An Open Letter from Dr. Hare

 

• Dear PMH Community,

  It appears my time with you may be coming to a close. My application for medical exemption from our

  CoVID-19 vaccination mandate has been refused. This was not a surprise to me. While I am happy to

  discuss openly why I decline to be vaccinated, the reasons are really not essential to the bigger purpose

  of my letter to you all.

  First, I want to let you know that this time has been very hard, personally. I cannot convey to you all

  how deeply grieved I am to be leaving. Working in a tiny community hospital has been so many things

  to me, ultimately, all positive. You all have enriched my life in ways that will continue to unfold and bear

  fruit for years to come.

  Indeed, the seeds we sow today often come into maturity much later. This is the reason I am writing to

  you all. To address the elephant in the room that grows daily. That elephant is discord.

  During the 7 years I have worked here I have seen a lot of uncertainty and change. As have all of you.

  There are many people who have been here way longer than I and can attest to that many times over.

  The one constant however, from my limited perspective, has been a felt sense of unity. The hospital is

  special for many, many reasons. One of the biggest is that it is staffed and utilized by the same tight-knit

  community. This makes it, for all its worth, a family.

  It now appears that the trauma of the last two years has infiltrated us. Maybe this was as inevitable as

  the virus itself. I know many of us find ourselves divided even within our own families – everyone sees

  what is going on in the world from a slightly different perspective. Indeed, in our hospital itself, there is

  tremendous confusion about what is going on and why. Allow me to give you my perspective.

  We have two distinct but related issues at hand – decisions, and implementation of these decisions. The

  decisions are based in science, or should be – that is, how best to combat a virus. The implementation of

  decisions must take into account law, and human nature. This boils down to management.

  In detail, we are being faced with mandating a high risk and low efficacy vaccine as the main weapon

  against CoVID-19. For some people that is a contentious statement, but if you would like me to back it

  up with real, independent science, not assertions from institutions with monetary interests that they do

  not disclose, contact me.

  Regardless of their scientific merits, as a business we cannot ignore the mandates, because CMS

  controls most of our revenue.

  Which brings us to the next issue: implementation. Many people cannot take this vaccine. CMS knows

  this, and at least for now, its mandate allows for reasonable exemptions. Per the clinic’s direct contact

  with a CMS agent, there is no specific list of exemption criteria. CMS simply wants facilities to show they

  have some process, some sort of structure, around exemptions. No further details than that are

  required.

  But if you investigate surrounding facilities, and compare what they are doing to the mandate that has

  been rolled out at PMH, the difference is stark. In short, at PMH we have been given an irrationally

  narrow, unlawful and draconian set of exemption criteria. This has appeared from what seems like

  nowhere, with zero discussion, consultation, or transparency. The legal terms “arbitrary and capricious”

  come to mind. Now that the dust has settled, I can see this very clearly. Based on the actual text of the
• PMH mandate exemption document, most of the medical-based exemptions that have now been

  permitted, should not have been. I know, I wrote a number of them. However, some have been while

  others have not. This is can only be interpreted as targeting of certain employees and/or departments.

  This is a harsh statement, but what else can I assume? I still have not been told who wrote this, or by

  what process, or who evaluated them. The obvious lack of honest and sensitive leadership has left

  many of us in the dark. This is the definition of an abusive and toxic work environment. This is a wound,

  that left unattended, will only fester.

  We cannot change the virus, the vaccine mandates or the government infrastructure, in the short term.

  But we can make better decisions as a group.

  At this time there is no reason for PMH to have a mandate at all, as the government has been enjoined

  from enforcing theirs. So, there is no reason to even push forward with an exemption process.

  Community Care has simply dropped the subject for now.

  Assuming the Federal mandate will eventually be upheld, a PMH mandate that is more stringent than

  CMS requires, will cause unnecessary loss of employees. And this will be only the first wave. Does the

  PMH administration know how many more people in our company will refuse boosters?

  I know that our leadership is aware of this loss potential, and how detrimental it will be to the hospital.

  But do they know that failure to address this issue openly has caused an incredible amount of

  supposition and gossip to circulate? Do they understand what that does to an organization? Maybe

  not. I recently discovered that at least two of our Board members had not even read our vaccine

  mandate, and had no idea what the fuss was all about.

  Good decisions can only be based on clear, honest and consistent communication. If there is something

  that an organization feels it needs to hide from its employees, that is probably something that it ought

  not be doing in the first place.

  As many of you know who have sat in meetings with me over the years, I do not like to bring up issues

  unless I have, at least in part, some solution to offer. Here is my proposed solution: PMH should impose

  no mandate, until and unless a federal mandate or mandates are definitively and finally adjudicated as

  lawful and binding on us.

  If we are forced to impose a mandate, this must accommodate the needs and beliefs of our staff to the

  greatest extent possible, consistent with the law. Application of any PMH mandate going forward must

  be 100% transparent and consistently carried out. It must be drafted and applied by a work group

  involving all leadership, including Risk Management and all department directors, and be formally

  adopted by the Board, not drafted and interpreted in secret by a few. As far as I can tell, there is no

  requirement to spend money on an outside lawyer to evaluate the legitimacy of a vaccine exemption,

  this can be done internally. In all the years I have declined the flu vaccines, no one ever went to a lawyer

  to decide if it was justified.

  I understand that a policy for handling unvaccinated employees went before the Board this week. In

  this “accommodation” policy it is being proposed that only unvaccinated employees be screened for

  CoVID-19 infection weekly and at their expense. This is a bad idea for several reasons.
• Firstly, screening without symptoms is likely to generate a number of false positives. This is in the

  current scientific literature and does not fall under the concept of best practice. Secondly, it is now well

  known and accepted that vaccinated individuals carry and pass the SARS-CoV2 virus just as well, and in

  some studies better, than unvaccinated individuals. So, either it makes sense to have everyone monitor

  themselves and test when symptomatic, or screen everyone the same. Therefore and thirdly, being

  forced to pay for this unscientific and abusive inconvenience is nothing but punitive. This looks like

  another policy that targets and penalizes a particular group in the workplace. As I write this, the

  Omicron variant is approaching, and will likely once again change everything. This policy is hasty and

  premature at its best. I, for one, cannot agree to these terms of employment.

  As I prepare to join the ranks of discarded and discredited healthcare workers, I truly want everyone to

  understand that I have loved my job here. It was precious to me, and its end takes an enormous toll. I

  also want to remind us that we are all still… us. The same people we were 2 years ago. There is no

  reason to hide, no reason to hate. There is every reason to talk and work out issues, moment to

  moment, and face to face.

  Please, take excellent care of yourselves.

  Best,

  Julie Hare, MD

  December 6, 2021
•