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."  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." 
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 .
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 . 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 . 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 . The current version requires these acknowledgments:
- Within the Association there are two levels of membership. Provider members are counselors and health care professionals who are issued a license by the Association to assist lay members improve health. All others are Lay members.
- Within the association no doctor-patient relationship exists, but only a contract member-member Association relationship, and fellow members that provide therapy, treatment and care, etc., do so in the capacity of a fellow member licensed by the Association and not in the capacity of a state licensed health care provider.
- Association-licensed members may offer advice, services and benefits that may not conform to conventional medical ideas.
- Membership services do not include on-call coverage, hospital care or the usual and customary care provided by most physicians.
- Association licensed members do not customarily file for insurance benefits or reimbursement on members behalf.
- All complaints or grievances are subject only to the jurisdiction of the Association's Ecclesiastical Tribunal. Members may not proceed outside the ecclesiastical tribunal to file any lawsuit, malpractice or otherwise against a fellow member unless that member has exposed them to a clear and present danger of substantive evil as defined by the U.S. Supreme Court and as determined by the Association. [Note: If you or anyone you know complained to the PMA tribunal, please email me about what happened.]
- The confidentiality, privacy and security of ecclesiastical and private membership records, along with all activities within the Association are private matters that members refuse to share with any person or entity outside the Association including the State Medical Board, the FDA, Medicare, Medicaid or insurance companies, unless the member and the Association have provided expressed specific permission. Because all are private records and activity, members also waive HIPAA privacy rights and complaint process. All records and documents remain as property of the Association, even if a member receives a copy of them.
- Applicants must affirm that they do not represent a state or federal agency whose purpose is to regulate the practice of medicine or otherwise.
- Violation of this contractual member agreement by a member will result in a no contest legal proceeding against them.
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 . Dahlstrom has a colorful legal history:
- In 1982, he was convicted of conspiracy to defraud the U.S. Government in connection with a tax-shelter program he had devised and promoted through membership in a group he had formed called the American Law Association. He was sentenced to serve five years in prison, but the conviction was overturned on appeal .
- In 1991, in two separate decisions, the U.S. Tax court concluded that Dahlstrom and his wife Clara had set up sham trusts and failed to report a total of more than $3.6 million for the years 1977 through 1984, for which the court assessed back taxes plus interest of nearly that amount [8,9]. The second decision said, "Legal smoke and mirrors, reams of paper, and strings of words will suffice no longer to evade or delay the payment of their fair share of federal income taxes. The time has come for them to join the rest of their fellow citizens at the annual income roundup."
- In 1992, the U.S. Securities and Exchange Commission filed a civil injunctive action against Dahlstrom, his daughter Karla, and two associates for their involvement in a nationwide solicitation campaign for the purpose of selling unregistered stocks. A permanent injunction was issued in 1993 .
- In 1996, criminal charges were filed based on the same activities alleged in the injunctive action . In 1997, a federal jury convicted Dahlstrom of mail fraud, securities fraud, and operating as an unregistered broker-dealer . He was sentenced to 78 months of imprisonment, to be followed by three years of supervised release, and the four defendants were ordered to repay $1,997,003 . Dahlstrom appealed the verdict, but it was upheld  and the U.S. Supreme Court declined to hear a further appeal. In a recent video, Dahlstrom joked about his imprisonment, saying that it enabled him to spend considerable time sharpening his legal skills in the prison law library.
- In 2015, Dahlstrom sued the prominent British scientist/author Richard Dawkins and the Richard Dawkins Foundation for Reason and Science for $58 million for "intentional infliction of emotional distress." More than 20 years ago, Dawkins had said that "anybody who does not believe in evolution is either ignorant, stupid, insane or wicked." Claiming that he was the only person to have disproven evolution, Dahlstrom asserted that re-publication of Dawkins's statement was "obviously" directed at him and had severely damaged him . In 2016, the case was dismissed for lack of jurisdiction and failure to state a claim .
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 . 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 .
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 . 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 . 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 . After the U.S. Court of Appeals upheld this ruling, the injunction was made permanent .
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 . 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 . 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." 
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.
Click here to read the text of a similar certificate.
- In 2010, the Oregon Board of Chiropractic Examiners concluded that Chris McCutcheon had practiced chiropractic without a license and assessed a $10,000 administrative penalty. The board's order noted that McCutcheon operated the Balanced Wellness Center in Klamath Falls, Oregon, where he referred to himself as a doctor and practiced a variation of chiropractic called alphabiotics .
In 2013, McCutcheon reopened his practice with the name "Balanced Health Wellness Center," called what he did "neurological balance technique," and structured his set-up as a "private membership association" that he claimed would enable him to provide treatment to "members" without regulation by the Board. However, a Circuit Court judge concluded that he was not exempt from regulation and ordered him to stop. A Board press release noted that McCutcheon's only apparent training had been a 100-hour course in alphabiotics .
- In 2013, following a jury trial, Garritt S. Mason, who operated the Alphabiotics Family Center in Hot Springs, Arkansas, was convicted of practicing chiropractic without a license and ordered to pay a $5,000 fine plus $170 for court costs. During the trial, a chiropractic board investigator testified that he was required to sign private a membership agreement and pay a $20 fee, after which Mason examined him and pulled his head while twisting it to one side and then the other. Toward the end of the trial, Mason, who defended himself without a lawyer, attempted to argue that the agreement protected him from prosecution. However, the judge stopped him and said this was a legal issue (not one for a jury to decide) that should have been presented to the court before the trial. In 2014, the Arkansas Court of Appeals upheld the trial court decision .
- In 2014, the California Dental Board disciplined Richard T. Hansen, Jr., D.M.D. and Andrew S. Yoon, D.M.D. who had been conducting business through their Comprehensive Health Association (CHA), which was set up as a private membership association. During the previous few years, patients who wished to be treated by them were required to join the group and agree to its bylaws, which prohibited the patient from pursuing any grievance without going through a CHA-controlled hearing that would cost $750. Each was placed on probation for three years, barred from further dealings with CHA, and ordered to pay investigative costs of about $12,000 .
- In 2014, the Idaho Board of Chiropractic Physicians challenged the use of muscle-response testing and magnets by Michael Anthony Smith, D.C., who was doing business as Dynamic Health, a private membership association in Coeur D'Alene, Idaho. Smith contended that his treatments were effective but he agreed to (a) provide patients with a written disclosure that described his treatments as experimental and (b) pay $4,943.82 to cover the cost of the regulatory proceedings . I don't believe that the board's action accomplished much, because it permitted him to continue the disputed treatments. However, the private membership association set-up did not appear to effect this outcome.
- In 2014, the Texas Medical Board obtained an agreed cease-and-desist order prohibiting Antonio Giovanni Paletta—who had a PMA "license" —from acting as or representing himself to be a physician qualified to practice medicine within the state. Among other things, he had been identified in an advertisement as "Dr. Antonio Paletta, M.D., PSc.D." 
- In 2014, Joseph Andrew Diruzzo, a/k/a Joe Delarosa, doing business as the Society for the Study of Cell and Molecular Biology (SSCMB), was charged with practicing medicine without a license by providing treatment that included withdrawal of blood and fluids and injections purported to be "stem cells. Before undergoing treatment, patients were required to sign a contract and pay a $10 fee for lifetime membership in SSCMB. When the case was tried, the jury found Diruzzo guilty and the judge ordered him to serve four years in prison and pay a $24,000 fine. Diruzzo's appeal argued that SSCMB was a "members only" association "intended to be set up under the authority and protection of the 1st and 14th Amendments of the United States Constitution." But the appeals court, siding with the prosecution, ruled that it is well established that the regulation of medical practice generally does not violate federal due process rights .
- In 2016, the Texas Medical Board entered into Agreed Cease and Desist Orders with Julio Jiminez, D.C., Pedro J. Lozano, John Madden, D.C., and Trevor Botts, D.C., all of whom were representing themselves as "doctors" licensed by the PMA. The orders prohibiting them from acting as, or holding themselves out to be a licensed physician in the state of Texas and noted that the PMA does not confer any authority to people practice medicine in the state of Texas [33,34].
- In 2016, chiropractor James J. Martin was arrested and charged with practicing medicine without a license, misprepresenting himself as a physician, and 11 counts of felony grand theft that involved taking money from patients. Various reports indicate that he was using the designation "D.PSc." and doing business as a private membership association . CBS Sacramento reported that at least nine patients were
suing Martin .
- In 2017, Diem T. Nguyen, D.C., who advertised herself as "Dr. Thyroid" and offered non-drug treatment for s spectrum of thyroid disorders, was arrested for practicing medicine without a license. She subsequently pleaded guilty and was placed on three years probation and ordered to make restitution to two of her victims . At the time of her arrest, she operated New Life Integrative Wellness clinics in Elk Grove and El Dorado Hills, California. Archived pages of her former Web sites indicate that in 2013, when doing business as NorCal Natural Integrative Healthcare, she used the initials "D.PSc." and said that she was "a provider for the Pastoral Medical Association Member Share Program" and provided services to members only.
- In 2017, the Medical Board of California revoked the medical license of Keith DeOrio, M.D. in connection with his treatment of two patients who had complained that he had acted unprofessionallhy and might be mentally impaired. During the proceedings, DeOrio refused to provide then on grounds that he was operating a private medical association over which the board lacked jurisdiction. But the board ruled that he was not exempt from regulation .
2017, the Medical Board of Texas ordered Ross Stewart, Ph.D. to stop practicing medicine without a license and said that future violations could trigger a penalty of up $5,000 per violation and/or each day of a continuing violation. The agreed order stated that he was treating customers with an undetermined substance that purportedly contained stem cells grown from the customer's blood but was actually a saline solution with vitamins. The order also said that he "sought to circumvent the law by having customers join the 'Turtle Healing Band' allegedly an Oklahoma Native American Tribe, and and signing unenforceable waivers purporting to release him from liability." . Stewart does business as Parkinson's Clinic International LLC (formerly called the Brain & Body Wellness Center) in Dallas, Texas, but offers treatment worldwide via Skype or FaceTime. Like PMA, the Turtle Healing Band and related entities issue credentials intended to help practitioners avoid government regulation .
- In 2018, David Kingcaid, D.C., settled charges that he had acted improperly by his thyroid and similar treatment under his Pastoral Medicine License, not his chiropractic license. The agreed order he signed with the Texas Board of Chiropractic requires him to differentiate his chiropractic practice from any of his other businesses that are outside the scope of chiropractic; remove all references of his other businesses from his chiropractic Web site; and (c) provide a statement in any advertisement that mentions the Pastoral Medical Association that it is not a state-regulated entity .
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 . 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 .
The "PSc.D." credential and the claims made for private membership associations have considerable potential for harm:
- Consumers may mistakenly conclude that the PSc.D. credential signifies doctoral-level training.
- Consumers may mistakenly conclude that PMA's "license" reflects competence and government approval.
- Licensed practitioners may be encouraged to expand their scope into areas beyond their competence.
- Unlicensed practitioners, including some who have had their real state license(s) revoked, may think that the PMA's offerings will exempt them from government regulation.
- Marketers of supplements and bogus devices may think they can get away with making bolder claims for their products.
- Dealing with PMA's credentials may be burdensome to regulators and the courts.
- About the PMA. PMA Web site, accessed, Jan 10, 2016.
- Commonly asked questions. PMA Web site, accessed Jan 19, 2016.
- For the public. PMA Web site, accessed Jan 24, 2016.
- PMA Directory registration page, accessed Jan 19, 2016.
- PMA Member Share Agreement, accessed Jan 19, 2016.
- 1st and 14th Amendment Private Medical Association for Unlicensed or Licensed Medical Practitioners. ProAdvocate Group Web site, accessed Jan 19, 2016.
- Decision. U.S.A. v Karl L. Dahlstrom et al. U.S. Court of Appeals, Ninth Circuit, 713 F.2d, 1983, Aug 24, 1983.
- Memorandum findings of fact and opinion. Dahlstrom v. Commissioner of Internal Revenue. U.S. Tax Court memo 1991-264, filed June 11, 1991.
- Memorandum findings of fact and opinion. Dahlstrom v. Commissioner of Internal Revenue. U.S. Tax Court Memo 1991-265, filed June 11, 1991.
- U.S. Securities and Exchange Commission. Litigation release No. 15019, Aug 20, 1996.
- U.S. Securities and Exchange Commission. Litigation release No 15464, Aug 28, 1997.
- U.S. Securities and Exchange Commission, Litigation release No. 15587, Dec 9, 1997.
- 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.
- 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.
- 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.
- 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.
- Federal Food, Drug, and Cosmetic Act, Public Law 114-89, Chapter II–Definitions, Section 201(e), 21U.S.C. 321.
- Disciplinary actions. South Dakota Board of Dentistry. Accessed Jan 23, 2016.
- 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.
- 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
- 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.
- Barrett S. Enforcement actions against Miracle Mineral Supplement (MMS) marketers. Quackwatch, Jan 23, 2016.
- 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.
- 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.)
- Barrett S. Phony naturopath receives 15-year prison sentence. Naturowatch, Jan 18, 2016.
- Barrett S. Oregon alphabiotics practitioner ordered to stop practicing without a license. Casewatch, Jan 22, 2016.
- Judge issues preliminary injunction against unlicensed practice of chiropractic. Oregon Board of Chiropractic Examiners press release, Oct 2, 2016.
- Slip opinion. Mason v. State of Arkansas. Arkansas Court of Appeals, Division II, No. CR-13-478, May 7, 2014.
- Barrett S. A close look at Richard T. Hansen, D.M.D. Quackwatch, Feb 28, 2015.
- Barrett S. Regulatory action against Michael Anthony Smith, D.C. Casewatch, Feb 16, 2016.
- Cease and desist order. In the matter of Antonio Giovanni Paletta before the Texas Medical Board, Oct 27, 2014.
- Opinion. Joseph Andrew Diruzzo v State of Texas. Court of Appeals, Thirteenth District of Texas, Case No. 13-16-00638-CR, April 26, 2018.
- TMB disciplines 62 physicians at March meeting. TMB press release, March 22, 2016.
- TMB disciplines 78 physicians at June meeting, adopts rule changes. TMB press release, June 27, 2016.
- Chiropractor ordered not to practice after felony arrest. California Board of Chiropractic Examiners news release, Aug 4, 2016.
- Ming K. Call Kurtis Investigates: TV doctor arrested for practicing medicine without a license. CBS Sacramento, Aug 25, 2016.
- Johnson D. Board to decide professional fate of El Dorado Hills chiropractor convicted of practicing medicine without license. Fox 40, Sept 19, 2017.
- Barrett S. License revocation of Keith DeOrio, M.D. Casewatch, Jan 18, 2018.
- Agreed cease and desist order. In the matter of Ross M. Stewart, Ph.D., P.C. Before the Texas Medical Board, March 3, 2017.
- 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.
- Agreed order. In the matter of David Kingcaid before the Texas Board of Chiropractic Examiners, Jan 25, 2018.
- From the board. Kentucky Board of Chiropractic Examiners Web site, accessed Jan 18, 2016.
- Barrett S. A skeptical look at the NutriMost Fat Loss System. Chirobase, Dec 29, 2016.
This article was posted on May 4, 2018.