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CAM Docket: Functional Endocrinology

 

One of the signature abilities of CAM practitioners is the creation of new diagnostic methods and treatments which convincingly demonstrate they have only a superficial understanding of human physiology. Here at SBM, posts have addressed such sterling examples of this phenomenon as cranial sacral therapy, applied kinesiology and chiropractic neurology. Now we have a new one on the horizon: functional endocrinology.

I don’t know who thought up this idea, but a primary promoter appears to be a Colorado chiropractor, Brandon Credeur, a 2002 graduate of Parker Chiropractic College in Texas. In additional to operating the Functional Endocrinology Center of Colorado, in Denver (where he practices with his wife, Heather Credeur, D.C.), he sold (and may still be selling) practice-building courses on functional endocrinology to other chiropractors.

What is Functional Endocrinolgy?

That’s a great question. Credeur’s website doesn’t give much of an explanation, although perhaps it is a new “specialty” within “Functional Medicine.” He spends most of his web video presentation on the subject talking about how M.D.s are simply prescribing drugs and not getting to the “root cause” of endocrine disorders, such as diabetes. Or, as he says, M.D.s are simply “bully[ing] the body’s physiology.” He, on the other hand, is able to ferret out what is actually causing these problems by determining exactly why your body is not producing enough hormones and proceeding to make your body produce them on its own, without drugs. He does not tell us specifically what the root cause is, how he finds it, how it his treatments supposedly work, or statistics on his results. (Testimonials, but no statistics.)

Credeur and his clinic have been the subject of a good deal of media scrutiny in the last two years, most notably from Denver’s ABC affiliate, Channel 7, which give some insight into how he operates, including patient interviews, an interview with Credeur, and a video of practice-building seminar.  In addition, the Colorado Board of Chiropractic Examiners complaint against him includes copies of his ads.

According to these sources, here is what was going on: Credeur was attracting patients with seminars and “gourmet dinners,” advertised in the newspaper, where diabetics were advised “how you too may be able to reverse your diabetes and put your health on a totally new trajectory” and, like others he’s treated, “walk away from diabetes.” At these events, diabetics were told, a “clinical model for successfully reversing diabetes” would be “revealed.” He also used television commercials promising free consultations.

Some patients said they had no idea Credeur was a chiropractor and thought he was an endocrinologist. According to one, she was told by office staff that Credeur was in fact an endocrinologist and another said his office was “lined with certificates about endocrinology.” His functional endocrinology treatments were described by a patient as “a diet outlined in a book given to all patients, supplements, [and] chiropractic adjustments,” which, as a Channel 7 report pointed out, all Colorado chiropractors are licensed to do.

Another patient reported that she was attracted to Credeur’s free consultations because she had lost her job. She wanted someone to look at a lump on her neck. Creduer told her that it was probably a “thyroid disorder” and said he would get her on a healthy lifestyle and diet. Fortunately, the woman was able to see doctors at a Denver health center and the University of Colorado Hospital, where she was diagnosed with Stage 2, B-cell lymphoma and hospitalized. She too thought Credeur was an endocrinologist.

Credeur’s functional endocrinology is not cheap either. Patients reported paying thousands of dollars. A Channel 7 producer was quoted a fee of $8,600 for six months treatment, all paid up front.

The Colorado Board of Chiropractic Examiners alleged in its complaint that Credeur and other chiropractors under his supervision at the clinic violated state law and regulations by:

  • False and misleading advertising
  • Failure to take a history and do physicals on patients
  • Diagnosing patients with diseases (diabetes and celiac disease), which is beyond the scope of chiropractic practice
  • Telling patients that they could reduce their medications
  • Failure to consult with patients’ physicians
  • Making promises of cures and guaranteed results
  • Failure to keep adequate records
  • Substandard practice

In addition to the state’s complaint, a number of patients are suing Credeur in a civil action. Trial is set for April, 2013.

As well as making money from his clinic, Credeur was conducting functional endocrinology practice-building seminars for chiropractors, who were told in one seminar ad: “Discover How to Attract More Sick Patients With Real Organic & Visceral Illnesses.” His website, HelpMorePatients.com, is no longer available, but a screen shot can be viewed courtesy of the “Way Back Machine” and a video of his practice-building techniques is posted on Channel 7’s website. In it, he brags about taking in over $300,000 a month in cash and advises fellow chiropractors to avoid calling themselves “chiropractors” and to remove chiropractic paraphernalia from their offices.

So what happened to Credeur? We’ll leave that question for later.

Meanwhile, over in Utah

One of Credeur’s chiropractic functional endocrinology students and Parker Chiropractic College classmate, Utah chiropractor Brandon Babcock, has also been the subject of media attention, mostly from the Salt Lake Tribune (here, here, here and here).  Babcock makes the same claims about his ability to “reverse” diabetes and the State of Utah brought charges similar to those against Credeur. Here we’ll go into a bit more detail about individual patients to demonstrate what functional endocrinology looks like in operation. (Part of Babcock’s charges have to do with his using a credit scheme to finance thousands of dollars’ worth of treatments, but we won’t go into those here. Patients are referred to by their initials.)

BB: 79 year old female with Type II diabetes, polio, recent heart valve replacement, saw ad that Babcock could reverse her diabetes and signed up for his program. Babcock did not examine BB, ask her about other meds or consult with her physicians, but did tell her to cut back on insulin and diabetes meds. BB called Babcock’s office to report declining health and legs swelling. He never called her back.

TL: 71 year old male suffering from Parkinson’s disease, dementia, thyroid problems, and diabetes. Was given supplements and prescribed “cleasing” techniques, even though he was on a strict diet at health care facility where he lived.

DO: 65 year old male, suffers from diabetes, high blood pressure and high cholesterol, had open heart surgery two years prior to seeing Babcock. Babcock told DO he could get DO off all meds, including heart med. Ordered $2,000 tests (spit DNA and stool) for DO but wouldn’t discuss results. Told DO after 2 months to stop Simvastion and reduce Metforman. When subsequent checkup at Veteran’s Administration health facility showed DO was much worse and cholesterol at dangerous levels, Babcock told DO “Not to worry. Your body is just going through a change.”

TH: 69 year old male diabetic, told by Babcock program could reduce or eliminate his insulin. Several months later TH admitted to hospital for kidney failure and pneumonia and there told to get off program’s diet and supplements.

RK: 83 year old male diabetic, told by Babcock he could reverse his diabetes and get blood sugar down to 110. Ordered same DNA and stool sample as DO. Told RK that without the program RK could have his foot cut off or go blind while driving.

DZ: Elderly female. Without any testing Babcock told her she had Hashimoto’s disease and leaky gut. Upon DZ telling Babcock she was suffering from swollen legs and cramps, he told her to eat more fish. Did not do further exam.

In addition to state administrative charges Babcock is, like Creduer, being sued by former patients, who are trying to get a class action certified of all his elderly patients treated by him for diabetes. In a newspaper report, their attorney said that her clients were charged $6,000 for supplements that cost less than $200 on-line. Babcock has also been charged by the District Attorney with 11 felony counts, 10 counts of exploitation of a vulnerable adult and one count of communications fraud.

What’s happened so far

We’ll get to a status report on these cases, but first, a look at chiropractic scope of practice.

In Colorado,

‘Chiropractic’ means that branch of the healing arts that is based on the premise that disease is attributable to the abnormal functioning of the human nervous system. It includes the diagnosing and analyzing of human ailments and seeks the elimination of the abnormal functioning of the human nervous system by [adjustment or manipulation]. . . and the use of . . . nutritional, and physical remedial measures for the . . . restoration of health . . . and the treatment of human ailments.

Colorado chiropractors cannot prescribe medications, but can prescribe dietary supplements.

Under Utah law,

Practice of chiropractic means a practice of a branch of the healing arts . . . that involves examining, diagnosing, treating, correcting or prescribing treatment for any human disease, aliment, injury, infirmity, deformity, pain, or other condition, . . .

They can advise patients regarding exercise and diet and prescribe dietary supplements, but cannot prescribe medications, although they can advise patients about the possible side effects of medications.

In one Salt Lake Tribune article, Mark Steinagel, director of the state’s Division of Professional Licensing, was quoted as saying that “diabetes treatment is within the scope of a chiropractor.”

The Utah Division of Occupational and Professional Licensing initiated an Emergency Adjudicative Proceeding against Babcock,

upon evidence that the continued practice of Brandon Babcock as a chiropractic physician represented an immediate and significant danger to the public health, safety, and welfare, and that the threat required immediate action by the agency.

The Division made findings of fact, which I briefly summarized above, and suspended Babcock’s license until further hearing. That case remains pending, as do the civil suit and criminal case. His preliminary hearing on the felony charges is set for November 20.

In July of this year, Brandon Credeur entered into a stipulation with the Utah Board of Chiropractic Medicine (as did his wife) which completely resolves his administrative case. The Board and Credeur stipulated that Credeur did not “completely document his patient interactions in certain records reviewed by the Board” so he agrees to a Letter of Admonition and to future adequate documentation.

That’s it. But the stipulation also says (emphasis added):

The Board affirms that the scope of chiropractic practice includes diagnoses and treatment of human ailments, including those affecting the endocrine system. [Credeur] and the Board expressly agree that it is appropriate for [him] to use the term ‘functional endocrinology’ in his practice name and to describe his services provided that he continues to disclose his credentials ‘D.C.’ when referring to himself as “doctor” to make clear that he is a chiropractor and that his services are provided pursuant to his chiropractic credentials.

The civil suits are still pending. Credeur’s website remains up and running and still advertises functional endocrinology, including his claim that it can reverse diabetes “in as little as three weeks. “

How ironic that the Babcock, the pupil, got his license suspended temporarily and 11 felony charges, while Credeur, his teacher, got off with a slap on the wrist and a confirmation that his practice of functional endocrinology is perfectly legal. Why the difference in result with similar factual allegations and similar scope of practice statutes?

A bright spot: Texas

Fortunately, M.D.s are on the case in Texas. The Texas Medical Association (TMA) has aggressively pursued chiropractors’ attempts to expand their scope of practice in lawsuits and complaints to the Texas Board of Chiropractors (TBCE). In one recent example, in August the TBCE voted against adopting rules recognizing “chiropractic neurology” as a specialty after the TMA complained. According to a Salt Lake Tribune report, the TMA is also concerned about chiropractors claiming, in TV ads similar to ones appearing in Utah, that they can treat diabetes. While a spokesperson for the TBCE said that chiropractors could “co-manage” diabetes with diet and exercise, the Board is reported to be working on a rule expressly banning chiropractors from treating thyroid disorders and diabetes. However, no such rule has been enacted or is currently proposed according to the TBCE’s website.

Confused?

It is shocking enough that chiropractors think they have the education and training to diagnose and treat endocrine disorders, which simply points up how poorly some of them are educated and trained. In other words, they don’t know enough to know they don’t know enough. It is even more shocking that a state would permit this.

These cases also highlight the mystery surrounding just what it is chiropractors claim they can do, and, more importantly, what are they competent to do. Are they primary care doctors, able to diagnose and treat all comers? Are they musculoskeletal specialists, like physical therapists? Are they limited to “detecting and correcting subluxations?” Can they specialize, as with “chiropractic neurology,” “pediatric chiropractic” and “functional endocrinology?” There is no agreement among chiropractors and no agreement among the states regulating them. If they don’t know, how is a patient supposed to know? Until all of this is resolved, the harm (financially and physically) to patients will go on and chiropractors will continue to profit.

For an update, see CAM Docket: Functional Endocrinology Update

Posted in: Science and Medicine

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