Crosstalk: April 16, 2020

Governors around the nation are assuming broad powers in order to shut down or extend shut-downs/stay-at-home orders all in the name of coronavirus protection. Now troubling reports have been coming out about individuals in the health care industry that are being laid off while many people who have medical needs for screening, exams, treatments and procedures are being turned away.

The guest on this Crosstalk wants to see doctors do what they do best and is telling governors to stand down and to stop practicing medicine.

Dr. Jane Orient is a medical doctor and executive director of the Association of American Physicians and Surgeons.

Dr. Orient began by communicating her concern about patients that can’t get medical care because their doctors are forbidden to give it.  Governors may claim that essential care can be provided, but she knows of physicians who are being harassed by state medical boards for doing things like fixing a compound fracture or a ruptured tendon.  These are obviously not life threatening but nonetheless can have painful and disabling consequences if not taken care of right away. This is why physician practices may permanently fold because their revenue is way down but their expenses keep increasing.

So who determines the definition of ‘essential?’  It’s whoever is on the medical board and that is someone who is not responsible to the patient if things go wrong.

Dr. Orient noted that some of these boards have physicians, while half or more of others may be comprised of non-physicians.  The executive director is usually a lawyer, while the members of the board may actually have little to say about decisions that are made.  The lawyers and bureaucrats that make up the staff determines what the board members will be told.

She questioned the status given to COVID-19.  For example, she explained that people with infectious diseases are all around us throughout the year and doctor’s offices are to have standard precautions in place to reduce the infection risk.  As an example, she contrasted how we’re handling COVID-19 vs. AIDS. When the AIDS epidemic broke out you wouldn’t refuse treatment, even dental treatment that creates the spraying of body fluids because there was the risk of stigmatizing the patient.  Now doctors aren’t allowed to offer treatment, at least not without the risk that you’ll have to come up before the medical board and have your license removed.

Then there’s the limitations placed on the prescribing of FDA approved drugs to treat or even prevent COVID-19.  Discussion on this point focused on anti-malaria drugs such as Hydroxychloroquine, drugs that have been around for 70 years.  Allegedly the governor of Nevada is hoarding these drugs for the prison system while at the same time prohibiting their use for anything other than Lupus and Rheumatoid Arthritis.

Interestingly, doctors are up against not only state governors, but also the American Medical Association.  Find out why, where ‘big pharma’ fits into all of this and much more on this edition of Crosstalk.