Ensuring public trust in medicine within our communities

The early stages of the COVID-19 pandemic were frightening to all, as the disease was unknown in its nature and impact. Each day new information was being shared across the world based on data that were arriving in bits and pieces in the news and in the scientific literature. It was challenging to fully appreciate the dynamic nature of the information as well as the ever-changing landscape of scientific discourse. As the pandemic progressed it became clear that some physicians were using their authoritative power and general respect within public spheres to communicate information that ultimately could result in harm to the public. Physicians began to cross professional lines by promoting and selling unproven COVID-19 therapies for personal profit. Certification organizations and state licensing boards began to take notice, and it was at this point that my story begins with the American Board of Emergency Medicine (ABEM). 

The ABEM board had already created a professionalism statement (April 2021) in response to the American Board of Medical Specialties’ Vision Commission recommendations, including the statement that “physicians should refrain from conduct that the Board determines, in its sole judgement, to be sufficiently egregious that it is inconsistent with ethical behavior by a physician.” This would include dissemination of blatantly false information that may lead to undue harm to patients. We realized that some physicians might not fully understand that misinformation might be regarded as unprofessional under ABEM’s standards.

At the same time, we were made aware of some outrageous claims by physicians that the COVID-19 mRNA vaccine altered a person’s DNA. Soon physicians and members of the public contacted ABEM to complain about physicians who claimed to be ABEM-certified who were publicly sharing misinformation. ABEM had never received so many complaints from physicians about other physicians. ABEM-certified physicians did not want misinformation-spreading emergency physicians to undermine the quality of the certification standard.

For full transparency, we needed to communicate the Board’s intention to review these complaints and to potentially take certification actions on those issues that were deemed to break the Code of Professionalism. It became clear that ABEM as a certifying body had a duty to act to ensure public trust and protect the value of certification by stating that “physicians who make public statements that are directly contrary to prevailing medical evidence can constitute unprofessional conduct, which may be subject to review by ABEM.” It was also important that the Board addressed this independently of other licensing bodies, and that it established a process that allowed for due process for physicians reported to the board with such behavior. 

There are a number of medical issues for which physicians will have legitimate differences of opinion. The allowance of open discourse in these situations is recognized as critical to further scientific and medical progress, which in fact will ultimately be adjudicated through well-founded principles of investigative research. It became clear, that we, as physicians, must evaluate ourselves and our own professional behavior, and to act to protect our respect for human life, and to ensure public trust in medicine within our communities. It is for these reasons that, as leaders within the house of medicine, we acted to uphold our commitment to the public and to not wait for others to respond. 

Dr. Gausche-Hill is the Medical Director for Los Angeles County Emergency Medical Services (EMS) Agency, Professor of Clinical Emergency Medicine and Pediatrics at the David Geffen School of Medicine at UCLA and serves as Clinical Faculty at Harbor-UCLA Medical Center in Torrance, CA. She is nationally and internationally known for her work as an EMS researcher and educator, and for her leadership in the field of EMS and pediatric emergency medicine. She is best known for her study of pre-hospital airway management for children published in JAMA 2000 and her work on the National Pediatric Readiness Project published in JAMA- Pediatrics in 2015. She has won numerous national awards for her leadership in emergency medicine, pediatric emergency medicine and EMS. Dr. Gausche-Hill currently serves as a senior editor for the textbook, Rosen’s Emergency Medicine: Concepts and Clinical Practice, and is the Immediate Past President of the American Board of Emergency Medicine Board of Director.