Shawn Whatley, Author at shawn whatley md

Mask Laws: Necessary or Nonsense?

COVID has caused two pandemics. The first infects our bodies. The second corrupts our minds. A respiratory virus caused the first; a mental virus the second.

We can beat the first pandemic with reason, science, and experimentation.

People will need comfort with ambiguity, uncertainty, and changing information. But it is not impossible to beat. We must embrace the exploratory nature of trial, error, and experiment.

The second pandemic cannot be beaten in the same way. It must be abandoned. We can inoculate against the nonsense caused by fear, but it will require hard work to learn things long ignored. Although fear caused the second pandemic, the disease itself manifests as political nonsense.

Mask Intolerance

What can we do about COVID19? We swab, social distance, and hand wash. But we have no treatment. Our entire plan rests on preventing transmission while we wait for a vaccine.

Masks seem a reasonable way to block a respiratory virus. But not everyone agrees. Despite public recommendations, some simply refuse to wear a mask.

This exasperates politicians and those working on the front lines of care. Even if we do not have perfect evidence, masks seem the neighbourly thing to do. Maybe we have no choice but to force people to wear them?

Mask Laws: Necessary or Nonsense?

Mask laws are not the same as masks. While obvious to most, some find this nuance strange, almost mischievous. They attack anyone who doubts the wisdom of mask laws, by flinging out evidence in support of masks. Even if we knew that masks worked perfectly (which we do not), we would still need to debate whether we should pass a law about them.

Some insist masks are the same as seatbelts. Seatbelt laws save lives. But aside from both being things that people wear, seatbelts and mask are entirely different.

Seatbelts protect drivers and passengers, not the pedestrians they run over. The causal connection between exposure and outcome for seatbelts is clear for those riding in the car. Continue reading “Mask Laws: Necessary or Nonsense?”

Flu Vaccine Fiasco

His abdomen gaped from sternum to pubis. Fat pushed up against the bed rails.

The crater in his gut held a wedding cake’s worth of gauze: a sponge soaking up yellow fluid. Tubes, lines, drains, and leads – with monitors attached to half of them – buried our patient. Aside from gnarled toes and mottled ankles, only a few square inches of skin showed.

“There’s nothing surgery can’t make worse,” someone said, sotto voce. Most of us missed the point.

As a surgical resident, I remember the rush of adrenalin, the anticipation of opening an abdomen. Our goal was always the same: get in before the staff surgeon finished scrubbing.

But staff never rushed into a new case. They would ask questions, walk down for coffee, then ask almost the same questions again. They hunted for any possible reason to not operate. It drove me nuts.

Proof of Exudate

Surgeons fix things on the sickest patients (often at 3 a.m.), which no medicine can cure. They operate when certain nothing else will do. Ideally, surgery is not just the right treatment; it is the only treatment.

I watched my Chief Resident operate on my first case as a resident.

“Wahoo!” he yelled.

A trickle of pus had oozed out behind his knife. The pus proved he chose wisely. The pre-operative uncertainty – Does this patient really need an operation? – was gone. He whooped with relief.

Flu Vaccine Fiasco

Surgeons avoid surgery until certain there is nothing better. They do not cut because they can but because they must. Nothing else will do.

Bureaucrats do the opposite. They build bureaucracy because they can, not because they must. It is what they do.

Apparently, the Ministry of Health (MOH) sends out flu vaccine directly to pharmacies across Ontario. Individual pharmacists have vaccine shortly after the MOH release.

Every year, doctors complain, “Why do all the pharmacies have flu vaccine and we have none?” Continue reading “Flu Vaccine Fiasco”

Is the OMA Distracted, Again?

OMA needs focus — What is the OMA’s focus?

Doctors love shiny objects. Many of us have ADHD or just old fashioned, ants-in-our-pants hyperactivity.

And doctors care deeply, not just about patients. Doctors pour passion into every shiny object that grabs us.

Social media survives on shiny objects. Media tells us what matters, and doctors are eager to show they care more than everyone else about it.

How the CMA Became Irrelevant

The Canadian Medical Association lost the war of distraction. It used to fight for doctors so that doctors could focus on patients.

The CMA seesawed for years between fighting for docs and pushing progressive politics. Progressives eventually won.

But they grew uncomfortable driving a bus built on profit from MD Management. How could they preach on social issues while owning the largest investment company in Canada, after the big banks?

So CMA sold MD for a few billion dollars. It no longer needs doctors or business or money. CMA can pursue progressive politics to its bleeding heart’s content, without concern for diversity or representation at all.

Fighting for doctors embarrasses the new CMA, for the most part.

How the OMA Can Become Irrelevant

The Ontario Medical Association faces the same battles as the CMA.

The OMA can fight for doctors so that doctors can focus on patients. Or it can throw members’ money at every popular crisis the media flashes in its eyes.

Small cliques of doctors have always rotated microphones to push pet issues in medical politics. Raised voices and red faces insist each New Issue is different. They have fought about everything from nuclear war to conflict in the Middle East, even perfume allergies and cats on planes. They expect everyone else to think and feel as they do.

Strat Plans Are So Boring

Why spend millions on a strategic plan if it is more fun to make one up at every board meeting?

The OMA has a very hard job. Representing doctors is not the hard part.

Several thousand important issues beg for attention. Each big issue has its own lobby group. The OMA needs strict discipline to stick to its own strategic plan and not promote other people’s plans.

Note, this is just in the narrow world of health policy and medical politics. Can the OMA stick to a few strategic issues where it can actually make a difference?

Lately, the OMA seems more interested in popular, non-health-policy issues. It would rather preach about popular politics than focus on helping doctors.

What difference is the OMA trying to make?

Which dial, exactly, is the OMA hoping to move?

How will it know when it has had an impact?

Aside from symbolic gestures aimed at emotional targets, could you please tell your members what you are trying to change and how you will show you changed it?

Resist Distraction

Distraction ranks as one of the biggest threats for any organization.

Peter Lynch coined the term diworsification, in his famous book, One Up on Wall Street. If you are a shoe company, build shoes not satellites. Stick to your knitting. Stay on strategy.

Regular working doctors beg you, OMA, please fight for us so we can focus on patients. Medical politics is not a popularity contest.