Health and Healthcare

Major Doctor Associations Call for End to Censorship About Emergency Room Conditions

Douglas A. McIntyre

Published: April 6, 2020 6:15 am

Doctors at a number of hospitals have been muzzled. Some have been threatened with being fired if they talk about what are often dire situations in the emergency rooms and intensive care units (ICUs). Several of the largest physician’s organizations have pushed back hard and protested, saying doctor’s descriptions of the lack of protective clothing and other practices that threaten health care workers are essential to improved conditions.

The largest of the groups that have started to fight hospital pressure on doctors who want to speak out about hospital environments due to COVID-19 is the Council of Medical Specialty Societies (CMSS). It issued a statement on behalf of 45 physical associations that represent about 800,000 doctors. The CMSS points to press reports of “threats and retaliation” against doctors who have spoken out on behalf of themselves and other medical personnel.

Robert McLean, M.D., president of the American College of Physicians, stated: “Our ethics policy is that physicians need to be able to speak out as part of professional and ethical respect on issues that affect public health and safety.”

The CMSS issued a five-point list of the rules that should govern doctors’ conditions during the COVID-19 pandemic. It also describes why physicians should have the ability to speak out about problems that put their safety at risk, along with a plan to protect those who call out problems:

1. CMSS and its member societies urge federal, state and local authorities to ensure an adequate supply and distribution of PPE for every frontline healthcare professional in the United States. Physicians and other healthcare professionals can and should expect their institutions to provide appropriate means to limit occupational exposure.
2. Physicians and other healthcare professionals should be allowed to bring their own PPE to protect themselves, colleagues, and patients when these items are in short supply at their institutions. CMSS supports the Joint Commission statement allowing the use of private PPE, but this option does not obviate an institution’s responsibility to provide adequate PPE to all healthcare personnel.
3. The United States needs a simple, uniform mechanism for all healthcare facilities to report their PPE needs and other medical supply needs to help guide optimal distribution of supplies across the country.
4. Physicians and other healthcare professionals should not be at risk of having their employment terminated, or be otherwise disciplined, for speaking out, within their health care systems or publicly, on conditions and practices related to care of COVID-19 patients (including lack of PPE) that the physician and other healthcare professional has direct knowledge of and deems to be in conflict with the health and safety of patients, themselves, and others involved in providing care to patients.
5. CMSS supports the American Medical Association (AMA) statement that “no employer should restrict physicians’ freedom to advocate for the best interest of their patients.” Physicians and other healthcare professionals may appropriately decide that going public (including to the news media and on social media) with their concerns is necessary to achieve needed change for the health and safety of patients and clinicians, both within the healthcare facility and more broadly.

It remains to be seen how hospitals will react. They may ignore the statements. They could claim that the disclosure of the circumstances harms the trust people have in hospitals. They may continue to punish doctors. However, the CMSS statement almost certainly will increase the friction between health care professionals and the places where they work.