Dr. Krop gets knuckles rapped, but vows to fight college's "Inquisition" ======================================================================== * Charlotte Gray FIGURE Last June, Dr. Jozef Krop received a reprimand from the College of Physicians and Surgeons of Ontario on the grounds that he had "failed to meet the standard of practice" required of doctors in the province. The college's Discipline Committee found that the controversial champion of "environmental medicine" had used inappropriate tests, misdiagnosed conditions and recommended unproven therapies, and it said he owed "a debt of honesty" to his patients. Eleven conditions were imposed on Krop's practice in an attempt to ensure that he conformed to standards set by the college. ![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/161/11/1431/F1.medium.gif) [Figure1](http://www.cmaj.ca/content/161/11/1431/F1) Figure. Dr. Jozef Krop The sentencing followed a January conviction for professional misconduct, in which Krop's treatment of 6 patients was ruled substandard.1 The college had been investigating Krop since 1989; the Discipline Committee hearings alone lasted 3 years. On paper, the college decision is a stinging rebuke. But is it? "It was a total surprise to me," the 55-year-old Mississauga physician says. "After all the gross accusations I had faced - the vilification, the abuse of process, the unfairness - I had expected to be sent to a reformatory for re-education. I was convinced they would take away my Vega. "Instead, I am able to continue to practise the way I have always practised. I use the Vega daily. I haven't changed anything, except for a few minor adjustments to the consent form that patients sign." (The Vega machine is based on "bioenergetic regulatory theory," which Krop claims can determine biologic age and assess "geopathic stress." The Discipline Committee considered the machine "unscientific, inappropriate, unproven.") So Jozef Krop is a much happier man today than he was last spring, when he assumed that the college would revoke his licence to practise. But his relief has not mitigated his sense of injustice or his determination to fight on. The college investigation was not triggered by complaints from patients, and he was not charged with harming anyone. The committee itself admitted that "Dr. Krop is sincere, hard working and devoted to the well-being of his patients. His caring approach undoubtedly plays a major role in their healing." Now, Krop is determined to clear his name and restore his reputation. "I want the whole thing struck from the college's record." Even before his January conviction, Krop was determined to appeal the sentence to the Ontario Court. The Polish-born doctor, who originally trained as a pediatrician, has served notice of appeal to the civil court and is trying to raise the money required. The transcripts alone, which cover the 40 days of college hearings, will cost $60 000, and legal fees are estimated at $200 000. (He says his legal fees for the original college proceedings were provided by $900 000 in donations from supporters.) Krop and his supporters say the conviction and sentence are not simply an attack on an unorthodox practitioner. "The seemingly benign reprimand," says Krop, "is an Orwellian device to preserve the status quo." In a letter sent to friends and colleagues, he argued that if the decision was allowed to stand, it "will set the precedent to continue to victimize doctors in circumstances where no reasonable grounds exist to do so." He describes the opposition to complementary medicine as "often corrupt and unjust," and appeals for funds to help his fight for "the whole cause of freedom to offer all options in medical care." Krop maintains that the decision convicts not just him but also a wide range of complementary diagnosis methods and therapies. Among the ones he mentions are hair analysis, rotation diets, sauna therapy for chemical detoxification, intravenous vitamin C and provocation/neutralization testing for food and chemical sensitivity. "The college had no right to convict therapies," he says, and its decision will have a chilling effect on the approximately 300 physicians he says practise alternative medicine in Ontario. Krop's lawyer, Matthew Wilton, endorses his client's view that the college decision has wider implications. "If the Discipline Committee's decision is not set aside, then every environmental medicine and complementary physician faces the prospect of being prosecuted by the college for acts of professional misconduct." In addition, he says, the decision gives the Ontario Work-place Safety and Insurance Board reason to disregard claims by policy-holders who are receiving alternative medical therapies. "The Krop decision has the effect of devaluing the work of an entire segment of the medical profession." One of Krop's most outspoken supporters is Dr. William LaValley, who chairs the complementary medicine section of the Medical Society of Nova Scotia. "It was a kangaroo court," says LaValley, who describes the Discipline Committee's conclusions as "illogical and not based on evidence." LaValley is incensed that the committee said Krop had failed to maintain standards of practice when there are no written standards. During the 10 years Krop has been under scrutiny, he says, alternative therapies like yoga and acupuncture have moved into the mainstream in Ontario; the Ontario Medical Association now has a Complementary Medicine Section, with an environmental medicine subsection, and public demand for complementary therapies has snowballed. "But the college's ruling will slow the spread," says LaValley, "especially if the Inquisition comes after other practitioners." Dr. Roy Fox, director of Halifax's Environmental Health Clinic and a professor of medicine at Dalhousie University, was 1 of 9 expert witnesses called by Krop during the college hearings. He considers the college's conduct as "a travesty. The stress Dr. Krop was under, the length of time it took and the amount of money he has had to spend to defend himself were outrageous." He is also skeptical about the college's recommendations. "Who is going to monitor Jozef's compliance with the conditions? The college is in no position to monitor a physician who operates on a different paradigm." However, he does not share his colleagues' concerns about the wider significance of the judgement. "The trial was on Jozef's style of practice and decision-making - the committee didn't examine the scientific evidence properly. I wouldn't generalize from this experience. I don't think this will set a precedent across Canada." Moreover, Fox is less dismayed about the weight that insurance companies might give the decision because "in my experience they already disallow claims that are not based on conventional allopathic medicine." Nobody at the Ontario college was prepared to comment on the Krop case. "The decision stands on its own," says Jill Hefley, the director of public affairs and communications, "and we never comment on the decisions of the Discipline Committee. Since it may go to appeal, it would be totally inappropriate for us to discuss it." However, in a news release the college insists that "environmental medicine was not the issue being debated." Instead, said the college, the focus of the hearings was Krop's practice as it related to his management of the 6 patients whose charts were entered in evidence. It is not clear when the court will notify Dr. Krop if his appeal will be heard. It is not unusual for college decisions to be appealed to the civil courts, "but the success rate is low," says Hefley. ## Reference 1. 1. Gray C. Huge court fight may be in offing as Ontario college considers penalty for maverick MD. CMAJ 1999;160(6):877-9. [Abstract/FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czo5OiIxNjAvNi84NzciO3M6NDoiYXRvbSI7czoyMjoiL2NtYWovMTYxLzExLzE0MzEuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9)