A bill (AB 2098) was recently passed in California to reduce the sharing of COVID-19 misinformation by physicians. However, ironically, it is in the midst of a misinformation campaign about what it is actually about. Certain pundits have recently claimed that the bill makes it illegal for physicians to disagree with the politicians who created it (regarding COVID-19). They have also claimed that first amendment rights are being infringed upon and that censorship is occurring in California because of the bill. During a particular broadcast, a physician said “The word misinformation… is against science. Science is not about consensus. It is about challenging. It is about saying existing dogma doesn’t work.” There is a misconception that the government is deciding on what is the correct medical information as opposed to the medical community.

Physicians, Not Politicians

The Medical Board of California is responsible for upholding the standards of professional conduct for physicians, under which this bill is framed. Cases of misconduct are reviewed by specially trained physicians who currently practice clinical medicine and are board-certified themselves. Physicians, not politicians, are charged with reviewing the cases and determining the degree of departure from the standard of medical care.

Bill AB 2098 states:

  • “This bill would designate the dissemination of misinformation or disinformation related to the SARS-CoV-2 coronavirus, or ‘COVID-19,’ as unprofessional conduct.”
  • “It shall constitute unprofessional conduct for a physician and surgeon to disseminate misinformation or disinformation related to COVID-19, including false or misleading information regarding the nature and risks of the virus, its prevention and treatment; and the development, safety, and effectiveness of COVID-19 vaccines.”
  • “‘Disinformation’ means misinformation that the licensee deliberately disseminated with malicious intent or an intent to mislead.”
  • “‘Misinformation’ means false information that is contradicted by contemporary scientific consensus contrary to the standard of care.”

 

The Infodemic

Many of us are far-too-aware that during the COVID-19 pandemic, there has been a parallel “infodemic” that has plagued the successful implementation of public health measures, eroded public confidence in vaccination programs, promoted invalidated treatment modalities, and sometimes denied the very existence of the pandemic. This has subsequently resulted in unnecessary morbidity and mortality during the pandemic caused by COVID-19.

So, when someone argues that trying to stem the flow of misinformation in healthcare is somehow unscientific, censorship, against the spirit of physicians’ ability to challenge science or independently practice medicine, and promotes dogma, I have to question their understanding of science. Misinformation is false information. And AB 2098 identifies it as contradictory to “contemporary scientific consensus contrary to the standard of care.”

It should be news to nobody in the field that, in medicine, we operate under standards of care that are outlined by scientific evidence: evidence-based practice. If there is not enough evidence to advocate for one health measure or another, expert opinion and consensus are relied upon, until scientific studies are performed to support one position or another. We use the best evidence that we have at the time. The constant in science is that it is always changing.  What we know today may change tomorrow. Science was not deliberately false at the time, we just learned more. With learning more, standards of care change. We all know this.

I don’t find extreme deviations from standards of care or lone voices promoting non-scientific measures against the scientific consensus particularly heroic. Sure, there were giants in scientific history who proved everyone wrong. But, during a pandemic, when health experts are doing their best to predict viral behavior and curtail viral spread and scientific research is being performed in an attempt to save lives in a compressed period of time, we have to use the evidence that we have at the moment. As evidence builds to support one healthcare precept or an opposing one over time, the medical community pivots. We in the medical community understand this, and we’re all familiar with every medical society meeting regularly to discuss changes in guidelines and approaches to every medical issue that you can think of. Why would COVID-19 treatment, prevention, diagnosis, and overall management be any different?

No Threat

I do not feel threatened by AB 2098. I do not feel that it limits the autonomy of a physician to practice adequately, concerning the diagnosis, management, and prevention of COVID-19. It really focuses on extreme deviation from scientific standards of care and consensus that are supported by the existing science and experts. Misinformation and disinformation are destructive. They are destructive to scientific progress, destructive to individuals’ survival and wellness, and destructive to public health. I don’t see AB 2098 as politicians or the government trying to control the medical community. I see AB 2098 as supporting us physicians who are trying to maintain the integrity of medical practice and prevent the further propagation of the COVID-19 pandemic.