This is a screenshot from the website of the Hippocrates Health Institute, showing its grounds.

Screenshot of the Hippocrates Health Institute’s website

 
Note: Also posted today is a brief profile of a new blog, Naturopathic Diaries: Confessions of a Former Naturopath, by Britt Marie Deegan Hermes, a trained naturopath who became disillusioned with her profession. I encourage you to have a look!

The State of Florida has finally taken action against Brian Clement.

David Gorski, Orac, and the Canadian media, especially the Canadian Broadcasting Corporation (CBC), have done an excellent job of chronicling the activities of “Dr.” Clement. All have reported on Florida’s taking action against Clement. I’ll give a brief background here, most of which comes from Dr. Gorski’s most recent post, as well as add some information and observations to theirs.

Hippocrates Health Institute, located in West Palm Beach, Florida, is licensed as a massage establishment by the state and run by Brian Clement and his wife, Anna Maria Gahns-Clement. Clement and Hippocrates came to the attention of the Canadian media when, last year, the families of two Canadian aboriginal girls withdrew their children from conventional cancer treatment, including chemotherapy. Prior to that, Clement had basked in the glory of fawning reports from local media, one of which described him as having an “inimitable, engaging style.” Another described him as coming “fresh from a detoxifying sauna” to the interview.

Had they completed conventional treatment, both girls had a very good chance of survival. The families opted instead for traditional medicine as well as “alternative medicine” at Hippocrates. Each paid a reported $18,000 for participation in a “Life Transformation Program” there. This included, for at least one of the girls, cold laser therapy, vitamin C injections and a strict raw vegetable diet.

Sadly, one of the girls, Makayla Sault, died in January. The other girl cannot be identified due to a court-ordered publication ban, but is referred to as “JJ” in news reports. As of last November, Hippocrates was still providing care for JJ by analyzing blood test results sent by mail. According to her mother, JJ must maintain a raw diet for two years with absolutely no sugar, presumably at Clement’s direction.

In previous statements, Makayla’s and JJ’s mothers identified Clement’s assurances of successful treatment at Hippocrates as the reason they decided to stop conventional cancer treatment. After all, why would any parent pay that kind of money and take her child out of the country had she not been convinced by someone that this considerable effort offered a real possibility of saving her daughter’s life? However, they are now walking back from those statements. The families are claiming that the girls’ trips to Hippocrates were a “family vacation.”

Clement has been fudging on his credentials, referring to himself variously as a naturopathic doctor, an NMD [naturopathic medical doctor] and a Ph.D. He has used the honorific “Dr.” (as recently as last November, on the HHI website) and called himself a “scientist.” But his degrees are from diploma mills. He is correct in claiming he is licensed by the state a nutritionist, a matter we’ll return to in a moment. His bio on the Hippocrates website is more circumspect since his troubles started. He still claims he is a Ph.D and is LN (licensed nutritionist).

Clement has made some wildly exaggerated claims about the effectiveness of treatments offered at Hippocrates. He’s asserts that “thousands and thousands” of people have “reversed” their cancer via Hippocrates treatments. He was recorded on video as saying:

We have the longest history on the planet Earth, the highest success rate on the planet Earth, of people healing cancer.

In response to the question “What ailments have you cured by putting your patients on a vegan diet?” posed on another video, he said:

Every known disease. Of course, we’re most notable for all of the people that have healed cancer.

And, in another video:

We’ve seen thousands and thousands of people reverse stage-four catastrophic cancer.

Medical experts have been widely quoted in news accounts debunking various nostrums offered there. David’s post last week thoroughly deconstructs these treatments:

They include almost every imaginable form of cancer quackery, including “detoxification,” colonics, wheatgrass, ozone pools, “bio-energy treatments,” the aforementioned “Cyber Scan,” and, of course, the Aqua Chi “detox footbaths.” One particularly silly treatment offered by HHI is called a “wheatgrass implant”, which, it turns out, are actually wheatgrass juice enemas. Indeed, if you believe the hype on the HHI website, there’s nothing that wheatgrass can’t do. If the HHI is to be believed, wheatgrass can increase red blood cell count, decrease blood pressure, cleanse the blood, organs and GI tract of “debris,” stimulate the thyroid gland, “restore alkalinity” to the blood, “detoxify” the blood, fight tumors and neutralize toxins, and many other fantastically beneficial alleged effects. Basically, combine a raw vegan diet with a veritable cornucopia of other kinds of quackery, and you have the HHI.

Unlicensed practice

Practicing any licensed health care profession without the appropriate license is a third-degree felony in Florida, with a penalty of up to 5 years in jail and a $5,000 fine. It is subject to administrative sanctions as well, such an order to cease and desist and a fine. According to the Florida Department of Health (DOH):

The Unlicensed Activity (ULA) program protects Florida residents and visitors from the potentially serious and dangerous consequences of receiving medical and health care services from an unlicensed person. The ULA unit investigates and refers for prosecution all unlicensed health care activity complaints and allegations.

The ULA unit works in conjunction with law enforcement and the state attorney’s offices to prosecute individuals practicing without a license. In many instances, unlicensed activity is a felony level criminal offense. More importantly, receiving health care from unlicensed people is dangerous and could result in further injury, disease or even death.

And:

investigations involving the unlicensed practice of a healthcare profession are criminal investigations that require the development of sufficient evidence (probable cause) to present to law enforcement or file charges with the State Attorney’s Office in the county of occurrence.

Florida law defines the practice of medicine as:

the diagnosis, treatment, operation, or prescription for any human disease, pain, injury, deformity, or other physical or mental condition.

Last November, I filed a complaint against Brian Clement for the unlicensed practice of medicine with the DOH. I also filed a complaint against Hippocrates Health Institute with the Florida Agency for Health Care Administration (AHCA) for operating a health care facility without the proper state license. AHCA licenses health care facilities, such as health clinics and hospitals. As I stated in the complaints, these allegations were not based on personal knowledge, but rather upon Canadian media reports. However, in light of what I had read, I felt an obligation to report Clement and Hippocrates to the state. It appeared to me that the health of these girls and others was at stake and it was appropriate for the state investigate what was going on.

The AHCA complaint was resolved first, with a surprising result. According to a January 28th email from AHCA:

After some additional Agency research, unfortunately this “Health Center” does not meet the definition of a Health Care Clinic, see [Florida Statutes] Section 400.9905(4),

“Clinic” means an entity where health care services are provided to individuals and which tenders charges for reimbursement for such services, including a mobile clinic and a portable equipment provider.

Since this institute is a cash-only business, it does not fall under AHCA’s regulation. The only recommendation I have, is to file complaints with the Department of Health (Board of Medicine) against the individual doctors, thanks.

In other words, since Hippocrates doesn’t get reimbursed by third party payers, such as health insurance companies, it does not need a license and AHCA had no jurisdiction to do anything about the clinic.

Interestingly, by not accepting insurance, Hippocrates avoids the usual limitations on insurance reimbursement for unproven treatments, typically deemed “experimental” in insurance policies and therefore not covered. It is thus able to escape any scrutiny a health insurer would normally apply to the treatments offered there, scrutiny that might otherwise raise suspicions among its clients when their insurance claims were denied.

The other complaint against Clement met with more success. On February 10th, I learned that DOH had taken action. First, DOH issued a Notice to Cease and Desist, saying

The Department has probable cause to believe that Brian Clement of Hippocrates Health Institute . . . is not licensed by the Department or the Board of Medicine and is practicing medicine in violation of [state law]. The practice of medicine without an active, valid license or permit is strictly prohibited [by law] and constitutes a crime.

Wherefore, in accordance with [state law], Brian Clement . . . is hereby notified to cease and desist from practicing medicine . . . unless and until Brian Clement is appropriately licensed by the Department.

An event that, we can safely assume, won’t take place.

It goes on to state that, if he violates the Notice, DOH can seek a court order to stop the violation and recover attorneys’ fees and costs.

DOH also issued a citation in the amount of $3,738 ($2,500 fine plus costs) for practicing or attempting to practice medicine without a license.

There is no right of appeal from the cease and desist notice but he can challenge the citation. Clement can request an administrative hearing within 30 days. This means he would have an opportunity to introduce testimony and evidence on his behalf before an Administrative Law Judge. The state, of course, would introduce testimony and evidence supporting the citation. If he loses, he can file an appeal to a state appellate court. If he does not challenge the citation, he would not get a hearing and the citation becomes a final order of the agency. However, he can still get another crack at it by filing an appeal, although his ability to argue against his being cited would be greatly limited.

According to Clement’s PR person, to whom we’ll return in a moment,

We deny these allegations from the Department of Health in their entirely and are vigorously contesting these allegations through the administrative process.

So it looks like Clement will be requesting a full administrative hearing.

DOH also notified Clement that

THE CITATION DOES NOT PREVENT OTHER ADMINISTRATIVE, CIVIL OR CRIMINAL PROSECUTION INVOLVING THE SAME FACTS AS USED IN THIS AGENCY ACTION.

And indeed, the investigative report states that DOH notified the Palm Beach County Sheriff’s Office about the matter on February 13th. Prosecution would be handled by the State Attorney.

In the investigative report accompanying the citation and notice, we learn that the DOH investigator reviewed the Hippocrates website and confirmed that Clement was using the title NMD. The report notes that Clement had been issued an informal Notice to Cease and Desist in the past for advertising and using the title NMD on the website.

The report says that the investigator did not attempt to obtain a release of patient information authorization from the Canadian girls because “their names were not provided or noted in the Canadian News Release.” This omission is curious because Makayla’s name and location were in several news reports and I mentioned her as well in my communication with DOH.

We also learn that a DOH investigator, who also reviewed the website and media reports, went undercover to Hippocrates on February 10th for an appointment with Clement, using an assumed name. He discussed his (unidentified) medical condition with Clement who gave him a “menu.” Based on the exhibit referred to in the report, this menu is a handwritten list, as follows:

Lifegive [a brand sold by Hippocrates] internal cleanser

2 AM, 2 PM

Mon, Wen, Fri, Sun

Lifegive B12

1 every morning

Pollen, teaspoon AM, PM

Quinoa Burger

Rice Pasta

Non Soy Burgers

Amy [brand?] Dinners

All Grains

Clement asked the investigator to provide a copy of his blood screen results; presumably, the blood screen was done prior to the appointment. Clement also gave the investigator a “specimen collection box” and told him to forward a sample to the company listed on the box. An attached exhibit shows a “fecal collection specimen box.” According to the report, Clement didn’t diagnose the investigator but said that the Hippocrates “medical team would review” his file.

Later, when the investigator revealed his true identity, Clement denied using the title “Naturopathic Medical Doctor” on the Hippocrates website despite his earlier run in with DOH for that exact thing.

A letter from DOH dated February 23rd notified me that “Dietetics & Nutrition Practice Council v. Brian R. Clement” was under review and, after an investigation, the DOH’s attorneys would look at the case and make a recommendation to the probable cause panel of the Council. (The Council operates under the auspices of the state medical board.) Although it is not clear, it appears as if DOH views me as the complainant in that case as well although my complaint did not include any allegations specifically regarding his nutritional counselor license.

Clement does hold a “clear/active” license to practice as a nutrition counselor. Florida no longer licenses nutrition counselors but they were grandfathered in under a newer law licensing dietetics/nutritionists, who have a broader scope of practice. Because they are no longer licensed, the statute does not tell us what the original educational and training requirements were.

By law, nutrition counselors can evaluate a person’s nutrition needs:

using appropriate data to determine nutrient needs or status and make appropriate nutrition recommendations.

One would assume that “Lifegive internal cleanser” and pollen are not an “appropriate” nutrition recommendation but I do not know if that is the basis of the complaint. It could be that his credentials were not in order when he applied.

Other legal problems and a PR offensive

According to media reports, Clement’s troubles with DOH are not his only legal problems. A complaint filed against Hippocrates with the Federal Trade Commission remains open. Several former employees, including the former director of nursing and an MD, are suing him over allegations that they were fired when they expressed concerns about Clement and other employees practicing medicine without a license. One RN alleges he was fired for refusing to follow Clement’s orders, which could be legally given only by an MD.

It is interesting that the Board of Directors of Hippocrates has not, to my knowledge, asked Clement to step aside pending resolution of these legal troubles, if not outright fire him. They would certainly be within their rights to do so absent some contractual arrangement with Clements that nixes his being ordered to stop practicing medicine as a firing offense, which is unlikely. It makes one wonder how closely the Board is overseeing the operations at Hippocrates.

Clement and/or Hippocrates have hired a top Florida PR firm to help handle the media heat. One can hardly blame them, considering the fact that Clement’s media interviews were just making him look like, well, like himself. Vicki Johnson, the PR firm’s VP, accused the Toronto Star of taking Clement’s “thousands and thousands” statements “out of context.”

As (Clement) has repeatedly emphasized, what Hippocrates does is educate people about the benefits of raw foods and exercise, and how a healthy lifestyle arms the body to fend off disease and in many cases heal itself.

Johnson might want to consider relying on medical information from someplace other than Hippocrates before she speaks to the media.

Johnson claims that all blood tests are administered by a medical professional and reviewed by the medical director. All Clements and his wife do is review the “guest’s” health history, including blood tests, to make nutritional recommendations. She says the medical director is responsible for all medical decisions. As the article points out, Hippocrates houses as many as 100 people at a time but has only one licensed medical director, Dr. Paul Kotteran. Sounds like a busy guy.

Johnson also challenged criticisms from a former Hippocrates employee who accused Clement of getting “as much money as possible” from deathly ill people:

He has dedicated his life to the health and well-being of his guests . . . Hippocrates grants thousands of dollars’ worth of scholarships to guests on an annual basis.

Lucky them.

Clement himself has also denied as “erroneous” a 2013 tax return filed with the IRS reporting his income as $529,000 and his wife’s at $432,000. We’ll see if an amended tax return is filed, as is required by federal law.

Clement and Hippocrates are clearly in the sights of the media and the blogosphere. The lawsuits by employees, the FTC action, the Florida Department of Health’s continuing investigation and the possibility of criminal charges will all be followed. Too bad Clement and Hippocrates have been able to successfully rake in millions of dollars by scamming so many people, some of whom died after they withdrew from conventional treatment, before the state decided to act.

What will be the actual effect of the Notice to Cease and Desist and Citation on Clement? That remains to be seen. Neither requires that the quack treatments or sales pitches to gravely ill people and their families be stopped. Hippocrates can continue to operate as a “massage establishment.” Clement will not suffer any penalty (other than the citation) for what he has done unless the FTC or state attorney take action. Any recovery in the suits brought by employees would go to them, not to the families of those who stopped treatment and died. Hopefully, the FTC and the state attorney will act to ensure more people don’t die because they abandoned conventional treatment for quackery.

 

 

Posted by Jann Bellamy

Jann J. Bellamy is a Florida attorney and lives in Tallahassee. She is one of the founders and Board members of the Society for Science-Based Medicine (SfSBM) dedicated to providing accurate information about CAM and advocating for state and federal laws that incorporate a science-based standard for all health care practitioners. She tracks state and federal bills that would allow pseudoscience in health care for the SfSBM website.  Her posts are archived here.