Update (October 3): California governor Gavin Newsom signed legislation last Friday that formally classifies the dissemination of COVID-19 misinformation from a physician to patients in their care as “unprofessional conduct.” The move paves the way for state medical boards to take action against physicians who spread falsehoods about the disease or its treatments, but only in a healthcare setting. The bill is “narrowly tailored to apply only to those egregious instances in which a licensee is acting with malicious intent or clearly deviating from the required standard of care while interacting directly with a patient under their care,” Newsom said in a statement.
Aphysician who alerted the Maryland state medical board about controversial scientist Robert Malone’s alleged promotion of COVID-19 misinformation has been harassed online, faced a retaliatory complaint to his own medical board, and received complaints to his institution after Malone publicly disclosed his identity.
The medical board in Maryland, meanwhile, has opted to take no disciplinary action against Malone.
Michael Patmas, a licensed physician and medical director of utilization management and referral relationships at Maui Health in Hawaii, filed a complaint with the Maryland Board of Physicians late last year after Malone, who holds an active medical license in Maryland and has been widely criticized for spreading misinformation about the pandemic, visited Maui and spoke at rallies opposing vaccine mandates.
In an interview with The Scientist, Patmas says that he was concerned by these events and perceived a subsequent increase in vaccine hesitancy in the local community. He adds that he felt a moral duty to notify the board because he thought Malone’s conduct in Maui and more generally violated guidance issued last summer by the Federation of State Medical Boards (FSMB), a nationwide nonprofit that supports state boards on licensing and regulation, about generating and spreading COVID-19 misinformation. Patmas notes that he acted in a personal capacity, not as a representative of his employer.
Shortly after being notified about the complaint by the Maryland board in December, Malone tweeted about it to his hundreds of thousands of Twitter followers. He disclosed Patmas’s name and workplace, and later spoke about the complaint in an interview with podcast host Joe Rogan, leading to Patmas being verbally attacked online, receiving complaints to his workplace, and becoming the subject of a retaliatory complaint made to his own medical board. Malone also informed colleagues in Maui about Patmas’s complaint and contacted Patmas through LinkedIn in a message containing the lines “Found you,” and “Merry Christmas,” plus a warning that his lawyers would be in touch.
Patmas says he’s concerned about the precedent his experience sets. “Retaliation for a complaint—if that’s allowed to stand, then other physicians are going to be reluctant to hold one another accountable,” he says. “If doctors who do that get their head cut off, well, you’re going to let doctors get away with bad things. It’s unethical, and it’s morally wrong.”
Nick Sawyer, an emergency physician in California who cofounded No License For Disinformation, a campaign advocating that doctors who spread false COVID-19 information be subject to disciplinary action, says that Patmas’s experience is very concerning. “There should be accountability for physicians who retaliate against physicians who submit complaints against them. You shouldn’t have to be scared to submit a concern with a state medical licensing board that that doctor is going to retaliate against you in some way. That is ridiculous.”
The Maryland medical board this month sent Malone a letter, which he shared with The Scientist, stating that it has decided to close its investigation without any further action on the complaint Patmas filed last year. The board didn’t provide an explanation for the decision, but Malone says it would appear that “they did not find any actionable information in the complaint filed against me.”
Sawyer says he isn’t surprised by the Maryland medical board’s decision. Board action against doctors accused of promoting misinformation is rare, says Sawyer, who filed a complaint last year in California against Simone Gold, a physician who encouraged people not to get vaccinated against COVID-19, promoted unproven COVID-19 treatments, and has been charged with taking part in the January 6 Capitol riot. Gold retains an active California medical license.
Indeed, according to an FSMB survey at the end of last year, although complaints about physicians engaging in misinformation soared in 2021, just 12 of the 58 medical boards that responded to the survey had taken any disciplinary action against a licensee on misinformation-related grounds. Legislators in a number of states are working on measures to block a medical board’s power to discipline licensees in cases of COVID-19 misinformation, according to Kaiser Health News and Politico.
Sawyer and others have conversely called for boards to do more to stem medical misinformation. “This is not a matter of free speech. This isn’t a matter of nuance,” Sawyer says. “These people are saying verifiably scientifically false . . . and verifiably dangerous things.”
Responding to criticism
Malone has gained international notoriety in the last year, both for his claims about his own role in developing the technology behind mRNA vaccines and for his association with physicians who encourage people to refuse vaccination and other health measures aimed at curbing the pandemic.
Although he rejects descriptions of himself as a vaccine skeptic and argues that his views are frequently misreported, he has spoken widely about purported reasons for parents to worry about vaccinating their children and argued that a large proportion of the population has been “hypnotized” into false beliefs about the safety and efficacy of vaccines, masks, and lockdown measures.
Doctors who just say, “Well, it’s not my job to stand up to him,” I think they’re abdicating their role, their professional responsibility to hold one another accountable.—Michael Patmas, physician
Fact-checkers at Politifact, The New York Times, and elsewhere have repeatedly labeled Malone’s comments on these and other issues as false or misleading. His Twitter and LinkedIn accounts were suspended at the end of last year.
Malone has also pursued people who have disagreed with him or have not given him what he says is due credit. In mid-2021, biochemist and mRNA-vaccine codeveloper Katalin Karikó, who has featured in multiple news stories about the vaccines, told The Atlantic that Malone had emailed her to accuse her of inflating her accomplishments. “This is not going to end well,” he told her in the email. Malone told the Atlantic that the message was not intended as a threat.
Earlier in 2021, during a dispute with the scientific publisher Frontiers over a special issue that Malone was guest editing, Malone and colleagues gave the publisher an ultimatum, saying they’d contact the media unless Frontiers gave them editorial control. The disagreement started over a manuscript that Malone had solicited from embattled physician Pierre Kory on the use of ivermectin as a COVID-19 treatment, and which Frontiers had rejected after identifying “a series of strong, unsupported claims.”
Frontiers’ chief executive editor Frederick Fenter told The Scientist at the time that the threat of negative media coverage seemed designed to frighten the publisher into backing down. “We’re never going to accelerate an acceptance of a paper or accept anything that hasn’t been validated because the editors tell us that if it’s not published by Friday, they’re going to go to the press,” he added. The special issue was axed soon afterward.
Calling on followers
On his visit to Maui last October, Malone joined a number of physicians accused of promoting misinformation at various gatherings to give speeches and presentations to politicians, doctors, and members of the public. At several events, Malone criticized US vaccine policies and accused the media and hospitals of “hunting” physicians for “speaking out.”
At the time, Maui County had the lowest vaccination rate in the state, with 62 percent of the total population fully vaccinated, according to Maui Now. Patmas wasn’t directly involved in the county’s vaccination efforts, but says that he witnessed the effects of events Malone attended, with a spike in the number of people locally who questioned the vaccines’ efficacy or refused to get vaccinated.
In November, Patmas, who has been critical of Malone on social media since the latter’s visit to Maui, filled out a complaint form and sent it to the Maryland medical board in line with FSMB guidance on COVID-19 misinformation, he says. That guidance states: “Spreading inaccurate COVID-19 vaccine information contradicts [a physician’s ethical and professional] responsibility, threatens to further erode public trust in the medical profession and puts all patients at risk.”
He included several links to media articles such as the Atlantic piece, which described Malone as a “vaccine scientist spreading vaccine misinformation.” Patmas made the complaint under his own name, rather than anonymously, in the hope that it would give the complaint more weight, he says.
When Maryland’s medical board sent the full complaint to Malone, along with a request for a response, Malone swiftly posted about the complaint to Twitter, claiming without evidence that it was “political retaliation for my having traveled and spoken out on Maui.” (His account was suspended by the platform about a week later.)
He also posted Patmas’s name and place of work, along with a link to his Twitter profile. Speaking on Rogan’s podcast the following week, Malone again discussed the complaint, this time referring only to Patmas’s job and location.
Malone tells The Scientist that he didn’t view the information in the complaint as confidential and that when he shared the information online, he wasn’t thinking about possible negative effects on Patmas.
His post about the complaint, which was retweeted hundreds of times within the hour and also made the rounds on other social media platforms, provoked an immediate response from Malone’s followers. Many posted hostile replies to tweets on Patmas’s Twitter page, while others discussed how best to get back at him, with several coalescing on a plan to try to get his medical license revoked and report him for misinformation.
In early 2022, Hawaii’s Regulated Industries Complaints Office, which oversees medical board complaints, informed Patmas that it had received an anonymous complaint about him. The complaint was explicitly retaliatory, alleging that Patmas had acted in an unprofessional manner by reporting Malone in Maryland. It further alleged that he had provided inappropriate medical advice over social media, citing one mid-2021 tweet about medications that Patmas says was clearly meant in jest as a response to another Twitter user’s tongue-in-cheek comment.
Malone tells The Scientist that the person who made the complaint against Patmas told Malone in writing about the plan in advance. Malone claims he didn’t encourage the person to make the complaint, but also rejects the notion that this act or the harassment Patmas faced were disproportionate or unreasonable. “I don’t see any problems here,” Malone says. “This gentleman sought to attack my ability to practice medicine and my ability to earn a living.”
Contacted for comment, members of the Maryland state medical board declined to discuss specific investigations, noting that decisions about licensees are taken on a case-by-case basis. However, they tell The Scientist that in general, a doctor under investigation should not contact, threaten legal action against, or otherwise harass a complainant.
They also informed The Scientist that such actions would potentially be grounds for further investigation, provided that those actions were detailed in a written submission to the board. Patmas says he did email the board multiple times in December and January to tell them about the retaliatory complaint, Malone’s LinkedIn message and outing of him as the person who filed the Maryland complaint, and harassment he was receiving online. He says he never got a response.
Hawaii’s investigation into Patmas was closed a few weeks after it was opened, with investigators deeming that no action was warranted. Nevertheless, Patmas says he found the whole episode disturbing. When he first heard about the investigation, he had family visiting and had made plans for the weekend, but “I couldn’t sleep,” he says. “That night, I just sat up and wrote a response to the board.”
Sawyer says he’d like to see the situation for physicians filing complaints improve, and for it to become easier for boards to discipline licensees for misinformation. A bill now under consideration in California, for example, would bolster the state medical board’s ability to crack down on doctors who spread false or misleading claims by classifying it as unprofessional conduct, Sawyer notes. But the fact that boards and legislators “let it get this bad, I’m not real hopeful. I think if they would have taken care of this problem when they should have at the beginning, we wouldn’t be here.”
Despite the blowback, Patmas says he is still glad he spoke up. “Doctors who just say, ‘Well, it’s not my job to stand up to him,’ I think they’re abdicating their role, their professional responsibility to hold one another accountable.”