Doctors, Politicians Battle Over COVID Disinformation, Standard of Care

USA

A growing number of state medical boards have been pushing back against the minority of healthcare professionals spreading dangerous COVID-19 disinformation and prescribing unproven coronavirus treatments. They are increasingly meeting resistance from conservative lawmakers.

“Physicians who generate and spread COVID-19 vaccine misinformation or disinformation are risking disciplinary action by state medical boards, including the suspension or revocation of their medical license,” reads a July 2021 statement from the Federation of State Medical Boards (FSMB). The statement was in response to the increase in healthcare professionals disseminating COVID-19 vaccine misinformation on social media platforms, online and in the media. “Due to their specialized knowledge and training, licensed physicians possess a high degree of public trust and therefore have a powerful platform in society, whether they recognize it or not. They also have an ethical and professional responsibility to practice medicine in the best interests of their patients and must share information that is factual, scientifically grounded and consensus-driven for the betterment of public health.”

According to a 2021 survey of FSMB members, the organization determined that two-thirds (67%) of its 71 member boards experienced an increase in complaints related to licensees disseminating false or misleading information; 26% made or published statements about the dissemination of false or misleading information; and 12 of its member boards (21%) took disciplinary action against a licensee for disseminating false or misleading information last year.

“The staggering number of state medical boards that have seen an increase in COVID-19 disinformation complaints is a sign of how widespread the issue has become,” said Humayun J. Chaudhry, DO, MACP, FSMB president and chief executive officer. “We are encouraged by the number of boards that have already taken action to combat COVID-19 disinformation by disciplining physicians who engage in that behavior and by reminding all physicians that their words and actions matter, and they should think twice before spreading disinformation that may harm patients.”

According to the FSMB, at least 15 state medical boards have adopted similar edicts. Further, more than a dozen boards have posted statements on their websites warning that physicians who spread disinformation are subject to disciplinary action.

The Political Blowback

The Tennessee Board of Medical Examiners, which is responsible for licensing and disciplining doctors throughout the state, unanimously adopted the FSMB policy on COVID-19 disinformation last year, publishing the warning on its website. In response, the board received letters from the co-chair of the Tennessee Joint Government Operations Committee threatening to dissolve the state agency if the statement wasn’t removed from its website. The Tennessee General Assembly followed suit, passing a legislative package that bars licensing boards from disciplining doctors who spread misinformation or dispense unproven medications for the treatment of COVID-19.

According to the FSMB, at least 13 other states are considering legislation aimed at limiting state medical boards’ authority to act in the furtherance of public health and patient safety. If enacted, those laws would make it more difficult for licensing boards to discipline a healthcare professional for spreading disinformation or to evaluate the standard of care and assess risk for patient harm.

Framing its proposed legislation as a First Amendment issue, Florida’s Free Speech of Health Care Practitioners bill would prohibit certain regulatory boards and the Department of Health from reprimanding or sanctioning a healthcare practitioner, and from revoking or threatening to revoke a practitioner’s license, certificate or registration for exercising their right of free speech — including, but not limited to, their use of social media — without proof beyond a reasonable doubt. If the board acts on a complaint for which it can’t be proven beyond a reasonable doubt that the healthcare professional’s speech led to the “direct physical harm of a person with whom the healthcare practitioner had a practitioner-patient relationship within the 3 years immediately preceding the incident of physical harm,” it could be liable for up to $1.5 million per occurrence for any direct or indirect damages to a healthcare practitioner.

In Michigan, state Rep. Mary Whiteford introduced a bill last month that would let doctors use unapproved medications — like ivermectin or hydroxychloroquine — to treat COVID-19 without fear of liability. The bill protects healthcare providers from the licensing sanctions or loss of Medicare certification that could ensue when a physician recommends a drug treatment not recognized by the U.S. Food & Drug Administration. It also absolves the provider of civil liability despite the treatment being considered outside the standard of care. If the bill passes, patients with advanced illness would be required to sign a consent form acknowledging that the treatment could worsen their condition and that their insurance policy might not cover the cost of using an unapproved medication. Also, their eligibility for hospice care could be withdrawn. The Michigan Department of Health & Human Services has warned against ivermectin use, and the Michigan Poison & Drug Information Center issued an advisory as well. The drug’s manufacturer, Merck, cautioned against its use for treating COVID, saying last year that existing studies lacked meaningful evidence and safety data.

Wisconsin legislators are considering three bills that would prevent health systems and medical credentialing boards from disciplining doctors who order — or advocate for — therapies or medicines that go against medical opinions held by their employers or regulators. The bills would also force pharmacists to fill all physician-ordered prescriptions, except under limited circumstances. Advocates of the legislation say it will restore the physician-patient relationship that medical bureaucracies eroded during the pandemic, whether it pertains to the treatment of COVID-19 or other diseases.

“As the state’s largest physician organization, we very carefully listen to our members to make sure there’s no undue interference with a physician providing appropriate care for their patients,” said Jerry Halverson, MD, chairperson for the Wisconsin Medical Society, in a statement. “There is an ever‐evolving body of accepted COVID‐19 science helping physicians treat and counsel their patients, and we have not heard concerns about regulatory boards, healthcare entities or pharmacies stifling these appropriate physician‐patient interactions. Therefore, we believe these bills are not necessary. Further, the bills appear to undermine some basic safeguards now in place that help prevent care that might fall below minimal accepted standards. So rather than potentially harming our state’s high-quality healthcare system, we ask our government policymakers to help physicians and their healthcare teams encourage vaccinations, promote smart behaviors and help us emerge from this pandemic as soon as possible.”

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