Dr. Gina Honeyman’s False
Claims For the past two months, I have talked with my attorney and other advisors and pondered what to do about a matter that deeply disturbs me. I would prefer that this matter not exist. As it turns out, however, I have no option but to deal with it. And, as unpalatable as it is to do so, I must deal with the matter publicly. Dr. Honeyman created her own website several months ago. By court order, I must keep a link to her site on each page of drlowe.com until March 1, 2008. However, the ordered link is requiring me to refer readers to false information written by Dr. Honeyman. As a result, the court order forces me to violate my own ethical standard of providing readers only with information that I believe evidence shows to be true. Hence, for reasons I detail below, but especially because of the court-ordered link, my demand for a retraction from Dr. Honeyman is imperative. To get right to the point, I have an ethical obligation to correct gross misrepresentations of my clinical and scientific work, especially when false representations are likely to reduce the potential benefits of my work to patients’ health. Because of this, I am forced to refute the false claims about metabolic rehabilitation (rehab) being made by Dr. Gina Honeyman. Over the years since I first created metabolic rehab, I’ve written and lectured a great deal about it and its scientific bases. I've done so in a conscious effort to pass the clinical protocol on to patients and other practitioners for their use and refinement. I did this from a deep-seated desire and commitment to relieve as much human suffering as possible during my short time here. Because of this, I'm motivated to do everything possible to see that metabolic rehab is accurately represented by those who write or speak about it. Dr. Honeyman’s misrepresentation of what metabolic rehab is threatens to diminish, if not fully dissolve, the potential benefits of the protocol for patients. The same desire and commitment of mind that brought about metabolic rehab now compel me to show her claims to be false.
On her website and in another document, Dr. Gina Honeyman implies that she created metabolic rehab, and then cavalierly claims that she "termed" it. On her site, she writes:
This statement is mostly true, except that it was actually 1997 when I became earnestly involved in teaching Dr. Honeyman how to use metabolic rehab. After she seemed proficient enough at using the protocol, I began referring patients to her. Eventually, I referred to her all patients who sought my care so that I could concentrate on writing about the protocol and its scientific underpinnings. I remained in the background, however, as clinical consultant on all her cases. As such, I researched and usually found solutions to patients’ problems that evaded Dr. Honeyman. She also writes:
This is a false claim. Dr. Honeyman could not have "quickly" added functional medicine procedures to my protocol. The reason is that it was my now-deceased friend, Dr. Nicholas Calvino, who introduced Dr. Honeyman—through me—to functional medicine, long after she claims to have added it. Dr. Calvino graduated from chiropractic college in 1998. [4] He soon began to work for a company named Metagenics. The President of Metagenics was a founder of functional medicine, and through working with the company under the President's influence, Dr. Calvino began learning functional medicine. Shortly afterward, he began communicating with me about this valuable clinical approach.I was duly impressed with what Dr. Calvino communicated to me, and I began imparting it to Dr. Honeyman. She and I occasionally talked about the concept. But at that time, we did nothing to integrate any feature of it into metabolic rehab. She was simply too busy better learning and practicing metabolic rehab, and I was too busy researching and writing The Metabolic Treatment of Fibromyalgia. That she and I didn't integrate functional medicine procedures into metabolic rehab until after 2000 is obvious from an email I wrote to Dr. Calvino on September 23, 2000. At the time, he was considering coming to work at our clinic in Boulder: "Our core protocol," I wrote to him, "is well-honed and highly effective, but it’s not 100% effective, and as I said on the phone recently, I believe we need to integrate features of functional medicine and possible other approaches into our protocol in an effort to increase our success rate. And I feel that working as a team, you, Gina, and I can accomplish that and build on the solid base we've already established."[1] It was Dr. Calvino, then, who stirred our interest in functional medicine, but we had not yet integrated it into metabolic rehab, even some three-to-four years after Dr. Honeyman claims she "quickly" added it. Dr. Honeyman also says on her website:
If she had quickly added the needed ingredients for success, then the protocol wouldn’t have "evolved," which by definition means to gradually change into a different state. This may seem a quibble, of course, but it is important to mention the contradiction, as it is emblematic of Dr. Honeyman’s carelessness in writing about metabolic rehab. To summarize, Dr. Honeyman states that by quickly changing my protocol (adding some other diagnostic and therapeutic procedures), my protocol became something different that she created—something she then "termed" metabolic rehabilitation. The sheer audacity of this claim is shocking. It arouses in me what a parent must feel when someone jerks her baby from her arms and runs down the road yelling, "My baby; my baby!" How the Term "Metabolic Rehab" Really Came About. I first began using the term metabolic rehab to describe my protocol roughly about the time I met Dr. Honeyman in 1995. I met her when I was on campus to speak to the faculty and student body at an assembly of the chiropractic college from which she was soon to graduate. In late May of that year, I would meet her again at a symposium on myofascial therapy where I received an award for my contributions to that field. It would be about another year before I would begin to train her to use my metabolic rehab protocol. It was sometime early in 1995 that I first realized that my treatment protocol was a form of rehabilitation. What caused me to realize this was an experience with a patient who had an especially fragile heart condition. I referred the patient to a cardiologist for an evaluation. During my twenty years of work in this field, I’ve referred many patients to cardiologists. But this patient with a fragile heart was unusual: she’s the only patient whom a cardiologist has ever advised to go through cardiovascular rehab before starting to use thyroid hormone. The patient investigated different cardiovascular rehab programs and finally settled on a hospital-based program. As she studied various programs, I was curious about them and learned along with her. I wanted to know what was common to all of them and what made these programs different from other protocols. This is how I came to understand the style of clinical work called "rehab." The Crux of Metabolic Rehab. As I learned what the patient would be doing in cardiovascular rehab, I saw that the program had in common a feature with musculoskeletal rehab programs—those that a physical therapist or chiropractic physician might design for individual patients. That feature, I realized, is the very heart of all rehab programs: a practitioner repeatedly assesses a patient’s condition through periodic measures. Based on what the practitioner learns from those measures about the patient’s response to the treatment program, he or she alters the program at proper times to enable the patient to further improve. Scores on tests the practitioner gives the patient are in some cases posted to graphs. The graphs let the patient and practitioner clearly see how the patient is progressing. I had been using the same type of repeated reassessments with fibromyalgia patients as they went through what, at the time, I most often called "metabolic therapy." Dr. John Gedye (physician, surgeon, and philosopher of science) wrote the Foreword to The Metabolic Treatment of Fibromyalgia, which was published in 2000. One of his major emphases in the Foreword was that, central to my treatment protocol, was the use of systematic feedback.[9,pp.40-41,44] My use of this, he noted, came from my early training in behavioral psychology, in which he, too, had been initially educated. I had been trained in a clinical form of behavioral psychology called behavior therapy. An essential feature of behavior therapy, the systematic use of feedback, was the same type of monitoring and graphing that clinicians use in cardiovascular and musculoskeletal rehab. After my experience with the heart-fragile patient who needed cardiovascular rehab, I suggested to Jackie Yellin that we call our metabolic treatment "metabolic rehab." Neither she nor I was especially fond of the term at first, partly because it wasn’t as succinct as "metabolic therapy." But we nonetheless began using the term interchangeably with metabolic therapy. After all, our patients were truly going through a process of rehabilitation. In 1996, a member of my research team Richard Garrison, MD, who was then with Baylor College of Medicine, objected to the term metabolic rehab. He trained family medicine residents and communicated with many practicing physicians. Based on his teaching and communications, he argued that the term "rehab" implied a different system from what most physicians use. And he was right, which is one reason more physicians haven’t taken up the full, proper protocol of metabolic rehab. Rather than systematic monitoring at close-enough intervals, and then using the outcome scores—"the feedback," as Dr. Gedye referred to it—they prefer a protocol of simply having patients check back with them at intervals and report how they feel in response to the treatment. As Dr. Gedye noted, this is a problem in modern outpatient clinical medicine. By contrast, medical staffs extensively use feedback in post-surgical wards. However, in outpatient medicine, the standard approach simply isn’t systematic and objective enough to maximize the effectiveness of many treatments. In 1996 my research team—which did not include Dr. Honeyman—used rehab-type monitoring and graphing in three double-blind placebo controlled studies. [3][7][8] In a 1997 report of one of those studies,[3] we described in detail how the monitoring and graphing was done, especially the repeated visual inspection of graphs. I want to emphasize that when we performed those studies, Dr. Honeyman was not part of my research team because at the time, I had just begun communicating with her about metabolic rehab.Dr. Honeyman’s Misrepresentation of Metabolic Rehab. From the foregoing narrative, it should be clear what features of metabolic rehab warrant its name: repeated testing and the use of systematic feedback to tweak a patient’s individualized treatment regimen. These are the backbone of metabolic rehab; without these, the clinical approach wouldn’t classify as rehabilitation. These features were intact long before I began tutoring Dr. Honeyman in the protocol—in fact, long before I even met Dr. Honeyman. In 1993 and 1994, for example, I published my first two papers describing the periodic collection of data and its use as systematic feedback for treatment assessment. [2][6]That the term metabolic rehab existed before Dr. Honeyman began using my protocol is conceded in her own words. Consider, for example, the following statements from page 53 of the book titled Your Guide to Metabolic Health. In the book, she and I wrote:
Then she wrote:
She continued:
Dr. Honeyman makes it clear in these statements that she learned "metabolic rehab" (the term she herself uses in the paragraph above) under my tutelage. I supervised her and taught her the value of the most basic feature, the backbone, of metabolic rehab. And even while I was training her—long before she imagines that she improved the protocol and then coined the name metabolic rehab—she was using the very name itself. The term’s birth, then, did not have to wait for her, as she says, to intermingle the protocol with other diagnostic and treatment methods. Understanding the nature of metabolic rehab, its true origin, and the source of its name is essential for practitioners and patients alike if they want to use the protocol successfully." Otherwise, Dr. Honeyman’s distortions may sabotage doctors’ and patients’ attempts to get the patients well. Understanding the protocol so that both doctor and patient can use it correctly makes it likely that patients will get well; they are far less likely to get well, however, if they misunderstanding it, and therefore misuse it. For the sake of doctors and patients who might learn of the protocol from Dr. Honeyman, then, she must retract her false statements and let the truth prevail. Refining Metabolic Rehab. During part of the time Dr. Honeyman and I practiced together, the following statement, which I wrote, was on the homepage of my website drlowe.com:
Some readers might say, "Well, even if Dr. Honeyman didn’t name metabolic rehab, this statement suggests that she at least helped modify and improve it." I readily give her credit for minor contributions, basically refinements, to the protocol. But any credit due her in this regard must be taken within my position on contributions by others. I recently interviewed a doctor who was considering coming on board at The Lowe Clinic and Research Center. I told him: "I invite science-based improvements of metabolic rehab. Anything to improve it is welcome, as long as the addition is science based, and our scientific testing of it shows that it improves our ability to help get patients well. I’ll thank you for any such refinements you make to metabolic rehab." However, I emphasized to him, the integrity of the skeletal core of metabolic rehab—its essential feature, systematic feedback—must be respected and preserved. The doctor concurred. I, myself, am continually looking for ways to improve the protocol. Over the last two years, for example, I’ve integrated home glucose tolerance testing into my use of metabolic rehab. The addition has proven immensely beneficial to many of my patients. And the addition has taught me things I previous hadn't known. For example, after scores of my patients did the testing, I learned—contrary to my previous presumption—that high blood sugar is far more common among them than low blood sugar. This revealed the mechanism of many patients’ fatigue and cognitive problems. I now understand this mechanism, and when I identify it, I give the patients evidence-based treatments to correct the high sugar levels. [5]Ongoing innovations to metabolic rehab, like the one I just described, are essential if the protocol is to progressively improve and help even more people. These innovations, improvements, or additions, however, are refinements, as I’ve already noted. The core of metabolic rehab never changes. If that core were to change, we would no longer have metabolic rehab. We might have treatment, therapy, or something else—but not rehab. To her credit, Dr. Honeyman did help refine the protocol over the years by suggesting that at least two additions be made. And while I thank her for those contributions, I must also remind her that small refinements to metabolic rehab are not the same as creating the clinical approach, nor the same as naming it. Conclusion. In Dr. Gina Honeyman’s bio on her website and through other documentation, she makes false statements about the creation of metabolic rehab and its naming—wrongly attributing both to herself. Before I ever met Dr. Honeyman, others had made valuable contributions to this clinical protocol which I created and named. Among these others are my collaborator of some twenty years, Jackie Yellin; nurse practitioner Mervianna Thompson; biochemist Malford Cullum; and physicians Alan Reichman and Richard Garrison. For Dr. Honeyman to essentially ascribe the creation and naming of metabolic rehab to herself—with only vague, passing mention of some research-based protocol of mine, but no mention of these other contributors who preceded her involvement—is to devalue the contributions of these individuals. Knowing the true history of the protocol, however, I must stand up in defense of these individuals’ contributions. Without their contributions (along with mine, which Dr. Honeyman belittles), she would not have metabolic rehab as a specialty to practice. In my last conversation with Dr. Richard Garrison, he was understandably perplexed and dismayed at Dr. Honeyman’s false claims. He was fully aware that he and others had been at work with me developing metabolic rehab before I met Dr. Honeyman. For example, before she became involved at all, he had arranged research meetings for me on behalf of my clinical and scientific work. These meetings were with individuals and groups at both Baylor College of Medicine and the University of Texas Health Science Center in Houston. The meetings were partly to brainstorm with other researchers over our studies and the development of metabolic rehab. And all of this occurred before I began training Dr. Honeyman to use the protocol. Why would she make such false claims and disregard Dr. Garrison's contributions and those of others? The answer is one Dr. Garrison won’t be able to hear from Dr. Honeyman, as he passed away a couple of weeks ago. I am outraged by the short shrift Dr. Honeyman gives to all, myself included, who contributed to metabolic rehab. But I can live with that. However, the world has too many doctors and patients who need metabolic rehab, who need to accurately understand it and correctly use it. Dr. Honeyman’s false claims about the protocol are likely to deprive these doctors and patients of what they need. Because of that, I cannot stand by quietly and ignore her false statements. Instead, I emphatically demand that from a simple respect for truth, she retract her false representations of the facts. References  2. Lowe, J.C.: T3-induced recovery from fibromyalgia by a hypothyroid patient resistant to T4 and desiccated thyroid. J. Myofascial Ther., 1(4):21-30, 1995. 3. Lowe, J.C., Reichman, A.J., and Yellin, J.: The process of change during T3 treatment for euthyroid fibromyalgia: a double-blind placebo-controlled crossover study. Clin. Bull. Myofascial Ther., 2(2/3):91-124, 1997. 4. http://www.zoominfo.com/people/Calvino_Nicholas_535239873.aspx. 5. Low blood sugar despite a complex carb diet: finding it and fixing it. News from Dr. John C. Lowe: The Lowe Clinic & Research Center, July 29, 2007, http://www.drlowe.com/emailnewsletter/2007archive11.htm. 6. Lowe, J.C., et al.: Improvement in euthyroid fibromyalgia patients treated with T3 (tri-iodothyronine). Journal of Myofascial Therapy, 1(2):16-29, 1994. 7. Lowe, J.C., Garrison, R.L., Reichman, A.J., Yellin, J., Thompson, M., and Kaufman, D.: Effectiveness and safety of T3 (triiodothyronine) therapy for euthyroid fibromyalgia: a double-blind placebo-controlled response-driven crossover study. Clin. Bull. Myofascial Ther., Vol. 2, No. 2/3, 1997, pp. 31-58 (Haworth Medical Press/1-800-haworth)
Our Menu of Services: We have a menu of my husband's clinical services and fees. We put the menu together so that you can avail yourself of some or all of the services, whichever best fits your budget. If you want to talk about Dr. Lowe's services, you can reach me at 603-391-6061. If you prefer, you can email me at Tammy@drlowe.comm. However, we also have a webpage where we describe our menu of services: Your Options for Metabolic Evaluations and Treatment. The Lowe Clinic and Research Center © 2007 John C. Lowe. All rights reserved. This email newsletter may be copied and distributed subject to three conditions: (1) All text within the full document or any section copied must be copied without modification with all pages included. (2) All copies must contain the following copyright notice: "© 2007 John C. Lowe." (3) Neither this full document nor any section of it may be published or distributed for profit. |