I imagine not many folks outside of Canada, or potentially outside of Globe and Mail readership, are following the lawsuit of Dr. Stanley K. Bernstein vs. Dr. Scott Seagrist.
Short version of the suit is that Dr. Seagrist once worked for/with diet MD Dr. Bernstein, and then branched out on his own, and according to Dr. Bernstein's team, benefited by using Dr. Bernstein's "secret formula" of dieting techniques.
According to the article in the Globe and Mail, Dr. Bernstein's lawyer reports that
"the “totality” of his (Dr. Bernstein's) treatments is unique and similar to a secret formula or trade secret."That leads me to wonder, were a physician to learn of a "secret formulas" or "trade secrets" as would pertain to the treatment plan for an established medical condition, would it be ethical for them to withhold that treatment from their patients? Do doctors not have an absolute obligation to deliver care to the best of their knowledge and ability?
Obesity is a medical condition that affects literally millions of Canadians. It causes co-morbidity, shortens lifespan and impairs quality of life and certainly is often a very difficult challenge to treat for the medical profession as a whole.
Without going into the issues of whether or not I believe a "formula" for weight loss is even theoretically possible given the complex and myriad causes of obesity, were Dr. Seagrist aware of a treatment modality that he believed to be beneficial in the management of his patients' obesity, could he fairly withhold it from them?
Remember, we're not talking about the breach of a patent here, we're talking about a treatment plan. Could a physician ethically withhold treatment because they learned the methods involved in that treatment from another physician? Is there any treatment in medicine that isn't learned that way?
The spirit of medical learning as taught to me was,
"See one. Do one. Teach one."Not,
"See one. Do one. Never breath a word of this to anyone.""Trade secrets" in medical care seem anathema to patient-centered medicine.
Here's hoping the courts don't deem there to be "secret formulas" in medicine, as that sort of precedent could set us off on a very slippery slope where you might find yourself one day not receiving the best possible care from your doctor because he or she didn't pay their teachers a licensing fee.
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His precious secret formula won't be secret for much longer if the Canadian legal system is anything like the U.S.
ReplyDeleteDepositions, courtroom testimony, etc.
Hi Steve,
ReplyDeleteHis team is arguing that the court records be sealed from the public due to his "secret formula".
I would agree that no, it is not ethical for a doctor to withold information that could benefit a patient.
ReplyDeleteHowever, I think that in the case of Dr. Bernstein's weight loss plan, a lot of the argument hinges on whether this treatment is actually effective in the long-term management of obesity.
From what I've read, there is no evidence his treatment has any long-term benefit, and the clinic does not follow up with patients after their time with the clinic is over. Please correct me if I'm misinformed on this.
Given my belief that Dr. Bernstein's treatment is not some secret cure for obesity, I would group it in the same category with all other weight loss products on the market.
If Dr. Bernstein actually does hold some magic weight loss formula that is effective in the long-term management of obesity, then I would have to group it in the same category with other effective medications for chronic disease like insulin or antihypertensive drugs. Just as it would be unethical to withold these treatments, it would be equally unethical to withold Dr. B's weight loss formula. But if this were truly the case, then Dr. Bernstein's treatment should be made readily available to the public and not offered in private (and very expensive) clinics.
It's an interesting debate. I guess the bottom line for me is that I just don't have much faith in Dr. Bernstein.
What do you think of PGX?
ReplyDeleteI know the Bernstein secret formula: eat fewer calories than you burn. Tell no one. Let's keep this between us.
ReplyDeleteSurely keeping a treatment formula "secret," for any medical condition, is contrary to "First do no harm."
ReplyDeleteI'm not aware of any studies that have been peer reviewed or published about Dr. Bernstein's program.
ReplyDeleteThat said, he makes very specific claims about his success rates on the radio.
For that I would hope that both the College of Physicians and Surgeons and the Competition Bureau would take notice and ensure their accuracy if they haven't done so already.
Interesting POV. What about docs that help develop new drugs, or who own copyright on books / videos / websites? I guess the limiting factor would be the secrecy aspect of Dr. B's argument, but that might also hold for patents on medications / devices etc. What does his medical licensing body say about this type of thing?
ReplyDeleteWould holding a patent on a medication not fall into the same category? Many docs are in that position in biotech and pharma. What does Dr. B's licensing body say about this sort of thing?
ReplyDeleteDrug companies develop a "secret formula" to treat a medical condition, and make it available in prescription drug form, where it is then available to everyone who can afford to buy it (or whose insurance covers it).
ReplyDeleteNewly developed surgical procedures may be taught by specific individuals, but again, they aren't intended to be kept "secret" -- they are intended to be "spread."
It's not about patient-centered medicine, it's about whether medicine is primarily a scientific endeavor or a commercial one. No one expects doctors to work for free, but if there is a specific treatment for a condition that is being kept secret, that person is no longer operating as a scientist/physician, they are a solely a businessperson.
I don't think there'd be a discussion here if we were talking about a patent.
ReplyDeleteI'm quite certain that were Dr. Bernstein to have a treatment methodology or potion that were patentable, he'd have already done so.
No, here we're talking about something non-patentable, and I would argue by definition, if it's non-patentable and it pertains to the provision of a medical treatment for a medical condition by trained physicians, that secrets cannot apply.
Of course I'm not a lawyer and I've learned over the years, law is anything but intuitive.
Kind of like Queen Anne of Denmark's physician who kept the "secret" of forceps from the rest of the doctors to ensure a long term prestigous career.
ReplyDeleteWrong then, still wrong now. Long live open source.
I think there are many scenarios where the legal or regulatory system prevents doctors from providing the best care possible. From that perspective, adding trade secrets on top of the pile of reasons for not providing the best care doesn't seem like that big of a deal.
ReplyDeleteHe should be forced to reveal his magic formula. As soon as that happens, it will be obvious there is no magic formula.
ReplyDeleteIsn't "radio" similar to peer-reviewed medical journals? And has Canada gotten as crazy as the US with senseless litigation? Where's his argument if there is no patent?
ReplyDeleteIt's a funny conundrum for him to be in--prove efficacy of the magic Formula, and you break the Hippocratic Oath, to first do no harm. Or be shown to have a worthless product and to have mislead the public and your patients.
Maybe his secret formula is placebo?