A Waterville doctor facing the loss of his medical license said he did not take standard measures to gather information on medical history and past ailments before issuing letters recommending that about 100 nurses and frontline workers be exempted from the state vaccination mandate.
Dr. Paul Gosselin, who ran a practice called Patriots Health, was suspended from practice in November by the state Board of Osteopathic Licensure after it found evidence that he spread misinformation about COVID-19 and had issued questionable letters of exemption before a November 1 vaccination deadline went into effect for certain Maine workers.
By the end of December, the case, which the board was considering, had been narrowed down to focus on a dozen exception letters issued by Gosselin in late October, shifting away from mention of COVID-19 science or Gosselin’s potential belief that how to best treat the disease.
Last Thursday, more than 150 people listened to the public hearing held over Zoom.
If the board decides against him, Gosselin could face a range of sanctions, from a reprimand to a revocation of his license and fines.
Gosselin, who has an extensive history of medical malpractice, testified Thursday that he did not keep records of the people who applied for the vaccine waiver letters, never requested a medical history and did not require or seek medical records confirming their allegations of past ailments, making vaccination risky. or inadvisable. His lawyer, F. Ron Jenkins, argued that he was not obligated to take these steps because the persons seeking letters were not actually patients.
Osteopathic physicians are trained in the same way as physicians and have the same powers to prescribe medication, perform surgery, and care for patients. Osteopathic education focuses more on a holistic approach to patient care that incorporates a study of related external factors in a patient’s life that goes beyond a strict diagnosis and treatment of symptoms with drugs.
At the time of his suspension, Gosselin’s website announced COVID-19 evaluations and alternative COVID-19 prevention and treatment options not approved by the Food and Drug Administration, including the use of the antiviral malaria drug hydroxychloroquine and deworming agent ivermectin, none of These have proven effective or safe. The Gosselin Clinic website also offered a one-time $ 200 price for an untested coronavirus regimen with vitamins with continued treatment through a membership program. It did not specify which treatments or medications are included in the benefit.
Gosselin’s lawyers have argued that the board unfairly targeted him because he has opposed accepting the wider medical community’s conclusions about the safety and effectiveness of COVID-19 vaccinations. The suspension of his license, his lawyers say, constituted a violation of his first right of amendment to freedom of expression and his right to a fair trial. Jenkins claims in submissions to the board that the case against Gosselin was brought in bad faith.
The board, which rejected Gosselin’s proposal to dismiss the case, said his arguments were misplaced and that the focus of the case is on the letters of exemption and his inability to generate and maintain medical records, not on his belief in how to treat COVID-19 .
A Gosselin secretary estimated he signed about 100 exceptions, often for a $ 100 fee, but said he did not charge for all of them and eventually stopped signing the letters because the number of requests distracted from his focus on to treat patients with chronic pain and substance abuse. .
“(The people who asked for letters) had no ambivalence or questions about the COVID-19 vaccine,” Jenkins said during the interrogation. “They had already decided they did not want it and no one could convince them to get it at all. They were not looking for Dr. Gosselin to diagnose or treat them.”
Jenkins, who declined a request for an interview, suggested that because there was no doctor-patient relationship, Gosselin did not have to keep the records that are standard in almost every modern medical setting.
An expert from the state disagreed.
Taking medical histories, obtaining previous medical records and following a standardized and accepted process to determine the proper medical course of a patient’s care – including whether to exempt someone from a vaccination – is a fundamental element of good medical practice while preventing injury, said Dr. Kathryn Brandt, Chair of the Department of Primary Care at the University of New England’s College of Osteopathic Medicine.
Keeping detailed notes on how and why a physician decided to take a particular step in a person’s treatment protects the patient, allows other physicians to understand past thinking, and can provide a refresher to a physician months or years after a visit.
“(The letters) did not meet the standard of care,” Brandt said. ‘They did not take into account any observation of the patient. There is no delimitation of thought process or defense of clinical decision making. Dr. Gosselin failed to evaluate these patients. “
Gosselin testified that he signed the letters without letting people fill out the paperwork or schedule personal visits or telesealth appointments. Some of the exceptions were issued after telephone conversations, and sometimes the caller spoke on the phone with his secretary and he was a few feet away.
Jenkins said health workers seeking Gosselin’s signature were sophisticated about their health care decisions and were informed of the alleged risks of vaccination and had already decided they would not be vaccinated. They sought Gosselin’s help to keep their jobs and did not seek a medical diagnosis or treatment. A woman referred to by her initials, JS, said her email to Gosselin seeking an exemption letter was a “last resort” to save her livelihood.
“I do not believe in the vaccine and the mandate,” wrote the 28-year-old who worked in an operating room at MaineGeneral Medical Center in Augusta. “I have applied for a religious exemption but was denied. I have already had and gotten over COVID-19. I love my job and I will not lose it.”
A former health worker, Katie York, said her employer asked for more specific information from Gosselin to accept the waiver letter he had written to her, including reference to CDC guidelines he did not appear to be familiar with.
“What exactly does the CDC say about exceptions?” Gosselin wrote back to her when she asked him to revise the language. York never responded and was eventually fired from his position at MaineGeneral.
York was the first witness to testify in Gosselin’s defense. She said she spoke to him directly on the phone and he asked her questions about her story, including about a previously unwanted reaction to the seasonal flu vaccine. She said nothing in the letter he signed on her behalf was false and she did not believe he had harmed her by signing it.
“I had expressed my experience, my concerns, what I was looking for, my intentions. He asked me some clarifying questions, and that was it,” York said of his conversation with Gosselin. “It was pretty direct.”
Gosselin’s legal team also demanded the rejection of a board member, Peter Michaud, a retired lawyer for the Maine Medical Association, arguing that Michaud’s pro-vaccination posts on social media and online comments, which they characterized as showing contempt and scorn for people, who were skeptical of the vaccine or refused to get one showed an impermissible bias. But that proposal and another last-minute request for reconsideration were rejected by Hearing Officer Rebekah Smith.
The consultation process operates under state administration law and resembles a traditional trial, but there is no judge. Instead, a consultation consultant oversees the process, makes decisions on proposals from both sides and also acts as legal counsel for the board. Two prosecutors from the State Attorney’s Office filed the case against Gosselin and questioned him and other witnesses.
Gosselin’s lawyers began presenting their defense Thursday, but will have to resume it next month. It is unclear when the board will make a decision, but it could happen at the next monthly meeting. After the board has made an oral decision, the hearing consultant makes a written decision.
Gosselin has previously been disciplined for professional misconduct. In 1999, it turned out that he had responded to emergency calls after consuming alcohol, and since he was not a doctor on duty. In 2001, he imitated his medical assistant and called two pharmacies in an attempt to get prescriptions for himself.
His next disciplinary case was settled in 2011 when the board found that Gosselin had committed professional violations in connection with a romantic relationship with a woman who was also a patient.
In 2013, Gosselin was charged with operating under the influence after his erratic driving in Fairfield caused two cars to crash before Gosselin drove into a ditch and then left the scene. Although he had no alcohol in his system, Gosselin showed signs of weakening, and a urine sample ordered by Fairfield police found several substances in his system, including morphine, according to the Osteopathy Board.
His most recent violation was in 2017, when he was found to have violated a probationary period. It is not clear when he resumed practicing medicine.