1 See Quacks, Bogus Treatments Infect the Internet, San Antonio Express-News, Oct. 21, 1996, at 1D [hereinafter Bogus Treatments].
2 Diane Jennings, Bitter Pill to Swallow; ‘Cybermedicine’ Simplicity Has Fans but Raises Concerns, Dallas Morning News, Nov. 6, 1998, at 1A.
3 See Alan S. Goldberg & Jocelyn F. Gordon, Telemedicine: Emerging Legal Issues 1–2 (1998); Barbara J. Tyler, Cyberdoctors: The Virtual Housecall—The Actual Practice of Medicine on the Internet is Here; Is it a Telemedical Accident Waiting to Happen?, 31 Ind. L. Rev. 259, 259–63 (1998).
4 See Goldberg & Gordon, supra note 3, at 1.
5 See Nicholas P. Terry, Cyber-Malpractice: Legal Exposure for Cybermedicine, 25 Am. J.L. & Med. 327, 328 (1999).
6 See Jennings, supra note 2, at 1A; Bogus Treatments, supra note 1, at 1D.
7 See Gunther Eysenbach & Thomas L. Diepgen, Evaluation of Cyberdocs, 353 The Lancet 1526, 1526 (1998); Bogus Treatments, supra note 1, at 1D; Good Morning America: Internet House Calls (ABC television broadcast, Aug. 3, 1999) (transcript #99080311-j01) [hereinafter Good Morning America]. A quack is “a pretender to medical skill” or “dishonest practitioner.” Webster’s Third New International Dictionary 1856 (Philip Babcock Gove ed., 1986).
8 See Jennings, supra note 2, at 1A; Gary Baldwin, Web Rx, Am. Med. News, Aug. 3, 1998, at 23.
9 See Jan Greene, Sign on and Say ‘Ah-h-h-h-h,’ Hosp. & Health Networks, Apr. 20, 1997, at 45; Bogus Treatments, supra note 1, at 1D.
10 See Jennings, supra note 2, at 1A.
11 See id.; Bogus Treatments, supra note 1, at 1D.
12 See George F. Indest, III & Barbara A. Egolf, Is Medicine Headed for an Assembly Line? Exploring the Doctrine of the Unauthorized Corporate Practice of Medicine, 6 Bus. L. Today 32, 33–34 (1997).
13 See id.
14 See infra notes 17–103 and accompanying text.
15 See infra notes 104–199 and accompanying text.
16 See infra notes 200–254 and accompanying text.
17 See Goldberg & Gordon, supra note 3, at 1.
18 See Alissa R. Spielberg, Online Without a Net: Physician-Patient Communication by Electronic Mail, 25 Am. J.L. & Med. 267, 268 (1999).
19 See id.; Alissa R. Spielberg, On Call and Online: Sociohistorical, Legal, and Ethical Implications of E-Mail for the Patient-Phyisician Relationship, 280 JAMA 1353, 1354 (1998).
20 Goldberg & Gordon, supra note 3, at 1.
21 See id. “Real-time” communication refers to communication via the Internet whereby computer users exchange written messages instantaneously transmitted through cyberspace, thereby creating the effect of a “live” conversation. See Greene, supra note 9, at 45; CyberDocs Today Announced the First Virtual Doctors Office on the World Wide Web!, M2 Presswire, Oct. 4, 1996, available at 1996 WL 11276562 [hereinafter CyberDocs Today Announced].
22 See Spielberg, supra note 18, at 269–70; Terry, supra note 5, at 328.
23 See, e.g., Spielberg, supra note 18, at 269; Christine Gorman, E-Mail Your Doctor; Frustrated by Phone Tag? Join the Growing Ranks of Doctors and Patients Talking Through the Net, Time, Aug. 17, 1998, at 82; Richard Saltus, Take Two Aspirin and E-Mail Me in the Morning, Boston Globe Mag., Jan. 18, 1998, at 11.
24 See Terry, supra note 5, at 327.
25 See id.
26 See id.
27 See id. at 335–36; Tyler, supra note 3, at 263.
28 See CyberDocs, at http://www.cyberdocs.com (last visited Apr. 8, 2000); Terry, supra note 5, at 349; Aaron Zitner, Cybermedicine Seen as Unhealthy by Some; Concerns Voiced Over Diagnosing Ills, Prescribing Medicine on ‘Net, Boston Globe, Aug. 6, 1998, at C1. Among other websites offering Internet medical consultations are Go Ask Alice! and Yahoo!. See Go Ask Alice!, at http://www.goaskalice.columbia.edu/about.html (last visited Apr. 8, 2000); Yahoo!, at http://www.yahoo.com/Health (last visited Apr. 8, 2000).
29 See Zitner, supra note 28, at C1; CyberDocs Today Announced, supra note 21.
30 See Tyler, supra note 3, at 285–86. A typical visit to CyberDocs costs fifty dollars. See id.
31 See id. at 286. A “cyberdoctor” is one who practices medicine over the Internet. See Lisa Ramirez, ‘Cyberdocs’ Popular, But Potentially Dangerous Some Say, Knight Ridder Washington Bureau, July 26, 1999.
32 See Zitner, supra note 28, at C1.
33 See Pill Box Pharmacy, at http://www.pillboxpharmacy.com/services.html (last visited Apr. 8, 2000); Jennings, supra note 2, at 1A. Other online pharmacies include U-Save Pharmacy and SafeNet Pharmacy. See U-Save Pharmacy, at http://www.capc.com/usave/ index.html (last visited Apr. 8, 2000); SafeNet Pharmacy, at http://www.safenet-pharmacy.com (last visited Apr. 8, 2000).
34 See Jennings, supra note 2, at 1A.
35 See id.
36 See id.
37 Marc Fisher, The Doctor is Out; When Illness Struck, He Plunged into the New Medical Reality—And Discovered That the Line Between Patient and Physician is Gone, The Washington Post, July 19, 1998, at W08.
38 See id.
39 See id.
40 See Tyler, supra note 3, at 263; Bogus Treatments, supra note 1, at 1D.
41 See Tyler, supra note 3, at 263; Greene, supra note 9, at 45.
42 See Tyler, supra note 3, at 259.
43 See id.
44 See id.
45 See id.
46 See id. at 260.
47 See Jennings, supra note 2, at 1A.
48 See id.
49 See id.
50 See id.
51 See Eryn Brown, Where to Find Medical Advice on the Web, Fortune, Mar. 17, 1997, at W2.
52 See id.; Jo Revill, Cyberchondriacs, Evening Standard, Nov. 15, 1999, at 10.
53 See Revill, supra note 52, at 10.
54 See, e.g., Ramirez, supra note 31; Jamie Talan, Medical Advice Gets Caught in the Web; Legality of Practice is Issue, Ariz. Republic, Nov. 5, 1998, at HL1; Bogus Treatments, supra note 1, at 1D. Dr. Nancy Dickey, president of the AMA, has expressed her view that cybermedicine is “not good medicine” and is “something to be terribly concerned about.” Jennings, supra note 2, at 1A.
55 See Tyler, supra note 3, at 288; Ramirez, supra note 31; Let the Surfer Beware, Newsweek, Nov. 16, 1998, at 90.
56 See Tyler, supra note 3, at 288; Zitner, supra note 28, at C1; Greene, supra note 9, at 45.
57 Ramirez, supra note 31.
58 See id.
59 See, e.g., Bogus Treatments, supra note 1, at 1D; Good Morning America, supra note 7.
60 See Bogus Treatments, supra note 1, at 1D; Good Morning America, supra note 7. Certain cybermedicine websites provide information regarding the qualifications of their doctors on staff. See Greene, supra note 9, at 45. CyberDocs, for example, posts copies of the physicians’ degrees, board certification, and licenses on its website. See id. Despite these safeguards, however, the Internet remains vulnerable to persons practicing medicine under invalid or false credentials. See Elizabeth M. Cosin, Surfing the Web Just Might Save or Extend a Life, San Diego Union-Trib., Nov. 4, 1996, at E-4; Good Morning America, supra note 7.
61 Ramirez, supra note 31.
62 See Good Morning America, supra note 7. There have been numerous other incidents where unlicensed doctors were found to be giving medical advice on the Internet. South Carolina medical regulators discovered that a doctor who had previously lost his license was giving medical advice on the Internet. See Greene, supra note 9, at 45. Likewise, members of the news service, Newsday, found out that Walter Scholl was a medical consultant for the Prodigy online service despite have lost his license two years earlier. See Bogus Treatments, supra note 1, at 1D.
63 See Good Morning America, supra note 7.
64 See id.
65 See id.
66 See id.
67 See Eysenbach & Diepgen, supra note 7, at 1526.
68 See id.
69 See id. These symptoms describe a textbook case of shingles in an immunosuppressed person. Let the Surfer Beware, supra note 55, at 90.
70 See Eysenbach & Diepgen, supra note 7, at 1526.
71 See id.
72 See id.
73 See id.
74 Id.
75 Eysenbach & Diepgen, supra note 7, at 1526.
76 See id.
77 Jennings, supra note 2, at 1A; Baldwin, supra note 8, at 23.
78 See, e.g., Dr. Robert Baker, ‘Ah Yes, Cancer—Just a Click Here for a Cure,’ Independent (U.K.), Nov. 18, 1999, at 9; Fisher, supra note 37, at W08. Furthermore, medical information sites are vehicles to advertise and sell products. See Tyler, supra note 3, at 273. Advertisers spent $74 million on Internet advertising in 1996 alone. See id.
79 See Jennings, supra note 2, at 1A; Baldwin, supra note 8, at 23.
80 Jennings, supra note 2, at 1A.
81 See id.
82 See id.
83 See id.
84 See Greene, supra note 9, at 45; Bogus Treatments, supra note 1, at 1D.
85 See Goldberg & Gordon, supra note 3, at 3.
86 See id.
87 See id.; Spielberg, supra note 18, at 291.
88 See Goldberg & Gordon, supra note 3, at 4.
89 See id. at 4–5; Ranney V. Wiesemann, Note, On-Line or On-Call? Legal and Ethical Challenges Emerging in Cybermedicine, 43 St. Louis U. L.J. 1119, 1146 (1999).
90 See Rita Rubin, Prescribing On Line: Industry’s Rapid Growth, Change Defy Regulation, USA Today, Nov. 2, 1998, at 1A (reporting that, despite ongoing investigations by five states—Arizona, Colorado, Nevada, Texas, and Washington—into doctors performing online consultations for Viagra prescriptions, no physicians had been disciplined or taken into court). But see Jennings, supra note 2, at 1A (noting that Ohio issued several cease-and-desist orders against pharmacies who were unlicensed in Ohio yet shipped pills there).
91 See Wiesemann, supra note 89, at 1148; Jennings, supra note 2, at 1A.
92 See Jennings, supra note 2, at 1A. Dr. Steven Kohler, co-founder of CyberDocs, predicts and recognizes the necessity of the creation of regulatory agencies to stem the abuses in cybermedicine. See id.
93 See Improved Access for Telehealth Act of 1997, H.R. 966, 105th Cong. (1997); Comprehensive Telehealth Act of 1997, S. 385, 105th Cong. (1997). In 1997, Representative Larry Combest (R-Tex.) and Senator Kent Conrad (D-N.D.) each introduced a bill in the House and Senate, respectively, that called for a study of physician licensure and telemedicine; neither bill was voted upon by Congress. See Improved Access for Telehealth Act of 1997, H.R. 966, 105th Cong. (1997); Comprehensive Telehealth Act of 1997, S. 385, 105th Cong. (1997).
94 See Goldberg & Gordon, supra note 3, at 5. The Model Act envisions a licensing scheme where physicians wishing to practice over state lines could obtain a special license from their own state medical board, without having to complete the full licensing process in the other states where they wish to practice medicine. See Telemedicine: Model Act Would Create Special Licenses for Physicians Practicing Telemedicine, Health L. Rep. (BNA) No. 43, at 1645 (Nov. 2, 1995).
95 See Goldberg & Gordon, supra note 3, at 6. The Model Act does not specify any medium of interstate medical practice that it seeks to regulate; rather, the Act proposes a generic “special purpose license to practice medicine across state lines.” See id. at 5. Only Alabama and Texas have enacted legislation based on the Model Act. See id. at 6.
96 See Spielberg, supra note 18, at 291–92; Goldberg & Gordon, supra note 3, at 5. States, rather than the federal government, traditionally have governed health care and the practice of medicine under the police power of the Tenth Amendment. See Joy Elizabeth Matak, Note, Telemedicine: Medical Treatment Via Telecommunications Will Save Lives, But Can Congress Answer the Call?, 22 Vt. L. Rev. 231, 240 (1997).
97 See Terry, supra note 5, at 359–60; Tyler, supra note 3, at 285.
98 Tyler, supra note 3, at 285.
99 See id. Though the issue lies beyond the scope of this Note, some commentators see the need for the creation of an international regulatory body to issue cybermedicine licenses. See Eysenbach & Diepgen, supra note 7, at 1526.
100 See Terry, supra note 5, at 359.
101 See id.
102 See id.
103 See id. at 360.
104 See Indest & Egolf, supra note 12, at 33–34. The corporate practice of medicine doctrine is alternately referred to as the “prohibition on the corporate practice of medicine” or the “unauthorized corporate practice of medicine doctrine.” Id.
105 See id.
106 NHLA/AAHA, Patient Care and Professional Responsibility: Impact of the Corporate Practice of Medicine Doctrine and Related Laws and Regulations 6 (1997); Jeffrey F. Chase-Lubitz, Note, The Corporate Practice of Medicine Doctrine: An Anachronism in the Modern Health Care Industry, 40 Vand. L. Rev. 445, 470–71 (1987). A few states maintain a strong and strictly enforced prohibition against the corporate practice of medicine, including California and Texas. See California Medical Practice Act, Bus. & Prof. § 2000 et seq. (1990); Tex. Rev. Civ. Stat. Ann. art. 4495b, §§ 3.07(f), 3.08(12), and 3.08(15) (West 2000). Many states such as Kansas, Massachusetts, and Minnesota enforce the corporate practice of medicine doctrine subject to certain well-defined exceptions. See Kan. Stat. Ann. § 65–2801 et seq. (1992) (exempting hospitals from the doctrine); Mass. Gen. Laws ch. 112, § 6 (1996); Mass. Gen. Laws ch. 111, § 51 (1996); Mass. Gen. Laws ch. 176B, § 7 (1996) (prohibiting the corporate practice of medicine other than by a physician-owned entity or a licensed clinic); Minn. Stat. § 147.081 (1998) (exempting non-profit corporations from the doctrine). A few states, including Arkansas and Oklahoma, maintain statutes which would suggest a ban on the corporate practice of medicine but do not actively enforce the doctrine. See Arkansas Medical Practice Act, Ark. Code Ann. § 17–95–101 et seq. (Michie 1995); Okla. Stat. tit. 59, §§ 491–494 (1989). Finally, a few states, including Florida, Maine, Missouri, and Vermont, have neither a statutory nor common law prohibition against the corporate practice of medicine. See generally D. Cameron Dobbins, Survey of State Laws Relating to the Corporate Practice of Medicine, 9 Health Law. 18 (1997).
107 See Indest & Egolf, supra note 12, at 34.
108 See id.
109 See id. at 33.
110 See George Rosen, The Structure of American Medical Practice 1875–1941, at 19 (1983); Paul Starr, The Social Transformation of American Medicine 82–83 (1982).
111 See NHLA/AAHA, supra note 106, at 3. Popular medical treatments during the nineteenth century included bloodletting, purging and administering heavy dosages of mercury or quinine. Rodney Coe, Sociology of Medicine 181–82 (1970).
112 See NHLA/AAHA, supra note 106, at 3; Rosen, supra note 110, at 19.
113 See Carleton Chapman, Physicians, Law, and Ethics 103 (1984).
114 See id. at 106.
115 See Andre Hampton, Resurrection of the Prohibition on the Corporate Practice of Medicine: Teaching Old Dogma New Tricks, 66 U. Cin. L. Rev. 489, 499 (1998).
116 NHLA/AAHA, supra note 106, at 4; Starr, supra note 110, at 198–206; see also James Burrow, Organized Medicine in the Progressive Era 119 (1977) (noting that “contract practice stood out in the Progressive Era as the most dangerous threat to whatever degree of unity the regular medical profession had achieved”).
117 See NHLA/AAHA, supra note 106, at 4; Starr, supra note 110, at 200–06; Burrow, supra note 116, at 119–20.
118 See Starr, supra note 110, at 204–06.
119 See Jeffrey Berlant, Medical Ethics and Monopolization, in Ethics in Medicine: Historical Perspectives and Contemporary Concerns 61, 61 (J. Reiser et al. eds., 1977).
120 See NHLA/AAHA, supra note 106, at 4; Berlant, supra note 119, at 61.
121 See Berlant, supra note 119, at 61.
122 See NHLA/AAHA, supra note 106, at 4.
123 See id.; Joseph Laufer, Ethical and Legal Restrictions on Contract and Corporate Practice of Medicine, 6 L. & Contemp. Probs. 516, 519 (1939).
124 See Hampton, supra note 115, at 501.
125 See id. at 499; Chase-Lubitz, supra note 106, at 464.
126 See Garcia v. Texas State Bd. of Med. Exam’rs, 384 F. Supp. 434 (W.D. Tex. 1974); People v. United Med. Serv., Inc., 200 N.E. 157 (Ill. 1936); see also Alanson Willcox, Hospitals and the Corporate Practice of Medicine, 45 Cornell L.Q. 432, 436 (1960).
127 See, e.g., Cal. Bus. & Prof. Code § 2400 (West Supp. 1987) (providing that “[c]orporations and other artificial legal entities shall have no professional rights, privileges, or powers”). But see Colo. Rev. Stat. § 12–36–134(7) (1985) (noting explicitly that corporations other than professional corporations are prohibited from practicing medicine).
128 Satellite and Commercial Medical Clinics, Report of the Board of Trustees: Part II, 253 JAMA 1314, 1315–17 (1985).
129 See United Med. Serv., 200 N.E. at 162–63; Hampton, supra note 115, at 496.
130 See Hampton, supra note 115, at 496 & n.41. The relevant agency principle is that acts of the employee are attributable to the employer. Courts thus reason that the acts of physicians employed by corporations are attributable to corporations, thereby creating a violation of licensing laws. See id.
131 See 200 N.E. 157, 157 (Ill. 1936).
132 See id. at 163–64.
133 See id. at 158.
134 See id. at 159.
135 See id. at 162.
136 See United Med. Serv., 200 N.E. at 163.
137 See id. at 163–64. The court further elaborated upon its holding that United Medical Service’s employment of physicians amounted to the unlawful practice of medicine, noting that “the practice of a profession requires more than the ability to employ competent persons.” Id.
138 See Hampton, supra note 115, at 496–97; Chase-Lubitz, supra note 106, at 466–67.
139 See Hampton, supra note 115, at 497.
140 See Willcox, supra note 126, at 438–39.
141 See id. at 442–43; Hampton, supra note 115, at 497.
142 See Willcox, supra note 126, at 442–43.
143 See, e.g., Bartron v. Codington County, 2 N.W.2d 337, 346 (S.D. 1942) (noting that the practice of a profession by a for-profit corporation would result in an over-emphasis on the financial aspects and profitability of the practice).
144 See 384 F. Supp. 434, 436, 438 (W.D. Tex. 1974).
145 Id. at 436.
146 Id. at 439–40.
147 See id.
148 See James C. Robinson, The Corporate Practice of Medicine 1–2 (1999).
149 See id. at 2.
150 See id. at 1.
151 See id. at 2; Michael E. Makover, M.D., Mismanaged Care: How Corporate Medicine Jeopardizes Your Health 13 (1998); Indest & Egolf, supra note 12, at 32–33. Managed care applies simple principles of business management to health care and has reduced medical costs and limited hospital stays. Makover, at 14–15.
152 See Hampton, supra note 115, at 500; Chase-Lubitz, supra note 106, at 475–82.
153 See NHLA/AHAA, supra note 106, at 8; Hampton, supra note 115, at 500.
154 See Chase-Lubitz, supra note 106, at 475–77.
155 See NHLA/AAHA, supra note 106, at 4; Laufer, supra note 123, at 519.
156 See NHLA/AAHA, supra note 106, at 8.
157 See In re American Med. Ass’n, 94 F.T.C. 701, 1017–18 (1979).
158 See id. at 1036–40. The AMA appealed the Final Order, but the United States Court of Appeals for the Second Circuit approved its enforcement with only minor modifications. See American Med. Ass’n v. Federal Trade Comm’n, 638 F.2d 443, 451, 453 (2d Cir. 1980). The Supreme Court later affirmed the Second Circuit’s decision per curiam by a divided vote. See American Med. Ass’n v. Federal Trade Comm’n, 455 U.S. 676 (1982).
159 See Hampton, supra note 115, at 501; Chase-Lubitz, supra note 106, at 478.
160 See Chase-Lubitz, supra note 106, at 478.
161 See Pub. L. No. 93–222, 87 Stat. 917 (codified as amended at 42 U.S.C. § 300e (1994)); Hampton, supra note 115, at 501.
162 See Willcox, supra note 126, at 442–43.
163 See Chase-Lubitz, supra note 106, at 480.
164 See id. at 481.
165 See Hansen, Laws Affecting Group Health Plans, 35 Iowa L. Rev. 209, 211–13 (1950).
166 See Hampton, supra note 115, at 501.
167 See id.
168 See 42 U.S.C. § 300e-10(a)(1)(B) (1994).
169 See Chase-Lubitz, supra note 106, at 482.
170 See Indest & Egolf, supra note 12, at 34–35.
171 See id. at 34; Adam M. Freiman, Comment, The Abandonment of the Antiquated Corporate Practice of Medicine Doctrine: Injecting a Dose of Efficiency into the Modern Health Care Environment, 47 Emory L.J. 697, 707 (1998).
172 E.g., N.D. Cent. Code § 26.1–49–02 (1995) (stating that “a nonprofit health service corporation . . . does not violate limitations on the corporate practice of medicine”); see also California Physicians’ Serv. v. Garrison, 172 P.2d 4, 11–12 (Cal. 1946) (holding that nonprofit corporation’s employment of physicians to practice medicine does not violate the corporate practice of medicine doctrine).
173 See People ex rel. State Bd. of Med. Exam’rs v. Pacific Health Corp., 82 P.2d 429, 431 (Cal. 1938) (stating that “since the principal evils attendant upon corporate practice of medicine spring from the conflict between the professional standards and obligations of the doctors and the profit motive of the corporation employer, it may well be concluded that the objections of policy do not apply to nonprofit institutions”); see also Lisa Rediger Hayward, Note, Revising Washington’s Corporate Practice of Medicine Doctrine, 71 Wash. L. Rev. 403, 410 (1996).
174 See Indest & Egolf, supra note 12, at 34.
175 See id. at 35.
176 688 N.E.2d 106, 106 (Ill. 1997).
177 See id. at 113. By this decision, the Illinois Supreme Court reversed the decision by the Illinois Appellate Court in Berlin v. Sarah Bush Lincoln Health Center, 664 N.E.2d 337 (Ill. App. Ct. 1996), enforcing the corporate practice of medicine doctrine for the first time in over sixty years. See Indest & Egolf, supra note 12, at 35.
178 See Berlin, 688 N.E.2d at 107.
179 See id.
180 See id. at 107–08.
181 See id. at 108.
182 See id. at 110.
183 See Berlin, 688 N.E.2d at 112.
184 See id. at 113. The court referenced the Hospital Licensing Act, 210 ILCS 85/3 (West Supp. 1995), which defines “hospital” as “any institution . . . devoted primarily to the maintenance and operation of facilities for the diagnosis and treatment or care of . . . persons.” Id. (emphasis added by court). The court also relied on language in the Hospital Emergency Service Act, 210 ILCS 80/0.01 (West 1994), requiring “every hospital which provides general medical and surgical hospital services” to also provide emergency services. Id. (emphasis added by court).
185 See id. at 113–14.
186 See id. at 114.
187 See NHLA/AHAA, supra note 106, at 7; Chase-Lubitz, supra note 106, at 470–71. Chase-Lubitz writes: “Individuals attempting to establish new modes of health care delivery occasionally detonate a corporate practice landmine.” Id. at 471.
188 See 48 Cal. App. 4th 1038, 1049, 1051 (1996).
189 See id. at 1042.
190 See id. at 1048–49.
191 See id. at 1049.
192 See id. at 1043 n.4.
193 See Conrad, 48 Cal. App. 4th at 1042–43, 1043 n.4.
194 See id. at 1049, 1051.
195 See generally Makover, supra note 151, at 27–48; Hampton, supra note 115.
196 See Makover, supra note 151, at 86.
197 See id. at 100–05; Hampton, supra note 115, at 519. Doctor C. Everett Koop, the former Surgeon General of the United States, refers to managed care as a “rapidly proliferating leviathan” that has changed its focus from the original laudable goals of preventive care and standardization of medical practice to one interested first and foremost in autocratic profit and only secondarily in maintaining health. Tyler, supra note 3, at 262.
198 See Makover, supra note 151, at 31–32; Hampton, supra note 115, at 519–20.
199 See Makover, supra note 151, at 31–32; Hampton, supra note 115, at 534.
200 See Tyler, supra note 3, at 263; Bogus Treatments, supra note 1, at 1D.
201 See Bogus Treatments, supra note 1, at 1D.
202 See supra notes 42–46 and accompanying text.
203 See supra notes 48–50 and accompanying text.
204 See Brown, supra note 51, at 162.
205 See Jennings, supra note 2, at 1A.
206 See supra notes 54–83 and accompanying text.
207 See supra notes 54–76 and accompanying text.
208 See supra notes 77–83 and accompanying text.
209 See Jennings, supra note 2, at 1A; Bogus Treatments, supra note 1, at 1D; Good Morning America, supra note 7.
210 See Bogus Treatments, supra note 1, at 1D.
211 See Goldberg & Gordon, supra note 3, at 17; see generally Hampton, supra note 115.
212 See supra notes 110–124 and accompanying text.
213 See supra notes 110–115 and accompanying text.
214 See supra notes 116–124 and accompanying text.
215 See Indest & Egolf, supra note 12, at 33; Willcox, supra note 126, at 442–43.
216 See, e.g., Garcia v. Bd. of Med. Exam’rs, 384 F. Supp. 434, 439–40 (W.D. Tex. 1974); Conrad v. Med. Bd., 48 Cal. App. 4th 1038, 1049, 1051 (1996); see generally Hampton, supra note 115.
217 See Garcia, 384 F. Supp. at 439–40; Conrad, 48 Cal. App. 4th at 1049, 1051.
218 See Berlin v. Sarah Bush lincoln Health Ctr., 688 N.E.2d 106, 113–14 & n.5 (Ill. 1997).
219 See id.
220 See id.
221 See generally Hampton, supra note 115.
222 See id. at 534.
223 See id. at 509.
224 See id. Hampton exemplifies this conflict in presenting the example of a doctor deciding whether to advise costly procedures that would be helpful to the patient but would have negative financial consequences for the physician. See id.
225 See id. at 519.
226 See Hampton, supra note 115, at 519.
227 See, e.g., Garcia, 384 F. Supp. at 439–40; Conrad, 48 Cal. App. 4th at 1049, 1051.
228 See, e.g., Garcia, 384 F. Supp. at 439–40; Indest & Egolf, supra note 12, at 33.
229 See Greene, supra note 9, at 45; Bogus Treatments, supra note 1, at 1D.
230 See, e.g., Garcia, 384 F. Supp. at 439–40; Hampton, supra note 115, at 519.
231 See Indest & Egolf, supra note 12, at 34.
232 See, e.g., Garcia, 384 F. Supp. at 434; People ex rel. State Bd. of Med. Exam’rs v. Pacific Health Corp., 82 P.2d 429, 429 (Cal. 1938); Conrad, 48 Cal. App. 4th at 1038 (civil claims brought by either state attorney general or state medical board).
233 See, e.g., Garcia, 384 F. Supp. at 439–40; People v. United Med. Serv., 200 N.E. 157, 163 (Ill. 1936); Conrad, 48 Cal. App. 4th at 1050–51.
234 See, e.g., Colo. Rev. Stat. § 12–36–134(7) (1985).
235 See Bogus Treatments, supra note 1, at 1D.
236 See id.
237 See, e.g., N.Y. Educ. Law, art. 131, § 6521 (defining the “practice of medicine” as “diagnosing, treating, operating or prescribing for any human disease, pain, injury, deformity or physical condition”); 225 Ill. Comp. Stat. 60/49 (1999) (defining the “practice of medicine” and providing sanctions for unlicensed persons who suggest a form of treatment for “the palliation, relief or cure of any physical or mental ailment or condition of any person with the intention of receiving compensation”); see also Goldberg & Gordon, supra note 3, at 3 n.2.
238 See Bogus Treatments, supra note 1, at 1D. There is no real consensus as to what constitutes the practice of medicine on the Internet. See id. Thomas Monahan, executive secretary for the New York State Board for Medicine, states: “If someone is diagnosing, that is considered the practice of medicine. But where’s the line?” Id.
239 See id.
240 See id.
241 See Rubin, supra note 90, at 1A.
242 See id.
243 See id.
244 See id.
245 See id.
246 See Rubin, supra note 90, at 1A. Issues of legal jurisdiction over Internet websites are beyond the scope of this Note. For more information on this topic, see generally Howard Stravitz, Personal Jurisdiction in Cyberspace: Something More is Required on the Electronic Stream of Commerce, 49 S.C. L. Rev. 925 (1998), and Richard S. Zembeck, Comment, Jurisdiction and the Internet: Fundamental Fairness in the Networked World of Cyberspace, 6 Alb. L.J. Sci. & Tech. 339 (1996).
247 See Jennings, supra note 2, at 1A.
248 See id.
249 See generally Hampton, supra note 115; see also Bogus Treatments, supra note 1, at 1D.
250 See Rubin, supra note 90, at 1A.
251 See Wiesemann, supra note 89, at 1152–53; Bogus Treatments, supra note 1, at 1D.
252 See Bogus Treatments, supra note 1, at 1D.
253 See Goldberg & Gordon, supra note 3, at 3.
254 See Rubin, supra note 90, at 1A. Though the regulation of health care traditionally has been a state function, Congress has the authority to enact health legislation under the Commerce Clause of the U.S. Constitution and has enacted such legislation in the past. See, e.g., Mammography Quality Standards Act of 1992, 42 U.S.C. § 263b (1994); Employment Retirement Income Security Act of 1974, 29 U.S.C. §§ 1001, 1144 (1994).