Stop Silencing Doctors: A COVID Clinician Manifesto

The Clinician Manifesto

Hey everyone, it’s Dr. Zubin Damania. That’s right, when I use my full name it usually means stuff’s about to get real. 

Okay guys, I’ve heard about the firing of Dr. Ming Lin up in Washington State. He’s a physician and an emergency doctor who was fired by his organization, PeaceHealth up there, for speaking out about the complete lack of PPE and protection for frontline staff. Now, this has been reported all over the place, and here’s the bottom line, guys. As clinicians, as the tribe of healthcare, COVID-19 will be the catalyst that burns this broken system to the ground. And here’s why.

When you have a dominator hierarchy where the profession is run by MBAs at the top getting ridiculous salaries who have never touched a patient, right, and I’m not talking about clinician leaders. I’m not talking about all those organizations around the country that are so well-led, where it’s a team, where every member of the team has a voice, where we’re all in this together, where everyone’s practicing at the top of their training together in service of the patient, and each other, that’s called Health 3.0. That’s not what we have in most institutions in this country.

What we have is this scenario where a businessperson turns a beautiful, sacred calling, OUR sacred calling, into dollars and cents, and yachts, and bonuses, and golden parachutes. And then when a crisis happens where we’re called on to sacrifice our lives in service of this calling they sit there and say, “You can’t have a voice.” Okay, this ends TODAY.

This is the end of the administrative technocracy that has destroyed medicine. COVID-19 will wash this filth back into the sea from which it oozed out. This is the end of it. And I’ll tell you why. We on the frontlines of healthcare will hold every single leader accountable when this is over. And why do I say when this is over? Because now we’re doing what we do to save lives with no support, no protection, and when we speak out, what happens? You’re fired. Is this the most absurd thing you’ve ever heard in your life?

Okay, here’s what we demand as clinicians, because when this is over, we will NEVER forget what they did. When this is over this is what we’re gonna demand, and if they don’t give it to us, we are gonna walk.

We will create it ourselves. We will go to those organizations that are already doing this, and they exist all around the country.  Clinician-led, wonderful groups that take the MBAs and use what they know to keep the lights on while people who actually are at the bedside touching patients run the show.

What we demand is this:  We demand an end to gag orders. We demand an end to non-competes. We demand an end to non-clinical leadership telling us how to take care of patients. We demand an end to the administrative technocracy. We demand an end to HIPAA as it sits. It has been a gag on us. We’re unable to innovate, we’re unable to speak out. HIPAA should be a choice for the patient. They control their privacy, not you.

How many times have we heard HIPPA being used as a sword against clinicians who need to speak out?  “Well, we’re worried about patient privacy.” No, you’re not. You’re worried about someone figuring out how much you make and how little you do to actually help patient care. You are a parasite. And when this is done, the people who have done this the people who fired Ming, anybody like that, we’re gonna flip the script. 

This is that call to action:  We will demand that they be fired. Instead of firing us, they will be gone. All right? We demand that EHRs are no longer a cash register. That they help us take care of patients. We demand an end to nurse slavery. Nurses are not slaves. They are not commodities. They are not cost centers. They are the beating heart of medicine. They are part of our team. And they will be treated as such, or YOU WILL GO. You will be GONE. Not the nurse. Not the nurse who speaks out. YOU will be gone. We demand teamwork where every person in the team has a voice, is practicing at the top of their training, and collaborating with each other to support not just our patients, but each other. Right?

We’d like malpractice reform. We’re tired of covering our asses, racking up costs, for no benefit to the patient. We would like, okay, in return to do some things. We would like to actually have quality science be a thing, quality improvement be a thing, and we promise that we will step up and realize and admit and fix the fact that most of what we do doesn’t help patients. We do it because we’re paid to do it. That has to change. Our incentives need to change.

We need to be paid to do telehealth. Hello? Most of what we do doesn’t need a patient to come and sit in a waiting room and pay a co-pay and be miserable. And we have to promise to focus on preventing patients from ever needing to come to see us. Wouldn’t that be something? Instead of sick care, going to actual healthcare. We call that Health 3.0, and that is coming after this COVID crisis.

The COVID will be the catalyst that burns the old system down and the new will emerge, and it’s gonna be so much more connected, re-humanized, technology will enable our human relationship instead of obstructing it, as it does now. And we will hold ourselves accountable to step up and make sure we wash our damn hands, because we still don’t, and we’re costing lives.

We’re gonna look at the things we do with a critical scientific eye and go, “does it actually help or is it just getting me paid to do this procedure?” And we’ll realize that we have to hold our patients accountable, because right now they expect a magic pill for everything. Those people that are sitting on the beach, going to the bars, not socially distancing, okay, we still take care of them when they show up and get ventilated with ARDS  in the unit because that’s what we do, but it’s time for them to uphold their part of this social covenant.

We are all in this together. Right?

So, here’s the call to action. Any administration that is misbehaving during this time, you, the frontline clinicians, hold them accountable. If we all speak out at once they cannot fire us all. You know why? They desperately need us. They desperately need us. And they have taken advantage of our altruism and our work ethic for way too long. To the leaders that are doing such a wonderful job, and I get messages from them all the time, about how they’re working 24-7 to try to get PPE when they can’t, to try to support their clinicians, to open up new spaces to take care of COVID patients, we love and support and will work with you.

All right? Share this video. The COVID Manifesto begins today. And when this is done, we will never forget, we will not stop this momentum, and we will fight for our patients and for our colleagues to the very end. Understand that. Health 3.0 is our demand, and we will have it. And that’s final.

That is the end of the discussion. Period. And this disaster will have that silver lining, if anything else.

All right guys?

I love you.

We out.