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Column: A warning to doctors — spreading COVID misinformation could cost you your license

Doctors
Doctors are the front line of defense against COVID, but some are also spreading misinformation. Are state regulators capable of reining in the wrongdoers?
(Zolnierek/Getty Images/iStockphoto)
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On the list of things that doctors shouldn’t need to be told, one would expect that promoting bogus COVID-19 remedies would rank pretty high. The top of the list, in fact.

But no. The problem has become so acute that the Federation of State Medical Boards recently felt compelled to issue a stark warning to medical professionals:

“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.”

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It’s one thing when a celebrity or an elected public official says something, but when a licensed physician says it, that amplifies the message and gives it some credibility.

— Humayun J. Chaudhry, Federation of State Medical Boards

The federation, which has been around since 1912 and represents 70 medical and osteopathic boards in every state and U.S. territory, also felt it had to spell out its rationale.

“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.”

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The federation mentioned doctors’ responsibility to share information that is “factual, scientifically grounded and consensus-driven,” and added: “Spreading inaccurate COVID-19 vaccine information contradicts that responsibility, threatens to further erode public trust in the medical profession and puts all patients at risk.”

That America’s medical regulators had to put this warning in black and white tells you that things are getting bad. That was already becoming clear, however. Misinformation and flat-out lies about the pandemic have been washing over us like a tsunami, thanks to the work of cynical politicians, uninformed celebrities and ignorant and irresponsible social-media “influencers.”

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What’s most distressing is how some of the purveyors of anti-vaccine claptrap and hokum about supposed COVID treatments and cures have the initials M.D. after their names.

“It’s one thing when a celebrity or an elected public official says something, but when a licensed physician says it, that amplifies the message and gives it some credibility,” Humayun J. Chaudhry, the federation’s CEO, told me. “Across the country, at a time when we don’t need this, we’re seeing a handful of physicians engaging in that sort of activity.”

Even if it’s only a “handful” of America’s approximately 1 million doctors, Chaudhry says the spread of misinformation by doctors has become so alarming that the federation board asked its ethics and professionalism committee to draft a statement to be presented at the board’s annual meeting in Denver at the end of July. The full board approved the statement unanimously.

President Trump’s hype of a potential treatment for COVID-19 gives false hope to virus patients and causes real harm to others.

“Science does change, we recognize that,” Chaudhry says. “But it’s incumbent upon physicians to keep up with what’s permissible, what’s approved, what’s authorized and what’s not.”

When it comes to vaccines, he says, “We’ve seen the gamut of everything from whether the vaccines contain a microchip or whether they’re connected to 5G communications networks or even whether they work or not. Our statement points out to physicians that if you’re going to make statements that are not grounded in science or consensus-based, you are taking a risk with your license to practice medicine.”

Doctors using their authority to give misinformation a veneer of respectability isn’t a new phenomenon. The hydroxychloroquine craze last year, in which an antimalarial drug was touted as a “cure” for COVID-19, was touched off by claims made by a French physician with an elite following. Before the drug was proved to be useless for the purpose, the theme was picked up by President Trump and Mehmet Oz, a doctor with a huge broadcast following.

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Some doctors have purveyed misinformation on Fox News and other right-wing broadcast outlets. Pierre Kory, a Wisconsin doctor assiduously promoting the anti-parasitic medicine Ivermectin as a COVID treatment despite the absence of valid scientific evidence for the claim, was even invited to testify to a Senate subcommittee.

Some have allegedly inflated or misrepresented professional credentials or achievements, which enhances their authoritativeness.

Take Texas doctor Peter McCullough, who has questioned the safety of COVID-19 vaccines and advised pregnant women and recovered COVID patients against taking them — advice that runs counter to that of the medical establishment.

Since Feb. 24, according to a legal filing, McCullough has conducted “dozens, if not hundreds, of interviews in print and video,” during some of which he is identified as a staff official at Baylor Medical Center or its affiliated institutions, such as “vice chief of internal medicine” at Baylor.

As with chloroquine, there’s no reliable evidence that ivermectin works against COVID-19. You can’t censor what doesn’t exist.

That’s a key date, according to a lawsuit filed against McCullough by Baylor affiliates, because it’s the date on which McCullough reached an agreement with Baylor not to use his previous Baylor titles or “hold himself out as affiliated” with Baylor or its related institutions. The July 28 lawsuit seeks to force McCullough to stop using his former relationship.

A McCullough lawyer told the Dallas Morning News that every misidentification cited in the lawsuit is “something said/printed by a third party with no encouragement from Dr. McCullough.” The lawyer told MedPage Today that the lawsuit was “a politically motivated attempt to silence Dr. McCullough as he saves countless patient lives from COVID-19.”

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A few state medical boards have taken action against doctors spreading COVID or vaccine misinformation, but enforcement appears to have been spotty.

In part that’s because in virtually every state and territory, investigations of doctors remain confidential at least until a formal accusation or stipulated resolution is filed. That moment can come years after the alleged wrongdoing, during which the doctor can continue practicing without informing patients of an ongoing inquiry.

Medical boards are typically underfinanced and understaffed, and often underambitious. They often sit on their hands until they receive a complaint, whether from a patient or a medical colleague, instead of opening investigations on their own initiative.

It also can be hard to expose doctors communicating misinformation, because that can happen privately in clinical encounters between doctors and patients, rather than through public statements.

State medical boards are typically most aggressive in disciplining doctors for offenses that fall into certain clear-cut categories, such as practicing while under the influence of drugs or alcohol, sexual improprieties with patients, or felony convictions. They’re shyer about making judgments about medical practice.

“When it comes to making judgment calls about doctors practicing outside of the standard of care, they’re a lot more reluctant to do so,” observes the veteran pseudoscience debunker David Gorski, a Detroit-area surgical oncologist.

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Thus far, there appear to have been only two disciplinary actions taken against doctors strictly for misinformation or disinformation related to the pandemic.

Ivermectin, touted as a treatment of COVID by the anti-vaccine crowd, has “no effect,” according to a major study.

Last December, the Oregon Medical Board issued an emergency suspension of the license of Steven LaTulippe after finding that he was seeing patients without wearing a mask, allowing his staff to interact with patients unmasked, and encouraging patients to doff their masks. Oregon law requires masks to be worn by healthcare workers in clinical settings.

LaTulippe’s “continued practice constitutes an immediate danger to the public,” the board ruled. LaTulippe stated in a letter to the medical board that “not only is the mask completely worthless, but it also is very dangerous” — a position that contradicts the medical consensus. He also spread anti-mask claims in public, including at a pro-Trump rally in November. “Take off the mask of shame,” he urged attendees.

According to the medical board, LaTulippe claims that “the body’s natural immune system is a more effective defense against COVID-19 than a mask.” He told the board at a hearing that the Centers for Disease Control and Prevention and the Oregon Health Authority favor masking because they have “an alternative agenda” that is “comprised primarily of money and power and politics and control of the population.”

The board’s order means that LaTulippe will be barred from practicing medicine in Oregon at least until its governor ends the ongoing state of emergency.

In January, a San Francisco doctor who had garnered notoriety for claiming that the pandemic was caused by the spread of 5G telecommunications technology voluntarily surrendered his license to the California Medical Board. Thomas Cowan, whose assertion was widely and conclusively debunked, already had said on his website that he would “re-emerge as an unlicensed ‘health coach’ or consultant.”

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Cowan had been placed on five-year probation in 2017 for prescribing an unapproved drug for a breast cancer patient, and without conducting a physical examination of the patient or examining records of her prior treatment.

Scientists are using the coronavirus to study the contagion of misinformation

When I asked the Medical Board of California if it was keeping its eye on whether California doctors were spreading misinformation, its spokesman, Carlos Villatoro, told me by email that “the Board will review complaints it receives about its licensees on this topic, as it does with all complaints. To date, no accusation has been filed against a licensee regarding this issue.”

He did say, however, that “publicly spreading false COVID-19 information may be considered unprofessional conduct and could be grounds for disciplinary action.”

In its most notable pre-pandemic action against a doctor for anti-vaccine practices, the California board in April 2020 sanctioned “Dr. Bob” Sears, an Orange County pediatrician who has spread anti-vaccine advice at his practice and through books, for “repeated negligent acts” — issuing medical exemptions from vaccines for four children “without an appropriate medical basis.”

But the board merely extended an earlier 35-month probation imposed on Sears for an earlier issuance of an unwarranted vaccine exemption. During this period he isn’t prevented from continuing to counsel patients.

Some medical boards apparently prefer to take a hands-off approach even to flagrant misrepresentations about the pandemic. After Stella Immanuel, a Houston physician, appeared at a Washington rally in July 2020 touting hydroxychloroquine as a “cure” for COVID-19, despite the lack of any scientific evidence for its efficacy, the Texas Medical Board issued a statement warning against the claim but not mentioning Immanuel by name.

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“In the past week there was a widely published claim of a ‘cure’ for COVID-19,” the board said in its July 28 advisory. “While there are drugs and therapies being used to treat COVID-19, there is no definitive cure at this time.”

Immanuel also claims that gynecological problems such as endometriosis and infertility are caused by “evil deposits from the spirit husband.” The video featuring Immanuel’s Washington appearance was retweeted by Trump, who called her “very impressive.” As of this writing, Immanuel remains a licensee in good standing with the Texas Medical Board.

Despite this unprepossessing record of vigilance, the federation’s statement drew fire from anti-vaccination groups. “The Federation of State Medical Boards Channels the Soviet NKVD,” wrote Tamzin Rosenwasser, an officer of the Assn. of American Physicians and Surgeons, a hive of anti-vaccination activism. Rosenwasser was equating the federation to the Stalin-era precursor to the KGB.

“Is there now a consensus among all 50 States that physicians are to be muzzled, silenced, and have their lives destroyed in case they do not agree with the new NKVD?” Rosenwasser wrote.

Unfortunately, given the torrent of deceit about the pandemic and the surfeit of information sources willing to funnel it into the public sphere, there’s reason to doubt that medical boards will be up to the task of regulating rogue physicians who bank on people’s inability to distinguish bunk from science-based medical consensus.

That’s especially true if medical boards don’t take the most aggressive tack possible to shut charlatans down. That means putting teeth on the threat of license revocation. Medical misbehavior is often life-threatening, but seldom has the threat been as dire as it is now.

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“What we’re saying is almost a truism,” Chaudhry says. “Every physician should know that what they say matters.”

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