The Serious Division in Medicine and in Our Country - Jane Orient, MD

Jane Orient, MD discusses the current divisions in our country at the Annual Meeting of the Association of American Physicians and Surgeons, 2024. She is also the author of a related article on the heavily politicized response to COVID which included a war on the use of ivermectin, an antiparasitic drug, despite the previously favorable response to the repurposing of old drugs to new uses, in the fall issue of the Journal of American Physicians and Surgeons.

The ivermectin controversy parallels that of hydroxychloroquine repurposing, she states, in many ways.

Laboratory studies showed potential antiviral activity, and the drug’s safety, affordability, and availability led to high hopes.

Numerous clinical trials were conducted, but instead of providing definitive answers, those multiple projects resulted in chaos and confusion. The significance, quality, validity, and implications of those studies have been assessed differently along partisan lines, Dr. Orient writes. Neither side of the conflict was convinced by the data contradicting its favored answer.

Initial studies were done under the pressure of a health emergency. Most importantly, studies were done in the setting of strong political agendas, which may influence both the process of conducting research and the interpretation of its findings, she states. Worse, there is a power asymmetry, and the empowered side does not hesitate to use its administrative authority to punish those who disagree with them.

Ivermectin-prescribing doctors brought court challenges. Although the court ruled that the FDA had indeed overstepped its jurisdiction, and the agency took down some social media posts, it has not changed its official position that ivermectin is ineffective for COVID, Dr. Orient states.

Medical officialdom favors evidence-based medicine (EBM). However, the base of the EBM pyramid is trust, and trust has been shattered, Dr. Orient points out. Moreover, she notes, clinical trials are based on populations, and physicians treat individual patients.

Beyond COVID, plans to repurpose other drugs for a variety of uses have been thwarted by profit-hungry manufacturers due to the controversies over ivermectin and hydroxychloroquine, Dr. Orient states.

The stalemate over repurposed drugs needs to be resolved so that patients can get access to drugs that physicians think are best for their patients, she concludes. Legislative action appears to be the most promising strategy. The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943.

Full Article: https://jpands.org/vol29no3/orient.pdf