Medical Care in the 21st Century: FIRST DO NO HARM

originally published at https://dianebederman.com/medical-care-in-the-21st-century-first-do-no-harm/

How can we condone health care that includes the unceremonious removal of a patient, especially a senior citizen, from their primary health care provider? It seems we do in Ontario. I wonder if this is all made possible by socialized medicine and  the new rules that our doctors are told to follow. Whatever happened to First Do No Harm?

I am sharing my story about “health care ” during Covid.

We talk a great deal about death with dignity. But rarely do we talk about life with dignity. We all witnessed the lack of care and compassion for our most vulnerable during Covid: seniors left alone in their beds and then denied the love of family as they died alone in hospital.

I am a senior citizen.   I was unceremoniously dumped from my health clinic; East Wellington Family Health Team in Erin, Ontario after reporting  what I consider to be below standard care from my primary physician. You know, the one that co-ordinates your health care.

I will not bore you with the details regarding the poor care given to me by my primary physician as this is not about him. I did report him to The College of Physicians and Surgeons. I should have accused him of dereliction of duty. I did my due diligence. First I reported my doctor to the lead physician, Dr. Khan, for his lack of care. No, this story is about the clinic.

It is about the ethical practices, or lack of, by the clinic. I am a Hospital Chaplain so medical ethics are deeply ingrained in me. East Wellington Family Health Team has 20 total employees across all of its locations and generates $4.63 million in sales (USD). According to Dun and Brad Street. Kim Bell is the executive director.

What ended my relationship with my doctor was a conversation we had, in person!, regarding the Covid vaccine.  I had called and asked him to send a requisition for a blood test for Covid. Covid testing is “free;” testing to see if one has immunity costs $200.00. The test came back: I had no immunity.

During our in person appointment I spoke to him about the blood test and the vaccine. I am pro-vaccine. My children and grandchildren received all of their vaccines and all of them who are of age have received the Covid vaccine. I have had unusual responses to many drugs, from Aspirin to Demerol to Crestor to anti-depressants and azithromycin. I seem to be developing reactions to more drugs as I get older.  I was required to take the flu vaccine to work at Toronto Hospital. I was very ill from the vaccine. I have not had a flu vaccine since then (22 years), nor have I had the flu. I do not take the pneumonia shot either and I have never had pneumonia. But I ran for the Shingles vaccine.I have a particular fear of THIS vaccine. When it was first rolled out there was a warning for people with drug allergies. That was it for me. That the warning was tempered or removed – no matter, my fear is with me.

I had already been referred to an allergist. We talked over the phone for all of 15 minutes. Well, she talked. And she decided in that call that what I needed was an epi-pen but did not pass the test for a vaccine exemption. Who does?

My conversation  did not go well with my physician. I expected him to treat me as an individual, not some statistic. To listen to me, to my fears, my concerns and my ethical concerns. I made the  mistake of mentioning the Nuremberg Code!

Well, imagine my surprise when I received a registered letter from my doctor informing me that he no longer would be my doctor.  I was OK with that as I did not trust him anymore and I had told him. More importantly, I was no longer allowed to be a patient at the clinic which has 10 doctors. This, for me is the most outrageous action taken by someone whose oath is to do no harm. I think he was just used as the messenger boy.  At the age of 70, I was left on my own to find a doctor, during Covid, at a time when doctors are scarce and demand is high. I would receive three months of prescription renewals and urgent medical care. How nice.

Thrown out like yesterday’s garbage, with no warning. No conflict resolution. I was being tossed to the curb based on their Best Practice standards.  It seems a request to switch to another doctor in the clinic could not take place if the reason for the request is dissatisfaction with care that follows Best Practice Standards. “it is the policy to deny requests to internally switch to another physician when the reason for the request is dissatisfaction with care that follows Best Practice standards.” Ahh…best practice standards.

What standards, you may ask?  Kim Bell, the administrator, first told me by phone; there was no written document. Oh. Asked again, she referred me to this official link.

Here are some of the guidelines from that link.

“The College does not view CPGs as rules “cast in stone,” but rather as important resources, which will provide physicians with a range of appropriate options for patient care, based on available research data and professional consensus.

Typically, CPGs are intended to provide physicians with a framework for diagnosing, assessing and treating clinical conditions commonly encountered in practice.

Because CPGs are developed to promote best practice for populations of patients, they will have variable applicability to individual patients.

They do not define a standard of care, but may inform the standard of care.

CPGs do not establish inflexible protocols for patient care, nor are they meant to replace the professional judgment of physicians.

Examples of CPGs produced by the College include: EEG (2000), EMG (2001), Methadone Maintenance Guidelines (2001), and Evidence-Based Recommendations for the Medical Management of Chronic Non-Malignant Pain (2000).”

I did not see anything at the site that pertained to my dismissal. Or an explanation for not being allowed to transfer to another doctor.

So I sent a media inquiry to the Board of the clinic: Ms. Bell, Dr. Rabia Khan, John Wilson, Mary Cunningham, Rachel Ingram, Carolyn Scott, Sandra Boyd, Terri Lynn Hansen, Morag Stewart, requesting a response by 5PM the following day.

Please share information from https://cep.health/  and  https://www.cpso.on.ca/Physicians/Policies-Guidance/Statements-Positions/Clinical-Practice-Guidelines regarding Best Practice Standards in primary care that are relevant to my dismissal, without warning.

No answer. Interesting as up until I requested information in the form of a media inquiry, Ms. Bell had no trouble “sharing” her views, by phone or email. As a matter of fact, she sent an email that was, well, let’s say, huh? She had written:

“Please be aware that, while I responded to this direct message from you as a courtesy given our telephone discussion, I note that you have revoked your consent to engage in communication by email so, out of respect for your wishes, will not respond to additional emails.”

Really? Show me that email. This was nothing but bullying.

So I am left wondering what “universal” Best Practice standard”  did I break that was so serious, that a HEALTH clinic would dismiss me?

It is my not so humble opinion that it was the mention of the Nuremberg Code and my request for a vaccine exemption that led to my dismissal from the clinic.  My opinion, as no other explanation has been provided. Our doctors and their associations seem to be unaware of the Nuremberg Code. Or afraid of it.  I am saddened that in the 21st century we need to refer to it for our health care. The Nuremberg Code is supposed to protect ordinary people from forced medical procedures but it is also there to protect doctors when faced with immoral or unethical dictums – which they are receiving from their associations. Silencing them.  My doctor had two choices: Follow the orders of the College or follow his oath: First Do No Harm. That these esteemed people in our society are only following the orders of their associations holds no water. “I was only following orders” is no longer an excuse. This at the same time that medicine is going down the same road as science – into make-believe – that men can become women and women can become men and men can get pregnant and this is taught in our medical schools.

It seems to me that our doctors fear their medical associations more than they believe in Do No Harm.  We know of doctors who have been harmed for refusing to follow their associations, including the remarkable Canadian Doctor, Kulvinder Kaur Gill.

Then there is Patrick Phillips, a doctor in Ontario who took to Twitter to criticize the Quebec government vaccine mandate decree, saying it is “violating the most basic principles of patient safety and autonomy they were created to protect: Free, uncoerced, fully informed consent.”

Dr. Roland Léger, who practises in Ottawa but is also licensed in Quebec. writes that he has practised almost 40 years but now feels that he has been “plunged into a global institutional betrayal of monstrous proportions.” He notes that the global recovery rate from the virus SARS-Cov2 is over 99 percent and that he and his wife, also a doctor, have a “fundamental human right to refuse the vaccine.”

“Our experience and conscience is telling both me and my wife that we should definitively not take this vaccine,” he writes. He outlines a number of demands and questions, and adds that if someone at the CMQ (Quebec government ed. note)—whom he doesn’t identify—will be liable in case of adverse effects, he will receive the COVID vaccine. Interesting. In my discussion with my doctor I asked who would be liable if I took the vaccine and got sick. Well, certainly not him.. Ahhh.

Phillips: “What’s most disturbing about this is that medical colleges … are created for patient safety, they’re created to protect individual patients from what exactly what they’re doing right now. To force somebody into a medical treatment—especially a novel one with no long-term safety studies—is kind of unthinkable,” he said.

There are 34 Family Health Teams in Ontario. Up until 2019 these clinics were under the auspices of the Ministry of Long term Care; the Ministry responsible for the care of our elderly in homes during Covid. We are all aware of that horror show. Now these health clinics are under the Ministry of Health.  So much talk about death with dignity, so little about life dignity. I lodged a complaint with them.

When I was dismissed from the clinic, they did not have to worry about losing a patient and the possible loss of income. There are 10 people waiting for each doctor. Talk about supply and demand. In socialized medicine you can be  treated like a widget, a cog in the wheel, a statistic, because if they don’t like you it seems they can summarily remove you based on these ephemeral Best Practice standards. First do no harm to the patients does not seem to be the model. Certainly not during Covid.

How many seniors have been removed this way? Where are the safeguards for the patient? It is no easy task to report a doctor or a health clinic. How many seniors are capable of reporting? And let’s not assume that this happens only to seniors. The fact is, I have no idea how many people have been treated this way.

Despite the attempts by governments to divide us into essential and non-essential people, we are all supposed to be treated equally.

Doctors are not gods. Neither are Family Health Teams.

FIRST DO NO HARM

From the Ethics of the Fathers: “Rabbi Tarfon used to say, it is not incumbent upon you to complete the task, but you are not exempt from undertaking it.”