new ones might emerge . One of them , a Dr . Jeff Barke , believes that ivermectin and hydroxychloroquine have helped his COVID-19 patients despite studies suggesting otherwise . 2
The American Medical Association however adopted a policy this June 3 that specifically addresses medical disinformation and the monetization of such disinformation over social media platforms . This policy “ affirms that all speech in which a health professional is utilizing their credentials is professional conduct and can be scrutinized by their licensing entity .” The policy encourages state licensing boards to take disciplinary action against those who post disinformation . They encourage specialty boards to use board certification credentials as a disciplinary tool as well .
The First Amendment literature and case law is vast . Determining what is protected speech and what is not has been an ongoing struggle since 1791 . The key issue to me is what constitutes “ unprofessional conduct ,” something that should fall under the purview of specialty associations and state medical boards . KRS 311.597 specifically notes as unprofessional : “ Issues , publishes , or makes oral or written representations in which grossly improbable or extravagant statements are made which have a tendency to deceive or defraud the public , or a member thereof , including but not limited to : ( a ) Any representation in which the licensee claims that he can cure or treat diseases , ailments , or infirmities by any method , procedure , treatment , or medicine which the licensee knows or has reason to know has little or no therapeutic value .” 4
Creating false confidence by prescribing highly doubtful to outright unproven treatments is essentially lying to your patient . This is not the same as acknowledging the placebo effect , to which both doctor and patient are susceptible .
Nasal saline helps relieve symptoms but is not curative for a bad cold , just as nasal steroids help allergies but do not remove them . Suggesting helpful but safe remedies for ailments that the body and spirit must cure on their own is good medicine . The relief of suffering is laudable if explained with the open admission that only time and Providence offer healing .
Profiting from the prescription of ineffective treatments with potentially significant side effects is very bad medicine . The doctor betrays the faith placed in her or him , and in our profession . Continuing to fly in the face of medical research by convincing vulnerable people to take useless treatments violates Kentucky ’ s statute - and California ’ s - and should be dealt with accordingly , under the auspices of our Board of Medicine .
The First Amendment does not protect child pornography , obscenity and “ true threats .” Rendering dubious care does not fall under those categories , but the Board of Medicine does have statutory protection in Kentucky to discipline those who prescribe what they know to have little therapeutic value .
I have a feeling the California law will not pass its First Amendment test and must undergo eventual revision . If so , what might happen to our statute ?
It all comes down to honesty : dishonesty is poison to any relationship , but particularly to your own evaluation of your soul . We have earned the right to care for other souls ; and only clarity and truth can help us keep them whole , and us sane .
1 https :// www . cnbc . com / 2022 / 09 / 07 / dr-oz-has-ties-to-hydroxychloroquinecompanies-as-he-backs-covid-treatment . html
2 https :// www . nytimes . com / 2022 / 11 / 30 / technology / medical-misinformation-covid-free-speech . html
3
https :// www . ama-assn . org / press-center / press-releases / ama-adopts-new-policy-aimed-addressing-public-health-disinformation
4 https :// law . justia . com / codes / kentucky / 2006 / 311-00 / 597 . html
Dr . Barry is an internist and Associate Professor of Medicine ( Gratis Faculty ) at the University of Louisville School of Medicine , currently retired and mulling her next moves .
We are always welcoming new writers on these topics and so much more ! Please reach out to Kathryn Vance at kathryn . vance @ glms . org if you ’ d like to share your thoughts in an upcoming issue .
LOUISVILLE MEDICINE UPCOMING THEMES
March – Physician Travelers ( due 2 / 1 )
Are you an avid traveler ? We want to hear about your travel woes and wins ! Share about your favorite destinations , give helpful tips for travel and talk about what travel is like post- COVID-19 .
April – Life After Medicine ( due 3 / 1 )
Of course there is life after medicine ! Have you retired yourself – if so , what are you doing now ? If you ’ re not retired yet , what do you plan to do in your life after medicine one day ?
May – Annual Report / No Theme ( due 4 / 1 )
As we look back on the last Presidential year and all that we have accomplished , we invite you to write on any topic of interest in this issue of Louisville Medicine . Medical or not , we want to hear what ’ s going on in your specialty and what ’ s on your mind !
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