Some Notes on the Pastoral Medical Association
and other "Private Membership Associations"

Stephen Barrett, M.D.

Hundreds of practitioners are using the credentials "PSc.D.," "D.PSc.," and/or "Doctor of Pastoral Medicine" to promote their services. These titles come from the Texas-based Pastoral Medical Association (PMA), which "licenses" practitioners and registers prospective patients as "members" who wish to receive care from these providers. The PMA, which is headquartered in Irving, Texas, describes itself as "a private ecclesiastical membership association with a mission to promote scripture-based health and wellness concepts." [1] Its practitioner members typically offer medical services that require a government-issued license to provide, but the PMA asserts that "regulation of the Almighty's health care concepts is outside the jurisdiction of . . . secular regulatory boards" and that "when PMA license rules are followed . . . PMA license has no effect on any state license and state license has no effect on PMA license." [2]

The PMA Web site does not specify its licensing requirements but describes them this way:

Health care practitioners, whether state licensed or not, as well as mental health counselors that seek license to offer services in the Network must pass rigid standards to qualify for PMA license. The practitioner must meet specific educational standards, must participate in a comprehensive evaluation of his or her credentials and practice as well as pass a detailed background investigation and participate in at least two interview sessions with a PMA license representative. Practitioners spend several hundred dollars in the license application process and their annual license fees can range from a few hundred to a couple thousand dollars. In other words, the PMA license process is more stringent and costly than many state license boards and as you can see, practitioners that succeed through the PMA license process are clearly dedicated practitioners who are very serious about their practice and services to you [3].

The site does not indicate how many providers have joined, but it claims that membership is growing at an average rate over 3,000 per month and that about half of its licensed members are "natural health professionals" and half are conventionally licensed [2]. Searching with Google, I found that most of the licensed members are chiropractors.

The PMA Web site gives little information about who operates the group. The only name I could find was Eric C. Carter, who is identified as PMA's president on some of its "ministerial licensing" certificates and formerly operated the World Organization of Natural Medicine Practitioners.

The "PMA Directory of Alternative Health & Medicine" on a separate Web site contains more than 2,200 providers who pay from $49/year for a "Basic Member" listing to $149/year for a "Pro Member" listing [4]. It is not clear whether PMA membership is required for listing in the directory.

The PMA "Member Share Agreement"

People who wish to receive treatment from the Pastoral Medical Association's "licensed" members are required to join its "Member Share Program" by signing its Member Share Agreement. This document, which is posted to the Web sites of the association and many of its members, sets forth an elaborate set of policies intended to shield the providers from government regulation and civil court lawsuits [5]. The current version requires these acknowledgments:

In simple terms, the agreement calls for patients assume all of the risks of a provider-patient relationship without any government protection. An earlier version called for a $1 million penalty for violating the confidentiality terms.

The Dahlstrom Connection

The "properties" window of the PDF-formatted Member Share Agreement identifies Karl Dahlstrom as the document author. I do not know whether he has any ownership or official capacity with PMA, but with further searching, I found that he has promoted and marketed "private membership association" concepts for many years, not just for health-related matters but for virtually anyone who wants to try to avoid government regulation. He asserts that members of these these entities enjoy Constitutional protection that enables them to "safely" exchange any information (including health-related advice) that does not constitute "a clear and present danger of substantial evil."  

Dahlstrom operates the ProAdvocate Group, which is described on its Web site as a private membership association with almost ten years of experience in establishing private medical membership associations for (a) unlicensed medical practitioners and researchers, (b) licensed practitioners under attack for "alternative medicine," (c) former licensed practitioners, and (d) any practitioners who need to operate in two or more states [6]. Dahlstrom has a colorful legal history:

Dahlstrom's books include The DNA of Scripture: How True Natural Science Confirms the Holy Scriptures as True (2015), The Organized Universe: Exclusive Scientific Proof That Darwinism Is a Fraud (2013), and How to Avoid Probate, gift, inheritance and Estate Taxes, Etc. (1977).

Are Wrongdoers Protected?

Dahlstrom teaches that providers who operate a private membership association can "privately" provide information and services to their members without worrying about whether they would be illegal in another context [16]. But there is good reason to be skeptical. Courts generally do not recognize agreements that are made to evade protective laws or give up the right to any claim for negligence. There is especially good reason to believe that people who market health-related products in interstate commerce cannot evade FDA jurisdiction with a private membership association set-up. Section 201(e) of the Federal Food, Drug, and Cosmetic Act defines the word "person" to include associations [17].

In a recent case, the primary defendant was Robert L. Lytle (better known as Dr. Larry Lytle). Lytle had begun manufacturing and distributing low-level laser devices in 1997, shortly before the South Dakota Board of Dentistry had revoked his dental license for fraud and substandard patient care [18]. The federal complaint, filed in 2014, charged that Lytle, doing business as QLasers PMA and 2035 PMA, had marketed a dozen devices with illegal claims that they could treat "over 200 different diseases and disorders," including cancer, cardiac arrest, deafness, diabetes, HIV/AIDS, macular degeneration, and venereal disease. QLasers PMA and 2035 PMA were private marketing associations whose customers were required to sign a membership agreement declaring their right and willingness to learn how the QLaser System could help them. The complaint also noted that during a 2012 inspection, Lytle refused to provide information requested by FDA investigators because they were not members, and he claimed that the the activities of his "private membership associations" were outside of FDA jurisdiction [19]. During the court proceedings, Lytle claimed that his devices were "primarily for people's (1) private education, (2) private experimentation and research, (3) for veterinary use on their pets, domestic animals and beasts; and (4) for whatever other private use a man or woman who elects to obtain one decides to apply it" and that neither the FDA nor the court could exert any lawful personal jurisdiction over the "private noncommercial distribution activity" of the defendant associations. However, the presiding judge—noting that placing devices and their operational manuals into the stream of commerce went beyond the First Amendment—issued a preliminary injunction which noted that "hiding behind a curtain of private membership associations" did not shield Lytle from the law or the court's jurisdiction [20]. After the U.S. Court of Appeals upheld this ruling, the injunction was made permanent [21].

In 2015, Louis Daniel Smith, of Spokane, Washington was convicted of conspiracy, smuggling, selling misbranded drugs, and defrauding the United States, for which he was sentenced to 52 months in prison [22]. Evidence at trial showed that from 2007 to 2011, Smith operated a business called Project GreenLife (PGL), which sold "Miracle Mineral Supplement" (MMS) through the Internet. Smith co-founded PGL and identified himself, at various times as the "trustee" of "Project Greenlife - a Private Healthcare Membership Association." The membership association set-up did not protect him [23]. In fact, during the proceedings, Smith indicated that the $48,000+ his company had paid to the ProAdvocate Group had gotten them "bad legal advice." [24]

I believe that state courts will ultimately agree that private membership associations and PMA-issued "credentials" cannot create any right to practice medicine or other form of health care that is defined and regulated by licensing laws. Government action has taken place in at least six states.

  • In 2014, Lynnette Blake, who had operated a clinic in Florida, pleaded guilty to practicing naturopathy without a license and was sentenced to 15 years in prison. During the sentencing hearing, the judge said she was shocked by the extent of fake credential documents Blake had put together [25]. One of these, shown to the right, was the PMA wall certificate that identified her as "Dr. Lynnette Blake, D.PSc". I wonder what "educational standards" she met when she was evaluated for PMA "licensure."

Click here to read the text of a similar certificate.

In 2015, the Kentucky Board of Chiropractic Examiners decided that Pastoral Medical Association services are "pastoral" and that Kentucky chiropractors were "free to join, advertise, and counsel under the Pastoral Medical Association as long as there is a separation between the PMA services and the chiropractic services being rendered. PMA services are pastoral in nature." To be separate, (a) consumers would have to receive "clear notice delineating PMA and chiropractic services," and (b) advertising, invoices, record-keeping, files, and services must be kept and provided separately [42]. This appears to indicate that Kentucky's chiropractic board might not limit any activity that chiropractors declare to be pastoral. I doubt, however, whether this will enable Kentucky's chiropractors to engage in any services that the law (and the state medical board) would define as the practice of medicine.

Some chiropractors have used the "PSc.D." credential without requiring their patients to join a private membership association. Most of these were offering the NutriMost Ultimate Fat Loss System, which I have described elsewhere [43].

My Concerns

The "PSc.D." credential and the claims made for private membership associations have considerable potential for harm:


  1. About the PMA. PMA Web site, accessed, Jan 10, 2016.
  2. Commonly asked questions. PMA Web site, accessed Jan 19, 2016.
  3. For the public. PMA Web site, accessed Jan 24, 2016.
  4. PMA Directory registration page, accessed Jan 19, 2016.
  5. PMA Member Share Agreement, accessed Jan 19, 2016.
  6. 1st and 14th Amendment Private Medical Association for Unlicensed or Licensed Medical Practitioners. ProAdvocate Group Web site, accessed Jan 19, 2016.
  7. Decision. U.S.A. v Karl L. Dahlstrom et al. U.S. Court of Appeals, Ninth Circuit, 713 F.2d, 1983, Aug 24, 1983.
  8. Memorandum findings of fact and opinion. Dahlstrom v. Commissioner of Internal Revenue. U.S. Tax Court memo 1991-264, filed June 11, 1991.
  9. Memorandum findings of fact and opinion. Dahlstrom v. Commissioner of Internal Revenue. U.S. Tax Court Memo 1991-265, filed June 11, 1991.
  10. U.S. Securities and Exchange Commission. Litigation release No. 15019, Aug 20, 1996.
  11. U.S. Securities and Exchange Commission. Litigation release No 15464, Aug 28, 1997.
  12. U.S. Securities and Exchange Commission, Litigation release No. 15587, Dec 9, 1997.
  13. Decision. U.S.A. v Karl L. Dahlstrom et al. U.S. District Court of Appeals, Fifth Circuit, 180 F.3rd 677, July 13, 1999.
  14. Complaint. Dahlstrom v. Richard Dawkins and the Richard Dawkins Foundation for Reason and Science. U.S. District Court for the Western Division of Texas. Civil action No 4:15-cv-1384, filed June 15, 2015.
  15. Memorandum adopting report and recommendation of U.S. Magistrate Judge. Dahlstrom v. Richard Dawkins and the Richard Dawkins Foundation for Reason and Science. U.S. District Court for the Western Division of Texas. Civil action No 4:15-cv-1384, filed Jan 6, 2016.
  16. The Best Kept Secret of the Legal System). (Videotaped seminar for "alternative" providers filed at the Dallas-Fort Worth Airport. Posted to YouTube, Nov 19, 2012.
  17. Federal Food, Drug, and Cosmetic Act, Public Law 114-89, Chapter II–Definitions, Section 201(e), 21U.S.C. 321.
  18. Disciplinary actions. South Dakota Board of Dentistry. Accessed Jan 23, 2016.
  19. Complaint for injunction. U.S.A. v. 2035, Inc., 2015 Inc, Robert L. Lytle d/b/a 2035 PMA and QLASERS PMA. U.S. District Court for the District of South Dakota, Case No. 5:14-cv-05075-JLV, filed Oct 21, 2014.
  20. Order granting preliminary injunction. U.S.A. v. 2035, Inc. et al. U.S. District Court for the District of South Dakota, Case No. 5:14-cv-05075-JLV, filed Jan 14, 2015
  21. Order of permanent injunction. U.S.A. v. 2035 Inc. et al. U.S. District Court for the District of South Dakota, Case No. 5:14-cv-05075-JLV, filed Oct 6, 2015.
  22. Barrett S. Enforcement actions against Miracle Mineral Supplement (MMS) marketers. Quackwatch, Jan 23, 2016.
  23. Order denying defendant's motion for judgment of acquittal or in the alternative for a new trial. U.S.A. v Louis Daniel Smith. U.S. District Court, Eastern District of Washington Case No. 2:13-CR-14 RMP-1, filed Sept 23, 2015.
  24. Motion for judgment of acquittal or in the alternative for a new trial. U.S.A. v Louis Daniel Smith. U.S. District Court, Eastern District of Washington Case No. 2:13-CR-14 RMP-1, filed Aug 8, 2014. (See page 24.)
  25. Barrett S. Phony naturopath receives 15-year prison sentence. Naturowatch, Jan 18, 2016.
  26. Barrett S. Oregon alphabiotics practitioner ordered to stop practicing without a license. Casewatch, Jan 22, 2016.
  27. Judge issues preliminary injunction against unlicensed practice of chiropractic. Oregon Board of Chiropractic Examiners press release, Oct 2, 2016.
  28. Slip opinion. Mason v. State of Arkansas. Arkansas Court of Appeals, Division II, No. CR-13-478, May 7, 2014.
  29. Barrett S. A close look at Richard T. Hansen, D.M.D. Quackwatch, Feb 28, 2015.
  30. Barrett S. Regulatory action against Michael Anthony Smith, D.C. Casewatch, Feb 16, 2016.
  31. Cease and desist order. In the matter of Antonio Giovanni Paletta before the Texas Medical Board, Oct 27, 2014.
  32. Opinion. Joseph Andrew Diruzzo v State of Texas. Court of Appeals, Thirteenth District of Texas, Case No. 13-16-00638-CR, April 26, 2018.
  33. TMB disciplines 62 physicians at March meeting. TMB press release, March 22, 2016.
  34. TMB disciplines 78 physicians at June meeting, adopts rule changes. TMB press release, June 27, 2016.
  35. Chiropractor ordered not to practice after felony arrest. California Board of Chiropractic Examiners news release, Aug 4, 2016.
  36. Ming K. Call Kurtis Investigates: TV doctor arrested for practicing medicine without a license. CBS Sacramento, Aug 25, 2016.
  37. Johnson D. Board to decide professional fate of El Dorado Hills chiropractor convicted of practicing medicine without license. Fox 40, Sept 19, 2017.
  38. Barrett S. License revocation of Keith DeOrio, M.D. Casewatch, Jan 18, 2018.
  39. Agreed cease and desist order. In the matter of Ross M. Stewart, Ph.D., P.C. Before the Texas Medical Board, March 3, 2017.
  40. Barrett S. Some notes on Eric Dover, M.D., the Indigenous Health Care Practitioners Organization, and the Turtle Island Providers Network. Credential Watch, May 4, 2018.
  41. Agreed order. In the matter of David Kingcaid before the Texas Board of Chiropractic Examiners, Jan 25, 2018.
  42. From the board. Kentucky Board of Chiropractic Examiners Web site, accessed Jan 18, 2016.
  43. Barrett S. A skeptical look at the NutriMost Fat Loss System. Chirobase, Dec 29, 2016.

This article was posted on May 4, 2018.

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