President Trump’s claim that physicians inflated the COVID-19 death count for financial gain sparked backlash from medical organizations and doctors who called his assertions a smear on the medical profession.
Responses came after Trump commented at a Wisconsin campaign rally last weekend that doctors in the U.S. were attributing deaths to COVID-19 when they were actually due to preexisting conditions such as heart disease or cancer, because it increases their reimbursements.
“You know some countries, they report differently,” Trump said in a speech. “If somebody’s sick with a heart problem, and they die of COVID they say they die of a heart problem. If somebody’s terminally ill with cancer and they have COVID, we report them [as COVID-19].”
He added that “doctors get more money and hospitals get more money,” telling the audience to “think about this incentive.”
The accusation provoked an immediate response from healthcare professionals.
Among those protesting: the American Medical Association (AMA), the American College of Physicians (ACP), the American College of Emergency Physicians, the Council of Medical Specialty Societies, the Society for Hospital Medicine, and the American College of Obstetricians and Gynecologists.
“Let’s be clear physicians are not inflating the number of COVID-19 patients,” the American Medical Association said in its statement. The tweet highlighted a study published in JAMA that showed there were 220,000 excess deaths in the U.S. this year, more than two-thirds of which were COVID-related.
Jacqueline Fincher, MD, president of the ACP, said in a press release that “to suggest that physicians would misstate the cause of death for financial gain is false, and represents a reprehensible attack on our profession and ethics.”
Referring to the president’s statements as “junk news,” Ashish Jha, MD, dean of Brown University School of Public Health, said on Twitter that the federal CARES Act did provide some additional funding for patients with a COVID-19 diagnosis so that hospitals could buy more PPE. However, he added that false coding could get physicians “fined or jailed.”
“Doctors aren’t taking random deaths, calling them COVID deaths,” Jha said. “That’s fraud.”
However, some physicians stated that there has been confusion about which deaths are from COVID, or from underlying conditions, with many erroneously recorded as having been caused by the coronavirus.
Jane Orient, MD, executive director of the politically conservative Association of American Physicians and Surgeons, said there is still confusion about deaths “with COVID” versus “of COVID.” She repeated Trump’s assertion of a financial benefit to diagnose patients with the virus, and cited “political incentives to inflate the numbers, for example, to blame the administration or to justify lockdowns.”
“The mortality stats on COVID are thus unreliable, and various jurisdictions are revising them downward” in recognition that some deaths are inappropriately listed as resulting from COVID-19, Orient asserted in an email to MedPage Today. She conceded in a subsequent phone call, however, that she couldn’t provide examples.
Sampat Shivangi, MD, a Mississippi psychiatrist and Republican Party activist, said it was unclear how to code COVID-related deaths if there are multiple causes, or if a patient has preexisting conditions such as diabetes, cardiac illness, or other pulmonary issues.
Shivangi said he believed the president’s claims about financial incentives, stating that he heard reports of hospitals making twice, even triple the amount of money when attributing deaths to COVID-19. However, he also could not provide specific examples.