A Wyoming doctor who was fired after prescribing Ivermectin and Hydroxychloroquine to COVID-19 sufferers urged state lawmakers Monday to pass a bill preventing doctors from being fired or stripped of their licenses for doing what he did.
The House Labor, Health and Social Services Committee did advance House Bill 164 on a 7-1 vote Monday.
If it becomes law, the bill would block employers from firing doctors, pharmacists and other prescribers who prescribe drugs to patients for off-label uses. It would also block the Wyoming Board of Medicine from disciplining prescribers for the same practice.
There are three carveouts in the bill: doctors could still be disciplined for prescribing drugs off-label to help kids switch genders, or to induce abortions. And they could be disciplined for prescribing the highly-addictive drugs listed in law as “schedule 1” and “schedule 2” and are associated with criminal markets.
The bill heads next to the state House of Representatives for three readings, then on to the Senate if it survives the House.
Proponents of the bill said it can protect doctors and patients from the meddling of hospital corporations or licensure boards acting on federal whims.
Opponents said it undermines hospitals’ and clinics’ abilities to discipline rogue doctors who disobey their own employers’ policies.
The state Board of Medicine said it has not disciplined any prescriber for writing off-label prescriptions – even during COVID.
Canned During Covid
During the COVID-19 pandemic Willard Woods, the doctor who was fired, told the committee Monday that he was “definitely active,” prescribing Ivermectin, Hydroxychloroquine, zinc and vitamins to those suffering from the virus, said Woods.
Appearing via virtual link, Woods said he’s a board certified obstetrician/gynecologist with training in general surgery and family care. He told committee members that he has practiced medicine for 53 years and spent 10 years as a general practitioner in the Army before he came to Wyoming, Woods said.
With many patients still in the waiting room, he was “unexpectedly fired one day” in a Wheatland clinic after a few warnings about how the off-label drugs he was prescribing weren’t recommended for COVID, he said.
And yet, said Woods, the treatment had been “very effective” and he saw no deaths among the nearly-1,000 people for whom he prescribed it.
As he watched the medical field shun the drugs, he became concerned that doctors were being led by computer-generated protocols driven by the pharmaceutical industry or the corporations running hospitals and clinics.
“This approach removed the providers’ ability to think for themselves and out of the box,” Woods said. “Every human is different. And a well-trained and experienced clinician should be able to make decisions based on each patient, rather than a computerized algorithm.”
Struggling
Rep. Ken Clouston, R-Gillette, ultimately voted in favor of the bill. But he said he struggled with the part of it dictating what employers can and cannot do to their own employees – often within the private-sector realm.
“What I’m struggling with is trying to balance professional autonomy with employment obligations,” said Clouston. And he turned Woods’ reported termination upside-down, asking how Woods would handle an employee of his own who wouldn’t align with company policy.
Woods did not directly answer that, but said his employer did not specifically tell him not to prescribe the controversial drugs. He was merely warned they weren’t recommended, he said.
Toni Decklever, of the Wyoming Nurses Association, echoed Clouston’s concern, saying hospitals need to have some check on their physicians because they are as capable of anyone of disregarding safety guidance.
“It is my job to follow the policy of my employer, and sometimes I like it, and sometimes I don’t,” said Decklever. “These are professional medical people, that make decisions about what is safe for their employees and the patients.”
We Don’t Do That Here
The Wyoming Board of Medicine hasn’t been disciplining doctors or other prescribers for prescribing drugs off-label, Kevin Bohnenblust, executive director of the board, told the committee.
Off-label prescriptions are nothing new and doctors have been writing them for decades. Viagra was developed as a blood-pressure pill; doctors will prescribe birth control to treat acne, Bohnenblust noted.
“In my time there’s not been a single instance of a licensure action against an MD, DO or PA related to off label prescribing,” said Bohnenblust. “Not one. That includes the whole period of COVID.”
He said the state board doesn’t advocate for or against bills but tries to advise lawmakers on their potential ramifications.
“I would caution, sometimes there are unintended consequences we don’t anticipate at the time of a bill being passed,” he added.
Clouston alluded to such a consequence, pointing to a “notwithstanding” clause in the bill that appears to discount any laws that would cut against it.
Jason Caswell, a doctor with the Cheyenne clinic of Cowboy Concierge Medicine, countered, saying the bill is meant to simplify the doctor-patient relationship down to a doctor’s health-oriented strategizing, and a patient’s informed consent.
“More likely than not, y’all’s primary care physician is serving way too many masters,” said Caswell.
He also spoke in favor of the carveout that would still make doctors culpable for using off-label drugs to gender-transition kids.
Rep. Mike Yin, D-Jackson, cast the only no-vote against the bill.
Clair McFarland can be reached at clair@cowboystatedaily.com.
