Dear Health Establishment…

Dear health establishment, one of my favorite musical genres is the singer-songwriter style of music most popular in the 1960’s and 70’s.  Guys like James Taylor and Jim Croce, ladies like Carole King.  The soulful meaning of the lyrics, the moral causes and personal crusades coupled with well-performed guitar work or piano instrumentation is a hallmark of this music.  The soft sound is juxtaposed against the heavy meaning of many of the lyrics.  As I opine here, I want to remind you of a verse from one of my favorite songs of all time. A song about the shifting tides of the exploration and radical shift in the individualistic thinking of the 1960’s.

Come gather ’round people wherever you roam, and admit that the waters around you have grown
And accept it that soon you’ll be drenched to the bone.
If your time to you is worth savin’, then you better start swimmin’ or you’ll sink like a stone.
For the times they are a-changin’.


– Bob Dylan, The Times They Are A-Changin’

I was recently made aware of the situation whereby the Medical Board of Tasmania & the  Australian Health Practitioner Regulation Agency (AHPRA) has acted to silence one fo their own, Dr. Gary Fettke.  A physician and orthopedic surgeon by trade, he has been outspoken about the evidence which exists that our modern diet (the so-called “Western Diet” or “Standard American Diet”) has led to a rapid and expansive increase both in our waistlines but also in the incidences of Type II diabetes.  Additionally, as an orthopedic surgeon, there is a vested interest in his part as it pertains to joint stressors brought on by obesity and a sedentary lifestyle…let alone the complications of diabetes up to and including limb amputation.  His very capacity to perform his job to the utmost of his capabilities is now at risk by what is apparently a schoolyard squabble over whether one of the most qualified medical practitioners of surgery in Tasmania (and likely in all of Australia) is competent to tell someone, like Arnold Schwarzenegger, to “Put the Cookie Down!”

What heinous crime did the good doctor commit for which he has been silenced by this board (I should point out that as I understand the process, silenced by an anonymous complaint and until resolution of the case against him)?  What did he do to deserve such a harsh rebuke and a depression of the pause button on his ability to benefit the health, wellbeing, and ultimate outcomes of his patients?  He said that excessive sugar consumption (specifically with a focus on Fructose) is inherently unhealthy.  A man with many years of training, licensure, certification, and credentialing.  A man whom the same review board is now adjudicating is the same man who has been trusted to perform a number of surgeries without any evidence of malpractice or poor performance for a number of years.  Even being trusted as a senior lecturer to those aspiring to follow in his footsteps.

I want to caution you, medical establishment.  I want to point out that the groundswell of support from the educated and enlightened masses has shifted the tides under your feet.

  • No longer will we blindly follow public policy handed to you under the guise of evidence-based practices.
  • No longer will we willingly be complicit in our own disease and unhealth.
  • No longer will we stand idly by while the access and availability of self-testing and open access to medical and health literature tells us what we have long since suspected.  Your recommendations don’t work.

You may argue that they work in theory (a statement I would dispute for all but spherical cows in a vacuum), but they don’t work in practice.  The world is getting fatter, sicker, and angrier with you – and yet at every turn of the bat (I’m looking at you South Africa…thank you Dr. Noakes for fighting the good fight!) the medical establishment appears to be hell-bent upon proving that if they’re shown to be wrong, the correct answer is not a course correction or a retraction, but instead a going all-in on wrongness in some effort to bluff those of us holding the better hand into folding.

It. Won’t.  Happen.


The times they are changing.  You cannot appeal to your expertise in the face of a mountain of evidence of your incompetence.  And when one of your own dares to point out the emperor has no clothes, the appropriate measure is not censure, it is rejoicing.  Dissent is the essence of science and the stuff of breakthrough.  You cannot, in the face of decades of peddling advice which has left your patients fatter and less ambulatory, appeal to your own authority when the foundations of that authority are crumbling under the sheer weight of our own fatness and illness.

Let me remind you of the last verse of the song from above.

The line it is drawn, the curse it is cast.
The slow one now will later be fast.
As the present now will later be past; the order is rapidly fadin’.
And the first one now will later be last,
For the times they are a-changin’.


Gary is unfortunately learning a lesson that Voltaire observed when he wrote that, “It is dangerous to be right in matters on which the established authorities are wrong.”  Dear health establishment…doctors, nurses, nutritionists, researchers…search both the anecdotal evidence with every presenting patient and your biochemistry textbooks.  Search the eyes of a child who has just been diagnosed with Type II diabetes.  Search the heart of a mother who, despite all of her efforts at following your advice, has brought her obese child to your facility exasperated and heartbroken.  Then search your soul and ask yourself a question that I find myself asking of many of my clients, “Is what I am currently doing working?”  Your patients are fatter than ever.  Your patients are sicker than ever. The answer is no.

The emperor has no clothes.  Dr Fettke hit the nail on the head.  He is challenging the status quo.  He should be celebrated for raising his hand, not censured to the detriment of his patients.  Let’s presuppose, however, that Dr. Fettke is wrong.  Perhaps the thousands of people who have improved, managed, or cured conditions such as Multiple Sclerosis, Diabetes, Epilepsy, and Cancer are simply the result of placebo and wishful thinking.  Perhaps the hundreds of thousands who have improved the conditions of PCOS, Insulin Resistance, or have overcome obesity…maybe they’re just delusional zealots who starved themselves thin and repaired their metabolism by accident or coincidence.  Maybe Dr Fettke is wrong…but if he is, then prove it with sound science, not a swift gavel.  Your very response belies the issue of mistrust in the authority you wield and why you have lost the trust of your patients.  Your version of evidence-based medicine or nutrition is a form of defensive practice based upon only the science which agrees with your presupposition.  There’s a term for that, and it isn’t EBM – it is confirmation bias.  I’m guessing you read about that in a research methodology or statistics course at some point in your education.


Admittedly, I realize I’m painting with a broad brush.  There are a number of highly competent medical and nutritional practitioners who haven’t yet exchanged their brain for a credential.  To those of you who dare to ask questions, challenge presupposition, and demand answers…thank you!  This is the foundation of what I learned in the third year of my elementary education when we learned about the “Scientific Method.”  Please know that you have the support of the rationally minded who are searching and efforting towards optimum health.  I don’t care what the eventual outcome is, whether our approach or someone else’s is proven correct.  What I celebrate is that you are willing to ask hard questions, to demand better research, and to utilize the years of training and expertise you have.  For that, I applaud you…and I’m guessing many others do as well.

About Author

Tyler Cartwright
Former fat guy (well, I'm still fat...but less so and getting thinner and stronger). I've lost 295 lbs - while on a ketogenic diet. I love to lift, to learn, and to live...anything else...just ask.


  1. Leo Tat

    The medical establishment silences those who can potentially put a dent in their profits. Whether some thing works or not, whether its good for us or not, is not what they are concerned about.

  2. JD

    Dear Tyler,

    Great article. The times sure are changing. However, I have to fight sometimes my frustration at the speed of that change.

    Only yesterday I was talking to a good friend who just went to a Nutrition MD and… Well, the same recommendations: Low fat diet AND the “new” Medicine, an injectable stuff (yes, she has to pinch herself a couple of times a day).

    I was very careful to ask her just some questions (she is overweight, not obese) which I knew the answers already:

    Me: and how has it worked?
    Her: Not so great. I’ve lost 5 pounds in a month but the doctor want doble.
    Me: Double? You are doing great! And for how long is this “treatment”
    Her: for 3 months
    Me: And what’s the plan afterwards?
    Her: Humm, I haven’t asked. But you get used to the new way of eating so…
    Me: yes, you get used to it, but you can always get “unused”
    She: 🙁 you’re right… And I have hi cholesterol. Trigs of 200+
    Me: that’s very high. You should cut carbs, specially processed ones.
    Her: Yeah, well, I’m following what my MD says.

    It’s very tough for regular folks to question beliefs that they have heard for decades and go against what someone with a white robe and a stethoscope tells them.

    Hope we all can help and be part of that change.

  3. Paul Mack

    I think here in Australia we are way behind in what is real science and what is conventional wisdom. You only have to look at the negative publicity Pete Evans got for his paleo cook book recently, all because he had a “bone broth” recipe for infants. My life has changed for the better since going “Primal” and I am no longer effected by excess carbohydrates. Keep up the good work Dr Gary Fettke.

  4. anna

    Sensational commentary.

  5. Susie

    Please…do get your facts right…Dr Gary Fettke is a ‘physician and orthopaedic surgeon’ by PROFESSION not TRADE….no need to add insult to injury…

    1. Tyler Cartwright (Post author)

      My facts are not in question – the term “by trade” infers that he/she engages in the job of being a physician and orthpedic surgeon. In a matter this important, I don’t think that it’s worth debating the semantics of connotative meaning vs denotative meaning, and I don’t think that it in any way detracts from the overall point of the piece in defending Dr Fettke. No one believes a phsycian goes to trade school and then, when he’s done changing your oil, also does surgery. That’s an absurd position to take, and I won’t permit this important topic to devolve into a discussion of vocabulary or word selection.

      1. Helen

        Exactly – a good ‘turn of phrase’ is often just what the doctor ordered!

  6. Ben Fury

    We already have clear evidence that the current guidelines are toxic. For a health regulating authority to muzzle a physician for trying to help people with clear guidance to eat real food and avoid processed junk is simply barbarous.

    Belinda Fettke discusses what Gary’s up against here:

    You are in all of our prayers, Gary. The truth will win.

    The fact that the authorities are going after people like you and Tim Noakes just shows how scientifically inept and morally bankrupt they are.

    Stick to the science and prove them wrong. Remember Dr. Annika Dahlqvist and her incredible victory in Sweden.

    1. robert lipp

      just follow the money and you will find the cause

      1. Tyler Cartwright (Post author)

        There’s a lot of money transacting hands in modern healthcare. I’m more concerned and think this has more to do with ideological battles taken to a regulatory authority. I don’t think this is “big pharma” (I loathe that term) or anything other than an angry physician who disagrees with the ideological framework from which Dr Gary speaks, teaches, and practices

  7. Ronnette

    Tyler this is such a well written piece. I am so glad to know you!!

  8. Linda

    Oh Tyler, beautiful post! You know most of us with health issues visit our docs to only push them in the direction that we already know is right instead of taking their advice. We already go into those visits with the presupposition that they are wrong and we are going to have to tactfully swing them in the right direction. Sometimes it works. Sometimes it doesn’t. But it shouldn’t be that you gave to go to battle for your health. Bravo! Keep the pressure on!

  9. Chris

    Well put. This story has to be broken in the mainstream press. A tale of cowardice and malpractice that puts Australia up there with the South Africans for self interested persecution and Ludditery.
    Some religious groups reject medical science for more plausible reasons than this mob!
    I hope some names can be attached
    to this obscenely obscured witch hunt.

  10. Jeff Cyr

    Awesome write up Tyler Cartwright. I am sharing.

  11. Alvin H. Danenberg, DDS

    I am in total agreement. I fight the fight. I am a traditionally trained periodontist. I have been treating patients for the last 42 years. But, four years ago I incorporated Primal Nutrition and Primal Lifestyle into my treatment for gum disease. My life has changed, and I am changing the lives of my patients.

  12. Yvonne Gillham

    Well said, that’s exactly what I wanted to write.


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