Thanks, Doc. I understand where you are coming from and appreciate your advice. We have a problem in our state. The Governor is our roadblock in receiving the "MABs" or Regeneron. Use off-label in this state and your license is revoked. You see advertisements for Regeneron at our local infusion center, but the Primary Care Physician is locked out - you have to go to the so called Covid ICU doctor. How many ICU docs do you know who are PCPs?
The problem you are missing is, "How many want to be hospitalized before treatment?" This is the major ethical problem I see within current medical practice. Can you see how far the medical profession has fallen? I don't mean what I say, or am asking, in any personal way - I simply do not like what I see happening. We can all go into the minutia of all the medical trials and papers, but that is truly irrelevant, at least until doctors can again become doctors (PCPs) as those who were in private practice, not an extension of government controlled institutions as large hospitals or academic propaganda machines. Possible you can give advice on how to get monoclonals (monoxlonals?) in a rigged system?
I don’t disagree with you in the least
I cannot stand that I cannot give regeneron is the hospital. It makes little sense to me. A whole lot of people are denied treatment for no good reason except some idiot bureaucrat who never stood at bedside thought this was a smart idea
As for the other issues I don’t know what to say. The majority of residents coming out have been told they need milk and cookies in their first year have strict time standards and as such are graduating into a job instead of a profession. There are still some good private practice independent physicians out there that actually will fight for the patient but our next generation of doctors are exactly as they are in real life. Shift workers without any interest in owning their own practice. They are content. Ring employees.
I do network across the country with doctors who are blessed by autonomy and are happy practicing medicine. The number however is dwindling.
One more thing. Unfortunately I have seen the enemy and it is we as physicians. About 25 years ago we were too busy running around to make dollars instead of running our hospitals and practicing. This gave rise to nonclinical administrators. In general hospital administrator teams are in direct competition with scum sucking bottom dwelling trial attorneys in terms of damage to medicine.