Dr Byron Hyde, a doctor who has championed ME patients for decades, has license removed

[Dechi]

I defend the right to competent, ethical and free health care for all Canadians for whatever ails you. And i will encourage physicians to be advocates for their patients and consider becoming researchers to find effective treatments for all. Sounds like we are moving in this direction as of yesterday.

Well, everything you defend, Dr Hyde was doing for his patients. He was the best advocate anyone with ME could ever have.

How many times have you spent 6 hours in a doctor’s office ? 6 hours... And felt like he cared, and was trying to find solutions for you ? How many times did you get emails from your doctor, enquiring about how you are, or giving you advice ? How many times did your doctor personnally write to you to explain your results ? Or called you from a foreign country at his own expense because he had something important to say to you ? How many times did your doctor not make you pay anything because he knew you had no money coming in ? How many times did he call another clinic to negociate a lower price for their fees in your name ?

Tell me. If someone did this for you, and not just for you, for all his patients. Would you say he deserves to have his license removed because he wasn’t following admin rules to the letter ? Dr Hyde is getting old. He is 82. He is not perfect. But we don’t need perfect. We need someone who cares and who pours all his heart into what he does,

Who do we have left now ? Someone who is perfect in all admin aspects, knows absolutely nothing about ME and will see you 10 minutes in their office before suggesting CBT and GET ? Wow, we’re so lucky !

 

[Alvin2]

Who do we have left now ? Someone who is perfect in all admin aspects, knows absolutely nothing about ME and will see you 10 minutes in their office before suggesting CBT and GET ? Wow, we’re so lucky !

Indeed.
Notice how those doctors have no one cashiering them out of practice for unethical behaviour. Dr Hyde does not recommend treatments that violate the Hippocratic Oath, the doctors and researchers who do are protected from their malfeasance by the same entity that is going after Dr Hyde.

 

[Inara]

I think too few people use their brains over guidelines. One of the reasons may be that a doctor gets problems if he doesn't stick to guidelines stupidly. To the disadvantage of lives. Guidelines are one of the big problems for ME, and they often have unscientific content, and they can be quite harmful. A doctor also made the Hippocratic Oath which says "first no harm", so where lies a doctor's duty? Sticking to guidelines he probably recognizes as harmful or to the Hippocratic Oath (and by doing so, risking his financial existence because "doctors associations" like the GMC, CPSO or Ärztekammer shit on the Hippocratic Oath)?

I don't know Hyde personally, but my impression is he chose to use his brains (which doesn't necessarily mean everything he does is correct or great, I can't say) - which shoots back now.

P.S.: I didn't mean Hyde didn't adhere to guidelines. I don't know Canadian guidelines.

 

[valentinelynx]

Take a good look at the charges- they are not subjective charges. It can all be proven.

Spoiler: Read charges here

Failure to Maintain the Standard of Practice of the Profession

The College retained Dr. Mark Nassim to provide an opinion with respect to Dr. Hyde’s care and
treatment of patients. In his reports, Dr. Nassim opined that:

a) Dr. Hyde failed to maintain the standard of practice with respect to his medical record-
keeping in that:
i. His patient charts are not clearly written, are disorganized and often lack an easily
identifiable patient record;
ii. He fails to maintain chronological SOAP notes or other clearly delineated summaries
of patients’ investigations and medical condition(s), such as a Cumulative Patient
Profile, and does not include pertinent positive or negative findings, rationale for
ordering investigations or discussions with patients about the results;
iii. Dr. Hyde uses unprofessional language in his charts to describe his patients;

b) Dr. Hyde states that he practices “complex disease management” primarily involving
Myalgic Encephalomyelitis and Chronic Fatigue Syndrome, which is outside the conventionally-
recognized scope of general or primary care practice;

c) Dr. Hyde takes diagnostic approaches that are not supported or corroborated by
conventional practice, and orders investigations the results of which are nonspecific and yield no
discernible constructive findings;

d) Dr. Hyde failed to follow currently accepted guidelines for the detection of prostate
cancer, including in ordering PSA testing;

e) Dr. Hyde lacked knowledge of opioid or benzodiazepine treatment contracts, despite
prescribing long-term benzodiazepines to patients;

f) Dr. Hyde lacked knowledge as to whether or not his electronic correspondence and
patient files are encrypted or stored in a secure fashion, despite the fact that he purported to
conduct an extensive telemedicine practice from Italy for several months each year.

Dr. Melvin Borins was retained to provide an opinion specifically with respect to Dr. Hyde’s
psychotherapy practice. In his reports, Dr. Borins opined that:

a) Dr. Hyde failed to record what is required of a practitioner providing psychotherapy, such as
a mental status exam, diagnosis, his psychotherapeutic treatment plans, his interventions and
the patient’s response to treatment;

b) In one case, where Dr. Hyde billed OHIP for providing psychotherapy 49 times between
2006 and 2016, Dr. Borins found only one adequate psychotherapy note;

c) In five cases, Dr. Borins could find no evidence in the charts that Dr. Hyde performed any
psychotherapy, despite Dr. Hyde’s numerous billings between 2005 and 2016.

d) In one case, Dr. Hyde prescribed addictive medications and opioids, including Dilaudid,
quietapine, clonazepam, and hydromorphone, without documenting the patient’s progress,
and how the psychotherapy he was providing was assisting the patient. He failed to properly
monitor the patient for risk of addiction, overdose and suicide. This displayed a lack of
judgment.

Dr. Hyde’s inappropriate care and treatment of his employee

Individual B was employed by Dr. Hyde. While Individual B was Dr. Hyde’s employee, Dr.
Hyde:

a) prescribed medication to Individual B on six occasions, including a prescription for a
tricyclic antidepressant; and

b) billed OHIP for providing treatment to Individual B on eight occasions, including for
psychotherapy on seven of those occasions, between April 2009 and August 2010.

Despite prescribing to Individual B, and billing OHIP for treating Individual B, Dr. Hyde did not
maintain a patient chart for Individual B.

Unprofessional communications, boundary violations, and conflict of interest

Dr. Hyde is the founder of a charitable foundation. Dr. Hyde wrote newsletters for his charitable
foundation, which he mailed to the patients in his medical practice.

In these newsletters, Dr. Hyde provided his personal opinions that the compensation of
physicians in Canada is inadequate, complained about the College’s requirements of physicians,
solicited patients to make donations to his charitable foundation, and disclosed inappropriate
personal information about himself and of his patients.

Patient A was a patient of Dr. Hyde’s between approximately 2008 and 2014. In appointments
with Patient A, Dr. Hyde disclosed his and other patients’ health information, questioned the
competency of other physicians, and complained about physicians’ remuneration and about the
College, including the College’s record-keeping requirements.

Block Fee for Uninsured Services

When Patient A first became a patient of Dr. Hyde’s, Dr. Hyde charged her $1,500, purportedly
as a block fee for services that are not covered by OHIP. In doing so, Dr. Hyde failed to comply
with the OHIP Schedule of Benefits, and the College’s policy on Block Fees and Uninsured
Services by:

a) improperly charging Patient A a block fee charged to cover the constituent elements of one
or more insured services;

b) failing to provide her with the alternative of paying for each service individually at the time
that it was provided; and

c) failing to offer the block fee in writing indicating the services that were and were not covered
by the block fee, and failed to provide her with a copy of the policy to ensure that she was
fully informed of her payment options.

Delay in Responding to Request for Patient Chart and Inappropriate Fee

In September 2013, Patient A’s lawyer wrote to Dr. Hyde requesting a copy of her chart, which
Patient A was required to produce for the purpose of motor vehicle litigation, enclosing a
direction authorizing Dr. Hyde to release it to the lawyer.

Patient A did not obtain any portion of her chart from Dr. Hyde until July 2014, despite having
made multiple requests for it both directly to Dr. Hyde and to his secretary, and despite attending
at Dr. Hyde’s office numerous times specifically for this purpose.

In July 2014, Dr. Hyde’s assistant informed Patient A that her chart was available to be picked
up, and that the fee would be $825. Dr. Hyde’s first invoice to Patient A, indicated that the $825
fee was for “medical-legal work”. When Patient A raised a concern with Dr. Hyde that his fee
was excessive, and that she had not requested that he do any medical-legal work, he provided a
revised invoice indicating that he had charged her $825 “to organize all patient data into a
comprehensive chart and copy the entire file at the request of [Patient A]’s lawyer”, and that this
had taken him four hours.

Then, at the bottom, this:



Dr Hydes pleads guilty to the charges. And while many patients felt they had a great doctor, this doctor did not obey the rules of his profession, such as maintain adequate records, sharing medical records in duly time, and monitoring prescription of opiates and barbiturates. These are just a few examples. Then the foundation scheme is a bit problematic in the light there has not been any research publication despite it being a research foundation.

This was not a lynching. It was the College of physicians who takes patient safety and professional code of conduct seriously. In Canada, to be a physician you have to play by the rules.

Patients deserve access to competent physicians, and have a right to certain standards of care. Privacy, ethical care, and safety concerning the use and monitoring of scheduled substances are all important both for patients and for the profession of medicine.

It's easy to see this as an indictment. These sorts of charges are often easy to bring up against older physicians, who practiced for decades without the ridiculous amount of regulation doctors are now subject to. It's the same in most professions these days: experience and wisdom are dumped in favor of following "guidelines." Violate those guidelines, which are often based on the consensus of inferior practitioners, and you are fair game to be cited and have your license suspended or revoked. Personally, I'd prefer to learn from (or be treated by) the 86 year old doctor who's seen it all than from a government book of clinical guidelines.

 

[Pearshaped]

I suppose many doctors don't keep records in the perfectly appropriate way.

It would be nice to let Dr BH know,that we still appreciate what he has done the CFS Community for the last decades.
I'd sign for something like that immediately.

I 'd disagree with his theory but lets face it; among all deseases,we are the odd ones,what we desperately need are not only researchers but also doctors who want to figure this out.Doctors who are curious and oassionate enough probably tend to be outlaws in their medical community nowadays.

 

[Gingergrrl]

I can wholeheartedly say (both from 12 yrs working as a hospital social worker and then being an extremely ill patient with several chronic unexplained illnesses myself), that it is the doctors who are the mavericks, who are willing to take a risk and order tests that may not be on the formulary, or go the extra mile to call the patient at home to make sure they are okay, etc, are the HEROES in my book vs. the ones whose charting is perfect.

I do not minimize the importance of proper charting BUT I would much rather have the doctor who cares about me, goes above and beyond the call of duty to help me and their other patients, and is open to new ideas, than someone who toes the line (even if this is CBT and GET) but has perfect charting. But that is just me!

 

[Kati]

I can wholeheartedly say (both from 12 yrs working as a hospital social worker and then being an extremely ill patient with several chronic unexplained illnesses myself), that it is the doctors who are the mavericks, who are willing to take a risk and order tests that may not be on the formulary, or go the extra mile to call the patient at home to make sure they are okay, etc, are the HEROES in my book vs. the ones whose charting is perfect.

I do not minimize the importance of proper charting BUT I would much rather have the doctor who cares about me, goes above and beyond the call of duty to help me and their other patients, and is open to new ideas, than someone who toes the line (even if this is CBT and GET) but has perfect charting. But that is just me!

This was beyond charting. There were ethical issues, privacy issues, overcharging issues and more. And he admitted to that.

 

[Gingergrrl]

I started going through the charges against Dr. Hyde line by line but I think this quote below is really the key:

b) Dr. Hyde states that he practices “complex disease management” primarily involving Myalgic Encephalomyelitis and Chronic Fatigue Syndrome, which is outside the conventionally- recognized scope of general or primary care practice

The College viewed the very treatment of ME/CFS, which is inherently complex, as "outside the conventionally-
recognized scope of general or primary care practice". They wanted to find a way to stop him and they did. And I do not blindly defend all doctors and when another doctor was recently accused of sexually harassing patients and colleagues, I did not defend him and felt that he had to be let go. This to me is very different.

 

[Kati]

If he could have, he would have retained a lawyer, etc. But he agreed with the college’s finding.

 

[Kati]

I started going through the charges against Dr. Hyde line by line but I think this quote below is really the key:



The College viewed the very treatment of ME/CFS, which is inherently complex, as "outside the conventionally-
recognized scope of general or primary care practice". They wanted to find a way to stop him and they did. And I do not blindly defend all doctors and when another doctor was recently accused of sexually harassing patients and colleagues, I did not defend him and felt that he had to be let go. This to me is very different.

What if the doctor billed for a specific billing code that has not been approved for a specific disease such as ours, and what if he could not bill for that code because he is not a specialist, he is legally a general practitioner? That would be a question of eligibility to that billing code.

https://www.dr-bill.ca/blog/ohip-billing-support-how-to-bill-e078-the-chronic-disease-premium

And as an aside, he made it clear he wasn’t offering treatment, but was only diagnosing. At least it was my understanding.

 

[Alvin2]

If he could have, he would have retained a lawyer, etc. But he agreed with the college’s finding.

people have been convicted of murder and found innocent on false confessions. People pressure others into making confessions so they have a noose to hang the victim with. This can include pressure, threats, violence or whatever. I highly doubt the college used illegal tactics here but pressure and financial punishment is highly likely.

https://www.innocenceproject.org/false-confessions-recording-interrogations/


the ones who do harm people are protected by the same system that cashiers a doctor for witch hunted reasons. Double standards.

Its funny that the only remedy for not harming people is dismissal and the remedy for harming people is protection. If someone keeps bad records one can retrain them to keep better records. If someone overcharges a patient and the situation is actually what they claim (remember that the information we have was designed to implicate him because the underlying reason was that he was doing diagnostics on a fake disease) then a fine and restitution to that patient makes sense.

 

[Dechi]

And as an aside, he made it clear he wasn’t offering treatment, but was only diagnosing. At least it was my understanding.

He did not treat because there is no treatment for this illness. He made it his life commitment to care for patients and help provide disability money so they would not end up on the street.

He would refer his patients to as many specialists as needed, and those specialists would offer treatment according to their area of expertise. He had a very wide network of specialists around the world, and they were always keen to help with his patients.

 

[Mary]

THIS THREAD IS BEING REOPENED. SEVERAL POSTS HAVE HAD TO BE EDITED OR DELETED DUE TO PERSONAL COMMENTS/ATTACKS, IN VIOLATION OF RULE 1, FORUM RULES EXPLAINED. DISAGREEMENT ON ISSUES IS FINE, BUT PLEASE NO MORE PERSONAL COMMENTS OR ATTACKS. RULE 1 STATES IN PART:

Please keep your focus on the facts of the topic under discussion - not on the person with whom you disagree.

 

[Research 1st]

One way to give the medical mafia two fingers up is to buy Dr Hyde's affordable little book on diagnostic tests. This way you can imbibe some of his knowledge, which is decades of helping ME CFS patients challenge misdiagnosis and possibly obtain new (and more appropriate) organic disability based diagnosese.

It simply explains the vast array of injury found in ME patients, something that directly challenges all governments and allied psych lobbies who globally insist 'there is no evidence' and ME is Chronic Fatigue requiring CBT/GET & psychotherapy. Well that's correct if you don't search! If you search, in some patients, you then open up a whole can of worms, giving ME patients the scientific ammunition to challenge their neglectful doctors health insurers refusing to pay compensation for post viral brain injury and of course, powerful government health agencies who will do everything in their power to not reveal the consequences of ME on your brain and other organs.

It has some useful information in it for those with chronic severe disability from post viral ME.

Missed Diagnoses Myalgic Encephalomyelitis & Chronic Fatigue Syndrome Second Edition

 

[Marylib]

Well, if I were getting on in age, I am sure I would be considering not being able to keep up with things, no matter what my profession was. I have a brother in law who had an early onset of vascular dementia and he was at a law practice. His staff had to explain to him that he was not able to do the work any more. He thought he was doing fine, but that is the nature of this form of dementia. It was very difficult for him to get the news and accept it at the time.

 

[frozenborderline]

@Kati thank you for including the charges - useful and necessary information to know.

As I read the charges, it seems a lot of these violations were against emerging standards of the practice of medicine. Eg, SOAP notes have only been used since the 70's, and there was no medical standard of keeping notes before then. HIPAA laws were enacted in 1996. Privacy laws around technology are still emerging and not necessarily common knowledge. I've found many doctors don't know every single little nook and cranny of the entire running of their practice and would assume some of these things (like secured software) is built-in.

It's easy to see how an long-practicing old school doctor could easily accidentally (or flagrantly - I don't know statistics about how often such rules are broken) step outside these laws. Not an excuse for bad behavior, overstepping boundaries, or breaking laws! Like @Kati mentioned, as a physician you have to play by the rules.

As a fellow human being, I can imagine that's pretty difficult and there are some gray areas that are clear now that maybe weren't at the time. Can imagine how hard it is to keep up in a field that has changed very rapidly, with a lot of new tech and laws, with time for patients whittled down as more electronic record-keeping takes over doctors' time, figuring out ways to document with patients who don't neatly fit in the given boxes, and feeling like you're on the front lines with more and more sick & desperate patients coming in.

A response from the doc (even he doesn't or can't dispute these charges - which seems likely) gives context. If many patients were helped, there's a chance to see the value in it despite the rest, to pick out what worked.

Over the years, I've watched so many doctors struggle with the incessant paperwork, electronic files, authorizations, pre-authorizations, denials & appeals, etc etc etc. Some of the care that has helped me the most has been non-standard care, and doctors willing to give it a try. I hope they all filed their paperwork appropriately!

I don't think it's humanly possible to know every nook and cranny of a practice 100% of the time. No one polices their behavior 100% of the time either, and sometimes you guess wrong about what matters. These cases of doctors breaking laws, but perhaps still being generally good and or/helpful doctors, are growing pangs and a necessary step to set standards in place. As patients, we can acknowledge wrongdoing, and still acknowledge the good deeds done.

Agree with this totally

Will say more later. Old school individualistic family doctors who are compassionate and have a broad and deep scope of practice getting forced out. Its happens to a couple of mine recently. Pain care is something they get them on too. Hence why many cfs docs resistant to even presceibe pain meds

 

[frozenborderline]

. Personally, I'd prefer to learn from (or be treated by) the 86 year old doctor who's seen it all than from a government book of clinical guidelines.

So right in so many ways but ESPECIALLY when it comes to palliative care. Which is NOT rocket science , and opioid are NOT as dangerous as current hysteria suggests , but are time tested medications that used to be over the counter ...but anyway old school family medicine docs or generalists know how to be compassionate and maybe violate a CDC guidelines or whatever the Canadian equivalent is (these are political, not medical guidelines, done out of political expediency to be seen as doing "something "). So when it comes to writing scripts for stuff like opioid and benxos, violating guidelines often means doing common sense compassionate prescribing. Of course that can get you in trouble. It would be another thing totally if he was using some really dangerous medications in a quack, alternative medicine type way. But for the most part, that's probably jot what happened. Just another doctor trying to help our immune systems and infections but also doing palliative care when he knows he can't cure someone... that should be welcomed ... Instead its punished .

 

[frozenborderline]

they did the same once to dr. levine in NYC i think..

This would explain why she's so nervous with some palliative care stuff ... I didn't know shed ever been sanctioned