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ILADS Dr. Jeffrey Piccirillo

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ILADS Dr. Jeffrey Piccirillo

Postby LymeH » Wed 13 Jul 2011 16:59

www.chicagotribune.com/health/ct-met-illinois-lyme-doctor-20110713,0,3542528.story
chicagotribune.com

Lyme doctor with troubled past offers controversial treatment


Banned from surgery, ex-Illinois physician now specializes in disease that's doubted by key medical groups

By Trine Tsouderos, Tribune reporter

July 13, 2011

When Dr. Jeffrey Piccirillo moved to the small college town of Grinnell, Iowa, the Joliet surgeon had been sued multiple times over allegations of malpractice, personal injury and negligence. In 2003, less than a year earlier, he had filed for bankruptcy.

Things didn't go much better for Piccirillo in Iowa. Within a few years, he was battling another lawsuit, this time from a knee surgery patient alleging that he failed to properly diagnose a fracture and prevent it from worsening, according to court records.

Then the Iowa Board of Medicine charged Piccirillo with "professional incompetency." Eventually, he signed an agreement with the board that placed his license on indefinite probation and prohibited him from practicing surgery in Iowa. A similar agreement with Illinois followed.

Now Piccirillo, 48, has started over again as one of Illinois' and Iowa's few "Lyme-literate" doctors — physicians who are willing to treat the dubious diagnosis of chronic Lyme disease.

Lyme disease is real. The bacterial infection, chiefly transmitted by deer ticks, can cause rashes, swollen joints and inflamed nerves, and usually is curable with a round of antibiotics.

But some doctors are telling patients with common medical problems such as back pain, poor concentration and fatigue that their ailments stem from a chronic form of Lyme disease that can evade standard laboratory testing and treatment. To fight what they say is a persistent infection, the doctors often order months or years of antibiotics, which can cost patients tens of thousands of dollars, often out-of-pocket.

Both the Infectious Diseases Society of America and the American Academy of Neurology have concluded there's little evidence this form of Lyme disease exists. These professional medical organizations also say there is strong evidence from clinical trials that long courses of multiple antibiotics are pointless and even dangerous.

In a lengthy statement to the Tribune, Piccirillo wrote that he is a "Lyme disease survivor" and that he is dedicating himself to the care of Lyme patients. He said he is treating dozens of patients each week, many for Lyme.

"Lyme disease is personal to me," he wrote. "It's my forte, my passion."

His past problems are irrelevant to his current work, Piccirillo wrote.

"The matters you address are prior to the beginning of my practice," he wrote. "I have trained hard in the area of Lyme disease to provide the type of care I hope to perfect over time. … I aspire to be a better care provider than I ever was in my previous work."

In an online forum for patients where Piccirillo is referred to as "Dr. P," one patient posted a link to the Iowa board's action against him and said the doctor had explained it to her without prompting.

"Once you learn the reason, I think you will feel as confident in his care as I do," the patient wrote on the Road Back Foundation message board. She reported taking two antibiotics and a medication that treats protozoans.

After receiving his doctor of osteopathy degree from the Philadelphia College of Osteopathic Medicine in 1989, Piccirillo started practicing as an orthopedic surgeon in Joliet in the 1990s.

By 2002, he was earning more than $500,000 a year and living in a nearly 8,000-square-foot home, according to court records. After he declared bankruptcy in 2003, assets listed in court filings included a Hummer, a Jeep, a Porsche and a 39-foot boat valued at about $100,000.


In an email, Piccirillo said he went bankrupt because of the failure of a Joliet restaurant in which he had invested.

Among the lawsuits referenced in his bankruptcy filings was that of Susan Sweet, a patient who sued the surgeon in 2004. Sweet alleged that Piccirillo failed to give her antibiotics before or after he operated on her broken ankle in 2002 and that she developed an ongoing infection that was improperly treated.

Sweet's mobility was never the same after the surgery, according to sister Lori Phillips. Because Sweet was unable to stand to cook, the sisters were forced to close a Joliet catering business they ran together, Phillips said. Sweet developed other health problems, she said, and died at 56 of a heart attack last year.

Court records show that the case was voluntarily dismissed, but as part of Piccirillo's bankruptcy process, Sweet was awarded $2,695.95 on a $1 million claim.

Piccirillo wrote in an email that Sweet's case never went to trial. "I have no clue where the $1 M dollar number comes from," he wrote.

Court records show that Sweet was among 15 patients or their families who have sued Piccirillo; six cases were filed in 2003 and 2004 alone. Most of the cases filed against Piccirillo were dismissed. One case went to trial, and the jury found in his favor, according to Piccirillo.

Piccirillo said he has been served notice of lawsuits only seven times. "I suspect lawsuits can be filed but never served on the opposing party," he said. He said his insurance company settled twice.

Three years after Piccirillo moved to Iowa in 2004, Joyce Haines, of Grinnell, filed suit against him. One of her physicians filed an affidavit alleging Piccirillo had broken Haines' leg during knee-replacement surgery, failed to tell her not to put weight on that leg and later told her it had healed when it had not.

The case was settled for an undisclosed sum, Piccirillo said.

In 2008, the Iowa Board of Medicine charged Piccirillo with a "failure to provide appropriate care and treatment to numerous patients," according to a news release.

The board alleged that he "failed to demonstrate necessary surgical skills, failed to demonstrate necessary clinical judgment, failed to provide proper surgical treatment … and failed to provide appropriate preoperative and postoperative care to patients."

A 2009 agreement between Piccirillo and the Iowa Medical Board placed Piccirillo's license on indefinite probation and ordered him to pay a $5,000 civil penalty.

The agreement also required him to submit to psychiatric care and mental health counseling. The board concluded that after a mental health assessment, Piccirillo was "safe to practice medicine subject to appropriate mental health counseling and board monitoring."

Citing him for "professional incompetence and practice harmful or detrimental to the public in his orthopedic surgery practice," the agreement also prohibited him from performing surgery under his Iowa medical license.

A few months later, he signed a similar agreement with Illinois.

In an email, Piccirillo said the Iowa board's action was spurred by a complaint from a hospital employee, not a patient. The Iowa agreement allows Piccirillo to petition to terminate the probation.

"Probation is probation," he wrote in his statement. "It serves a protective and reconstituting purpose when allowed to run its course; it doesn't end one's life or one's productivity, but it also most certainly does not keep others from trying to do so, or from trying to exact an additional pound of flesh."

Piccirillo wrote that he believes he contracted Lyme disease in January 2006 while doing missionary work in Haiti. While he was a surgeon, he wrote, he was suffering from the ravages of Lyme disease — "ravages which took away my first love as a physician but made me a better doctor as a result."

He likened his past as a surgeon to Michael Jordan's unremarkable tenure as a baseball player, saying his new work was a better fit and something he excels at.

"I don't profess to be free of flaws, I'm no Michael Jordan, of course, but I'm just as focused at being the very best every bit as much as he was and still is today in his endeavors," Piccirillo wrote.

Piccirillo said he trained as a Lyme doctor with the International Lyme and Associated Diseases Society, a group that promotes the diagnosis and treatment of chronic Lyme disease. He has treated Lyme patients for about 21/2 years, according to news reports.

The society's treatment guidelines support treating patients diagnosed with chronic Lyme with long courses of antibiotics, sometimes administered intravenously and sometimes multiple drugs at once.

Piccirillo's statement said he uses a treatment protocol he attributes to his training from the society and his personal experience with Lyme. Referring to the standard treatment for Lyme infections, a short course of antibiotics, he asked why mainstream medicine would want to "accommodate the Lyme bacteria by letting it sip on two or three weeks of antibiotics after it has permeated the inter-recesses of every component of the body, including the brain, in its chronic form?"

Infectious disease physicians dispute Piccirillo's description of Lyme. Clinical trials found little or no benefit from long-term antibiotics along with serious — potentially fatal — risks. In one study, one-fourth of the patients suffered severe problems linked to the treatment, including blood clots, infection and the loss of a gallbladder.

Some doctors who treat Lyme disease patients with long-term antibiotics and other unproven regimens have been disciplined by medical boards, the Tribune reported in December.

In some of those cases, patients crowded board hearings to support their "Lyme-literate" doctors. And in Piccirillo's case, some patients also seem willing to look past his trouble with medical regulators.

"I think it's our gain," one person wrote on a message board in September. "I am most happy to be seeing him in 2 weeks!"

ttsouderos@tribune.com

Twitter @ChicagoScience

Copyright © 2011, Chicago Tribune


Last edited by LymeH on Wed 13 Jul 2011 17:17, edited 1 time in total.
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Re: ILADS Dr. Jeffrey Piccirillo

Postby LymeH » Wed 13 Jul 2011 17:15

"Piccirillo said he trained as a Lyme doctor with the International Lyme and Associated Diseases Society"

Here is some history about the ILADS Educational Foundation.

viewtopic.php?f=7&t=1178&start=20#p22485

Richard Horowitz, MD

{ President }

Dr Richard Horowitz is President of the International Lyme and Associated Diseases Educational Foundation (ILADEF), and he is a founding board member of ILADS. He is a board certified internist and medical director of the Hudson Valley Healing Arts Center in Hyde Park, N.Y., an integrative medical center which specializes in the treatment of Chronic Lyme Disease and other tick-borne disorders. He has treated over 11,000 Chronic Lyme patients in the last 20 years, and has published on the role of co-infections and toxins in Chronic Lyme Borreliosis. He was awarded the Humanitarian of the Year award by the Turn the Corner Foundation for his dedication and research in the treatment of Lyme Disease.


http://www.ilads.org/lyme_programs/lyme_training.html
ILADS/TTC Physician Training Program
Back To Educational Opportunities

This physician training program will train the next generation of physician-scientists who will be future leaders in the treatment of Lyme and Associated Diseases.

The ILADS and Turn the Corner Foundation (TTC) Physician Training Program, a groundbreaking project vital to fostering excellence in care for Lyme disease patients, directly addresses challenges in properly diagnosing and treating Lyme and other tickborne diseases. The Training Program provides medical and other healthcare practitioners the opportunity to study with Lyme-literate healthcare professionals. Through this experience, participants will develop the skills necessary to properly diagnose and treat Lyme disease. These professionals will be able to return to their community with enhanced skills and the ability to provide superior care to Lyme patients, improving the health and quality of life for those that suffer from the most debilitating effects of Lyme disease.



The International Lyme and Associated Diseases Educational Foundation provides an opportunity for training in the latest diagnosis and treatment of tick borne diseases. By shadowing an expert for a week, the doctor can begin to become familiar with the most modern treatment protocols. Turn the Corner, in conjunction with ILADEF, offers a stipend of $1500 to offset the cost of participation. There is also an ability to self-pay for qualified medical professionals.

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Re: ILADS Dr. Jeffrey Piccirillo

Postby Spanky » Sat 16 Jul 2011 15:36

I hesitate to post this...as it probably gives this more attention than it deserves...but, well, here:

Tincup:

posted 07-14-2011 02:24 AM
--------------------------------------------------------------------------------
Looks like Al Capone is back! And as evil as ever.

I feel sorry for Chicago folks who have to put up with so much garbage from a newspaper and a sink-pot reporter that is suppose to help their communities and enrich the people living there.

I am also sorry that the trash out in Chicago is actually coming from a little skunk, a true blithering idiot on the east coast.

Give a duck-head with a mile wide evil streak a computer to play with and what do you get?

An IDSA supporter!

No way to stop them. Just got to learn to walk around them like they are a big pile of poo-poo in the street.

But, you can take comfort in knowing they will eventually die off and become extinct like the rest of the dinosaurs. Or the devil will carry them home to their final resting place and none too soon if you ask me.

In the meantime, support your doctors, educate others as much as you possibly can and get involved to help fight SLYME!


"Evil", as has been mentioned here, before, is sometimes in the eye of the beholder.

For instance, some people might consider the practice of lining up, herding, their fellow human beings like sheep to get "fleeced"...to be "evil".

And around here, in the wicked, "evil" City of Chicago...we have words to describe people, entrepreneurs, in a way, who assist others, to "hook-up" others for...shall we say..."personal services"?

And the word isn't "concierge", either.

PS. "Poo-poo"?

LymeNUT now officially declared braindead.
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Re: ILADS Dr. Jeffrey Piccirillo

Postby Camp Other » Tue 19 Jul 2011 10:45

I was not pleased with Dr. Piccirillo's decision to become an LLMD. What is already an area of medical controversy, he has taken his preexisting disciplinary record into it to make it even more controversial.

It's one thing to decide to give patients more antibiotics than that which the guidelines state - and another to be charged with incompetence and having a record of doing harm and being negligent to patients.

On one hand, if I take the guy's statements at face value, maybe he really was a lousy surgeon and makes a better doctor. But did he have to choose being an LLMD? ILADS? Why?

Talk about going into a controversial and high profile job. Did he think others including naysayers would not look at his record?

In his shoes, I would have considered other jobs.
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Re: ILADS Dr. Jeffrey Piccirillo

Postby Spanky » Tue 19 Jul 2011 16:39

"Camp Other":

I was not pleased with Dr. Piccirillo's decision to become an LLMD.


And I was not pleased with the reaction to the Tribune article by some misguided "activists" and commentators.

The patient population needs to be warned.

(BTW: There is no such thing as an "LLMD").
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Re: ILADS Dr. Jeffrey Piccirillo

Postby Camp Other » Tue 19 Jul 2011 18:54

I totally agree that people need to know about the backgrounds of their doctors and make informed decisions about their medical care. And I think that Dr. Piccirillo, given his record, should be one of the last people treating polymicrobial tickborne disease conditions when he has a record of not giving his own patient
antibiotics that were necessary pre- and post-op surgery. There is irony in this situation, no?

I left some comments on that list that may have been less than popular with some people. But I think it's fair to question the backgrounds and experience of all doctors regardless of what fields they are working in, and whether or not they treat Lyme disease, malaria, HIV, and any other condition. As patients we have a right to see qualified, competent doctors who follow the edict, "do no harm". Having a record which underlines a doctor's history of incompetence and negligence should be a red flag.

I disagree that there's no such thing as a Lyme-literate doctor. There are doctors who are clearly not clueful about Lyme disease and doctors who are.

The first doctor who saw me after I'd been bitten by a tick and had the EM rash told me it was an allergic reaction and that there was no Lyme disease in the area I had picked up the tick, when by clinical definition the rash was already expanded enough to qualify and looked like an EM rash and not a reaction rash. Also, the state health department stated I'd been bitten in an endemic area.

My LLMD had a map and could point out endemic areas - the same ones the state was aware of, including where I'd been bitten. My LLMD knew what an EM rash was and also knew about Babesia, of which I had symptoms develop somewhat later. A number of doctors in this state which I have spoken to have not known any of this, and when I went to the ER at one point, the physician on staff did not know what Babesiosis was and asked me to spell it.

No, really, some doctors are literate and knowledgeable - and some are not.
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Re: ILADS Dr. Jeffrey Piccirillo

Postby Spanky » Tue 19 Jul 2011 19:10

"Camp Other":

I totally agree that people need to know about the backgrounds of their doctors and make informed decisions about their medical care.


Then, why take the Trib to task for doing that very thing, putting out a warning about certain questionable practitioners, may I ask?

from the Camp Other Blogsite:

Chicago Tribune's Dubious Writer is at it Again...

"It's sensationalism, and it is about getting the audience's outrage in print. It's an open invitation for the general public (who is fed up with mainstream medicine and bad doctors, and often rightly so) and skeptics (who do not think Lyme disease can be a persistent infection) to comment on how horrible Lyme literate doctors must be in general if someone specializing in the treatment of chronic Lyme disease has a background such as Dr. Piccirillo's".


I disagree that there's no such thing as a Lyme-literate doctor. There are doctors who are clearly not clueful about Lyme disease and doctors who are.


In terms of its connotations, it has become a virtually meaningless term. And it certainly has no medical or professional importance.

Within Lymeland, I think that it is fair to say that it has gradually taken on the meaning of one of "our" doctors...one who is on the approved list of the LDA/CALDA/ILADS/IGENEX one-minded 'entity'.


No, really, some doctors are literate and knowledgeable - and some are not.


Well, I would agree that some doctors are knowledgeable and some are not. But a mainstream, ID or the neurologist who diagnosed me, can be knowledgeable...without the nonsensical "LLMD" tag.

And while we are discussing terminology and semantical differences, I would suggest that the term "LLMD" does have a generally-accepted meaning within online Lymeland.

The reason that I say that there is no such thing as an "LLMD" is that the term has become so diluted in meaning, that it means pretty much who a relatively small group of "activists" say it does.

You know, the ones they say you have to go see.

The ones who won't take insurance.

And the ones, that when they get hauled in front of a disciplinary board, the ones they say you have to write checks to help defend.

And the ones who sit on their board.

And the ones whose DVDs they say you have to buy.
Last edited by Spanky on Wed 20 Jul 2011 1:24, edited 2 times in total.
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Re: ILADS Dr. Jeffrey Piccirillo

Postby rlstanley » Tue 19 Jul 2011 22:01

Spanky:
...And while we are discussing terminology and semantical differences, I would suggest that the term "LLMD" does have a generally-accepted meaning within online Lymeland.

The reason that I say that there is no such thing as an "LLMD" is that the term has become so diluted in meaning, that it means pretty much who a relatively small group of "activists" say it does....


See the thread An LLMD is in the eye of the beholder
viewtopic.php?f=11&t=3158 where this term is discussed rather well.
.
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Re: ILADS Dr. Jeffrey Piccirillo

Postby Camp Other » Wed 20 Jul 2011 23:16

Spanky:

"Then, why take the Trib to task for doing that very thing, putting out a warning about certain questionable practitioners, may I ask?"


From my perspective, Tsouderos is continuing a variation of a theme from her December 2010 "Chronic Lyme: a dubious diagnosis" article, wherein the focus is on a few doctors' disciplinary charges and one charlatan who was taking advantage of people.

While it's important to inform the public of doctors who are incompetent and negligent towards patients, to frame it in terms of whether or not they treat Lyme disease with antibiotics beyond the guidelines is a separate issue. A doctor of any stripe could be treating cancer or HIV or anything else... and if they have a record of malpractice and negligence, people need to know.

Conjoining the two topics together over two articles - doctors' records and chronic Lyme disease treatment - and the focus appears to be that doctors with a negative mark against them engage in a given treatment which is not supported and unnecessary. While this may be true, Tsouderos only reports on this aspect of the issues when I would point out that the treatment of chronic Lyme disease has become a medical controversy in itself and that doctors without disciplinary charges from both ILADS and not affiliated with ILADS have treated patients with additional antibiotics - and patients who have gone on to get well and work again.

It is Tsouderos point to highlight these doctors along with treating chronic Lyme disease in particular. Why? What is her purpose behind doing so?

And in the article in December, she wrote about chronic Lyme disease being a dubious diagnosis without actually explaining why it was dubious, without sharing whether or not there was any evidence that Lyme disease infections can persist (citing animal and human studies and cases), and without providing supporting evidence for alternative hypotheses such as the autoimmune basis for persisting symptoms.

She provided none of this, and just said she didn't think chronic Lyme disease may not even exist in the first place. Instead, the focus was on activists, doctors with charges, a charlatan, and pseudoscience. She really should have named the article "Disciplined doctors and charlatans treat controversial chronic Lyme disease" or something similar, rather than "Chronic Lyme: a dubious diagnosis".


Re:"LLMDS"
"Within Lymeland, I think that it is fair to say that it has gradually taken on the meaning of one of "our" doctors...one who is on the approved list of the LDA/CALDA/ILADS/IGENEX one-minded 'entity'. "


I'd like to disabuse the general public of this notion. I understand what you're saying, and I think that the definition should be expansive and not limited to a small number of practitioners who are within ILADS. There are a wide range of physicians who are savvy about Lyme disease and other tickborne infections and they are not all ILADS members. Conversely, there are people who are self-proclaimed LLMDs who are not ILADS members who do not know as much about Lyme disease and other TBIs as they claim. One has to be cautious about such labels in their use in online ads and promotions, and really check their references and claims.

Anyway, I for one am working to claim the label "LLMD" as simply meaning "knowledgeable about Lyme disease and tickborne illnesses" and dismiss the use of "LLMD" as only applying to ILADS doctors.
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Re: ILADS Dr. Jeffrey Piccirillo

Postby Spanky » Thu 21 Jul 2011 1:09

Camp Other:

While it's important to inform the public of doctors who are incompetent and negligent towards patients, to frame it in terms of whether or not they treat Lyme disease with antibiotics beyond the guidelines is a separate issue.


Is it? Is it really? There are more than a few disciplinary boards that disagree. That's a policy question that I would suggest belongs within the province of the medical profession.

If the controlled studies on the subject suggest that extended antibiotic treatment is not effective...and guidelines developed by professional societies discourage the practice...then do you mean that a doctor that decides that he/she knows better should somehow be immune from media criticism or professional discipline?

Isn't that doctor outside accepted parameters of professional conduct when they subject patients to unproven (and EXPENSIVE) remedies?

And remember...patients are paying for this. If the treatment is basically worthless...(or worth little)...then, aren't these doctors exploiting their patients? Intentionally or unintentionally?

And the media has no right to call them to task for that?

And in the article in December, she wrote about chronic Lyme disease being a dubious diagnosis without actually explaining why it was dubious, without sharing whether or not there was any evidence that Lyme disease infections can persist (citing animal and human studies and cases), and without providing supporting evidence for alternative hypotheses such as the autoimmune basis for persisting symptoms.


It's a "dubious" diagnosis because there is no persausive evidence that it exists. There is no solid evidence that even if some bacteria aren't killed off...that the surviving amounts are capable of driving symptoms.

When we are talking about "chronic Lyme" we are NOT talking about an "autoimmune reaction", or PLS.

We are talking about a chronic INFECTIOUS process. This is simply unproven to exist. And the issue isn't really whether the infection persists or not...it is whether extended antibiotics are effective against the assumed persistent infection or autoimmune condition.

And the currently available evidence suggests not.

She provided none of this, and just said she didn't think chronic Lyme disease may not even exist in the first place.


And what is wrong with that?

I am pefectly willing to accept the possibility. Are you?

Re:"LLMDS"
"Within Lymeland, I think that it is fair to say that it has gradually taken on the meaning of one of "our" doctors...one who is on the approved list of the LDA/CALDA/ILADS/IGENEX one-minded 'entity'. "


I'd like to disabuse the general public of this notion.


Good luck with that. The above-named entities are working 24/7 against you.

But actually, I think that it is an overworked phrase and belongs in the round file. It now has some rather...oh...negative connotations in some quarters.

You either are knowledgeable about Lyme...or not.
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