CAN WE AVERT A DARK COVID WINTER?

As the COVID-19 pandemic drags on into 2022, we should not keep doing the same thing over and over again, expecting a different result. If a general is losing the war, he is replaced.

Current control measures have not worked, despite their enormous cost and the destruction of livelihoods, education, usual medical care, and hope. The promised vaccines have not brought relief. All-cause mortality is increasing as more people get vaccinated, not decreasing as would be expected with a safe and effective vaccine.

HOSPITAL CRISIS

Hospitals are being overwhelmed, largely because of inadequate staffing. Despite this, dedicated and experienced staff are being terminated because they decline the COVID injections—even if they have demonstrated natural immunity. If staff morale is low, could it be because workers feel that dedication is not valued, their own professional judgment is disrespected, and their own health is less important than vaccination statistics?

Burnout is epidemic. A key cause is moral injury, which occurs when people are forced to act in ways they believe to be immoral. Hospitals are enforcing rigid protocols, even when ineffective or harmful, despite patients’ objections and pleas to try something different. Any who deviate will most likely be terminated and possibly kept from working in medicine ever again.

Formerly popular “shared decision-making” is thrown out with respect to COVID-19. Hospitals may insist on giving remdesivir despite poor evidence of effectiveness and a high incidence of renal failure and other serious adverse effects. Hospitals may absolutely refuse to try anything not in their restricted protocols even though patients are dying. Doctors may assert that “there’s no [CDC-accepted] evidence that that works,” while there is clear evidence that what they are doing does NOT work in a particular real patient.

There is substantial evidence, summarized at c19study.com, that many treatments (vitamin C, vitamin D, ivermectin, hydroxychloroquine, and several others), especially if started early in sequenced combinations, reduce morbidity and mortality. Results are far better than with remdesivir, and without complications such as multiple organ failure. The electronic health record is supposed to allow us to tell “what works.” And if staff members were permitted to speak freely without fear of retaliation, they could share observations and scientific publications. Hospitals, however, are blocking queries or communications not supportive of their predetermined opinions.

INFECTION CONTROL MEASURES

Masking and distancing mandates have not worked. Regions with more rigorous restrictions are not doing better. What about requiring N95 masks? N95 masks are more effective than surgical masks IF they are properly fitted. This is a process that takes at least 15 minutes. Men need to be clean-shaven—even a one-day stubble can interfere with fit. These masks impair gas exchange and can cause acid-base imbalances. Thus, they cannot be tolerated for prolonged periods.

N95 masks produced by 3M 10 years ago were all stamped In bold large print: “WARNING: This respirator helps protect against certain particles. Misuse may result in sickness or death.” Currently manufactured masks do not carry this warning, but there is no evidence that they are safer.

Airborne respiratory viruses can also enter through the conjunctiva, so eye protection is as important as masks in high-risk exposures.

Mandatory vaccination or constant pressure to get vaccinated and boosted according to the prevailing recommendations, say with every visit to a medical facility, is advocatedby authorities from the Biden Administration down to local levels. People freely choose to be vaccinated to reduce the risk of severe illness or death from COVID-19. However, mandatory vaccination is not justified on public-health grounds:

  • The COVID-19 vaccines are not demonstrated to prevent infection or transmission.
  • The current vaccines may offer no protection against new variants.
  • The Vaccine Adverse Event Reporting System (VAERS)—our early warning system, is signaling an unprecedented rate of death and permanent disability following vaccination. For persons at low risk of death from COVID, vaccination risk may well exceed potential benefit.
  • The long-term effects of these novel genetically engineered vaccines cannot be known. These could include cancer, autoimmune disease, infertility, birth defects, immune deficiency, or antibody-enhanced disease.

WHAT COULD WE DO DIFFERENTLY?

Instead of the bipartisan but highly politicized failing agenda of test, mask, isolate, vaccinate, and boost, policymakers should consider the following:

Infection-control measures that would also be of benefit in other infectious conditions, but are generally neglected, include:

  • Far-ultraviolet (far UVC) air purification, even in occupied areas; air filtration with HEPA filters and UV exposure; disinfecting clinic or hospital rooms and public transportation with ozone;
  • Reducing viral load with povidone iodine or other mouthwashes, gargles, and nasal sprays.

Pre- and post-exposure prophylaxis, as is now routine for HIV, is appropriate for both vaccinated and unvaccinated individuals. This overlaps with early treatment. Some health workers report that very few seriously ill individuals in the hospital had had early out-patient treatment. Access to monoclonal antibodies has been difficult, and these may be of reduced effectiveness against new variants. The medical community is not informing people of the need for adequate levels of vitamin D and zinc. Prescriptions for hydroxychloroquine and ivermectin are discouraged, despite theoretical and clinical support for their use and an excellent long-term safety record. Regulatory agencies are impermissibly interfering with physicians’ prescribing, pharmacists’ dispensing, and access to over-the-counter agents such as N-acetyl cysteine (NAC).

Preserving our hospitals requires recognizing and mitigating the reasons why they are overwhelmed. These include: vaccine mandates; an unprecedented influx of migrants who are not medically screened; refusal of early treatment to ambulatory patients until seriously ill enough for admission; and government policies that force shutdown of remunerative services just in case more COVID beds are needed, so that reserve capacity is lost.

I would appreciate the opportunity to discuss these issues with you further.

Respectfully yours,

Jane M. Orient, M.D. Executive Director, Association of American Physicians and Surgeons

AAPS Sets The Record Straight

In his oped published on August 30, EJ Montini severely mischaracterizes the Association of American Physicians and Surgeons. We’d like a chance to set the record straight.

Mr. Montini apparently heavily relies on an attack piece against AAPS and Dr. Kelli Ward published by a far left publication, Mother Jones, without doing much research of his own. As far as we know, he did not make an effort seek our input on his assertions or the claims made by Mother Jones.

Since 1943, AAPS has advocated for the sanctity of the patient-physician relationship. Our motto is “All for the Patient.” Increasingly, bureaucrats are interfering in patient care, to the detriment of the delivery of quality care.  AAPS finds such interference immoral.  However, Mr. Montini misleadingly seems to suggest that AAPS is summarily against caring for the poor and elderly.  This could not be further from the truth.

If Mr. Montini is truly concerned about care to the most vulnerable, we suggest he take a close look at AHCCCS. A preliminary audit of publicly available documents by a forensic accountant showed that the programs managed-care contractors made more than $225 million in pre-tax profits in just one year. In 5 years, nearly $400 million of Medicaid funding was transferred to other state agencies. A deeper level audit is needed to determine the truth of the assertion that only 20 to 40 cents of every Medicaid dollar actually buys any medical care, meaning that 60% to 80% of revenue is diverted away from care of the needy.

AAPS favors solutions that increase the availability of low cost, high quality care. In fact, many of our members are leading the way in offering increased value to their patients by cutting out the middlemen who detract from patient care.

We also favor an open discussion about the patient impact of policy and medical interventions. Reading Mr. Montini’s piece leads us to the conclusion that his goal is to suppress an open dialog by slandering those he disagrees with.  We hope we are wrong and would welcome a dialog with him and others who seek what is best for patients.

AAPS AZ Chapter Writes Senators Flake and McCain

Dear Senator:

The Arizona Chapter of the Association of American Physicians and Surgeons calls on all Republicans to honor their Party’s frequently repeated campaign promise to free us from ObamaCare, which might best be called the Unaffordable Care Act.

The Senate bill at present reneges on the promise to repeal ACA. Apparently, Republicans feel they cannot overcome resistance to full repeal from Democrats and some Republicans. But it is essential for any bill to contain an off-ramp to freedom, permitting individuals and states the option to provide for their medical needs in the manner they choose, without IRS punishment.

Additionally, the Medicaid program needs serious reform, and its expansion must be constrained. Federal taxpayers and creditors cannot afford this continuing hemorrhage.

We strongly disagree with the special interests represented by the Arizona Medical Association, pleading for continuation of the enormously increased funding of the AHCCCS program. ArMA was strongly opposed to a Resolution presented at the 2017 House of Delegates meeting that called for a forensic audit of the program. Taxpayers need to know how much of the multibillion dollar flow of funds is actually being used to provide medical care to the needy. And how much is being diverted to other state agencies and to the profits of the managed-care cartel that increasingly controls medical care in Arizona? Medicaid should not be a means of “leveraging” taxpayer funding of nonaccountable private interests, or for back-door funding of state government.

A preliminary audit of publicly available documents by a forensic accountant showed that managed-care contractors made more than $225 million in pre-tax profits in just one year.  In 5 years, nearly $400 million of Medicaid funding was transferred to other state agencies. A deeper level audit is needed to determine the truth of the assertion that only 20 to 40 cents of every Medicaid dollar actually buys any medical care, meaning that 60% to 80% of revenue is diverted away from care of the needy.

We urge you to support an end to ACA mandates, provisions to permit a free market in health insurance, and changes that will constrain unsustainable Medicaid spending and permit reforms that return control to patients and their physicians instead of private-sector and government bureaucrats. An actual decrease in the price of premiums and medical services should be the goal, not counts of persons enrolled in plans that may provide very little care.

Despite helpful Senate amendment, licensure Compact still misses the mark

Update: Yesterday, the AZ Senate Committee of the Whole (COW) gave the Interstate Medical Licensure Compact bill, HB 2502, a “Do Pass as Amended” (DPA) recommendation.  We appreciate the efforts of Senators to fix problems in HB 2502 through an amendment approved during yesterday’s proceedings.

There are several good things in the amendment:

  • It prohibits board certification from being required for licensure through Arizona’s existing licensing process.
  • It directs.the Arizona Medical Board to develop its own expedited licensure process for physicians wishing to avoid Compact licensure.
  • It prevents Compact licensure from being required as a condition of employment.
  • Arizona courts would maintain some level of supervision over Compact-authorized subpoenas issues outside of the state

Despite these helpful changes, overall the Compact is still the wrong solution for improving Arizona’s licensing process:

  • Arizona laws are still subject to being superseded by Compact provisions and rule-making.
  • Board certification requirements for Compact participation remain and trump any Arizona laws to the contrary, perpetuating a broken, corrupt, and counterproductive MOC industry.
  • Physician due process rights are still weakened, potentially impacting physicians not participating in Compact licensure.
  • The Compact is still untested. No licenses have been issued through the Compact and no date has been announced for when licensing will commence.
  • There are unforeseen consequences resulting from the Compact beginning to surface. For instance we heard from a physician in a Compact state about complications related to renewing his malpractice insurance.
  • Adding the Compact Commission creates another layer of bureaucracy and costs, according to CATO scholar, Shirley Svorny Ph.D.

A full Senate vote on HB 2502 as amended may occur next week.  If passed then the House will have to reconsider the amended measure.

Please continue to educate Arizona legislators about these issues!

Email addresses for all Senators can be found here: https://goo.gl/P7O3fH and House members here: https://goo.gl/rIIC5O

Phone numbers for all legislators can be found here:http://www.azleg.gov/MemberRoster.asp

Action Alert: NO on HB 2502, Interstate Compact

The Interstate Medical Licensure Compact “may seem like a positive step to those who don’t have the time to look at it very closely,” explains CATO adjunct scholar Shirley Svorny, PhD.  She continues, “[t]he compact is being promoted, disingenuously, as addressing license portability and access to interstate telemedicine…. Adding the Compact Commission creates another layer of bureaucracy and costs.”

Last Wednesday, HB 2502, the bill to push Arizona into the Interstate Medical Licensure Compact, narrowly passed through the AZ Senate HHS Committee after a contentious hearing.

Now the bill will move on to the full Senate if it can make it through the Senate Rules Committee.

Please contact Senate President, Andy Biggs and his leadership team on the Senate Rules Committee to express your opposition to HB 2502.  Email addresses you can copy and paste into your message: abiggs@azleg.gov, ggriffin@azleg.gov, syarbrough@azleg.gov, jburges@azleg.gov Continue reading “Action Alert: NO on HB 2502, Interstate Compact”

Concerns about HB 2502, Interstate Medical Licensure Compact

To: President Andy Biggs, Sen. Sylvia Allen, Sen. Gail Griffin, Sen. Steve Yarbrough, Sen. Nancy Barto:

Re: concerns about HB 2502, Interstate Medical Licensure Compact (IMLC)

The Health and Human Services Committee heard lengthy testimony on HB 2502. While it narrowly (4:3) approved a do-pass recommendation, testimony on both sides provides serious reasons to reject the Interstate Medical Licensure Compact (IMLC) being aggressively promoted by theFederation of State Medical Boards (FSMB).

The hearing showed a stark division in the medical community: big multistate healthcare systems, also represented by the Arizona Medical Association (note that ArMA and Mayo have a common lobbyist), and independent physicians, represented by the Association of American Physicians and Surgeons (AAPS). Continue reading “Concerns about HB 2502, Interstate Medical Licensure Compact”

Expansive Disciplinary and Investigative Provisions in Interstate Medical Licensure Compact

Are certain investigative and disciplinary provisions in the Interstate Medical Licensure Compact applicable only to physicians licensed through the Compact?  The answer seems to be no. Read more in our letter to the Arizona Senate’s Health and Human Services Committee.

Madam Chair and Members of the Committee:

Thank you for allowing a lengthy discussion about HB 2502 at the March 16th hearing. I appreciate your hard work on this and other bills before the Committee.

It was stated at the hearing that provisions in the Compact only apply to physicians voluntarily licensed through the Compact. However, I’ve heard concerns from physicians about several sections that appear to apply more broadly, that may impact physicians who chose the traditional licensure pathway and are licensed in multiple Compact-participating states. Continue reading “Expansive Disciplinary and Investigative Provisions in Interstate Medical Licensure Compact”

AZ Chapter Dinner 3/9/2016 Featuring Twila Brase

Is a “free trade zone” for medical care possible in the U.S.? Join us on March 9, 2016 for dinner and a presentation by Twila Brase, founder of the Citizens’ Council for Health Freedom (CCHF).  She will review CCHF’s Wedge of Health Freedom, an innovative free-market health care solution that will defuse Obamacare.

In addition, special guest Senator Nancy Barto, Chair of the AZ Senate HHS Committee, will give an update on healthcare related bills under consideration this session at the Arizona Capitol.

CLICK HERE to RSVP today. Seats are limited; you will not want to miss out on this important event.

What: AAPS Arizona Chapter Dinner Meeting

When: Wednesday, March 9, 2016

  • 6 pm – Networking and Drinks
  • 6:30 pm – Dinner
  • 7 pm – Presentations

Where: Old Spaghetti Factory,
1418 N Central Ave, Phoenix, AZ 85004

Cost: No Charge; free will contributions welcome

RSVP: http://aapsonline.org/azdinner

Questions: Call AAPS Business Manager, Jeremy Snavely, 520-270-0761 or email aaps@aapsonline.org.

AAPS Supports SB 1443, SB 1444, and SB 1445

The Arizona Chapter of AAPS provided the following testimony to the AZ Senate HHS Committee:

Feb 10, 2016

To: Senate Health and Human Services Committee

The Association of American Physicians and Surgeons (AAPS) and its Arizona state chapter support SB 1443, SB 1444, and SB 1445.

AAPS was founded in 1943 to preserve and promote the practice of private medicine and the sanctity of the patient-physician relationship. It is a national organization representing thousands of physicians in all specialties, including hundreds in Arizona, and the thousands of patients they serve.

The ethical standard of AAPS is the Oath of Hippocrates, which states: “I will prescribe regimen for the good of my patients according to my ability and my judgment and never do harm to anyone.”

The best regimen for an individual patient may not be found in the drop-down menu of “expert guidelines.” Innovative treatments may take years or decades to become accepted, and “standard-of-care” treatments may be prescribed long after they should have been discarded. The mutilating Halstead radical mastectomy of my medical school days comes to mind.

Resistance to change is a human characteristic—especially if enormous profits are being made by continuing the current regime. If we are to see breakthroughs in medical treatment, we must encourage pioneers, not suppress them or even drive them out of the profession by turning “guidelines” into rigid mandates. An “evidence base” can never develop for a treatment that cannot be tried. A large number of beneficial, widely used treatments would have to be outlawed if we applied the same standard to them as to new or off-label uses of, for example, hyperbaric oxygenation for neurological conditions, long-term antibiotics for chronic Lyme disease, or adult stem cells. Patients and their physicians need freedom to pursue options that in their judgment are best for the individual patient. For every possible medical intervention there is “potential harm” in using it—or in withholding it.

If regulatory boards are to serve the interests of the public, their actions must be transparent, they need to follow fair rules that assure due process, and members need to be held accountable.

Respectfully submitted,

Jane M. Orient, M.D., Executive Director, AAPS

Anti-MOC & Physician Bill of Rights Resolutions at ArMA meeting

The Pima County Medical Society is bringing several important resolutions to the Arizona Medical Association Annual Meeting this Friday and Saturday, May 29 and 30, 2015.

Details about the meeting are here: https://azmed.org/?page_id=1294

If you are eligible to attend and participate your help is needed to speak in support of these resolutions. Please drop us a quick note by replying to this email if you are attending.

1) Resolution 5-15, Protecting Patients and Physicians from harmful effects of MOC:
https://azmed.org/wp-content/uploads/2015/05/Res05-15MaintenanceofCertification.pdf

2) Resolution 7-15, Protecting physician autonomy in medical decision making / Physician Bill of Rights:
https://azmed.org/wp-content/uploads/2015/05/Res07-15ConsolidationResolution.pdf

3) Resolution 6-15, Compensation for Non-Face-to-Face Work:
https://azmed.org/wp-content/uploads/2015/05/Res06-15MedicaidNon-Face-To-FacePhysicianReimbursement.pdf

Thank you! ~AAPS