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.
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).
Tx Tim. The universe of medicine is well beyond randomized controlled trials though... Just like these rcts demonstrate there are still lots of open questions with regards to Paxlovid. Those who support the use of Ivermectin have lots of issues with the -ve RCTs to date, so I would give latitude to senior experienced clinicians to come to different conclusions. If we're going to start sanctioning doctors who practice outside of the RCT framework, there would be very few doctors left, and the one's that were left would be terrible.
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).
Tx Tim. The universe of medicine is well beyond randomized controlled trials though... Just like these rcts demonstrate there are still lots of open questions with regards to Paxlovid. Those who support the use of Ivermectin have lots of issues with the -ve RCTs to date, so I would give latitude to senior experienced clinicians to come to different conclusions. If we're going to start sanctioning doctors who practice outside of the RCT framework, there would be very few doctors left, and the one's that were left would be terrible.
Well, until they come up with some good evidence, I will continue to regard them as quacks.