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What AMA President Patrice A. Harris MD Needs to Say Tomorrow.

Posted on | April 6, 2020 | No Comments

https://www.press.org/events/npc-virtual-newsmaker-ama-president-patrice-harris-md

Mike Magee

The lead in this morning’s New York Times story read that Rudolph W. Giuliani, personal attorney to Prsident Trump, had assumed a “new role: as personal science advisor to a president…” But if that is a suggestion that this is uncharted territory for Giuliani, nothing could be farther from the truth. More on that in a moment.

But first, let’s turn to preparation for AMA president, Patrice A. Harris’s speech tomorrow at 11 AM at the National Press Club. The promo reads, that Dr. Harris “will deliver a live national address via a National Press Club livestream on Tuesday, April 7 at 11 AM EDT, about the essential need for relying on science and data to protect public health, particularly in the face of the COVID-19 pandemic.”

My message to the AMA speech writers: Come down hard on two Americans who are prescribing without a license – Trump and Giuliani.

That defining power to prescribe, as I explain in Code Blue: Inside the Medical Industrial Complex, was intended to correct abuses of medications, but instead became the ultimate market differentiator for the profession.

As I write: “The Harrison Narcotic Act of 1914, which required prescriptions for products exceeding an allowable limit of narcotics, mandated increased record-keeping for physicians and pharmacists who dispensed such drugs. Before Harrison, the right to prescribe came with the license to practice medicine, which was a state-granted affair. The federal government now wanted to prevent doctors from treating addicts simply by piling on the opioids, and to prevent them from selling drugs and remedies out of their own offices.”

The right to prescribe has been jealously protected by the profession ever since, notably against pharmacists and nurses, seen as using the tool to expand their scope of practice and compete economically with doctors.

Unfortunately, though the original legislation required physician prescriptions and an orderly paper trail, regulation alone has been unable to prevent our modern-day opioid epidemic.  Which brings us back to Dr. Guiliani.

Most Americans are aware that, following 9/11, the former New York mayor launched a security firm called Giuliani Partners. Few may be aware that during its first five years, their largest and most lucrative client was Purdue Pharma, the maker of Oxycontin. Fewer still appreciate that interventions between Giuliani and members of the Goerge W. Bush administration, especially DEA lead Asa Huchinson, have been credited with getting the DEA to back down and lower fines on Purdue Pharma for illegal activity from a projected $20 in 2002 million to $2 million in 2004.

At the time, Purdue Pharma’s lead lawyer admitted without reservation that, “We believe that government officials are more comfortable knowing that Giuliani is advising Purdue Pharma. It is clear to us, and we hope it is clear to the government, that Giuliani would not take an assignment with a company that he felt was acting in an improper way.”

Giuliani not only enriched himself, but arguably played a role in adding several years to the manmade opioid epidemic leading to the needless loss of thousands of lives.

Some fifteen years later, Giuiliani finds himself once again in a role defending a drug on behalf of its makers, and in collusion with the White House. On April 5th, another unlicensed presecriber, Donald Trump, advised Americans to try an unproved treatment for Covid-19, hydroxychloroquine in combination with zithromax, coming back to the topic three or four times, and preventing Dr. Anthony Fauci from answering a reporters question on the matter.

Specifically, Trump the doctor said:

 The drug combo was one of “the biggest game changers in the history of medicine.”

“The known and potential benefits to treat this serious or life-threatening virus outweigh the known and potential risks when used under the conditions described in [the order].”

And offered that “I hope they use it, because I’ll tell you what, what do you have to lose? I may take it. I’ll have to ask my doctors about that.”

Dr. Guiliani gamely reported the same day that he has spoken in favor of the unproven therapy three or four times with Trump. It was one of at least 14 messages Giuliani has posted during the past three weeks endorsing the combination of the anti-malarial drug and the antibiotic azithromycin for covid-19.

On April 3rd, he let his hair down on “FOX and Friends” in acknowledging Dr. Fauci’s opposition to the therapy, saying, “We’ve got thousands of people dying, sweetheart. And by the time you blind test it, we’ll have 100,000 people who are dead. Why don’t we get in the real world of being a doctor instead of being an academic? We’ve got to take a little risk, god dammit, if we want to save lives. We are looking at a slaughter.”

Guiliani has also taken the time during this crisis to attack appropriate regulatory checks and balances by the FDA in attempts to ensure that our prescribed drugs are safe and effective. He recently said, “The general reputation of the FDA — and I don’t mean to be critical at a time like this — but that it’s very slow. I’ve represented pharmaceutical companies in very, very difficult situations, and it was my observation that they just took forever.”

As our AMA President takes the podium tomorrow, here is what she will confront:

  1. A President and his personal lawyer, both practicing medicine without a license.
  2. A run on supplies of hydroxychloroquine ignited by the President.
  3. A clear intent to further undermine a century of safeguards and thoughtful regulation to insure the safety and effectiveness of the medicines our physicians prescribe.
  4. And an expansion of the scope of practice to non-physicians on a scale well beyond any we could have imagined.

Dr. Harris’s voice and words must be clear and direct, “Mr. President, you (and your lawyer) are not authorized to practice medicine in these United States.”

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