Thread by @robinmarty

So now that we know the result, I have a LOT to say about politicized and unregulated medical boards, the weaponization of HIPAA and the real effects of witch hunts like this. So please buckle up, this will be long. washingtonpost.com/nation/2023/05…

for those who don't remember we had a similar issue w Dr. Torres - the state gave her a license until they realized she was doing abortions. Then they suddenly found "issues" with her application. theguardian.com/world/2023/mar…

Once upon a time, medical boards didn't used to be completely politically controlled entities. But as they become more under the control of governors who appoint them, they become more partisan and agenda driven.

Some very good examples over time is the addition of the head of Ohio Right to Life to Ohio's medical board (spoiler - not a doctor) or Iowa's former governor's addition of Catholic priests in the 2010s to "represent Catholic Healthcare"

After Branstad replaced the entire medical board in Iowa, they ruled to ban telemed abortion as dangerous - despite the fact that there had never been a single patient complaint filed. desmoinesregister.com/story/news/hea…

Med board hearings act just like any legal hearing, which means you have to lawyer up. That the state got outside legal counsel to assist is even beyond the usual extremes. Regardless of what the outcome was, I promise you Dr. Bernard is now facing at least $100K in legal fees

And that's another way Med boards have unprecedented and unchecked power - you cannot sue for legal expenses. You want to fight? You have to pay.

And let's talk about payment now. Dr. Bernard has a $3000 fine to pay. That will go into the system. As does every other fine that a doctor is forced to pay. And I can tell you basically every doctor pulled into a hearing will end up with a fine. The med board never admits errors

Where do all these fines go? That's an excellent question. It's one we are still trying to figure out, as Alabama seems to ding doctors a lot. There is a lot of fine collecting, but not much reporting on what happens after. That's...dubious at best.

So, we have her $3000 fine and a letter of reprimand. That doesn't sound so awful, right? I mean, she never had her license taken (our Dr had hers pulled for the entire 8 month period, with no option for her to get it back until it was done). How bad is this, really?

It's bad.

The result of a board investigation with any sort of letter of reprimand means that from this moment onward, that will be a part of her public file. It will need to be explained ANY time she applies for a medical license in ANY state.

New job? Has to be explained in detail in order for her to be added to the malpractice insurance. Contract work? Same. It will pull up any time anyone accesses her in a practitioner database from here on. Trust me, we know because we live this.

Of course, this is NOT how medical boards are supposed to work - permanent punitive effects on doctors because of politics. According to national standards: journalofethics.ama-assn.org/article/role-s…

But how do you challenge a medical board that oversteps? You can't, really, because there isn't a higher authority to appeal to. And that is why doctors are fleeing red states - they can't trust the lawmakers, and the definitely can't trust their medical boards.

So one last topic before I wrap this ridiculously long thread up. Let's talk about HIPAA and the hypocrisy around "patient privacy."

Dr. Bernard is being accused of violating HIPAA by sharing info that allegedly violated that patients privacy. Let's set aside for the moment that this patient would never have been identified if reporters hadnt made it a quest to find her because she was accused of making it up

(Sorry, kids are home from school). Patient privacy is something the GOP loves to throw around when they want to silence doctors, but then ignore when they want to try to punish them.

HIPAA is used to weaponize silence on the harms caused by bad medical policy while deemed completely unnecessary when religiously based pregnancy centers provide what they claim is healthcare.

HIPAA is Health Insurance Portability and Accountability Act. The biggest aspect of that is that patients are supposed to be able to access their files and transfer them to other providers. It's to help patients continue their care.

And yet - we have MULTIPLE documented accounts of CPCs, doctors, even HOSPITALS who have both refused us records when we call for them after patients sign off on a transfer, and refused providing them to the patients themselves. THATS what violating HIPAA looks like

The information that Dr. Bernard provided a reporter? That's also the same sort of information that many red states require for every single patient, to be provided straight to their Department of Health and state offices every month or year.

In red states (back when we could still do abortions) the board of health was allowed to come in at any time, unannounced, and inspect unredacted patient files to assure compliance with state laws. THAT is violating patient privacy. And it's state supported.

Roll all that info back up to the top of this thread, to the policitized medical board, the one that even has anti-abortion activists on it, and you see how this is all a system of hypocrisy, corruption and power. Dr. Bernard? She's just the most public victim. (/end thread)

oh, okay I lied, one last thing: want to protect patient privacy? Get rid of antis being able to hang out in front of clinics. reprotection.org/new-bill-would… (note, this org was founded by a woman who originally ran Indiana Right to Life