Sunday, October 31, 2021

Was the Alec Baldwin Shooting Accidental?

Even casual followers of the news are aware that actor Alec Baldwin killed one associate and wounded another during a film rehearsal.  It was a horrible tragedy that captured the nation’s attention.  How could such a thing happen? This is the same question we ask when we learn that a surgeon has removed the wrong kidney.  

I’ll leave aside how much attention this tragedy has received in comparison to the intentional killings that occur daily in cities throughout the country.  While all lives are equal, it does not seem that every life receives the same attention.

Based on what is now known, it does not seem to me that this shooting was a mere accident that occurred from pure happenstance.  Of course, the shooting was not intentional, but it appears that there was a reckless disregard of established firearm safety protocols.  Investigators will surely discover how a live bullet ended up in Alec Baldwin’s gun.  More facts are emerging daily that indicate a laxity of gun safety and multiple deviations from industry standards.  I suspect that the ongoing investigation will only further highlight the negligent behaviors that culminated in a tragic homicide that should never have occurred.  Criminal charges are possible.

If my tire is punctured while driving and my car hits a tree, this is an accident.

If I notice that my front tire is deflated, and I take it for a drive anyway, is it still an accident if the tire blows and I hit a tree?

Live Rounds on the Set?


I’ll admit that I don’t know much about filmmaking, and I know even less about firearms.  But, I know quite a bit about safety processes and protocols to minimize the risk of adverse events.  We are all aware that airline pilots methodically run through a checklist before every flight to verify that everything is in proper order.  We would likely feel less secure if pilots simply took a quick scan of the cockpit and then flashed us a thumbs up.  This checklist is the result of intense research and experience and is designed to catch any item that is out of line.  The key is that this process must be faithfully executed every time without exception. 

Physicians understand this process well.  Before every surgery or medical procedure, the team participates in a ‘time out’, when the patient’s identify is confirmed as well as the intended procedure and any potentially complicating factors.  Does the x-ray with the broken hip hanging in the operating room correspond to the patient about to be put under?  Complacency and indifference can lead to tragic outcomes. We have all heard about patients who had the wrong organ removed or received medication intended for another patient.  The checklist procedure minimizes the risks of these outcomes.

I surmise that the results of the Alec Baldwin investigation will show serial deviations of process that involved multiple individuals all of which led to a horrible outcome.  Does this sound like an accident to you?

 

Sunday, October 24, 2021

Jeopardy Host Sidelined but Still Kept His Job?

When improper actions are followed by proportionate and predictable consequences, it serves as an incentive for us to behave better.  Let’s face it.  We are not hardwired to do the right thing. If we were, then there would be no need for thousands of laws, rules and regulations to guide our behavior.  We need laws against theft, insider trading and assault because we have accepted that our natural human inclinations often lead us astray.

And, if we were moral creatures by design, parents, teachers and religious leaders would not have to devote so much effort to teaching us to do the right thing.

When a consequence is hollow it threatens our confidence in the integrity of the system.  When a professional athlete has committed assault, the investigations and punishments have seemed to be a very different process than we would expect if an ordinary person, like me, were the accused.  We have all witnessed examples of this over the years.

Some time ago, Mike Richards, who was anointed as the designated new host of the Jeopardy game show, was pulled from his position based on prior offensive social media postings.  Yet, he continued to serve as the show's executive producer.  How does this make sense?  If the company believes that his violation of social norms rendered him unqualified to host the show, how does he still serve as a corporate leader?  Was Sony, who produces the game show, trying to calibrate the minimum level of punishment that would satisfy critics and yet still permit his employment?  Don’t companies realize that these tortured attempts to thread the needle nearly always come back to prick them?


Sony's Corporate Policy

It took a full 10 days for Sony to do what it should have done at the outset.  Richards was removed from the executive producer position.  Sony, however,  was not held to account for this clumsy bungling.

We can’t legislate or incentivize every behavior.  Many acts are wrong and yet escape accountability. Try this hypothetical.  An individual refuses the COVID-19 vaccine and has no medical or religious exception.  His mask, when he does don one, is dangling underneath his nostrils.  Consider some potential outcomes

He infects several people one of whom requires a ventilator.

He spreads the virus at work causing a work shutdown.

He does not reveal to his dating partners that he is unvaccinated.  Two of them become ill.

He infects his grandchild who contracts COVID-19.  His classmates must now return home for remote learning for a period of time.

Should there accountability for this behavior?

 

Sunday, October 17, 2021

Will We Be Wearing Face Masks Forever?

I don’t foresee them disappearing from the public landscape anytime soon.

I think there will be a segment of the population that will continue to wear masks even after the pandemic has subsided.  Indeed, there are parts of the world where donning a face mask is routine.

And as we have all seen, there is a vocal segment of the population that will refuse mask wearing regardless of the circumstances.  For example, sitting governors, with a keen eye for politics, have ordered that no mask mandates can be instituted in their states.  Score 1 for Politics and 0 for Science.

Just as our country has not experienced its last hurricane or wildfire, there are other pandemics lurking over the horizon.  So, over time, mask wearing will rise periodically when nature’s germ warfare strikes us again.



'The Mask Stays!'


I also suspect that many health care institutions will require their staffs to wear masks long after the public will have been advised that masking is no longer advised.  These hospitals and medical facilities may truly believe that ongoing mask wearing will offer protection with no downside.  And, it may serve as a branding function to reassure the public regarding the institution’s culture of safety.  Many medical images – a stethoscope, the nurse’s cap of yore, the white coat, the doctor’s black bag and a surgical mask – are viewed favorably by the public. 

Have you ever noticed how often physicians being interviewed on television are wearing a white coat when there isn’t a patient in site?  Image matters.

I don’t envision that a face mask will become a permanent wardrobe accessory for me.  But I expect to see others masked up on ground and air transportation, in theaters and at sporting or entertainment events.  Perhaps, our marketing gurus, who spend their professional lives convincing us to buy products that we don’t need, will convince us that masks are cool.  Imagine a 30-second ad spot during the Super Bowl depicting a biker on a Harley cruising up a dirt road, sunlight gleaming off the motorcycle, mask in place... 

 

 

 

 

 

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.  





 

 

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