This is the final of a two-part series on the strange case of Australian orthopaedic surgeon Dr Gary Fettke. The country’s medical regulatory body has banned him for life from talking to patients about their sugar intake. Fettke says that he just wants to save patients’ limbs and lives. Senators have come to his aid in an Australian Senate Inquiry and wife Belinda speaks up when Fettke feels he can’t speak out. Here, they look at anomalies in AHPRA’s case against Fettke.
By Marika Sboros
On November 16, 2016, the Australian Health Practitioner Regulation Agency (AHPRA) issued an ambiguous statement relating to Dr Gary Fettke. AHPRA said that by law it could not disclose details of Fettke’s case unless he gave permission. However, AHPRA then proceeded to do just that: disclose details. Not surprisingly, senators conducting an inquiry into AHPRA’s medical complaints process were none too happy with that.
The statement contained cherry-picked sections of AHPRA’s Medical Board’s code of conduct for doctors, including that it:
- Requires doctors to ensure that their personal beliefs do not compromise the care they provide to patients;
- Prevents doctors putting their commercial interests ahead of patients’ care;.
Senator Peter Whish-Wilson told AHPRA CEO Martin Fletcher that he was “clearly making a statement about Dr Fettke”.
“You are not supposed to be making public statements about him yet in a sense you are.”
Fletcher, however, disagreed. He said that AHPRA was just responding to “misinformation” about the “caution” it had given to Fettke. He said that the media had incorrectly reported it as a “gag” or “ban”. Click here to read AHPRA’s full statement.
Whish-Wilson asked Fletcher how long AHPRA had given Fettke to respond to the request for permission before going public. Fletcher said: “about an hour”. Whish-Wilson said that Fettke was “more precise”. AHPRA had given him just 52 minutes.
He asked Fletcher: “Can you understand that giving a busy surgeon an hour to actually know about this and then speak to his lawyers and give you an informed decision on whether he should or should not release the documents is unfair?”
Whish-Wilson reminded Fletcher that Fettke had Freedom of Information (FOI) requests to AHPRA to release the documents. However, these FOI requests had failed. He said that it would have been more helpful if AHPRA had told the public about Fettke’s FOI requests in the statement. Instead, it had implied that Fettke was blocking the release of documents.
Fletcher said that he did not think that’s what AHPRA was implying.
Whish-Wilson and Senator Nick Xenophon questioned the route that AHPRA uses to decide whether a complaint is vexatious. Both senators described it as “labyrinthine”.
Whish-Wilson told Fletcher: “You have gone down a very long rabbit hole against a surgeon for essentially providing dietary advice to patients. Where is your jurisdiction? If you do not have it over dietitians, why are you pursuing this against a medical practitioner?”
Both senators said that the Dietitians Association of Australia (DAA) had obvious conflicts of interest with Fettke. They pointed out that Anonymous DAA dietitians had lodged complaints against Fettke. Thus, they questioned why that did not immediately raise flags of vexatious complaints.
Fletcher responded that the intention of a complaint “may not have been particularly honourable”. However, there may still be “an issue of patient safety”, he said. As a result, he wouldn’t consider it a vexatious complaint.
Xenophon said that it was common for doctors to advise obese patients on diet. It was also common knowledge that excess weight wasn’t good for patients.
He called it “trivial” for AHPRA to go after a medical practitioner who had advised a medically acceptable dietary programme. He questioned why AHPRA would go after a doctor “with guns blazing” if patients weren’t complaining.
“Don’t you have better things to do?” Xenophon asked.
Click here for a full transcript of the second hearing of the Parliament of Australia Senate Inquiry into AHPRA’s medical complaints process. Or watch the video of the Senate Inquiry.
Fettke says that AHPRA’s latest statement is “a smear and slanderous”. “How is it fair to ask me to give AHPRA permission to disclose documents relating to my case that I haven’t seen?”
He says that he has proof that AHPRA has “embellished at least and fabricated at worst” documentary evidence against him. He presented that evidence to AHPRA investigators but they ignored it.
Fettke has also described the stress of defending himself against AHPRA without knowing the evidence against him. “It’s like boxing shadows,” he said.
Consequently, in the wake of the Senate Inquiry, AHPRA faces a litany of credibility, legal and ethical issues in its actions against Fettke. It hasn’t helped itself by not acting against doctors and other health professionals under its jurisdiction who routinely give nutrition advice, including LCHF.
In its most recent media release, AHPRA said that it expected registered medical practitioners to provide “appropriate dietary advice to patients when this is indicated”. Thus, its action against Fettke is inconsistent, say critics.
Click here to read: KENDRICK: SWEDEN GETS IT RIGHT WITH ‘IDIOT’ DIETITIANS
AHPRA has also reportedly gone after Fettke for being “disrespectful” towards other health practitioners. However, he has strenuously denied that.
The problem for AHPRA is that it hasn’t acted against doctors, nurses and midwives under its jurisdiction who make defamatory comments about Fettke on social media. Furthermore, these include admin members of a particularly toxic Facebook hate page, one of whom actually works for the pharmaceutical industry.
Consequently, concerns about AHPRA’s processes are not new. Xenophon called for a Senate inquiry in 2015. He said that AHPRA was “all about protecting a closed shop”, not best standards of patient care.
Top Sydney neurosurgeon Dr Charlie Teo also backed Xenophon’s call at the time. Teo told of a culture of bullying in the profession that went “right to the top”. He said that it was “destroying the lives of doctors and their families”.
Critics of AHPRA – they are many and growing – have called it a “star chamber”. That’s a reference to legal antics of an ancient high court of England that King Henry VII established in 1487 to break the power of the landed gentry. The English parliament abolished it in 1641 for abuses of power.
Australian cricket team doctor, Prof Peter Brukner, has called for AHPRA to review the ban urgently.
Brukner is professor of sports science at La Trobe University and the Australian cricket team doctor. He says that AHPRA’s ban doesn’t make it clear which doctors are and are not allowed to give nutrition advice.
Although doctors receive little nutrition education as medical students, Brukner says that they all receive equal amounts of nutrition training. Some, such as Fettke, go on to “explore the science behind nutrition more fully”.
The field of nutrition is going through an interesting time, Brukner says, and this is challenging some long-held beliefs. As well, many unqualified nutrition “gurus” are giving advice about what we should and should not eat.
Thus, it must surely be preferable for a doctor to give nutrition advice, not unqualified individuals, Brukner says.
He said that he has heard Fettke speak on nutrition at conferences and was impressed with his depth of scientific knowledge and passion for patients’ welfare.
A recent Diabetes Australia report has shown that there are now a million Australians diagnosed with type 2 diabetes. The total number could be high as 1.7 million, Brukner says, as the number of Australians currently with undiagnosed, “silent” type 2 diabetes is unknown. Furthermore, with a population of 23.3 million, that means around 7% of Australian have type 2 diabetes.
As well, experts have estimated the number of people with pre-diabetes and at high risk of developing Type 2 diabetes to be around 2 million.
Brukner says that the authorities should encourage doctors to give lifestyle advice in an attempt to reduce the rapidly increasing numbers of Australians suffering from obesity and Type 2 diabetes.
On her Facebook page, Belinda Fettke has posted An opinion ‘peace’ on vested interests. In it, she rejects AHPRA’s claim that Fettke hid a conflict of interest from patients relating to a private dietitians’ clinic he set up.
She says that he always told patients about his connection with Nutrition for Life clinic. Especially relevant is that he has declared that interest openly in every public lecture and on social media platforms. He is also pictured and named on the Nutrition for Life website as co-founder.
Click here to read: CAN YOU TRUST DIETITIANS WHO ARE IN BED WITH BIG FOOD?
In the “caution” email to Fettke, AHPRA accuses him of “failure to disclose or properly manage a conflict of interest (eg receiving a benefit for recommending a product or service).”
Belinda points out that Nutrition for Life did not exist when the original anonymous dietitian complained in June 2014. Thus, the conflict of interest charge does not apply. As well, if AHPRA investigators had bothered to do an audit during its 832-day investigation of Fettke they would have found that:
- 76 doctors currently refer patients to Nutrition for Life and Fettke is just one of them.
- Of the 1,122 clients that the Nutrition for Life team has seen, Fettke has directly referred only 28 patients since opening on September 1, 2014.
“If AHPRA wants to hang the tag ‘vested Interest’ on Gary for his involvement with Nutrition for Life, so be it,” she says. “We are proud to have a vested interest in our community’s health. We are also proud to have put our time, energy and money into something that we believe to be very special.
“Why? Because we have nothing to hide.”
- Click here to read Part 1 of this series
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Do people still do not realise that all this comedy (or tragedy) in Oz is related to the love of money?
Yeah, or as the Bible says: the root of all evil. I think many Down Under are seeing the attack on Dr Fettke for what it really is: a travesty and a real kangaroo court.
I do not usually comment via social media as it is not my most favoured form of communication, however on this occasion i feel compelled to. Like many i simply can’t believe the sheer arrant stupidity of the Australian Health Practitioner Regulation Agency’s position. Their processes more closely resemble those of the witch hunter general than those of rational 21st century professionals. I fear that vested interests and arrogance are the basis for the actions rather than any care for patient welfare. The sooner this body is disbanded and replaced by something based in care and common sense the better.
Dr Fettke is providing true care for his patients beyond the needed surgery or amputations, so that they live longer and healthier lives. How can this be made out to be against patient care and responsibility? Beware of the forces behind the scenes with their ‘anonymous’ front men doing the dirty work to bring down responsible doctors. It is the patient who also loses out here.
I don’t know how many people feel as I do. The frustration, the injustice, the stupidity of people with access to the internet, the mendacity of the conglomerates on the tiger’s tail awaiting the fate of the tobacco barons? (yeah – but anyone there been prosecuted?) We are small, as gnats or see ums are, but nobody can ignore death by a thousand bites.
Really, the only way things will change is for folk sitting with a keyboard in front of them an intellect seeking truth starts beating the drum and kicking down the door!
I suspect many people feel as you do, Michael. Vested interests make a big mistake to treat people like ignorant idiots. Social media have become a powerful vehicle for highlighting abuses. They are kicking down the doors.
The whole deal can be summed up thus:
…inappropriate reversal of type2 diabetes.
Dr Fettke, stay strong. Science and truth are on your side. One day the scoffers and mockers will see that their empires had been built on sand. Meanwhile millions of lives are at risk. The only thing necessary for the triumph of evil is that good men do nothing. You do not stand alone – but you stand as an inspiration for us who have chosen to question orthodoxy – we need to fix what is broken before it breaks our nation’s health and health budget.
This is just daft. The Australian Authorities are lining themselves up for a BIG litigation avalanche. When the truth comes out about the current “authorised / approved dietary advice” that has millions of Australians diabetic or pre diabetic, there will be some questions needing answers. When it gets proven beyond doubt that pain and suffering has been lobbied successfully for in the chambers of Government for individual profit – It is going to hit the fan. Rather than making this “hulla balloo” the whispers should have been “mum’s the word”. Never forget what Winston Churchill said: “The Truth Will Out!” First in South Africa, now it’s Australia. Next, just wait to see what happens when the American lawyers get hold of this.
“… However, there may still be ‘an issue of patient safety’ ”. (Fletcher)
Yeah, right. Dr Gary Fettke advises diabetic patients to cut back on sugar and other refined carbohydrates (giving a figure for an upper limit on sugar consumption that the WHO now agrees with) and there may be “an issue of patient safety”. In which alternative universe?
Perhaps AHPRA means that fat (or saturated fat) present in the cheese, egg and yoghurt shown in the photograph above are a danger to patients – because the diet-heart hypothesis said so. This was, of course, the hypothesis of the American celebrity-academic Dr Ancel Keys, whose Seven Countries Study is a poster-child for shoddy and manipulative science. Keys, I only learned recently, took economics as his first degree; later he spent many years studying the physiology of fish. He had studied neither the heart nor nutrition, and his theory was disputed by Dr John Yudkin who was an expert in both areas. There never was any evidence for Keys’s hypothesis; there still isn’t. But there is some pretty compelling evidence against it.
Maybe Dr Fettke should have studied economics and the physiology of fish and that would entitle him to given an opinion on dietetics and health.
APHRA’s behaviour and statements just get curiouser and curiouser:
“… And its most recent media release, AHPRA said that it expected registered medical practitioners to provide ‘appropriate dietary advice to patients when this is indicated’. ”
So can doctors advise or can’t they? APHRA is unable to be consistent because it doesn’t have a reasoned position. It is merely pursuing a vendetta against a particular doctor for reasons best known to itself and unlikely ever to be disclosed.
I suggest the Australian senators could well take the timing of the caution issued to Gary as an attempt to frighten other witnesses they might like to speak to and hence as a gesture of contempt towards the Australian Senate. I wonder if APHRA is beginning to realise what thin ice it is skating on.
Well, South African scientist Prof Tim Noakes must be glad he’s not Australian. This is a mockery of justice and it makes Australia look like a banana republic.
Anonymous complaints and hearings taking place without the defendant, who isn’t allowed to see the evidence? Even (Zimbabwean leader) Robert Mugabe might think such bias and lack of process a little embarrassing. Indeed, the Star Chamber of Henry VII in the 1490s would not have permitted any of these things, yet it is now a byword for injustice.
Kangaroo court indeed! Big Food and Big Pharma behind it all.