From the British Medical Journal, 8 November 2011 (story by Clare Dyer).
A GP who diagnosed an infection similar to Lyme disease in patients with chronic fatigue syndrome adopted an “unwavering mindset” that ignored mainstream medicine, a General Medical Council fitness to practise panel has said.
The panel decided that Andrew Wright’s fitness to practise was impaired, despite his recantation and his resolution to practise only evidence based medicine in future. The sanction to be imposed will be decided at a later date.
Dr Wright ran a private practice in Bolton, Lancashire , specialising in the management of fatigue disorders from 2003 to 2006. He faced charges over his management of 11 patients, all of which he admitted.
Dr Wright admitted sending samples of patients’ blood to the Bowen Research and Training Institute in Florida , although the institute was not licensed for clinical laboratory testing and its tests should not be used for diagnostic purposes.
In some cases he carried out direct microscopy himself on samples of patients’ blood, although this was not the appropriate test for diagnosing Lyme disease or other Borrelia infection and he lacked adequate specialist training in microscopy.
In one case he diagnosed borreliosis on the basis of a fluorescent antibody test that was not generally recognised as being validated for the purpose and then recommended treatment.
In a report to one patient who was given a diagnosis of a bacterial illness on the basis of results from the Bowen institute, Dr Wright admitted incorrectly describing the structure and function of “granular structures,” wrongly describing cell wall deficient bacteria in white cells, and incorrectly stating the role of vitamin D and angiotensin II in “cell wall deficient L form” bacterial illness.
Dr Wright acknowledged letting down his patients at a time when they were vulnerable and looking for hope and a diagnosis; putting them at risk of harm, whether actual or perceived; and subjecting them to unnecessary expense. He told the panel that he had stopped treating patients with chronic fatigue syndrome, had had “a fundamental change of mindset,” and would practise only evidence based medicine in future.
The panel said it accepted that Dr Wright was “a good and caring doctor” with a previously unblemished career who knew more about chronic fatigue syndrome than most GPs and was motivated by a wish to help his patients. But he had prescribed long term antibiotics and other unconventional treatments, including “medilight” therapy, which involved the removal and reinsertion of patients’ blood in a non-sterile environment, described as “horrifying” by an expert in microbiology.
Although the panel was satisfied that Dr Wright did not pose a future risk to patients, it concluded that “this was serious misconduct which had put patients at unwarranted risk of harm, brought the medical profession into disrepute, and breached fundamental tenets of the medical profession.”