Dr. Harvey Risch: "Doctors Must Be Free to Practice Medicine with Independence"
by Paul Alexander
By Harvey Risch
September 26, 2022
When the White House Coronavirus Response Coordinator, Ashish Jha, noted that “G-d gave us two arms” as part of a coordinated push encouraging both the flu and Covid vaccines, it represented more than an offhand quip. Jha’s statement showed that even as the global pandemic recedes, the “government-knows-best” mentality of the last two and a half years is here to stay.
In today’s climate, it may not be easy, but doctors must be willing to demonstrate professional independence. Doctors should always trust their own instincts and expertise, drawing from the full spectrum of observational, academic, and personal evidence to offer treatment to patients as they think best, without fear of reprisal or political pressure.
This is especially difficult at a time when certification boards and even states threaten doctors who exercise independent judgment. The California State Senate has passed legislation—which is sitting on Governor Newsom’s desk—that would take legal action against medical practitioners deemed guilty of “mis-informing” patients about Covid vaccines. But the vaccine risks have been carefully enumerated. Why should doctors who discuss these facts with patients be threatened with the loss of their livelihoods? Don’t patients have the right to receive informed consent? Isn’t that obligatory for doctors to provide?
Science is not static. It is always evolving. The pandemic has shown time and again that theories dismissed one day as fringe can become established, and then even further refined. Early in the pandemic The National Institutes of Health emphatically recommended against the use of corticosteroids to treat Covid, then a few months later it reversed course. And of course, Fauci has flip-flopped on masks and on lockdowns since March 2020—and regrets nothing. Most important of all, for a year and a half, CDC maintained that the Covid EUA vaccines strongly reduced population risk of infection transmission. Full stop. Any other message was deemed “misinformation.” Remarkably, on August 11, CDC itself publicly admitted that taking two vaccine doses does not prevent transmission, and that booster doses provide only transient and waning benefit. That is, that the vaccines have failed as a public health response to limiting Covid infection. Many scientists and doctors already observed this failure six-to-nine months ago. Should telling that fact to patients have been illegal then but allowable now?
Punishing or delegitimizing doctors who exercise independent judgment flies in the face of hundreds of years of medical practice. Some are fighting back. The Association of American Physicians and Surgeons has just filed suit in the Southern District of Texas against the American Board of Internal Medicine, the American Board of Obstetrics & Gynecology, and the American Board of Family Medicine, who have been threatening to de-certify doctors for expressing independent judgment. Several doctors have sued the FDA for unjustly influencing their independent medical practices.
The trust between patient and doctor must be repaired as soon as possible, and especially ahead of the next major public health crisis. We need to learn from two years of avoidable mistakes that have inflicted untold pain and cost lives needlessly.
Telemedicine has important roles to play in this process. The practice, which is essentially a virtual face-to-face visit with a medical professional, makes it easier for patients to access doctors, as well as to obtain second opinions. More than 20 percent of Americans already use telemedicine for their health needs. With 74 percent of doctors practicing in tightly controlled hospital or corporate medical environments, telemedicine provides patients with a pathway to access independent-minded doctors who exhibit critical thinking and draw from a broader range of evidence and practice to treat individual needs and circumstances.
Not all telemedicine groups allow unfettered doctor expertise and independence. But the recognition that a large fraction of doctor-patient interactions can be carried out by telemedicine, and that patients benefit by saving substantial travel and waiting time and have access to a wider geographic distribution of care, has stimulated its broader use. It’s a major opportunity to reverse the trend of increasing straitjacket corporatism of medicine and return ability back to independent doctors who use their considered expertise to do the best for their patients.
With the pandemic waning, I hope that more doctors will rediscover their intellectual independence and practice medicine freely without fear.