Dr. Krop’s Punishment: Alternative Medicine at Risk?

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Helke Ferrie

A dubious form of justice was rendered by the College of Physicians of Ontario (CPSO) in January of this year when it found Dr. Jozef Krop guilty of "professional misconduct" for his treatment of six patients using unconventional therapies. (See "The Kafka- esque Conviction of Dr. Jozef Krop," Fraser Forum, March 1999.) The 10-year disciplinary investigation of Dr. Krop, an environmental medicine expert, concluded after a 2-day sentencing hearing on June 22. There, the CPSO sentenced Dr. Krop by imposing 11 conditions on his future practice. In sum, these conditions require Dr. Krop to inform his patients of the expected consequences of his therapies and apprise them of conventional treatment options. These stipulations were imposed to ensure that his patients may provide "informed consent" to any treatment he recommends, and are based on 1997 CPSO guidelines (the so-called "Walker Report"). Dr. Krop has appealed his sentence in the Ontario Provincial Court.

Does Dr. Krop deserve this punishment? The CPSO, in fact, did not prove acts of medical misconduct. Dr. Krop was, rather, convicted for diagnosing and treating systemic candidiasis, chemical sensitivity, sick building syndrome, and similar conditions. Moreover, the CPSO acknowledged that the patients thus diagnosed and treated improved as a result.

The Krop Case began in 1989 with the CPSO seeking to prove incompetence and impose revocation of license. A decade later, they backed down to the lesser charge of "falling below the standard of medical practice in Ontario" and issued a strangely worded reprimand. The CPSO’s sentence of Dr. Krop opened with the statement that Dr. Krop may continue to use all of his previous supposedly substandard practices, provided fully informed patient consent is obtained (which he had always obtained). He is also required to adhere to the guidelines of the CPSO’s 1997 Walker Report for complementary physicians: "In assessing patients, members of this profession should henceforth be expected to ... reach a conventional diagnosis first and use generally accepted modalities."

The CPSO, however, is bound by the Regulated Health Professions Act which contains no reference to or definitions of "conventional diagnosis" which would provide a universal standard. Thus, this first-time use of an internal CPSO policy report as an instrument of punishment is alarming, especially since the Walker Report is deeply flawed medically. It is the equivalent of plumbers telling electricians how to do their job; it came into being by ignoring democratic procedure; it was handed down after doctors practising complementary medicine had had their repeated requests to be part of that committee unilaterally rejected. The Walker Report’s worst flaw is evident in its alarmingly anti-scientific assumption that the past must be the sole source of current and future standards of practice.

A great deal of public pressure was brought to bear on the resolution of Dr. Krop’s case. A full two-page report in the Toronto Star on February 28 by Michael Downey emphasized the CPSO’s abuses in the Krop Case. Other papers published similar articles.

Eleven national and Ontario-based patient advocacy groups held their second press conference on January 21 at the Ontario legislature buildings, supporting Dr. Krop. The Ontario Society of Physicians for Complementary Medicine joined forces with the Ontario Society for Environmental Medicine in a press conference in support of Dr. Krop on February 11th, criticizing the CPSO for systemic bias. Pressure was also exerted by politicians who have had personal experience with environmental illness. The Canadian Medical Association Journal ran an article in its March 23 issue presenting, for the first time, a rather balanced view of the Krop Case in a mainstream medical publication.

In contravention of Canadian medical legislation guiding the CPSO [Ontario’s Regulated Health Disciplines Act section 64 (3)], most of the information upon which the CPSO relied to try Dr. Krop was shredded by them, as their officers stated themselves in cross-examination. The Health Disciplines Act (then section 64, now section 75) requires that "reasonable and probable grounds" must exist to believe that "an act of professional misconduct or incompetence" has occurred. No such act was ever proven by the prosecution. The case proceeded without patient or peer complaints.

All scientific literature published after 1990 (including Dr. Krop’s own publications) introduced by the defense, as well as the exhaustive peer review of Dr. Krop’s practice prepared by the American Academy of Environmental Medicine (of which Dr. Krop is a Fellow), were dismissed as "lacking the authority of acceptable scientific evidence." But most of the important research in environmental medicine was published after 1990, when many of its conclusions became part of World Health Organization statements. Dr. Krop’s use of treatments pioneered in Europe were dismissed because they were not North American.

The June 21 and 22 sentencing began with picketers and police outside the CPSO in Toronto. A delegation of citizens marched in formal procession to the Ontario legislature buildings and presented a petition to MPP Monty Kwinter (Liberal opposition). His "Kwinter Bill" seeks to prevent further witch-hunts of doctors. During the lunch break, a well-attended press conference in support of Dr. Krop was held in the legislature.

During the proceedings, the very patients on whose files the entire case rested were never cross-examined, but they finally took the stand at the sentencing hearings. Their histories ranged from food allergies to sick building syndrome and shared the common theme of the failure of conventional medicine to diagnose their conditions, let alone to treat them successfully, and the often dramatic improvement offered by clinical ecology, in which Dr. Krop specializes. One child, chronically ill for years, who had been scheduled for corrective spinal surgery, recovered under Dr. Krop’s treatment, which identified systemic allergies and a compromised immune system as the problem; surgery was cancelled, and she went on to become a figure skating champion. The prosecution lawyer, Mr. R. Armstrong, interrupted this testimony, declaring it to be "just another example of how the defense has tried to derail these proceedings for years with their shenanigans!"

One of Dr. Krop’s lawyers, Morris Manning, a prominent medical law expert, once observed that this was a truly Kafkaesque case. The sentence reminds one of the scene in Kafka’s 1925 novel, The Trial, when the hero must chose between "apparent acquittal, and postponement of acquittal," a true acquittal based on proven innocence being impossible. The CPSO sentence means postponement of acquittal, leaving the field open to further abuse of patient’s rights and more "test" cases against doctors, regardless of the ever-increasing supportive science.

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