A Sydney ‘Lyme disease specialist’ doctor has been found guilty of professional misconduct by a medical tribunal for inappropriate management of patients with neurological symptoms, including failure to refer them to a neurologist for investigation.
The Civil and Administrative Tribunal New South Wales considered complaints brought against Dr Peter Richard Dobie by the Health Care Complaints Commission in relation to four patients who he treated for suspected Lyme disease.
The tribunal heard evidence that Dr Dobie had treated hundreds of patients with symptoms such as chronic fatigue and pain who believed they had been failed by other practitioners.
The complaints alleged that he had failed to adequately consider and investigate alternative diagnoses for patients he diagnosed as having Lyme disease or chronic Borreliosis, and that he had treated them with inappropriate therapies such as long term IV antibiotics.
In the case of one patient, the tribunal was told that Dr Dobie had failed to appropriately respond to her neurological complaints including brain fog and fatigue, did not take a detailed history, arrange a central nervous system examination or reconsider his antibiotic regime as a contributor to the symptoms.
Instead, Dr Dobie prescribed long courses of oral and IV antibiotics and sometimes thyroid extracts and cortisone.
In a complaint relating to a male patient the tribunal again heard that Dr Dobie inappropriately focused his investigations on Lyme disease instead of investigating the possibility of other more common diagnoses.
And after prescribing long term antibiotics, Dr Dobie was alleged to have failed to seek a neurologist’s opinion in response to a Brain Spect-CT report and instead inappropriately attributed the changes to Lyme disease.
“Dr Dobie conceded in cross-examination that he should have referred Patient C to a neurologist, and he could not recall or explain why he did not. The level of Dr Dobie’s demonstrated incompetence in this case is such as to amount, here again, in our view, to professional misconduct,” the tribunal stated.
In the case of another patient who consulted him for insomnia, weight gain, and neck and back pain, Dr Dobie prescribed medications including Duromine (phentermine), benzodiazepines and opioids, when he should have referred her to a physiotherapist, a psychologist, a pain specialist, and a drug and alcohol specialist, the tribunal found.
The tribunal heard that Dr Dobie was an advocate for people who believed they had Lyme disease, and was a member of the International Lyme and Associated Diseases Society (ILADS).
“ILADS has a strong focus on the diagnosis and treatment of patients with chronic Lyme disease. I formed the opinion that some of the patients I was seeing in Australia with chronic illness might be suffering from Lyme disease/borreliosis and may benefit from the treatment approaches advocated by ILADS doctors,” he told the tribunal.
The tribunal concluded that in each of the cases Dr Dobie’s had demonstrated unprofessional behaviour so serious as to amount to professional misconduct. It said further proceedings would be listed for directions.