Medicine

One of the most frequent complaints leveled at pro-science advocates who defend vaccines against antivaccine misinformation and pseudoscience is that we’re way too fast to label them as “antivaccine,” that we use the term as a convenient label to demonize their views. We’re not really antivaccine, they tell us. We’re vaccine safety advocates. Really. Now, I have no doubt that this is how most of these antivaccinationists masquerading as vaccine safety activists see themselves, to the point where sometimes I find it refreshing when I encounter an antivaccine activist who proudly labels herself…
We in Michigan are dealing with yet another effort on the part of NDs, which stands for “naturopathic doctors” but more appropriately should mean “not a doctor, to achieve licensure in the form of Michigan HB 4531. As I mentioned when I first learned that HB 4531 was passed by the House Committee on Health Policy and sent to the full House for consideration, it’s a scary, scary bill. Moreover, it’s supported by the Michigan Association of Naturopathic Physicians (MANP), who are taking money from the supplement industry to lobby for this bill’s passage. It’s a bill that would grant NDs a wide…
Most scientists I know get a chuckle out of the Journal of Irreproducible Results (JIR), a humor journal that often parodies scientific papers. Back in the day, we used to chuckle at articles like "Any Eye for an Eye for an Arm and a Leg: Applied Dysfunctional Measurement" and "A Double Blind Efficacy Trial of Placebos, Extra Strength Placebos and Generic Placebos." (What saddens me is that this is basically what research into so-called “complementary and alternative medicine,” now more frequently referred to as “integrative medicine” boils down to.) Unfortunately, these days, reporting on…
One major thing that differentiated science-based medicine (SBM) from alternative medicine and quackery is that in SBM there is a generally accepted standard of care. This was even the case back in the days before the proliferation of evidence-based guidelines, in which professional societies and expert panels try their best to synthesize what is often an unwieldy mass of sometimes conflicting studies into guidelines on best care practices for different conditions. True, back then there was wider latitude because each physician was largely left to fend for himself in applying the medical…
One common theme that has been revisited time and time again on this blog since its very founding is the problem of how science and medicine are reported. For example, back when I first started blogging, one thing that used to drive me absolutely bonkers was the tendency of the press to include in any story about vaccines an antivaccine activist to “tell the other side” or for “balance” to the story. So in a story on vaccines, on the one side you would have Paul Offit, a bona fide, legitimate vaccine expert, and on the other side you would have J.B. Handley, Jenny McCarthy, Andrew Wakefield,…
With a bill to license naturopaths (HB 4531) wending its way through the Michigan legislature supported by supplement manufacturers, its current status being in consideration by the full House of Representatives, periodically I feel the need to provide ammunition to the bill’s opponents, because we need to protect the patients in the state of Michigan from the naturopathic quackery that would be unleashed if this bill were to be passed into law. If there is one area that naturopaths have been invading with a vengeance and even gaining enough seeming legitimacy to propose what they risibly…
"Complementary and alternative medicine" (CAM), now more frequently referred to as "integrative medicine" by its proponents, consists of a hodge-podge of largely unrelated treatments that range from seemingly reasonable (e.g., diet and exercise) to pure quackery (e.g., acupuncture, reiki and other "energy medicine") that CAM proponents are trying furiously to "integrate" as coequals into science-based medicine. They do this because they have fallen under the sway of an ideology that posits a false dichotomy: To practice true "holistic" and "preventative" medicine, physicians and other health…
To say that I, as a cancer surgeon, am not a fan of Ty Bollinger is a massive understatement. He’s not exactly one of my fans, either, but I view the hatred of a man like Bollinger directed at me as a badge of honor. Indeed, if a man like Bollinger didn’t detest me, I would view my efforts as a failure because I view him as a quack whose desperately deceptive film series The Truth About Cancer has been correctly dubbed untruthful about cancer by Harriet Hall and whose message has led cancer patients into rejecting conventional medicine in favor of treating deadly cancers with alternative…
One of the more annoying health crazes going around right now is the gluten-free diet. While it’s a boon to the very small proportion of the population who have real celiac disease and thus truly cannot tolerate gluten, at the same time gluten has become the health demon that is touted as the cause of virtually all health problems, be they major or minor, with the cure—of course!—being the now nearly ubiquitous gluten-free diet. The gluten-free diet has become so popular that restaurants and food manufacturers ignore it at their financial peril. Indeed, restaurants that don’t have some gluten…
There's always been a major thread of distrust of the medical profession in the African-American community, understandably so given the history of abuses such as the Tuskegee Syphilis Experiment, in which the natural progression of untreated syphilis was studied in African-American men for 40 years. It’s not just that experiment that’s responsible, either. During the time of slavery, slaves often served as the subjects of medical experimentation. Dr. Crawford Long, for instance, conducted most of his early experiments with ether on slaves, while Dr. Walter F. Jones used slaves to test a…
I realize that it's a cliché to say so, but some clichés are true. Time really does fly. It's hard to believe that a year ago California—and, by proxy, the rest of the country—was in the throes of a major political war over the bill SB 277. SB 277, you will recall, was a bill introduced into the California Assembly in the wake of the Disneyland Measles outbreak in early 2015 that eliminated non-medical exemptions to school vaccine mandates beginning with the 2016-2017 school year. Ultimately, SB 277 passed and was signed into law by Governor Jerry Brown last July. It was an uncommon victory…
If there's one lesson that I like to emphasize while laying down my near-daily dose of Insolence, both Respectful and not-so-Respectful, it's that practicing medicine and surgery is complicated. Part of the reason that it's complicated is that for many diseases our understanding is incomplete, meaning that physicians have to apply existing science to their treatment as well as they can in the context of incomplete information and understanding. The biology of cancer, in particular, can be vexing. Some cancers appear to progress relentlessly, meaning that it's obvious that all of them must be…
I hate these stories, because they so seldom end well. Unfortunately, this one is more messy than even the usual messiness of the typical story of this type. The type of story I’m referring to, of course, is one that I’ve told from time to time ever since near the first year of this blog’s existence, that of the child or teen with cancer who, for whatever reason, refuses curative chemotherapy in favor of some sort of quackery. The litany of names depresses me to contemplate: Katie Wernecke, Abraham Cherrix, Sarah Hershberger, Daniel Hauser, Makayla Sault...the list goes on. In the vast…
About a month and a half ago, I became aware of the case of Ezekiel Stephan, a 19-month-old Canadian toddler living in Alberta who in 2012 developed bacterial meningitis. Unfortunately for Ezekiel, his parents, David and Collet Stephan, were believers in alternative medicine. They didn’t take Ezekiel to a real doctor. Instead, they relied on herbal remedies and consulted a naturopath while their child suffered and died. As a result, they were put on trial for failing to provide the necessaries of life for Ezekiel. During the trial, they raised money by appealing to the worst quacks, claiming…
Arguably, one of the most popular forms of so-called "complementary and alternative medicine" (CAM) being "integrated" with real medicine by those who label their specialty "integrative medicine" is acupuncture. It's particularly popular in academic medical centers as a subject of what I like to refer to as "quackademic medicine"; that is, the study of pseudoscience and quackery as though it were real medicine. Consider this. It's very difficult to find academic medical centers that will proclaim that they offer, for example, The One Quackery To Rule Them All (homeopathy). True, a lot of…
I heard the news yesterday morning. I was in clinic seeing patients. It was a bit of a slow morning; there was time between patients. So I spent it, as is my wont when clinic is a bit slow, signing charts (OK, signing off on charts in the electronic medical record; I haven’t actually physically signed a chart in a while) and idly checking Facebook and Twitter when finished with that. Then I saw it: Authorities Respond to a Medical Call at Paisley Park, with a comment that Prince was dead. I read the article; it said that someone had been found dead at Prince’s estate in Minneapolis and that…
Of all the forms of quackery that have been “integrated” into medicine of late, arguably one of the most popular is acupuncture. It’s offered in fertility clinics. It’s offered in hospitals and medical clinics all over the place. The vast majority of academic medical centers that have embraced quackademic medicine offer acupuncture. (Quackademic medicine, for those not familiar with the term we reserve for the study of alternative medicine in academic medical centers that really should recognize it as quackery.) Hell, quite a few that haven’t embraced quackademic medicine offer acupuncture.…
If there's one thing that really animates me and angers me, it's the unnecessary death of a child due to quackery. Competent adults, of course, are perfectly free to choose any form of quackery they wish for themselves or even to refuse treatment at all (which is less harmful than quackery). Children, on the other hand, must trust that their parents or guardians will act in their best interests. When they betray that trust and their duty to act in the best interests of the child, I wonder how this can happen. When there the government sides with the parents, I become even more agitated. So it…
And now for something completely different. Yes, it's about time for that, isn't it? I've probably beat the Tribeca Film Festival story into the ground, even for me, having spent the last week blogging about it. Scratch that. There's no "probably" about it. I frequently write at length about the quackery that is homeopathy. One reason I do this is because it is one of the most perfect forms fo quackery there is. There is about as close to no chance that it could work as there can be, and the only reason I don't call homeopathy completely impossible is because I have a hard time calling…
After a trilogy of posts on the lamentably bad decision on the part of the Tribeca Film Festival to screen a pseudoscience- and misinformation-filled documentary by hero to the antivaccine movement, Andrew Wakefield, that is basically one long conspiracy theory, I thought it was time for a change. I had briefly toyed with the idea of having some fun with the flying monkeys (a.k.a. antivaccine commenters) who've descended upon the Tribeca Film Festival entry for the documentary, but, as of this writing, the total number of comments is over 1,700 and it wouldn't surprise me if it were over 2,…