I need to start saying, "I'm a doctor; I don't care" when the security guard hands me a mask. I'm usually in such a hurry, I take it so as to avoid confrontation slowing me down...then toss it in the trash around the corner. I also need to use the word "shitty" more.
How about this one? I have my own, enclosed office. If I get up to go to the photocopy/fax room next door, I have to put my mask on and then I can take it off upon return to my office. How does this make sense?
Also, I see a helluva lot of non-compliance around this hospital in general. At some point someone has to have the cajones to call this shit off.
My mom is in long-term care. I'm supposed to be masked at all times. She has difficulty hearing me as it is. So, sorry, not going to have a visit with her where I have to yell.
Have seen at least one medical emergency made more dangerous by masks -- masking muffles speech and reading lips can be very useful in a chaotic situation with high ambient noise.
When healthcare workers communicate, I’ve noticed an interesting difference between both unmasking to talk (most intimate) vs one unmasked vs both masked (most formal). Sort of reminds me of a non-verbal tu/tum/aap conjugation.
The sociological dynamics are interesting and should be written more about.
Two additional reasons to abandon forced masking in hospitals:
1. It makes the entire medical community look foolish as well as complicit in the covidian excesses that have taken place over the past 3 years years. Many people have figured out that the face coverings are a farce and the covid public health response was a disastrous, tragic failure.
2. For the remaining true believers, it perpetuates and reinforces the falsehood that non-respirator face coverings "slow the spread" of airbourne respiratory viruses.
I also agree that forced masking diminishes the hospital environment and probably makes staff recruitment and retention more difficult, esp. for non-professional staff who would not have to mask in any other work environment.
I am also inviting patients in clinic to unmask if they wish - most do so happily.
Totally agree, having spent the last two weeks with my mom in a hospital. Most nurses were reasonable people and a couple confided during conversations about their jobs that they were very glad that the booster wasn't required and knew VE nurses. For the true believers, the Karens at the nurses station (i.e. one of six or so) were enforcing the mask law, using their exasperated/condescending tone to make sure all heard if you forgot to put a mask on when coming out of a room. I believe they derive more pleasure from the "authority" they have than any belief about slowing the spread. Useful idiots.
I'm a pulmonologst and I quit wering a mask at work 9 months ago despite there still being a mandate. When I see patients in clinic, the first thing I say when I walk in the room is "Please feel free to take off your mask". I actually spoke to our new CEO this week to ask specifically why we are still masking in the hospital at all. We have incredibly low community rates of COVID and other nearby hospitals are no longer doing it. Never mind that it just doesn't work. I was told that while she agreed with me personally, the parent organization is "following the CDC guidelines" and thus our hands are tied until those guidelines change. When I went to actually look at what it says on CDC website, i was saddened but not surprised to find out that their guidelines on this haven't been updated in over a year. Every day that I go maskless, I wait for someone to confront me so I can educate them, but alas, no one has said a word to me. (I did find out someone filed a complaint about me not masking, but it turns out the hospital needs me more than I need them, so nothing was actually done).
Infection control in our hospital is conducting masking audits (aka spying) because DNV busted us for not enforcing our own protocol. Instead of amending the protocol or doing away with the masking we spy. So now we get scolded for drinking coffee at the nurses' station with the mask down. I guess we are supposed to do California masking and pull up our masks between bites/sips (not in the protocol). We have to mask everywhere the public can see us. The offices, education centers, conference rooms, break rooms, etc are exempt. To me, that's proof it's not about infection control but appearances. I'm over it, heck, we all are. Tell me how wearing the same mask all day in and out of patient rooms (without having to change it) is keeping me safe. Please.
My dad was force masked while recovering from heart surgery and could not convey his needs nor comprehend the (mostly ESL) nurses and medical assistants caring for him. If I wasn’t there it would’ve been a blood bath.
As a hospital administrator ( CMO of a small hospital in Ohio) , I disagree that the goal of administration is to inflict pain and suffering irrationally on employees,visitors,and patients. Mask mandates were promoted/imposed by regional,state, and federal “guidance “ with all but the power of requirements. No organization was going to stand against such pressure to conform. There is enormous pressure from CMS to conform, or risk being barred from participation in Medicare, Medicaid and other federal programs. ( Made bluntly obvious in the CMS Covid vaccine mandate, imposed with the full knowledge that there was NO benefit in stopping transmission by being vaccinated. This is a significant cause of staff shortages.)
Our hospital has returned to pre-Covid respiratory isolation practices. I am confident we will not see any significant increase in infections. I’m absolutely prepared to take responsibility if we do see an increase.
Most of the pandemic response has been of the emotional/political type; an imperative to “do something,anything!” to prove competence in a confusing environment. Sadly this approach still persists, especially amongst those who made the worst errors in judgment. I doubt that cohort will ever stop defending their mistakes. Worse, the same imperative will Drive response to any future pandemic as it seems few lessons have been learned.
*YOU* have a duty to your staff and patients. Not to blindly follow Pfizer funded CDC/FDA based on politics and not science. Do you really think that Medicare would stop paying your hospital? If CDC brought back thalidomide w/ research done on 8 mice, would you blindly follow the advice? I've lost so much faith in almost all doctors, FDA, CDC that **ANYTHING** uttered by them is suspect. And Dr. Prasad is right. Administrators and Politicians....throw them all out.
Fine, then the goal of regional, state and federal organizations is to inflict pain and suffering irrationally on employees, visitors and patients. (And I believe that, incidentally.) But why is it OK as an administrator to take the "I was just following orders" defense here and smile about it? If even 10% of the administrators who were not in it to inflict pain "just said no" it would have died.
There is a major institutional failing here -- sacrificing good health care on the alter of government money sounds like a good way to ensure that health care is not about health...and that is just what we have seen.
I personally have refused to wear a mask, knowing as a hematologist/microbiologist that masks have a long number of RCTs going back 50 years that show no value. (Fraudci knew that, too, until one weekend he didn't.) I got lots of looks and occasional comments, but was always willing to take anyone on with facts rather than "the government said to and they will take my money if I do not do these bad things to you...sorry".
Just 10% of hospital administrators saying no would have ended the charade. I despair.
Do you have any evidence to support your 10% claim? I eagerly await such proof.
Federal funding represents more than 50% of the revenue for most health care organizations. I have no doubt that CMS would gladly cut costs and quit paying to make examples of a few places that refused to follow guidance. Perhaps you can survive a 50% revenue loss. “No margin, no mission” is the reality. Or perhaps you have a magical solution to this dilemma?
Did you have to make decisions beyond the magnitude of personal choice? If so, did you take responsibility for any and all consequences of such choice?
If money means more than care, there is no conversation, I suppose. It is the famous slippery slope. In general, 10% has been the "magic number" for establishing resistance against forces considered insuperable. For instance, only 10% of the colonists were involved in the American Revolution -- which did just fine.
In many areas of the country, losing one hospital would be devastating -- so CMS would have hell to pay if they did something. And it is unlikely that CMS would withstand the pressure of an appreciable number of resisters -- congress would quickly get involved. But I suppose if everyone says "it is more important to take the money and whatever happens, happens" that is a choice as well.
Exactly. Follow the damn money. Why does the Biden admin need to push out the end of the emergency until May 11 (if you get to pick the date of the end of the emergency then it's not an emergency)? Because there are multiple entities that have to be weaned slowly off the government teat. If only there had been more health systems across the country that had stood on principle instead of cowering when the almighty dollar was threatened. Shameful.
The hospital administrators use the excuse that they have to follow the CDC guidelines because of Medicare participation. I think that is BS, but once again it comes down to our failed CDC with their ridiculous, non evidence based recommendations.
Medicare/Medicaid participation is the reality, without regard to your beliefs. Do you have evidence to the contrary? Are you working or retired? If working as an independent practice, could you afford to abandon 50% of your revenue?
I work in a hospital where masks are no longer mandatory. It is a beautiful thing. I am quite surprised by how many people still choose to wear a mask. Seems like it would be quite simple in this environment to study those who choose to wear a mask versus those who don’t and see if it really results in more or less illness. Personally I’d rather have one or two extra colds and never see another mask outside the OR again…..
Here's another nail in the casket of mask uselessness:
In China there is a natural experiment just concluding now that strongly supports the futility of masks in reducing covid transmission: Draconian behavioral restrictions were in force from the beginning of the pandemic until early December 2022. Around that time the CCP and Chinese public health authorities finally caved to the inevitable: Their zero covid policies were no longer tenable. Under the former policy, many cities had to be shut down by putting a large number of residents into semi-permanent house arrest. Economies suffered, people suffered. The damage to the economy was obvious, in addition to disasters such as the apartment fire resulting in many deaths because quarantined residents could't escape the flames.
In the natural experiment starting around December 6 or 7, 2022, many restrictions were lifted, except masking when outside of home. i.e. The variable of interest -- masking -- continued when all other major restrictions were lifted. The outbreak curve from December through present looks like the contour of Eiger north face. I don't have vetted data, but I've seen reports of 800 million to a billion covid cases in the PRC from early December 2022 to present. Based on this experience, it's impossible to argue that masks are a "critical public health tool" in controlling the spread of covid. I would point out that in general, the Chinese citizenry is compliant with mask usage, likely much more than the practice in the USA, even at the worst of the outbreak here. Were's the flattened outbreak curve in China?
We need to bury masking mandates in the graveyard of bad ideas.
I need to start saying, "I'm a doctor; I don't care" when the security guard hands me a mask. I'm usually in such a hurry, I take it so as to avoid confrontation slowing me down...then toss it in the trash around the corner. I also need to use the word "shitty" more.
How about this one? I have my own, enclosed office. If I get up to go to the photocopy/fax room next door, I have to put my mask on and then I can take it off upon return to my office. How does this make sense?
Also, I see a helluva lot of non-compliance around this hospital in general. At some point someone has to have the cajones to call this shit off.
My mom is in long-term care. I'm supposed to be masked at all times. She has difficulty hearing me as it is. So, sorry, not going to have a visit with her where I have to yell.
Have seen at least one medical emergency made more dangerous by masks -- masking muffles speech and reading lips can be very useful in a chaotic situation with high ambient noise.
When healthcare workers communicate, I’ve noticed an interesting difference between both unmasking to talk (most intimate) vs one unmasked vs both masked (most formal). Sort of reminds me of a non-verbal tu/tum/aap conjugation.
The sociological dynamics are interesting and should be written more about.
I agree. Administrators are making the practice of medicine "shitty." Bad for both the doctor and the patient.
Two additional reasons to abandon forced masking in hospitals:
1. It makes the entire medical community look foolish as well as complicit in the covidian excesses that have taken place over the past 3 years years. Many people have figured out that the face coverings are a farce and the covid public health response was a disastrous, tragic failure.
2. For the remaining true believers, it perpetuates and reinforces the falsehood that non-respirator face coverings "slow the spread" of airbourne respiratory viruses.
I also agree that forced masking diminishes the hospital environment and probably makes staff recruitment and retention more difficult, esp. for non-professional staff who would not have to mask in any other work environment.
I am also inviting patients in clinic to unmask if they wish - most do so happily.
Totally agree, having spent the last two weeks with my mom in a hospital. Most nurses were reasonable people and a couple confided during conversations about their jobs that they were very glad that the booster wasn't required and knew VE nurses. For the true believers, the Karens at the nurses station (i.e. one of six or so) were enforcing the mask law, using their exasperated/condescending tone to make sure all heard if you forgot to put a mask on when coming out of a room. I believe they derive more pleasure from the "authority" they have than any belief about slowing the spread. Useful idiots.
Did I read the wrong Cochrane review?
Physical interventions to interrupt or reduce the spread of respiratory viruses
Do physical measures such as hand‐washing or wearing masks stop or slow down the spread of respiratory viruses?
Key messages
We are uncertain whether wearing masks or N95/P2 respirators helps to slow the spread of respiratory viruses based on the studies we assessed.
Hand hygiene programmes may help to slow the spread of respiratory viruses.
...
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006207.pub6/full
Awesome rant!
I'm a pulmonologst and I quit wering a mask at work 9 months ago despite there still being a mandate. When I see patients in clinic, the first thing I say when I walk in the room is "Please feel free to take off your mask". I actually spoke to our new CEO this week to ask specifically why we are still masking in the hospital at all. We have incredibly low community rates of COVID and other nearby hospitals are no longer doing it. Never mind that it just doesn't work. I was told that while she agreed with me personally, the parent organization is "following the CDC guidelines" and thus our hands are tied until those guidelines change. When I went to actually look at what it says on CDC website, i was saddened but not surprised to find out that their guidelines on this haven't been updated in over a year. Every day that I go maskless, I wait for someone to confront me so I can educate them, but alas, no one has said a word to me. (I did find out someone filed a complaint about me not masking, but it turns out the hospital needs me more than I need them, so nothing was actually done).
Amen
Infection control in our hospital is conducting masking audits (aka spying) because DNV busted us for not enforcing our own protocol. Instead of amending the protocol or doing away with the masking we spy. So now we get scolded for drinking coffee at the nurses' station with the mask down. I guess we are supposed to do California masking and pull up our masks between bites/sips (not in the protocol). We have to mask everywhere the public can see us. The offices, education centers, conference rooms, break rooms, etc are exempt. To me, that's proof it's not about infection control but appearances. I'm over it, heck, we all are. Tell me how wearing the same mask all day in and out of patient rooms (without having to change it) is keeping me safe. Please.
And the patients don't want you wearing them!!! Especially the elderly can't understand a word with those stupid masks--and that's good patient care?
My dad was force masked while recovering from heart surgery and could not convey his needs nor comprehend the (mostly ESL) nurses and medical assistants caring for him. If I wasn’t there it would’ve been a blood bath.
As a hospital administrator ( CMO of a small hospital in Ohio) , I disagree that the goal of administration is to inflict pain and suffering irrationally on employees,visitors,and patients. Mask mandates were promoted/imposed by regional,state, and federal “guidance “ with all but the power of requirements. No organization was going to stand against such pressure to conform. There is enormous pressure from CMS to conform, or risk being barred from participation in Medicare, Medicaid and other federal programs. ( Made bluntly obvious in the CMS Covid vaccine mandate, imposed with the full knowledge that there was NO benefit in stopping transmission by being vaccinated. This is a significant cause of staff shortages.)
Our hospital has returned to pre-Covid respiratory isolation practices. I am confident we will not see any significant increase in infections. I’m absolutely prepared to take responsibility if we do see an increase.
Most of the pandemic response has been of the emotional/political type; an imperative to “do something,anything!” to prove competence in a confusing environment. Sadly this approach still persists, especially amongst those who made the worst errors in judgment. I doubt that cohort will ever stop defending their mistakes. Worse, the same imperative will Drive response to any future pandemic as it seems few lessons have been learned.
*YOU* have a duty to your staff and patients. Not to blindly follow Pfizer funded CDC/FDA based on politics and not science. Do you really think that Medicare would stop paying your hospital? If CDC brought back thalidomide w/ research done on 8 mice, would you blindly follow the advice? I've lost so much faith in almost all doctors, FDA, CDC that **ANYTHING** uttered by them is suspect. And Dr. Prasad is right. Administrators and Politicians....throw them all out.
Fine, then the goal of regional, state and federal organizations is to inflict pain and suffering irrationally on employees, visitors and patients. (And I believe that, incidentally.) But why is it OK as an administrator to take the "I was just following orders" defense here and smile about it? If even 10% of the administrators who were not in it to inflict pain "just said no" it would have died.
There is a major institutional failing here -- sacrificing good health care on the alter of government money sounds like a good way to ensure that health care is not about health...and that is just what we have seen.
I personally have refused to wear a mask, knowing as a hematologist/microbiologist that masks have a long number of RCTs going back 50 years that show no value. (Fraudci knew that, too, until one weekend he didn't.) I got lots of looks and occasional comments, but was always willing to take anyone on with facts rather than "the government said to and they will take my money if I do not do these bad things to you...sorry".
Just 10% of hospital administrators saying no would have ended the charade. I despair.
Do you have any evidence to support your 10% claim? I eagerly await such proof.
Federal funding represents more than 50% of the revenue for most health care organizations. I have no doubt that CMS would gladly cut costs and quit paying to make examples of a few places that refused to follow guidance. Perhaps you can survive a 50% revenue loss. “No margin, no mission” is the reality. Or perhaps you have a magical solution to this dilemma?
Did you have to make decisions beyond the magnitude of personal choice? If so, did you take responsibility for any and all consequences of such choice?
If money means more than care, there is no conversation, I suppose. It is the famous slippery slope. In general, 10% has been the "magic number" for establishing resistance against forces considered insuperable. For instance, only 10% of the colonists were involved in the American Revolution -- which did just fine.
In many areas of the country, losing one hospital would be devastating -- so CMS would have hell to pay if they did something. And it is unlikely that CMS would withstand the pressure of an appreciable number of resisters -- congress would quickly get involved. But I suppose if everyone says "it is more important to take the money and whatever happens, happens" that is a choice as well.
Life is all about choices, after all.
Exactly. Follow the damn money. Why does the Biden admin need to push out the end of the emergency until May 11 (if you get to pick the date of the end of the emergency then it's not an emergency)? Because there are multiple entities that have to be weaned slowly off the government teat. If only there had been more health systems across the country that had stood on principle instead of cowering when the almighty dollar was threatened. Shameful.
The hospital administrators use the excuse that they have to follow the CDC guidelines because of Medicare participation. I think that is BS, but once again it comes down to our failed CDC with their ridiculous, non evidence based recommendations.
Medicare/Medicaid participation is the reality, without regard to your beliefs. Do you have evidence to the contrary? Are you working or retired? If working as an independent practice, could you afford to abandon 50% of your revenue?
Great article. The fact that you have to write this shows how out of touch hospital administrators and PH people are.
I work in a hospital where masks are no longer mandatory. It is a beautiful thing. I am quite surprised by how many people still choose to wear a mask. Seems like it would be quite simple in this environment to study those who choose to wear a mask versus those who don’t and see if it really results in more or less illness. Personally I’d rather have one or two extra colds and never see another mask outside the OR again…..
Here's another nail in the casket of mask uselessness:
In China there is a natural experiment just concluding now that strongly supports the futility of masks in reducing covid transmission: Draconian behavioral restrictions were in force from the beginning of the pandemic until early December 2022. Around that time the CCP and Chinese public health authorities finally caved to the inevitable: Their zero covid policies were no longer tenable. Under the former policy, many cities had to be shut down by putting a large number of residents into semi-permanent house arrest. Economies suffered, people suffered. The damage to the economy was obvious, in addition to disasters such as the apartment fire resulting in many deaths because quarantined residents could't escape the flames.
In the natural experiment starting around December 6 or 7, 2022, many restrictions were lifted, except masking when outside of home. i.e. The variable of interest -- masking -- continued when all other major restrictions were lifted. The outbreak curve from December through present looks like the contour of Eiger north face. I don't have vetted data, but I've seen reports of 800 million to a billion covid cases in the PRC from early December 2022 to present. Based on this experience, it's impossible to argue that masks are a "critical public health tool" in controlling the spread of covid. I would point out that in general, the Chinese citizenry is compliant with mask usage, likely much more than the practice in the USA, even at the worst of the outbreak here. Were's the flattened outbreak curve in China?
We need to bury masking mandates in the graveyard of bad ideas.