Dr. Weeks’ medical license was stolen in 2013 because his practice of holistic or integrative medicine was deemed a “theoretical” risk of harm to the public. No patients were harmed and no patients complained. The Washington State medical board (MQAC) has a track record to harassment of integrative medical doctors and the sanction which the medical board (MQAC) levied against Dr. Weeks was finally admitted by their counsel, almost 7 years after the fact, to be impossible to fulfill. That means Dr, Weeks has been suffering an illegal de facto revocation of his license to care for patients for 7 years. The administrative courts have not protected his constitutional rights, so Dr. Weeks is appealing now for donations to fund his appeal at a higher civil court which understands its obligation to protect the constitutional rights of all citizens.
In retaliation for my having served my patients for twenty five years using cutting edge functional biochemistry to help them attain better success in fighting cancer and becoming healthy enough to discontinue prescription drugs by using “centsible” (safe, effective, and cost-effective) corrective care protocols, the Washington State Medical Board (MQAC) shut down my medical practice in March 2013.
I am appealing what I maintain was a vindictive, unjustified assault on my practice (and those of other holistic medical doctors in Washington State) as well as a tremendously tragic deprivation of my patients’ rights to the care of their choice.
I am asking for help now from people like you who value health care freedom. I need to raise $60,000 to fund my appeal which, when we win, will set a powerful precedent nationwide against state medical board harassment of integrative medical doctors.
Please understand that I consider this harassment against me to have been politically motivated, as there were no patient complaints, no allegations of harm to any patients, and the Medical Commission attorney in charge admitted that it was a “self-generated” investigation. Insiders know that state medical boards serve a valuable role when they discipline doctors who are acting unethically (examples: sexual harassment, self-medicating to the point of incompetence and other fraudulent or illegal behavior). However, the state medical board over reaches when they act as little more than monopolistic trade guilds which use the power of the state to control the health care market and to restrict the public’s access to integrative health care doctors. This medical board (MQAC) is a state agency that is comprised of a majority of self-serving market participants (doctors) operating with inadequate state oversight who illegally commandeer the power of the state to suppress competition from integrative medical doctors.
I urge you to roll up your sleeves and study the legal info below (or simply refer this to your personal counsel for her or his legal opinion) to better appreciate the merits of my precedent-setting case knowing that I welcome any inquiries from potential donors. In addition to receiving your support by calling us at 360-969-2169, we also gratefully accept legal support from attorneys who understand about the unconstitutionality of administrative power.
I thank you on behalf of lovers of freedom of choice in health care!
THE CASE SUPPORTING
DR. BRADFORD S. WEEKS, M.D.
AND HEALTH CARE FREEDOM
IN DEFENSE AGAINST
THE OVER REACHING of
the WASHINGTON STATE MEDICAL BOARD
On March 7th 2013, after 4 years of administrative harassment and expense by the Washington State Medical Quality Assurance Commission (MQAC) and the office of the Attorney General (AG), the license of Dr. Bradford S. Weeks, M.D. (www.weeksclinic.com and www.weeksmd.com) was suspended and he was deemed a “moderate to severe risk to the public” because he prescribed human growth hormone (HGH) to 3 patients from 2006-2009 – an act which was deemed simply a “theoretical” risk of harm to the public. (Yes. You read that correctly: a holistic doctor beloved by his patients for more than 20 years had his license suddenly suspended because he was judged by the medical board (MQAC) to be a “theoretical” risk of harm to the public. This story about preserving health care freedom and choice in America is worth reading. Let’s read on!)
The case turned on one crucial question:
“Is it legal to prescribe Human Growth Hormone to patients?”
The answer is: yes and no.
Yes: It is LEGAL to prescribe HGH if it is prescribed for the treatment of disease by a physician – or for a condition which is admittedly not a disease but deemed “other recognized medical condition” provided that “condition” has been authorized by the Secretary of Health and Human Services.
No: It is ILLEGAL to prescribe HGH for performance enhancement i.e. “muscle enhancement purposes” especially in the context of competitive athletics or if it is “distributed” by non-physicians (athletic trainers, coaches, parents) for the purpose of performance enhancement.
Background on HGH:
All that most Americans have heard about HGH is negative. Some doctor somewhere was caught giving HGH to some professional athlete (who is suspiciously hitting too many home runs) and consequently, guilt is assumed everywhere. But what we are not told is that HGH is actually safe and effective for people – the issue being that it is so good for you that it gives an unfair advantage, especially to a competitive athlete. HGH is a critically important medication for diseased elderly people and, contrary to what Dr. Weeks’ accusers claim, it is entirely legal for a doctor to prescribe HGH to a patients, unless (as noted above) it is prescribed for performance enhancement “without a medical necessity to do so”. What is curious is that there are no civil court cases to be cited as precedent that have directly addressed the off-label prescription of growth hormone by physicians to patients for the purpose of treating diseases. The court cases that do mention off-label prescribing are “dicta” – meaning that they tangentially mention the use of off-label growth hormone but that the essence of the case is a different issue. That said, one of the few cases to even mention the off-label prescribing of growth hormone by doctors to treat patients is Rost, wherein it is explicitly stated that “The FDA has approved [GH] only for the treatment of three specific pediatric disorders and of AGHD. Physicians may prescribe GH for non-FDA-approved indications (i.e. off-label”), but the FDCA prohibits pharmaceutical companies from marketing drugs for such off-label uses.”
Let’s look at the laws regarding HGH
1) The State of Washington Law re HGH
Despite erroneously classifying HGH as a “steroid” (even the MQAC expert witness agreed HGH is NOT a steroid) the only law regarding the prescribing of HGH in Washington state only prohibits HGH for performance enhancement.
RCW 69.41.320 states:
(1)(a) A practitioner shall not prescribe, administer, or dispense
steroids, as defined in RCW 69.41.300, or any form of
autotransfusion for the purpose of manipulating hormones to
increase muscle mass, strength, or weight, or for the purpose of
enhancing athletic ability, without a medical necessity to do so.
2) The Federal Law re HGH
Reasonable people can disagree about meanings of words and, in this case, the grammar of the sentence in question affords a somewhat ambiguous interpretation. Join us for a moment in the courtroom for the discussion. Here is the federal law:
“21 U.S.C.A. §333(e) Prohibited distribution of human growth
hormone. (1) Except as provided in paragraph (2), whoever knowingly
distributes, or possesses with intent to distribute, human growth hormone
for any use in humans other than the treatment of a disease or other
recognized medical condition, where such use has been authorized by the
Secretary of Health and Human Services under section 355 of this title
and pursuant to the order of a physician, is guilty of an offense..”
Here is my argument: HGH like all other prescription drugs can be prescribed off label if there there is scientific validation for its clinical application. MQAC disagrees. MQAC argues that HGH alone is the ONLY prescription drug in the history of US pharmaceutical law which can NOT pre prescribed off label. That is an incredible assertion. You see the argument turns on the grammatical meaning of the disjunctive word “or”.
What is a Dysjunctive?
A dysjunctive like the word “or” is used to create two independent phrases. The “or” is like a period – a full stop- in that the phrase before the “or” stands alone as does the phrase after the “or”. Understood correctly, the Federal law should be interpreted as follows.
“21 U.S.C.A. §333(e) Prohibited distribution of human growth hormone. (1) Except as provided in paragraph (2), whoever knowingly distributes, or possesses with intent to distribute, human growth hormone for any use in humans other than the treatment of a disease is guilty of an offense. Whoever knowingly distributes, or possesses with intent to distribute, human growth hormone for any use in humans other than the treatment of another recognized medical condition, where such use has been authorized by the Secretary of Health and Human Services under section 355 of this title and pursuant to the order of a physician, is guilty of an offense..”
If you don’t see grammatical argument clearly, let me give you another example of a sentence with a dysjunctive: What if a young lady told you the following: “You are invited to breakfast and you can have orange juice to drink or you can have a Blood Mary with vodka if your mother gives you permission.”
My medical license was unjustly suspended for 7 years based upon a disagreement about grammar in the context of an ambiguous law.
MQAC argues that the approval by the Secretary (SHHS) is required not just for treatment of “other recognized medical condition” (i.e. non-diseases like being too short etc.) but also that the approval of the Secretary is required for each “disease” being treated. Again, this would mean HGH is the only US drug which can not be used off label. MQAC argues that the sentence should be read in the conjunctive: the approval is necessary both for the treatment of diseases AND for medical conditions. On the contrary, over 26,000 medical doctors and scientists in 110 countries (www.a4m.com) disagree: we doctors read that sentence in the disjunctive: wherein the “or” implies that HGH can be used to treat both diseases OR specific medical conditions (which are not diseases) provided that those specific medical conditions are approved by the Secretary. For example, AIDs (the disease) is not considered to benefit from HGH but people who are wasting from AIDs (“AIDs wasting” is a medical condition, not a disease) can receive HGH since the Secretary of Health and Human Services has approved HGH for the treatment of AIDs wasting. What is another example of a “medical condition” where the prescription of HGH is approved by the Secretary of HHS? Just being too short: “idiopathic short stature – non-growth hormone deficient short stature” – indeed, this entirely cosmetic medical condition is certainly not a disease, but it has been approved by the Secretary of HHS for the use of HGH.
Furthermore, we doctors understand that a drug which is FDA approved for one purpose can be used “off label” and we consider HGH to be no exception. Remember that HGH is NOT a controlled substance. It is NOT a scheduled drug which means it is more freely available than these commonly prescribed drugs:
- Cold cough Syrup: chlorpheniramine/dihydrocodeine/pseudoephedrine
- Vicodin acetaminophen/hydrocodone
- Hydrocodone chlorpheniramine/hydrocodone/phenylephrine
- Marinol .dronabinol
- Suboxone buprenorphine/naloxone
Also bear in mind that if HGH is deemed not able to be prescribed “off-label”, then it is the ONLY drug in America which can not be prescribed “off-label”. And yet the nations’ top endocrinologists claim HGH is safe and has no side-effects – just swelling and sodium retention if given at too high a dose. Dr. Weeks was found to be giving HGH in low dosages. At this point, the issue of whether HGH is legal to prescribe “off-label” has never been adjudicated in a case of law simply because no one has every challenged the right of a doctor to prescribe it “off-label” because it is common knowledge that doctors can prescribe FDA approved drugs like HGH “off-label”!
THE POSITION OF THE UNITED STATES DEPARTMENT OF JUSTICE (DOJ)
What follows for the next few pages is the position paper of the US Department of Justice – note how it instructs its field agents to NOT harass medical doctors who prescribe HGH for diseased patients. Despite this clear instruction, the over reaching and over zealous MQAC has destroyed the practice of Dr. Weeks and has stranded hundreds of his patients who have been failed by conventional medical doctors and specifically sought out nontraditional medical care with Dr. Weeks.
Note that there are NO legal case precedents which directly address the legality of a physician prescribing HGH off-label despite the law being on the books for almost 30 years. Why? Because everyone including the Department of Justice knows that a doctor prescribing HGH to a diseased patient is legal! The only cases involving illegal HGH prescription involve performance enhancement for athletes because that is cheating! So lets look at how the Department of Justice (DOJ) instructs their own agents to interpret the law.
SOURCE of the following Historical Overview:
(Note: I will underline critical text and add comments in [bold and Arial text below so the reader can note what is the DOJ instructions and why are our comments to the DOJ instructions).
An historical overview
1. Prosecuting under the FDCA (Federal Drug and Cosmetic Act)
The distribution of anabolic steroids and/or human growth hormone for muscle enhancement purposes for may involve conduct designed both to defraud the United States and to violate federal law. Since 1938, federal law has prohibited the distribution of anabolic steroids and/or human growth hormone outside a legitimate doctor-patient relationship. Originally, the government’s principal legal claim was made under the Federal Food, Drug, and Cosmetic Act and involved allegations that individuals were distributing anabolic steroids and/or human growth hormone, both of which are prescription drugs, without a prescription. See 21 U.S.C. § 353(b)(1)(B).
[Comment: here we see legislative intent is not to interfere with the doctor-patient relationship where the doctor is using HGH to treat a disease, but rather to stop the “distribution” (not “prescription” – later we will clarify the difference) of HGH for performance enhancement in athletes “muscle enhancement purposes” by trainers or coaches “outside a legitimate doctor-patient relationship”]
Pursuant to this statute, prescription drugs such as anabolic steroids and/or human growth hormone could be legally distributed only in those instances in which a physician, based upon an individualized determination of a proper course of treatment, authorizes the drug’s distribution to a patient under his supervision. See Brown v. United States, 250 F.2d 745, 746-47 (5th Cir.), cert. denied, 356 U.S. 938 (1958); DeFreese v. United States, 270 F.2d 730, 733 & n.5 (5th Cir. 1959), cert. denied, 362 U.S. 944 (1960); see also United States v. Zwick, 413 F. Supp. 113, 115 (N.D. Ohio 1976).
[Comment: here we see that the physician is allowed to prescribe HGH to a patient under his supervision”]
If prescription drugs are distributed outside of this relationship, then the drugs are deemed misbranded. See 21 U.S.C. § 353(b). Distribution of prescription drugs outside these restrictions has resulted in the prosecution and conviction of laypersons,[FN1] pharmacists,[FN2] and physicians.[FN3]
[Comment: here we see that it is legal to prescribe growth hormone with in the relationship of doctor-patient but not outside of that relationship as, for example, athletes being given “black market” or “redirected” HGH by trainers or coaches.]
2. The 1988 Amendments
In recognition of the fact that illegal drug trafficking in anabolic steroids and human growth hormone was becoming larger in scope and presenting an ever-increasing health risk to young athletes, Congress addressed the issue with two amendments, first in 1988 and then later in 1990. The purpose of both of these amendments was to criminalize steroid and human growth hormone trafficking.
[Comment: here again we see that the concern is the risk to young athletes because coaches and trainers were giving growth hormone to high school athletes. In addition, parents were giving their children HGH in order to enhance their athletic performance and later their marketability as scholarship recipients to colleges. (See Maron, docket # 07-08-A-1098MD agreed order dated September 20th 2009 where a medical doctor illegally prescribed HGH to his step-son under the guise of “short stature” despite the youth being a competitive athlete and standing 5-9 3/4” and weighing 152 pounds… (??) What was Dr. Maron’s punishment by MQAC? A simple reprimand, a fine, restriction on prescribing HGH, restriction of treating family members and finally, MQAC approval before “acting in any professional capacity with any sports team.” No license suspension. Hmmm… unequal treatment under the law is not legal!
The first of these amendments was enacted as part of the 1988 Anti-Drug Abuse Amendments, Pub.L. No. 100-690, §§ 2401, 2403, and took effect on November 18, 1988. The 1988 Anti-Drug Abuse Amendments had two important components. The first was the creation of a new statute (codified at 21 U.S.C. § 333(e)(1)) which made the distribution of anabolic steroids illegal unless (1) it was done pursuant to the order of a physician, and (2) it was for the purpose of treating a disease. Pub.L. No. 100-690, § 2403.
[Comment: again we see that the law allows physicians to prescribe HGH “for the purpose of treating a disease”. Later that will allow for the treatment of specific medical conditions provided those conditions are approved by the Secretary of Health and Human Services.
3. The 1990 Amendments
In 1990, Congress enacted more stringent controls with higher criminal penalties for offenses involving the illegal ” of anabolic steroids and human growth hormone. This new legislation, which was enacted as part of the Anabolic Steroids Control Act, Pub.L. No. 101-647, title XIX, §§ 1901-05, resulted in a reconfiguration of the statutory scheme regulating the distribution of both anabolic steroids and human growth hormone. The 1990 Act reclassified anabolic steroids as Schedule III controlled substances, effective February 27, 1991.[FN5] See 21 U.S.C. § 812(c) (1992). The 1990 Act also amended 21 U.S.C. § 333(e)(1) to explicitly criminalize as a five-year felony the distribution and possession, with intent to distribute, of human growth hormone “for any use . . . other than the treatment of a disease or other recognized medical condition, where such use has been authorized by the Secretary of Human Services . . . and pursuant to the order of a physician . . . .”[FN6] Pub.L. No. 101-647, title XIX, § 1904 (codified at 21 U.S.C. § 333(e)(1) (1992)).
[Comment: here we see that HGH is legal for the treatment of disease.]
In 1993, these provisions outlawing the distribution of human growth hormone for non-medical purposes were recodified at 21 U.S.C. § 333(f) pursuant to Pub.L. No. 103-80, § 3(e), 107 Stat. 775.
[Comment: here we see that the illegal behavior involves “non-medical” purposes.]
B. Practical Considerations
Prosecuting distribution of human growth hormone is different from virtually any other drug prosecution under the FDCA. Among other things, proof of interstate distribution of the drug is unnecessary. Additionally, the mens rea requirement for a felony is “knowing distribution” or “knowing possession with intent to distribute,” not “intent to defraud or mislead.”
[Comment: In a related statute, the critical distinction between “prescription” or “administer” (what physicians do) and “distribution” (what non-physicians do) is clarified . http://www.deadiversion.usdoj.gov/21cfr/21usc/802.htm
(2) The term “administer” refers to the direct application of a controlled substance to the body of a patient or research subject by–
(A) a practitioner (or, in his presence, by his authorized agent), or
(B) the patient or research subject at the direction and in the presence of the practitioner,
whether such application be by injection, inhalation, ingestion, or any other means.
(11) The term “distribute” means to deliver (other than by administering or dispensing) a controlled substance or a listed chemical. The term “distributor” means a person who so delivers a controlled substance or a listed chemical.
This further establishes that the law is intended to focus on criminalizing the “distribution” by non-physicians of HGH for purposes of performance enhancement “for muscle enhancement purposes”. Remember: legally speaking physicians don’t “distribute”, but rather then only “administer” “dispense” or prescribe”. The law was never intended to be used to interfere with a legitimate doctor patient relationship.]
Thus, prosecuting non-physicians for distributing human growth hormone is akin to prosecuting a narcotics case under the Controlled Substances Act. As a result, establishing liability in such cases is simpler than for other FDCA offenses. This is particularly true because the only two authorized manufacturers of human growth hormone (Genentech and Eli Lilly) have both established stringent restrictions over the distribution of their products to ensure that only physicians can gain access to the drugs. Under the current restrictions, only hospital pharmacies can order the drug; local pharmacies cannot. Thus, most non-physician cases involving the distribution of human growth hormone will involve one of three scenarios: (1) diverted human growth hormone, obtained either through theft or via a drug-dealing physician; (2) smuggled human growth hormone; or (3) counterfeit human growth hormone.
[Comment: again we see the law is focused on preventing “non-physicians” from distributing HGH and is not concerned with HGH being prescribed by legitimate doctors to treat diseases.]
Prosecuting a physician brings other considerations into play. Because section 333(f)(1) allows physicians to distribute human growth hormone in connection with either (1) “treatment of a disease” or (2) “other recognized medical condition” which has been authorized by the Secretary of Human Services, additional evidence is necessary to prove that a physician is a drug dealer. Obtaining such evidence can be difficult. Consideration should be given to attempting “controlled buys” using undercover agents or informants. Both search warrants and grand jury subpoenas for the physician’s medical files will often need to be utilized. Of course, in so doing, care must be given to protect the bona fide privacy interests of any legitimate patients the physician might have.
[Comment: Here we have the DOJ’s interpretation of the current law and we call your attention note the use of the disjunctive: “or”. We see, by the use of parentheses, that the Department of Justice takes pains to interpret section 333 and instruct their agents that the law allows doctors such as yours truly to use HGH in an “either / or” situation. Either the treatment of disease OR the treatment of a medical condition – provided that the medical condition is approved by the Secretary of Health and Human Services. The English majors who have read this far will also note that the comma after “medical condition” (present in the law itself) is no longer present in this memo by the DOJ to its agents demonstrating that the DOJ agrees that approval by the Secretary is required only for the medical conditions and not for the treatment of diseases. That was Dr. Weeks’ argument before MQAC and Superior court judge Alan Hancock and we were denied justice in each instance. Hence the appeal!
Before we leave the legal arguments, it is important to understand that many legal scholars argue, as we do, that this federal statute 333 is not intended to interfere with the doctor patient relationship. Most articulate of these is by Ryan Cronin referenced here in his 2008 article Bureaucrats vs. Physicians: Have Doctors Been Stripped of Their Power to Determine the Proper Use of Human Growth Hormone in Treating Adult Disease?
NOTE: that concludes the text of the DOJ instructions to its agents as regards HGH with comments in Arial font.
Now we continue with the Case supporting Dr. Weeks.
BIASED MOTIVATION OF THE STATE MEDICAL BOARD
So why was Dr. Weeks attacked by the Washington State Medical Board (MQAC) in the first place and why was he considered too dangerous to be allowed to continue to practice?
Here are some relevant and illustrative facts of the case all of which are available for your review at http://correctivehealth.org/wp-content/uploads/2012/02/Stay-Motion-6-6-13.pdf
- The complaint against Dr. Weeks was “self-generated” by MQAC.
- No patients complained.
- No patients were injured.
- All patients declared under oath and in written testimony that Dr.. Weeks’ treatment of their illness was superior to that which they had experienced with conventional medical doctors.
- the medical board’s hostile expert witness testified that all patients seemed to improve under Dr. Weeks’ care
- The risk of harm to the public was termed “theoretical”
- Nonetheless the risk was considered “moderate to severe” allowing for suspension of Dr. Weeks’ license.
- The egregious behavior was prescribing low dose HGH to three diseased patients from 2006-2009 and not since then.
- In the three years of the investigation, MQAC made no effort to stop Dr. Weeks’ practice.
- However, at the administrative hearing, the MQAC deemed this prior behavior ending in 2009 (which helped patients recover) to be a present danger sufficient to suspend Dr. Weeks’ license.
In short, the state medical board attacked Dr. Weeks as part of a comprehensive strategy to eliminate leading integrative holistic medical doctors because such care is not approved by Corporate Medicine (Big Pharma Big Insurance and the AMA). In that sense, Dr. Weeks represents a threat to orthodox medical doctors and the entire industry of disease management. The fact that government appointed “public servants” would operate with such bias and careless disregard of both Washington State law and Federal Law is a travesty of justice the details of which should be shouted from the rooftops! Health care freedom of choice is being attacked by bureaucrats who are pawns of Corporate Medicine (Big Pharma, Big Insurance and the AMA). If they are allowed to proceed unchallenged, your children may very well only have side-effect laden, expensive, patented medications available when they are sick. As the great poet Goethe remarked: “Nature holds no spectacle more hideous than that of ignorance in action.” Don’t let the bureaucratic pawns of Corporate Medicine steal your health care freedom!
Every riveting story needs to have heroes as well as villains and this story is no exception – the evil villains are numerous.
So, who are the villains?
Villain #1: Introducing Dr. Thomas Perls.
- 1. Discredited: Tom Perls was greatly embarrassed when he was forced to retract his only major articles published in medical journal. “… there was something goofy about the results. One of the systems used to analyze the DNA SNPs had a flaw — a flaw known to most geneticists in the field. “ (http://www.npr.org/2011/07/22/138585089/poor-peer-review-cited-in-retracted-dna-study ) According to Wikipedia: “A controversial paper regarding the genetics of aging with which he was associated was retracted from the journal Science in 2011 due to flawed data. “Scientists Retract Report on Predicting Longevity”. The New York Times. 22 July 2011. “Big “Oops” Forces Retraction of Longevity Study”. CBS News. 21 July 2011.) Other retractions include http://www.nytimes.com/2011/07/23/science/23retract.html?_r=0 http://www.nature.com/news/2011/110721/full/news.2011.429.html http://www.npr.org/2011/07/22/138585089/poor-peer-review-cited-in-retracted-dna-study and http://health.yahoo.net/news/s/nm/us_science_retraction
- 2. Opinionated: Perls, not a lawyer, asserts dubious legal opinions and claims to teach what is legal and illegal about HGH. He published a commentary (not a peer-reviewed scientific article) in the medical journal JAMA wherein he opines that HGH is illegal for “anti-aging medicine” without defining “anti-aging medicine” and in direct opposition to the actual law. This opinion became accepted as fact without adequate scrutiny. See JAMA Commentary | June 18, 2008 New Developments in the Illegal Provision of Growth Hormone for “Anti-Aging” and Bodybuilding S. Jay Olshansky, PhD; Thomas T. Perls, MD, MPH JAMA. 2008;299(23) The problem is, Perls’ legal opinion is not accurate. HGH is only illegal for performance enhancement and the term “anti-aging medicine” was not in common usage when the law was written so it can’t reasonably
“In 1993 the provisions outlawing the distribution of specifically growth hormone were recodified as 21 USC 333 (f). Section 333(f) (1) of the FDCA permits distribution of HGH in connection with (1) “treatment of the disease” or (2) “other recognized medical condition” that has been authorized by the Secretary of Health and Human Services.” ibid above
Note that Perls’ own punctuation and his use of parentheses support the disjunctive “either / or” interpretation that HGH is legal for the treatment of a disease and that only the medical condition (and not the disease) needs to be authorized by the Secretary of Health and Human Services. At any rate, Tom Perls is NOT a lawyer and although entitled to his published opinion regarding legality of HGH, lawyers like Ryan Cronin have rebutted his assertion in support of Dr. Weeks’ practice as well as the practice of 26,000 doctors in 110 countries who are members of the American Association of Anti-Aging Medicine – the wave of the future. www.a4m.com
Any residual doubt about the actual legality of HGH can be alleviated by simply searching “HGH and any major city” and you will find doctors offering HGH to people for the treatment of diseases without permission of the Secretary of Health and Human Services. For example: “HGH and Miami” (http://www.miami-hgh-therapy.com) or “HGH and New York” (http://www.hgh1.com/hgh-nyc-low-t-therapy-clinics-doctors-new-york-ny/ ) or HGH and Los Angeles” (http://rejuvalife.md/anti-aging-medicine/human-growth-hormone). However, the FSMB (puppet master of state medical boards) has these practices in their crosshairs and if Dr. Weeks’s appeal is not successful, HGH will be shut down across the country based on erroneous interpretation of legislative intent and Federal law.
3. For Hire: Tom Perls’ income depends upon soliciting gigs as an “expert” witness against holistic anti-aging doctors. He lectured to FSMB to further strategic assault on integrative medicine and is a biased expert witness.
4. Conflict of Interest: Tom Perls appears biased. See his website: www.hghwatch.com. Rather than offer an unbiased scientific assessment, his value is solely that of a well-funded hit man against innovative medical doctors. He reportedly was also a part owner of a biotech company(s) “Arch Venture Capital” which was developing a product to compete with natural HGH but clear and full disclosure has not been accomplished. If indeed this conflict of interest exists and was not disclosed when he was hired by Washington State AAG, there will be consequences.
Villain #2: Introducing Dr. Andrew Hoffman
Despite MQAC being charged with affording defendants like Dr. Weeks “fair and objective decisions” and to “Recuse themselves when there is a real or potential conflict of interest, or the appearance of such a conflict.” http://www.doh.wa.gov/LicensesPermitsandCertificates/MedicalCommission/CommissionInformation/Purpose.aspx , MQAC chose a highly suspect expert witness and broke many ethical rules is continuing to use his services.
What is a fair ethical expert witness?
Let’s consult The Ethical Medical Expert Witness (Journal of Medical Licensure and Discipline vol. 89 No 3 2003)
1) “Expertise in the specialty in which the defendant is practicing should be the sine qua non of an ethical expert witness. Expertise is appropriately established on the basis of knowledge of the field and relevant experience.”
In this instance, Hoffman was an academic professor who admits ignorance and disinterest and distain regarding holistic and complementary and integrative and anti-aging medicine. Hoffman claims to be an authority of HGH but the record shows he prescribes HGH solely in a specialty tertiary care practice for a rare group of patients with brain injury, not similar in any manner to the patient population Dr. Weeks cares for: elderly, diseased patient. Despite being unqualified to be an expert witness in a case such as Dr. Weeks’ (which required an assessment of the practice of an integrative holistic medical doctor), Hoffman, under oath, endorsed the mission statement of the very professional organization, American Academy of Anti-aging Medicine, which he denigrated.
The American Academy of Anti-Aging Medicine, Inc. (“A4M”) is a not-for-profit medical society dedicated to the advancement of technology to detect, prevent, and treat aging related disease and to promote research into methods to retard and optimize the human aging process. A4M is also dedicated to educating physicians, scientists, and members of the public on anti-aging issues.
A4M believes that the disabilities associated with normal aging are caused by physiological dysfunction which in many cases are ameliorable to medical treatment, such that the human life span can be increased, and the quality of one’s life improved as one grows chronologically older.
A4M seeks to disseminate information concerning innovative science and research as well as treatment modalities designed to prolong the human life span.
Anti-aging medicine is based on the scientific principles of responsible medical care consistent with those of other healthcare specialties. Although A4M seeks to disseminate information on many types of medical treatments, it does not promote or endorse any specific treatment nor does it sell or endorse any commercial product.
2) Also from The Ethical Medical Expert Witness (Journal of Medical Licensure and Discipline vol. 89 No 3 2003)
“Ideally, before reviewing the records the expert witness should know nothing about the case except for the broad subject matter and filing deadline the expert witness should know nothing about the case.”
In this case, Hoffman had consulted on a HGH case two years prior to the charges against BSW and other doctors, and in fact had collaborated with the Attorney General on the drafting of the new standard of care for the use of HGH that Washington State put forth in 2010. Furthermore, Hoffman allowed himself to be thoroughly prepped for his testimony by the AAG in flagrant violation of this code of ethics.
3) Also from The Ethical Medical Expert Witness (Journal of Medical Licensure and Discipline vol. 89 No 3 2003)
“An ethical expert witness must be careful in differentiating for a jury between widely excepted standard of care and ideally care, or care that might be provided by the most astute clinician faxing under optimal circumstances. This is a particular hazard for clinicians who is only practice experience has been in tertiary care facilities (for example, medical school faculty), who are testifying in cases involving community facilities with typical practicing clinicians working with limited backups and equipment.”
4) Also from The Ethical Medical Expert Witness (Journal of Medical Licensure and Discipline vol. 89 No 3 2003)
“Acting as an expert witness has become profession for some individuals. The medical legal animals are replete with testimony by “hired guns” who earn a significant portion or even the majority of their professional income from testifying in malpractice cases.” “Compensation for time expended acting as an expert witness should be commensurate with compensation that would be earned during the same amount of time devoted to medical practice and not be indexed to the market rate for expert testimony…. For a physician to earn more through work is next for witness as a practicing physician is morally questionable if not unethical – yet many do.”
In this instance, despite the stipulation that an expert witnesses must be paid a reasonable rate (commensurate with their actual wages) in order to not “incentivize” witnesses to amount to no more than “hired guns”, during the two day deposition, Hoffman was paid $700/hour (and $500/hour for travel time) -both grossly in excess of his VA hospital wages. This was a flagrant violation of ethics in that those inordinate wages incentive Hoffman to be neither objective nor unbiased because if his employer MQAC is not satisfied with the testimony, he might not be rehired for this lucrative gig! It also is a lamentable waste of tax-payer funds. (Note: it is curious that MQAC tried and failed to hire a Washington expert so they had to go out of state to California.)
5) Also from The Ethical Medical Expert Witness (Journal of Medical Licensure and Discipline vol. 89 No 3 2003)
“The primary responsibility of the next witness must always be to the truth.”
How can a truthful statement embrace both these ideas: 1) “Dr. Weeks is a moderate to severe danger to the public” and 2) “The harm Dr. Weeks represents is theoretical.” Hoffman was hypocritical and intellectually dishonest to the point of disqualifying himself when he declared, under oath, that the use of HGH in non-AGHD adults was dangerous, yet refused to acknowledge that the very article from which he drew his conclusions, a meta-analysis he co-authored, revealed that the one study that used low dosages similar to those prescribed by Dr. Weeks (the rest were up to 20-30 times higher) caused NO harm or side effects. Yet Dr. Hoffman was willing to testify under oath that Dr. Weeks risked moderate to severe harm to his patients, a calculated strategy between him and the AAG which allowed them to apply a second tier sanction of three year suspension.
Conflict of Interest:
– Conflicts of interest should disqualify expert witnesses. In the case of Hoffman, he was consultant paid with stock options to a biotech company Ambrx, which expects to market a drug which would directly compete with natural HGH, a long acting patentable analogue of HGH. Therefore Hoffman is incentivized to stigmatize HGH and doctors prescribing HGH so that the market will be open and receptive to his synthetic long acting HGH. Hoffman understood the huge market for his long-acting HGH in the anti-aging market and in direct contradiction to his sworn testimony (we see in his power point presentation for CME at UCSF in 2009 wherein he also describes the potential market for HGH as being:
“Treatment of non-growth hormone deficient adults with HGH: Potential Future Uses” (currently off label)
1) insulin resistance (a disease)
2) sports (meaning performance enhancement)
3) somatopause (normal health aging – therefore an anti-aging use)
To his shame, “judge” Kuntz (see Villain #3 below) did not allow the power point in as evidence at Dr. Weeks’ MQAC hearing. Had he done so, it would have disqualified the MQAC’s only expert witness. MQAC knew that this conflict of interest existed and refused to act ethically and disqualify Hoffman.
Villain #3: Introducing “judge” John Kuntz (not really a judge, just an “administrative officer” acting like a judge in the administrative kangaroo court which is the MQAC hearing)
The MQAC is composed of 18 commissioners appointed by the Governor who are charged with protecting the public health and safety through the regulation of licensed doctors. The rules of MQAC are that commissioners sitting in judgment of a doctor need to be unbiased. Yet Kuntz allowed a highly biased former commission member (who had been aggressively against HGH when an active commissioner) who had not been on the MQAC for three years (retired 2010) to sit in judgment of Dr. Weeks.
Kuntz refused to allow justice into the proceedings in a number of ways. First and foremost, he refused to grant any continuances despite Dr. Weeks’ attorney Michele Atkins unilaterally abandoning Dr. Weeks a mere 2 weeks before deposition having not identified any expert witness! Any ethical judge would have granted extension in the name of fairness. Dr. Weeks’ new attorney routinely complained “We don’t have enough time to do justice to this case.” All other HGH defendants were granted continuances for a variety of reasons For example, one defendant voluntarily hired a new lawyer and was given a continuance whereas Dr. Weeks was abandoned by his lawyer and had to find a new lawyer at the 11th hour who was not granted a just continuance.
Another issue related to time was the limitation of Dr. Weeks’s defense at the MQAC hearing to only a few hours making it impossible to allow for testimony of three of his witnesses Dr. Forsythe (who himself was vindicated in a HGH case), and two of the patients in the case who were prepared to testify that Dr. Weeks’ care was the best they had ever received from a doctor and that HGH was essential to their recovery. Dr. Weeks’ defense was cut short because Kuntz noticed that the court stenographer was getting tired so, instead of arranging for a replacement for the weary stenographer, he ended the hearing prematurely thereby compromising Dr. Weeks defense efforts.
Kuntz refused all discussion about the law at the hearing stating “I will instruct the commissioners in all matters of law”. The facts demonstrate that Kuntz was entirely ignorant and uninformed about the law thereby denying legal rights to Dr. Weeks.
Villain #4: Introducing Judge Alan Hancock, Superior Court Island County
Aristotle says justice consists in what is lawful and fair, with fairness involving equitable distributions and the correction of what is inequitable. Immediately after my license was suspended in 2013, I petitioned Judge Alan Hancock to “stay the sanction pending judicial review” meaning, during the appeal Dr. Weeks requested that he be allowed to continue caring for his severely ill cancer patients and employing his loyal staff. Since no patients had complained and no patients were harmed, we all expected Hancock to stay the sanction while a legal fight ensued. To our shock and disappointment, Judge Hancock, took less than a half hour to reject all my appeals and refused to consider the legal arguments of my counsel. He failed to exercise judgement to seek fairness and rather deferred to a different state agency than his courtroom, the state medical board.
“The standard of care is frequently defined as “the degree of care that would be rendered by a reasonably competent physician practicing under the same or similar circumstances”. “One expert who is unusually candid admitted privately that although informed by number of sources the standard of care that she applies in any given case is essentially “made up” because nowhere is it clearly defined.” see The Ethical Medical Expert Witness , Journal of Medical Licensure and Discipline vol. 89 No 3 2003 p.129).
A former prosecutor, Judge Hancock overreached in a number of instances: He stated that because Dr. Weeks’ practice differed from the state’s expert Dr. Hoffman’s, therefore it did not meet the standard of care. Hancock demonstrated no interest in considering the facts of the case: 1) that Hoffman’s practice in no way resembled Dr. Weeks’ practice and 2) that even Dr. Hoffman admitted under oath that Dr. Weeks patients got better under the holistic care but he was bothered that he didn’t understand how that could be! 3) the principle of the “respectable minority” from whence often innovation and progress arise and which therefore must not be silenced. Again, no patients complained. No patients were injured and Dr. Hoffman could only accuse Dr. Weeks of a “theoretical” risk of harm; and 4) that MQAC and Hancock entirely discounted Dr. Weeks’ own expert witness, an expert endocrinologist who actually practiced integrative medicine in a manner similar to Dr. Weeks. Consequently, Hancock simply allowed MQAC to suspend Dr. Weeks’ license because Dr. Weeks was deemed ” a theoretical risk of harm” thereby depriving hundreds of patients of their chosen health care option as they are legally entitled to under Washington State law:
“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.” RCW 18.130.180 (4):
There are rules of procedure in legal proceedings. They are logical and failure to conform to these rules results in censure or consequences by a fair judge. In Dr. Weeks case, his attorney filed the “petition to stay the sanctions” in a timely manner and the response from the opposing Assistant Attorney general (AAG) for MQAC was due on a Thursday, 6 days prior to the court date. It did not arrive and Dr. Weeks’s attorney was astonished. By the end of day Friday, any objection by the AAG to Dr. Weeks’ request for stay of sanctions had still not arrived. There was no word over the weekend, and so on Monday, four days after the AAG’s anticipated rejection of our petition for stay was due, Dr. Weeks’ attorney petitioned the court to grant the stay, since the AAG had missed her chance to argue against Dr. Weeks’ petition. No word from Judge Hancock. Then Wednesday, the court received the AAG’s motion to reject Dr. Weeks petition to stay the sanctions…. 6 days late! Adding more insult, there was no explanation by the AAG for her having ignored the time requirements, so when Judge Hancock alerted both parties on Thursday that the case would be heard the next day, Dr. Weeks’ attorney suspected the sole purpose would be for Judge Hancock to read the AAG the riot act for her insolent tardiness in frank disrespect for the rules of the court. Instead Judge Hancock totally disregarded her lateness despite acknowledging that it allowed inadequate time for Dr. Weeks’ attorney to prepare a response. Unjust judgment at every level.
In January 2019, Judge Hancock finally heard our argument that the MQAC allegations were unjust, that Dr. Weeks’ due process rights were violated, that the sanction was unfulfillable and that I did not violate any federal law. Despite being paid to be a judge, Hancock punted, or rather kicked the can down the road and deferred to the medical board, a state agency just like his own. More astonishingly, in an amazing display of ignorance exceeded only by arrogance, Hancock listened to the argument that I was following the guidelines of the DOJ and its field guild to enforcement officers and stated:
“…Dr. Weeks points to the Department of Justice’s civil resources manual, which states in this regard “Section 333E allows physicians to distribute human growth hormone in connection with either one treatment of the disease” or two “Other recognized medically condition.” Which has been authorized by the secretary of human services.” The first thing to note about this manual, and of course this reference in this manual, is that it is not the law and it is by no means an authoritative indication of congressional intent. It is by no means binding on this core. The second thing to note is that it is plainly wrong as I have explained, I am at a loss to understand how the department of justice could make such a glaring error but there is…”
Friends, to be clear, the DOJ is the government agency most concerned with interpreting and enforcing the federal law and yet a judge on a tiny island off the coast of Seattle was arrogant enough to claim to know the law better than the DOJ. Astonishing arrogance!
Villain #5: Introducing Attorney General Ron McKenna and assistant Attorney general (AAG) Kirstin Brewer
Heartless: It is a truism that in law “winning” counts more than the realization of justice. Repeatedly requests for due process and fairness as well as consideration of the welfare of Dr. Weeks’ patients were ignored. The AG and AAG are motived to discipline doctors in order to justify their budget and in compliance with the encouragement of the FSMB which incentivized members of MQAC to increase attacks on holistic medical doctors declaring complementary medicine to be “questionable” and “dangerous”. As Goethe so succinctly remarked “Nature holds no spectacle more hideous than that of ignorance in action.”
Arch-Villain #6: Introducing FSMB – The Federation of State Medical Boards aka The Puppet Master
According to the Alliance for Natural Health (http://www.anh-usa.org) “The FSMB is an elite, highly influential, secretive private organization. We also believe that it is thoroughly corrupt. See Action Alert!
They warn patients in all 50 states: “Is Your State Medical Board in Bed with the FSMB? The Federation of State Medical Boards (FSMB) is a private trade organization representing the seventy state medical and osteopathic boards of the US and its territories. Whatever the FSMB suggests in terms of medical care policies are often adopted by the state medical boards, yet it has no public funding, transparency, or accountability.
The organization is also extremely hostile to integrative medicine, calling it “quackery.” Because of this, the FSMB has consistently defined “standard of care” as excluding integrative medicine, and so many state medical boards follow suit. The FSMB receives a great deal of money from the pharmaceutical industry, and supports the use of addictive opioid drugs to treat long-term pain.
The Senate Finance Committee has launched an investigation into the close ties between pharmaceutical companies and the FSMB. Please contact your local state medical board and demand information about its relationship with the FSMB!”
It is clear that the FSMB is actively trying to influence legislation and outlaw holistic medicine.
“State medical boards should review their Medical Practice Acts and pursue legislative support for revisions to strengthen the medical board’s ability to regulate physicians engaging in questionable health care practices. There are increasing political and social pressures to provide the public with access to unconventional medical treatments, as evidenced by various recent federal and state legislative proposals. The committee believes that there may be substantial direct and indirect harm to patients resulting from enactment of such legislation unless appropriate safeguards are included. In order to fulfill state medical boards’ responsibility to protect the public from incompetent, unprofessional, improper, unlawful, fraudulent and/or deceptive medical practice, it is necessary for state medical boards to maintain legislative authority adequate to regulate all practices constituting the practice of medicine.”
Source: Section VI Legislative Strategies of the “SPECIAL COMMITTEE ON QUESTIONABLE AND DECEPTIVE HEALTHCARE PRACTICES FEDERATION OF STATE MEDICAL BOARDS OF THE UNITED STATES, INC. (Note: originally this report was produced by the Special Committee on Health Care Fraud. At the Federation’s 1999 House of Delegates meeting, the committee was renamed the Special Committee on Questionable and Deceptive Healthcare Practices. The Federation of State Medical Board’s governing body accepted this Report as policy in April 1997. Here FSMB is arrogant enough to seek to thwart the will of the people which is trending to seeking more laws allowing for “access to unconventional treatments”.
The interference of private trade lobbying organizations with appointed public servants (medical boards) was so egregious that in May 2012 two senators from the Finance Committee sent letters to the American Pain Foundation, three drug companies, and the FSMB, expressing concern about their undisclosed financial relationship with each other. Immediately, the Foundation announced that it would “cease to exist, effective immediately.” Coincidence? http://www.finance.senate.gov/newsroom/chairman/release/?id=021c94cd-b93e-4e4e-bcf4-7f4b9fae0047
Is it Legal for a Sanction to be Imposed which is Impossible to Fulfill?
Administrative bodies like MQAC are given tremendous deference by civil judges as expertise is presumed and the risk of corruption or self-service in restricting trade by the market participants on the administrative board is not considered. All that is demanded from MQAC and its allied agencies is that constitutionally protected rights of medical doctors must be protected and due process fairness be guaranteed under the State Constitution.
Here is another injustice which I suffered and which I expect will be corrected upon appeal. At the conclusion of my 2013 MQAC administrative hearing (i.e. kangaroo court hearing where the MQAC people played all the following roles: 1) accuser, 2) investigator 3) judge 4) jury 5) executioner) my license was suspended until I paid $5000 fine (done) and completed a “one year residency or fellowship equivalent”. Only after completing both parts of the sanction could I apply for reinstatement of my medical license to care for my patients.
That was 7 years ago. What happened?
Well within a couple months I learned that this part of the sanction was impossible to fulfill: “one year residency or fellowship equivalent”. Why? Because these programs all require that the doctor works and sees patients during the “one year residency or fellowship equivalent” and since my license was suspended and since all programs require that the doctor have an unlimited license, no “one year residency or fellowship equivalent” program would accept my application. I was in a “catch 22” wherein the sanction was impossible to fulfill and therefore my suspension was actually an unjustified and illegal de facto revocation.
When my attorney notified MQAC and the allied DOJ people in 2013 that the sanction was impossible to fulfill, my attorney was told that that is not MQAC’s problem. That was MQAC’s mistake. Finally after stonewalling me for 6 more years, the civil judge Hancock remanded the matter to MQAC – meaning that they needed now to determine whether the sanction “one year residency or fellowship equivalent” was fulfillable in 2013 when levied and whether it is fulfillable today in 2019. MQAC accepted the remand and finally admitted that the sanction was indeed impossible to fulfill and that they had actually revoked my license to care for my patients illegally – but not “intentionally”.
“In retrospect, it appears that the sanction may have been unintentionally doomed to impossibility by the realities of residency and fellowship requirements.” (page 6 line 18 ff)
So, whereas what I was accused of (i.e. being a “theoretical risk of harm to the public”) was not egregious enough to justify anything other than a suspension, I suffered actually a greater punishment – a de facto revocation for an additional 4 years past the original 3 year suspension. That is a violation of my constitutionally protected rights.
The Supreme Court of the United States (SCOTUS) landmark decision re. over-reaching by state administrative agencies like MQAC
In 2015, SCOTUS ruled that the North Carolina Dental Board (NCDB) was misbehaving. It was deemed that the NCDM was operating unconstitutionally by restraining trade because it was misusing the power of the state being 1) comprised of a majority or market participants and 2) not being adequately supervised by the state. See this powerful legal analysis of the case and how it bears on harassment of integrative medical doctors by state medical boards.
Professor Hamburger at Colombia Law school thinks administrative agencies are breaking the law. He refuses to describe what they do as “law” stating instead that they exercise “unchecked administrative power”. Prof. Hamburger describes medical boards as operating not according to law but rather with a power which is extra-legal. It is an area ripe with potential for abuse corruption and self-service.
Here is my most recent declaration asserting my case. Please have your lawyer review it. My hope is that the appellate judges will see the pattern of abusive harassment by MQAC in general against integrative medical doctors and in particular see the injustice against me where my constitutional rights were arbitrarily and capriciously violated my a corrupt state medical board for the past 7 years.
SUMMARY and INVITATION
So, that is the story of the persecution of Dr. Weeks spanning his entire career as an innovative and courageous medical doctor and culminating after 25 years with a 4 year investigation followed by immediate suspension of license by the state medical board (MQAC). The suspension was actually admitted to be an illegal de facto revocation and now, after 7 years of standing up for his constitutional rights, Dr. Weeks is excited to appeal his case in order to make the world safer for integrative medical doctors to serve their patients.
We need your help in broadcasting this case and our appeal for a legal defense fund to support this just cause.
Please broadcast this LINK to people interested in health care freedom.
In this story, as in life itself, we have people behaving honorably (innovative doctors like Dr. Weeks and his 26,000 integrative medical colleagues all of whom fear their state medial boards and all of whom tirelessly seek safe and innovative treatments which exceed the standard of care and in order to deliver superior treatments for informed patients like you who desire cutting edge medicine)
we have people behaving dishonorably (operating in the murkiness of extra-legal unconstitutional administrative processes conspiring to restrict the free trade and competition in violation of the following Washington state law).
Washington State law RCW 18.130.010 Section 34, lines 4-7, gives citizens freedom of choice re health care but MQAC is seeking to quash that law:
“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.”
That intent sounds reasonable and indeed this law reflects the spirit of citizens of Washington State who think that they are entitled to freedom of choice in selecting among a variety of health care options. Nevertheless MQAC has conspired against integrative medical doctors for almost 30 years and in doing so it has actually harmed the public by restricting their access to integrative care. It is far past time for this to injustice to stop.
HOW YOU CAN MAKE A DIFFERENCE
So what is your role in this dramatic story, dear reader?
Well, assuming (since you read this far!) that you are interested in health care freedom and are an intelligent, informed and discriminating consumer of health care, your role is to become politically active. Also, and very importantly, you and your company or friends can make a donation to Dr. Weeks’ legal defense fund to support his appeal. Consider this to be an investment in freedom of choice in health care and your opportunity to help draw a line in the sand against FSMB (puppet master of state medical board and agent of Corporate Medicine) -Big pHARMa, Big Insurance and the American Medical Association).
Please call Dr. Weeks today to learn how you can help his case and the case for health care freedom of choice. 360-341-2303
Your health is worth fighting for!
We are your champion and we are committed to fighting for your rights and the rights of your children to access freedom of choice in health care.
Consider an investment in preserving holistic medicine and freedom of choice in health care.
Please Donate today using either this PayPal link or by calling us up 360-341-2303 and specifying an amount to be charged to your credit card. Checks can be sent to Dr. Weeks PO Box 132 Langley WA 98260. And crypto can be sent to the Bitcoin wallet here
or using the code below.
All donations are honored and appreciated.
Friends of the Weeks Clinic