Hearing Wrap Up: COVID-19 Mandates Fractured Physician Autonomy, Doctor-Patient Relationships
WASHINGTON — The Select Subcommittee on the Coronavirus Pandemic held a hearing titled “Oh Doctor, Where Art Thou? Pandemic Erosion of the Doctor-Patient Relationship” to examine the importance of maintaining physician autonomy and preserving the doctor-patient relationship during times of crisis—including future pandemics. Expert witnesses testified to the intense political and professional pressure on physicians during the pandemic to toe the line between personal autonomy and government mandates. Select Subcommittee members discussed the value of receiving treatment from a doctor who understands the nuances of personal medical history, as opposed to a government mandated one-size-fits-all approach. Excessive government overreach, coupled with broad mandates, eliminated the decision-making power of patients and physicians. Further, forcing physicians to administer the COVID-19 vaccine, regardless of whether they thought it was the best decision for their patient, is inherently incompatible with the “do no harm” Hippocratic Oath. The Select Subcommittee is committed to continuing our investigation into any wrongdoing by public health authorities that placed the safety of Americans, and ultimately the doctor-patient relationship, at risk.
Key Takeaways
The COVID-19 pandemic eroded the doctor-patient relationship. Excessive government overreach, coupled with one-size-fits all mandates, eliminated the decision-making power of patients and physicians.
Dr. Azadeh Khatibi — accomplished surgeon, physician, and medical freedom advocate — explains an effort by a group of California physicians to restore the sanctity of the doctor-patient relationship and eliminate excessive government overreach: “In California, I’ve seen the attempt to remove physicians’ basic rights. So, I, along with some colleagues, have sued the governor and the Medical Board of California. In 2022, they passed a law that declared it unprofessional conduct for a physician and surgeon to disseminate misinformation or disinformation related to COVID 19. And it defined misinformation as false information contradicted by contemporary scientific consensus contrary to standard of care. It was clear to me, even though it wasn’t clear to the California Medical Association, that this violated doctors’ right to free speech by chilling their speech and also the patient’s First Amendment right to hear their doctors’ speech…Lives and liberty were at stake.”
Dr. Jeffrey Singer — private practice physician, founder of Valley Surgical Clinics, and Cato Institute senior fellow — criticizes public health officials and politicians for using scare tactics to erode the doctor-patient relationship: “During the coronavirus pandemic, most medical scientists, for instance, uncritically accepted the epidemiological pronouncements of government affiliated physicians who were not epidemiologists. At the same time, they dismissed actual epidemiologists as, quote, fringe when those specialists dared to question the conventional wisdom. In my essay, I postulate that the deference to government endorsed positions is probably related to funding.”
Seeing a doctor who knows you personally and understands the nuances of your medical history has significant value. Physicians do not need government interference to make informed decisions regarding a patient’s care.
Dr. Jerry Williams — neurologist and founder of Urgent Care 24/7 — describes the value of physician autonomy, specifically citing his publicly vilified decision to operate outdoor exam rooms during the pandemic: “I found a paper from 2010 that addressed the H1N1 influenza pandemic of 2009, and it showed a reduction of flu transmission to health care workers by using outdoor exam rooms. So, we had the first outdoor exam rooms that I knew of anywhere, and I was immediately attacked on social media, and I was immediately attacked by a local hospital for violating OSHA and HIPA by having outdoor exam rooms, which, by the way, became the standard nationally and internationally.”
Representative Mariannette Miller-Meeks — trained nurse and ophthalmologist — details the effect of the COVID-19 pandemic on patient care and highlights the destruction of physician autonomy. “As a physician and a nurse with decades of experience delivering care to patients of all ages and in various health care settings, I recognize the value and the reality that patient medical needs can rarely, if ever, be broad brushed. Individual needs vary drastically. These can be due to allergies, co-morbidities, intolerances, various other medical factors, or social factors, that require a robust doctor patient relationship…Never before have we had governors threaten the medical licenses of individuals, if through their interactions and their medical knowledge, were to prescribe a patient a certain type of medication or boards of pharmacies to be told that those certificates would be removed.”
Vaccine mandates represent a direct assault on the doctor-patient relationship. Not only were these coercive mandates ineffective at stopping the spread of COVID-19, but they also led to an increased level of distrust between patients, physicians, and public health authorities.
Dr. Khatibi characterizes the fear felt by physicians across the country when recommending COVID-19 vaccines without data or science to support the mandate: “Doctors are afraid to speak out. They tell me their stories. One doctor tells patients, I tell you what I think, but I can’t because it’s illegal. Another says, I don’t speak up about dosing concerns about the vaccine that I have. One responds to vaccine safety requirements by giving patients a list of vaccine side effects and otherwise stays silent. Another tells patients, I can’t say what I want to say because I might lose my license. One doctor invites a group of us docs in a social setting, don’t ever write a vaccine exemption because you’re going to be investigated and you might lose your license.”
Dr. Singer explains how the federal government broadly uses mandates as an incentive to encourage mob mentality, even when the directive does not necessarily align with scientific facts: “In fact, it’s not limited just to the coronavirus pandemic. In general, when government agencies recommend things, it oftentimes becomes a de facto mandate either because of the government agency being a source of funding or maybe having regulatory oversight that could be detrimental to the entities that it is making recommendations to it. So, I jokingly say that, you know, when the CDC recommends something, it’s oftentimes like when Tony Soprano recommends something.”
Member Highlights
Select Subcommittee on the Coronavirus Pandemic Chairman Brad Wenstrup (R-Ohio) recognizes that the COVID-19 pandemic decreased quality of care, increased wait times, shortened medical appointments, and caused missed disease diagnoses.
Dr. Wenstrup: “I want to talk about missed appointments a little bit because of disruptions in care during the pandemic. The number of patients who were screened for cancer fell significantly. Correspondingly, the numbers of diagnoses also fell off. Early-stage cancer diagnoses fell by almost 20% in 2020. A recent study in Lancet Oncology found that this has now led to an increase in diagnosis of deadly late-stage cancers across almost all types of cancer. Dr. Singer, are you seeing similar trends in your field?”
Dr. Singer: “Yes, in fact, we even saw this during the darkest days of the pandemic. I’m a general surgeon so among the spectrum of diseases that I’ll deal with is, for example, appendicitis or diverticulitis, we were seeing patients show up in the emergency department with very advanced cases, you know, several days old, ruptured appendicitis or ruptured diverticulitis or peritonitis, the kind of thing we rarely see in our, you know, developed society these days. And since then, too, we’ve seen an unusually large number of people coming to, presenting to our office with surgical problems that are in a much more advanced state than we’re accustomed to seeing them as.”
Dr. Wenstrup: “I mean, I even had a sheriff call me because someone who was scheduled for their painful hernia, their case was canceled, at a time when in that county, there were no cases of COVID and he ended up taking his life because he was in so much pain.”
Rep. Mariannette Miller-Meeks (R-Iowa) dismantles unscientific COVID-19 vaccine mandates that forced brave Americans in the military and healthcare fields — as well as healthy children who were at no risk of illness — to get the jab.
Dr. Miller-Meeks: “If you were in the health care setting, despite over a year of having provided care to patients with PPE, you were mandated to get a vaccine or lose your job. I know of people who lost their job. If you were in the military, you were required to get a vaccine even if you were 18 or 20 years old, even if you had your risk for getting myocarditis or pericarditis may have in fact been greater than your risk of being hospitalized or dying of COVID-19.
“We did not recognize infection acquired immunity, which we have in every other type of infectious disease, but not in this one. Somehow it just evaporated when it came to COVID-19. And in our school systems, you couldn’t go to school as a child if you weren’t vaccinated.”
Rep. Debbie Lesko (R-Ariz.) discusses how the use of off-label drugs that had the potential to treat COVID-19 were systemically and unjustly demonized by the federal government.
Dr. Singer: “There was anecdotal and observational evidence that these drugs may be effective to prevent or treat COVID-19. It was a, I would argue, the ethical thing for a physician speaking to a patient to say. I’m aware from anecdotal evidence, this may be helpful. We’re talking about drugs that are very safe, a very good safety profile going around for years, used for other things and don’t have a very high complication rate. And I think it would have been unethical for the physician not to mention to the patient that this may be helpful, providing you understand that I can’t guarantee it because all the information isn’t in and providing that you’re willing to accept whatever risks this drug has and then let the patient decide, so this became politicized. And this is kind of unprecedented because as was mentioned earlier during the testimony, 20% or more of all the drugs prescribed in this country are off-label prescriptions.”
Rep. Lesko: “Well, I agree. And so, thank you very much. Dr. Williams, do you have anything more to say on this subject?”
Dr. Williams: “As a pediatric subspecialist, as a child neurologist, I’ve had to use drugs off label for my pediatric patients, for example, my entire career. I mean, we did it every single day of fellowship, for example. So, I was used to having that conversation with my patient about off label use risk benefit and we make a decision, the patient makes a decision, in consultation with their medical care provider, whether it’s a physician, nurse practitioner, PA, etc. So that’s part of that sacred relationship that we’re here talking about today.”
Rep. Michael Cloud (R-Texas) examines the federal government’s use of manipulative and political tactics to strong-arm doctors into following one-size-fits-all protocols, regardless of whether it was best for their patients.
Rep. Cloud: “Dr. Singer, you talked a lot about the cash incentive involved in it. It seems like there’s kind of almost a carrot and stick to this in the sense that the federal dollars flowing into the system, in ways, have kind of messed up the incentive structure of honest feedback. It seems also in a sense, there’s also the legal recourse in that a lot of people, like the CDC will just come out and just say, oh, it’s a recommendation, but, you know, unspokenly if you don’t follow it, that you open yourself up to lawsuit abuse. Meanwhile, you know, you have these massive companies that have kind of protecton from liability, specifically in the case of vaccines. I just wonder if you could speak a little more to your concerns in that.”
Dr. Singer: “I think it’s just a natural phenomenon of the way it is when government gets involved in these things. I think it’s unavoidable, but that contributes to an accretion of distrust between the patient and the doctor because, especially with the experience we’ve had where there was constant changing of different recommendations, which is understandable because the information was changing. So, these recommendations had to be revised. Patients started wondering, are you, doctor, recommending this to me because you really believe this is what you think I should do or are you recommending this to me because you’re afraid you’ll get in trouble if you don’t recommend this to me? And that’s not a healthy relationship between a patient and a doctor.”
Rep. John Joyce (R-Pa.) asks about the compatibility of the Hippocratic Oath and coercive vaccine mandates, referring to physicians’ medical and moral obligation to their patients to “do no harm.”
Dr. Joyce: “Dr. Singer, do you believe that vaccine mandates, without exemption, are incompatible with the Hippocratic Oath or the tenets of the basic doctor-patient relationship?”
Dr. Singer: “Yes, I do. I think it’s actually that you have no right to force someone to be vaccinated. Obviously, I believe that the vaccines saved hundreds of thousands of lives, and I got vaccinated. I got the first two shots, and I got the booster shortly thereafter. And I’m glad I did. But my role is to recommend to people, not to force people, not to compel people.”