Clinicians depart a patient room after re-positioning a COVID-19 patient. (Mario Tama | Getty Images)
Rep. Shae Sortwell (R-Two Rivers) kicked off his Wednesday press conference on a package of “medical freedom” bills to protect doctors who dispense alternative remedies for COVID-19 by reading a quote from George Orwell. In the quote, Orwell calls for a time “when thought is free … when truth exists,” and when people can get away from “the age of Big Brother, from the age of doublethink.”
Orwell’s dystopian vision of a repressive society in his classic novel 1984 is “what we are facing right now in Wisconsin, and really across the United States, where doctors and medical professionals are being silenced,” Sortwell declared.
The problem, according to Sortwell and the other GOP sponsors of a package of “medical freedom” bills, is that the government and medical licensing organizations are discriminating against doctors who prescribe controversial remedies including, specifically, ivermectine and hydroxychloroquine.
“I want my doctor to be able to use his or her medical experience without fear of retribution,” Sortwell said. That’s why he authored a bill to prevent health care entities and credentialing boards from “discriminating and retaliating” against health care providers for ordering “innovative therapies.”
In a memo to colleagues seeking cosponsors for the bill, Sortwell writes, “The better part of the past two years has featured what appears to many observers to be a coordinated effort to censor information and suppress the use of cheap, generic and repurposed drugs for the outpatient treatment of COVID-19.”
Another bill in the “medical freedom” package would forbid pharmacists from refusing to dispense such drugs.
“Big government, corporate media, and big pharma have waged a war of intimidation on pharmacists who distribute medicines in the treatment or prevention of COVID-19,” the bill’s author, Rep. David Murphy (R-Greenville), said at the Capitol press conference. “I hold pharmacists in the highest regard, but the law should not allow them to be bullied into determining a course of treatment.”
Murphy said many of his constituents in the Fox Valley have complained that “they couldn’t get the medicine they needed for COVID-19 simply because they couldn’t find a pharmacist that would fill their prescription for ivermectin or hydroxychloroquine.”
In a way it was appropriate that Sortwell chose to introduce the “medical freedom” bills with a quote from Orwell — but not in the way he intended. Orwell created a whole vocabulary to describe the misleading use of words by people in authority to mean their opposite — coercion described as “freedom,” war described as “peace,” lies described as “truth”. The language in the “medical freedom” bills is distinctly Orwellian.
‘We need to trust our doctors’
“We all should be able to express our personal professional opinions without retribution,” said Rep. Clint Moses, a chiropractor and sheep farmer who lives in Menomonie, explaining a bill that would protect medical professionals from retribution for expressing unorthodox opinions. Reps Sortwell, Murphy, Elijah Behnke (R-Oconto), Rachael Cabral-Guevara (R-Appleton), Donna Rozar (R-Marshfield) and Chuck Wichgers (R-Muskego) are cosponsors. (Cabral-Guevara and Rozar are both nurses; each of them recently cited that personal detail when they voted for a bill to require employers to waive vaccine mandates for employees who had so-called natural immunity from a previous COVID-19 infection.)
The bill prohibits examining board and credentialing boards “from retaliating against, discriminating against, or taking adverse action against, or denying, suspending, limiting, or revoking a credential to, a health care provider for expressing his or her professional opinions.”
That’s pretty rich coming from Rozar, who recently co-authored a Texas-style eight-week abortion ban that would make it a crime for doctors as well as friends and family members of women seeking abortions to help them access abortion care, and sets a $10,000 “reward” for anyone who successfully sues an abortion provider.
“No one should be able to prevent you from getting the treatment that your doctor prescribes. Not the media, not the government and not even a pharmacist. We need to trust our doctors,” said Murphy, explaining a bill that does the exact opposite of a pharmacist-conscience bill supported by most of the Legislature’s Republican caucus back in 2005, that sought to allow individual pharmacists to deny forms of birth control they deemed “abortifacients” to patients, including birth control pills, as conscientious objectors. Interestingly, the “medical freedom” bill requiring pharmacists to dispense alternative COVID therapies is a mark-up of existing legislation that lays out the “duty to dispense lawfully prescribed contraceptive drugs” (a reaction to the anti-abortion pharmacist conscientious objector movement). In Murphy’s bill, the word “contraceptives” is struck out.
Broadly, the “medical freedom” bill authors claim to be serving the interests of science, good medical care, and respect for doctors. A cosponsorship memo for the pharmacist bill states, “Throughout the pandemic, we have not seen our doctors treated like the medical scientists that they are.”
But the bills’ real effect, according to doctors who having been working directly with COVID patients, is to undermine their credibility, stir up distrust, make it harder for them to do their jobs and endanger the health and lives of their patients.
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The Centers for Disease control has warned that ivermectin has not been proven effective against COVID-19 and that misuse of the drug has increased, “as shown by a rise in calls to poison control centers reporting overdoses and more people experiencing adverse effects.”
Not for nothing has the board of directors of Wisconsin’s largest physicians’ group, the Wisconsin Medical Society, opposed the “medical freedom” bills. The group has also cautioned doctors against “deliberate, negligent, or reckless misinformation that rise to the level of professional misconduct.” And board chair Jerry Halverson told Wisconsin Public Radio in a statement that “we have not heard concerns about regulatory boards, health care entities or pharmacies stifling these appropriate physician-patient interactions.”
That will probably not assuage the medical freedom fighters, who view establishment groups like the Wisconsin Medical Society with skepticism.
“Many continue to speculate as to the exact reasons why the efforts of these health care professionals have been actively suppressed by those who have assumed the responsibility of dictating the response to the COVID-19 pandemic,” Sortwell writes in the cosponsorship memo for his legislation, with an ominous, if vague, wave at the idea of a vast conspiracy to prevent people from getting the medical care they need.
“Regardless of the forces behind this troubling trend,” Sortwell adds, his proposed legislation “seeks to reverse the unprecedented level of interference with the physician-patient relationship that has been witnessed over the past two years, whether it pertains to the treatment of COVID-19 or other diseases.”
To back up his claim that doctors are being meddled with, Sortwell trotted out Dr. Daniel Koster, a family practice doctor from Green Bay and president of a newly formed group called Physicians for Freedom, at Wednesday’s press conference. Koster described how a pharmacist had refused to fill a prescription he gave to one of his patients for ivermectin, on the grounds that there are no scientific studies supporting its use as prescribed.
“I think that’s why these bills are important,” Koster added. “We need to prevent those who would assert their power to coerce rather than have a free exchange of information.”
‘It’s just going to increase distrust’
Doctors who are caring for COVID patients from all over the state currently jamming Madison hospitals disagree. Forget the language about “freedom” flying around in the Capitol. In the hospitals where these doctors work, the bills’ real-world effects are visible.
“Very few docs are prescribing these things, and it’s just going to increase distrust and make it harder to treat these people who are already distrustful of us,” says Dr. Simone Glinberg, a hospitalist at Meriter Hospital in Madison.
“It’s not just about the handful of doctors who are probably making some money prescribing this stuff,” Glinberg adds. “It’s also calling into question what all of us are doing — saying we’re preventing people from getting care, which is not true.”
While the “medical freedom” bills will likely go nowhere — even if they make it to the floor of the Legislature and pass, they are bound to be vetoed when they reach Gov. Tony Evers’ desk — they are already doing damage by contributing to a toxic, politicized atmosphere that is taking a heavy toll on doctors and on public health.
For the first time in her career, Glinberg says, she and her colleagues are faced with an onslaught of patients and family members demanding inappropriate treatments they’ve read about on the internet, insisting that they are not getting proper care.
“We have these people coming in from all over the state and their relatives are demanding we put them on ivermectin,” she says. “They come here. They’re unvaccinated. They don’t trust the treatments we’re giving them but they demand to come to Madison because we have the best facilities and ventilators and the best science-based care — and then they demand that we give them ivermectin.”
“We have to fight with them about why it’s not effective, and then these patients and families say, ‘Well, why don’t you just try it?’ These people are so sick and then we have to argue with them about not using things that don’t work.”
Speaking by phone from the hospital, Glinberg said the frustration and burnout among doctors and nurses is palpable. She had just come from seeing a COVID-19 patient who told her he doesn’t believe in vaccinations and that he had been taking ivermectin. “Do you believe in it?” He asked her. Another patient said, “I know I’m not even allowed to use the word ‘ivermectin’ because it’s political.”
A very sick patient’s distrustful family members confronted a doctor in the intensive care unit, saying, “The last thing he said before he was intubated was, ‘Don’t let them kill me.’”
“It’s a battlefield,” Glinberg says.
Among the casualties are the non-COVID patients who aren’t getting the care they need.
One of Glinberg’s patients arrived at the hospital with chest pains and couldn’t get a bed. “He was having a heart attack and he couldn’t get a [heart catheter] for 24 hours,” Glinberg says. “This is the reality. We are turning away people with acute medical conditions because of these people who are demanding unproven medical care and they didn’t take the vaccine.”
“It’s hurting the patients,” she adds. “They refuse to do things we recommend and then they get sicker and then they come back. It’s such a waste of resources.”
‘We’ve been accused of wanting to have someone die’
Dr. Robert Hoffman, a hospitalist at St. Mary’s Hospital in Madison, has dealt with patients and family members making abusive comments, refusing to wear masks, and trying to provoke physical confrontations with doctors. “It’s been awful,” he says.
He has unvaccinated patients who refuse antibody treatments that could prevent severe infection in the first week of the disease. Then, in the second or third week, he says, when they are in the inflammatory phase of the disease and anti-viral medicine is no longer effective, they demand ivermectin. “Even if it was an anti-viral, it wouldn’t work anymore, and they’ve refused the proven antiviral,” he says.
One of his patients was taking heartworm medication meant for dogs that he ordered on the internet. “He was insistent that that was an important thing, even though it hadn’t done anything to help him,” Hoffman says. “I gave him a treatment that helped him and he ended up saying no to my treatments and leaving the hospital AMA [against medical advice] because of this incredible disbelief, even though he was getting better on some of the things that I was giving him.”
“There’s this belief that somehow, you know, doctors and nurses, who formerly used to be the most trusted profession in the world, are actually intentionally trying to cause harm,” Hoffman adds.
“We’ve been accused of wanting to have someone die so we could list it as a COVID death and we could make more money off of it. And the conspiracies are just something that none of us have ever even remotely seen before in the field of medicine. It makes it so much harder to take care of people. And it makes it really hard to maintain your empathy and concern when you’re seeing people in the hospital who were there because they chose not to get vaccinated. And then they’re going to say that they want all these other conspiracy things done. And they’re going to call you names if you don’t do it.”
The “medical freedom” bills, he adds, are “just fanning the flames; it’s not going to make a single thing different. You know, the same handful of doctors who want to prescribe ivermectin are still going to prescribe ivermectin. The rest of us, who are going based on the evidence, won’t. But just having the bills discussed in the Legislature raises questions about the intent of the medical community and about whether these are medications that are valid or not. It raises these questions when there are no questions.”
Orwell said it best in 1984: “The very concept of objective truth is fading out of the world.”
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