Paul Thomas and the antivax legal assault on state medical boards

Dr. Paul Thomas is an Oregon pediatrician whose practice is located in a Portland suburb. He initially rose to prominence in the antivaccine movement a few years ago, to the point where I once referred to him in 2018 as a “rising star in the antivaccine movement,” based on his “delayed” vaccine plan that resembles Dr. Bob Sears’ plan and his agitation against vaccines in his “holistic” practice with “misinformed consent” (while taking on Jenny McCarthy’s mantle of being “pro-safe vaccine”). He also claimed, as the late Dr. Mayer Eisenstein did without ever actually showing the evidence, the the prevalence of autism in the unvaccinated patients in his practice is much lower than in his vaccinated patients, a dubious result that he dumped as a publication into an appropriately dubious journal just as the first cases of a mysterious and deadly new viral illness were puzzling doctors in Wuhan, China in late 2019. A month later, as the coronavirus disease that would ultimately be named COVID-19 was spreading through Wuhan, Dr. Thomas teamed up with another antivaxxer (James Lyons-Weiler) to publish a risibly bad modeling study falsely concluding that the childhood vaccine schedule had dangerous amounts of aluminum in it.

The final bit of background about Dr. Thomas that you need to know is that in December 2020 the Oregon Medical Board, spurred by complaints, ordered an emergency suspension of his medical license. On June 3, 2021, Dr. Thomas’ license was reinstated, but with significant limitations. To boil it down, Dr. Thomas agreed to an Interim Stipulated Order in which he would “voluntarily limit his practice to acute care; refrain from engaging in consultations or directing clinic staff concerning vaccination protocols questions, issues or recommendations; and refrain from performing any research involving patient care pending the completion of the Board’s investigation into his ability to safely and competently practice medicine.”

More recently, on November 21, 2021 the Oregon Medical Board entered an amended complaint against Dr. Thomas “regarding unprofessional or dishonorable conduct; making false or misleading statements regarding the efficacy of the licensee’s treatments; repeated negligence and gross negligence in the practice of medicine; willfully violating any provision of this chapter; knowingly making a false statement or representation on a matter; failing to comply with a Board request; and failing to report an adverse action,” noting that this “is a preliminary action by the Board” and that a “final Board action in this matter has not been taken.” The case dragged on, as these cases often do.

Several months later, Dr. Thomas decided to continue the antivax assault on state medical boards for their COVID-19-inspired efforts to crack down on physicians spreading disinformation. He did so using an old tactic of quacks, cranks, and antivaxxers: The bogus lawsuit. However, he turned the legal thuggery up to 11 by suing the individual members of the Oregon Medical Board in their capacity as members for a total of “at least $35 million.”

My primary purpose in writing about his is not so much to go into minute detail about every one of Dr. Thomas’ claims, but rather to try to put this lawsuit into context as part of the antivaccine assault on state medical boards in response to their attempts to rein in misinformation and antivaccine quackery. First, however, let’s look at the lawsuit.

Paul Thomas strikes back

On June 30, 2022, Dr. Thomas sued the members of Oregon Medical Board for a total of $35 million, alleging that, among many other allegations, the Board had (allegations picked from a large number):

• Defendants have an ulterior motive to silence Dr. Thomas from speaking about the risks of childhood vaccines with patients and the public. This ulterior motive is unrelated to their job to regulate physicians in Oregon.
• The 2020 Board Defendants intentionally violated the rules for disciplining physicians in furtherance of their ulterior motive.
• The 2020 Board Defendants seized Dr. Thomas medical license in the furtherance of their ulterior motive.
• The 2020 Board member may only temporarily suspend a license without a hearing if the continued practice of the licensee constitutes an immediate danger to the public.
• There was no immediate danger to the public.
• The Board violated Dr. Thomas’ rights pursuant to ORS § 677.205.

I’m not a lawyer; so I can’t comment much on the validity of the legal “reasoning” (such as it is), but Dorit Reiss can and has. In brief, she concluded that this lawsuit is an “attempt to signal to supporters that Dr. Thomas is being persecuted and to harass the members of the medical board and intimidate them.” No doubt it is. Otherwise, why sue the individual members of the Oregon Medical Board instead of suing the Board itself? She also notes that this lawsuit runs smack dab into the issue of qualified immunity. You might have heard of qualified immunity protecting police officers who have used excessive force or even assaulted and killed people for no good reason, but there is a reason for qualified immunity to protect government officials from being sued for damages when they are acting in their official capacity. In the case of someone like Dr. Thomas and a state medical board:

Qualified immunity is certainly overused, but if there is a place for it, it is where an unhappy litigant wants to avoid action in a disciplinary hearing where the litigant has procedural rights. Allowing a doctor to sue because a medical board acted against him is in tension with the goal of qualified immunity, as other jurisdictions found. And Dr. Thomas’ complaint did not identify “an earlier decision by the Supreme Court or a federal appeals court in the same jurisdiction holding that precisely the same conduct under the same circumstances is illegal or unconstitutional.” Qualified immunity applies to state officials in Oregon, and should cover the board members even before all the rest. This should mean that the complaint is dead on arrival.

Other allegations in the lawsuit are that the Board violated his free speech rights, as well as some statutory claims. For example, there is the question of whether his due process rights were violated by the prolonged time between the emergency suspension and the limited reinstatement of his license. I’m not qualified to comment on them in much detail, but Dorit Reiss is and concludes that even the strongest claim in the lawsuit is pretty weak sauce. You can read the details here.

Dr. Thomas’ lawsuit is also full of reasoning (if you can call it that) based on antivaccine tropes, misinformation, disinformation, and his own scientific studies, all of which are risibly awful and were published in bottom-feeding antivax-sympathetic journals, as I’ll mention. Before I do that, though, let’s take a look at what originally prodded the Oregon Medical Board to take emergency action against Dr. Thomas a year and a half ago.

Dr. Thomas versus vaccines

Let’s step back in time to see just how bad Dr. Thomas’ failures were that they resulted in what is a very rare action from a state medical board, an emergency suspension without a hearing. I wrote about it in detail when it happened, quoting parts of the order, such as this one:

The Board finds that Licensee’s conduct has breached the standard of care and has placed the health and safety of many of his patients at serious risk of harm. It is therefore necessary to emergently suspend Licensee’s license to practice medicine. The acts and conduct that support this Order for Emergency Suspension follow:

3.1 Licensee has published an alternative vaccination schedule that decreases the frequency of many recommended vaccines and omits others, including rotavirus. Licensee promotes his unique, “Dr. Paul approved” schedule as providing superior results to any other option, namely improved health on many measures, and fraudulently asserts that following his vaccine schedule will prevent or decrease the incidence of autism and other developmental disorders. Licensee uses this claim to solicit parental “refusal” of full vaccination for their children, thereby exposing them to multiple potentially debilitating and life-threatening illnesses, including tetanus, hepatitis, pertussis (whooping cough), rotavirus, measles, mumps, and rubella.

Licensee’s promotion of this alternative vaccination schedule exposes patients to the risk of harm in violation of ORS 677.190(1)(a), as defined by ORS 677.188(4)(a).

As I noted at the time, the Oregon Medical Board has the power to temporarily suspend the license of a physician without a hearing when the “Board has evidence that indicates that Licensee’s continued practice constitutes an immediate danger to the public” or finds that “that Licensee’s continued practice of medicine by a physician presents a serious danger to the public health or safety,” noting that this was important because I couldn’t at the time recall any previous cases in which a quack or antivaxxer had had their license suspended because their state medical board viewed them as such an imminent threat to their patients or to public health. There were horrifying examples, too, such as Patient D. This patient suffered a dirty scalp laceration, sutured by his parents, who also treated it with colloidal silver. Dr. Thomas’ failed to recommend a tetanus vaccine to this unvaccinated child when he saw him:

Never mind, let me just quote the original Board finding:

3.3.3 Patient D, a now 9-year-old male, was completely non-immunized. Patient D sustained a large, deep scalp laceration at home in a farm setting on August 8, 2017, and was treated with colloidal silver and with his parents suturing the wound independently. Patient D subsequently developed acute tetanus requiring intubation, tracheotomy, feeding tube placement and an almost two- month ICU stay at Doernbecher Children’s Hospital. Patient D was then transferred to Legacy Rehabilitation. Licensee saw Patient D for follow-up in clinic on November 17, 2017. Licensee’s notes documented a referral to a homeopath, recommendation of fish oil supplements, and “phosphatidyl seine.” He did not document an informed consent discussion about the risk/benefit of immunization for a child who had just sustained and still had sequelae of, and remained vulnerable despite prior infection, to tetanus, a life-threatening and disabling disease that is preventable by proper vaccination. Licensee’s care placed Patient D at serious risk of harm and constitutes gross negligence.

I stated my opinion at the time that, assuming these findings of fact were accurate, this sort of behavior on Dr. Thomas’ part constituted gross malpractice of the most negligent kind. Tetanus infection doesn’t make you immune to a second infection, because it’s a toxin produced by Clostridium tetani, the bacteria tetanus that causes tetanus, that is dangerous. The child was still susceptible to tetanus when Dr. Thomas saw him after discharge.

In his complaint, Dr. Thomas argues:

111. Patient D. At six years of age, Patient D was a completely unvaccinated boy who sustained a forehead laceration, was stitched up at home, and developed tetanus. Patient D spent almost 2 months in the ICU at Doernbecher Children’s Hospital. By merely including Patient D in its emergency order the Board deceptively conveyed that Patient D was Dr. Thomas’ patient before his injury. Patient D was not Dr. Thomas’ patient before the injury. The Board’s deceptive description was designed to intentionally create a false impression.

112. Patient D was not seen by Dr. Thomas until after Patient D was discharged from the hospital. Omitting this critical fact amounts to a fraudulent misrepresentation by the Board.

113. Also not disclosed by the Board is the reason that Dr. Thomas saw Patient D was because other doctors would not accept Patient D because his parents adamantly refused to vaccinate him. During Patient D’s first visit with Dr. Thomas in 2017, the parents made it clear to Dr. Thomas that they would refuse all vaccinations. There was no basis for any discipline of Dr. Thomas related to Patient D. The Board’s emergency discipline of Dr. Thomas three years after he saw Patient D is without any justification and is an intentionally hostile act designed to damage Dr. Thomas.

To me this is a dodge and is basically nonresponsive. Even if parents refuse vaccination, the standard of care is to recommend the vaccination, try to address the parents’ concerns, and then, if they still refuse, document their refusal, not to refer the patient to a homeopath and recommend fish oil supplements, and “phosphatidyl serine.” I will concede that the original order was not clearly worded enough to preclude the interpretation that Patient D was Dr. Thomas’ patient before his laceration and infection with tetanus.

However, Patient D was not the only example were a number of other examples, including an infant with a persistent fever that Dr. Thomas didn’t take sufficiently seriously and who later contracted pertussis because he was unvaccinated; cases where he failed to adequately document specific parental refusal of vaccines and provide parental clarity; and a number of other problems. Personally, it’s not any individual case that leads me to conclude that an emergency suspension of Dr. Thomas’ medical license was justified. It’s the number and overall pattern of his behavior.

I can’t help but note this passage from the original Board action suggesting that Dr. Thomas is not so respectful of parents who are pro-vaccine and want the standard vaccine schedule:

3.2 Licensee is insistent and direct in his communication with parents and guardians that they should accept his alternative vaccine schedule.

And here are the cases:

3.2.1 A patient’s mother sought subsequent treatment by Provider X after having been “reduced to tears” by Licensee’s “bullying” her into his personal vaccine schedule against her express wishes for full vaccination for her child.

3.2.2 Patient A’s mother requested polio and rotavirus vaccinations for Patient A according to CDC Recommendations, but Licensee did not have those vaccines in the clinic, and Patient A would therefore not be able to get them. Patient A’s mother reported that the Licensee questioned why she wanted Patient A to get the polio vaccine and asked whether they were traveling to Africa. During the appointment, Licensee continually connected vaccines (not specific) with autism. Licensee asked her how awful she would feel if Patient A got autism and she could have prevented it.

As I noted at the time, this sounded a lot like a common description by antivax mothers of pediatricians and nurses trying to persuade them to accept the CDC vaccine schedule, that of “bullies.” After all, Dr. Thomas tried to guilt one mother into not giving her child recommended vaccines using a false claim that vaccines cause autism, an antivaccine claim that has been tested time and time and time again through numerous studies, none of which has produced any scientifically convincing evidence that vaccines cause or even are associated with an increased risk of autism, and reduced another mother to tears because she wanted to follow the standard, science-based CDC-recommended vaccine schedule for her child. Apparently, Dr. Thomas is only understanding, empathetic, and willing to work with parents, as long as the parents do what he wants them to do, rather like the caricature of science-based physicians recommending the standard CDC-recommended vaccine schedule. Moreover, if he’s bullying parents who want to fully vaccinate their children, he should not be practicing medicine.

Indeed, the Board got it right the first time:

3.1 Licensee has published an alternative vaccination schedule that decreases the frequency of many recommended vaccines and omits others, including rotavirus. Licensee promotes his unique, “Dr. Paul approved” schedule as providing superior results to any other option, namely improved health on many measures, and fraudulently asserts that following his vaccine schedule will prevent or decrease the incidence of autism and other developmental disorders. Licensee uses this claim to solicit parental “refusal” of full vaccination for their children, thereby exposing them to multiple potentially debilitating and life-threatening illnesses, including tetanus, hepatitis, pertussis (whooping cough), rotavirus, measles, mumps, and rubella.

Personally, I was gratified that the cases described in the original order, plus Dr. Thomas’ documented history of using his bogus “alternative vaccine schedule” and bullying parents to dissuade his patients from vaccinating were enough to get the Oregon Medical Board to take emergency action. (Dr. Thomas denies that he did this, but I’m hard-pressed to believe him.) Again, from my perspective, it’s not the individual cases so much as the overall pattern that showed Dr. Thomas to be a menace to patients and public health.

The Galileo gambit and standard antivax tropes

The more interesting aspect of Dr. Thomas’ complaint is the sheer number of antivax tropes that he packs into it. For instance, for no apparent reason, his lawyers included quotes like:

92. The nature of science is to question. “The important thing is to not stop questioning.” Albert Einstein. “The scientist is not a person who gives the right answers, he’s one who asks the right questions.” Claude Lévi-Strauss.

93. “In questions of science, the authority of a thousand is not worth the humble reasoning of a single individual.” Galileo Galilei.

94. Knowledge about childhood vaccines cannot progress when questioning the safety of the CDC recommendations is considered so dangerous that even venturing into the facts is too great a risk.

95. Dr. Thomas published facts that question the safety of the CDC recommendations. By trying to silence Dr. Thomas, the Board is trying to use its authority stop the progress of knowledge.

96. By trying to silence Dr. Thomas, the Board is trying to take away the rights of parents to informed consent. Like totalitarians throughout history, the Board wants to limit the spread of knowledge that contradict the official narrative and to strip parents of access to information that contradicts the Board.

I must say that I’ve never seen passages like this quoting scientists in a legal complaint before. Regular readers will immediately recognize the Galileo gambit, in which the crank likens his “questioning” of science to that of Galileo. As I like to say, there are only a couple of correct responses to the Galileo gambit, namely that it is not enough to be persecuted for questioning existing science; you have to demonstrate that you have a case or, even better, be proven correct. After all, for every Galileo, Ignaz Semmelweis, and other scientific “heretics” threatened with torture, attacks, “silencing,” or—dare I say it?—cancellation who were ultimately proven right, untold hundreds or thousands (or even tens of thousands never see their ideas accepted, mainly because they are wrong.

I also like to add that the reason the ideas of Galileo, Semmelweis, Copernicus, Darwin, Pasteur, et al, were ultimately accepted as correct by the scientific community is because they turned out to be correct! Their observations and ideas stood up to repeated observation and scientific experimentation by many scientists in many places over many years. The weight of data supporting their ideas was so overwhelming that eventually even the biggest skeptics could no longer stand. That’s the way science works. It may be messy, and it may take longer, occasionally even decades or even longer, than we in the business might like to admit, but eventually in science the truth wins out. In fact, the best way for a scientist to become famous and successful in his or her field is to come up with evidence that strongly challenges established theories and concepts and then weave that evidence into a new theory. Albert Einstein didn’t end up in the history books by simply reconfirming and recapitulating Newton’s Laws. Pasteur didn’t wind up in the history books by confirming the concept that disease was caused by an “imbalance of humors.” I daresay that none of the Nobel Prize winners won that prestigious award by demonstrating something that the scientific establishment already believed.

Then, of course, there’s the outright conspiracy mongering, a variation of the central conspiracy theory of the antivaccine movement: “They” know that vaccines are dangerous. “They” are trying to silence Brave Maverick Doctors like Dr. Thomas who are only trying to tell The Truth to their patients. Also note the not-so-subtle likening of the Oregon Medical Board to the Pope and the Catholic Church, with Dr. Thomas likening himself to Galileo. That’s some serious arrogance there.

Let’s just say that Dr. Thomas…falls way short of those scientists of the past who were attacked and later vindicated. What do I mean? Dr. Thomas cites some of his own “research” in support of his claims that the CDC-recommended vaccine schedule is not safe:

79. On or about July 23, 2020, the OMB sent a letter to Dr. Thomas notifying him that the OMB received another “complaint” alleging Dr. Thomas engaged in unethical “human medical research” when for a study titled, “Can Integrative Medicine approaches and a selective vaccination schedule impact the health and rates of autism in a general pediatric population?” Again, the OMB did not reveal who made the complaint or what prompted this investigation.

80. But Dr. Thomas had received a regulatory opinion in 2015 from the Western Institutional Review Board (“WIRB”) stating that the research that Dr. Thomas was planning to perform was permitted under the law. It was permitted because it involved existing documents and the data utilized would be devoid of any identifying information linked to the identity of the patients.

81. In early 2019, the Board asked Dr. Thomas to show that his vaccinefriendly plan was better than the CDC recommended schedule.

82. Dr. Thomas then initiated an analysis of the population of his patients and the health outcomes as a function of vaccination status. The patient data was collected an anonymized. James Lyons-Weiler, an expert in data analysis, performed the analysis.

83. This is exactly the information the Board asked Dr. Thomas to produce. But the answer did not comport with the Board’s dogmatic opinion. On December 3, 2020, a few days after Dr. Thomas’ peer-reviewed paper became available online, the Board’s Investigative Committee met. Harder reviewed the case for the Investigative Committee which then forwarded the case to the full Board for action. On that same day, December 3, 2020, the full Board met. All eleven Board members who were present voted to suspend Dr. Thomas’ license to practice medicine on an emergency basis.

I laughed out loud, particularly at the part in which Dr. Thomas’ lawyers describe James Lyons-Weiler as an “expert in data analysis.” In any event, the study to which Dr. Thomas refers in his complaint is one that I analyzed in detail for its numerous design flaws, lack of ethics, and failures. The most glaring of these is the invention of a new metric without any validation of its reliability, the Relative Incidence of Office Visit (RIOV) based on billing records. The paper also reeked of p-hacking, given the sheer number of comparisons coupled with the bogus new metric.

The paranoia is rather thick, as well:

Dr. Thomas published his “Vaccine-Friendly Plan” in 2016. Starting in December 2018, the Board began its campaign aimed at damaging Dr. Thomas’ medical career and reputation. Since December 2018, OMB has been scouring the earth with the intent to find something to put Dr. Thomas out of business. The reason that the Board is singling out Dr. Thomas because he dares to give parents factually accurate information about the risks of the childhood vaccines. For that, the Board is hellbent on ruining him.

Got it, sheeple? Dr. Thomas is being “persecuted” by the Oregon Medical Board because he’s telling parents The Truth, based on his “science”:

A natural scientific observation, given the in autism and other disorders that track with the rise in childhood vaccination since 1986, is to question whether the vaccines are poisoning children’s brains at the time when they are the most vulnerable

Again, this is standard antivax boilerplate confusing correlation with causation. Vaccines do not cause autism, other neurodevelopmental disorders, or the panoply of autoimmune diseases and other maladies that antivaxxers attributed to vaccines.

Still, “Help, help, I’m being repressed!”:

This case is a particular example of how the Board and its individual members sought to destroy Dr. Thomas because he asked questions and failed to blindly follow its anti-science doctrine that all children must be injected with all the CDC recommended vaccines.

And tried to destroy—that’s right destroy—this Brave Maverick Doctor:

Dr. Thomas has shown, with peer reviewed scientific inquiry, that children who do not follow the CDC recommended vaccine schedule are much healthier than fully vaccinated kids. For the sin of following the science and revealing truth, the Board engaged in a campaign to punish Dr. Thomas. In its zeal to crush opposing views, the Board succeeded in destroying Dr. Thomas’ medical practice, marriage, and peace of mind.

Hint: He’s shown nothing of the sort with respect to unvaccinated children being “much healthier” than “fully vaccinated kids,” his frequent claims otherwise notwithstanding

73. As described in his book, for the more than 1,000 children born into Dr. Thomas’ practice who followed his vaccine-friendly plan there were no cases of autism. Other doctors around the country with similar protocols also saw excellent results.

74. In contrast, for those who presumably follow the advice of mainstream pediatricians—the recommended CDC vaccine schedule—one in forty-five children are diagnosed with autism. The difference in outcomes between Dr. Thomas’ patients and other children is stark and sobering. Autism is a significant life-changing impairment that lasts a lifetime. The dramatic increase since 1986 in rate that autism strikes our children is a national tragedy. That this dramatic increase is likely caused by vaccines intended to protect children is sickening.

75. If you were a parent, would you not want to know that one in forty-five children following the CDC schedule become autistic, while zero in 1,000 children who followed the vaccine-friendly plan became autistic? Dr. Thomas wants to inform you of those facts. The Board wants to silence Dr. Thomas so that you will not be informed of those facts.

“As described in the book.” Of course, Dr. Thomas has never published the data from his practice that led him to this conclusion in the peer-reviewed biomedical literature in a manner that would allow physicians and scientists to evaluate his methodology and analysis. I wonder why. Worse, whenever he does try to publish anything about vaccines or his vaccine schedule in the scientific literature, it’s crap studies in bottom-feeding journals that no decent scientist takes seriously because they are so clearly not serious studies.

I could go on, but let’s put this in context, as I said I would.

The antivax assault on state medical boards

Legal thuggery has long been one of the go-to responses of quacks, cranks, and antivaxxers to criticism or a government regulatory body (such as a state medical board) trying to protect the public from them. Here, Dr. Thomas is turning the thuggery up to 11 by suing the individual members serving on the Oregon Medical Board at the time the emergency suspension of his license was ordered. From my perspective, his intent is clear. He and his lawyers probably realize that they have little chance of prevailing—or even of getting very far with this lawsuit—but prevailing isn’t really the purpose. I see Dr. Thomas’ purpose as being intimidation and a grift show designed to burnish his brand as a Brave Maverick Doctor (fighting for you—yes, you!). By threatening financial ruin to individuals serving on a state medical board, he’s also setting a precedent that could lead any physician who’s an advocate of science-based medicine interested in helping to purge the medical profession of quacks and antivaxxers to hesitate or refuse out of concern about facing potential financial ruin if they vote to take action against a quack like Dr. Thomas. This is nothing new as a general tactic. It’s the level to which Dr. Thomas has taken this tactic that is arguably new.

As I’ve long written, quacks and their legislative supporters targeting state medical boards is nothing new. It’s long been a tactic of antivaxxers and quacks to target state medical boards legislatively, just as advocates for pseudomedical “disciplines” like naturopathy, acupuncture, and the like have long targeted legislators to achieve licensure in more and more states. I like to cite one example in particular. Dr. Rashid Buttar once led a successful effort by the North Carolina Integrative Medical Society to persuade legislators to change state law to make it friendlier to practitioners of alternative medicine. Now, North Carolina law prevents its medical board from disciplining a physician for using “non-traditional” or “experimental” treatments unless it can prove they are ineffective or more harmful that prevailing treatments. During the pandemic, efforts to get state legislatures to hamstring state medical boards so that they can’t act against antivax physicians who promote unproven COVID-19 treatments like ivermectin have proliferated.

Since the pandemic, though, cranks have turned their attention to attacking and harassing the individuals serving on state medical boards, just as during the pandemic they have attacked and harassed public health officials trying to implement public health interventions. Sometimes, these attacks have been menacing and potentially violent, an extension of what pro-vaccine legislators like Dr. Richard Pan have endured for years now. Now, “pioneered” by Dr. Thomas, it would appear that cranks are planning on seeing if they can attach legal liability to individuals serving in public health and regulatory capacities, such as state medical boards, if they act to strip quacks of their licenses.

I fear that the increasing level of harassment and threats, now coupled with the possibility of financial ruin from defending against frivolous lawsuits like Dr. Thomas’ very well might work in its intended purpose, to intimidate those who might want to make a difference by serving on state medical boards. And who could blame medical board members if they bail, concluding that it’s not worth the personal risk? After all, most medical board members are underpaid, overworked, and do what they out of a sense of duty, even as the boards themselves are understaffed and underfunded. That’s the idea behind the war on state medical boards, even if, as it appears to richly deserve, Dr. Thomas’ lawsuit is dismissed without ever going to trial.