In the first week of August 2020, Dr. Shveta Raju, an internal medicine primary care physician, wondered why her children’s school district in Georgia was closed when the neighboring district had reopened. Why, she asked, was a fraternity house open in the same neighborhood where a kindergarten was closed? Although she proactively advocated for in-person school reopening in her community, Dr. Raju doesn’t think enough physicians did, due in part to institutional policies. Almost 70% of U.S. doctors work for hospitals or corporations as opposed to independently or in small practices—a tremendous shift from just 20 years ago. “Preserving the independence of physicians is really critical,” she told me. “Part of it is that physicians should be able to maintain their voice regardless of where they practice.”
Laws or protections, Dr. Raju said, should be put in place to prevent employers from silencing them. Instead, the trend is moving in the opposite direction. The California state legislature is now considering a bill that would threaten doctors with disciplinary action if they share anything the medical board deems “misinformation.” This approach to alternative perspectives is exactly what needlessly left millions of American children out of school. It is not “misinformation,” but an official culture of censorship and credentialism that produced immense suffering.
Dr. Duriseti wonders if the aversion to considering multiple voices was in part motivated by a desire among public health bureaucrats to avoid scrutiny of their choices. “The people who forwarded this policy may have not wanted to have a conversation that they were ill-equipped to have,” he said. “It seemed, at times, that they were both numerically incapable of having the conversation or were concerned that scrutiny would breed warranted skepticism.” He pointed out that most of the people formulating COVID-19 policies like school closures had never treated COVID-19 patients at volume. Dr. Noble echoed this observation. ‘Public health officer’ is a desk job, she said, but “you need people inside public health agencies who have their feet on the ground.”
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