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COVID-19: The Government Practice of Medicine

April 14, 2020

I hope you are doing well--for access to medical help is increasingly threatened.

By now, about half the states’ governors have handed down edicts restricting physicians’ prescribing or pharmacists’ dispensing FDA-approved drugs if they are to be used for treating or preventing COVID-19. The use of drugs for an indication not listed on the label is part of the practice of medicine, and the FDA does not have the authority to regulate that. If off-label use were not possible, you’d have to throw one-fifth of your prescriptions away.

Still more intrusively, government is banning the practice of medicine altogether for “non-essential” needs if it can’t be done by telemedicine. The authorities define “non-essential.” A doctor who dares to repair your painful but not life-threatening injury could be defending his medical license before the state medical board.

The rationale? The doctor might use a mask or a pair of gloves, and there aren’t enough for caring for COVID-19 patients. So, instead of making more, should we find a way to seize a few boxes stored in private offices for redistribution?

So, while doctors sit idle, your medical conditions remain untreated. Doctors’ revenues are plunging by more than 55%, and expenses continue. Will your doctor’s practice survive?

Once in the hospital, your care will be dictated by corporate guidelines. However brave and dedicated your assigned doctors may be, their use of independent judgment will be constrained. What about your choices for care? There will be no outside second opinions, no visits by family members to assess your care or your condition first-hand, and limited communication with overstressed staff. Automatic “do not resuscitate” orders are being considered.

Once in the hospital, you might or might not be able to get the forbidden hydroxychloroquine, perhaps only on an experimental protocol. It may be too late, or in the wrong dose, or without the combination of drugs that might make it more effective, such as zinc and azithromycin.

So, who is really in charge? Governors are probably not making up rules all by themselves. If an independent doctor does or does not do something, he can be held accountable. Generally not so for the shadowy entities advising the politicians.

Who benefits from the crisis? Big Pharma, scenting billions in profits from new drugs  and vaccines, which would be threatened by use of cheap generics? Big insurance/hospital cartels, whose dominance is threatened by independent doctors? Political entities lusting for more power? Medical organizations whose revenue depends on any or all  of the above?

The FDA, the CDC, the AMA, state governors, and others setting the agenda have no answers, as more patients die. But their edicts are paralyzing the people who can help.

Freedom is the most important casualty, and its loss will assure far more death and destruction than the coronavirus possibly could.

Government needs to stand down. It should be supporting doctors, not blocking and threatening them. If independent doctors survive, they can help you survive.

For further information, see our compendium of Coronavirus Articles.

Article Tags
Health Care Regulation
Author
Jane M. Orient, M.D. is executive director of the Association of American Physicians and Surgeons and president of Doctors for Disaster Preparedness.
janeorientmd@gmail.com @jorient

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