Elizabeth Bates, M.D. Ordered
to Stop Hormone Treatments

Stephen Barrett, M.D.


In August 2018, the Kentucky Board of Licensure has ordered Elizabeth Bates, M.D. to stop offering hormone replacement and hormone "optimization" therapy to patients. The board's order of indefinite restriction also requires her to pay $47,287.50 to reimburse the board for the cost of its disciplinary proceedings.

Bates was the medical director of Body Shapes Medical (now called 25 Again), which has offices in Kentucky, Ohio, and Indiana, most of which were staffed by nurse practitioners. The board became concerned about Bates after a pharmacist complained about about her high volume of prescriptions for Armour thyroid. Two consultants who reviewed 15 of Bates's charts concluded that she was inappropriately prescribing this drug for patients with normal thyroid function. The board also had concerns that Bates prescribed testosterone inappropriately for both men and women.

In April 2017, the board issued a complaint (shown below) plus an emergency order restricting Bates's use of hormone therapy, but a court lifted the restriction pending the outcome of the board's scheduled hearing, In April 2018, the hearing officer concluded that Bates had acted improperly in her "hormone optimization" practice by (a) failing to perform adequate and appropriate physical examinations of patients before prescribing thyroid or testosterone hormones, (b) starting treatment for patients with TSH and testosterone levels within the normal range and without appropriate justification, (c) treating all patients with thyroid hormones by reference to T3 levels instead of TSH levels, (d) initiating treatment with Armour Thyroid instead of the standard drug (levothyroxin), (e) prescribing Armour Thyroid for weight loss, and (f) having the patients donate blood, instead of reducing their testosterone prescriptions, when their red blood cell levels increased as a result their testosterone treatment.


COMMONWEALTH OF KENTUCKY
BOARD OF MEDICAL LICENSURE
CASE NO. 1810

IN RE:THE LICENSE TO PRACTICE MEDICINE IN THE COMMONWEALTH OF KENTUCKY HELD BY ELIZABETH VEENEMAN BATES, M.D., LICENSE NO. 1680, 421I SPRlNGHURST BOULEVARD, SUITE 101, LOUISVILLE, KENTUCKY 40241

COMPLAINT

Comes now the Complainant Russell Travis, M.D., Chair of 4he- Kentucky Board of Medical Licensure's Inquiry Panel B, and on behalf of the Panel which met on July 20. 2017, states, for its Complaint against the licensee, ELIZABETH VEENEMAN BATES, M.D., as follows:

1. At all relevant times, Elizabeth Veenemen Bates, M,D., was licensed by the Board to practice medicine within the Commonwealth of Kentucky.

2. The licensee's medical specialty is lnternal Medicine.

3. The Board opened an investigation pursuant to an anonymous grievance received on or about August 3, 2015. The grievant stated that she was a concerned pharmacist who had seen a "slew of prescriptions called in from from Body Shapes Medical for Armour Thyroid 60mg (always for the same strength.)" The grievant was concerned that Body Shapes Medical was using the meditation to hyperstimulate the thyroid to promote weight loss in patients with normal thyroid activity.

4. The Board obtained fifteen (15) patient charts randomly selected from a list of patients seen by the licensee and prescribed Armour Thyroid 60mg between July 1, 2015 and July 31, 2015.

5. The licensee responded to that grievance, through her attorney, on or about October 28, 2015. The licensee stated that she practiced internal medicine for twelve and a half years before becoming the Medical Director of Body Shapes Medical in March 2013. The licensee described her practice and explained the use of Armour Thyroid in her practice.

6. A Board consultant who is Board-certified in Internal Medicine reviewed fifteen (15) of the licensee's patient charts and found that the licensee departed from or failed to conform to acceptable and prevailing medical practice in the following manner:

As is evident by the table that all the patients when initially seen had normal thyroid function tests. Patients were then given Armour thyroid in 2/3 of cases started at a dose of 60mg 60mg and 1/3 of cases were given Armor 10mg. The main reason of giving a euthyroid patient thyroid medication is not to optimize his or her thyroid function, but only to increase the metabolism so as to make the patient lose weight. With the thyroid meds, then other meds were given to increase different functions such as libido, and energy.

Armour thyroid was increased gradually until it was seen that TSH was decreased and T4/T3 was increased. This was to make sure that patient was hyperthyroid and has an increased metabolism.

I did not see any consultations by the dietitians or the exercise plans by any physical therapists. Sole reason was to make the thyroid work harder and patients to lose weight without doing any exercise or diet.

The Board consultant's report is attached and incorporated in its entirety.

7.  A second Board consultant, who specializes in Endocrinology reviewed the licensee's patient charts and found that he licensee departed from or failed to conform to acceptable and prevailing medical practices in regard to diagnoses in seven (7} charts in regard to treatment in eleven (11) charts, overall in five (5) charts and was overall Borderline in nine (9) charts.

8. The Board consultant found concerns with thyroid hormone replacement and testosterone use in both males and females. The Board consultant's report is attached and incorporated in its entirety.

9. On or about May 10, 2016, the licensee responded in writing, through counsel, to the first Board's consultant's review of her patient charts. In her response, the licensee responded to the Board consultant's concerns in detail,

10. On or about May l1 2017, the Iicensee responded in writing, through counsel, to the second board consultant's review of her patient charts. In her response, the licensee responded to the Board consultant's concerns in detail,

11. On or about July 11, 2016, the first Board consultant issued a final report after reviewing the licensee's response. The Board consultant refuted the arguments made by the licensee, and the Board consultant's opinion of the medical care of the cases he evaluated did not change.

12. On or about June 8,2017, the second Board consultant issued a final report after reviewing the. licensee's response, the second Board consultant refuted the arguments made by the licensee, and the Board consultant's opinion of the medical care of the cases he evaluated did not change.  

13. On or about July 11, 2017, the Board's Inquiry Panel B determined that the licensee's practices placed her patients end the public at risk and in danger.  As a result, the licensee was restricted from practicing medicine In the context of hormone replacement therapy pending resolution of this Complaint.

14. By her conduct, the licensee has violated the provisions of KRS 311.595(9), as illustrated by KRS 311.591(3), and KRS 311.597(4).

15. Accordingly, legal grounds exist for disciplinary action against her Kentucky medical license.

16. The licensee ls directed to respond to the allegations described in the Complaint within thirty (30) days of service thereof and is further given notice that:

(a) Her failure to respond may be taken as an admission of the charges;

{b) She may appear alone or with counsel, may cross-examine all prosecution Witnesses and give evidence in her defense.

17. NOTICE IS HEREBY GIVEN that a hearing on this Complaint is scheduled for January 8-11, 2018 at 9:00 am, Eastern Standard Time. at the Kentucky Board of Medical Licensure, Hurstbourne Office Park,310 Whittington Parkway, Suite 1B, Louisville, Kentucky 40222. Said hearing shall be held pursuant to the Rules and Regulations of the Kentucky Board of Medical Licensure and pursuant to KRS Chapter 13B. This hearing shall proceed as scheduled and the hearing date shall only be modified by leave of the Hearing Officer upon a showing of good cause.

WHEREFORE Complainant prays that appropriate disciplinary action be taken against the license to practice medicine held by ELIZABETH VEENEMAN BATES, M.D.

This 10th day of August, 20 l7.

_________________________
RUSSELL L. TRAVIS, M.D.
CHAIR. INQUIRY PANEL B

This page was posted on August 29, 2018.

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