'Trying to reflect the upbeat attitude': How transparent does the president's doctor need to be?

Josh Rivera and Elizabeth Weise, USA TODAY
·6 min read

A day after evading direct questions about President Donald Trump's medical treatment, Dr. Sean Conley said Sunday outside Walter Reed National Military Medical Center he was "not necessarily" intending to mislead the public.

Conley a Navy commander and the president's physician, said he was "trying to reflect the upbeat attitude that the team, the president, the course of his illness has had. (I) didn't want to give any information that might steer the course of the illness in another direction.”

Before testing positive for COVID-19, Trump has minimized the severity of the disease, saying he didn't want to "create a panic."

"I wanted to always play it down," Trump said to journalist and author Bob Woodward during a recorded interview on March 19. "I still like playing it down because I don't want to create a panic."

On Saturday Conley would not answer questions about whether the president had ever been on supplemental oxygen, only stating that Trump was not at the time on it. The White House later confirmed that Trump was given oxygen at the White House on Friday before going to Walter Reed.

'Ups and downs': Doctors say Donald Trump is improving while hospitalized; aides project image of calm

Conley admitted that "it came off as if we were trying to hide something, which wasn't necessarily true."

Dr. Sanjay Gupta, chief medical correspondent, said on CNN's "Reliable Sources" that "conveying an upbeat attitude," as Conley suggested, isn't what a physician is supposed to do.

"He's coming out to debrief the public about the president ... if you're going to do that then you have to be absolutely honest. It wasn't just sort of conveying an 'upbeat attitude.' It was purposefully misleading yesterday about a very basic issue, which is whether or not the president had been on supplemental oxygen," Gupta said.

Anatomy of a White House response: Timeline of what officials said about Trump's COVID-19 battle

What can be shared, according to HIPAA law?

The Health Insurance Portability and Accountability Act (HIPAA) is set to "assure that individuals’ health information is properly protected, while allowing the flow of health information needed to provide and promote high quality health care and to protect the public's health and well being."

As with any civilian, the law protects the president's health records from being divulged to the public without his consent.

“The doctors are not going to get on television and contravene the narrative. It’s the president’s privacy. If he doesn’t want to share information with the public, they can’t,” said Dr. Russell Buhr, a pulmonologist and critical care professor at UCLA.

Dr. Sean Conley, physician to President Donald Trump, briefs reporters at Walter Reed National Military Medical Center in Bethesda, Md., Sunday, Oct. 4, 2020. Trump was admitted to the hospital after contracting the coronavirus. (AP Photo/Jacquelyn Martin)
Dr. Sean Conley, physician to President Donald Trump, briefs reporters at Walter Reed National Military Medical Center in Bethesda, Md., Sunday, Oct. 4, 2020. Trump was admitted to the hospital after contracting the coronavirus. (AP Photo/Jacquelyn Martin)

"The president has the same rights to privacy about his medical condition under federal laws such as HIPAA as anyone else, violations of which can be met with steep penalties that can vary from state to state. As such, we can expect that Dr. Conley and the team would not disclose anything they were specifically asked not to," Buhr said.

There are criminal penalties for HIPAA violations. The minimum fine for willful violation of HIPAA rules is $50,000, the maximum is $250,000, according to the HIPAA Journal.

Health care workers who violate patient’s HIPAA privacy can also be fired or potentially face sanctions from professional boards. For doctors and nurses, medical licenses are issued by the states, so their state’s medical board could also lose their medical license suspended.

Serious case?: Trump's doctors say he could go home Monday. Other COVID-19 physicians say that seems early

Trump COVID-19 treatment: President had stakes in Regeneron and Gilead, makers of antibody cocktail, Remdesivir

In the case of President Trump, who is the commander in chief, military doctors are even more so expected to maintain his privacy.

“We shouldn’t be surprised that the information is going to be very filtered. They’re doing their job,” said Buhr, who served as chief resident at the Washington, D.C., Veterans Affairs Medical Center and has worked with and trained military doctors.

What we're not getting

Conley admitted that he was not entirely truthful at a time when the American people deserve transparency and candidness, said Paul Brandus, a frequent speaker at presidential libraries and author of "This Day in Presidential History."

"People need to know that the president is a sick man and (the White House) is trying to spin it in a way to minimize the danger that the president is in," he added. "People should place less credence on what (Dr. Conley) is saying."

With presidential health crisis, "the first thing you can count on is deception," agreed Ross Baker, distinguished professor at Rutgers University. "I don't know of a single historical example in which those around the president ... did not minimize the gravity of the presidential illness."

President Trump and his administration have been known to make false or misleading claims to project a favorable image. A fact that has been verified by multiple sources throughout his presidency.

Trump privately admitted earlier this year to Woodward that the coronavirus was highly contagious and dangerous, going as far as saying that is "rips you apart.” Publicly, however, the president claimed he wasn't worried about contracting the virus himself.

Bob Woodward book takeaways:Trump admits 'playing' down COVID-19 threat, secret nuclear program, Kim Jong Un letters

"No one is surprised that this is what (the White House) is doing. They always try to downplay things. They always try to hide unpleasant facts," Brandus said, adding that he certainly understand why the administration is doing this in the middle of an election. "But they've been doing it since day one."

"We need an honest appraisal of the president's health," added Baker, advising that upcoming updates from his medical staff "will all be inevitably reassuring, they won't say anything unless it's positive."

Transparency in the past

This isn't the first time the veracity of the updates on a president's health have been placed into question. Several presidents have died from natural causes while in office, and some even tried to conceal their actual state.

Most recently, President Ronald Reagan was not diagnosed with Alzheimer’s until five years after leaving office, in 1994. His son, Ron, said his father showed early signs while in office. In 1955, the White House told the press President Dwight Eisenhower had a "digestive upset," when in fact he suffered a heart attack. And before him, President Franklin Roosevelt – suffering from polio – hid from the public his use of a wheelchair and inability to walk unaided. In 1945, Roosevelt died of a stroke while in office.

This article originally appeared on USA TODAY: Trump's doctor says president is 'upbeat.' Is that all Conley can say?