A Case of Medical Malice?

IT WAS the day harsh realities intruded on what some consider the esoteric world of holistic medicine. The soothing melody of babbling brooks and chirping birds was filtering through the sound system of the Vital Life Centre when 10 officers from Central Police Station marched into the Duddell Street premises.

Brandishing a search warrant, the armed squad spent two hours combing a labyrinth of ''new age'' treatment rooms, where some of the territory's wealthiest and most fashionable people go for hypnotherapy and acupressure.

Finally, it is alleged, they uncovered a quantity of medical drugs in the office of the centre's medical director, Dr Manik Hiranandani, who has rented space there for 11/2 years.

The drugs were confiscated, as were some of the doctor's papers. His assistant volunteered to be interviewed and went to Central Police Station.

Three weeks after the raid, police are still considering whether to prosecute and want to speak to Dr Hiranandani, who is staying out of Hongkong on legal advice.

But those involved in alternative medicine claim the incident goes far beyond the case of just one man. For the territory's holistic community, the raid is the culmination of what it sees as a malicious vendetta waged by some members of the powerful medical establishment.

The police action - which followed a tip-off from the Department of Health - is the latest and most public salvo in a bitter feud between practitioners of alternative medicine and orthodox doctors.

The alternative doctors say they have become the target of a smear campaign prompted by professional and financial jealousy.

And, there can be no doubt the smell of money is not far from the battlefield. The holistic movement has become a multi-million dollar industry in recent years as an increasing number of Hongkong people have opted for alternative care.

The Vital Life Centre has become the symbol of alternative treatment, available at exclusive prices. Yet, despite its popularity, the medical establishment largely refuses to recognise the field, citing lack of control and uncertain standards.

Doctors claim some alternative practitioners have questionable credentials. One doctor said a woman, who professed she was experienced as a nurse, was referring to the fact she had played one in a television soap.

But, homeopath Dr Alexander Yuan of the Optimum Health Centre in Causeway Bay said the behaviour and attitude of the medical profession was tantamount to ''harassment''.

''They treat us as if we are doing something criminal,'' he said. ''They are using the police and taxpayers' money to attack us.'' Dr Yuan said raids on the premises of colleagues had been conducted for no apparent reason. He said he was convinced they had followed complaints from mainstream doctors.

''Of course they are resentful,'' he said. ''There is no reason, but they just want to monopolise the health-care industry.'' Insiders say it is this animosity that triggered the raid at the Vital Life Centre on February 12. Police confirmed the raid.

Stories abound that such was Dr Hiranandani's popularity - on some days he would see up to 40 patients, at prices starting from $800 an hour - that one or more doctors may have been antagonistic and prompted the police raid to see exactly what Dr Hiranandani was up to.

Those within the industry referred to the raid as a ''witch-hunt''.

Ms Nancy Bekhor, director of the Vital Life Centre, was in Australia at the time, but is still shocked that after six years of business, something like this could have happened.

The centre was one of the first in Hongkong set up to promote holistic healing, which includes everything from herbal treatments to acupuncture, iridology (diagnosing a condition by looking at the eyes) to ''new age'' treatments such as crystals.

While Dr Hiranandani is a qualified medical doctor, he treats his patients holistically and is not registered as a doctor in Hongkong, prohibiting him from prescribing or dispensing drugs.

Holistic practitioners in Hongkong are not subject to any type of regulation. Effectively, anybody can set up shop and promote himself as a ''healer'': he does not need to display degrees, take examinations or convince any medical boards or association that he is qualified to practise.

While Ms Bekhor runs and operates the Vital Life Centre, she says she is effectively a landlady. At any time, up to a dozen practitioners work out of the centre - some for only a few hours a week, some daily. They rent a room to set up their practice andrely on the centre's extensive mailing list to make their services known.

''The Vital Life Centre is an umbrella title,'' Ms Bekhor said. ''They run their own practices. I screen the people who want to work here, checking their certificates and track records. It has happened in the past where they don't appear to be doing what they said they did and then I ask them to leave.'' Ms Bekhor is in favour of a regulatory body. Discussions have taken place with other practitioners, but she said the idea was in its infancy.

In the meantime, the centre continues to house 12 holistic practitioners as well as Dr Hiranandani. Services do not come cheap. Dr Hiranandani charges $840 per hour for initial consultations while other practitioners' fees start at $350 to $700 an hour.

Ms Bekhor admitted it was not her business to know what happened between practitioners and clients, and that she had no liability for the practitioners if anything went wrong.

This raises the questions: whose responsibility is it and how do people who try alternative healing get protection? Bodies such as the Hongkong Medical Association and the Hongkong Medical Council are not impressed by many of the alternative treatments on offer or the people who offer them.

''We do not regard them as proper doctors or as colleagues in the medical profession,'' said Dr Rosie Young, chairman of the Hongkong Medical Council.

''Those who practise alternative medicine are placed in the same category as unqualified practitioners. The trouble is there is no proper training or accreditation, and nobody sets the standards.

''Other places have colleges of alternative medicine, but if we are going to do that in Hongkong we may as well set up a traditional college, which is better known and a much more important discipline.'' Dr Young said members of the council were prohibited from writing a letter of referral for a patient to visit a holistic practitioner.

Her views were echoed by Dr Lee Kin-hung, spokesman for the Hongkong Medical Association.

''Our policy is they are not Western-trained medical practitioners,'' he said. ''They should not mislead people into thinking they are registered and medical doctors should not make a referral to someone who is not a registered professional. How will the doctor know the patient will benefit?'' When asked if holistic healers could help people, Dr Lee said: ''As far as we are concerned, we believe those who take part in medical treatments should be properly trained. We don't know of their methods and they have not attained the sort of trainingwe recognise.

''It is difficult to liaise with them because we believe in different principles and we don't think liaison will lead anywhere.'' Another leading body, the Hongkong College of General Practitioners, said alternative practitioners should be regulated.

A member of the public education committee of the college, Dr Maryse Badawy, said: ''It is disturbing to hear of untrained or self-trained alternative medicine people practising their trade.

''They are not limited by codes of ethics regarding advertising, so they take out advertisements expounding their abilities which may or may not be supported by qualifications.

''I have recently heard of a particular practitioner claiming nursing experience which was on a television show playing the part of a nurse.

''These practitioners take over management of patients and at times give advice, which is detrimental if not potentially lethal to patients.'' Dr Badawy cited the example of a diabetic who was told by a holistic practitioner to stop insulin therapy.

''This is totally unacceptable,'' she said. ''An insulin-dependent diabetic needs insulin to control metabolism, without this the metabolism goes out of control, the patient slips into a coma and dies, unless urgent medical attention is administered.'' Dr Badawy's biggest concern is that when complaints arise among people who have tried alternative medicine, there is no body to which patients can lodge complaints.

''Is there an ethics committee which can exonerate or find fault and take disciplinary action against the accused practitioners? We cannot remain inactive to the issue at hand,'' Dr Badawy said. ''There is a problem which must be addressed. There needs to be a regulatory body to register, control, standardise and discipline alternative medicine practitioners.'' While Dr Badawy called for urgent action, she conceded that even the medical profession was ''not perfect''.

''However, we spend a minimum of five to six years training, we are conferred degrees, are accredited, enrol in post-graduate education programmes and we abide by a code of ethics,'' she said. ''We are registered by a council and are members of colleges.

''We are continuously assessed and scrutinised in our daily practice of medicine. And we are the most capable and qualified in providing holistic care for the community of Hongkong.'' The holistic profession scored a major coup last month when the Chiropractors Registration Bill was passed by the Legislative Council, ostensibly recognising the professional status of chiropractors.

Dr Yuan said there was no legislation relating to other holistic disciplines, despite claims of medical boards that they were concerned for the public.

''Other disciplines haven't even got a chance to start regulating themselves,'' he said. ''We just don't have the background to do it. So of course people can be exploited.

''But if protection of the public is really at the forefront of the minds of medical doctors, they should be interested in trying to register us in a reputable fashion. But by registration, they are recognising us and conferring a recognised status on us,and that is something they don't want to do.

''Instead, they are downgrading us, and by hook or by crook will see to it that we are legislated out by concocting drummed-up charges.'' Dr Yuan said orthodox allopathic medicine had traditionally ''battled'' against naturopathic schools.

''Allopathic medicine always tries to suppress and monopolise, under the pretext of protecting the public,'' he said. ''Things in Hongkong are no different: Chinese medicine has been totally ignored and they can't say it is not scientific because in Chinait is part of the recognised medical system.

''There are schools in China, Japan and Korea for the study of herbal medicine, and in the US you have to study for three years at an acupuncture college.'' Two chiropractors in Hongkong said they were subject to harassment by what they believed to be the medical profession.

Dr Thomas Wong said he received a telephone call from the police soon after he opened his Melbourne Plaza practice last year; he had used the Chinese words yi sang, meaning doctor, to advertise the opening of his practice, and was told he was subject to prosecution.

''I was shocked when it happened,'' he said. ''But I learned a medical doctor alerted the police. Some doctors who are trained in Hongkong are very closed-minded and think they are the only ones who are qualified health-care doctors. They are not thinkingof the benefit of the patient, but rather their own benefit.

''It comes down to harassment, and they don't realise that what we do is legitimate in other countries. Under the US system, you have to spend five academic years in chiropractic school.'' Dr Lu Chak-keung, a chiropractor in Mongkok, said a member of the Criminal Investigation Division once posed as a patient.

''He came to my clinic and asked me for painkillers,'' he said. ''I refused to give him any medication and suggested he have an X-ray. Later that day, a squad from the Mongkok police station came in with a warrant to search my office, charging me with illegally using 'doctor' before my name.

''I studied chiropractic therapy in the US for 41/2 years and they wanted to discredit me. They took me to court, but the magistry said they had no grounds. But I know it was a doctor who alerted the police.'' The raid at the Vital Life Centre has left practitioners fearful of being investigated. A practitioner at another holistic clinic, who asked not to be named for fear of the same thing happening, said she was saddened by the lack of co-operation from allopathic doctors.

''A lot of us are concerned about this at the moment,'' she said. ''Our way is to live in harmony with the medical profession. We are complementary to them, not in competition.'' She often received referrals from medical doctors, and also referred patients to doctors if they needed drugs or surgery.

''We realise our limitations,'' she said. ''It doesn't have to be an us versus them situation. There is enough work for everyone here. But the truth is there are some people not wanting the drugs and the surgery and who are looking for another way. So maybe doctors are losing clients but they must realise they don't need to destroy other people to survive.'' Dr Hiranandani was in Dubai at the time of the raid tending to a cancer patient. After being told about the search, he moved to Delhi to be with his family.

Speaking from Delhi, he said he did not know what to make of the police's discovery, and was awaiting ''further clarification'' before returning to Hongkong.

''I was out of Hongkong and I don't know what the status is,'' he said. ''The whole situation is extremely unclear at this time.'' Dr Hiranandani said medical drugs found in his office may have been left behind by somebody else or may have been samples.

''I don't use Western drugs,'' he said. ''I am not registered in Hongkong so if people bring drugs to my office, this is not something for which I am liable. I am not sure what they have found. I don't think I've ever harmed anybody. I've never given medical drugs and don't need to. If I think someone needs drugs I tell them to see their doctor.

''I'm not trying to score points because Western medicine does have a role to play. But what they must understand is nobody has all the answers.'' A spokesman for the Hongkong Island police said a file was being put together and that ''certain people'' could be subject to criminal charges. He said a complaint was received through the Department of Health and that during the search ''certain materials'' were seized which are now being analysed by the Government chemist.

''We would like to speak to the doctor involved pending his return to Hongkong,'' he said. ''There are a number of avenues we have to investigate.'' When asked about the raid on the Vital Life Centre, a spokesman for the Department of Health said: ''Yes, the director of health has referred the case to the police for action. We have nothing to add at this stage.''