Organization seeks to temper the spread of statements that don’t line up with its standards.
The American Board of Emergency Medicine (ABEM) recently had a Zoom seminar to update senior directors, including EPM board members, to provide updates on several important issues. ABEM president Marianne Gausche-Hill shared her thoughts with EPM on ABEM’s statement on medical misinformation.
EPM: ABEM recently released a statement on medical misinformation. What led to that action?
MGH: The umbrella organization for ABEM is the American Board of Medical Specialties (ABMS). The ABMS standards require ABEM to post professionalism expectations for ABEM-certified physicians.
Those expectations were reflected in several of our policies, but never as a cohesive, stand-alone document. The board had been working for a few years to consolidate our professionalism expectations in a Code of Professionalism that we released April 2021.
EPM: Your statement seems to be focused on misinformation related to COVID-19.
MGH: That’s correct. Earlier in the pandemic, we posted a statement on misinformation by physicians, but it was not specific about consequences.
As the pandemic progressed, there were a number of emails we received regarding emergency physicians, identified as board certified, who were promulgating misinformation about COVID-19. These inquiries led to our stronger statement that we issued in August of this year.
EPM: What were some of those factors?
MGH: We posted our Code of Professionalism in April 2021 and realized that some physicians might not fully understand that misinformation might be regarded as unprofessional under ABEM’s standards. At the same time, we have been aware of some outrageous claims by physicians such as the COVID mRNA vaccine alters a person’s DNA.
Recently, a number of physicians and members of the public have contacted ABEM to complain about physicians who claim to be ABEM-certified who are publicly sharing misinformation.
We’ve never before received so many complaints from physicians about other physicians. ABEM-certified physicians did not want emergency physicians spreading misinformation to represent the quality of the certification standard.
For full transparency, we needed to communicate the intention of the board to review these complaints and to potentially take certification actions on those issues that were deemed to break the Code of Professionalism.
EPM: Scientific debate and free speech are two practices that medicine has valued. Are you limiting this?
MGH: Not in the least. Remember that the First Amendment pertains primarily to political speech. In addition, there are numerous limits to free speech rights. For example, you can’t yell “fire” in a crowded theatre or commit a fraud through speech. ABEM encourages active scientific debate.
Our specialty is made better when we wrestle with difficult scientific issues that are informed by data. Such scientific explorations have helped to transform our specialty. ABEM has no interest in becoming a referee in the legitimate resolution of scientific questions. This is about information that threatens public safety and creates patient harm.
EPM: How have emergency physicians responded to the statement?
MGH: ABEM-certified physicians have been overwhelmingly positive. There have been a few physicians who continue to disagree with our statement, largely because they fear that ABEM is trying to insert itself in the physician-patient relationship, which is not true.
What’s been interesting are the number of physicians for other specialties as well as members of the public who have supported our statement.
EPM: Are the other specialties doing anything about misinformation?
MGH: We should recognize that last year ACEP and AAEM made a joint statement on physician misinformation. In addition, ACEP made a statement against the use of ivermectin for treating COVID.
More recently, the Federation of State Medical Boards issued a statement about the possibility of losing one’s medical license due to misinformation. That actually happened to a physician in Oregon. Soon after ABEM issued our statement medical certification boards for Pathology, Pediatrics, Family Medicine, Internal Medicine, and Allergy and Immunology also issued statements. In addition, the ABMS made a statement in opposition to medical misinformation.
EPM: Now that you’ve made the statement, is ABEM doing anything to enforce it?
MGH: Fortunately, ABEM-certified physicians are highly ethical and professional. There have been a small number of physicians whose statements are being reviewed through ABEM’s processes for assessment of misconduct. Any action is reviewed by a panel of clinically active emergency physicians. Moreover, ABEM has detailed due process provisions and an appeals process.
EPM: Is there anything else you want EPM readers to know?
MGH: Throughout the COVID pandemic, emergency physicians have been heroes. They’re tired. We need to responsibly bring COVID under control.
When physicians intentionally provide factually incorrect information that puts the public in harm’s way, our specialty needs to do something. We need to find ways to bring relief to a dedicated group of emergency physicians who are selflessly working tirelessly.
ABEM certification does not give a physician the license to do anything that is unethical. Likewise, ABEM certification does not grant immunity from acting irresponsibly and worsening the lives of patients, the public-at-large and the work conditions of our own colleagues. We need to support those who continue to support our emergency safety net and are going above and beyond in caring for the public.
EPM: Thank you for taking the time to talk about ABEM’s announcement.
MGH: Thank you. It’s been a pleasure.