Medical boards rarely take disciplinary action against physicians for spreading misinformation despite several concerns raised about doctors spreading false medical claims during the Covid-19 pandemic.
This is according to research by Richard S Saver, Arch T Allen Distinguished Professor of Law at the University of North Carolina School of Law, and Professor in the Department of Social Medicine at the UNC School of Medicine.
Through analysis of more than 3 100 medical board disciplinary proceedings across the US’ five most populous states, Saver found that spreading misinformation to the public was the least common reason for physician discipline, accounting for just 0.1% of all disciplinary offences.
Even when physicians spread misinformation directly to patients, it resulted in discipline in only 0.3% of cases – exponentially lower than more common reasons like practitioner negligence at 28.7%, reports MedicalXpress.
“There’s a striking disconnect between medical boards’ statements about the dangers of physician misinformation, as well as increasing public attention to the problem, and the actual enforcement actions,” said Saver.
“Even within the small number of actions involving misinformation, the data show that boards are far more comfortable disciplining physicians for misconduct involving direct patient care than addressing erroneous public statements. Yet false public communications may cause wider harm.”
The research, published in JAMA Network, which examined disciplinary actions from January 2020 to May 2023, revealed that medical boards face significant challenges in policing physician misinformation, particularly communications made to the general public rather than to individual patients.
This raises important questions about whether the current medical board system is equipped to address the modern challenge of medical misinformation.
“Medical boards traditionally focus on monitoring physician-patient relationships,” Saver said. “But in today’s digital age, when a single physician spreading misinformation can influence thousands of people, our regulatory framework may need to evolve.”
Study details
Medical Board Discipline of Physicians for Spreading Medical Misinformation
Richard S. Saver, JD.
Published in JAMA Network on 12 November 2024
Abstract
Importance
False medical information disseminated dangerously during the Covid-19 pandemic, with certain physicians playing a surprisingly prominent role. Medical boards engendered widespread criticism for not imposing forceful sanctions, but considerable uncertainty remains about how the professional licensure system regulates physician-spread misinformation.
Objective
To compare the level of professional discipline of physicians for spreading medical misinformation relative to discipline for other offences.
Design, Setting, and Participants
This cross-sectional study analysed and coded publicly reported medical board disciplinary actions in the five most populous US states. The analysis included data from January 1, 2020, to May 30, 2023, for California, Florida, New York, and Pennsylvania and from January 1, 2020, to March 30, 2022, for Texas.
Main Outcomes and Measures
Medical board disciplinary proceedings that resulted in some form of sanction were analysed. Codes were assigned for the different types of offences relied on by medical boards for imposing physician discipline.
Results
Among 3 128 medical board disciplinary proceedings in the five most populous states, spreading misinformation to the community was the least common reason for medical board discipline of physicians (6 [0.1%] of all identified offences). Two reasons tied for third least common: patient-directed misinformation (21 [0.3%]) and inappropriate advertising or patient solicitation (21 [0.3%]). The frequency of misinformation conduct was exponentially lower than more common reasons for discipline, such as physician negligence (1911 [28.7%]), problematic record-keeping (990 [14.9%]), and inappropriate prescribing (901 [13.5%]). Patient-directed misinformation provided a basis for discipline three times as often as spreading misinformation to the community. The frequency of disciplinary actions for any reasons related to Covid-19 care, even if not about misinformation, was also quite low (10 [0.2%]). Sanctions in misinformation actions tended to be relatively light.
Conclusions and Relevance
The frequency of discipline for physician-spread misinformation observed in this cross-sectional study was quite low despite increased salience and medical board warnings since the start of the Covid-19 pandemic about the dangers of physicians spreading falsehoods. These findings suggest that there is a serious disconnect between regulatory guidance and enforcement and that medical boards relied on spreading misinformation to patients as a reason for discipline three times more frequently than disseminating falsehoods to the public. These results shed light on important policy concerns about professional licensure, including why, under current patient-centred frameworks, this form of regulation may be particularly ill-suited to address medical misinformation.
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