MAINE, USA — Maine doctors accused of COVID-related violations constitute less than 1 percent of all cases taken up by the state’s medical and osteopathic licensure boards since March 2020, a Maine Monitor analysis of disciplinary actions found.
The Maine Board of Licensure in Medicine and the Board of Osteopathic Licensure have issued more than 70 public actions, from license suspensions to consent agreements, in 65 disciplinary cases from March 2020 to the beginning of this month.
Of those, only four cases involving three doctors dealt directly with COVID-related matters, such as prescription of unapproved medications for COVID treatments to improper issuance of medical exemption letters for healthcare workers in noncompliance with state immunization requirements.
Those doctors include Dr. Meryl Nass, an Ellsworth internist fighting the charges against her. The medical board suspended her in January 2022 for prescribing ivermectin and hydroxychloroquine, among other allegations.
Multiple national and international health agencies, including the U.S. Food and Drug Administration, the U.S. Centers for Disease Control and Prevention, the National Institutes of Health and the World Health Organization, have warned against using the two drugs — both antiparasitics — for treating COVID-19.
In April 2020, the Maine medical and osteopathic licensure boards issued a joint statement saying improperly prescribing hydroxychloroquine, chloroquine or azithromycin, an antibiotic commonly sold as Z-Pak, to treat COVID could constitute “unprofessional conduct” and put other patients who need the medications at risk.
The former chair of the medical board said although she could not comment directly on Nass’ case because she had not listened in on the hearing sessions, she said it and the other cases are likely examples of the most “egregious behavior” displayed by physicians.
There is a line between doctors trying their best to treat patients in an “unknown situation” during the early days of the pandemic and those who continued to use treatments even after proved ineffective, said Dr. Louisa Barnhart, a Waterville-area psychiatrist who retired from the medical board in 2021 after 10 years, the last two as chair.
“The line is that the board doesn’t want to squelch people trying to treat people early on, but on the other hand doesn’t want people then fleecing individuals by giving them medications” that lack scientific evidence of their efficacy in treating the disease, she said.
Dr. Jeffrey Barkin, a Portland psychiatrist and immediate past president of the Maine Medical Association, said doctors have a “moral obligation through the Hippocratic Oath and the Oath of Maimonides to be competent and share the best information — not misinformation, not disinformation — and … to not just run with an idea that they have but to vet that idea with other physicians and other thought leaders so as to minimize misinformation and disinformation.”
Among the expert witnesses Nass called on her behalf are two founders of a fringe organization that promotes widely debunked COVID “treatment protocols” called the Front Line COVID-19 Critical Care Alliance.
Nass has claimed in multiple interviews that the board and providers who lodged complaints against her are going after her for “perfectly legal and proper” practices. Among the allegations are that Nass lied to a pharmacist to get a hydroxychloroquine prescription for a patient.
In an interview following last month’s session, Nass said that because “federal and state agencies acted illegally outside their purview” to limit use of the medication for COVID, she was “forced” to misrepresent her patient’s diagnosis.
Barnhart said the board “strives very hard to stay out of politics, but there are certain people who would like to drag politics into the board.”
Nass has said that her legal fees are being paid for by Children’s Health Defense, an anti-vaccination group chaired by Robert F. Kennedy Jr., who has drawn criticism from mainstream medical professionals for spreading misinformation about COVID vaccines.
Each day of the hearing has been livestreamed on CHD’s website and YouTube channel, where live chats are often filled with vitriolic comments aimed at board members.
“I’m angry,” Barnhart said when asked about the attention the board received from Nass’ supporters.
“I’m angry about what’s going on but there’s nothing I can do about it. I feel sorry for my board members.”
The board has worked on Nass’ case “very diligently,” Barnhart said. Nass’ adjudicatory hearing wrapped up its sixth full day at the end of last month, 18 months after the board initially issued its suspension. The hearing has had more sessions than any other she could recall in her decade on the board, Barnhart said.
The medical board did not respond to requests for comment on Nass’ case.
Nass said last month that if the medical board revokes her license, she’ll elevate the case to a “real court and we’ll get a real jury.”
“I’m happy to go to court and fight this as high up as I need,” she said.
The Board of Osteopathic Licensure said in an email that its members are not allowed to discuss board-related matters but said it dealt with one COVID-related issue in the case of Dr. Paul Gosselin, who operated a Waterville practice called Patriot Health.
Another case before the osteopathic board cited negative comments about COVID vaccinations made by an Augusta doctor as part of a longer list of ways he “behaved unprofessionally,” including making religious and political statements to patients.
In its November 2021 notice of immediate license suspension, the board stated that following its review of “multiple COVID-19 exemption letters signed by Paul Gosselin … as well as provider reports concerned with Dr. Gosselin’s spread of misinformation regarding COVID-19,” it determined the doctor had “engaged in conduct that constitutes fraud or deceit,” incompetent practice and unprofessional conduct.
The Maine Department of Health and Human Resources updated its immunization requirements for healthcare workers in November 2021 to include the COVID vaccine. A worker was exempt from the rule if a licensed physician, nurse practitioner or physician assistant provided a letter stating that immunization “may be medically inadvisable.”
DHHS announced last month that it removed COVID vaccination from the list of required immunizations for healthcare workers and instead will “encourage voluntary vaccination.”
In June 2022, a majority of the osteopathic board voted that Gosselin demonstrated unprofessional conduct by violating a standard of professional behavior when he failed to properly examine the patients for whom he issued exemption letters, and to create or maintain proper medical records for them.
The board placed Gosselin on a one-year probation, during which he had to complete 20 hours of continuing education and pay a $1,000 fine for hearing costs. In total, Gosselin’s license was suspended for nearly seven months while the case was pending. His probation ended this June.
Attempts to reach Gosselin through his attorney, F. Ron Jenkins of Portland, were unsuccessful.
In addition to Gosselin and Nass, a third doctor, a Lewiston pediatric cardiologist, faced board action for disparaging comments made to a patient about COVID vaccinations. Last November, more than a year after the medical board initiated the complaint, it ordered the doctor to undergo a psychiatric evaluation. It is unclear if the doctor complied; his license is listed as expired as of May 31.
A recent Washington Post article included Nass’ case as one of at least 20 instances nationally from January 2020 to June 2023 in which state medical boards penalized doctors for complaints related to COVID misinformation.
“Across the country, doctors who jeopardized patients’ lives by pushing medical misinformation during the pandemic and its aftermath have faced few repercussions from medical boards in all 50 states,” the Post reported.
Although Maine is fortunate to have only a few physicians face COVID-related discipline out of the 4,400 or so licensed in the state, the conversation around misinformation remains as relevant as ever, Barkin said.
Nationally, COVID infections appeared to spike this July after six to seven months of a decline, CDC COVID-19 incident manager Dr. Brendan Jackson told NPR.
“This could be the start of a late summer wave,” he said.
In June, the FDA advisory committee that oversees vaccinations recommended that the fall tranche of COVID vaccines should be formulated for a specific lineage of the omicron variant, which was and appears to remain the dominant strain in the U.S.
According to studies published by the CDC, the bivalent booster, which became available last fall, “cuts the risk of having to visit an emergency department, urgent care facility or hospital due to COVID-19 by half or more for most people.”
“The number of available drugs to treat us if we get sick is very limited,” Barkin said. “And I feel like if it feels like old news and that contributes to people not getting vaccinated, that’s not good. That’s desensitization.”