Naturopathic doctors in Arizona have the widest range of practices in the country. However, is cosmetic surgery possible within that range?
PHOENIX — Bruce Tucker was scrolling through Groupon, checking out discounts and offers in the greater Phoenix area. A special offer caught his eye. It was an advertisement for liposuction surgery.
“It came out of nowhere and it looks like a great deal,” Tucker said.
The surgery costs about $3,000, which is significantly less than what a Scottsdale plastic surgeon offered, he said.
In the summer of 2019, Tucker contacted the office directly to make an appointment.
But during the surgery, Tucker said he realized the deal might have been too good to be true.
“I was feeling every one of their jabs.”
He said it gave Tucker a feel for the surgery, among the many issues he would eventually bring in a medical malpractice suit.
“Then it started to really hurt to the point where I was moaning,” Tucker said. “I told him to numb it again because I was feeling all their jabs.”
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After the surgery, Tucker said she was never given compression garments, which are typically used to reduce swelling and bruising and aid the healing process.
“That’s really important after liposuction,” says Tucker. “No textbook I’ve ever seen says it’s an option. It’s required. Every website says it’s required. He couldn’t understand that to me. .”
Ms Tucker said the surgery left her with uneven healing and a scar of hardened fluid around her abdomen. Its influence is still felt today.
“There’s like a ribbon of hardened meat underneath,” Tucker explained. “I’m a stomach sleeper. Since then, I can’t sleep on my stomach because it hurts when I put pressure on my stomach.”
Suspicious side effects led Mr. Tucker to take another look at the man he had operated on. That’s when Tucker realized he wasn’t a surgeon at all.
The doctor who cut open Tucker’s body was actually a licensed naturopath.
“Actually, I was blaming myself too. I felt really stupid,” Tucker said.
Naturopathic medicine is a form of alternative medicine that traditionally involves natural remedies without drugs.
According to Arizona law, the practice of naturopathic medicine includes “nonsurgical methods,” but Arizona’s naturopathic license allows for minor surgeries.
However, neither the law nor the license explains or defines what minor surgery is. This leaves large legal loopholes for liposuction and other cosmetic procedures.
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12 News has learned that some naturopathic doctors in Arizona are performing Brazilian butt lifts. This surgery has a high mortality rate of 3 to 4 percent and is considered one of the most dangerous cosmetic surgeries in existence.
“Even when done correctly, serious complications can occur,” says Scottsdale-based plastic surgeon Sean Leal, M.D., who is board certified by the American Board of Plastic Surgery.
Dr. Leal performs liposuction and Brazilian butt lift surgery. Dr. Leal describes 16 years of education, including 3 to 5 years of general surgery training, followed by a 2 to 3 year training program specifically focused on plastic surgery, to become qualified to perform the surgeries he performs. doing.
“You have to be educated, you have to have the background, you have to have the experience, you have to have the knowledge to have different options for how to get that patient out safely if you run into a problem. What is the problem? ” Dr. Leal said.
Major naturopathic programs are four years long and typically take place after a bachelor’s degree.
Dr. Leal says it’s clear that cosmetic procedures like liposuction and Brazilian butt lifts are not trivial surgeries.
“Both liposuction and Brazilian butt lifts are major surgical procedures that, if done incorrectly, can have serious consequences for patients,” Dr. Leal said. “I don’t think it’s beneficial to the welfare of the patient for people without the appropriate training or background to perform this type of surgery.”
State and national experts agree.
Local and national medical experts say liposuction is ‘major surgery’
Naturopathic doctors in Arizona have the most extensive practice in the country, and a law signed by Governor Ducey in March 2022 granted them even more protections.
The new bill would qualify naturopathic doctors as medical providers who can remove or clear patients after sustaining a concussion or head injury. Naturopathic doctors can now also test the blood alcohol levels of people who die in car accidents. Naturopathic doctors are also permitted to provide services beyond their scope of practice to people in life-threatening situations.
Naturopathic doctors in Arizona are already expanding their reach when it comes to prescribing medications. Naturopathic doctors here can prescribe controlled substances and will be issued a DEA number.
In some states, naturopathic doctors are prohibited from practicing medicine at all. In fact, only 23 states recognize naturopathic medicine, according to the Association of Accredited Naturopathic Medical Colleges.
Arizona’s broad scope of practice and loose regulations have been criticized by local and national medical experts.
“ANMA represents genuine naturopathic practitioners and genuine naturopathic medicine never includes such procedures,” the American Naturopathic Medical Association said in response to questions about liposuction and other cosmetic procedures. said in an email to The News.
“Through regulations that continue to expand the scope of naturopathic practice, Arizona legislators have made it possible for licensed naturopathic physicians to practice medicine in Arizona without attending medical school.”
Rebecca Mitchell, executive director of the California Board of Naturopathic Medicine, says that the only simple administrative procedures that naturopathic doctors can perform in California are “repairing superficial tears and abrasions,” and “repairing foreign objects in superficial tissues.” He said it can be removed. Naturopathic doctors in California are not allowed to perform sutures.
Mitchell said California has no plans to allow traditional liposuction or other procedures not typically performed in a home practice setting.
The Maricopa County Medical Association released the following statement, stating that cosmetic procedures such as liposuction are also major surgeries.
“Such procedures are major surgeries and should not be performed by unqualified medical professionals. There are significant differences in training between naturopathic doctors and certified board-certified plastic surgeons. For example, Medical (MD) and osteopathic (DO) surgeons must complete residency and fellowship training, which takes 3 to 7 years and totals 12,000 to 16,000 hours of patient care. Therapists are not required to complete residency or fellowship training; their total patient hours may be as low as 720 to 1,200 hours, which impacts patient safety and quality of care.”
The Arizona State Medical Association also does not classify liposuction and Brazilian butt lifts as minor surgeries.
Tucker thought so too. He took action, filing a lawsuit with the Phoenix Police Department, the Attorney General, and the Arizona Naturopathic Medical Board, which is tasked with regulating the profession.
“So I thought they would do it all,” Tucker said. “That’s not exactly what happened.”
Board declines to take action against naturopathic doctor performing surgery
Tucker’s case from fall 2019 is detailed in meeting minutes and recordings of the Arizona Board of Naturopathic Medicine. These indicate that the board has decided not to discipline the naturopathic doctor who performed the liposuction procedure. They wrote a non-disciplinary letter to the naturopath instructing him to keep better records.
12 News has learned that this is not the first time a case involving a naturopathic doctor who performed liposuction procedures has been brought before the board.
“Arizona has a far greater scope of practice for naturopathic doctors than any other state in the country,” said attorney Mark Ryan.
Although Ryan is not representing Bruce Tucker, he was working on a separate civil lawsuit brought against another naturopathic doctor who performed liposuction on another patient in Arizona. The patient ended up staying in the hospital for several days due to complications from the surgery.
Ryan’s lawsuit was ultimately settled for more than $200,000, according to Naturopathic Board meeting minutes. However, when the case came before the board, members decided that the naturopathic doctor had already “learned a hard lesson” in a major court settlement and chose not to take any disciplinary action.
12 News did not name the naturopathic doctors in this article because they had not been disciplined by the board.
“Liposuction is an important medical procedure that should be performed by a qualified allopathic physician or osteopath,” Ryan said. “You know when enough is enough? Does it take a patient’s death for the board to take action?”
Naturopathic Board Executive Director Gail Anthony declined multiple interview requests, so 12 News showed up to the board meeting to speak with her before it began.
Only Anthony and a lawyer from the attorney general’s office arrived in person. 12 News was unable to speak directly to the board member as all other board members called back.
12 News asked Anthony, “Will the board effectively say it’s OK for naturopathic doctors to perform liposuction surgery?”
“Well, you can make that decision for yourself,” Anthony said. “What I can tell you is that in neither case did the board determine that the physician was ineligible.”
Board neglects to define “minor surgery”
12 News has learned that the liposuction loophole is no secret to Anthony and the board. The definition of “minor surgery” has been repeatedly discussed at least four times since January 2021. Members continue to avoid making decisions.
12 News asked Anthony where she and the board stand on defining the term “minor surgery” and eliminating the gray area that exists due to the lack of a definition.
“The board took that into consideration,” Anthony said. “We haven’t made a decision yet.”
This issue is still being fought in court in Mr. Tucker’s case. He worries that if the loophole is not closed, someone else will get hurt.
“I guess we’ll have to wait, but how many more people will be injured or killed before the trial begins?” Tucker said. “I feel like I’m some kind of crusader to other people.”
The Arizona Naturopathic Medical Association, Southwest Naturopathic Medical School in Tempe, and the American Naturopathic Physicians Association declined to comment for this story.
