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What a bottle of ivermectin reveals about the shadowy world of COVID telemedicine
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An anti-vaccine group known for spreading medical disinformation is writing prescriptions for unproven COVID-19 treatments, with the help of a doctor whose medical license was revoked in Alabama.
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RACHEL MARTIN, HOST:
Millions of Americans believe that the drug ivermectin can be used to treat COVID-19. That is not true. The best available science shows ivermectin doesn't work against COVID. Even so, a small number of doctors are willing to sell prescriptions to these patients.
NPR's Geoff Brumfiel has more on one case of a doctor profiting off disinformation and the troubling questions it raises.
GEOFF BRUMFIEL, BYLINE: Just before Christmas, a right-wing journalist named Ben Bergquam became really sick with COVID. He described what happened in a video from his hospital bed in California.
(SOUNDBITE OF ARCHIVED RECORDING)
BEN BERGQUAM: My oxygen levels got below 80. And it's scary when you can't breathe. It's not a fun place to be.
BRUMFIEL: Bergquam told his audience he is not vaccinated. He doesn't believe in the vaccines. But what he does believe in is the drug ivermectin. Ivermectin is used to treat parasitic worms. The FDA advises against taking it if you're sick. But many on the political right believe it's a secret cure-all for COVID. In the video, Bergquam holds up a bottle.
(SOUNDBITE OF ARCHIVED RECORDING)
BERGQUAM: Bring your own meds because there's no guarantee that what they're going to do, especially in a state like California, is in line with what's best for you and your health.
BRUMFIEL: He told the audience he got his ivermectin from a group known as America's Frontline Doctors. Their leader, Dr. Simone Gold, is well known for spreading anti-vaccine propaganda. She tells audiences across the country that instead of taking the shot, they should give her a call for an ivermectin prescription.
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SIMONE GOLD: We set up on our website a mechanism to connect you with telemedicine doctors who would provide you a consult, and then the medication would be mailed to you in the privacy of your home.
BRUMFIEL: They charge 90 bucks for the call. And demand is strong. According to CDC figures, at one point last year, ivermectin prescriptions surged to over 20 times pre-pandemic levels. And the Frontline Doctors are getting a cut.
KOLINA KOLTAI: I would reckon that telehealth and telemedicine is one of the major income-generating streams for America's Frontline Doctors.
BRUMFIEL: Kolina Koltai studies vaccine misinformation at the University of Washington. She says this group is one of a handful of organizations and individual doctors all over the country willing to fill the public's demand for things like off-label COVID drugs for a price. Often, these same groups spread false information about treatments that work.
KOLTAI: They're profiting off of medical misinformation, using their medical expertise as currency.
BRUMFIEL: That video from conservative journalist Ben Bergquam provided some rare clues into exactly how this all works. From his hospital bed, he thanked the Frontline Doctors.
(SOUNDBITE OF ARCHIVED RECORDING)
BERGQUAM: God bless the Frontline Doctors. Dr. Cullen, thank you so much.
BRUMFIEL: Kathleen Ann Cullen is a physician based in Florida and not licensed in California. Under California law, she's supposed to have a California license to practice telemedicine in the state. And there's more. She had her medical license revoked in Alabama in November for her involvement in a separate telemedicine business.
Wilson Hunter is general counsel for the Alabama Board of Medical Examiners.
WILSON HUNTER: She was working for a telemedicine company and was utilizing her medical license to further their ability to generate billable events without actually providing health care to the patients.
BRUMFIEL: In other words, Cullen was ordering a battery of expensive genetic tests remotely without ever seeing or even speaking to the patients she was testing. It was so bad, Hunter says, she was ordering prostate cancer screenings for female patients, who, of course, don't have prostates. The company doctor Cullen was working for at the time was called Bronson Medical LLC. It no longer has a functioning website. And its owner pleaded guilty in 2020 to federal health care fraud charges. When the Alabama board confronted Cullen, she failed to produce the patient records.
HUNTER: At the hearing, she knew nothing, saw nothing, heard nothing, understood nothing and did not take responsibility for her actions.
BRUMFIEL: That hearing happened in January of 2021. It took the Alabama board the better part of a year to revoke her license. And Cullen still has active licenses in North Carolina and Florida. It appears she's now using those medical licenses to prescribe ivermectin on behalf of America's Frontline Doctors.
ASHLEY BARTHOLOMEW: Where's the accountability in all of that?
BRUMFIEL: Ashley Bartholomew is a nurse who's with the organization No License For Disinformation, a group of medical professionals who are trying to force medical boards to take action in cases like these. Bartholomew was the first to notice Cullen's name on the bottle. She said the entire video made her nervous because Ben Bergquam appeared to be bringing in his own outside medication to a hospital setting.
BARTHOLOMEW: Is the nurse aware that he's also taking these prescribed medications from this doctor in Florida while he's a hospitalized patient? And then are his team of doctors there aware? And is the pharmacy aware?
BRUMFIEL: Neither Ben Bergquam, America's Frontline Doctors or Kathleen Cullen responded to NPR's request for comment. As for the medical boards in Florida and North Carolina, where Dr. Cullen continues to hold licenses, public records show that the Florida Department of Health has filed two administrative complaints, but her license is listed as clear and active on their website. They did not respond to repeated requests for comment. The North Carolina Medical Board, meanwhile, said it would not confirm whether an investigation was underway.
But Brian Blankenship, the board's deputy general counsel, says that investigations take time.
BRIAN BLAKENSHIP: As a state agency - and I don't think too many people would disagree with this statement. State agencies have to give people due process rights based on evidence.
BRUMFIEL: Ashley Bartholomew, the nurse fighting disinformation, says this case shows just how broken America's medical licensing apparatus is. Cullen already lost her license for poor telehealth practices, and yet a tangle of state medical boards, laws and procedures continues to allow her to write prescriptions for questionable treatments.
BARTHOLOMEW: How many patients have to suffer from disinformation until we actually have action?
BRUMFIEL: Unless more is done, she worries the public will continue to be at risk.
Geoff Brumfiel, NPR News.
(SOUNDBITE OF DANIEL PORTMAN'S "ODYSSEY") Transcript provided by NPR, Copyright NPR.