examination. The objective portion of the charting includes weight but there is no indication of how it was obtained when the patient was not actually present.

(v) Respondent inappropriately delegated patient oversight and contact to an unlicensed person during their use of hCG, and contributed to the unlicensed practice of medicine.

Patient C: Patient C's intake form reporting current and past medical problems is absent from the patient's records. Respondent's handwritten note is the only page in the chart. Respondent's notations list restless legs, blood clots, and allergies which may be exacerbated by hCG treatment but none of these potential interactions is addressed other than merely being listed. There is no physical examination noted in the patient charting. The treatment plan consists of hCG injections, hCG diet, and exercise. There is no copy of an actual prescription in the chart. Patient C's evaluation did not meet the standard of care for a naturopathic physician practicing in Washington State:

(i) Patient was not informed that hCG use has a minimal chance of helping with weight loss based on available evidence.

(ii) Patient plan was not adjusted to accommodate pre-existing conditions that could be exacerbated by hCG treatment nor was he advised of these risks.

(iii) Patient interview was conducted by Skype which is not HIPAA compliant.

(iv) Patient was not seen in person and there was no physical examination. The objective portion of the charting includes weight but there is no indication how it was obtained if the patient was not present.

(v) Respondent inappropriately delegated patient oversight and contact to an unlicensed person during their use of hCG, and contributed to the unlicensed practice of medicine.

Patient D: Patient D's intake form reports current and past medical problems that may be exacerbated by hCG treatment including headaches and pain. There is no physical examination noted in Patient D's charting. Patient D's evaluation did not meet the standard of care for a naturopathic physician practicing in Washington State:

(i) Patient D was not informed that hCG use has a minimal chance of helping with weight loss based on available evidence.

(ii) Patient D was not queried, advised of, or cleared for potentially serious side effects from combining hCG with past and present health issues.

(iii) Patient D's interview was conducted by Skype which is not HIPAA compliant.

(iv) Patient D was not seen in person and there was no physical examination. The objective portion of the charting includes weight but there is no indication how it was obtained if the patient was not present.

(v) Respondent inappropriately deligated patient oversight and contact to an unlicensed person during their use of hCG, and contributed to the unlicensed practice of medicine.

Patient E: Patient E's intake form does not include questions about shortness of breath, edema (form only asks about ankle swelling, not enough), irritability, restlessness (form includes nervousness but this is not adequate), allergies (form asks about hay fever but this is not enough), or blood clots even though they may be exacerbated by hCG treatment. Patient E did not check any of the remaining hCG side effects that were in fact on the form. Patient E's progress note does not inquire about nor address any of the potential interactions that were not on the form. There is no physical examination noted in the chart. The treatment plan consists of hCG injections, hCG diet, vitamin 812, and Ultra Lean chocolate, a weight loss protein powder. There is no copy of an actual prescription in the chart. Patient E's evaluation did not meet the standard of care for a naturopathic physician practicing in Washington State:

(i) Patient E was not informed that hCG use has a minimal chance of helping with weight loss based on available evidence.

(ii) Patient E was not queried, advised of, or cleared for potentially serious side effects from combining hCG with past and present health issues.

(iii) Patient E's interview was conducted by Skype which is not HIPAA compliant.

(iv) Patient E was not seen in person and there was no physical examination. The objective portion of the chart note includes weight, alert, white female and in no distress but there is no indication how that was obtained if the patient was not present.

(v) Respondent inappropriately delegated patient oversight and contact to an unlicensed person during their use of hCG, and contributed to the unlicensed practice of medicine.

Patient F: Patient F's intake form report does not include questions about shortness of breath, edema (form only asks about ankle swelling, not enough), irritability, restlessness (form includes nervousness, but this is not adequate), allergies (form asks about hay fever, but this is not enough), or blood clots even though they may be exacerbated by hCG treatment. Of the remaining hCG side effects that were on the form, Patient F checked fatigue, indigestion, and hay fever. Patient F's progress note assessment includes fatigue and depression but does not advise the patient about any of these potential interactions. There is no physical examination noted in the chart. The treatment plan is hCG injections,·hCG diet, and Ultra Lean, a weight loss protein powder. There is no copy of an actual prescription in the chart. Patient F's evaluation did not meet the standard of care for a naturopathic physician practicing in Washington State:

(i) Patient F was not informed that hCG use has a minimal chance of helping with weight loss based on available evidence.

(ii) Patient F was not queried, advised of, or cleared for potentially serious side effects from combining hCG with past and present health issues .

(iii) Patient F interview was conducted by Skype which is not HIPAA compliant.

(iv) Patient F was not seen in person and there was no physical examination. The objective portion of the chart note includes weight, alert, white female and in no distress but there is no indication how that was obtained if the patient was not present.

(v) Respondent inappropriately delegated patient oversight and contact to an unlicensed person during their use of hCG, and contributed to the unlicensed practice of medicine.

Patient G: Patient G's charting consists solely of a fax form ordering hCG, syringes, and alcohol swabs for the patient. There is no progress note, intake form, or other information in the chart. Patient G's evaluation did not meet the standard of care for a naturopathic physician practicing in Washington State:

(i) There is no evidence that the patient was informed that hCG use has a minimal chance of helping with weight loss based on available evidence.

(ii) There is no evidence that Patient G was queried, advised of, or cleared for potentially serious side effects from combining hCG with past and present health issues.

(iii) There is no evidence that the patient was seen in person or that there was a physical examination.

(iv) Respondent inappropriately delegated patient oversight and contact to an unlicensed person during their use of hCG, and contributed to the unlicensed practice of medicine.

2. ALLEGED VIOLATIONS

2.1 Based on the Alleged Facts, Respondent has committed unprofessional conduct in violation of RCW 18.130.180(1), (4), and (10), which provide in part:

RCW 18.130.180 Unprofessional conduct. The following conduct, acts, or conditions constitute unprofessional conduct for any license holder under the jurisdiction of this chapter:

(1) The commission of any act involving moral turpitude, dishonesty, or corruption relating to the practice of the person's profession, whether the act constitutes a crime or not. If the act constitutes a crime, conviction in a criminal proceeding is not a condition precedent to disciplinary action. Upon such a conviction, however, the judgment and sentence is conclusive evidence at the ensuing disciplinary hearing of the guilt of the license holder of the crime described in the indictment or information, and of the person's violation of the statute on which it is based. For the purposes of this section, conviction includes all instances in which a plea of guilty or nolo contendere is the basis for the conviction and all proceedings in which the sentence has been deferred or suspended. Nothing in this section abrogates rights guaranteed under chapter 9.96A RCW;

. . .

(4) Incompetence, negligence, or malpractice which results in injury to a patient or which creates an unreasonable risk that a patient may be harmed. The use of a nontraditional treatment by itself shall not constitute unprofessional conduct, provided that it does not result in injury to a patient or create an unreasonable risk that a patient may be harmed;

. . .

(10) Aiding or abetting an unlicensed person to practice when a license is required;

. . . .

2.2 The above violations provide grounds for imposing sanctions under RCW 18.130.160.

3. NOTICE TO RESPONDENT

The charges in this document affect the public health, safety and welfare. The executive director of the Board directs that a notice be issued and served on Respondent as provided by law, giving Respondent the opportunity to defend against these charges. If Respondent fails to defend against these charges, Respondent shall be subject to discipline and the imposition of sanctions under Chapter 18.130 RCW.

DATED: March 20, 2015

STATE OF WASHINGTON
DEPARTMENT OF HEALTH
BOARD OF NATUROPATHY

_____________________________
CHRIS HUMBERSON
EXECUTIVE DIRECTOR

______________________________

THOMAS F. GRAHAM, WSBA# 41818
ASSISTANT ATTORNEY GENERAL

This page was posted on June 19, 2105

Links to Recommended Companies