Sen. Mark Steffen listens to testimony March 8, 2022, on legislation shielding doctors from discipline for prescribing ivermectin for COVID-19. (Sherman Smith/Kansas Reflector)
TOPEKA — Kansas Sen. Mark Steffen bragged about the attention he received for sending a threatening letter to doctors encouraging the use of ivermectin for early treatment of COVID-19 based on a law the Legislature didn’t pass.
In a Facebook post from his personal account, Steffen said he sent the letter — dated March 31 and written on “Senate Chamber” letterhead — to “over 250 Kansas hospitals, clinics and government agencies.”
The Republican and anesthesiologist from Hutchinson pointed out the letter earned praise in a tweet from Peter McCullough, a national figure known for spreading misinformation about COVID-19 vaccines and the off-label use of drugs like ivermectin.
McCullough called Steffen “an American hero.”
Steffen called the tweet “humbling.”
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Steffen has championed proposed legislation that would shield doctors from discipline for prescribing unproven treatments for COVID-19, and require pharmacists to fill those prescriptions. He revealed that he was under investigation by the Kansas Board of Healing Arts after personally prescribing ivermectin to patients.
The Senate passed the bill, but the House didn’t consider it before adjourning last week for a three-week break.
In his letter, Steffen said support for the law means doctors no longer have to worry about interference from pharmacists or the Board of Healing Arts. Furthermore, Steffen wrote, the “legal community” has indicated that a failure to prescribe drugs like ivermectin will be considered “wanton disregard.”
Jeremy Presley, a family physician in Dodge City, said he was shocked by the unsolicited correspondence from a state senator he had never heard from before.
“I interpreted it as the intent being, ‘This is the word and you will follow it,’ and, ‘This is me warning you,'” Presley said. “I mean, it’s worded in a mildly threatening manner.”
Medical literature doesn’t support Steffen’s claims about the use of off-label drugs to treat COVID-19, Presley said.
“Basically,” Presley said, the letter is “blatantly telling us that you will be guilty of malpractice by not providing this care.”
Presley said he wasn’t aware before checking with colleagues that the Legislature didn’t actually pass the law referenced in the letter. He now reads the letter as “a bald-faced lie,” Presley said.
“It really came across as a real threat,” Presley said. “It’s telling us this is the law, and here’s your expectation, and you will do this or you will be held accountable for it. So not something I want to hear from a elected official.”
Steffen didn’t immediately respond to emails seeking comment for this story.
Susan Gile, acting executive director of the Board of Healing Arts, said the board hasn’t provided any direction regarding the use of specific medications for COVID-19.
However, the board provided some direction for the use of off-label drug prescriptions in a Feb. 8, 2022, memo. The memo said investigations into the use of off-label drugs to treat COVID-19 will be based on the “standard of care,” which can generally be defined as “what a reasonable physician would have done under the same or similar circumstance.”
“The board cautions health care professionals to ensure that they are complying with the standard of care and standards of professional conduct in regard to any prescription order for ‘off-label’ use of drugs,” the memo said.
The memo said the board has not taken any public disciplinary action against a physician for off-label prescriptions to treat COVID-19.
Steffen’s letter begins with a passage about the two-year struggle to respond to COVID-19 and the “legal duty” a health care provider has to facilitate treatment as quickly as possible.
Delays in treatment, he wrote, are no longer acceptable.
“All providers caring for those infected with Covid must have mastery of protocols heretofore considered beyond the FDA or CDC,” Steffen wrote.
Doctors use drugs like Paxlovid because studies show they are effective in treating COVID-19. But Steffen pointed out there are concerns about the availability of those drugs, and that those drugs can cause problems when interacting with other medications. Meanwhile, Steffen wrote, “ivermectin, hydroxychloroquine, and fluvoxamine remain readily available and are historically well tolerated.”
Peer-reviewed clinical trials routinely show those drugs provide no benefit in the prevention or treatment of COVID-19. Still, Steffen said “hundreds of studies” show the drugs have “significant efficacy that can no longer be dismissed.”
“With the recent passage of Senate substitute for HB 2280 by the Kansas Senate Public Health and Welfare Committee and subsequently the Senate as a whole, there is no reason to think that prescribing problems will arise from pharmacist or Board of Healing Arts interference,” Steffen wrote. “In consultation with the legal community, indications are that ‘failure to treat’ will now be considered ‘wanton disregard.’ As such, any perceived statutory immunity will be rendered invalid.
“Providing care to the ill is difficult yet rewarding when done correctly and with a patient-first approach. I wish you the very best as our treatment of Covid becomes more sophisticated.”
Rachelle Colombo, executive director of the Kansas Medical Society, said Steffen’s letter has prompted questions from physicians.
“While it’s concerning and confusing to those who have received the letter, because it is presented as factual and authoritative, there should be no confusion that the Board of Healing Arts is the arbiter of standard of care,” Colombo said.
She also said physicians could look to a recent opinion issued by Attorney General Derek Schmidt for guidance on the topic.
The March 24 opinion from Schmidt was written in response to Senate President Ty Masterson and concludes that “nothing in Kansas or federal law prohibits the off-label prescribing of FDA approved drugs such as ivermectin or hydroxychloroquine for the prevention or treatment of COVID-19.”
“In so prescribing, physicians and other prescribers are bound by professional standards of care in the treatment of patients,” Schmidt wrote. “Determinations as to standard of care are factual determinations based on the particular circumstances of treatment and, as such, is outside the scope of this opinion.”
Mike Pirner, spokesman for Senate leadership, said “senators all choose their letterhead” and Steffen’s use of “Senate Chamber” at the top of the letter “has no relation to leadership or the Senate.”
COVID-19 has killed 8,397 Kansans since the start of the pandemic, according to an official count from the Kansas Department of Health and Environment. The agency has recorded more than 770,000 infections.
Medical professionals encourage the use of safe and effective vaccines to prevent serious illness from COVID-19. The Centers for Disease Control and Prevention reports that 71.6% of Kansas adults have been fully vaccinated.
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