The health freedom fighters attack

If there's one thing shared in common among nearly all advocates of pseudoscience, it is the belief that they know The Truth. More importantly, they know The Truth, and The Powers That Be don't want you to know The Truth and will do almost anything to makes sure that The Truth stays secret. Think about it. This sort of thinking is common, be it among advocates of alternative medicine, cold fusion advocates, HIV/AIDS denialists, 9/11 "Truthers," birthers, creationists, moon hoax believers, or Holocaust deniers. For instance, Mike Adams and Joe Mercola will tell you that the government in the form of the FDA (the most government agency most hated by quacks) and state medical boards, all in cahoots with Big Pharma, has crushed "alternatives" and don't want you to know that you can use "natural" and "non-toxic" strategies to cure cancer, cure diabetes, live to be 100, cure heart disease, and in general take care of medical problems that the existing Pharma-Industrial Complex would prefer that you take toxic pharmaceutical drugs to combat. Creationists will tell you that atheistic Evolutionists, in concert with the little part of our Constitution that disallows government establishment of religion, have crushed any "questioning" of Darwin. Holocaust deniers will tell you that a Zionist conspiracy created the Holocaust and is now working to keep The Truth about it a secret, while "birthers" will tell you that there is a government conspiracy to hide The Truth about where President Obama was born and 9/11 "Truthers" will tell you that, yes, 9/11 was a government conspiracy and that there is still a government conspiracy to hide The Truth that 9/11 was an "inside job."

And what are the reasons for The Man suppressing The Truth? Usually, it boils down to a combination of three things: money, power, and ideology. According to the crank, revealing the hidden Truth would cost rich and powerful interests lots of money or diminish their power. Alternatively (or complementary), revealing The Truth would be such a threat to the ideology of The Powers That Be that such revelations cannot be tolerated.

This tactic is also a highly effective marketing tool. Everybody wants to think of himself or herself as special and possessing knowledge that most other people do not. Everybody wants to be in on "the secret." (Why do you think the woomeisters responsible for the Law of Attraction called it "The Secret," anyway?) There is an underdog appeal to thinking that you belong to a group that possesses secret knowledge that is being persecuted. I was reminded of this tactic a while back when I came across an amusing little rant by the Alliance for Natural Health USA, Is the Federation of State Medical Boards Behind the Brutal Attacks on Integrative Medicine Practitioners?

"Brutal attacks"? You keep using that term. I do not think it means what you think it means. Apparently your "brutal attack" is my "toothless flailing." At least, that's certainly the case when it comes to state medical boards. The examples are legion: Stanislaw Burzynski, Rashid Buttar, Rolando Arafiles, Mark Geier, and many others whose practices range from highly dubious to outright quackery but who for some reason have been nearly untouchable by state medial boards. Burzynski should have had his medical license yanked at least 15 years ago, but he's still practicing, still charging patients exorbitant sums of money to sign up patients on clinical trials that never go anywhere for his antineoplaston therapy. Rashid Buttar outright shamed the medical board in North Carolina, in essence using the clout of an organization of fellow "alternative practitioners" to buy a law that defanged the board. The Geiers managed to keep using their chemical castration therapy for autistic children for several years before medical boards started taking action. As far as I know, they're still managing to do it in some states.

Perhaps the most instructive example is Rolando Arafiles, who was protected by powerful local interests, including his local sheriff, and didn't end up being disciplined until the light of publicity was shined on his case. Even then, it was criminal charges of his misusing his position in a conspiracy to go after the nurses who complained about him that did him in, not his medical incompetence and quackery. In other words, it was that felony conviction that finally stripped him of his medical license, not his medical misconduct. that's the way it is, too. It's actually very hard to lose a medical license for practicing "alternative medicine" unless a doctor is foolish enough to commit a felony at the same time, as Arafiles did. In fact, all the Texas Medical Board did to discipline Arafiles before his conviction was fine him $5,000, put him on probation, and require him to take continuing medical education classes.

So, keeping that in mind, let's see what the ANH is clutching its pearls about:

The Federation of State Medical Boards (FSMB) is a private 501(c)(6) trade association that purports to represent the seventy state medical and osteopathic boards of the US and its territories, and cosponsors the United States Medical Licensing Examination. It is tremendously powerful: whatever it suggests in terms of medical care policies are often adopted by the state medical boards. A private trade association with no public funding, transparency, or accountability arguably has the power to interpret state medical law and grant or revoke medical licenses! Ever wonder why it’s so hard to find a doctor who will prescribe bioidentical hormones or administer chelation therapy? We believe it’s because the FSMB has made it such a career risk for the doctor to use his own independent judgment.

So far as we can tell, it seems that the FSMB was infiltrated in the late 1990s by the so-called “quackbuster” contingent—people openly hostile to complementary and alternative medicine. At the 1996 annual meeting of the FSMB in Chicago, there was a radical shift from a focus on health fraud as defined by the federal government (overbilling, un-bundling, and kickbacks) to another definition of health fraud: alternative medical care. It seems a concerted effort to label innovation in health care—and especially any natural treatment that competes with an emphasis on drugs and surgery as the ideal for modern medicine—as mere “quackery.” (In fact, at just one session of that meeting, Dr. William Fleming—a member of the FSMB’s board of directors, and chair of its Ad Hoc Committee on Health Care Fraud—used the word “quack” or “quackery” 139 times.)

Gee, and the ANH says this as though it were a bad thing!

Of course, the mid-1990s were around the time that the emphasis on evidence-based medicine was starting to take hold. It wouldn't surprise me at all if the FSMB was responding to that movement by broadening its mandate to promote EBM and try to root out medicine that is not based on evidence; i.e., quackery, the sort of medicine advocated by the ANH. In any case, if you actually read the transcript, you'll find some disturbing examples, such as the marketing of a gadget that "would diagnose cancer anywhere in the body by using a computer and thermal couples - temperature monitoring devices on six acupuncture points on the back of the thigh, and they were able to tell you whether this was cancer in your nose, or your lungs, or your pancreas, or your liver, or your prostate or your breast or anywhere." (Hmmm. This kind of sounds like the EPFX/QXCI, Quantum Xrroid Consciousness Interface.) It also came up with a series of preliminary recommendations that were quite sensible. There were other examples, including Kurt Donsbach, a chelationist who adds hydrogen peroxide to his chelation therapy and calls it "chetox," and a series of quacks who claim to have been nominated for the Nobel Prize.

So what got the ANH upset enough to write its little screed? This:

The Milwaukee Journal Sentinel and MedPage Today recently reported that the FSMB asked for $100,000 from Big Pharma to help create and distribute the organization’s new policy on pain medication to their 700,000 practicing doctors. The federation won’t say how much money it received from industry, but estimated that it will cost $3.1 million for its campaign.

And what is this campaign? To get the word out about “safe” use of opioid analgesics in the treatment of chronic pain! That’s right, FSMB’s new policy favors the use of opioids for long-term pain management, despite an epidemic of painkiller abuse and addiction (not to mention the terrible crime rates that accompany it)—and a lack of scientific support for this use of the drugs.

Now, I'll be the first to admit that it was a bit unseemly of the FSMB to hit up pharmaceutical companies. It was definitely a mistake, particularly when considering that the trend in academia is to go the other way, to eschew funding from pharmaceutical companies for educational activities, particularly activities in which the pharmaceutical company has a direct financial interest. Hopefully, the FSMB has learned from the (apparently) deserved backlash. However, guidelines for the safe prescribing of opioids are not outside the purview of the FSMB or state medical boards, particularly given evidence that many patients with chronic pain are underdosed. Moreover, the FSMB's position sounds a lot more nuanced than the parody of it that the ANH touts. Indeed, at the keynote address for the FSMB, it was pointed out that "opioids represent only a small part of the spectrum of options for mitigating pain, but they carry a substantial level of risk" and that the "statistics on opioid-related misuse, diversion, morbidity and mortality are unacceptable."

That parody leads the ANH to publish this "Action Alert" to contact state medical boards to disassociate themselves from the FSMB. It's a perfect example of how cranks take a legitimate concern (how much pharmaceutical influence medical organizations tolerate or seek out), pump the concern up to epic proportions in order to imply that the entire system is corrupt, and rally the troops to attack the system because it is "suppressing" its favored pseudoscience. Of course, it almost always strains credibility that such shadowy organizations could simultaneously keep such epic conspiracies secret (if there's anything we've learned, it's that in any conspiracy involving more than a few people someone always talks eventually), have enough power to enforce their will, but let groups like the ANH reveal The Truth.

Obviously, there must be great appeal to being part of a small band of "freedom fighters" who know The Truth. On the other hand, as a willing shill and minion of the great conspiracy, I have to wonder if perhaps such groups are useful idiots that allow the suspicious to blow off steam.