Your doctor no longer has all the answers — who can you trust?
I have always said, when it comes to your medical concerns and decisions, you should trust your doctor first and foremost. But now the landscape has changed significantly, and even though we all need a trusted voice in the middle (or at the end) of the pandemic, I am not entirely sure that your doctor is still the main go-to person. And this trend may continue beyond the pandemic into the future of our fractured and inefficient health care system.
Don’t get me wrong, I am not saying that your doctor is deliberately misleading you, that he or she might not still be a trusted ally and even friend. But in a growing world of rapid technological advancement, not to mention disease progression, your doctor may not have all the ready answers you need. Not only that but he or she may be beset with the same or different political biases that you are, which may affect his or her advice on everything from insurance coverage to pandemic preparedness to the proper treatments or essential vaccines. And your doctor is also likely to be submerged under paperwork, so his or her time may be so limited and overcommitted that he or she cannot spend the time needed to guide you through nuanced decisions.
It has long been the case that doctors have worked under a time crunch but never more so than right now. And even before the pandemic, health insurance and government regulations superimposed and hamstrung a doctor’s role. This has played out in a multitude of ways — including higher deductibles, narrow networks of providers, pre-certifications and rigid, superimposed guidelines — but also has intruded on the essential exchange of information between doctor and patient.
When it comes to the pandemic, it is difficult to know who to trust. Don’t get me wrong, there are certainly doctors who are guiding beacons of information who reach beyond politics to provide real perspective. It is imperative that moving forward, we seek out and rely on sources such as these for direction.
Dr. Eric Topol, the head of Scripps Research, is one such beacon who looks carefully at the prevalence and the impact of vaccines and other interventions which he told me are limited in our “libertarian society.” He also carefully factors in the usefulness of natural immunity after infection and just this week wrote that one shot after infection is just as protective as three shots alone.
He has taught me a lot during radio interviews on SiriusXm, as has former FDA commissioner Dr. Scott Gottlieb who was the first to bring to my attention on Doctor Radio that we were not likely to get anywhere close to the number of vaccinated we needed to reach herd immunity.
Dr. Paul Offit, head of the Vaccine Education Center at the Children’s Hospital of Philadelphia, told me that booster shots were not necessary in many cases because of persisting memory B cells and T cells and immune protection against severe disease in those who had been vaccinated.
Dr. Michael Osterholm at the Center for Infectious Disease Research and Prevention in Minnesota warned me months ago about the limitations and psychological costs of excessive masking, while Dr. Ashish Jha, dean of the School of Public Health at Brown University instructed me and our listeners just last week that if we don’t pull back on restrictions now that cases are plummeting, the public won’t listen to us later on if we need them to hunker down again.
Dr. Kavita Patel, who served as the director of policy for the Office of Intergovernmental Affairs and Public Engagement during the Obama administration is, like me, a practicing internist. She is also a television commentator, and though we work at news stations that frequently disagree, Patel and I often do not. She comes on my show on Doctor Radio and we agree on policy based on real patient experiences, including mask and restriction fatigue and the need to start to consider pulling back especially now that the case and hospitalization numbers are finally dropping.
The Centers for Disease Control and Prevention director is a very difficult job, especially during a pandemic and at a time of great political divisiveness. The CDC is trying to transition to a more reactive model in real-time, an important process filled with painful growing pains and limited by hospitals’ and states’ abilities to provide data on vaccine effectiveness and breakthrough cases. There is clearly a need for greater transparency and increased funding for CDC boots on the ground in all 50 states and for an extensive digital network that sends the CDC hospital data in real-time. The paradigm focus needs to shift from case numbers to hospital capacity. The CDC is also finally introducing a system for surveilling wastewater for COVID-19 markers to monitor an area for a variant before it predominates.
I believe that CDC director Dr. Rochelle Walensky is a smart virologist and public health expert with vast experience to draw on and a lot to offer the nation. Too much media time has been spent trying to trap her inside a sound bite. On the other hand, I think she is caught in a political whirlwind that influences what she says or how it is interpreted.
We have many knowledgeable experts coming at us from different perspectives and we need to build a composite of their recommendations, both now and beyond the pandemic, to guide us forward. Dr. Google won’t suffice, nor will government guidance nor even our own physician alone, unfortunately.
Marc Siegel, M.D., is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent and author of the new book, “COVID; the Politics of Fear and the Power of Science.”