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LIPO LOOPHOLE: Naturopath discplined for allowing unlicensed medical assistant to perform liposuction procedure

The disciplinary action comes amidst criticism from some in the medical community that Arizona naturopaths are practicing outside their scope of practice.

PHOENIX — A Valley naturopathic physician has been disciplined by the Arizona Naturopathic Physicians Medical Board after allowing an unlicensed medical assistant to treat his patient who was experiencing complications.

The complications stemmed from a full-body liposuction procedure, which some in the medical community say naturopaths are not qualified to perform.

The allegations against the naturopath, Jose Ortiz, were laid out in a board meeting over the summer.

According to the patient, Ortiz performed liposuction surgery on her on December 16, 2021. 

"All areas below the breast line," Ortiz explained during the hearing. "She was not happy with the fact that her buttocks wasn't as large as she wanted it."

The board was less interested in the physical results and more in the treatment of the patient after the surgery was done.

Two weeks later, she texted Ortiz that she was experiencing complications. Specifically, she was experiencing fluid build-up.

She texted Ortiz asking him if she should go to the hospital.

“She asked me and I said if she felt like she needed to, she should go,” Ortiz explained.

The board was critical of Ortiz's response.

“You said protocol is to send people to the emergency room. And then you broke protocol by only saying, 'only if you need to.' But I don’t know how the patient’s supposed to know if she needs to or not," said Dr. Daniel Rubin, a board member.

Instead, Ortiz, who was out sick, had his patient see a medical assistant who worked in his office. 

When the board asked if that assistant was licensed, Ortiz said she had displayed a certificate in her office but he had no idea and never confirmed whether she was appropriately licensed to perform the fluid drainage procedure.

Ortiz told the board he had no affiliation with the medical assistant and described her as a tenant in his building.

"I don't know what she was working as," Ortiz said.

Ortiz allowed her to do the procedure, unsupervised, anyway.

“This is a tenant in your space, a subcontractor, who you don’t know anything about them is what you’re saying. You don’t even know what they’re doing and you said no go have her stick a needle in you?" Rubin said.

“What I’m trying to understand is how you came to the conclusion that it’s okay to send her to this particular person."

The board placed Ortiz on probation for six months.

"It’s just not okay to delegate some kind of duty like that which could have other repercussions and to break protocol and to send it to some, in this case, near-random individual," Rubin said.

Through his attorney, Ortiz declined to provide comment for this story.

Some in medical community allege cosmetic surgeries are outside the scope of practice for naturopaths

This board investigation came amidst criticism from some in the medical community that naturopaths like Ortiz are practicing outside their scope of practice when performing cosmetic surgeries. They describe it as a patient safety issue.

Some plastic surgeons across the state say cosmetic surgeries like liposuction and Brazilian butt lifts are high-risk, major surgeries. They point to the difference in required education between a plastic surgeon and a naturopathic physician.

Plastic surgeons receive up to 16 years of education before practicing. Leading naturopath programs are four years and typically come after a bachelor’s degree. 

RELATED: Arizona allows people who aren't medical doctors to perform liposuction and Brazilian butt lifts.

There are no clear statutes that define the scope of practice for naturopaths in Arizona and the American Society of Plastic Surgeons has said the board has failed to address the problem. The ASPS has asked the legislature to step in.

"We brought it to the attention of the naturopathic board and said, 'hey, there's a problem, can you help us deal with this?' And we didn't really feel like that got the attention that it deserved. And certainly, the patient safety issue has not been addressed," said Dr. Raman Mahabir, a board-certified plastic surgeon in Tucson. 

RELATED: Plastic surgery societies call on Arizona lawmakers to stop naturopaths from performing surgeries

Ortiz was sued in 2019 by another patient, Bruce Tucker after Tucker said his liposuction surgery was botched. In that case, the board issued a non-disciplinary order, requiring Ortiz to complete additional medical charting and patient intake training.

In September, a judge dismissed four out of five of Tucker's claims against Ortiz, including medical negligence. Tucker's attorney plans to appeal that decision.

“We can't leave the public unprotected. That's the overriding issue here," said Robert Gregory, Tucker's attorney.

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