The Danger and Hypocrisy of Physician Censorship

In late July 2021, the Federation of State Medical Boards (FSMB), a non-profit self-selected lobbying organization for US state medical boards, issued a press release threatening suspension or revocation of medical licenses for physicians that “generate and spread COVID-19 vaccine misinformation or disinformation.” The American Board of Internal Medicine, American Board of Pediatrics, and American Board of Family Medicine issued a joint press release in support of the FSMB’s statement and further threatened to revoke a physician’s specialty certification on similar grounds.

While likely well-intentioned and politically favorable on its surface, this policy risks compromising physicians’ due process, free speech, and patient care. Physicians serve on a multitude of research data safety monitoring boards and for the Food and Drug Administration, among others. Is leveling a cudgel against US physicians to control speech really in the best interest of promoting thoughtful scientific discourse? It is chilling to think that any private business can control what medical information constitutes “misinformation.”

Misinformation is common in the midst of any pandemic, especially when so much remains unknown about the coronavirus, its origin and variants, their spread, and potential therapies proposed to combat the disease and its comorbidities. While false information has been spread on social media channels by a tiny handful of physicians, the vast majority of working US physicians support the appropriate use of COVID-19 vaccines.  Giving strong, scientifically credible rebuttals to vaccine skeptics is much more likely to quiet skepticism of the vaccines than idle threats from afar by little known non-profit organizations with little real power to control speech.  

Working physicians are familiar with political propaganda, another form of “misinformation” that has become all too commonplace in US healthcare that is increasingly dependent of government funding. The FSMB is a self-interested private business that is not actively supervised by the state(s) and has a long history of attempting to link Maintenance of Licensure for physicians to the lucrative Maintenance of Certification physician educational product promoted by the member boards of the American Board of Medical Specialties, including the American Board of Internal Medicine, American Board of Pediatrics, and American Board of Family Medicine. In 2018 the FSMB also supported legislation that tried to circumvent the 2015 Supreme Court decision that held unsupervised professional boards could not make decisions that potentially violated antitrust laws and quashed competition.

The American Board of Internal Medicine (ABIM) also engaged in "misinformation" by secretly funneling $80 million of physician test fees from 1989-1999 to create the ABIM Foundation that  magically appeared to the public in 1999. Physician were told the Foundation was created to define “medical professionalism,” the same year the ABIM Foundation purchased a $2.3 million 2-bedroom condominium complete with a chauffeur-driven town car. Physicians can only assume that same “medical professionalism” the ABIM promotes extends to their undisclosed offshoring of over $6.5 million dollars to the Cayman Islands in 2015 and labeling their lobbyists in Washington as “consultants” on their tax forms, too. 

The profession of medicine and scientific inquiry are never perfect but demand constant vigilance to ensure its integrity. Just as any medical treatment demands careful weighing of its risk and benefits to our patients, the self-interested private entities that comprise the US medical regulatory system should carefully weigh the adverse effects of their edicts before they are unilaterally imposed on practicing US physicians.

Caveat emptor. Primum non nocere.

-Wes