UK: Dr Sarah Myhill

Whatabout arguments are rarely helpful because they almost never capture a practical equivalence. In this case Myhill is under threat of sanction because she willfully spoke as a qualified (but not licenced to practice) health professional in terms that are in contravention of well established medical science and which have an obvious and widespread threat to an entire population in the grip of a pandemic; in contrast what we might call the British interpretation of BPS enthusiasts involved themselves in a contentious area of research lacking settled medical science and affecting only a fraction of the general population. That BiBPS enthusiasts acted with arrogance, poor practice and disregard for patients maybe true but a it's a very different sin to Myhill's, carried out in very different circumstances.

Post Shipman the lone GP is an inevitable focus of concern, the recommendations of the Shipman inquiry focused heavily on peer review and support, and the NHS has almost entirely moved to multi GP practices based on the Shipman recommendations.

I don't think it's correct to say the BiBPS enthusiasts are predominantly male - certainly the limelight fell on the grim three (Wessely, White, Sharp) but Moss Morris, Loades, Crawley, Chalder and many others with a Clinical Psychology backgound who have been BPS, CBT and GET supporters for ME/CFS, are female.

 

I just don't get putting out statements known to be in conflict with guidelines when one knows they have a target on their back.

 

This suggests she has moved totally away from EBM towards a world-view based entirely on the tenets of naturopathy which has connections to other groups, some mainstream, maybe fringe, fueled by social media

(I have done some work in the intersection of culture and beliefs, some people do have a mental health problem (moving on the spectrum of agreed cultural norms right up to delusional thinking, while others just have a political agenda). They are prepared to sacrifice one for the other and lose perspective).

 

I think it has generally as simple as whoever does all the sanctions not being bothered about ‘therapist delivered’ - which of course is v different to it not being possible to be harmful.

It could be a blind spot (heck that’s a long discussion but one that needs to be had of ‘as long as a psych said do’ type thing), or just basically’territory’ or ‘not my job’ - potentially because it’s delivered and developed under clin psych / physio but suggested by psychiatrists and now embedded by all then people literally have ‘no one board’ playing that same role as eg GMC on medicine.

But as you say things like Shipman and Wakefield incidents often shaped policies and actions ie it takes actual big events and inquiries of sort putting the ‘what could happen must not let it happen again’ stuff on the agenda.


interesting to note the ME stuff in this context and how it flags inquiries being needed for change perhaps.

but yes I think there does need to be a different route looking at them - it’s no ‘lesser’ just different in the context of how it’s been done where the issues were and playing the game etc ?

I’d hope the general public has grown up, particularly since there is more in film culture media and of course better internet access to show the potential for harm being just as possible as help if unregulated but whilst it’s sold as ‘you can try those risky steroids or painkillers or….. what about this nice little try at just changing routine or cbt (which is seen amazingly differently by many tI what we think) even some of us have said ‘yeah before I jump in with the hard stuff’ type thing and how little did we know.

cbt bit: the short course idea is known by psychs as seeming way more acceptable/sellable particularly when they say ‘it won’t be about your past just changing what you can do bla’ because pop psych has become so embedded partly thru work training courses.

But also no one in the industry describes it as anything other than if it was one thing - they don’t note it could be dodgy if based on a dodgy model because it’s just a delivery vehicle etc.

 

I think Dr Myhill revels in it. I think she fancies herself as a sort of renegade, and she knows she has enough patients and other business interests to continue having a good income, even if she can't practise for a while.

 

Well if she doesn't like it she can stop producing potions and casting spells can't she.

 

My understanding was that Myhill has practiced as a naturopath since she was struck off the GMC register and, to my knowledge, this profession is both unlicensed and unregulated in the UK. Is this correct? If so, this suspension won’t affect her business.

 

Myhill hasn't been struck off - she has been suspended in the past, but has been back on the Register for some years - ironically if she was still struck off the current case wouldn't have been heard. A Dr can be on the Medical Register, but not have a current licence to practice medicine, - being on the Register and having a licence to practice are two different levels of qualification - you need both to practice as a Dr but many Drs stay on the register after retirement, but do not maintain a licence.

Naturopath isn't a recognised medical profession in the UK and so isn't subject to a medical licence. The 9 month suspension imposed by the Medical Practitioners Tribunal Service doesn't stop Myhill from doing her Naturopath thing but anyone checking her bona fides as a Dr will see that she has been suspended, clearly this is of concern to Myhill as she is appealing the Tribunal decision: https://www.gmc-uk.org/doctors/2734668


"Details
Pending
This doctor has a suspension which is pending an appeal period"

So currently Myhill is on the Register, but does not have a licence to practice as a Dr. If her appeal fails she will be removed from the register for nine months, after which her name will go back on. No one can stop her selling services and supplements as a 'naturopath' unless maybe if she breaks consumer law. However if she continues to use the term Dr she risks prospective customers checking her out on the Medical Register.

 

She specifically told me she was deregistering as a medical doctor following the insurance problem. That was the term used. I guess that wasn't true.

 

Any Dr can seek voluntary erasure , i.e having their name taken off the Medical Register:

"Choosing to give up your registration (voluntary erasure) means that your name will remain on our online register but with the status ‘Not registered – Having relinquished registration’

You can request to give up your registration up to three months in advance

If you hold a full registration with a licence to practise, you still need to take part in revalidation until your registration ends. So you’ll still receive revalidation notices from us until then.

If you hold provisional registration, you will save your available days allowed by giving up your registration."

 

I suspect there is an element of it being a witch hunt, I can not see that she has endeared herself to the British medical establishment, with part of what people hold against her including her attempts to have the PACE authors/advocates sanctioned by the GMC. However given her practice in relation to unevidenced supplementation and now in relation to Covid, she has left herself more than open to accusations of being a ‘witch’, using the term metaphorically. Certainly I suspect if she has not been as outspoken, at least pre Covid, her confusion between possibilities and certainty might have slipped under the radar.

It is interesting how devoted her followers are, and how resistant they are to any criticism of her methods/beliefs. When I have tried to point out to some that her recommendations are often not based on any evidence, they insist it is all based on good science. Some of this belief in her comes from people confusing explanations using scientific terms with scientific evidence, some comes from her absolute confidence that she is right and perhaps some comes from what I believe is her genuine concern for people with ME however misguided she might be. For many she has been the only medic that genuinely seemed to be there for them.

 

Dr Myhill’s response. She says she applied to deregister in August 2020 but the GMC launched further investigations and refused her request.

https://www.drmyhill.co.uk/wiki/Res...uspend_me_from_its_Register_-_1_February_2023

 

I think I understated things when I said Dr Myhill did not endear herself to the UK medical establishment:

The General Medical Council is not fit for purpose. Established in 1858, it is the oldest regulatory body in the world. I like to use analogies – had the GMC been my patient then I would diagnose senile dementia. In suspending me from its register for my advocacy of vitamins, minerals and natural therapies, the GMC has demonstrated how it is controlled by Big Pharma. General Medicine has been reduced to symptom supressing, pill popping, and doctors have become glorified prescription medicine dispensing automatons. By its actions the GMC is bringing the medical profession into disrepute. It is no wonder that our glorious NHS is in decline – doctors are no longer allowed to doctor.. Any doctor who strays from this pill-popping path risks GMC persecution, loss of job, career and security.

 

Are her vitamins not prescribed in the form of pills? Has she not been on her own prescription pill-popping path over the years? It seems her main difference with the GMC is in the type of pills to be popped, and the fact that she considers the GMC 's conduct to be unbecoming.

 

Conspiracy theorist.

This is their way, same in my country. They say the laws governing medical practice is wrong (law developed by the public, justice system and government over many centuries to stop charlatans and pseudoscience), add Big Pharma as buzz word to speak to your adherents of various fringe groups. Try to bring in “oldest regulatory body”…. Invoking other likely groups (eg implying they are behind the times and perhaps misogynistic).

I stopped reading her appeal as I have heard it all before. They also get advice from lawyers, (also supporting/deluded by conspiracy theory) and one big misinformation/disinformation factory spread on social media (and encrypted text chat now). That is happening here.

All doctors (and other professional health practitioners) have to have regulatory bodies because that is how you are registered to be fit to practice on the public because of the rigorous training for the qualification. There are requirements to meet ethical standards and much more.

A doctor can have different views on practice outside the “scientific” realm, including naturopathy, that is not new. But to claim your unproven scientific treatment can prevent covid infection is bordering on delusional.

 

Oh Jesus.

She started this out meaning well many years ago, working out of a genuine desire to improve things for PWME (although her grasp of science has never been fantastic), but now she’s fully bought into all these conspiracy theories.

I read a thread on Twitter recently that might have some relevance:
https://twitter.com/user/status/1618295784277159937

 

Thing is, most doctors have a poor grasp of science.

For your average doctor, their poor grasp of science means taking the people in charge at their word. In terms of things like "vaccines are safe and effective", that's good. In terms of things like "GET Is safe and effective", that's bad.

For your Sarah Myhills, having a poor grasp of science means... this.

 

Is there any evidence that Dr Myhill has killed or injured (by omission, missing diagnoses, or incorrect prescribing) any of the people that she has treated or advised? If there is none then I don't understand why people are so angry with her.

 

I don't know about angry but "killed or injured" is hardly a test for medical professionalism, by that point it's too late. The test is, as @hibiscuswahine puts it above: "laws governing medical practice ....... law developed by the public, justice system and government over many centuries to stop charlatans and pseudoscience".

My view is that this particularly matters to people with ME/CFS because Myhill not only chose as a professional (qualified, registered and licenced) to build a practice around claims of treating ME/CFS, but also authored research on ME/CFS and involved herself in public campaigns around ME/CFS, which means any taint on her professionalism has a potential to taint public and professional views of ME/CFS treatment, research and advocacy. At the very least Myhill has to be answerable to her professional peers (as defined by her qualification, registration and licencing) because the system of wider protection of the public demands it.

 

How many patients think about the law before consulting naturopathic doctors (or whatever they call themselves)?

I understand your point of view, and to some extent I would agree. But from the point of view of any new ME patient who doesn't know anything about ME or how doctors treat it I can understand the lure of people like Dr Myhill.

What options does the patient have?

1) Get no help at all.
2) Get offered anti-depressants because the doctor thinks they must be depressed and anxious.
3) Get offered CBT and/or GET.
4) Get gaslighted, disbelieved and dismissed.
5) Get offered vitamins and minerals and dietary advice.

From my personal point of view I think of the following two scenarios...

a) Get diagnosed with ME and vitamin D deficiency - nothing offered has helped. Despair.

b) Get diagnosed with ME and vitamin D deficiency or any other vitamin or mineral deficiency - treat the deficiency, "just" leaving the ME, feel a little bit better, and feel happier as a result.

People with ME have to take every possible win they can get, in my opinion, particularly if the "win" can be achieved easily and cheaply and could improve quality of life.

Nothing would make me try to become a patient of Dr Myhill, but I wouldn't pour scorn on anyone who felt they had no other choice.