Disciplinary Action against Yvoune K. Petrie, D.C.
Stephen Barrett, M.D.
Yvoune Petrie is a chiropractor who directed and practiced for several years at Virginia Functional Medicine, a clinic in Vienna, Virginia. In 2013, as shown below, the Virginia Board of Medicine concluded that (a) she had engaged in misleading advertising by representing that she could "reverse" Type II diabetes and (b) such services were outside the legally authorized scope of practice for chiropractors. The board then fined her $25,000 and suspended her license for a minimum of six months, after which she could apply for reinstatement provided:
- Her practice complies with Virginia law, which does authorize chiropractors tom diagnose, manage, or treat thyroid disease, diabetes, or metabolic disease, or interpret medical tests or examinations
- Her practice does not include or imply that it includes the prevention, diagnosis, and treatment of human physical or mental ailments, conditions, diseases, pain or infirmities by any means or method, which is the statutory definition of the "practice of medicine or osteopathic medicine"
- Her promotional materials do not claim she can prevent, diagnose, or treat such ailments,
- She does not administer or prescribe any drugs, medicines, serums, or vaccines.
Petri appealed the board's order to a circuit court, which upheld the board's order. She then appealed to the Virginia Court of Appeals and filed a federal antitrust suit that sought to overturn the licensing board's action. The antitrust complaint (amended in 2014) asserted that regulating blood sugar and treating the underlying cause of thyroid disease are within the scope of chiropractic because they "normalize the transmission of nerve energy, which is a hallmark of chiropractic treatment." This complaint also alleged that the Board's action was intended to prevent chiropractors from competing with medical doctors. The Virginia Court of Appeals denied her appeal on grounds that it was too late to raise issues that were not raised during the board proceedings. The federal court subsequently ruled that Petrie failed to show any actual anti-competitive effect or conspiracy to restrain trade, and, in 2016, the U.S. Court of Appeals agreed. The clinic, is now doing business as Virginia Integrative Health LLC, with two physicians and a chiropractor offering services.
BEFORE THE BOARD OF MEDICINE
IN RE: YVOUNE KARA PETRIE, D.C.
License No.: 0104-556481
In accordance with the provisions of Sections 54.1-105, 54.1-110, 2.2-4020 and 2.2-4021 of the Code of Virginia (1950), as amended ("Code"), a formal administrative hearing was convened before the Virginia Board of Medicine ("Board"), on February 22, 2013, in Henrico, Virginia, to receive and act upon evidence that Yvoune Kara Petrie, D.C., may have violated certain laws governing the practice of chiropractic in the Commonwealth of Virginia. These matters are set forth in the Board's Notice of Formal Hearing and Statement of Particulars dated September 14, 2012.
Pursuant to Sections 2.2-4024.F and 54.1-2400(11) of the Code, the hearing was held before a panel of the Board with a member of the Board presiding. Erin L. Barrett, Assistant Attorney General, was present as legal counsel for the Board. The proceedings were recorded by a certified court reporter. The case was prosecuted by Corie E. Tillman Wolf, Assistant Attorney General, assisted by Gerald A. Milsky, Adjudication Specialist. Dr. Petrie appeared at the formal administrative hearing and was represented by L. Thompson Hanes, Esquire.
FINDINGS OF FACT
Now, having properly considered the evidence and testimony presented, the Board makes the following findings of fact by clear and convincing evidence:
1. Yvoune Kara Petrie, D.C., was issued license number 0104-556481 by the Board to practice chiropractic in Virginia on July 12, 2006. Said license is currently active and will expire on September 30, 2014, unless renewed or otherwise restricted.
2. Dr. Petrie advertised and/or represented her services in a manner that is false, deceptive, and misleading. Specifically:
a. Dr. Petrie practices as a chiropractor under the name "Virginia Functional Medicine" while simultaneously engaged in business and holding herself out as, and advertising herself to be, by implication in her advertising and on her Internet website, a diet and nutrition counselor under the same business name and the same business address.
b. Dr. Petrie's references to her credentials as a chiropractor in her advertisements and on her Internet website for her diet and nutrition counseling business are misleading to those viewing such advertisements and website, as they imply that Dr. Petrie's credentials and license as a chiropractor provide her with specialized knowledge in the treatment of the underlying causes of Type II diabetes.
c. On or about May 19, 2010, Dr. Petrie told Individuals X and Y, prospective patients who had come to her office in response to her newspaper advertisement, that her treatment could "reverse" Type II diabetes. Dr. Petrie further told Individual X that her treatment could "reverse" his erectile dysfunction condition.
3. Dr. Petrie provides services that exceed the scope of practice for chiropractic, as defined in Section 54.1-2900. Specifically:
a. By her own admission, Dr. Petrie provides treatment of Type II Diabetes to individuals with diabetes, including diet and nutrition counseling, that Dr. Petrie claims is designed to "reverse" diabetes.
b. By her own admission, Dr. Petrie regularly orders blood, saliva, stool, and urine tests that are unrelated to the definition of "practice of chiropractic" for those she treats for Type II Diabetes.
4. Dr. Petrie holds herself out, and advertises herself to be, by implication in her advertising and on her Internet website, a qualified dietician or nutritionist without satisfying the criteria set forth in Section 54.1-2731 of the Code and! or 18VAC75-30-10 of the Regulations Governing Standards for Dietitians and Nutritionists (18VAC75-30-10 et seq.).
5. Dr. Petrie advertises and/or represents her services in a manner that is false, deceptive, and misleading. Specifically:
a. In or about 2011, Dr. Petrie published or caused to be published a newspaper advertisement for "Liposuction without surgery" using the ''Zerona™ [sic] laser" that identifies her only as "Dr. Petrie" without including a clarifying title, initials or language that identifies the type of practice for which she is licensed.
b. The references to "Dr. Petrie" in her newspaper advertisement for "Liposuction without surgery" are misleading to those viewing the advertisement as they imply that Dr. Petrie's credentials and license as a chiropractor provides her with specialized knowledge of rapid weight loss.
c. On or about June 6, 2011, Dr. Petrie entered into an agreement with Patient A for six treatment sessions under the title "Zerona® Laser Inch Loss (2 Week) Special." At that time, Dr. Petrie informed Patient A that the average inch loss from the treatments was 3.64 inches in 80 of patients, and that 20 of patients have no inch loss. However, knowing that Patient A had consulted Dr. Petrie specifically with regard to reducing his "love handles," Dr. Petrie failed to adequately and completely explain to Patient A how she measured inch loss, i.e. a total of inches lost in the waist, hips, and thighs combined. Further, Dr. Petrie failed to provide an explanation of the manner in which the benchmark waist, hip, and thigh measurements against which she would measure results were determined and recorded. As a result, there was no adequate means for Patient A to understand the standard that would be applied in Dr. Petrie's determination as to whether the treatments met her minimum guarantee.
6. Dr. Petrie provides services that exceed the scope of practice for chiropractic, as defined in Section 54.1-2900 of the Code. Specifically, by her own admission, Dr. Petrie provides, in her capacity as a licensed chiropractor, "non-invasive dermatological aesthetic treatment for the reduction of circumference of hips, waist, and thighs," which treatments are unrelated to the definition of and outside the scope of the practice of chiropractic.
7. Dr. Petrie permits individuals under her supervision to engage in the unlicensed practice of medicine. Specifically, by her own admission, Dr. Petrie trains, authorizes, and directs unlicensed members of her staff to independently perform cosmetic procedures on patients. In performing these cosmetic procedures, the unlicensed individuals utilize intense pulsed light devices that involve revision, destruction, incision or other structural alteration of human tissue, constituting "laser surgery" within the meaning of Section 54.1-2400.01 of the Code, and hence the practice of medicine.
8. Dr. Petrie testified that she used to perform traditional chiropractic adjustments, but is currently unable to provide such adjustments due to a medical disability.
9. Dr. Petrie testified that, pursuant to the advice of her attorney, she had discontinued treating patients with the Zerona® laser.
CONCLUSIONS OF LAW
1. Finding of Fact No.2 constitutes a violation of Sections 54.1-2915.A(12), (13), (15), (16), and (18) of the Code, and 18V AC85-20-30.E of the Board of Medicine General Regulations.
2. Finding of Fact No.3 constitutes a violation of Sections 54.1-2915.A(3), (13), and (16) of the Code.
3. Finding of Fact No.4 constitutes a violation of Sections 54.1-2915.A(16) and (18), and Sections 54.1-111.A(3), (4), and (8) of the Code.
4. Finding of Fact No. 5 constitutes a violation of Sections 54.1-2903, 54.1-2915.A(12), (13), (15), (16), and (18) of the Code, and 18V AC85-20-30.E of the Board of Medicine General Regulations.
5. Finding of Fact No.6 constitutes a violation of Sections 54.1-2915.A(3), (13), and (16) of the Code.
6. Finding of Fact No.7 constitutes a violation of Sections 54.1-2915.A (3), (12), (13), (16), and (18) of the Code, and 18VAC 85-20-29.A(1) of the Board of Medicine General Regulations.
WHEREFORE, based on the foregoing Findings of Fact and Conclusions of Law, it is hereby ORDERED that the license of Yvoune Kara Petrie, D.C., is SUSPENDED for a period of not less than six (6) months from entry of this Order.
Upon the entry of this Order, the license of Dr. Petrie will be recorded as SUSPENDED and no longer current.
Pursuant to Section 54.1-2920 of the Code, upon entry of this Order, Dr. Petrie shall forthwith give notice, by certified mail, of the suspension of her license to practice chiropractic to all patients to whom she is currently providing services. A copy of this notice shall be provided to the Board when sent to patients. Dr. Petrie shall cooperate with other practitioners to ensure continuation of treatment in conformity with the wishes of the patient. Dr. Petrie shall also notify any hospitals or other facilities where she is currently granted privileges, and any health insurance companies, health insurance administrators or health maintenance organizations currently reimbursing her for any of the healing arts.
Further, it is ORDERED that Dr. Petrie shall pay a MONETARY PENALTY in the amount of twenty-five thousand ($25,000.00) dollars. Said monetary penalty shall be paid to the Board in not less than six (6) months from entry of this Order.
It is further ORDERED that in not less than six (6) months from entry of this Order, Dr. Petrie shall submit written certification to the Board attesting that all promotional or patient educational materials, in paper form, electronic form, or other, will comply with Board regulations applicable to advertisements.
Upon receipt of evidence satisfactory to the Board of Dr. Petrie's compliance with the above requirements, the Board authorizes the Executive Director to terminate the suspension of Dr. Petrie's license, and to REINSTATE her license subject to the following conditions.
Dr. Petrie is prohibited from advertising that her completion of any training or continuing education, or her provision of training or continuing education to others, provides her with expertise in any subject unless such training or continuing education is received from or provided through an institution or course approved by the Council on Chiropractic Education. All advertised training or expertise that does not meet the above criteria must be removed from all current and prospective advertising materials utilized by or on behalf of Dr. Petrie.
Dr. Petrie is prohibited from referring to herself or allowing others to refer to her as "doctor" without inclusion of the clarifying term "doctor of chiropractic" in her current and prospective promotional materials, in paper form, electronic form, or other, office signage, printed informational material, or public appearances.
Dr. Petrie shall limit her practice of chiropractic to the scope of practice as defined under Section 54.1-2900 of the Code of Virginia, which does not include the diagnosis, management, or treatment of thyroid disease, diabetes, metabolic disease, or interpreting medical tests or examinations. Dr. Petrie's chiropractic practice shall also not include or imply that the practice includes the prevention, diagnosis and treatment of human physical or mental ailments, conditions, diseases, pain or infirmities by any means or method, which is the statutory definition of the "practice of medicine or osteopathic medicine" as defined in Section 54.1-2900 of the Code of Virginia.
Dr. Petrie shall not claim to prevent, diagnose, or treat the traditional ailments, conditions and diseases of medicine or surgery, obstetrics, or osteopathy in any of her promotional materials, in paper form, electronic form, or other, and Dr. Petrie shall not administer or prescribe any drugs, medicines, serums or vaccines.
Violation of this Order may constitute grounds for the suspension or revocation of Dr. Petrie's license. In the event that Dr. Petrie violates this Order, an administrative proceeding may be convened to determine whether such action is warranted.
As provided by Rule 2A:2 of the Supreme Court of Virginia, Dr. Petrie has thirty (30) days from the date of service (the date she actually received this decision or the date it was mailed to her, whichever occurred first) within which to appeal this decision by filing a Notice of Appeal with William L. Harp, M.D., Executive Director, Board of Medicine, at 9960 Mayland Drive, Suite 300, Henrico, Virginia 23233. In the event that this decision is served by mail, three (3) days are added to that period.
Pursuant to Sections 2.2-4023 and 54.1-2400.2 of the Code, the signed original of this Order shall remain in the custody of the Department of Health Professions as a public record, and shall be made available for public inspection and copying upon request.
FOR THE BOARD
William L. Harp, M.D.
V Virginia Board of Medicine
ENTERED: 2/28/13This article was revised on May 17, 2016..