By Marika Sboros
Australian orthopaedic surgeon Dr Gary Fettke’s professional reputation and licence to practise medicine are no longer under threat. The Australian Health Practitioner Regulatory Agency (AHPRA) recently cleared Fettke of any misconduct over his opinions on nutrition.
That response was legally and ethically correct, under the circumstances. However, it raises more questions than answers.
One question is why AHPRA went to war on the side of the Dietitians Association of Australia (DAA) and its members who mobilised against Fettke. Another is why no heads have rolled in AHPRA’s prosecution of Fettke – in a case that legal analysts called a “kangaroo court“.
Yet another is why AHPRA has ignored extensive evidence of bullying, mobbing and intimidation of Fettke at his workplace, Launceston General Hospital (LGH) in Tasmania, for more than eight years. That is raising questions of a cover-up at the highest levels.
Those questions don’t just apply to AHPRA and the DAA. Fettke says that they also apply to executives at LGH and the Tasmanian Health System (THS) and even the Tasmanian government for their role in getting AHPRA to go after him. Also implicated are “medical evangelists” belonging to the Seventh-day Adventist Church.
Why would so many groups gang up on Fettke?
South Australia independent senator Cory Bernardi believes he has some answers.
“The world has gone completely mad,” Bernardi writes on his Weekly Dose of Common Sense blog.
He utters that phrase most days, these days, he says, because he has to confront “absurdities, deceptions and idiocy of public advocacy groups and government”.
Many groups are now “hell-bent on fuelling the grievance industry” and generating new “victims” almost daily, Bernardi says. We should all question the motives behind “almost every public utterance” they make.
“Public interest” advocacy now seems to be all about money, he says. Even seemingly reputable organisations are “not above selling out to feather their own nest”.
DAA dietitians ‘vexatious’
It’s not hard to see that Bernardi has AHPRA and the DAA in his sights. And it is common knowledge by now that DAA dietitians at LGH started the case in 2014 by reporting Fettke to AHPRA vexatiously.
They “didn’t like a mere surgeon giving dietary advice so they complained to (AHPRA)”, Bernardi writes.
They also objected to what Fettke was telling his patients. But what exactly did he say that so infuriated the DAA and AHPRA?
Fettke advised patients with weight-related joint issues, chronic metabolic disease and diabetes complications to reduce their sugar intake. He also told them to eat fewer processed carbohydrates and to reintroduce healthy natural fats.
Fettke wasn’t asking for a radical overhaul of the hospital’s menus. He just wanted LGH to make eggs, full-fat yoghurt and cheese available for his patients. He was advocating for the basics of low-carbohydrate, healthy-fat (LCHF) diets.
Fettke did not aim his advice only at patients. Fettke questioned the number of sugary drinks and the amount of junk food available to all the hospital’s patients, staff and visitors.
Bernardi finds that “sensible advice”, especially from “a medical professional at the front line of dealing with a serious problem”.
Whose advice is ‘dangerous’?
Yet DAA and its dietitians deemed that advice dangerous. That’s despite being unable to produce any evidence, a victim or proof of any harm to anyone. AHPRA, as Fettke has shown, went along with that thinking.
But the problem for them from the outset is that Fettke is no “mere surgeon” when it comes to nutrition. He has made a special study of nutrition science since 2012. The main driver was his own battle with cancer.
Click here to read: Cancer therapy of the future? Already here, says Fettke!
In 2000, Fettke was 37 when doctors diagnosed an aggressive pituitary tumour requiring a craniotomy to save his eyesight. A period of intensive stereotactic radiotherapy and many years of chemotherapy followed.
Despite these marvels of modern medicine, the tumour continued to be “active”. Fettke had more surgery in 2004 and ended up on a cocktail of drugs. In the best tradition of iatrogenesis (doctor-caused illness), doctors prescribed some drugs to counteract the side effects of all the others he was taking.
By 2009, Fettke was overweight, prediabetic and hypertensive (had high blood pressure). He was also experiencing increasing episodes of cardiac arrhythmia (irregular heartbeat). It did not occur to him that his diet was a factor.
Why Fettke went LCHF
After all, he religiously followed conventional dietary advice and believed he was “doing all the right things”.
He ate at least five portions of vegetables and two portions of fruit daily. He spread “heart healthy” margarine and honey or peanut butter on his wholegrain toast. Fettke used polyunsaturated oils only for cooking and ate lean meats and low-fat dairy. He also drank fruit juice daily.
In 2012, Fettke read David Gillespie’s book, Sweet Poison. He began intensive study of the metabolic model of cancer that includes the role of glucose in keeping cancer alive and thriving in a host body.
Fettke changed his diet to LCHF and went off chemotherapy under medical supervision with regular check-ups.
In 2015, he spoke at a world-first low-carb summit in Cape Town. He called his presentation Cancer: A Time To Rethink? The subtitle was: So you think you need sugar? Your cancer needs it even more. It was provocative at that time. It elicited a mostly positive reception from the global experts and assembled audience.
Fettke has been off chemotherapy for more than five years now. Follow-up blood tests and MRI have shown no sign of any cancer cell activity. He has also reduced his medications from 15 a day to one and a half tablets.
Saving patients’ limbs – and lives
“I could not achieve this on a conventional low-fat, high-carb, sugary diet,” Fettke says.
The evidence for LCHF was robust, not just for cancer but for obesity and diabetes as well. Therefore, Fettke felt compelled to share it with his patients and to raise issues of quality assurance and patient safety at LGH.
As an orthopaedic surgeon, Fettke was frustrated at amputating limbs from growing numbers of his diabetic patients. He made it clear that he prefers not to have to cut off parts of patients’ bodies when simple dietary changes can save their limbs – and lives. And he did not hold back from making his views known about conventional dietary advice.
Hospital authorities did not take kindly to that. Nor, apparently, did AHPRA and the DAA.
Click here to read: Why DAA may regret ‘sleeping with the enemy’
The “long story made short”, writes Bernardi, is that AHPRA, at the DAA’s behest, told Fettke to stop what he was doing. (That was after AHPRA held a behind-closed-doors investigation for two and a half years.)
And in 2016, AHPRA slapped a ban on Fettke from speaking to his patients or in public about nutrition. It didn’t stop there. Bizarrely, AHPRA said that even if LCHF became mainstream in future, he still could not speak about nutrition.
Fettke ignored the ban and appealed. AHPRA resisted, as Bernardi notes, but finally recanted and apologised in writing.
That put the spotlight back onto the DAA and food industry influence in Fettke’s case.
Cabal of cereal industry CEOs
Bernardi cites Fettke’s own investigations showing the influence of a small cabal of cereal industry CEOs. They had become concerned about the fall in cereal consumption among consumers. These industry executives meet annually to plot ways to increase consumption of their products, Bernardi writes.
They also identified a list of individuals to target to strengthen their cause. Bernardi notes that Fettke was the only doctor on the cereal makers’ “hit-list”.
They appear to have “enlisted the DAA to do their dirty work” – hence, the dietitians’ complaint to AHPRA, Bernardi says. And while justice was eventually done, it “calls into question every piece of advice from the DAA”.
Click here to read: Does DAA target dissident LCHF dietitians with fake news?
“If the DAA are prepared to sell out our health and their credibility for funding … how can the health-conscious public rely on anything (the DAA) tell them?” he asks.
DAA guidelines are used to justify almost every institutional menu – from school tuck shops to hospital food, kids’ lunches through to the ubiquitous food pyramid, Bernardi says. The processed food industry appears to have spent 20 years funding the DAA to “push an anti-dairy, anti-meat message” in favour of its products.
It is “little wonder” that obesity and diabetes are becoming a health epidemic across the community, Bernardi says. It is “just another example of how a once-trusted institution has imploded under the weight of greed and self-interest”.
And it is little wonder that the public can no longer tell real news from fake news, he says. Perhaps the DAA can blame the Russians, since “everyone else does”, Bernardi says.
Digging up the dirt on DAA
The reality is that AHPRA did not have to dig too deeply to find the DAA’s extensive conflicts of interest (COIs) of interest in this case. COIs show up in the DAA’s well-documented links with food and soft-drink industries that benefit from conventional dietary guidelines. (Click here to read Foodmed.net’s four-part series on the DAA’s COIs.)
In February this year, Fettke received a letter of release from AHPRA giving him access to an 845-page submission from the THS to AHPRA’s Medical Board in 2015. AHPRA appears to have done no fact-checking on the THS allegations against Fettke.
The submission is proof – if any more were needed – that the case against him was a sham, says Fettke. It also proves that AHPRA’s handling of it was a “star chamber”, he says. (A “star chamber” is a reference to the former court of inquisitorial and criminal jurisdiction in England from the mid 15th to late 17th centuries. The court sat without a jury and was noted for its arbitrary methods.)
The submission proves what he and wife Belinda have always suspected: that the DAA and AHPRA did not act alone in prosecuting him. The LGH, THS and even the Tasmanian government probably also conspired against him and are “complicit in a cover-up”.
In preparing evidence in his defence against the dietitians’ complaints, Fettke and his wife also uncovered the phenomenon of “medical evangelism” as a contributing factor. And in particular, the activities of medical doctors and dietitians belonging to the Seventh-day Adventist Church. These medical evangelists may also have contributed to the cover-up, they say.
Coincidence – or something more sinister?
That cover-up has not only adversely affected Fettke. He says that it has “obstructed public health policy and caused community harm”. That harm comes from “(causing) distrust and withholding best practice (from patients)”.
The submission certainly is incriminating. It includes communication between the DAA’s former CEO Claire Hewat and the CEO of Launceston General Hospital. Hewat effectively demands that he silence Fettke. And while it might just be coincidence that the first DAA dietitian’s complaint followed soon after, the Fettkes don’t believe that it is.
Hewat resigned her position earlier this year. The DAA’s new CEO Robert Hunt has now pledged to sever its financial ties with the sugar lobby.
Along with the exoneration of Fettke, those steps may be too little too late for the DAA and AHPRA to save their credibility over this case.
But perhaps one of the most vexed ethical questions is why AHPRA has ignored all the evidence of bullying and intimidating of Fettke at Launceston General Hospital.
The response of the hospital and the THS has been telling in this regard. Executives threatened Fettke with deregistration (loss of his licence to practise medicine) if he continued to talk about nutrition. They also questioned his qualifications to talk about nutrition.
Authorities cancelled Fettke’s research projects at LGH and the University of Tasmania, where he was a senior lecturer for many years, without explanation. Posters for his upcoming talks were defaced.
Fettke found lolly wrappers stuck into his hospital locker. Someone even defaced a photograph of Fettke’s kitten by drawing a dagger through its stomach (see left). He had taken the photograph to work as part of a team-building exercise in the hospital’s theatre.
In short, Fettke was practising medicine in a toxic hospital environment. His bosses did nothing about that. Instead, they contributed to making his working life a misery.
Belinda has documented the lengths to which they were prepared to go on the I Support Gary website. She started it to give voice to Fettke’s fight to clear his name after AHPRA’s attempt to silence him in 2016.
It makes deeply disturbing reading.
Fettke presented that evidence at a Senate inquiry into AHPRA’s secretive complaints processes in 2016. The Senate put AHPRA on notice. It suggested that Fettke refer the case to the National Health Practitioner Ombudsman and Privacy Commissioner. The Commissioner considered that there was an issue with the AHPRA process.
An independent medical board finally reviewed Fettke’s case. And in late September 2018, AHPRA sent a letter to Fettke clearing him of any misconduct.
Public support for Fettke has grown throughout this case. People came forward to say that the system “fiercely protects strict dietary and health guidelines” and has disempowered them.
‘Band-aiding sick care’
Patients told him how healthcare professionals threatened to withhold medical treatment and services from them because they use LCHF principles to manage and improve their health. That’s despite tangible proof on blood testing and marked improvement in their overall health and wellbeing.
Patients also told Fettke how medical professionals told them to stop eating LCHF foods because their blood glucose control was “too good”. And, that therefore, they would not qualify to go onto a new drug.
Earlier this year, Fettke chose not to renew his contract with Launceston General Hospital. After 25 years’ service, the decision “was not an easy one”.
“I can no longer be part of a system that rewards band-aiding of sick care over prevention,” Fettke says. “I can’t have anyone telling my patients that the advice I give is dangerous and can kill them.”
Fettke remains committed to caring for patients and teaching students. However, he says that the hospital has made it impossible for him to continue to provide best practice to his patients and the broader community. It has done so by undermining him, he says.
Fettke has called for a satisfactory resolution of his bullying, mobbing and victimisation claims. He says that the hospital must acknowledge and satisfactorily resolve the many breaches of his current Visiting Medical Practitioners agreement. Until then, his situation is “untenable”.
AHPRA declined to answer emailed questions on the specifics of Fettke’s case.
A spokesman for AHPRA’s Medical Board of Australia said: “We note that Dr Fettke has released information about a new decision of the Medical Board of Australia. On this basis, the Board can confirm it has reconsidered its decision to caution Dr Fettke.
“A different state board of the Medical Board of Australia considered all the information and circumstances that are now known, with additional evidence.”
“The Board decided no further regulatory action was needed to protect or manage risk to patients.
We have communicated this decision to Dr Fettke.”
(Editor’s note: Fettke clearly states that no “additional evidence” was supplied. There has simply been an independent review of what was already presented, he says That raises the question of further cover-up by the AHPRA process.)
Perils of change
Belinda is clear about her husband’s strengths and what got him into trouble in the first place.
“My husband has the perspective of a patient, the spirit of an activist and the heart of a healer,” Belinda says.
That’s taken from a quote by Dr Rich Joseph, a US resident physician who cared for Dr Bernard Lown in hospital. Joseph greatly admired Lown for being a “change agent” in medicine throughout his career. In an article in the New York Times in February 2018, Joseph wrote of Lown: “(He) has inspired me to go to work every day with the perspective of a patient, the spirit of an activist and the heart of a healer.”
Belinda also describes her husband as “a change agent”.
And like all change agents (and whistle-blowers), Fettke has paid a high price for going against orthodoxy. He believes it was worth it.