The Process Is The Punishment

Doctoring Off The Reservation

It was recently reported that pathologist Ryan Cole is in hot water with his medical board primarily for comments he has made in the media on the vaccines and the pandemic.

Early on when I was prescribing ivermectin to local pharmacies many pharmacists reported me directly to the medical boards (never a patient).

I was asked by 3 medical boards to explain myself.

In one case the medical board asked why I was conducting unauthorized “experiments” on my patients.

At that point I had been practicing as a board certified internal medicine hospitalist for more than 10 years.

I would routinely take care of very sick patients in the hospital, including those on the regular floors as well as in the ICU and CCU (coronary care unit).

I had never had a complaint from a patient, pharmacist or any issues with any medical board until I decided to prescribe ivermectin off-label - one of the least risky medical interventions you could ask for.

Ivermectin is a drug that is so safe it is routinely prescribed for the entire population of a nursing home suffering an outbreak of scabies - both those who have it and those who do not - simply as a preventive.

Ivermectin has been taken billions of times for river blindness and has probably never seriously harmed or killed anyone.

When I got the medical board complaint I realized that there were lawyers who specialized in helping physicians deal with medical boards.

I retained one of these high priced lawyers and was glad I did, because he gave me a lot of specific pointers on my response that I would not have thought of myself.

Each medical board requested medical records for a number of patients, including evidence of an informed consent, and required a written response from me regarding the complaint.

Gathering the requested materials and drafting my response took at least 2-3 full days per medical board.

But beyond the cost of the lawyer and the loss of income due to time spent on the paperwork, the worst part of the process was the stress of not knowing how it would go while waiting for the medical board response.

If the board ruled against me they could yank my license and report to any other board I was a member of.

Or they could decide that I needed to provide more information or even appear in person at a board meeting.

In each case it took a few weeks to finally hear back.

Luckily all my complaints were resolved without any escalation.

This was probably in part because I had guidance on how to reply and not incriminate myself.

For example if I had tried to defend my “experiments” to the board that accused me of experimenting I would have been in hot water for sure.

The difference between an experiment and off-label use may seem like simply an issue of semantics, but if someone is running an experiment on their patients they require specific oversight and monitoring, whereas if a physician is simply trying a drug off-label they require no more than an informed consent.

So in my reply I made sure to explain the difference between an experiment and off-label use.

I also cited all the safety data and research showing that ivermectin was effective for COVID-19.

Being able to refer to the FLCCC and their top notch physician leaders was definitely beneficial since there’s nothing more dangerous than being completely alone as a physician with no one else on your side.

I likely also benefitted from the luck of the draw on who was assigned to review my case.

Other physicians have not been so lucky, or they stood accused of more “serious” infractions like prominently speaking out against vaccines, which is like a 3rd rail in medicine today.

Many thousands of physicians including myself are no less culpable, but the boards like to make an example of prominent docs - eg those who have made the rounds in the media or are particularly well known by both patients and other physicians.

So we have seen attacks on the likes of Pierre Kory, Paul Marik, Peter McCullough, Meryl Nass and now Ryan Cole.

The case of Meryl Nass is typical, and we have some of the details because she has blogged about it, revealing that the board clearly made up charges since they had nothing real they could stick to her.

For example they faulted her for staying in touch with her patients via email, phone and text message after her official consult and not conducting a full physical exam for each of those “telemedicine encounters”.

This is obviously ridiculous as doctors have always kept in touch with their patients by all of these methods and not felt the need to treat each separate communication as a technical “visit” requiring a full history and physical exam.

The board also subjected her to a mandatory psychiatric examination, since apparently she must have been crazy to treat patients off label for COVID-19.

After a legal battle including in person hearings before the board (which leads to even higher legal fees, especially if expert witnesses are required), and despite having done nothing wrong Dr Nass’s license to practice medicine was suspended by her board.

If she is licensed in any other state she is mandated to report her suspension to them as well, which will likely trigger its own investigation.

The ultimate punishment is removing a physicians ability to practice medicine and earn a living which is what happened to Dr Nass.

The specter of this hangs over each and every physician and awareness of these public cases is usually the best way to keep the majority of physicians in line.

But even if you escape that ultimate punishment, just the process itself is often punishment enough and discourages most physicians from stepping out of line.