A comprehensive analysis of medical board disciplinary actions revealed that less than 1% of sanctions involved physician-spread misinformation, despite increased attention during the COVID-19 pandemic.
In the cross-sectional study, published in JAMA Network Open, investigators examined 3,128 disciplinary proceedings, identifying 6,655 offenses across the five most populous U.S. states.
The study covered actions from January 2020 through May 2023 in California, Florida, New York, and Pennsylvania, and through March 2022 in Texas as a result of data availability. Research assistants with legal training coded proceedings using 11 primary categories plus additional codes for misinformation and COVID-19 pandemic conduct.
Among all disciplinary actions analyzed, spreading misinformation to the public was the least common reason for sanctions (6 cases, 0.1%), whereas patient-directed misinformation tied for third-least common (21 cases, 0.3%). By comparison, practitioner negligence led disciplinary actions (1,911 cases, 28.7%), followed by problematic record-keeping (990 cases, 14.9%) and inappropriate prescribing (901 cases, 13.5%).
State-specific variations emerged in the data. New York reported no physicians disciplined for any misinformation offenses, whereas Florida and Pennsylvania recorded no cases involving misinformation to the public. All five states consistently ranked negligence and inappropriate prescribing among their top four reasons for discipline.
Additional findings included:
- Criminal activity: 599 cases (9.0%)
- Alcohol/substance abuse: 320 cases (4.8%)
- Inappropriate relations with patients: 198 cases (3.0%)
- Physical/mental impairment: 174 cases
- Patient confidentiality violations: 29 cases
- Continuing medical education issues: 28 cases
- Fraud unrelated to misinformation: 345 cases.
The data showed that disciplinary measures for misinformation cases typically involved public letters of reprimand or probationary license status. No license revocations occurred specifically for misinformation-related cases, though one California physician voluntarily surrendered their license during an investigation.
COVID-19–related conduct, excluding misinformation, represented just 0.2% of all disciplinary offenses (10 cases). Patient-directed misinformation resulted in discipline three times more frequently compared with public dissemination of falsehoods.
For context, the Federation of State Medical Boards had reported in December 2021 that 21% of member boards took adverse action against physicians for spreading misinformation. The organization also noted that two-thirds of medical boards reported increased complaints about COVID-19 misinformation during that period.
The study methodology relied on publicly available disciplinary records, as confidential complaints and informal board actions remained inaccessible. Multiple offense codes could be assigned to single cases when boards cited various reasons for discipline.
The analysis represented the first comprehensive examination comparing misinformation-related discipline to other forms of medical board sanctions during the COVID-19 pandemic across major U.S. jurisdictions.
The authors declared that they have no competing interests.
