Government Reform and Oversight Committee

February 12, 1998

Tammy Guerkink Born, MD

I am here today to give you a perspective from a Licensing Board member, because in spite of all of the work already done on FDA reform the job remains unfinished. It remains unfinished in a vitally important area - True Patient Access. Unfortunately the FDA Reform bill passed last year did little to change the accessibility to alternative or complementary medicine. In spite of what we have been told it did nothing to increase patient access to unapproved therapies and only codified existing law as it pertains to access to drugs already in the IND pipeline. I hope to give you a perspective from a practicing physician and as a member of a licensing board.

I am the Vice-President of the Michigan Osteopathic Board of Licensing and Regulation. I have also been recently appointed as a voting delegate to the Federation of State Medical Boards. I have been practicing scientifically based complementary medicine for ten years in Grand Rapids, Michigan. I have included for the record a few of the dramatic testimonials written by our patients over the past years of the successes they have experienced by combining the best of alternative and traditional therapies.

My main objective today, however, is to give you a perspective that you may not yet have heard. A perspective that may explain to you why true patient access does not exist currently. Two years ago I attended a National Federation of State Medical Boards conference in Chicago, Illinois. The focus of the very first presentation was how to stop the practice of alternative and complementary medicine. As one Assistant Attorney General of California said at that meeting -"It is difficult for us to get patients to complain about these doctors, so we will have to find ways to get them ourselves.'' He asked for a show of hands for how many states had prosecuted alternative medicine doctors and many of the state representatives raised their hands. Then he asked for a special conference to compare how other states had been successful in prosecuting alternative physicians simply because they were alternative not because they practiced bad medicine. Doctors may have been prosecuted for recommending nutritional or dietary therapies, not necessarily controversial treatments. In fact out of the four years that I have been on the board in Michigan, the number of alternative doctors that have been prosecuted for incompetence is extremely low. Many physicians practicing complementary therapies combine them with traditional therapies to allow patients their choice of the best in each tradition. Many states have adopted policies that have forced patients to seek medical care in other countries or other states that may have more progressive policies. If competent and well intentioned doctors are forced out of practice because they cannot bring the type of care that their patients need or want patients will be forced to seek their health care from unregulated and unlicensed practitioners. Many good doctors with advanced degrees are unwilling to provide complementary therapies because of FDA and local medical society pressures. Despite overwhelming evidence that many complementary therapies are more effective and less costly, many doctors are unwilling to incorporate them into their own practices. Every doctor practicing Food medicine should be able to incorporate complementary therapies Into his or her own practice without fear of retribution from FDA and state medical boards .

My job description as member of the State Board of Michigan has been to protect the people of Michigan. I have been amazed at the swift and decisive actions which can take place in an effective medical board while policing it's member physicians. The Access to Medical Treatment Act would do nothing to undermine the board's authority. Physicians who harm their patients or in some way endanger the lives of patients are dealt with swiftly and effectively by State medical boards. The Access to Medical Treatment Act actually compliments these medical boards and allows it to do its work much more effectively as the Bill demands that practitioners have solid reasons for believing that a therapy will work before providing it to anyone. No good doctor would want to jeopardize his or her license and/or lively hood by providing unethical treatments. The Access to Medical Treatment Act provides that the practitioner Doubt know that the therapy will not cause hand. This provision can only help a state medical board while encouraging patient education and patient antinomy. Ensuring that physicians provide the best treatments for patients and the opportunity for the much needed research on complementary medicine are the AMTA's most notable provisions.

Many of my patients can afford the best of any medical care and they have chosen nontraditional therapies. While the FDA has done a good job at protecting patients from harmful drugs it is unclear who they are protecting while prohibiting the further research and practice of complementary therapies. These patients are not vulnerable or likely to be taken in by doctors offering "quack cures". These patients are well informed and educated and the name therapies should be afforded patients who are less fortunate and uneducated. Patients need to be informed of all of their options and make a decision in conjunction with their family, their doctor, and their spiritual guide as to the right treatment for them.

It has been my goal to offer the best and most affordable health care to the most patients that I can. I love my job. I have been able to help hundreds and hundreds of people to live more full and enjoyable lives. I could tell you stories of patients who had no hope; who had legs amputated or who could only walk twenty feet without getting chest pain and now are able to walk or were able to save their remaining leg from amputation. I have patients who have been outraged that they were not given all of the information available from their doctors. They were not given options concerning their amputation or their surgeries. I have many patients who have traveled to other countries to receive treatments for their cancer or other chronic ailments because no physician in the United States was able to offer this treatment for them. The Access to Medical Treatment Act will allow patients who cannot afford to travel to Czechoslovakia for a cancer treatment or to Italy for and AIDS treatment, a glimmer of hope that these treatments may one day be studied more thoroughly in the United States.

I believe that I have a moral obligation to offer my patients information concerning all therapies that are available to them. I did not enter medical school knowing that I would become interested in and practice complementary medicine. In fact much the opposite. I planned on being a surgeon. However, my own experience and insight has lead me on a path which can only lead me forward. Forward into the future. A future in which all patients are afforded the best medicine that we as physicians can offer.

In a recent Grand Rapids Press article a study was cited in which the administration of significant doses of Folic Acid and Vitamin E were tested in thousands of nurses. The death rate from heart attacks dropped more than 50%. With The Access to Medical Treatment Act the recording of beneficial medical treatment is required, therefore, enabling this very significant information to be disseminated in a much more timely fashion, saving hundreds maybe thousands of lives. The research studies encouraged by The Access to Medical Treatment Act will significantly impact the lives of the American public. Lives will be saved and health care will be administered in a more cost effective and efficient manner. What traditional therapy can offer a 50% reduction in deaths due to heart disease? Yet, are physicians routinely recommending that their patients take high doses of Folic Acid or Vitamin E? Many are not! Rich and poor patients, educated and uneducated people, professional and laborers will all benefit from the research encouraged by this bill.

If the United States is to continue to offer the best medical care in the world we must look at the beet of non-traditional and traditional therapies. Fifteen years ago when I entered medical school we had no courses on nutrition or alternative medicine. In fact there were no lectures in all four years of medical school on the importance of diet and nutrition in promoting a persons health or preventing a disease. Now a few medical schools across the country are offering courses in alternative medicine. While this is a great beginning, I can see how the impact of The Access to Medical Treatment Act could be much more profound for our already aging and ailing Medicare population. Our illness based curriculum and the attitude of "you give me a symptom and I'll give you a pill" by many medical practitioners is not good medicine and is in many ways unethical today. Many illnesses and diseases can be treated without costly medicines or surgeries if the public is aware of ways in which they can take responsibility for their own health care and their own treatment. Everyone will benefit. While it is very important to teach doctors how to treat a patient when they are ill, it is more important to teach them how to maintain health and wellness. If patients are given the freedom to steer the course of their health care, assisted by trained health care providers everyone benefits.