“When that white coat is weaponized to spread misinformation, it does public harm,” Brian Castrucci, the CEO of the public health non-profit the de Beaumont Foundation in Bethesda, Md., who supports the action taken by health regulators.
The federation expects its members will conduct more investigations that would lead to disciplinary actions. But in some cases the responses from some medical boards and state officials have been stymied by political backlash. States like Tennessee and North Dakota, for example, have restricted state medical boards’ powers. And now legislators in 10 other states — including Florida and South Carolina — have introduced similar measures.
Some state boards also lack the legal tools to discipline doctors for sharing unreliable information via social media. They believe the precedents in their states for unprofessional or unethical behavior more narrowly apply to actions or speech made directly to patients under their care.
“We need the medical boards to stand up and evolve,” said Castrucci, who cited the need to preserve the public’s trust in medicine. “With the click of a mouse button, two million people can get information that’s incorrect.”
Pressing public health problem
Misinformation hasn’t just distorted the public debate over vaccines, Castrucci and his peers warn. It also has helped create a market for unproven drugs and treatment against Covid-19, sometimes with harmful side effects. Poison centers have recorded increased numbers of callsrelated to ivermectin and oleandrin, with some patients requiring hospitalizations. And a recent study in The New England Journal of Medicine projected nearly $2.5 million in wasteful insurance spending on ivermectin in a single week.
Both substances have been the beneficiaries of considerable hype from commentators online and elsewhere outside the mainstream of the medical profession — even after negative clinical evidence came in — for their alleged anti-coronavirus properties.
Facing a flood of misinformation, plus the anti-establishment mood in many red states, the regulatory structure upholding professional standards is “unraveling,” said Richard Baron, the leader of the American Board of Internal Medicine, one of the private-sector bodies that certifies doctors. “We’re trying to figure out what the most effective way to act,” Baron said, conceding that he was uncertain about the most effective way to confront the problem. “There are major backlashes. You want to make sure you’re on solid ground.”
Legal structures developed for the 20th century are, in many states, not suited to discipline doctors who broadcast misinformation on social media because the physicians are not directly treating patients, Federation of State Medical Boards CEO Humayun Chaudhry said. So, some boards — and other regulators that license providers and the non-profits that certify physicians for their expertise — feel uncertain about disciplining such doctors, even though they might be contributing to lagging vaccination rates.
“Doctors who are out in the public domain, making broad statements about discredited treatments, our processes weren’t designed for that,” acknowledged Kristina Lawson, the head of the Medical Board of California. “We’re actively thinking about that.”
When Lawson’s board started to crack down last year on doctors spreading misinformation about the coronavirus vaccines, she began getting threats. Anti-vaccination protesters accosted her at a parking lot and flew a drone over her house, she has said.
“I’ve had to have private security,” she told POLITICO. “I’ve had to have regular conversations with the California Highway Patrol,” an agency that protects high-level politicians in the state.
Now and then
Despite those constraints, continue to crack down on some of their own.
The federation said that two-thirds of their members had seen an increased number of complaints related to disinformation in a December 2021 survey. “There might be right now, dozens or hundreds of investigations going on [into misinformation],” Chaudhry said.
But it’s unclear whether the activity will make a difference. Many inside the profession are pessimistic.
Some of the medical professions’ trade groups have been called to act. In November, the American Medical Association’s House of Delegates asked the organization to develop a strategy to address misinformation. The association’s president, Gerald Harmon, told POLITICO around that time he had “the goal ahead of me,” but the “devil is in the details.” The association has no new updates.
Anti-vaccine sentiment and vaccine skepticism has drawn backlash. When Houston Methodist Hospital suspended a doctor’s privileges November after she allegedly spread misinformation over social media about vaccine policies, the doctor hit right back. She broadcast on Facebook that she was suing hospital for financial information, alleging the hospital had profited from its administration of the vaccines. She also touted her cocktail of a high-dosage steroids, ivermectin, vitamin C, among other medications. (Some steroids have had success in treating Covid.)
The targets of misinformation investigations typically claim they’re better scientists than the scientists bringing the disciplinary actions. “It’s not ‘research’ if they’re censoring opposing information,” tweeted Simone Gold, the founder of America’s Frontline Doctors, one of the groups promoting ivermectin treatments. Gold has been indicted in the Jan. 6 riot on the Capitol. She has pleaded not guilty.
Such conflicts over supposed cures have been a constant in American history — snake oil cures involving goats’ testicular glands and, later, so-called treatments derived from apricot pits boomed during the early parts of the 20th Century. But, observers said, today we are in a different climate than in previous surges of medical falsehoods.
“The difference between 2009 and now is the ubiquity of social media,” Chaudhry said. “Any lone voice suddenly has the ability to get tens of thousands of followers, or hundreds of thousands, for an outrageous comment.”