Loading ...JEFF CHILDERS : ON THE NEW FLORIDA REGULATIONS PERTAINING TO MEDICINE
DESANTIS BRILLIANT RESPONSE TO THE CORPORATE HOSPITAL DICTATS VS INDIVIDUAL DOCTOR PATIENT RELATIONSHIPS
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I am interested in what Dadoc1 has to say about this…Calling Dadoc1
Dr. Joe Ladapo — a Harvard-trained doctor and a member of the Front Line Covid-19 Critical Care Alliance (FLCCC) — was officially confirmed in Florida’s Senate two days ago. Liberal media in Florida are feeling very triggered and hysterical about it; I mean, Dr. Ladapo never even talks about EQUITY. How can that be science?
? Even though I already knew the Governor planned to sign HB 7021 yesterday, it was still a gut punch when I heard it had happened. While I rationally understand the political and practical justifications, and even though I recognize the record-shattering nature of what DeSantis did first, emotionally I still felt white-hot outrage knowing that corporate hospitals would receive any benefit of any kind at this point. It stinks.
After two years of difficult and emotionally draining work, this lawyer’s opinion is that our corporate hospital system is irretrievably broken. There’s no way to fix it. It will have to be replaced by something new. It will take time, maybe a long time, but it must be done. So.
CHANGING THE GAME
The law’s extension was the bad news. But the war continues and there’s a lot left to do. And, more importantly, while we may have lost the temporary battle for the veto, we didn’t lose the war at all. Our efforts DID produce results. And not just little ones. What we did get is substantial, maybe game changing, and WILL save lives. Maybe a lot of them.
I can’t think of any other blog that has ever accomplished anything like this. I don’t take the credit: I’m just the tip of the pen. (Yes, yes, it’s not a pen, it’s a keyboard, but the “tip of the keyboard” sounds ridiculous.) YOU GUYS — team C&C — were the ones who did it. And we’re still learning…
Anyway, early yesterday afternoon, the governor’s office announced the name of the new program, and it is an epic grandmaster-level media troll: “Buck the CDC!” That’s right, buck it. I can’t wait for all the outraged reporters to start yammering about how disrespectful and unprofessional the name is.
In a Rumble video, Governor DeSantis and Dr. Ladapo announce a group of new health policies in three parts: (1) encouraging employee mask choice; (2) limiting quarantine periods for kids and workers to five days regardless of their testing status; and — the part we’re interested in — (3) promoting effective, “evidence-based” treatment for Covid including off-label drugs. Governor DeSantis explained the new Covid protocols in an introduction that was pregnant with possibilities:
“The other thing that we’ve updated is some of the treatment protocols that have been out there. If you take a look at Fauci, what he puts out, what he says you can do, he’s been very negative on a lot of treatments that have actually shown positive results. And so what Dr. Ladapo has done is made sure that practitioners understand that they have the flexibility, and they can use their judgment, to use off-label products in order to treat Covid-19.”
A NEW STATE POLICY
Three things struck me about the Governor’s comments. First, I appreciated the slam on that nauseating centipede Fauci. You can’t possibly criticize him too much for my taste. Second, it’s clear they decided to work AROUND the hospitals by promoting individual physicians instead. And third, the reference to “off-label” products is code, code for using evidence-based treatment including, obviously, ivermectin — the most well-known off-label treatment for Covid. Finally.
I carefully reviewed the “Provider Alert” that the Department of Health sent yesterday to all licensed healthcare practitioners in Florida (https://tinyurl.com/36k2f38w). The language was very carefully drafted. The body of the alert is titled, “Use of Emerging and Off-Label Treatments.” It begins by advising doctors that, when treating Covid-19, physicians “should exercise their INDIVIDUAL clinical judgment and expertise based on their patients’ needs and PREFERENCES.”
That’s a direct slam on hospitals. The hospitals are all following a one-size-fits-all outdated CDC protocol. Now, the State’s official policy is that doctors’ INDIVIDUAL judgment, not some kind of corporate judgment, should drive patent treatment. And based not only on a patient’s needs but also on a patient’s PREFERENCES. Meaning, patients should have a say in it too. Imagine that.
As a lawyer battling in this space, I immediately began to see ways to use this policy. For starters, every Covid patient in Florida should print the Alert and show it to their doctors. Hang it above the bed. Let’s talk about patient treatment PREFERENCES, instead of stupid CDC guidances from Washington, from bureaucrats who’ve never been near the patient.
ENDORSING OFF-LABEL DRUGS
Next, the Alert directs that treatment “options may include emerging treatments backed by quality evidence, with appropriate patient informed consent, *including off-label use or as part of a clinical trial*” (emphasis in original). This short phrase, included in an official state advisory, is huge. It’s gigantic. It’s an earthquake. It’s difficult to overestimate how helpful this will be.
Florida just officially endorsed the use of “off label” drugs for Covid treatment.
And the “evidence-based” language is also important. That expands the universe beyond “peer-reviewed studies.” It means that doctors should use things that they can see are working, as long as THEY, the doctors, have evidence suggesting efficacy.
SAVING LIVES
You may be wondering how this short policy can help save lives. I will explain it. As soon as I read through it, I thought about a client — a particular Florida doctor. You’d probably recognize this doctor’s name if I mentioned it, especially if you’re in Florida. The doctor was well aware of the HB 7021 controversy.
I thought of this doctor in particular because yesterday was our deadline to respond to the medical board for him. The medical board is challenging this doctor for, among other things, treating Covid patients with off-label drugs. I wish I’d seen the Alert first. If I had, I would have sent a short one-page letter instead of the three-page monster we did send. I would’ve just attached the new policy and said, “read this.”
Anyway, after I saw the announcement, I immediately texted the doctor a link to the Governor’s video. Here’s what he said, word-for-word: “Listened and very impressed. I think he is putting hospitals on notice in his own way.”
That’s the rub right there: the effect this Alert could have on doctors. Not just my doctor, but other doctors who are on the fence or who are terrified they’ll get “investigated” by medical boards for prescribing off-label products. If this advisory only encourages ten more doctors to get into the game, literally thousands of lives can be saved. We might stop a lot of people from having to go to the hospital in the first place with early treatments.
This is also going to push back on recalcitrant pharmacies, because it makes off-label drug use for Covid treatment the official policy of the State. You can’t argue effectively with that.
PRESSURE ON HOSPITALS
And it gets better. There’s a second part of the Alert, titled “Reporting Noncompliant and Unlicensed Facilities.” Oooh, I thought, that looks interesting. It WAS interesting. In bold-faced type, it provides a way to file complaints against hospitals who won’t let doctors treat their patients as individuals:
If you are a health care practitioner who is aware of a hospital that is preventing licensed health care providers from using evidence-based care and exercising clinical judgment in treating patients, please report those instances to the Agency for Health Care Administration.
Boom! Two can play at the complaints-filing game. The Alert provides a phone number (888-419-3456) and a website for filing complaints against hospitals (https://apps.ahca.myflorida.com/hcfc/). The term “evidence-based care” is important; it distinguishes the alternative, which is the CDC’s “one-size fits all” protocol. The Alert doesn’t even mention the CDC, at all.
You see what this means? Our outside doctors just got some effective leverage against hospitals. They had none before. In my highly-publicized case involving Dan Pisano’s death, Mayo Hospital refused to allow Dan’s outside physician to provide treatment. If we’d had this policy, we could have reported Mayo for preventing Dr. Balbona and their own staff doctors from using “evidence-based care” and “exercising clinical judgment.”
This policy supports independent doctors over corporate care. Which is exactly what we need to do if we’re going to replace the corporate hospital system and disconnect it from the federal money machine. We’ll need strong independent physician rights. So it looks like DeSantis and his team were looking toward the long game, not just the next two years.
THE WAY FORWARD
I never thought we could completely stop HB 7021; I even agreed that liability protection makes a lot of sense for independent doctors, clinics, and nursing homes (just not hospitals). My original hope was to get it vetoed so it could be amended to provide patient protection.
But when you tally up all the pro’s and con’s, consider the possibilities, and imagine how many lives could be saved either way, the Governor’s approach might actually be better in the long run than what I had in mind. It kind of reminds me of the clever way Florida handled vaccine exemptions to defeat the mandates. At the time, we were frustrated that the special-session law didn’t ban mandates outright, but quickly realized that a ban would have been preempted by the federal laws anyway. Literally millions of jobs were saved.
Personally, I don’t want hospitals to have ANY liability protection for Covid treatment. What is happening in those hospitals is unforgivable. But I’d rather have THIS — liability protection plus the new policy — over a bare veto. The policy gives us a LOT to work with.
Florida just became the first state in the country to officially endorse off-label treatments for Covid — which empowers patients and protects doctors. And it put hospitals on notice that they need to fix themselves. Imagine what fruit could be harvested if other states follow Florida’s lead.
This is what we accomplished with our efforts to stop HB 7021. It’s not what we had in mind, but we got a historic new health policy that might be the first domino in a cascade of new patient rights.
A great first step. Much more needs to be done. Suggestion regarding hospitals. To offset the “bounties the Federal govt. pays hospitals(which keeps them in line regarding garbage decisions like preventing transplants for patients who aren’t vaccinated or their parents or spouses who aren’t vaccinated) Florida and any other state who adopts a similiar set of protocols, needs to put in fines in amounts over and above the amounts the FEDs pay them. They need to disincentivise the hospitals from these draconian practices by hitting them in their pocketbooks.
They need to disincentivise the hospitals from these draconian practices by hitting them in their pocketbooks.
I like that idea.
I’m thinking along similar lines for the incentives bankers now get for lending to central governments (mandated AAA ratings) over the private sector, and for loans to bigger corps for buybacks etc over modest loans to small business. The debt has to come down, but it has to shift in mix as well, to create independent small business over a world of collusive monopolies.
I’ve been in the private sector half my career and the current half in the US federal sector as a federal employee. Yes, I’m still unvaxxed and employed.
In the private sector the physician has a lot more say in terms of what he can and cannot do. It would be rare for someone to countermand his order. Usually, it would be a pharmacist that significantly disagrees to the point that treatment may do harm.
Federally, it is a much different beast. There are only certain drugs on formulary that are allowed to be prescribed unchecked. Others must me requested with a prior authorization and require a pharmacy review. If it is denied then that decision is appealed up the chain. One of my jobs is to adjudicate those appeals. Some of these are quite interesting and generally if there is any halfway decent data to support the use of the drug we grant the approval. However, pharmacists are involved and often want to go with specific forced guideline directed therapy. This sometimes makes for interesting and contentious discussions.
As for COVID drugs like ivermectin and hydroxychloroquine they are on lockdown for only specific indications period. There is no way around that currently.
Florida’s approach towards physician centered care is the right one. Often there are a lot of factors determining a specific treatment and there is rationale for it by that physician. If the drug is cheap then I never understand the hesitation to use it.
These are perilous times and every day I come to work not knowing if that will be the day that I’ll be confronted with the specter of losing my job over my refusal of a vaccination. Unfortunately, the docs have caved. But, the other ancillary medical staff including foremost nurses have not done so. I suspect all this will go away soon once COVID is mostly gone and simply a seasonal flu like illness.