Sunday, October 10, 2021

Doctors Spreading COVID-19 Vaccine Misinformation

(As published recently in cleveland.com)

Should a physician who spreads misinformation on coronavirus vaccines lose his medical license?  Would this violate the doctor’s right to free speech?  Shouldn’t physicians be able to offer their patients counsel and advice that differs from mainstream medical thought? 

Every profession has ethical and legal requirements to maintain the integrity of the profession as well as the public trust.

·      If an attorney lies to a judge, then this lawyer can expect to be severely sanctioned. 

·      If a public-school teacher instructs science students that the world was created exactly as recorded in the Book of Genesis, then professional repercussions are expected.

·      If a police officer is discovered to have planted evidence to justify an arrest, then the officer will likely face criminal penalties.

In the medical profession, there are also professional and ethical boundaries that practitioners must respect.  Consider these flagrant violations.

·      A doctor falsifies a medical record to buttress his legal defense in a medical malpractice case.

·      A physician accepts a kickback for sending referrals to a colleague.

·      A physician performs unnecessary procedures to make money.

·      A doctor submits false documentation when applying for hospital privileges.

Such breaches may very well jeopardize the doctor’s professional standing and even his personal liberty. 

This past July, the Federation of State Medical Boards (FSMB) stated that doctors who spread misinformation on Covid-19 vaccines risk disciplinary action which could include revocation of their medical licenses.  The FSMB instructs that physicians are obligated to share medical advice that accords with sound science and medical judgment.

The State Medical Board of Ohio requires every licensed physician to report misconduct which includes, among other behaviors, a colleague practicing below minimal standards.  Indeed, a physician who fails to report suspected misconduct to the Board may face disciplinary actions.


                         

Hippocrates, remember him?


One would expect that physicians who promote false information regarding Covid-19 vaccines would be ripe for sanction.  Remember the Ohio physician who testified before a House Health Committee hearing this past June that coronavirus vaccines magnetize recipients?  In the doctor’s own words, “… they can put a key on their forehead. It sticks.  They can put spoons and forks all over them and they can stick...”  The Plain Dealer recently reported that her medical license was just renewed by the State Medical Board of Ohio for 2 years, an automated process that does not mean she is not also under a confidential disciplinary investigation.  Let’s hope that the Board does the right thing.

Her testimony might make for a compelling Twilight Zone script, but it has no place in the medical landscape.  This is not a free speech issue. It’s a competency issue.  

Governing bodies of professions have rules and standards that must be enforced if they are to mean anything. 

Scientific support for coronavirus vaccines is overwhelming - much more solid than for many other standard medical treatments that physicians prescribe every day.  I wish that my own advice to patients was in the range of >90% effective with almost zero risk of serious complications. 

Millions of Americans have become ill and hundreds of thousands have died from this virus.  And there will be more to come.  If a medical practitioner is advising against coronavirus vaccines on medical grounds, or recommends ivermectin as a treatment or promotes misinformation that risks the health of patients and the community, then please sell your snake oil elsewhere.  You took an oath upon becoming a doctor.  And if you willfully violate it, as well as the medical profession’s clear standards, then you should be called to account.  We physicians must denounce anyone who purveys deception and misinformation that threatens everyone’s health, even if it is one of our own.  





 

 

Sunday, September 26, 2021

I won’t take the COVID-19 vaccine!

 Recently, I faced 3 patients who had chosen not to receive a COVID-19 vaccine.  Interestingly, each had a different reason underlying their hesitancy. 

The first patient gave an adamant refusal that there is no way he would ever submit to the vaccine.  He didn’t trust the government.  The second patient offered the canard that the approval process was rushed.  The third patient had simply procrastinated.  Her family members had all been vaccinated and she has received many other vaccinations.  She was simply perched on the fence and hadn’t moved.

I offered counsel to Patients #2 and #3 as I felt there was a chance I might have impact with them.  I hope that I did.



Stop Vaccine Tyranny!

The walls are closing in on the unvaccinated.  With the recent formal Food and Drug Administration (FDA) approval of the Pfizer vaccine, and the increasing number of businesses, organizations and venues that will only admit the vaccinated, the vast space that the unvaccinated have inhabited is fast shrinking.  Will the unvaccinated be able to function if they cannot attend a concert, visit a museum, dine at a restaurant, take ground or air transportation, attend theater or even their place of employment?

Some will submit to the vaccine because rising inconveniences would be unbearable.  Others may belatedly decide on the merits that the vaccines make sense.  And yes, there will be some diehards who will continue to reject reason and science.   For them, rolling up their sleeves or donning a mask is to surrender.  We saw during Hurricane Ida, as we do in all prior deadly storms, when some folks reject all of the repeated dire warnings to evacuate and hunker down instead.

 It’s hard to understand how some folks place themselves in avoidable danger just to prove a point. I have a different understanding of what they are actually proving to the rest of us. 

Sunday, September 19, 2021

TSA Fails to Protect Passengers from COVID-19

We are taught from a young age to finish the entire job.  I confess that I still need reminding on this virtue.

I suspect that all of us must plead guilty to partial task completion from time to time.  Have you ever washed some of the dishes remaining in the sink?  How about cleaning out part of the garage and rationalizing that this is enough work for one day.  How many of us have projects around the house that are waiting patiently for our attention as they sit frozen in time?

There are more stark examples  when stopping short if the finish line is downright absurd.

Consider some examples extracted from my imagination.

  • An artist paints only on one side of the canvas, and I don’t mean for artistic reasons.
  • A car wash cleans only the rear section of automobiles.
  • A publisher distributes books that are 100 pages short of their true length.

Silly, right?

It’s easy to conjure up similar examples regarding the medical universe.

  • A surgeon washes only one hand prior to surgery.
  • A doctor prescribes antibiotics for only half of the standard number of days.
  • A hospital housekeeper cleans half of a patient’s room after discharge.
  • A gastroenterologist begins a colonoscopy and decides to end the procedure at the halfway mark.

In these examples, the medical interventions are all pointing in the right direction, but they are simply insufficient. 

Half measures are called that for a reason.



We're Half Safe on Airplanes Today


Recently, the Transportation Security Administration (TSA) extended its mask requirement for travelers using air and ground transportation from September 13th to January 18,2022.

This is the Mother of All Half Measures.  Yes, we know that masks have impact and I have been wearing one more often since the Delta variant has taken off.  But the better response – which every responsible public health expert (or even novice) endorses - is vaccination.  If COVID-19 vaccine has incredible safety and efficacy data, far superior to masking, then why doesn’t the TSA require this?  Technically, it wouldn’t be a vaccine mandate since the individual is still free to forego travel. But I suspect it would make vaccination more attractive for those that wish to use public transportation and air travel. 

In addition, masked travelers are permitted to demask when taking food or drink, which markedly decreases the masks’ effectiveness. 

If we are wheeled into the surgical suite to hear the scrub nurse in the operating room announce that half the instruments have been sterilized, wouldn’t we be sprinting out of there like a race horse?

Why then are we satisfied traveling if we are only half protected?

 

 

Sunday, September 12, 2021

Religious Exemptions to the COVID-19 Vaccine

We have all been counseled to avoid discussing religion and politics in order to reduce the risk of a hostile encounter.  I recall being reminded of this maxim when dining with a new acquaintance many years ago.  My response?  ‘That’s all I like to talk about!’

I am writing this at 9:30 a.m. on a Saturday and I’ve already had multiple conversations – both directly and electronically – with people in my life on both of these radioactive subjects.  As far as I know, all of the friendships remain whole.  Indeed, these debates and exchanges serve to fortify our friendships rather than to threaten them.

I recognized that discussing religion can be fraught for many individuals and might be best avoided for them.  Same with politics.  Many a thanksgiving dinner has been sullied by someone who decides to serve as the family turkey 

Look at the national response when a Colorado baker refused to bake a wedding cake for gay couple in 2012.  The cake shop owner claimed this violated his religious beliefs at a time that the state did not recognize same-sex marriage.



Praying for Wisdom

The COVID-19 pandemic has provided fuel for some to argue that the vaccine encroaches on their religious freedom.  Indeed, federal law provides for a vaccine exemption for a sincerely held religious belief.  (Individuals can also claim a medical disability exemption under the Americans with Disability Act.)  If the exemption claims are legitimate, then the employee is entitled to receive a reasonable accommodation at the workplace so long as this would not pose undue hardship on the employer.

While defining a medical disability can be somewhat objective, how does one define a religion?  This is murky terrain.  Try to do this yourself before reading further and you’ll see what I mean.

Here’s a summary statement on the definition of religion taken from the Equal Employment Opportunity Commission (EEOC).

The presence of a deity or deities is not necessary for a religion to receive protection under Title VII.  Religious beliefs can include unique beliefs held by a few or even one individual; however, mere personal preferences are not religious beliefs.  Individuals who do not practice any religion are also protected from discrimination on the basis of religion or lack thereof.  

Seems rather a broad definition to me.  The courts will be charged with defining religion and they will need Solomonic wisdom to achieve this.  Might veganism or vegetarianism be religions?  Satanism?  Atheism? One man’s religion is another man’s cult.  All of this will be good news for discrimination lawyers whose prayers for prosperity have been answered.  

 

Sunday, September 5, 2021

The Meaning of Labor Day 2021

Labor Day, which honors American workers, was established well over a century ago in 1894. The holiday emerged from a cauldron of worker unrest protesting against harsh, unfair and unsafe working conditions.  Indeed, there were strikes and even violence in the early years of the fight for workers’ rights.  Over the ensuing decades, organized labor gained membership and power as increasing numbers of workers sought out union protections.   Those numbers have declined over time for several reasons.  Currently, about 11% of workers belong to unions.




While I have not always supported organized labor’s positions and actions, I certainly agree that every employee -union or non-union - is entitled to a fair wage and safe working conditions.

It’s been a very tough year for labor and for the rest of us.  When a company or a business is forced to close by an enemy that we can’t see or touch, toxic ripples spread out far and wide.   When a restaurant shuts down, for example, imagine how many people are impacted directly and indirectly.

Many important holidays seem to have lost their meaning.  Labor Day for many has become a day to purchase sale items or to throw burgers on the grill.  Memorial Day’s significance has similarly dimmed.

Let's honor all those who have built this country, fought for fairness and are still laboring to lead us forward.

Sunday, August 29, 2021

Politics and the Pandemic - Progress Denied

Over the course of this pandemic, we have learned a lot about the country, our leaders and ourselves – and not all of it has been good.  One thing we have learned is that anything can be politicized.  Will anyone be shocked, for example, if a protest movement develops demanding that that Mother’s Day either be abolished or renamed?  

Overall, Governor Mike DeWine has provided sober guidance and directives here in Ohio.  I think that his performance during the pandemic will be an important reason why he will be reelected in 2022.  Interestingly, although he is a bonafide conservative, he will face primary threats from the right in a state that Trump handily won in the past 2 presidential elections.  As we all have learned in November 2016, anything can happen.

But, DeWine, like every other political leader considered the political impact of public health decisions.


Governor DeWine Understands the Pandemic and Politics.

In April 2020, he issued a mask mandate for customers and employees in newly opened retail establishments and businesses.  The slogan was ‘no mask, no work, no service, no exception.’  The governor issued this recommendation after consulting with public health experts.  Although I have only rudimentary public health knowledge, this measure seemed very rationale to me. 

What a difference a day makes.  Within 24 hours, the governor did a political back flip and reversed the requirement that customers must be masked.  This abrupt U-turn resulted after howls of protest from mask opponents.  The public health facts certainly didn’t change, but the politics did. 

We have seen repeatedly our political leaders caving to serve political concerns. I am not suggesting that public health experts are the only ones wearing white hats.  Because their mission is to protect the entire population, I think some of them have been overzealous to protect the public at the expense of our economic health, the education of our kids and mental health consequences of mitigation strategies.  It’s easier to recommend that someone else lose his job to serve the greater good.  It’s easier to support extending the eviction moratorium if you are not a landlord.   It’s easier for teachers to support cancelling classroom learning for ‘safety’s sake, than it is for parents who must quit their jobs so that they can become homeschool teachers. 

I don’t claim to know where to establish the balance between public health protection and society’s other needs.  Of course, this is not a mathematical query that has a single correct solution.  Experts will disagree as they face a moving target with insufficient data.  But, had politics been stripped from the process, then we would be a lot farther along than we are now. 

 

  

Sunday, August 22, 2021

Biden Botches Afghanistan - Where Does the Buck Stop?

 We have all witnessed the debacle from our clumsy and precipitous withdrawal of our military from Afghanistan.  The humanitarian and moral disaster was as astonishing as it was avoidable.  Not only do our allies and our adversaries correctly point out our incompetence, but so do members of the the president’s own political party and administration.  Perhaps, this is an issue that might unite the Democrats and the GOP. 

Indeed, the record contradicts President Biden’s claim that no military experts warned him that his plan risked chaos and catastrophe.  All of us certainly heard the president reassure us only weeks ago that the Taliban were unlikely to prevail in the short term and there would certainly not be a ‘Saigon moment’, recalling an iconic and humiliating scene from 1975.

The president also claimed that he was handcuffed to withdraw troops as he needed to honor the prior agreement between the Taliban and the former administration.  This is malarkey!  First of all, President Biden already broke the prior deal by extending the withdrawal deadline from May 1st to August 31st.  And Biden’s fidelity to Trump’s Taliban agreement seems inconsistent as he readily and enthusiastically reversed many other Trump actions with regard to the Paris Climate Agreement, the World Health Organization and the Iran nuclear deal. 

Of course, the president and his minions tried to deflect by arguing that we needed to extricate ourselves from this ‘forever war’, a point that most of us agreed with but was not the actual point. The withdrawal was botched even if the strategy to disengage was sound.

We also heard the president argue that he didn’t want a 5th president to inherit this war as if the next presidential election were only days away. 



'Joe, take a lesson from Harry.'

But, here’s the point of this post.  I find Biden’s reaction and explanation to this colossal failure to be deeply disappointing and contrary to his repeated pledge to be straight with us.  In his initial explanation to the nation on 8/16/2021, he stated that ‘the buck stops with me’, while his remarks were largely devoted to blaming everyone else (except the Taliban) for what transpired.  And during subsequent remarks and interviews, he continued to deny any personal responsibility.  We didn’t even hear the typical passive voice construction that ‘mistakes were made’. 

While it may have been painful and difficult, the president should have admitted to what we all saw with our own eyes.  And in the same speech, he would promise to do all he could to make the situation right.  Isn't this what we try to teach to our kids?

Not only would such a course be the right thing to do, but it would also serve the president’s interest.  It would reinforce to all of us that his promise to give it to us straight is still true.

 

 

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