Medical Censorship Part One: The Danger of Silencing Doctors

“Great spirits have always encountered violent opposition from mediocre minds.”

-Albert Einstein

For the second time in my career, the Maryland Board of Physicians investigated whether to censor me.  The first occurred during COVID, when the medical approach to science constituted following orders and staying quiet.  In that frightening era, all of science became embedded in the proclamations of a few “leaders” and anyone who dared challenge their unsubstantiated and often harmful dogma was censored, sometimes by being reprimanded as I was, sometimes by losing their licenses or being expelled from academic and even private practice settings.  Often during medical crises society in general, and the medical establishment in particular, seeks to promote a single voice and squelch all dissent; this is true during wars and other national calamities as well.  We can argue the merit of suppressing ideas that could be helpful to waging wars or fighting pandemics, but that is the subject of other blogs and discussions. 

But medical censorship does not only rear its head during crises.  Recently a group of physicians in my town sought to silence me because what I presented to my patients veered from their rigid medical Zeitgeist.  These were cardiologists, and their approach to care is very different than mine; theirs is an organ-specific lens, while mine is whole-patient;  they use calculators and protocols to establish absolute norms, I see nuance everywhere and believe that each patient is unique and that protocols/calculators can never capture the whole patient and can often hurt them; they rely on measurements to establish fixed lines that define illness and cure (blood pressure, cholesterol, echocardiographic readings, stress test/catheterization findings, heart irregularities), while I use numbers to buttress what my patient tells me and how they feel and allow a great deal of numerical flexibility especially as patients age; they are very quick to prescribe drugs and perform procedures based on the tests they order, while I am very skeptical of a high-intervention approach to care as it lacks good validation and often creates more problems than it solves.  These are different approaches, and to underpin my approach I not only have the collective wisdom encased in the hundreds of years of clinical experience by myself and countless geriatric doctors who have written about this, but also hard evidence found in reputable medical journals.  It was my presentation of that evidence that disturbed the cardiologists and pushed them to try to censor me by reporting me to the Board.

Medical censorship is antithetical to science, to good patient care, and to how we as a medical society should approach health.  Because censorship often is instigated when a doctor questions protocols or “standards” of care, it locks us into robotic thinking that typically promotes drug use and specialized procedural medicine by negating nuance and a patient-centric approach, and too by promoting a false credo that all medical knowledge can be distilled into digestible nuggets of protocols and calculated numerical norms.  As physicist Richard Feynman stated: “The first principle [of science] is that you must not fool yourself—and you are the easiest person to fool.”    And as Carl Sagan wrote: “What counts is not what sounds plausible, not what we would like to believe, not what one or two witnesses claim, but only what is support by hard evidence, rigorously and skeptically examined.” And of course we have Einstein who stated: “The important thing is not to stop questioning.”  Censorship suppresses skepticism, it mutes questioning, it leads to self-deception.  It is the very antithesis of science and of what the art and science of medicine needs to be for it to properly care for its trusting patients.

While censorship is fallaciously touted as a means of protecting the science of medicine, in actuality it is a tool to safeguard the industry of medicine.  Since many of us who are censored question the proclamations of Big Pharma and self-serving specialist societies, we are perceived to be threats.  This is not science; it is an attempt to preserve industry-scripted dogmatism by suppressing crucial components of scientific discourse and skepticism.  None of this is new.  As Osler warned us over a century ago: “Far too large a section of the treatment of disease is today controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science.”  The control over so many tentacles of our medical system by drug company dictates—often inscribed into calculators, protocols, and academic studies—and by specialist societies has led to assembly line medicine, an approach dismissive of whole-patient healing and wellness, especially in the geriatric population, and one that drives up the cost of care without reducing disease burden or death.  It does make powerful people richer, and as such is often protected by the institutions that should be promoting good health care and robust medical science.

When many doctors seek discourse, read studies fully and do not rely on their interpretation by specialist societies and drug company summaries, practice individualized care to each of our patients that transcends the simplistic dictates of calculators, understand how age and polypharmacy impact the blind need of doctors to measure and fix numbers, we are often assailed and censored by those unnerved by our attempt to engage in real science because it threatens the status quo.  Disease is not something that can be distilled into measurements and top-down dictates, and unfortunately our medical system thrives from just that approach: simplify everything, make everything uniform, insist that all doctors think alike.  Again, as Osler tells us, “No two cases of the same disease are ever alike; the constitution of the person, his individuality, stamps each with certain peculiarities.”  However, we as doctors are asked to stay within a proscribed lane that is paved by groups and companies that benefit from blind compliance, thereby erasing nuance and patient variability.  This is what the cardiologist group most objected to: my willingness to explain to my patients the diversity of scientific thought beyond the narrow cage of protocols.

My own case is illustrative of the conflict between science and our current medical dogmatism.  In the newsletter I write for my practice, I include several studies from major journals that often provide a counternarrative to what many specialists tell their patients.  Again, these are published peer reviewed studies.  In my December 2025 Newsletter I summarized the years’ worth of studies we presented.  The local cardiologists who found offense with the studies I presented—and who have reported many doctors to the Medical Board, as I later learned—wrote to the Maryland Board of Physicians, challenging my right to publish studies with which apparently, they did not agree.  The head of the cardiology group wrote: “I am writing to express my concern regarding Andrew Lazris.  Attached is a handout that he provides to his patients. [this was the December newsletter page summarizing the year’s studies.]  The highlighted information [he highlighted the conclusions of some of these studies] is either false patient advice that does not follow American College of Cardiology appropriate use guidelines or is otherwise misleading information.  I am not sure of the appropriate forum to express my level of concern.  If some patients follow this advice it could lead to significant patient harm.” 

As noted, the items with which he found offense were published studies that challenge the often self-serving and fallacious narrative of the American College of Cardiology (ACC) and his own practice.  In fact, as I show in part two of this blog, much of what cardiologists preach to patients is blatantly deceiving and will, if blindly followed, lead to more procedures (conducted by them at high profit) and more unnecessary medicines with the potential for more harm.  However, these doctors who use drug-company programmed calculators to give patient precise (and wildly inaccurate) risk scores, who scare them, who assault them with copious tests/procedures/drugs that may well be against their own self-interest, do not want to see anything that challenges their undeviating messaging.  And thus, rather than provide information that counters the studies I included in my newsletter, rather than discuss the issue and accept the uncertainty inherent to medical treatment, their approach was to request that I be censored.

Doctors have a right to make outrageous accusations to the Board, but what is most concerning is that the Board accepted their complaint, forced me to defend articles I had not written and my right to put those articles in a practice newsletter, and did not hold the cardiologists accountable to defend their dissemination of “facts” that largely diverge from scientific reality.  The Board’s response to the cardiologists’ complaint should have been: Dr. Lazris has documented everything he wrote, and he has a right to provide data that may be contrary to what you tell patients.  Rather, by taking the case, the Board demonstrated its advocacy for censorship; it sought to defend a status quo scripted by specialty societies like the ACC, while disparaging the right of generalist doctors like me to provide my patients with a more balanced approach.

I am not the only doctor who writes and speaks about the danger of a specious self-serving approach to care that erases nuance, mangles the facts, and supports anything that enhances profits.  I remember being at a lecture by an academic cardiologist who so vehemently assailed his colleagues for their mercenary approach to care that I thought he was going to get a heart attack up on stage!  I have spoken to many cardiologists, including some prominent academics, who disagree with everything the ACC and the local group who reported me misrepresent as being factual.  Shelves of books from prominent academic doctors assail our medical system’s dogmatic profit-driven ethos and often point to cardiology as being one of the most onerous fields in this regard.

Personally, I have written dozens of peer reviewed books and articles challenging the “truths” spit out by specialist medical societies, protocols, calculators, and far too many doctors.  When I write I use data and I interrogate the data deeply.  Clearly, the doctors who offered this challenge to my ability to speak do not; there is no evidence that they have any academic publications in their name, nor is there any evidence that they approach patient care in a scientific way.  When many years ago I called one of these doctors and challenged the scare-tactics he was using to convince patients to take medicines against their best interest, and offering to send him studies to debunk the simplistic calculations used to disseminate data that was clearly not age-appropriate, he hung up the phone on me.  He did not want to listen, because anything that disputed his dogma he viewed as threatening.  That is not science.  That is not good patient care.  That is bad medicine in every way.  And yet, the Board of Physicians gave credence to their posturing and demanded that I defend my position lest I be rebuked.

Medial Boards have been with us since the start of our republic.  Early in our nation’s history, States had many Boards that accommodated the diversity of medical providers.  But in the early 1900’s a more corporatized medical system—as we discuss in our book A Return to Healing and which I studied in depth while writing my master’s thesis on the origins of our racialized medical system and will soon publish—changed the nature of Boards.  After 1911 the AMA ran the show and allowed only one authorized Board in each State.  That Board now possessed power over licensing and was beholden to the medical gospel of the AMA; only doctors deemed worthy could join.  Of course, “worthiness” and “scientific” were made to seem equivalent.  For instance, no African American doctors could join most State Boards or the AMA because at the time medical science declared racial difference and Eugenics to be scientific fact, and any doctor who disputed that dogma could be, and was, punished by the Board.  The Boards became a disciplinary tool created not to ensure that good medicine was practiced, but rather that no doctors strayed from the corporate, top-down precepts as articulated by the AMA.  In today’s medical universe, with the AMA’s diminished role, specialty societies along with drug companies and their conduits (like the American Heart Association, as we discuss in the next blog) have defined how doctors are expected to practice, and any doctors who veer from their edicts can be disciplined by Boards.  Boards are extrajudicial; they do not have to follow standard legal procedures and can punish, censor, and remove the license form any doctor they deem to be outside of the medical norm.  Thus, being reported to the Board is no light matter, as I have learned.

For me, after “reviewing the case,” the Board sent me an advisory letter and a threat. The Board quoted the AMA code of ethics, stating that when physicians interact with the media (implying absurdly that my newsletter is part of the media) they must “confine their medical advice to their areas of expertise and clearly state the limits of their knowledge where appropriate.”  Ironically my area of expertise is general medicine and geriatrics, the very issues I was discussing, while the area of expertise of the cardiologists certainly drifts far from the geriatric realm, especially since, as we show in the next newsletter, ACC guidelines rarely include older people in their studies nor do most cardiology studies, protocols, and calculators.  Clearly, everything I presented was in my area of expertise, and I dug through every study I put in my newsletter to assure my understanding of it.  But the Board believed that I swerved out of my lane, and they strongly implied that I better not do that again.  As a threat, the Board stated: “In the future, should the Board receive complaints of this or a similar nature, it may, in its discretion, reopen the matter.”  In other words, watch you say, because if the cardiology group is upset again and reports you, we will act.  They saw no need for the cardiology group to stay in its lane or to justify its positions or what it tells its patients.  I actually made a complaint against the cardiology group subsequently (I had been collecting data on tests and procedures that group performed on my patients, very profitable tests and procedures to them, that I believed were unnecessary and even in defiance of ACC guidelines) and the Board did not even address it.  The message is clear: if you dare cross the line and challenge the status quo, we will censor you.

What the Courts Say about Medical Censorship:

Over the years courts have generally provided Boards wide leverage to discipline doctors, but the issue of censorship is far vaguer.  Medical boards are extrajudicial, meaning they can discipline doctors without due process of law, and that applies to censorship.  But historically only certain types of speech have satisfied the criteria justifying censorship, and some legal cases have explored this issue.  Again, the courts are not interested in how toxic censorship is to patient care, our bloated medical budget ($5.4 trillion), or to medical science.  Their lens is strictly legal and is focused on one issue: at what point do the rights of doctors to speak freely clash with their duty to provide what medical Boards deem to be proper care.  Traditionally, in both legal cases of malpractice and Board disciplinary actions, the courts have accepted a very dangerous myth that whatever the majority of doctors and medical societies believe to be true is by definition the standard of care.  Lately, though, that definition has been assailed, especially since the “standard of care” is scripted by those in power who seek to profit from what may well be poor care, something becoming more apparent by a plethora of academic writing typically in books and journals published outside the United States. 

For many decades courts adhered to what is called the Foundational Doctrine: professional speech deserved less first amendment protection than ordinary speech in that medical boards regulate professional conduct including speech.  This changed in 2002 under Conant vs. Walters, when the ninth circuit court held that a federal policy threatening to revoke the licenses of doctors who recommended medical marijuana to doctors was unconstitutional. These doctors merely spoke with patients and made recommendations but did not provide marijuana to them and the court asserted that they had a right to speak their minds.  Similarly in Wohlschlaeger vs Florida the eleventh district court struck down a Florida law preventing pediatricians from asking parents if they kept firearms in their houses, again declaring that physician speech alone could not be suppressed by a State Medical Board.  In 2018 the Supreme Court issued a ruling in NIFLA vs Becerra stating that professional speech enjoys the same first amendment rights as ordinary speech and that neither medical boards nor state regulations can impede free speech.  Several courts have allowed Boards to sanction doctors who provided treatment that clashed with board imperatives, but speech itself has been protected in recent rulings.

Some nuance has been cited with regard to speech in two categories: one, if it is being used to profit the physicians, and the other in cases in which the speech may cause imminent harm.  Commercial speech—speech tied to profits—has historically received fewer first amendment right protections than other speech.  Courts have largely allowed prosecution of doctors who sell products or services by telling patients they are necessary or effective, something the cardiology group that reported me does all the time in promoting cardiac procedures that they perform.

The idea that speech can cause “clear and immediate danger to the public” typically is accepted during a crisis such as COVID.  Our nation has allowed censorship during major crises, from the two world wars through the cold war.  This has been hotly debated by courts and typically they either sanction or do not comment on such censorship until after the crisis ends.  This occurred during COVID.  Several states such as Delaware and California permitted and encouraged boards to revoke licenses from doctors who spread “misinformation” about COVID and its treatment.  In Kory vs Bona in California a federal judge blocked the board’s attempt to discipline doctors merely for speaking their minds on COVID, but higher courts would not comment on the issue and it is now in the hands of the Supreme Court.  In Stockton vs Ferguson, physicians similarly have hit a roadblock in pushing back against disciplinary action for speaking out against COVID policy; that case too is under appeal.  A similar case occurred in Oregon in Thomas vs Harding when a doctor lost his license when he published documented data showing that unvaccinated children were healthier than vaccinated ones; that case too is under review.  It should be noted that in all of these cases, the courts ordered the physician to be given their licenses back until the case is resolved.

My own story during COVID sheds a little light on the danger of censorship.  I was sanctioned by the Board not for anything I did, but for merely stating a fact.  I had to get a lawyer and fight for my license, which the Board allowed me to retain with a caveat that I would shut up.  What did I say to elicit this response?  I reported late in 2020 that in my long-term care facilities we were seeing massive amounts of COVID despite having a strictly enforced masking policy.  This was a fact and not subject to interpretation.  But to the Board it represented a challenge to the masking edicts.  I was suggesting that masking was not enough to protect my patients, and the facts proved that.  But in the overly politicized atmosphere of COVID, facts became misinformation, and those of us who sought an effective solution were censored. The results were catastrophic.

Regardless of the censorship that transpired during COVID and left far too many scars, we do know that censorship is rampant during crises.  But what about the accusation made against me now?  Less than 1% of Board inflicted sanctions on doctors are related to free speech, and virtually all of them apply to doctors profiting from what they say or occur during a crisis.  I could not find any legal cases that sanctioned censorship pertinent to my behavior: citing journal articles in a newsletter.  In my case, I was using real data to help patients negotiate a medical system often cluttered by information that could be injurious if misapplied.  That the Board considered censoring me for being a thinking patient-centric doctor who is not profiting from what I say is outside what has been legally validated by the courts.  And certainly, rather than shut my mouth and fall prey to such onerous censorship that is an affront to science and to medical care, and a threat to my patients, I will continue to read and write and explain.  Should the Board assault me again, I will be one of many who files a lawsuit.  And given the large number of doctors that this particular cardiology group has already reported to a Board, I am sure I will have a lot of company.

In part two of this blog, I will counter much of what the cardiologists who sought to silence me claim to be unassailable truth.  This information can be found in my books and articles, all of which are peered reviewed and fully documented, and in the books and articles of so many prominent doctors and journalists who squarely dispute the position of these cardiologists.  Science is not on their side, as I will show.  It is unfortunate that the Board has turned its back on the need for a diversity of opinions among doctors, on science, and on patient-centric medical care, something injurious to the art and science of our profession and to the health and lives of our patients.

To end with a quote by the great Carl Sagan: “If we are not able to interrogate those who tell us that something is true and be skeptical of those in authority then we’re up for grabs for the next charlatan who comes rambling along.”  Sadly, with Medical Boards endorsing censorship, and specialists relying on that tactic to silence anyone who challenges them, we are already there.