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John Stiller's avatar

Dr. Faust is exactly right. The outrage over President Biden’s diagnosis ignored both the science and the guidelines that protect older patients from the harms of overtesting and overtreatment. His doctors followed evidence-based medicine. The real problem is the assumption—often implied—that VIP-style deviation would have been better.

Some of the loudest criticism came from physician pundits who should know better. They engaged in post hoc reasoning, confused public disclosure with clinical timeline, and used a bad outcome as proof of bad care. That is not just wrong. It is reckless.

It also reveals the persistent myth that VIP medicine is better medicine. In reality, it often means distortion, overreach, and poor judgment shaped by optics. The idea that following guidelines was the mistake is exactly backward.

This kind of commentary erodes trust and pressures doctors to abandon individualized, evidence-based care. We need fewer hot takes and more humility. Bad outcomes do not equal bad medicine.

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Amanda R's avatar

A pearl I learned in my first year of medical school: VIP = Variation In Practice

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Carol Belding's avatar

COVID Guidelines: We flew to SFO for a family wedding and despite our kn95 masks in the airport and on planes, I contracted my second case of COVID. I went to the CDC website to get more info on masking and recovery guidelines. I was startled to be sent to a page for all respiratory viruses. COVID doesn't deserve it's own page???? I went to Mayo and other academic sites (knowing they will be affected), and then Canadian and NHS sites. Is this our future? I needed more concrete information than I saw. (Maybe I was too sick to put it all together.) I'm "physician adjacent" so had resources most folks don't have. I stayed home day 1-10. Symptoms diminished and I had three negative tests. When I did go out, on day 10, I wore a mask. (We are a couple of hours away from the Canadian border and will go there to get whatever vaccines we, our kids, and grandkids need.)

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Jeoffry Gordon, MD, MPH's avatar

I love your insightful and informed views on the progression of unprecedented challenges to medicine, science and academia as they roll out. Kudos!

When looking at the Administration's attacks on academia, scientific research, and public health an objective journalistic approach just will not do! The only logical explanation for these societal harms is that Mr. Trump very much resents the criticism directed at him by these institutions as he failed in 2020 in dealing with the COVID pandemic and he is eager to repay them for their unkindness.

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