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California Officials Push to Rein In Medical Disinformation

— Bill under debate may be tough to enforce; some say it restricts innovation

MedpageToday
The Medical Board of California logo over a photo of a man with duct tape over his mouth.

Frustrated that California has so many physicians spreading false or misleading information about COVID-19 vaccines and treatments, state officials are that would give its licensing agencies specific authority to take disciplinary action.

"We are the standard bearers" with a responsibility to rein in licensees who spread COVID misinformation and disinformation, said Eserick "TJ" Watkins, a non-physician member of the Medical Board of California, during the agency's recent meeting on whether to support the bill, AB-2098, which is now winding its way through the state legislature.

As a state that licenses some 155,000 physicians -- more than any other -- the board's actions should "filter out to the rest of the world [to serve] as an example," he added.

Nick Sawyer, MD, an emergency physician at the University of California Davis Medical Center, told the board that disinformation has already harmed too many patients.

"What I want to remind you is that ... there is no evidence that the COVID-19 vaccines have killed more people than COVID," Sawyer said, and they don't "inject nanoparticles into your body that the government is going to use to control you."

"I continue to see it, and it's really harming everybody on the front lines who are taking care of these patients," he said.

To date, the Medical Board of California has taken no actions against several physicians who some allege have met the criteria for spreading false and misleading COVID information, including that the COVID vaccines are more harmful than the virus itself.

This type of misinformation would be defined as unprofessional conduct in the bill, which states that "some of the most dangerous propagators of inaccurate information regarding the COVID-19 vaccines are licensed health care professionals."

Limited Scope

The bill defines misinformation as "false information that is contradicted by contemporary scientific consensus to an extent where its dissemination constitutes gross negligence by the licensee" and disinformation as "misinformation that the licensee deliberately disseminated with malicious intent or an intent to mislead," while "disseminate" is defined as "the conveyance of information from the licensee to a patient under the licensee's care in the form of treatment or advice."

However, the bill apparently does not cover disinformation stated "on the airwaves or in social media" that a person who is not the clinician's patient decides to follow, said Watkins. That provision was edited out of an earlier version of the bill.

Furthermore, the bill states that in deciding a case against a doctor, the board "shall consider whether the licensee departed from the applicable standard of care and whether the misinformation or disinformation resulted in harm to patient health."

If it becomes law, the legislation would further empower the agency to take action against certain physicians, even as at least 14 other states have gone in the opposite direction, considering or passing legislation prohibiting disciplinary actions against doctors who spread misinformation or allowing them to prescribe off-label medications that have failed to show benefit for COVID-19, such as ivermectin.

The Federation of State Medical Boards (FSMB), which last year warned doctors that spreading COVID vaccine misinformation may put their medical licenses in jeopardy, is .

California is the only state to date that is considering an empowerment bill, according to an FSMB spokesman.

The fact that some members of the board believe it does not currently have enough power to act has frustrated many, especially its president, Kristina Lawson, JD, who has been the target of America's Frontline Doctors. The group's members staked out her law firm's parking garage and confronted her last December and recently featured her in a video depicting her as a Nazi.

Simone Gold, MD, who leads America's Frontline Doctors and who pleaded guilty to one of five criminal counts filed against her in connection with her participation in the January 6 insurrection at the U.S. Capitol, is a California licensee.

"The fact of the matter is we have California licensed physicians causing great harm in our communities, and we have to figure out a way to address that," said Lawson, adding that the bill does not go far enough.

These physicians "have intentionally spread false and misleading claims about a wide variety of things, including COVID-19 vaccinations. They're advocating for the use of unproven, dangerous therapies that actually are harming California consumers. And they're stoking fear in communities, not only in California, but across the country," she noted.

Medicine Is Not 'Stable'

However, some board members have expressed concern that what is misinformation today may in time be proven to be a miracle cure, and that doctors with unorthodox theories may eventually be proven correct.

"You've got to remember that medicine is not a stable thing," said Dev GnanaDev, MD, former president of the Medical Board of California. "What is today considered to be experimental or even voodoo becomes the treatment of choice several years down the road. So, this is not as simple as we thought when the bill first came in."

Board member Richard Thorp, MD, an internist, said that he's "been practicing long enough to know that what we thought was good science when we began our practice a number of years ago ... is not good practice now. And, in fact, the whole pharmacy of medicine has changed in the last 40 years, the whole practice of surgery is dramatically changed."

People now revered as pioneers "were looked at as outliers," not conforming with the standard of care, he added. "We've got to be careful that we don't put ourselves in a place where we're so reacting to the current situation that we don't allow for innovation and improvement in medicine."

The California Medical Association, a co-sponsor of the bill, acknowledged that enforcement of such a law will be tricky, noting they will "try to thread that needle, although it will be challenging."

Meanwhile, several patient advocacy groups have objected to the bill. Christina Hildebrand, founder and president of A Voice for Choice, noted that COVID "is evolving and the treatments and vaccines are evolving."

Kristie Sepulveda-Burchit, of the group , pointed out that medically fragile families "need a range of options for care and treatment, and doctors who offer such should not be labeled as purveyors of misinformation," calling the proposed legislation an unconstitutional restriction of free speech.

The bill, which passed out of the State Assembly, must still be reviewed by several committees and the State Senate and may undergo amendments. It faces strong opposition from anti-vaccination coalitions and isn't expected to be finalized until August.

Also, at the annual House of Delegates meeting of the American Medical Association in Chicago earlier this week, members approved a 21-page report on how clinicians can address and prevent disinformation disseminated by health professionals.

The report specifically calls for efforts to "ensure licensing boards have the authority to take disciplinary action against health professionals for spreading health-related disinformation" and says that "all speech in which a health professional is utilizing their credentials is professional conduct and can be scrutinized by their licensing entity."

  • author['full_name']

    Cheryl Clark has been a medical & science journalist for more than three decades.