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Monday, December 6, 2021

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

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A local archivist who specializes in all things Pocahontas County