License of Tri-Cities doctor temporarily suspended by WA medical commission

The Washington Medical Commission has temporarily suspended the license of a Kennewick doctor while disciplinary proceedings continue.

Dr. Stephen L. Smith, whose clinic is Northwest Integrative Medicine, specializes in alternative medicine and integrating traditional medicine practices with complementary therapies.

According to the medical commission allegations he:

Treated numerous close family members without keeping adequate records, performing necessary evaluations or documenting serious risks of treatment.

Prescribed testosterone and anastrozole, which decreases the amount of estrogen the body makes, without adequately evaluating male and female patient needs for the medication or documenting discussions with the patients of possible risks of the medication.

Reinfused blood into patients without evidence of proper training or sterile procedures and equipment, creating a risk of blood infections.

A charging document reviews his treatment of 38 patients, including eight close family members.

It is a breach of ethical care to provide long-term care, including mental health care and the prescription of controlled substances to family members, according to the document.

Issues that could arise include the compromise of professional objectivity, the possible inclination to treat problems beyond the doctor’s expertise, concerns regarding patient autonomy and awkwardness in discussions of sensitive topics, such as suicidal thoughts.

Kennewick doctor treated family

In one case, Smith is accused of treating a family member who reportedly had been diagnosed with bi-polar disorder and had a history of substance abuse and mental health issues.

There was no charting, no documentation of essential standard of care safety monitoring, no rationale for prescribing a years’ worth of lithium nor a monitoring plan for suicide risk or lithium toxicity.

Smith said the lithium prescription was written at the request of his relative’s current medical provider due to insurance issues, but there was no documentation of that in the patient’s records, according to the charging document.

They also allege that Smith willfully misrepresented facts when he denied treating the relative before July 2022. Investigators found prescriptions written by Smith for the relative since at least 2014, according to the charging document.

Smith also prescribed a “potent anti-depressant” to another relative but documented no inquiry about suicidal thoughts, no plan for follow-up and no referral to a mental health provider, according to the charging document.

Smith prescribed Adderall, a highly addictive amphetamine used to treat attention deficit/hyperactivity disorder to two relatives without documenting the basis for diagnosing ADHD or discussing the risks or benefits of the prescription, according to the charging document.

In another case, Smith is accused of prescribing up to twice the typical replacement dosage for testosterone.

There was no documented discussion of the potential risks, including heart attacks and strokes, even though the patient was at high risk of cardiovascular disease, according to the charging document.

He also is accused of prescribing a relative a blood pressure medication that can cause kidney injury, without documenting a plan to monitor for adverse affects, according to the charging document. And he is accused of prescribing ivermectin to a female relative of reproductive age even though it could possibly cause birth defects, according to the charging document.

Smith’s care for other patients

A review of the care of two dozen other patients found substandard care with respect to testosterone prescribed to men and women and to prescribing amphetamines for ADHD without documenting the diagnosis, according to the charging document.

Smith also is accused of not meeting the standard of care for the diagnosis and treatment of hypothyroidism for six patients. In some cases he treated them with animal thyroid extract which has a variable amount of thyroid hormone, increasing the need for monitoring. But there is no documentation of monitoring, according to the charging document.

Smith treated two patients with their own blood. In one case he irradiated blood removed from the patient, treated it with ozone and then reinfused the blood back into the patient, according to the charging document.

Extracting, processing it and reinfusing it back into a patient requires meticulous laboratory equipment and trained personnel, which there is no evidence that Smith had, according to the charging document. Without strict sterile techniques, patients are exposed to the risk of life-threatening blood infections.

Questions also were raised about prescriptions of “expensive or non-evidence-based medical therapy” without a strong rationale, according to the charging document.

The Washington Medical Commission also accused Smith of failing to comply with its 2020 order that he document that patients had seen a primary care provider of subspecialist within a year of his treatments, did not give a copy of his treatment records to those providers and did not document that gloves were used to administer injections.

The statement of charges gives Smith the opportunity to defend himself against the charges. He has held a medical license in Washington since 1981.