This post was originally published on WashingtonPost.com here by staff writer Chandra Bozelko.
An emergency physician in Bellingham, Wash., Ming Lin used his personal Facebook account to claim that patients and staff lacked the necessary personal protective equipment (PPE) in his hospital. Having made public his grievances with his employer’s handling of the covid-19 pandemic, he was fired soon after.
Lin’s case is an ominous example. We cannot punish doctors for speaking out during this pandemic. They have a perspective that we need badly now — bringing back first-person knowledge of the worst extremes of a still-building crisis.
Until recently, it was difficult for physicians to share their experiences in newspapers and other publications, unless they could contort their own perspectives into the confines of a constantly mutating news cycle. As it did to so many facets of life, the coronavirus pandemic changed that. Suddenly, news outlets are actively seeking input from physicians and nurses. It should be an ideal time for these fellows to publish and lead. And it would be, if only their employers weren’t getting in the way.
On the day that Lin said he was fired, I sent a group of doctors that I work with in my capacity as a facilitator for the OpED Project a link to a CNN form that asked clinicians to share their experiences. In less than 10 minutes, my email was met with another from a hospital administrator, saying “[The hospital] is asking that you NOT share your stories with the media per an email that went out yesterday.”
Soon after, a message arrived from the hospital’s media office explaining the prohibition: “The format that these kinds of submissions would take inherently make things look more chaotic than they actually are,” it read, adding, “We wouldn’t want to create the impression that we are detracting from patient care in order to shoot these.”
On March 11, another physician connected with my program posted an innocuous mention of a lack of tests and a picture of herself at work; the post was shared more than 1,800 times. She messaged me later saying “turned down interviews w ABC nightly news and Good morning America” because her posts had angered “some important people.” She didn’t say exactly what irked them, but the only part of her post that would have had anything to do with her employer was the fact that it didn’t have enough supplies, which aligned with Lin’s complaints.
Similar issues seem to be playing out elsewhere. Fortune magazine and Bloomberg News have both reported that NYU Langone Medical Center in New York has forbidden staff from contacting the media without permission under threat of termination. A number of physicians have complained that they can’t speak to the media for fear of being fired.
Protecting patient privacy is a must. So is treating patients; health-care providers shouldn’t prioritize media appearances over medical appointments. But after working with health-care professionals during this crisis to facilitate their inclusion in the news, I don’t think there’s much risk to privacy or patients themselves. From what I’ve witnessed in working with them, my fellows are committed professionals, and they know that, in this unprecedented crisis, patient care includes public advocacy, minus the personal details.
We need to confront what this media management is really about. Esther Choo, an emergency physician at Oregon Health and Science University, said on CNN this past weekend that much of this is simply hospitals “not wanting to be upfront about how things aren’t going well inside their walls.” That sounds a lot like an attempt at self-preservation by corporate entities.
That’s not to say that all hospitals have something to hide. Indeed, a shortage of PPE isn’t an oversight on the facility’s part; they are victims to failed leadership by the federal government. And it is true, of course, that we need clinicians doing on clinical duty, not getting ready for their close-up, though all the doctors I know put their professional responsibilities first.
But as the virus spreads, so do health-care providers’ job descriptions; they’re being asked to fill out clinical rosters in specialties they’re not used to. It’s not always clear whether this added media responsibility is one of whistleblower or citizen journalist but I don’t think that matters. All that matters is that they be allowed to do it without fear of repercussions.
I’m an ER doctor. The coronavirus is already overwhelming us.
For safety and privacy reasons, journalists can’t embed themselves in emergency department bays. The reporting of physicians and nurses is essential. In fact, it might be what saves us. That one Facebook post written by the doctor who declined all of those invitations to speak on national news shows convinced a local politician to activate state agencies in Massachusetts. Another published an op-ed in which he drew on his clinical experience in the hospital to explain how the United States could avoid becoming like Italy. Manufacturers and experts contacted him, inquiring how they could help. I suspect that his employer will eventually tout him as one of the heroes who helped solve the ventilator shortage, as will those of Lin and all the other physicians in the news — if they allow their employees to speak.
Not every doctor or nurse who’s had a media appearance has been quieted or threatened. But I fear that many of those who’ve been allowed to speak have been encouraged to do so out of an interest in branding, rather than from a desire to provide real information.
Some may argue that these physicians should take their lumps if they don’t follow their employers’ orders. And there’s some truth to that: When your job and health insurance are in play, sometimes it’s wise to walk a safe path. But this is not one of those times — and they shouldn’t have to put themselves in professional jeopardy to help inform us when they’re already in the line of fire. And that means it’s on their employers to let them speak up. Rendering clinicians inconsequential during a worldwide pandemic is the worst thing they can do.