On the despicable physician witch-hunt by the medical establishment
In a quaint time, some years ago, the idea that a physician could lose their ability to practice medicine because of a stance on a politically controversial matter of the day would be frankly ridiculous. Those days are well behind us. It is absolutely clear and evident that physicians who want to continue practicing their craft need to keep their mouths tightly shut about anything that is remotely controversial or political. Generally speaking, I have come to realize that its a mistake for physicians to be overtly political because for a significant segment of the population this interferes with the therapeutic relationship. But we’ve crossed well beyond that particular rubicon to medical organizations sanctioning physicians because they may not agree with the prevailing consensus on certain medical topics of the day.
The gist of the argument is that when in a public health emergency, physicians better toe the line or risk damaging the health of the public. This is an incredibly dangerous road for medical organizations to travel because this stance actually does put the public’s health in danger. Consider the issue of masks. Anthony Fauci famously advised everyone not to wear masks… until he was for wearing masks. The public health community almost universally opposed travel restrictions… until they were vociferously for travel restrictions. The CDC said there was no link between vaccines and myocarditis before they finally acknowledged the link. The list of flip-flops by the establishment with no intervening, earth shattering change in the science is a mile long. Challenging consensus is very much how medicine progresses. These oracles of objectivity and science will of course never be threatened… because they are in power. The powerful decide what you can and cannot believe, and when you can transition from one accepted belief to another accepted belief. The medical establishment could not be more like the medieval church which famously declared Galileo’s idea of heliocentrism as “formally heretical” if they tried. I imagine there is some secret society in a dungeon in some major US city where people in masks cast ballots while chanting to decide when they’re going to say the science now says 2 year old’s need to be masked in daycare (except when sleeping and eating lunch together).
The current targets for mischief in medicine is, of course, the outgroup that isn’t at these meetings that, god forbid, have independent thoughts about medicine. It is no accident that the most popular physicians that have challenged the orthodoxy during the time of COVID are the ones targeted by the establishment. The high profile names of physicians who have broken from the consensus position include Dr. Simone Gold, Dr Peter Mccullough, Dr. Pierre Kory and Dr. Paul Marik. Prior to the pandemic most of these individuals were employed in academic settings, and in good repute at their places of work.
But none of these physicians have been spared by organized medicine for the thought crime of breaking with the consensus on COVID. In this particular case, these physicians believe in early treatment of COVID with a combination of drugs that includes ivermectin and hydroxychloroquine and have also raised concerns about adverse events related to vaccines. I’m not going to try to adjudicate whether these two drugs actually work early in the treatment of COVID or not, because that isn’t the point. The point is that well respected, smart, senior physicians have reviewed the evidence, and decided that this drug regimen would help patients. Unless someone can demonstrate that there’s clear evidence of harm being meted out by the prescription of these relatively benign drugs, I think it absolutely crazy that medical organizations would attempt to prevent them from practicing medicine. But that is exactly what is being attempted.
Pierre Kory’s recent substack details the letter written to him by the American Board of Internal medicine that essentially amounts to him being hauled in front of a kangaroo court to face sanction.
The sanction being discussed in this particular letter is to strip him of his board certification status in critical care which he has paid and passed the requisite tests for. Hospitals typically require this particular certification in order to practice in an ICU so it effectively means Dr. Kory would be unable to take care of critical care ICU patients because of his feelings on the benefits of ivermectin and hydroxychloroquine for COVID19. How completely ridiculous!
The sanctioned treatment for COVID of course is Paxlovid, even though the trial that lead to the approval of Paxlovid was in primarily unvaccinated patients and we have recent data from Pfizer to suggest Paxlovid is only very modestly beneficial to vaccinated patients. VP Kamala Harris, who has no known high risk factors, was apparently prescribed Paxlovid for having asymptomatic COVID. There is zero evidence that we are doing anything for the Vice President by giving her Paxlovid (if those details are accurate). Dr. Anthony Fauci took not just one course of Paxlovid but 2 courses back to back because he suffered rebound COVID. Which doctor prescribed him that, and why?
Now, I disagree with both Paxlovid prescriptions here because my review of the evidence to date suggests the benefits here are going to be very small, but I would never ever suggest a doctor who thought it was reasonable to try Paxlovid in these 2 clinical settings have their license or certifications revoked! Medicine is complicated, and maybe Dr. Faucii ends up being right about an extended course of Paxlovid, but in the meantime there’s going to be some differences of opinion that organized medicine needs to tolerate. The “public health emergency” moniker that gets thrown around as justification is also nuts because it has been more than 2 years now and if hospitals are still acting in emergency mode, why is COVID +ve Mr. Jones [made up name] in hallway bed 3?
Going after high profile ‘contrarian’ physicians sends a message to the entire community of physicians to get in line. And it will work because the financial costs of losing certification are not small for physicians, and many of the professional organizations that grant certifications have a monopoly over the process. If something good is to emerge from this embarrassing episode, it would be to once and forever legislatively dismantle the medical certification monopoly in the interest of public health.
Anish Koka is a Cardiologist. Follow him @anish_koka
We can be fairly certain at this point that ivermectin and hydroxychloroquine don’t work for COVID. They’ve been tested in large randomized controlled trials and found lacking. And there was never a very good rationale for them to work in the first place. Researchers are welcome to continue studying them, but physicians actively treating people with these drugs or advising that people take them should be sanctioned, in my opinion.
There is a certain amount of hypocrisy among those who decry unproven medications but encourage use of Paxlovid in healthy, vaccinated people. However, the situations are not quite comparable. We at least know Paxlovid is effective in the unvaccinated, and since trials have not yet been run in vaccinated people, there is genuine uncertainty and arguably some room for physician discretion (I think physicians should be more judicious, though, and wait for a trial).