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Dr. Google and Mr. Hyde

Anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that “my ignorance is just as good as your knowledge.”

Isaac Asimov

The first principle is that you must not fool yourself – and you are the easiest person to fool.

Richard P. Feynman

The Internet.

What would we do without it? It’s become so necessary, so pervasive, so utterly all-enveloping that it’s hard to imagine a world without it. Given how much it pervades everything these days, it’s easy to forget that it wasn’t that long ago that the Internet was primarily the domain of universities and large research groups. Indeed, the Internet hasn’t really been widely and easily available to the average citizen for very long at all. Go back 20 years, and most people didn’t have it. For example, Netscape Navigator, the popular browser that made the Internet accessible, wasn’t released until 1994. Amazon.com, an online store I can’t imagine living without now, didn’t sell its first book until 1995, and I didn’t discover it until 1996 or 1997. Google, that ubiquitous search engine that everyone uses, wasn’t incorporated until 1998. Now, less than 14 years after Google was incorporated most people have the Internet in their pockets with them in the form of mobile devices that have computing power undreamed-of in the 1990s and can access the Internet at speeds that increasingly blur the line between landline access and mobile computing. It’s been an amazingly fast social and technological revolution, and we don’t yet know where it will take us, but we do know that it’s not going away. If anything, the Internet will continue to become more and more pervasive.

Like all major new technologies, the Internet has a good side and a bad side. In many cases, the same property is both good and bad, and one place that this is particularly true is in medical information. The Internet has an abundance of medical information, all there for the reading and learning, and various discussion forums that began with online BBS services and the now mostly obsolete global discussion community of Usenet allow people from all over the world who would never have communicated directly with each other before to share information and experiences. Unfortunately, there is a dark side to this. Regular readers of this blog know what that dark side is, too. The same technology that allows reputable scientists and doctors to publish reliable medical information to the world at very low cost also allows quacks and cranks to spew their misinformation, nonsense, pseudoscience, and quackery to the whole world at very little cost. And, boy, do they ever! In many ways, the quacks are a far more effective online presence than skeptics and supporters of science-based medicine. I mean, look at SBM itself. We’re still using a generic WordPress template. Now look at an antivaccine website like The International Medical Council on Vaccination or Generation Rescue or the antivaccine blog Age of Autism. Look at quack websites like NaturalNews.com The comparison, at least when it comes to web and blog design, is not flattering.

The reason I started thinking about these issues is because at The Amazing Meeting this year, Steve Novella, Harriet Hall, Rachel Dunlop, and I will be discussing these very issues at what has become a yearly event at TAM, the SBM workshop. Coincidentally yesterday, a mere three weeks before TAM, I happened to be perusing the antivaccine crank blog Age of Autism, when I came across a post by someone named Cathy Jameson entitled Look It Up. In it, Ms. Jameson, after extolling the glories of the Internet and how it makes our lives easier (which it arguably does in so many ways), laments how she perceives herself to be treated by medical professionals when she tells them she’s looked something up on the Internet. In fact, she seems to think that doctors don’t want parents of children with autism to be looking things up on the Internet:

I know that some people don’t appreciate what’s available on the internet to an autism parent, nor do they want those parents anywhere near it. Those answers, that research, these numbers, that cover up. What a parent finds online is likened to a national secret. Looking up their child’s signs, symptoms, diseases or potential diagnoses is just not okay. The internet is not a viable source and its use should never be allowed by parents, especially autism parents. Heaven forbid they stumble across something beneficial for their child! And, they better not think that they can share that information with anyone, especially with the doctor they’ve hired to help them.

For a parent to admit they might have looked something up “online” while face-to-face in an exam room with their child’s medical provider—you would have thought it criminal! It should be outlawed! And, don’t dare tell anyone else you did that. EVER. If you do? Oh, boy. The parent who did take the time to do a little bit of research is given the hairy eyeball, the condescending how-dare-you facial expression or worse, a lecture about how it’s not their place to do that kind of research for their own child. Hrmpf!

While this is primarily a straw man argument (no doctor that I would know would tell a parent not to go on the Internet), there is a grain of truth to the extent that experience has taught us that a lot of what parents like Ms. Jameson find on the Internet is either wrong, incomplete, or, worse, dangerous quackery. The reason that pediatricians sometimes have a hard time not rolling their eyes or sighing when a parent like Ms. Jameson tells them that she has some information that she found on the Internet is that they know that what will follow is likely to be the same misinformation that they’ve had to try to refute time and time again. As hard as it is to believe, doctors are human, too. We have our moments of weakness, when we have a hard time not showing our frustration at the same pseudoscience that we’ve heard time and time again. Arguably, we need to try our hardest not to let such feelings bubble to the surface when we are in a room interacting with a patient or parent, but we do sometimes. However, there’s also the matter of perception. A quite reasonable comment to a parent pointing out that the information she has discovered online is not scientifically valid and comes from a website that is not reliable is interpreted as a fascistic crushing of her freedom of speech and assembly. For instance, take a look at this comment after Ms. Jameson’s post by AutismGrandma:

All of this reminds me of Germany in WWII, where Nazi government radio information was the only sanctioned legal option. Anyone caught listening to Radio Free Europe was thrown into a concentration camp. Were Jewish people and many others being killed with poison gas in concentration camps? Radio Free Europe said Yes it’s true. Are babies and children being poisoned with vaccines? The INTERNET says Yes it’s true.

Because telling a patient or parent that a website is full of nonsense, no matter how diplomatically one tries to do it, is exactly like crushing all competing sources of information and killing Jews in gas chambers. Sadly, that is the sort of rhetoric that is common in the quackosphere in general but in particular the antivaccine crankosphere. But what to do? Most parents and patients aren’t as paranoid and hostile as AutismGrandma. They’re just regular people who want reliable information about various conditions they or their children suffer from but are not sufficiently scientifically sophisticated to separate the good health information from the bad. How do we help them do that? Certainly Google and other search engines are little or now help. There is no filter to them other than the number of incoming links. A quack site to which a lot of other sites link, particularly if they are sites that also have a lot of incoming links and thus a high Google rank, will show up very high on Google searches. The scientific value of content is basically irrelevant. I’ve seen Mercola.com, Age of Autism, or NaturalNews.com links show up in searches right above or below links from reputable websites like the NIH, CDC, or the American Cancer Society. The democratization of information on Google is the very fulfillment of Isaac Asimov’s warning so many years ago.

Vaccine misinformation online

If there’s a medical topic about which there is more misinformation available on the Internet than vaccines, I’m hard pressed to think of it. The only topic I can think of that even comes close is cancer. Antivaccinationists are vocal and active, particularly online. They’re very good at getting their pseudoscience-laden websites listed high on Google search results. Indeed, our very own Mark Crislip wrote about this very issue a couple of years ago, when Anna Kata of McMaster University published a study about vaccine misinformation on the Internet. Amusingly, Mark pointed out that Kata is an anthropologist, and he needs an anthropologist to help him explain a culture (the antivaccine underground) in which science and the facts do not matter. In any case, the study examined the specific sorts of misinformation that are easily found online, with 100% of antivaccine sites stating that vaccines are dangerous and contain poisons, and the vast majority of them claiming that vaccines do not work.

Kata is also the author of a recent study published in Vaccine entitled Anti-vaccine activists, Web 2.0, and the postmodern paradigm – An overview of tactics and tropes used online by the anti-vaccination movement. Scott Gavura has already discussed it, but that won’t stop me from briefly using it as a means of pointing out the sorts of misinformation that can cause physicians to react negatively to patient Internet research.

Kata’s opening sets the stage:

Vaccinations are a significant public health achievement, contributing to dramatic declines in morbidity and mortality from vaccine-preventable diseases [1]. However, by reading certain websites, one might be persuaded to think the opposite – that vaccines are actually ineffective, useless, or even dangerous. These are merely some of the arguments posed by the anti-vaccination movement, an amorphous group holding diverse views that nevertheless shares one core commonality: an opposition to vaccines. The popularity and pervasiveness of the Internet today has facilitated the transmission of such beliefs.

Many people search online for health information, and the information found impacts patient decision-making; it is therefore essential to understand what is shared online. This paper provides an overview of how the new generation of the Internet (Web 2.0) and its emphasis on user-generated content has combined with characteristics of the current postmodern medical paradigm, creating a new environment for sharing health information. The anti-vaccination movement has taken advantage of this milieu to disseminate its messages.

Kata then launches into a discussion of how Web 2.0 has proven to be a two-edged sword in medicine, just as I’ve pointed out above that it is. As I’ve discussed before on SBM several times, paternalism is on the decline and medicine is moving towards a model of shared decision-making between the physician and patient, a process facilitated by the availability of more high quality information about health on the web than has ever been so easily available before. Unfortunately, that movement can be (and often is) easily hijacked by the dark side of Web 2.0. While 20 years ago, medical knowledge was largely bound to textbooks, journals, and medical institutions, today, not only is it available on many websites but even the primary literature is in many cases available to the public, thanks to laws requiring that NIH-funded research be deposited in PubMed Central and that clinical trials and their results be deposited in ClinicalTrials.gov. Unfortunately, the power of the Web 2.0 to empower patients is also the power to confuse and misinform. As Kata points out, postmodern attitudes, in which science-based medicine is just “another way of knowing” can combine with new “expert systems” in which people without advanced training come to think themselves just as much “experts” as the real experts. Although Kata doesn’t mention it, it’s the Dunning-Kruger effect writ large, the arrogance of ignorance.

Kata also correctly identifies most of the common tropes and tactics of the antivaccine movement. First, the tactics:

  1. Skewing the science. This involves cherry picking studies, denigrating science that doesn’t support an antivaccine viewpoint, and endorsing bad science that supports antivaccine agendas.
  2. Shifting hypotheses. Otherwise known as moving the goalposts, this involves continually changing the standards of evidence deemed necessary to convince antivaccinationists of vaccine safety so that they can’t be met and constantly coming up with new causation hypotheses that share only one thing in common: it’s always about the vaccines. Always. No matter how the hypotheses or goalposts shift, it always boils down to: The vaccines done it!
  3. Censorship. This is an extreme characteristic of the antivaccine movement. For instance, Age of Autism does not allow much in the way of dissenting comments. The Autism One yearly quackfest routinely kicks out those its organizers perceive as enemies, even though they follow the rules and don’t disrupt anything. For example, last year Ken Reibel and Jamie Bernstein were expelled. Just last week, the antivaccine group Canary Party refused to register a skeptic, P.Z. Myers, who wanted to attend its meeting in Minneapolis next month. In the meantime, they go ballistic when one of their own is asked to leave a scientific function. We’ve seen this several times, such as when AoA and its hanger-on Ginger Taylor wailed and gnashed their teeth over Paul Offit’s and Seth Mnookin’s having asked AoA’s one trick pony irritant to leave and Offit’s accurately characterizing him as a “stalker.” I’d take their complaints slightly more seriously if the antivaccine movement didn’t so ruthlessly censor its perceived enemies and refuse to let them anywhere near their crank venues. On the other hand, I can sort of understand why they do it. After all, if there are talks about using bleach enemas to cure autism or by a Nobel laureate turned crank who now buys into homeopathy and also thinks that autism is due to bacterial infections, one can see that they definitely have something to hide. It’s not for nothing that I refer to Autism One as a quackfest.
  4. Attacking the opposition. The antivaccine movement is particularly incessant in this tactic, in my experience. I’ve lost track of how many times I’ve been attacked or had antivaccine cranks try to cause me annoyance at my job by e-mailing my bosses. Almost exactly two years ago, a bunch of antivaccine cranks, “inspired” by a false accusation of an undisclosed conflict of interest from Jake Crosby, tried to get me fired from my job through a campaign of e-mails, phone calls, and letters to the board of governors at my university. And what I’ve experienced is minor indeed compared to what someone like Paul Offit has experienced.

One tactic that Kata left out is one that I’ve noted before. It’s not a tactic unique to the antivaccine movement, but antivaccinationists certainly use it. I’m referring to crank conferences gussied up to look like legitimate scientific conferences. For example, we have the yearly quackfest known as Autism One every year in Chicago around Memorial Day. Recently, Autism One has joined forces with the health freedom movement, combining an Autism One conference with the Health Freedom Expo from March 2-4, 2012 in Long Beach, CA. In this, we might be seeing an even more obvious sign of the scientific bankruptcy of antivaccinationists in that Patrick “Tim” Bolen was featured on a “Vaccine Panel.” I thought that having Dan Olmsted chair a panel called Malfeasance in the Media that includes Tim Bolen, David Lewis, and Andy Wakefield was bad enough. After all, that’s a group that could give the masters’ how-to-do-it course on media malfeasance. Then there was “movie night,” which featured the Burzynski movie, as well.

Now, here are the tropes:

  1. “I’m not antivaccine; I’m pro-safe vaccines.” Yes, indeed. This one is the biggest, baddest, most irritating trope of all, repeated by everyone from Jenny McCarthy to J.B. Handley to Barbara Loe Fisher. A variant of this is to liken vaccines to cars and say that “I’m not ‘anti-car,’ I just want safer cars.” Not a good analogy. A better equivalent would be if they demanded absolute safety of cars and refused to use them unless GM, Ford, Chrysler, Toyota, Honda, et al swear that they’ll never be injured in a car crash.
  2. Vaccines are toxic. A.k.a. “the toxin gambit.”
  3. A demand for absolute safety.
  4. A demand for absolute “proof” that vaccines are safe.
  5. “Vaccines didn’t save us,” one of the more intellectually dishonest of many intellectually dishonest tropes used by these cranks.
  6. Vaccines are “unnantural.”
  7. Choosing between “vaccine injury” and disease. Jenny did this famously when she said vaccination are a choice between autism and infectious disease and that she’d take the measles.

Kata lists more of these tropes, and this is one case where I can’t think of any that she missed, at least not major ones, except for perhaps the recent coopting of the term “denialism” for their own by antivaccinationists. The term “denialism” is used to describe movements that deny well-established science based on flawed reasoning, pseudoscience, and misinformation, such as evolution denialists or anthropogenic global warming denialists. Kata also didn’t emphasize the concept of “misinformed consent” enough, in which under the guise of “informed consent” antivaccine pseudoscience is used to make vaccines seem more dangerous and less effective than they actually are.

It’s not just vaccines, of course, about which there’s copious easily locatable misinformation on the Internet. I simply chose to spend most of this post discussing vaccines because Ms. Jameson’s post “inspired” me to and, of course, because there appears to be the most research out there about how the Internet can affect parents’ attitudes to vaccination and how parents use it to find information.

My specialty is, of course, breast cancer; so I try to keep up with what sorts of misinformation and quackery are making the rounds on the Internet so that if I’m asked about them I can respond intelligently (or at least try to appear to). Recently, I noted that a particularly nasty form of cancer quackery, Cantron, is making the rounds. Then, of course, Stanislaw Burzynski’s “antineoplastons” wax and wane in popularity, seemingly depending upon how much he is in the news. Throughout all that, certain tactics and tropes remain the same in cancer, such as claiming that chemotherapy doesn’t work, that most oncologists wouldn’t choose chemotherapy for themselves, that there are “natural” cures for cancer that the [INSERT ONE] FDA/big pharma/government/cancer industry/AMA/etc. don’t want you to know about. Indeed, just yesterday I found a website Healing Cancer Naturally, which I might have to discuss in more detail in the future. In the meantime, it will suffice to point out that it touts quackery like detoxification, choosing the right cancer treatment using applied kinesiology, Max Gerson’s therapy, ozone and hydrogen peroxide therapies, and, of course, “energy healing.”

In fact, I sometimes think I should see if Kata would like to team up to do a similar study about cancer information on the Internet.

“Research.” You keep using that word. I do not think it means what you think it means

A large part of the problem with Internet “research” by patients and parents is that lay people have a very different idea of what “research” is than scientists and physicians do. I’ll show you what I mean by going back to what Ms. Jameson wrote:

Several incidents within a week’s time had me reeling about how some medical people guard the internet as if it was their own. Oh, that look of disdain they threw toward me when the word internet came out of my mouth. Give me a break! Not only do they sound ridiculous, they look ridiculous too as they tried to dismiss my well thought out, educationally minded, researched contribution about my son’s issues. It wasn’t rubbish. It most certainly wasn’t some back alley mumbo jumbo. What I shared was information found on credible sites and in online medical journals they too have access to.

Let’s for the moment take Ms. Jameson at her word and not quibble over whether what she considers to be “credible sites” probably differs greatly from what a physician would consider a “credible” site. Let’s assume that what she was showing her pediatrician was in fact nothing but studies from peer-reviewed journals or second-hand reports of such studies. Here’s the problem, and it’s a problem to which Mark Crislip alluded. To become a real expert in a field requires paying dues that go beyond doing some searches on Google and finding studies that confirm your preexisting beliefs. Yet, that is what patients and parents like Ms. Jameson do and call it research.

Indeed, a commenter named Bridget N. even basically admitted this, without actually knowing that that’s what she’s doing. First, she related a story in which she told her pediatrician that there were “aborted fetal cells” in vaccines and that vaccines caused autism. Apparently her pediatrician, if Bridget is to be believed, didn’t react that well. Here’s what Bridget did when she got home:

When I got home, I did a simple internet search, probably on Google or Yahoo, and with very few clicks of the mouse, I found the phamaceutical companies own documentation with regard to the aborted fetal cells. Detailed information was just a click away, but I was the moron for bringing it up?!

If you would like to see the sort of information that Bridget no doubt got from her search, simply type “vaccines aborted fetal cells” into Google. What came up for me first was a website called Children of God for Life. Several of the other links that came up on the first page included one from Mercola.com (Human DNA in Vaccines Linked to Autism), one from VacTruth.org (Aborted Human Fetal Cells in Vaccines), and a number of other fear mongering articles. In all fairness, the Catholic Church’s position statement on the issue also comes up; however, several of these posts imply or state that something about the “aborted fetal cells” is dangerous, when this is not true. No doubt she found the “review” of vaccines by Helen Ratajczak, who claimed that homologous recombination of fetal DNA from these cells cause autoimmune disease in a breathtakingly ignorant bit of scientific speculation. Then, if you Google “vaccine autism,” you will find a number of reputable sites. But you will also find a number of antivaccine sites, such as Generation Rescue, Infowars, and articles by David Kirby.

This is not “research.” It is motivated reasoning. The problem, of course, is telling the difference between real debate and research and cherry picking studies to defend one’s preexisting beliefs. The latter is motivated reasoning, and it’s one of the reasons that the educated are often prone to pseudoscience. They’re simply better at constructing reasonable-sounding arguments to defend their pre-existing beliefs.

It’s also a matter of context and quality control. Advanced training in science is not so much about learning a body of information, although that is certainly important. It is far more about learning the scientific method, learning how to do science. It involves learning to learn, how to do research, how to evaluate the quality of research, and, most importantly, how to put the results of new studies into the context of existing knowledge. There’s a reason it takes many years to learn these skills; they’re difficult and require a lot of work to acquire. There is no shortcut, either, not even the University of Google. True, there is a difference in medicine, specifically that it is more necessary to learn a large quantity of rote information. Medicine is not science, and most physicians are not scientists (I realize I get into trouble for pointing out this simple fact), but medicine should be science-based. What Ms. Jameson and Bridget N. do resembles research in the same way that doing a junior high school science project resembles doing Nobel Prize-worthy research, the difference being that the kid doing the junior high school science project is much more likely to gain an accurate insight into an aspect of science than Ms. Jameson or Bridget N. are to gain useful scientific insight into vaccines or autism.

What to do

It all once again boils down to a single question: What to do? The Internet is a Dr. Jekyll and Mr. Hyde phenomenon, as far as health information goes. When it’s good, it’s really, really good, and when it’s bad it’s horrid. That misinformation is out there, and it has an effect. As Scott Gavura has pointed out, it doesn’t take a lot of misinformation, and it doesn’t take very long for that misinformation to color people’s perception of the risk-benefit ratio of vaccines. Going back to the article by Kata, I note that she closes by remembering a famous quote by J.B. Handley, in which he likened Andrew Wakefield to “Nelson Mandela and Jesus Christ all rolled up into one,” after which she concludes:

Such a statement is a reminder that finding common ground with those who question, fear, or crusade against vaccines is no easy task. Their arguments are constantly shifting and evolving – this has been furthered by the fluidity of the Internet and social media. While acknowledging and correcting flawed arguments is important, an approach that moves beyond providing “the facts” is likely needed. With the anti-vaccination movement embracing the postmodern paradigm, which inherently questions an authoritative, science-based approach, “facts” may be reinterpreted as just another “opinion”. This issue is as much about the cultural context surrounding healthcare, perceptions of risk, and trust in expertise, as it is about vaccines themselves. For these reasons it is possible the minds of deeply invested anti-vaccine activists may never be changed; therefore it is for both the laypersons with genuine questions or worries about vaccines and the healthcare professionals who work to ease their fears that keeping abreast of the methods of persuasion discussed here is essential. Recognizing anti-vaccine tactics and tropes is imperative, for an awareness of the disingenuous arguments used to cajole and convert audiences gives individuals the tools to think critically about the information they encounter online. It is through such recognition that truly informed choices can then be made.

If there’s one thing I’ve tried to do on this blog, it’s to hammer away at each and every one of these common anti-vaccine tropes, as well as the not-so-common ones as well. The reason is that I don’t want them to be able to spread these tropes unopposed and unanswered, although the antivaccine movement is so protean and I have a day job that it seems like a Sisyphean task in which progress appears minimal. Yet the skeptic movement and physicians like Paul Offit appear to have had some effect, particularly in the wake of Andrew Wakefield’s downfall. At least anecdotally, I see less antivaccine propaganda making it into mainstream media reports, less blatant false “balance,” in which antivaccine propagandists are given equal voice with scientists as though there were two equivalent sides to the argument, and more skeptical articles that refute antivacicne myths and expose antivaccine autism quacks. Kata is right. The basis for such progress is the wide dissemination of good science about vaccines, refutation of the misinformation spread about vaccines, and shining the light of day on the various quacks who take advantage of the antivaccine movement.

In fact, one of the commenters after Ms. Jameson’s article states:

And if a physician cannot explain to me – in layman’s terms – why I’m wrong then how much does he/she really know about the subject? IMHO the mark of true knowledge is the ability to make the complex concept more comprehensible.

I realize that such a person is unlikely to accept even such arguments that make the complex comprehensible to the educated lay person, but being able to do that is the bare minimum that we as physicians must be accomplish. But even that’s not enough. We have to be able to communicate these concepts one-on-one in a manner in a manner that is not condescending or angry, as difficult as that is. Yet, even that’s not enough.

At least, it’s not enough in and of itself, but it’s a start.

Posted in: Science and the Media, Vaccines

Leave a Comment (35) ↓

35 thoughts on “Dr. Google and Mr. Hyde

  1. art malernee dvm says:

    If the FDA has justified why they told the public to revaccinate again this year with the flu vaccine we got last year I woul like to read what they said or have any data they based their opinion on.
    Art Malernee dvm

  2. Deetee says:

    Sadly, a look through the comments after Cathy Jameson’s article on AoA tell us all we need to know about the problem. Most of the tactics/tropes you mention above are plainly evident.

    One poster even states how he/she and his/her son have been cured of problems after “researching frequency healing” on the internet. Yep, that’s right – he/she is full of praise for Hulda Clark’s zapper and Raymond Rife. “I’m so thankful every day for the world wide web!!” is the comment (but I bet those quacks who exploit credulous, vulnerable marks for money are even more thankful for it).

    These people insist what they are doing is “research”, and will tolerate no suggestion that in order to make sensible and rational judgements about the relevance of the material they need more than just a highschool diploma or a knowledge of some medical jargon. What they seek is as you say, motivated reasoning, and there is no attempt to look at the totality of evidence, to scrutinise evidence that is counter to their own bias, or to seek an truly objective overview from an independent source. Anything they “research” that runs counter to their own preconceived notions on a topic can be rationalised away as being a govt. conspiracy, or a CDC disinformation campaign, or a conflicted/flawed study, or pharma-funded propaganda.

    PS: When one of the latest posters (Eileen Simpson) commented: “This AOA site is an excellent example of free speech because participation is invited.” I nearly fell off my chair.

  3. Deetee says:

    @art, that’s way off topic, but I did check. (I don’t know whether to feel pleased that you have not done your own internet “research” on the subject and have come to scienceblogs for a considered, informed answer, or not.)

    http://www.cdc.gov/flu/about/season/vaccine-selection.htm

    On February 23, 2012 the WHO recommended that the Northern Hemisphere’s 2012-2013 seasonal influenza vaccine be made from the following three vaccine viruses:

    an A/California/7/2009 (H1N1)pdm09-like virus;
    an A/Victoria/361/2011 (H3N2)-like virus;
    a B/Wisconsin/1/2010-like virus (from the B/Yamagata lineage of viruses).
    While the H1N1 virus used to make the 2012-2013 flu vaccine is the same virus that was included in the 2011-2012 vaccine, the recommended influenza H3N2 and B vaccine viruses are different from those in the 2011-2012 influenza vaccine for the Northern Hemisphere.

    So it’s not the same vaccine, but one with different flu strains (with the exception of the H1N1 swine flu which is still prevalent, and so still in the vaccine).

  4. art malernee dvm says:

    So it’s not the same vaccine, but one with different flu strains (with the exception of the H1N1 swine flu which is still prevalent, and so still in the vaccine).>>>>

    Thank you so much. I had read on the Internet the government had us getting the same formula flu vaccine we got last year and google was not helping me. Your information made my day.
    Art Malernee dvm

  5. windriven says:

    Gutenberg isn’t responsible for “The Protocols of the Elders of Zion” and Al Gore* isn’t responsible for “Age of Autism.” Delusional ignorance will likely always exist and will likely always exploit every possible means of transmission.

    *No, I don’t believe that Al Gore invented the internet.

  6. Another great article by Dr. Gorski. A point that I would have directly made is that the “problem” with the Internet is it gives “both sides” the illusion of equal footing. “Well, it has a website [$10/month] and the person writing it has a PhD [$1,000 from a fake univeristy], there fore it must be true.” Indeed, the majority of laymen, when they say they researched something, mean that the put a few keywords into Google and read the first five articles that popped up. And let’s be honest, the layman probably can’t discern fact from fiction on those quack sites.

    re: Tim Bolen, I received a hilarious email from him when I ran my website. He of course threatened me, demanded all my personal information, etc. I saved a copy. Of course I didn’t respond. But I did read his website, where he wrote libelous things about most for the authors here. After receiving dozens of hate mails from psychotic people who believe in conspiracy theory-like things related to health care, chiropractors who practice all sorts of ridiculous quackery and diagnose people with fake diseases, and seeing what sort of garbage is written about legitimate doctors, I took down my website.

    I’m not at the point in my career where I don’t care what people write about me, and I run a charitable organization that does medical mission trips and don’t want it tarnished by quacks. I don’t want my name Googled and a bunch of slanderous junk shows up. I literally saw fake claims about a doctor raping a patient. Screw that. They won. The fear of them spreading lies on the Internet about me made me just delete my website.

    When you think about it, it’s pretty messed up. We are literally only trying to educate people about quackery, and we are treated as the bad guy. If you point out that a chiropractor is practicing quack NUCCA therapy, they threaten a lawsuit, if you point out that people diagnose people with fake diseases, they threaten lawsuits. I don’t have the time or energy to defend myself against rank idiots. What are we to do?

    In light of the litigious nature of these idiots, I whole-heatedly take off my hat and bow to our authors here. You guys take a lot of crap from these quacks, and your “Internet reputation” takes a slanderous beating, all in the name of providing higher quality healthcare to the sick and dying. Seriously, I applaud you. Thank you for what you do (and I mean all of you.)

  7. qetzal says:

    Like it or not, I think physicians need to start being proactive and ask their patients whether they’re researching medical issues online, and encouraging a discussion about what they’re reading. Otherwise, the physician may have no chance to counter any misinformation, or worse, any dangerous health practices (like vaccine refusal) that their patients might adopt.

    Some patients will not be persuaded, of course. But many will hopefully be willing to listen to their physician, especially if they feel that their questions are welcomed and that they won’t be scolded for readong online info.

    I’m not an MD, but I recognize that this is problematic, since it potentially requires more time from the physician and may not be easily reimbursed. But the fact is that more and more patients will be doing their owm medical research on Google U. Failure to deal with that in an up-front and non-judgmental way guarantees that the physician’s advice will be undermined and ignored by a significant fraction of patients.

  8. “…at The Amazing Meeting this year, Steve Novella, Harriet Hall, and Rachel Dunlop will be discussing…”

    I don’t mean to invoke pedantry, but I’m hoping that the omission of yourself from this list isn’t intentional, and it doesn’t mean that you’ve pulled out of TAM 2012 &/or that you won’t be part of the SBM workshop.

  9. shawmutt says:

    Most people are looking to confirm their bias when doing “research” on a malady. The main way quacks and cranks have a leg up over actual medicine is by getting the most hits on a Google search.

    My son suffers from severe eczema. I do a search on “eczema” and find some pretty good articles on what it is. However, I don’t need to know what it is, I want to know “how to cure eczema”. I go deeper down the rabbit hole with that search. And, well, if I was inclined to think natural equals better, I might search for “how to cure eczema naturally”. It gets darker and darker.

    But I want I really want to know is how other parents are dealing with their children’s eczema, so I search for “eczema forums”. Wow, talk about disheartening. Even if one can slog through the obvious sales pitches there are multitudes of misguided anecdote to slog through.

    I’m typing too long, but in conclusion: the issue is that most doctors still haven’t figured out how to deal with the internet. We need more of a professional presence that folks like me can rely on when I go to an allergist and he turns out to be a quack. Forget about fancy flashy websites, we need more good information to counteract all the bad. The good news is it only takes one article to counteract all the sites parroting the same tropes. However, average people need to know where to find the good articles when their buried in a sea of crap by Dr. Google.

    Thanks to the panel of doctors on this blog that are getting us one step closer to that goal.

  10. DavidRLogan says:

    Fun read…”Netscape Navigator” was a real blast from the past.

    I was surprised and disappointed to see this website’s spilled over into your (and Skeptical Health’s) personal life. That’s too bad…as a student I’ve really gotten a great deal out of SBM and am grateful for the various commenters. I used to entertain a version of the “vaccines haven’t helped us” trope…it was this website that helped me realize what a knucklehead I am (I think it was Chris).

    Thanks for another interesting post.

  11. Old_skeptic says:

    I’m not a doctor, and I don’t even play one on TV.

    But wouldn’t it make sense for doctors to caution their patients that a lot of the health information on the Internet is rather awful? And can’t doctors advise patients that it would be a good idea to start their Internet research on health topics by searching MedlinePlus, rather than by doing a Google search?

    Admittedly, this approach won’t help patients who have already become convinced of the validity of something that isn’t supported by science. But for most patients, it could help to ensure that they at least start out their Internet investigations by reading something sensible.

  12. Woody says:

    “I’m not an MD, but I recognize that this is problematic, since it potentially requires more time from the physician and may not be easily reimbursed. But the fact is that more and more patients will be doing their owm medical research on Google U. Failure to deal with that in an up-front and non-judgmental way guarantees that the physician’s advice will be undermined and ignored by a significant fraction of patients.”

    @qetzal – It doesn’t “potentially” require more time – it requires more time in the setting of a brief office visit where there already is an inadequate amount of time to accomplish the necessities of the purpose of the visit – reviewing the results of diagnostic studies, relaying a diagnostic impression, discussing treatment and planned follow-up. That all has to happen typically in 15 to 30 minutes, ideally including the various electronic orders, prescriptions and appropriate documentation and coding for the encounter.

    To really tackle the education you propose, you are looking at a time investment of at least 20 minutes, just to scratch the surface. There quite simply is not enough time, and I don’t think most patients would be receptive to a statement like – “I am concerned that you may be getting some misinformation about this topic, and I think we should schedule a follow-up visit at some time in the future to delve into this further, as there is not enough time to do it justice at today’s visit”, recognizing that they have to pay out of pocket for that educational visit as well as the opportunity cost of missing another half-day of work. Most people want one-stop shopping, and if a doctor doesn’t address all of their concerns in that brief visit, then they probably leave feeling that the doctor was dismissive, distracted, or hurried, all of which of course could be true, but usually the last reason is the main one, at least speaking for myself. When I take the time to tackle these issues, it is at the expense of me seeing my next patient on time.

    My worst personal experience with the “Google U phenomenon” involved a very well-educated patient with a doctorate degree in a non-medical area. For every office visit, this person came equipped with a stack of research articles printed off the internet, most based on animal studies or bench science only peripherally-related to the medical issue for which I was seeing the individual. In total there were several hundred pages of material brought to me, aside from the “usual” medical records. At the last visit, this person requested a trial of seven psychoactive medications concurrently based on their “research”, none of which were clinically-indicated or tested specifically for the medical issue at hand. When I explained respectfully that such treatment was not supported by evidence and would be risky given the numerous potential interactions of the various medications, it was met with outrage. I was accused of being dismissive, paternalistic, not respecting patient autonomy, etc. All because I was reluctant to try untested therapies. An official complaint was filed by the individual to my state medical board regarding the incident, and though it was eventually dismissed, it required many more hours of me providing documentation that my care was not substandard in any way. From that point on I have been more hesitant to openly voice disagreement with dubious treatments that my patients may be pursuing. Not that I don’t do it, but I confess I am now a bit gun-shy. Being “upfront” can be perceived as being confrontational if the medical opinion does not align with the desires of the patient.

  13. Quill says:

    One of the things a good liberal arts education gives you is a grounding in research. Or it used to. I recall the first thing I was told to do when encountering a new book: turn immediately to the bibliography to check the sources, see where the author was coming from. This is such a basic habit that it is also the first thing I do when encountering a website purporting to purvey information. Where is it coming from? No cites or sources? Just opinion. If sources are listed, are they things I count as legitimate, such as well-recognized institutions, publications, or names? That sort of stuff.

    I wonder what happened to caveat emptor in terms of searching the internet? How do people who live in fear and assume vast conspiracies against them regarding medical things start out being so gullible, so accepting of what they find online? Why are they so unbearably skeptical regarding standard sources but totally accepting of fringe elements? I think it goes beyond motivated reasoning, or deeper, into some kind of pathology we don’t have a name for yet.

  14. Quill says:

    Dr. Gorski wrote:

    Medicine is not science, and most physicians are not scientists…but medicine should be science-based.

    This simple sentence strikes me as the heart of a problem, the path to a solution and the solution itself. But how to go about it all?

    Medicine should be made into more of a science. Physicians should be better trained as scientists and obviously medicine should be science based. Ok, where to start? Reforming the first year medical school curriculum to train future doctors in science-based reasoning, thinking and research evaluation?

    It is one of those things called an “open secret” that many of our best undergraduate universities have a lot of first-year courses that are essentially remedial education gussied up with fancy names. They long ago recognized that most of their students were arriving lacking in basic reading and comprehension skills and decided to do something about. Can medical schools do the same thing? Provide a mandatory year-long course or courses to remediate the lack of scientific thinking that permeates most aspiring doctors? I hope so.

  15. It would be a good idea to collect money by internet so that this website can be improved. The most important step is to make the information both very understandable and free for everybody. Many people use facebook and twitter nowadays, I don’t remember any SBM on these platforms.

    The only way to directly combat pseudo-science is to teach and inform the general public. Every bullshit news in the internet and newspaper should be analyzed and criticized. In that way, everybody will be free judge by themselves what is true and what is a illusion

    Thanks for the post

  16. WilliamLawrenceUtridge says:

    shawmutt, for the most part it’s pretty easy to get the kind of reliable information a patient might need from a very short list of websites (for non-CAM topics, I trust the Cochrane Collaboration, eMedicine, Medline/NCBI/National Library of Medicine, the CDC, the FDA, the Mayo Clinic, Harvard Health Watch and PubMed using the “Meta-Analysis/Reviews/Systematic Reviews” options in the “Article Types” tab to the left of the search results screen). That’ll give a very fast sense of the mainstream causes and treatments for most conditions.

    Most are terrible when it comes to reporting CAM, natural, holistic or integrative “treatments”, for all the reasons discussed on this blog. For information on CAM, SBM itself and Quackwatch are probably the best sources.

    Where these sites may fall down is the cutting edge of research, ongoing clinical trials and the like – but that’s not “treatment” anyway, it’s investigational stuff that probably won’t be available to the general public.

    If information found in those sites isn’t helpful, it’s possible there simply aren’t any effective treatments for the condition. Though this may be disappointing, the likelihood of finding more trustworthy information in a web fora or random webpage is vanishingly small. Chances are if you can’t find the information you need in the list above – effective treatments may not exist. It sucks, but that’s reality.

    In general I would say the mainstream sources of reliable medical information are pretty good at aggregating information you can trust – but can be terrible at giving hope where there is none. CAM, on the other hand, is fantastic at giving people hope (and terrible at giving people cures).

  17. WilliamLawrenceUtridge says:

    The only way to directly combat pseudo-science is to teach and inform the general public. Every bullshit news in the internet and newspaper should be analyzed and criticized. In that way, everybody will be free judge by themselves what is true and what is a illusion

    The problem is the amount of time it takes to develop a BS detector. It took me years to learn how to spot a crank (though now it’s fast). Doing the basic medical skeptical readings (Quackwatch’s core pages, the “top ten” pages on SBM covering vaccination and cancer quackery – which inevitably lead to chains of hyperlinks in background reading, the Skeptic’s Dictionary, etc) and learning to recognize the most common logical fallacies and why they’re not effective, all this takes a considerable amount of time. And much of this assumes a basic knowledge of biology which many readers might not have.

    I wonder if the best way to combat pseudoscience in medicine might be rebuilding trust in the primary institutions of medicine – doctors, the AMA, the CDC, the FDA and other “official” agencies. There’s a reason my previous post listed them as the core of my trusted links, they’re the core of scientific medicine and embody the processes and knowledge that underscores all that is good about conventional medicine. It would be nice if “conventional medicine” could stop being a pejorative CAM/quack term and could once again become a source of pride and trust.

    Though my inkling is it would take a series of very public deaths at the hands of quacks for this to happen, or a dramatic shift in how medicine is portrayed in the media.

    Meh, perhaps the pendulum will swing back within my lifetime.

  18. meghara says:

    I have been following SBN for a while now, and greatly admire the work that is being done here to inform and educate. I especially admire how many of the regular posters here take their time to patiently describe to the uninformed the importance of relying on accurate and science-based evidence when making health-related decisions.

    I am also a a regular reader of BoingBoing, and am having a hard time coming to grips with a new series they are hosting, the inaugural article of which came out today. http://boingboing.net/2012/06/25/make-yourself-healthy-daughte.html#more-149689

    I know my initial feelings about this article, but would be extremely interested to find out what the experts here have to say about it.

  19. ksadrieh says:

    Great read. I agree with previous posters that guiding patients to credible websites is the only way to battle “internet research.” It’s scary what people can find and what they can rationalize…

    “Jenny did this famously when she said vaccination are a choice between autism and infectious disease and that she’d take the measles.”

    I wonder if she would still choose measles if she had ever had it, knew any of the nearly 200,000 people it kills a year worldwide, seen someone with a post-infectious complication lilke ADEM (acute disseminated encephalomyelitis), or, heaven forbid, ever seen a case of SSPE (subacute sclerosing panencephalitis, which is the reason I didn’t let my kids play with non-vaccinated children until they were old enough to get the 1st MMR)

  20. qetzal says:

    Woody,

    Thanks for the comments. You’re right that I should never included the word “potentially” regarding the extra time.

    Regarding the patient you describe, what a horror story! My sympathies. From your description, however, I’d guess that sort of patient is going to be a ‘Google U’ problem regardless of whether or not you broach the issue first. But I imagine there are others that might only become problems if you open the door.

    Still, it doesn’t seem like the issue can just be ignored. Patients are going to be doing more and more online research. Some of them willbe misled by quack sites and will make dangerous medical decisions. If you don’t know they’re doing that, doesn’t that compromise your ability to manage their health properly?

  21. Woody says:

    Qetzal,

    I agree that the topic should not be ignored, and when I have the time I do engage patients in discussions about how to “sort the wheat from the chaff” when it comes to evaluating medical information. I unfortunately often don’t have the time to do it justice in routine office visits, and I can’t imagine what it is like for a general internist or pediatrician who may only have 15 minutes booked for a clinic visit.

    Another problem is that many patients are reluctant to disclose information that they feel will be negatively viewed by their provider. I know some local pediatric groups refuse to take on children as patients if the parents are not willing to adhere to standard vaccine schedules. Another example would be a disclosure that could compromise a person’s livelihood – most pilots or commercial drivers would be out of work if they disclose to a medical professional any condition that impair their ability operate such vehicles. I would like to think most people do the right thing and disclose all relevant information to their physicians, but the reality is far from ideal.

  22. nybgrus says:

    @meghara:

    The article is actually decently written, though obviously written by someone who really doesn’t have one single clue about medicine or biology.

    I would say that roughly 80% of the piece is pretty spot on and reasonably written. There are a few bad assumptions and that led to the (partly) incorrect conclusion at the end.

    The first part I take issue with is this common dietetic trope:

    All animals have an evolutionary niche and we should try to stay within it, said Smith. Ginna was impressed

    Yes, that is true… to an extent. The two things that are very important and never considered by people making such statement are that a niche is rarely so incredibly specific and it assumes that evolution has stopped at some arbitrary point depending on what the person is trying to hawk.

    For the first point, relatively few examples of such highly specific ecological/dietary niches exist in the animal world. By limiting what energy sources are useable a species would make itself much easier to go extinct should an ecological change make that particular food less available. Having the ability to successfully use a wide range of energy sources makes a species more evolutionarily robust. I agree that species will thrive better on different percentages of intake of certain foods – cats should have more meat for example. But to tie that in with gluten enteropathy (the general term for celiac’s disease) makes no sense and is completely incidental.

    The second point is key here as well and many smart people completely fail to understand it. Michio Kaku, a brilliant theoretical physicist, was widely ridiculed in the evo bio community for his video talking about how humans have stopped evolving. We haven’t. Not by a long shot.

    So having an arbitrary point at which “we evolved” and deciding whatever foods were prevalent at those times are the “best” for us makes no sense. Furthermore, the secondarily implicit assumption there is that the predominant food at the time was actually even the best for us at the time – it may have merely been all that was available for myriad reasons and we just barely subsisted on it! That seems much more plausible to me.

    The other big flaw of this piece is the misattribution. Gluten enteropathy is a disease of hyperactive immunity – the same as any allergic reaction. People who tend to have hyperactive immune systems also tend to have more types of allergies as well as autoimmune disease – the two processes are connected at the basic cellular level. Without going into odious detail, I’ll leave it to say that all the autoimmune diseases that Gail suffered are all known to be fundamentally connected through a complex genetic predisposition. Having a hyperactive immune system also leads to immune complexes (the IgA stuff amongst others – IgG, IgM, IgE) circulating in the blood. This deposits in the kidneys and causes them to decrease in function. Removing the source of the aggravation to the immune system (in this case the gluten) means less circulating immune complexes, which means that the deposition process can be reversed, and the kidney function can return to varying degrees. This is all to be expected and quite reasonably understood by medical science (though many of exact specifics are yet to be elucidated, the basic processes involved are well validated and understood).

    In other words, yes, gluten free certainly helped this woman in many ways. But that was only because she had gluten enteropathy. The article clearly implies that anyone would be similarly helped by a gluten free (or “Paleo”) diet. This is not true. It would be like saying that someone who is allergic to milk gets better after stopping drinking milk, therefore everyone should stop drinking milk to get better. And all built on a few flimsy premises and a lack of recognizing the underlying unifying concepts.

    For a bit of a better article about the Quantified Self aspect of it, I would direct you to this article. I will be upfront that a friend of mine is the lead author on the piece and I helped him edit it, but he is very much into the QS idea and takes an (IMHO) appropriately skeptical outlook on it and discussion of its limitations.

    Lastly, I’ll say that the article was not only written by someone without any relevant background, but apparently very quickly as well. If you notice in the last paragraph GFR becomes a typo – GFK.

  23. Sauceress says:

    Unfortunately, there is a dark side to this.

    I think Andrew Vachss put it rather well in an a 1997 article he wrote for MSNBC: “Cyber-chumps’ Are Net’s Big Victims”

    The real danger of the Internet is seduction of the arrogantly ignorant.

  24. AlbanyLynne says:

    In January, 2011, I was diagnosed with Stage IIB breast cancer. A good friend came to visit me after my surgery, and, as I make a living as a computer geek, my friend said to me:

    “I suppose you have googled all your treatments options”

    I said “Nope”

    He became more emphatic “No? You haven’t researched all the treatments?”

    I said:

    “No – I have done no searches and I am not going to.”

    I told him that when I was diagnosed, I noticed that to treat this disease, I was given not one, not two, but THREE doctors who would treat me – a surgeon, an oncologist, and a radiation oncologist. Between them, I estimated they must have 60 or more years of experience treating breast cancer.

    And I am going to discover all the pros and cons of my treatment options with a 5 minute google search? I don’t think so!

    I am deeply grateful to the Skeptics Guide to the Universe and other skeptical podcasts that I had been listening to for providing me with information on how to think critically. So, when I received my breast cancer diagnosis, I knew exactly what I would do – go to the largest medical hospital (that did not have a religious name) and get referred to good doctors.

    And, resist all the woo.

    When a friend brought me the book “Knockout” by Suzanne Somers, and begged me to read it, I also knew just what to do – google it.

    That google search led me to the Science Based Medicine blog. Your posts on Suzanne Somers are excellent. And, reading those posts is how I became totally hooked on Science Based Medicine. During many hazy hours of exhaustion after chemotherapy treatments, I read every post on cancer on your site lying in bed with my iPad. I watched the videos – I read everything. I am deeply appreciative of all of the work and effort that goes into the SBM blog, and I still read it almost every day.

    I will admit, chemotherapy and radiation treatments are really pretty miserable. However, I am pleased to discover, that when the treatments end, so does the misery. And, now I feel fine. And the statistics are on my side for living a normal life span.

    I think that people who turn to CAM do not realize that once the cancer treatments are over, the miserable side effects from the treatments are over too. That yes, with our current state of knowledge, the treatments are really harsh. But, breast cancer is an awful disease which left untreated kills in an extremely painful manner. Seven months of chemotherapy and radiation misery beats dying from breast cancer.

    Thank you everyone at SBM for the blog!

  25. Chris says:

    One of my kids recently had surgery at a Big Medical Mecca in Minnesota. A physician’s assistant warned me against looking up information on the internet. I told her much of the stuff on the internet was dreck, something I learned when the big search engine was AltaVista (on Netscape Navigator, I remember the “N” slowly spinning as the pages loaded slowly over a phone modem). I failed to tell her I have met four of the SBM authors (it would have been five but I was diverted by someone as I tried to corner Dr. Crislip at TAM9 in Las Vegas).

    Oh, cripes. I’m a groupie. ;-)

  26. pmoran says:

    I think that people who turn to CAM do not realize that once the cancer treatments are over, the miserable side effects from the treatments are over too. That yes, with our current state of knowledge, the treatments are really harsh. But, breast cancer is an awful disease which left untreated kills in an extremely painful manner. Seven months of chemotherapy and radiation misery beats dying from breast cancer.

    I think many patients do fail to realise that chemotherapy is mostly given as a finite course, especially when used as an adjuvant, as in the primary treatment of potentially curable breast cancer. I have never seen that point made on a CAM site or within an “alternative” cancer forum.

  27. Dingo199 says:

    I came across this post on the comments to the Cathy Jameson article on AoA from someone called Iama Poe (or was I just imagining it?)

    Cat, you are so right! If it were not for the internet I would be lost. My son Brad has had so many fantastic treatments and supplements since I was able to do online research for my own on what helps autism, and not bother with those silly cautions from my doctors to be careful what I read. Honestly you think they’d be afraid I might find something harmful using Google …as if! Why they think I might not be able to judge the relative merits of all these different sources of information about autism I haven’t the faintest idea. I mean, it’s not like I haven’t got 11th grade math or anything, because I have!

    Just look at a few of the wonderful remedies we have been able to get for Brad recently – There was that stem cell therapy in Tijuana which I would never have been able to find if I hadn’t seen it on the Natural News website. Totally ace! I know the cost is rather prohibitive, but what’s $50k when it comes down to getting your child back? I think the benefits are even greater than we got with that course of chelation last year, although it’s so hard to tell, since Brad doesn’t seem to say much to us anymore since that first series of stem cell lumbar punctures. But at least with the Lupron protocol we won’t have to worry about him getting some poor girl pregnant in a few years – now that’s a relief I can tell you, what with that trouble we had with Savannah last year!

    But I must let you know about what must be the best treatment so far, which I would never have known about without the meticulous online research I did on your AoA website. Yup, it’s that MMS stuff, the perfectly harmless supplement to give your autistic child. All it takes is regular enemas of something that sounds a bit like it could be bleach but it is so totally not (I mean is table salt the same as chlorine gas? Absolutely no way!!!). And as soon as Brad gets out of intensive care I am sure he will start enjoying the benefits of it, as long as I can convince him to let me stick those enema tubes up him again. I know he cries a lot, but it’s all for his own good obviously, not mine!

    Like you, I’m constantly on the internet. And like you, everyone I know relies on the information they find online for some reason or another. I mean, who would have possibly known Obama wasn’t born in the USA if it hadn’t been for the internet! Every day I count my blessings, and one day Brad will count them too in the future. I just have to hope we have enough money left to get there! But I don’t want to end by leaving you thinking I am so gullible that I believe everything I see online. For example only last week I read someone say that Mark Geier had his license suspended in yet another State. As if that could be even vaguely true, huh? The guy is a hero, and no one could possibly believe some ridiculous internet propaganda, could they? Well not me anyway!

  28. David Gorski says:

    Oh, geez. Those are hysterical. AoA’s censors moderators must be slipping. Or you imagined it.

  29. mattyp says:

    One of the reasons the paediatricians/doctors roll their eyes is that they encounter this so much that it can be draining having to justify your decisions to somebody who is not qualified to judge you.
    But here’s the thing – parents of children who are sick or ill are often reasonable, rational people who have been pushed and budged into an uncomfortable situation. Whereas once they may have pontificated or reasoned that they would listen and heed the advice of medical professionals, when desperate, rational people become irrational. That is why it is encumbant on all responsible doctors who practice science-based medicine to ensure that these reactions, whilst they may be the first thing that comes to your head, simply must not be offered.
    Parents need to see a doctor who values their opinions and the effort that they have gone to to look out for the welfare of their children, even if it is just paying it lip service for goodness sake. It might make your doctor-patient-parent interaction a more meaningful experience and it might prevent the parents from taking up the quackery…
    This is not directed at any doctor on this forum in particular, but could be aimed at doctors who feel the urge to “roll the eyes” at people like Ms Jameson

  30. BillyJoe says:

    mattyp,

    They’re probably rolling their eyes at you right now. ;)
    I think they know and agree with what you’re saying. They’ve vitually already said so. What they’re also saying is that doctors are human and therefore fallable. I often wonder what line of work people are in who make demands like this of others and whether they are as perfect in their own jobs.
    How is with you, mattyp? Are you perfect?

  31. mattyp says:

    Far from it. My upcoming exam results will probably attest to that. I still shoot for it though.
    Did I suggest that I was? Did I ask for perfection?

    Are we not in agreeance?

  32. JessA says:

    My mother is a nurse and pain management specialist who works mainly with MS and ALS patients. She has a strict rule (not enforceable, obviously) that they are not allowed to stray more than 4 clicks past the Mayo Clinic or NIH websites. WebMD is expressly forbidden.

  33. Narad says:

    If you would like to see the sort of information that Bridget no doubt got from her search, simply type “vaccines aborted fetal cells” into Google. What came up for me first was a website called Children of God for Life.

    Speaking of Cogforlife, their BFF HLI is in some hot water.

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