ABEM and COVID-19 Misinformation

4 Comments

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?


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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.


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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.


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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.

 

 

ABOUT THE AUTHOR

Marianne Gausche-Hill, MD, FACEP, FAAP, FAEMS is the president of the American Board of Emergency Medicine Board of Directors. Other roles include serving as the medical director of the Los Angeles County EMS Agency; a professor of Clinical Emergency Medicine and Pediatrics at the David Geffen School of Medicine at UCLA and a member of the clinical faculty for Harbor-UCLA Medical Center, Departments of Emergency Medicine and Pediatrics.

4 Comments

  1. Ethical Standards. Misinformation. Responsible speech. Yadda yadda yadda. At the end of the day that’s has been little to no substantiative dialogue to find common ground between widening gaps. It seems there are only more administrative cudgels being used to threaten anyone who dares to question the dogma. We don’t even know what misinformation is or isn’t…only that if you express concerns over an mRNA therapy rolled out in under a year with no long term data to support efficacy and a VAERs resume of neuro and cardio effects… you, the concerned provider are the problem. And yet despite a lot of very bright Docs voicing concerns the reality is that there is still only the label of “misinformation” applied to avoid an actual discussion.

  2. Joseph Soler MD on

    Recent medical history shows that we almost destroyed an Australian physician who stated that bacteria could cause GI ulcerations., e.g. H. Pylori. It was philosopher Santayana who said: “Those who don’t remember the past are condemned to repeat it.”

    The ABEM Policy Update is hugely overly broad, and it contains unforeseen ramifications that could be used in the future against any physician. It is a knee jerk reaction, and could have been avoided by a simple statement from ABEM that such opinion does not conform to current medical knowledge. Opinions can become facts and vice versa. Time will tell which is which.

  3. Bradley R. Caloia D.O. on

    History is replete with poor decisions couched in good intentions. This is an egregious example of badly considered action. It is sadly politically motivated and based in a the sad state of general and civic education of the people now running our institutions. This is no exception. I’d like to point out that you can, in fact, call out fire in a theater. This particular quote from Oliver Holmes reflects an idea that was never binding law, represents one of the most shameful decisions in supreme court history and was overturned more than 40 years ago. The speaker above likely heard it uttered by further clueless political actors and believed it sounded good. I expect more from those people who are supposedly the learned leaders of our profession. This is simply mindless repetition of a bad idea used to defend a mindless and unnecessary policy of speech suppression. While it is obvious that mRNA changing DNA is a crazy idea, this policy will be used, and probably is already being used to punish and prevent much less controversial advice. It is being used to pressure physicians into ideological conformity. Questioning established medical practice, both long established and newly minted, is critical to our advancement as a specialty and to the physician-patient relationship. ABEM should continue to make policy and clinical recommendations, not threaten anyone who disagrees with the progressively tightening noose of thought police. Threatening individuals for nonconformity REEKS of authoritarian thinking.

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