Every so often, as the health care reform initiative spearheaded by the Obama Administration wends its way through Congress (or, more precisely, wend their ways through Congress, given that there are multiple bills coming from multiple committees in both Houses), I’ve warned about various chicanery from woo-friendly legislators trying to legitimize by legislation where they’ve failed by science various “alternative” medicine practices. This began much earlier this year, when I pointed out how Senator Tom Harkin (D-IA) invited the Four Horsemen of the Woo-pocalypse to the Senate to testify. These included Dr. Andy Weil, Director, Arizona Center for Integrative Medicine, University of Arizona, Vail, AZ; Dr. Dean Ornish, Founder and President, Preventive Medicine Research Institute, Sausalito, CA; Dr. Mark Hyman, Founder and Medical Director, The UltraWellness Center, Lenox, MA; Dr. Mehmet C. Oz, Director, Cardiovascular Institute and Complementary Medicine Program, New York-Presbyterian Hospital, New York, NY. This occurred after Harkin had famously complained about the National Center for Complementary and Alternative Medicine, the Center in the NIH that he, more than anyone else, had created, because it had not validated enough quackery. (Yes, I know he didn’t use those words, but that was what he had done.) Most recently, Harkin tried to insert language that would mandate that the government and health insurers pay for quackery, as long as it was from licensed practitioners. Given that some states license naturopaths and even “homeopathic physicians,” such an amendment, if it stayed in place, would open the way for paying for all manner of nonscientific quackery.
However, there is another bit of chicanery that legislators are pulling, this time with the Senate version of the bill, that I have been made aware of by Rita Swan of CHILD and fellow SBM blogger Kimball Atwood. This time, the threat is religious, with Senators trying to insert measures into the health care reform initiatives that will pay for “religious” treatments, such as Christian Science prayer. Indeed, one of these, S.1679, entitled Affordable Health Choices Act requires the government or private party insurers to pay for faith-based therapies:
It’s rather amazing how sometimes the best laid plans of mice and men (and bloggers) come to naught. I had planned on doing a followup post to my previous post about the cancer quackery known as the German New Medicine by discussing a particularly nasty French variant of it. Unfortunately (or fortunately, depending upon your point of view), events conspired to move my blogging ire towards another target, particularly since I had addressed this isse before. Specifically, I’m talking about 2009 Recipient of the Richard Dawkins Award, comedian and HBO talk show host Bill Maher.
As you may recall, about a month ago, I wrote a rather long post (par for the course for me, I know) detailing ad nauseam how Bill Maher not only embraces germ theory denialism, anti-vaccine nonsense, and alternative medicine, in particular his apparent belief that “aggregate toxicity” or the typical unnamed “toxins” that alternative medicine mavens are so fond of blaming most disease on or, as Maher likes to call it, the “poisons” that we are eating and otherwise exposed to every day, but has been preaching this pseudoscience since at least 2005. Maher then followed this up a mere week before receiving his award named after a famous scientist with a hideously irrational promotion of cancer quackery. At that point, I thought I was done with the topic, at least as far as this particular blog goes (others know that elsewhere I’ve not been so quiet). At least, I had intended not to deal with this again on SBM.
Unfortunately, Bill Maher had other ideas. This is the perfect description for how I felt having to blog about this again:
Yes, it fits, particularly after Maher Tweeted to his fans:
If u get a swine flu shot ur an idiot.
Dr. Weil is often seen as the smiling “mainstream” of alternative medicine. He’s a real doctor (unlike, say, Gary Null), and much of what he advocates is standard and uncontroversial nutritional advice. But Weil illustrates the two biggest problems with so-called alternative medicne: once you’ve decided science is dispensible, the door is open to anything, no matter how insane; and no matter how altruistic you may start, sooner or later you start selling snake oil. Most doctors out there are working hard to help their patients prevent and overcome disease use the available evidence. Others decide that science is too constraining and start practicing at the periphery of knowledge, throwing plausibility and ethics to the wind.
The fact that Weil claims to donate to charity all of his ill-gotten gains does not mitigate the harm he causes.
The flu pandemic has been challenging to all of us who practice medicine. We try to keep up day to day with the latest numbers, evidence, and best practices, while trying not to worry about getting ill. And since the vaccine isn’t widely available yet, we also worry about our family’s health. So we go about our work every day, wearing masks when appropriate and washing hands frequently. If the numbers reach a certain threshold, we will implement sophisticated pandemic plans.
All of that is rather hard, though, so perhaps we should just throw caution to the wind and start selling flu snake oil just like the smiling Dr. Weil.
The FDA and FTC have let Weil know in very clear terms that his fake flu remedies are being marketed illegally. Weil has taken the site down, but here’s a relevant screen shot.
Oh Canada. Look over here. Not there. Not at the press release. Look here. A real study. Published. With methodologies you can evaluate. Something you can sink your teeth into to help guide policy decisions. You know, published epidemiology. Science.
Its called “Partial protection of seasonal trivalent inactivated vaccine against novel pandemic influenza A/H1N1 2009: case-control study in Mexico City.” and published on line in the BMJ on October 6th.
Are you aware of….Oh, Canada, pay attention, your eyes are wandering.
Forgive the departure from my usual verbosity. I’m on my way to a meeting, and I don’t have the time. Today I’ll report disturbing content found in health care bills that are competing for passage in Washington. Thanks to Linda Rosa for keeping our attention on language in one of the Senate bills: “S.1679 – Affordable Health Choices Act,” sponsored by (guess who?) Senator Tom Harkin (D-IA). According to Linda, Harkin and supporters will attempt to merge his bill with Baucus’s. Here are some of the choice passages in Harkin’s 800+ page bill (emphasis added):
A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law. This section shall not require that a group health plan or health insurance issuer contract with any health care provider willing to abide by the terms and conditions for participation established by the plan or issuer. Nothing in this section shall be construed as preventing a group health plan, a health insurance issuer, or the Secretary from establishing varying reimbursement rates based on quality or performance measures.
…(4) ensure that the health team established by the entity includes an interdisciplinary, interprofessional team of health care providers, as determined by the Secretary; such team may include medical specialists, nurses, nutritionists, dieticians, social workers, behavioral and mental health providers (including substance use disorder prevention and treatment providers), doctors of chiropractic, licensed complementary and alternative medicine practitioners, and physicians’ assistants;
…(c) Requirements for Health Teams- A health team established pursuant to a grant under subsection (a) shall–
(1) establish contractual agreements with primary care providers to provide support services;
(2) support patient-centered medical homes, defined as mode of care that includes–
(A) personal physicians;
(B) whole person orientation;
…(F) provide coordination of the appropriate use of complementary and alternative (CAM) services to those who request such services;
…(H) provide local access to the continuum of health care services in the most appropriate setting, including access to individuals that implement the care plans of patients and coordinate care, such as integrative health care practitioners; (more…)
Some of our more astute readers may have noticed that we are paying influenza slightly more attention than other topics of late. That’s because this situation is new, rapidly changing, and covers more areas of science and medicine than one can easily count. It’s also a subject about which the general public and media are keenly interested. This is an outstanding learning and teaching opportunity for us as a professional community. Unfortunately, it is also fertile ground for confusion, fear, and misinformation, and a playground for those who would exploit such things.
Mercola.com is a horrible chimera of tabloid journalism, late-night infomercials, and amateur pre-scientific medicine, and is the primary web presence of Joseph Mercola. Unfortunately, it is also one of the more popular alternative medicine sites on the web and as such is uncommonly efficient at spreading misinformation. I am not a fan, and have addressed his dross in the past.
Joseph Mercola has recently posted an excerpt from an individual he evidently holds in high regard, Bill Sardi. Bill published “18 reasons why you should not vaccinate your children against the flu this season.” Mercola chose his nine favorites (one would assume the nine best reasons), and re-posted it on Mercola.com. There are so many mistakes, so much misinformation in so little space, it’s almost a work of art. You know, like that crappy art that you might expect to find on the wall at an hourly motel. Without further delay, let’s examine Mercola and Sardi’s nine best reasons for you not to vaccinate your children against influenza this season: (more…)
Dr. Jay Gordon is a pediatrician to a particular subculture of pseudoscientific celebrities, such as Jenny McCarthy. He lends his MD cred to this community. He also appears, in my opinion, to be a shameless self-promoter – one of those pop professionals (Dr. Oz, Dr. Phil) who has sold his soul for some easy celebrity.
Regardless of his motivations, he has been spouting arrogant nonsense about vaccines for years, essentially arguing that his clinical gut feeling and anecdotal experience trump the actual science. This is exactly the wrong approach to science-based medicine.
In a recent open letter on his website, he adds to the anti-vax chorus advising not to get the H1N1 (swine flu) vaccine. It’s almost as if this crowd wants to maximize the morbidity and suffering from this somewhat preventable disease. I know this is not literally true, but their ideologically motivated and confused actions will have the same effect.
On 10/08/09, the NIH and Science through press releases announced the following remarkable information: Consortium of Researchers Discover Retroviral Link to Chronic Fatigue Syndrome (CFS.) From Science on line:
Scientists have discovered a potential retroviral link to chronic fatigue syndrome, known as CFS, a debilitating disease that affects millions of people in the United States. Researchers from the Whittemore Peterson Institute (WPI), located at the University of Nevada, Reno, the National Cancer Institute (NCI), part of the National Institutes of Health, and the Cleveland Clinic, report this finding online Oct. 8, 2009, issue of Science.
“We now have evidence that a retrovirus named XMRV is frequently present in the blood of patients with CFS. This discovery could be a major step in the discovery of vital treatment options for millions of patients,” said Judy Mikovits, Ph.D., director of research for WPI and leader of the team that discovered this association. Researchers cautioned however, that this finding shows there is an association between XMRV and CFS but does not prove that XMRV causes CFS.
I know we have been focusing on the vaccine issue extensively, but this is crunch time and the anti-vaccine forces are relentless. We are now facing a regular seasonal flu spiked with the H1N1 pandemic. Our best weapon against morbidity and mortality caused by the flu is information, and yet the public is being barraged with misinformation designed to encourage poor choices and thereby result in maximal morbidity and mortality.
I confess I was never impressed with FDR’s famous quip, “All we have to fear is fear itself,” – I think there is plenty else to fear. But his sentiment is very appropriate to the current situation – fear mongering around the seasonal flu and H1N1 vaccines is what we have most to fear.
And of course, as is almost always the case, accurate information is complex and requires a nuanced understanding. This creates uncertainty, which is easy to exploit to manufacture unreasonable fear.
The anti-vaccine fear mongers are playing every card in the deck. They are arguing (falsely) that H1N1 is not severe enough to warrant getting the vaccine, that the vaccine does not work anyway, and that there are unacceptable or unknown risks to the vaccine. In the most extreme cases, bizarre conspiracy theories are brought to bear, but I will not discuss these here as anyone compelled by such fantasies is likely beyond the reach of any information I could provide.
A reader sent me an interesting post from her own blog. It’s well-written, compelling, and betrays an exceptional intelligence. It’s also completely wrong.
The piece is called, “Bias, Racism, and Alternative Medicine”, an intriguing title. The first part tries to establish that “Western medicine” in one of many ways of understanding health and disease. She starts with some personal anecdotes—always interesting, rarely generalizable:
While receiving Western biomedical treatment for ADD, the side effects of my therapy convinced me that western medication alone would not provide a solution to my problems.
One of the author’s fundamental misunderstandings is that the failure of a particular treatment to make her feel better does not invalidate all of medical science, and more important, it does not validate “other ways of thinking”. Still, I can understand how this happens. Personal experience is powerful; unfortunately, it is also misleading. I like this writer. She seems very kind. She goes on to describe her enlightenment further, but this is where a pleasant anecdote goes terribly wrong: (more…)