Ripples From O.C. Healer’s Case Spreading

To many of his clients, Salvatore Anthony D’Onofrio is an inspired healer, offering the sort of relief that the jealous medical establishment can neither match nor understand.

To the state of California, he is a criminal suspect, charged with practicing medicine without a license--and molesting unsuspecting women in the process.

He says he was employing a “legitimate” immune-enhancing technique called “ozone therapy” that sometimes calls for inserting oxygen tubes into women’s vaginas. The state contends that in at least two instances, he was seeking sexual gratification. Next month, if his case goes to court as planned, the evidence will be weighed and measured.

Whatever the outcome, this Laguna Beach controversy is about more than one self-proclaimed holistic healer and his run-in with the law.

Already, the prosecution of the personable and popular D’Onofrio has inflamed tensions between the so-called “healing community” in this seaside resort town and authorities acting in the name of consumer protection.

And it has drawn interest--and impassioned rhetoric--from outsiders as well.

“Dr. D’Onofrio’s case is a spark from the crucible,” said Dr. Paul H. Goodley, a Big Bear-area physician and fan of holistic medicine who joined more than 30 other D’Onofrio supporters at a recent court hearing.

“It is a tinder [box] situation. There is a desire to intimidate those who would use untraditionalism. For the Police Department to be part of a vicious witch hunt is a terrible, terrible statement.”

At the least, in a town known for its appetite for “alternative” anything, the case has raised a divisive question: Should unlicensed health-care practitioners be left to their own devices, or should they be held to similar standards as doctors and other more conventional providers?

The issue has national resonance, as one in three Americans turns to alternative medicine each year, sometimes desperate for help after standard approaches have failed.

Some forms of what might be considered alternative health care already are regulated in California--chiropractic, osteopathy and acupuncture, for example. But many, including D’Onofrio’s field of “nutripathy,” are not, meaning that there are no specific educational, ethical or clinical requirements of practitioners by the state.

That, some critics say, is dangerous. “You have to have standards of conduct,” said William Jarvis, president of the National Council Against Health Care Fraud. “Those standards have to have teeth. You have to have some sort of regulatory agency to make sure these [practitioners] are competent, and to make sure they aren’t scoundrels.”

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It is illegal in California for anyone to diagnose or treat patients without a medical license. Yet, from a practical standpoint, the state cannot pursue every person who hangs out a shingle or whispers a word of medical advice.

The Medical Board of California, which licenses doctors, also investigates unlicensed practitioners--but often, only when a complaint arises. And the board has no plans--or resources--to beef up such enforcement, said supervising investigator Dave Thornton.

Thornton said formalizing the state’s regulation of unlicensed practitioners poses its own dangers.

“I think that if we did anything that would put a stamp of legitimacy on [a practice], then the state is condoning that treatment,” he said.

For their part, many unlicensed practitioners are wary of regulation. They are used to their maverick roles, and believe the only sanction they need is from the clients they serve.

“The sanction is on the grass-roots level,” said Harri Wolf, a lay homeopath from Laguna Beach. Besides, he said, “I’ve been a loner all my life; I’ve sort of done this alone. I have my principles and my ethics.”

Even those who support enhanced oversight are not certain what form it should take.

“When you have a wholly unregulated field like some forms of alternative medicine, you have enormous potential for abuse,” said Paul Root Wolpe, a senior faculty member at the University of Pennsylvania Center for Bioethics.

“I think it should be regulated. . . . On the other hand, my fear is how you do it. Most of the existing regulatory agencies have no way to assess alternative therapies, and often they do not accept the philosophical framework, or even the scientific framework, under which they operate.”

One measure of the sensitivity of the D’Onofrio case is the cautious approach of prosecutors. Their tone seems to have shifted from the days after D’Onofrio’s arrest, when they predicted more charges would follow and sought a hefty bail of $500,000. No new charges have materialized, and last week, D’Onofrio was released without any bail on his own recognizance. He was even allowed to continue seeing clients under very limited conditions.

“I have a very open mind,” said Deputy Dist. Atty. Rosanne Froeberg, who is consulting with experts in holistic health as she prepares the case.

Froeberg said she isn’t “conceding anything” in the case at this point, but that the office has to “take into consideration the healing community’s perspective on this.” D’Onofrio and his attorney, Charles Benninghoff, argue that D’Onofrio’s arrest, which stemmed from a patient complaint, never would have occurred if his practices had been examined by peers familiar with his approach. As it stands, he faces eight counts of penetrating two women with a foreign object, and one of practicing medicine without a license. He has pleaded not guilty.

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According to D’Onofrio, inserting ozone through tubes in the vagina is a powerful, immediate way to activate the immune system. It can be used to treat local problems, such as yeast infections and endometriosis, or systemic ones, including cancer, he said.

The practitioner insists he is experienced, with a doctorate in nutripathy--a discipline that focuses on nutrition, emotional and spiritual health--from the American College of Nutripathy in Scottsdale, Ariz.

The non-accredited correspondence school no longer exists, but a spokesman for the unaffiliated university that replaced it confirmed D’Onofrio’s degree. Ward Adams, dean of students at North American University, said he does not believe D’Onofrio’s course work included instruction in vaginal ozone therapy.

Jarvis considers the vaginal approach “pure raw-bone quackery.” But advocates say some forms of treatment with ozone are accepted in at least 16 countries, and that these methods used to be favored in the United States until the American Medical Assn. objected in the 1930s.

D’Onofrio’s supporters say he is not simply the target of standard medical skepticism, but of more sinister forces.

“It’s probably political and economic,” D’Onofrio said during an interview last week, a day after his emergence from a six-week jail stint.

“Fully one-third of the country is seeking alternative care, and that’s quite a big chunk of money out of the orthodox medical system. These people [conventional doctors] are financially frightened by the success that the natural healing process has had.”

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D’Onofrio supporters hint at a loose conspiracy between law enforcement, the medical board, pharmaceutical companies and politically muscular organizations like the California and American medical associations.

“This has become a turf battle instead of a battle of rationality,” Goodley said.

Jarvis, of the anti-fraud council, scoffs at the notion.

“There is a strong alienation factor in those people,” he said. “They don’t trust anything about mainstream society. Whether they are the regulators, the [American Medical Assn.], the [Food and Drug Administration]. . . . There is a total reversal of trust. They mistrust the wrong people.”

Yet Wolpe, the University of Pennsylvania bioethicist, points out that certain legal developments have bolstered the alternative medical community’s suspicions. Perhaps most significant was the outcome of a lawsuit nearly a decade ago in which a federal judge ruled in favor of chiropractors who accused the American Medical Assn. of launching an anti-competitive boycott against their profession.

Some physicians acknowledge that standard medical practitioners must accept some blame for driving consumers into the welcoming arms of the alternative community.

“This [movement toward alternative care] reflects a searching on the part of people to find a healer who will listen and pay attention,” said Dr. Robert Tranquada, a professor of medicine and public policy at USC. “And that represents a failing of mainstream medicine.”

To many following the D’Onofrio case, in Laguna Beach and beyond, the debate is a clash of ideals, and it is cast in extreme terms. One side sees it as a question of liberty, the freedom of consumers to make choices about their own health care. The other invokes society’s duty to protect unwitting consumers against charlatans and pseudo-scientific sociopaths.

Complicating the issue, from the standpoint of regulators, is the fact that many clients of unlicensed practitioners are more than willing to give moving testimonials extolling the virtues of their cherished “healers.”

In D’Onofrio’s case, his girlfriend, Sandra Hart, rounded up a group of client-fans of D’Onofrio in a show of support at his court hearings.

“He treated my problem,” said Deborah Lee, 43, a musician from Aliso Viejo, after last week’s hearing. She had been “pretty much bedridden” with knee pain, she said, and traditional medical doctors could not say why. But D’Onofrio determined within 10 minutes that her body was having trouble absorbing calcium, she said. After his treatment with an acidic calcium supplement, her pain diminished.

Jarvis counters that testimonials are not “evidence-based” science.

“There are so many ways to trick people into thinking something good has happened,” he said.

Wolpe agreed, but cautioned against a call to arms by either side. Even those alternative practitioners who rail about the perceived arrogance of organized medicine acknowledge they take their children to medical doctors when they fall off the jungle gym. Some get patient referrals from physicians as well. They consider their services not so much “alternative,” they say, as “complementary.”

Of course, in the heat of battle “there is a tendency for both sides to impugn the motives of the other,” Wolpe said. “The truth of the matter tends to be that neither of these viewpoints is entirely [right].

“Often there are very powerful alternative therapies that are later co-opted by organized medicine. . . . And organized medicine is not motivated entirely by an attempt to control all medical care. There is a sincere belief that many of these [alternative] therapies are dangerous.”