It is with deep regret that I write to inform our community of my decision to withhold signing a 3 year contract to continue working in the Public Hospital System. After 25 years of service to the Launceston General Hospital, I can assure you this has not been an easy decision.
I remain committed to caring for patients and teaching students, but I cannot continue to work in an environment that condones bullying behaviour; a workplace that undermines the evidence-based recommendations of a Visiting Medical Officer; and I refuse to go to work and be punished for raising concerns about Quality Assurance and Patient Safety, any longer.
After 7 years of this inappropriate behaviour by both senior administration, and allied health practitioners, I say ... enough is enough!
Until there is a satisfactory resolution of my bullying, mobbing and victimisation claims, and more importantly, the acknowledgement and satisfactory resolution of the many breaches of my current Visiting Medical Practitioners agreement, my situation is untenable. It is impossible for me to continue to provide best practice to my patients, and indeed the broader community, when I have been unsupported and undermined in my work place since 2012. Particularly as there has been no incident of patient harm, nor patient complaint regarding my circumstances.
When my concerns are addressed I have every intention of returning and resuming my clinical and teaching duties.
Until then, I will continue to see patients in my private practice.
Unfortunately, I have been unsuccessful in seeking support from the Minister of Health and the senior administration of the Tasmanian Health Service (THS) to date. Without a satisfactory resolution I will be forced to leave the THS when my contractual agreement ends on March 10th, 2018.
Dr Gary Fettke, Orthopaedic Surgeon
M.B.,B.S.(University NSW), F.R.A.C.S.(Orthopaedic Surgery), F.A.Orth.A.
Gary has been desperately trying to avoid his imminent departure from the Launceston General Hospital (LGH) having been strung along by senior administration who continue to say one thing, yet do another. Unfortunately, the obstruction and denial at senior levels of the Tasmanian Health Service (THS) are indicative of the declining care and health of our Tasmanian Community.
It isn't just Gary's experience, either. Issues of 'no confidence' are being raised by the Tasmanian AMA and the Legislative Council's recent inquiry into Tasmania's acute health system.
2 weeks ago Dr Brian Kirkby, the North's only Vascular Surgeon and Surgical Director of the LGH resigned as he was allegedly left out of key administrative decisions. Last year Dr Kurien Koshy, the only full-time neurologist in the north, also left the state because he felt he wasn’t being listened to by the Government.
How many more Health Professionals will the Northern Tasmanian Health System lose? Gary knows of several senior colleagues looking at their options at the moment.
"I can't keep going to work and bandaiding sick-care and I certainly can't continue to recommend Low Carb Healthy Fat principles to my patients and have that advice undermined by senior administration and the allied health departments in my own hospital!"
Since December, Gary has been led to believe that the THS were working towards a resolution. Gary has supplied documentation that is currently before the senior management of the THS that will allow a full resolution of the situation, but ongoing attempts to mediate have not been progressive. Over some years, ‘the system’ has acknowledged Gary's issues 'off the record' but they refuse to put that acknowledgement in writing, for what appears to be a presumed fear of liability. Limitation of that liability has been addressed in the supplied documentation before them.
Disappointingly, late last Friday we received notification via legal representation that;-
1) 'they' would not be writing the letter to AHPRA which had been agreed upon 'behind closed doors'. That letter needs to acknowledge 845 pages supplied by the THS which contained material that was biased, personal, vexatious and UNSUBSTANTIATED. The submission to AHPRA involved some 57 people in both internal, and external email correspondence, with no case of patient harm nor patient complaint. It is even more concerning when you consider the THS submission began with the Director of Medical services (who had collated the entire document) stating; 'My issues with Dr Fettke's nutrition advice ...'
BTW, this is the same Director of Medical Services (and identifying himself as such) whom I stumbled across posting inappropriate and defamatory material about Gary onto a Facebook Hate Page in the time frame of the AHPRA investigation.
2) 'they' would not be writing an internal document advising staff at the Launceston General Hospital that Gary is to be supported with the medical advice he offers his patients, including recommendations to reduce sugar and processed carbohydrates for improved health outcomes. Gary's Evidence-Based recommendations are in line with the CSIRO's 2017 Low Carb management of Type 2 diabetes, especially for patients with poor control of their blood glucose and complications of T2D ... Which means patients will continue to be told, by some of the allied healthcare practitioners within the hospital, that Gary's recommendations around Low Carbohydrate Healthy Fat principles are dangerous and "will kill people."
3) 'they' would not be considering any reimbursement for the expenses we have incurred as a result of their actions, legal or otherwise.
**To date we have not received correspondence that comes anywhere near to what is required, nor what Gary was led to believe was forthcoming.
Early in 2013 I captured a gorgeous image of our kitten jumping up to catch a piece of string. Gary took it to the operating theatre suite as part of a 'bring an image of your pet to work' activity. A couple of days later he found the defaced picture of Mia stuck to his locker surrounded by lolly wrappers... with a dagger drawn through her body :-( This cowardly and disturbing act was distressing, especially to our children. Unfortunately, this was not an isolated incident.
Every time Gary reported incidents like this internally through appropriate channels, the case was opened and closed without him being involved.
Many of you would be aware that Gary says he was a fat kid and grew up outrunning a bad diet in his teens and early twenties. He succeeded for a while but succumbed to health issues in his 30's, including cancer in the year 2000 when we had 3 young children. He had surgery and radiotherapy which was followed by years of chemotherapy. 11 1/2 years in fact!
He came across David Gillespie's book 'Sweet Poison' in 2012.
Cutting out sugar helped Gary lose weight and begin to regain his health. It also peaked his interest in nutrition and how that might apply to his orthopaedic practice.
Early on, Gary came across research explaining the metabolic pathway of Fructose which had only been described in 2010 by Luc Tappy, so it was all very new! Firstly he learned about sugar and Acetyl coenzyme A (acetylCoA ) before delving further into the body's metabolism. After understanding the composition of processed carbohydrates, the amount of sugar in low fat products, and the huge influence of the cereal/grain manufacturers and the soy/fake food industry, Gary became determined to promote fresh, seasonal and local produce as much as possible. I know ... such dangerous advice! NOT.
His research led him to understand the harms of polyunsaturated seed oils in our diet and from there, he developed his hypothesis 'The Nutritional Model of Modern Disease' in April, 2014.
The more Gary researched the more he uncovered. The information coming out about sugar/carbohydrates and insulin response was fascinating considering most of his patients have weight-related joint issues, inflammation and the complications of diabetes.
"I hate to admit this, but despite having trained as a doctor (and having studied biochemistry and physiology at university) remembering that carbohydrates are simply 'glucose once ingested' took a couple of months to sink in, even after I quit sugar."
Excited by the thought that he could provide tangible strategies to help people take back control of their health, Gary wrote a handout sheet for his patients who were interested in understanding more about sugar. The handout also offered some simple ideas, and swaps, to help people get started on reducing sugar from their diet. It was a handout with broad principal recommendations that could be kept, or thrown away...
Gary was encouraged by family and friends to start speaking to our local community in 2014 and I helped him create his Facebook Page 'Gary Fettke No Fructose' for people who were interested in reducing sugar from their diet and wanting to know the latest nutrition science.
Little did I realise back then how influential Vested Interests and Ideology were in shaping the dietary and health guidelines Guidelines which have become strict Rule-Books, fiercely protected by Associations that partner with Food and Pharmaceutical Industries and are subsequently enforced by Regulatory Bodies, such as the Australian Health Practitioner Regulation Agency (AHPRA).
I wrote a blogpost 'Don't Shoot the Messenger' the week after Gary was notified by the Tasmanian Medical Board of AHPRA (Australian Health Practitioners Regulation Agency) about him being anonymously reported for recommending that one of his patients reduce their sugar intake in hospital. He wanted to help control their blood glucose levels and improve the circulation to their damaged feet.
You may wonder how we have been able to confidently claim that it was a dietitian from the hospital that reported Gary to AHPRA when the notification was considered to be anonymous? Well, it appears AHPRA doesn't understand Social Media platforms. If they did, they would have known that supplying a redacted 'anonymous' notification using screen grabs from Facebook would also require redacting their friends listed down the right hand side of the screen image ... It didn't take long for Gary and I to work that one out!
Yes, we knew who had reported him but we have always believed the 'push to report' came from 'higher up' and late last year Gary was finally given access to the 845 page document that the THS had submitted to AHPRA. Within that document Gary found 2 letters from the CEO of the Dietitians Association of Australia (DAA) addressed to then CEO of the Launceston General Hospital effectively demanding that he be 'Silenced'.
Incredibly, the CEO of the LGH wrote to the Director of Medical Services, copying in 3 other people, asking "Can we push this along to the next level?" A few days later Gary was 'conveniently' reported to AHPRA.
Prior to this period Gary tried numerous times to speak with the dietetics department. I honestly can't tell you how excited (and naive) Gary was when he first understood the link between sugar consumption and diabetes, and what reducing sugar could mean for his patients.
Unfortunately, the dietetics department weren't as excited as Gary was. Instead, internal correspondence was sent to various key administrative staff complaining about Gary and copying in the Minister for Health.
After questioning 'the fairness of that gesture' including the content of the email, Gary was informed by the Allied Health Department that an apology letter (written on February 18th 2014) was sitting on the CEO's desk.
Well, that apology letter sat on the CEO's desk despite Gary requesting it on multiple occasions. He finally received the apology letter July 23rd, 2015 over 16 months later! During that time Gary felt he was baited on numerous occasions as false promises to meet with the CEO were proffered and then meeting after meeting was cancelled, over and over again.
The Medical Board of Tasmania, under the umbrella of the Australian Health Practitioners Regulatory Authority, ruled; ”In particular, that Gary does not provide specific advice or recommendations on the subject of nutrition and how it relates to the management of diabetes or the treatment and/or prevention of cancer.”
Gary is not allowed to comment on the central role of nutrition in preventative health, nor in the management of chronic illness on any social media platform. The ruling is life-long and non appellable.
Gary has been silenced and as such should not discuss nutrition with his patients in the clinical setting, regardless of any undue stress on joints before replacement, inflammation, or even diabetes complications requiring amputation.
During the 832 day star chamber investigation the ‘goal posts’ kept being changed by AHPRA and the wording of many of the documents changed with each piece of correspondence.
The similarities to Professor Tim Noakes' case in South Africa are remarkable.
Gary disrespects the AHPRA ruling 'Silencing' him from talking about the health benefits of reducing sugar and encouraging Low Carb Healthy Fat (LCHF) principles to his patients and the broader community. Gary would rather be deregistered for improving health outcomes than stay silent and cause harm.
There was a National Senate Inquiry in 2016 into the medical complaints process and it was found to be flawed. Gary was a witness in the proceedings. The follow up piece written in the local Examiner Newspaper is here.
Gary's presentation at the Health Practitioner Australia Reform Association Is AHPRA Throwing Rocks Inside Their Glass House is well worth watching if you would like to understand the complexity of the failed AHPRA process that he, and other health professionals, have been subjected to.
As Gary discovered more about sugar he realised it was our environment that was confounding the situation and he believed that our hospitals should be setting an example of health to our community. It seems ridiculous that the place in which patients are meant to recuperate and recover is the very place that is feeding them so much sugar and highly processed carbohydrates. A workplace full of junk food can't be good for the staff, either!
Kerry Finch MLC, already a huge advocate for reducing sugar, presented to the Tasmanian Legislative Council who debated the issue of Junk Food and Hospital Food on October 29 2013.
The motion he proposed was passed in the affirmative;- 'That this House calls upon the Government to order a review of foods prepared, and/or sold in hospitals, including their canteens, kitchens, or vending machines, with a view to considering similar legislation which has been enacted in South Australia controlling the sale of junk food in hospitals.'
Since Kerry Finch spoke to our local Parliament much has happened around Australia, but not in Tasmania.
"The NSW government will become the first state in Australia to apply a blanket ban on its hospital cafes, staff kiosks, vending machines and catering services from selling sugar-sweetened beverages with no nutritional value, such as Coke and Pepsi.
"Leadership by the health sector is a critical step. We saw this happen with smoking - where the health sector leads, workplaces and other public places follow," advised public health lawyer Alexandra Jones from The George Institute for Global Health.
"The Alfred Hospital in Melbourne reduced sugary drink sales by 36,500 a year by removing them from display at its main service cafe and placing them under the counter in 2010, while overall drinks sales have remained steady.
"In Victoria's south-west, 13 health districts have discontinued the sale of sugary drinks at their hospitals and facilities.
"New Zealand has had a government-enforced ban on the sale of sugar-sweetened drinks at healthcare sites since 2015 and Britain's National Health Service is considering a similar move."
It is pretty obvious Tasmanian hospitals can't be 'the first' anymore, but let's not be the last to help our community make healthier choices!
Please help me share this post far and wide to put an end to the bullying and harassment of health professionals who dare to question the entrenched practices which are doing harm.
"Science evolves by being challenged, not by being followed" Dr Gary Fettke
I would love you to show your support by sharing your story in the comments section below.
Thank you to our on-line community for their incredible support. I just have to share the Facebook post so you can see the response we have received from our community.
I often wonder how different the last 7 years would have been if people had not been so closed to debate and insistent on following guidelines which should evolve over time as we understand more. How many lives would have changed for the better. I also look back and think how enriched our lives have become because of the road blocks. It led Gary to research more and get onto social media and there is no doubt ... we have found 'our people'