Dietitians Association of Australia: Judge, Jury and Executioner?

This post focuses on a complaint that was made against me for my recommendation of low carb diets in diabetes management. It was made by another dietitian, lodged with my workplace and later forwarded to the DAA.

In particular, I’d like to highlight how the DAA complaints process worked in my case. It’s important to note that the DAA is a self regulated organisation that is not under the jurisdiction of any independent agency, including the Federal  Government (Federal Health Ministry, COAG, Ombudsman, AHPRA etc) that I could find. It sets it’s own rules, make decisions which may result in personal and financial loss to individuals, all with apparent impunity.

So here’s a chance for the DAA to shine as I take a look at our time together during the investigation into my practice.

The Beginning

A letter from DAA dated 10 September 2014, was sent to me giving notice that the DAA was “in receipt” of a complaint made by another dietitian.

The issues of the complaint were:

A. That my recommendation of a very low carbohydrate diet for type 2 diabetes management is inconsistent with Evidence Based Practice.

B. That a letter from a patient indicates that I dismissed previous evidence based advice* given to this patient and provided contradictory advice, resulting in a confused and disgruntled consumer.

*which happened to be from the dietitian making the complaint

C. The use of patient testimonials on my website for my book. (I promptly removed these and the matter was not brought up again by DAA as an issue of concern.)

In this letter I was also informed that the “complaint” had been referred to the Vice President who had “….. determined that there is a need for investigation under the Complaints and Disciplinary process.”

It was a really unnerving letter to receive because it seemed to imply more than the issues the complainant had raised. For example, the DAA mentioned “….breaches of the Code of Professional Conduct and Statement of Ethical Practice….”. I was unsettled by the tone but nevertheless happy to answer what the DAA saw as “areas of concern”.

Response sent

I thought I did a pretty good job with my response, particularly in providing evidence for the use of low carb diets in diabetes management as asked. I was surprised, however, that I had to point out to the DAA that they themselves, by deferring to American guidelines by the ADA, must also support low carb diets as one  of the options in diabetes management.

But apparently the DAA was not satisfied.

I am not sure why my response was considered inadequate but I received a letter from CEO Claire Hewat on 19.11.2014 saying that, “…you will still be required to provide a response regarding the two areas of concern highlighted already by the Vice President.”

I wanted to reply: “I’ve already provided responses. Haven’t you read them?” but dutifully sent off two further replies: One, Two with more details.

I did however have to ignore what I considered an unnecessarily menacing tone in the DAA letter. In view of the fact I had responded promptly to every request, I think it was unnecessary for the DAA to write, “A general response is not sufficient. If no satisfactory response is received, DAA will progress this case as allowed by our By-laws. You will have deemed to have disengaged from the process and

the material will be sent to a Hearing and Assessment Panel for consideration with or without your input.”

WHOA!!! Where did that come from? A friendly bit of advice to assist a member or barely veiled intimidation?

Oh, but on a more positive note, CEO Claire Hewat finished her letter with the lovely offer that if I required support, “please do not hesitate to contact me”.

Possibly one of the greatest comedic lines in the DAA joke book.

Did I receive a fair hearing?

It has been suggested to me recently that the DAA may have contravened it’s own By-Laws in the handling of my case.

The By-Law for Complaints and Disciplinary Procedures clearly sets out the steps to be followed after a complaint is made.

Firstly, the Chief Executive Office completes an initial assessment of the material gathered concerning the Complaint.

According to the relevant By-law, the INITIAL ASSESSMENT OF THE EVIDENCE states that:

“5.1  The Chief Executive Officer must assess all the information and material provided by the Complainant, the Respondent, itself and any other third party in relation to the Complaint.”

After gathering this information, the CEO is then supposed to discusses the issues with the Vice President, who then determines whether the complaint should be dismissed or proceed.

“All the evidence” referred to is stated to include both the complaint and the response, otherwise it would only be one side of the story. Obviously. And how could the Vice President be expected to make a decision about what is to happen next if she doesn’t have all the information?

Well………..

In my case, CEO Claire Hewat appears to have had a discussion with the Vice Pres after receiving the complaint but BEFORE I’d even been informed that there was a “complaint” against me. Not only that, the Vice President made her decision that there was a need for an investigation rather than any other course of action BEFORE having received, and therefore read, my response.

Anyone smell a rat?

How does that constitute giving due consideration to the complaint and the evidence if I hadn’t yet been given the chance to provide a response to the accusations? Is it possible that I wasn’t being treated fairly?

Anyway, this farce of what could be likened to a Kangaroo Court continued for a while and by the end of the ordeal, DAA’s decision was no surprise.

The Verdict

A letter from DAA dated 21.4.15 informed me of the Board’s decision.

The Board resolved that the complaint from the dietitian had been upheld; they deemed me guilty of professional misconduct (the DAA has refused to specify of what) and I was to be expelled from membership of the DAA.

Also, the Board supported the recommendation to alert relevant authorities such as Medicare, health funds and relevant government departments and  I was informed that my “status” would be noted on the public section of the DAA website. The DAA wrote to the SNSWLHD to inform them of the Board’s finding and I consequently lost the job I had held for over 20 years.

Thanks DAA.

Possible next post:

SNSWLHD directive that “Nutritional advice to clients must not include a low carbohydrate diet”