A "holistic" doctor throws a hilariously disingenuous tantrum over board recertification

In the early days of 2016, my attention was drawn to a local antivaccine doctor of whom I’d heard before but never really paid much attention to. What caught my eye was a blog exchange between this “holistic” family practitioner and former Scienceblogs blogger, friend, and local internist Peter Lipson over this physician’s blog posts attacking a local Jewish summer camp for children for its new requirement that campers must be up to date on their vaccinations as a requirement for attending. Not surprisingly, Dr. Lipson took the side of science and refuted the antivaccine nonsense that had been laid down by this local “holistic” physician, leading to a response to Dr. Lipson entitled The Great Vaccine Debate in which he tried to refute Dr. Lipson and failed miserably, to amusing effect that I couldn’t resist blogging about in order to provide a heapin’ helpin’ of some Not-So-Respectable Insolence.

That was the last time I paid attention to Dr. David Brownstein, the “holistic” doctor in question. I had noted that his website was chock full of antivaccine misinformation and tropes, and that Dr. Brownstein embraced antivaccine pseudoscience enthusiastically. Indeed, just for yucks, I perused his website again in writing this introduction and found newer articles with titles like Vaccines, Autism, and our Do-Nothing U.S. Congress; Congress Should Be Shamed: The Vaccine Crises Continues; Censorship is Alive and Well in 21st Century America; and CDC Cover-Up of Autism and Vaccine Link Continues. Yes, Dr. Brownstein, credulous and, apparently, not too bright fellow that he is, totally buys into the “CDC whistleblowermanufactroversy and all the lies about it in Andrew Wakefield’s and Del Bigtree’s movie VAXXED. And, yes, he’s still laying down sheer antivaccine idiocy like:

Folks, the truth of the matter is that the claim that vaccines are safe and effective is an example of a platitude that is continually repeated. Vaccines have not been properly studied and many vaccines simply don’t work. The truth of the matter is that the vaccine schedule has never been studied. We simply don’t know if it is safe to inject our children with over 70 vaccines before they are adults.

I can assure you of one thing: It is not safe to inject our children (or any living being) with toxic additives such as mercury, formaldehyde, aluminum or MSG. It is not rocket science to predict that people injected with toxic items that negatively affect the human body will suffer neurological and immunological problems.

Simply repeating that vaccines are safe and effective does not make them so. Watching our young people suffer with so many chronic illnesses should make anyone question the validity of injecting more toxins into them.

All of these are lies and misinformation that I’ve debunked on more occasions than I can remember over the last 12 years. (You’ll just have to take my word for it this time; debunking them all again will make this post much, much longer than you probably want to read, even by my standards.) What it did remind me of is the reason I was going to write about Dr. Brownstein again anyway. Specifically, it led me to the question of how “holistic physicians” like Dr. Brownstein can remain board certified in their specialties. What made me ask that question again was a post on that repository of all things conspiracy, quacky, libelous, and just plain dumb, Mike Adams’ NaturalNews.com, which reposted an article written by Dr. Brownstein under the title After 7-hour medical board exam about prescription drugs, holistic Doctor decides to skip board certification, which turns out to be a reposting of the article from Health Impact News entitled After 7-Hour Medical Board Exam on Drugs, Holistic Doctor Decides to Give up Board Certification, which turns out to be a reposting of the original post from Dr. Brownstein’s blog in April entitled Family Practice Exam: Drugs, Drugs, and More Drugs.

Poor, poor pitiful me, Dr. Brownstein is saying. The test is all about drug treatments. One wonders what he expected. Before I delve a bit deeper into Dr. Brownstein’s whining, first let me point something out. Dr. Brownstein is most definitely not giving up his board certification. What he said is that he was so disgusted that his taking the recertification exam in family practice “will be the last time I put myself through something as ridiculous as that endeavor!” In other words, Dr. Brownstein’s posturing is the rhetorical equivalent of the brown, stinky stuff that comes out of the hind end of male bovine creatures.

Why do I say this? First, I looked at Dr. Brownstein’s picture and figured that he’s probably roughly my age. A search for his CV revealed that I was correct; he graduated from college a year later than I did. Also, depressingly, I learned that Dr. Brownstein went to medical school where I am faculty now and before that attended the University of Michigan as an undergraduate, which means we were on the same campus for three years. Of course, he was a psychology major and I was a chemistry major; so I probably never encountered him. It does disappoint me that the same schools I attended and am on faculty at failed Dr. Brownstein so miserably that he became the “holistic” doctor he is now. Be that as it may, that means that Dr. Brownstein is probably roughly my age, which means he’s probably 10-12 years from retirement, give or take; that is, if he retires at age 65. Board certification lasts ten years and very likely he’s taking the exam a year or two before his current board certification expires, meaning that, assuming he passed his exam, he’s probably good for another 11-12 years. See where I’m going with this? He’ll be good until the time he’s ready to retire or at least close to it.

This leapt out at me because I’ll be facing a similar situation soon. My board certification in general surgery will expire at the end of 2018, but this year I got a notice that I could take the recertification examination in November or December. Unfortunately, I didn’t get the notice until May and that my practice is super-specialized in breast cancer, which means reviewing all of general surgery will be a daunting task that I couldn’t manage in only six months as well as submit multiple grant applications this fall to keep my lab going. The bottom line is that I decided to spend all of 2017 reviewing and take the test in late 2017, a decision I’m comfortable with. More importantly, assuming I pass the recertification examination next year, that means my board certification will be good until the end of 2028, when I’ll be 66. You see where I’m going. Will it be worth it for me to recertify when I’m potentially that close to retirement? I have no idea. I might want to practice until I’m 70 or older if things are going well and I’m still enjoying it, or I might want to retire then, following the example of the professor who was most responsible for hiring me who retired last year at age 66. Who knows?

The point is that Dr. Brownstein is posturing most ridiculously. in 11 or 12 years he’ll be in basically the same position I will be: Close to retirement. Moreover, unlike me, since he isn’t associated with a hospital and doesn’t accept health insurance of any kind, he could easily keep practicing a few years after his board certification expires. Heck, he even admitted that he had considered not recertifying this time:

I have been Board-Certified in family practice since I graduated from my residency (with a short period where I missed taking the exam). I last recertified 10 years ago and when my letter came informing me that I would have to sit for another exam, I debated whether to do it.

You see, over the last twenty years or so, I no longer practice conventional family practice. Now, I practice holistic medicine. I still use much of what was taught to me in my training, but now, I primarily rely on items that support the body’s physiology and biochemistry and I strive to avoid using items that poison and block the body’s pathways. Unfortunately, nearly all of the drugs currently used in conventional medicine work by disrupting the body’s physiology and biochemistry by poisoning enzymes and blocking receptors. I have written about this extensively in my books, Drugs That Don’t Work and Natural Therapies That Do and The Statin Disaster.

This is, of course, a false dichotomy. Yes, one of the first things I was taught in physiology and pharmacology in medical school is that nearly all drugs are cellular poisons in that they tend to block the function of some protein or cellular function or other to achieve their effect. Here’s the dirty little secret about “holistic” medicine: If an herbal “natural” medicine “works” it works by functioning like a drug, which means that it, too, is probably a cellular poison. It’s an adulterated drug whose potency will vary from lot to lot, but it’s a drug nonetheless. As for “supporting the body’s physiology,” what does that even mean? Take a look, for instance, at what sorts of treatments Dr. Brownstein offers:

  • Acupuncture
  • Massage Therapy
  • Polarity Therapy
  • Manipulative Medicine
  • N.A.E.T.
  • Micro-current Facials
  • J.M.T.
  • N.M.T.
  • Emotional Freedom Technique (E.F.T.)
  • Vitamin and Mineral Supplementation
  • Intravenous Vitamin and Mineral Therapies
  • Elimination and Allergy Diets
  • Body Composition Analysis (B.I.A)
  • Electro-Dermal Screening (E.D.S.) Full Bio-Profile Reports

I’ve written about several of these before, particularly acupuncture and intravenous vitamin therapies, both of which are, in my opinion (and that of pretty much every doctor with an understanding of science), pure quackery based on pseudoscience (intravenous vitamins) or prescientific beliefs (acupuncture) that in no way “support the body’s physiology and biochemistry.” I ask the same of emotional freedom technique, which is a treatment designed by a New Age energy healing guru who eliminated the need for all those nasty needles in acupuncture and claimed to cure people by tapping “meridians” with his fingertips. He also claims to be manipulating “subtle energies.” Another, NAET, which is described as a “non-invasive, drug free, natural solution to alleviate allergies of all types and intensities using a blend of selective energy balancing, testing and treatment procedures from acupuncture/acupressure, allopathy, chiropractic, nutritional, and kinesiological disciplines of medicine.” In other words, NAET is clearly nonsense. Electrodermal screening reminds me, more than anything else, of using a Scientology e-meter. No wonder Harriet Hall refers to it as “fooling patients with a computerized eight ball.”

The claim that any of these therapies, all of which are quackery other than massage therapy, “support normal physiology,” is risible in the extreme.

Dr. Brownstein further complains:

In my SEVEN (miserable) hour board exam today, I found myself getting more and more irritated. Nearly every question was about a drug—how it is used, the side effects associated with it, and how it interacts with other drugs. There were virtually no questions about the importance of diet or the importance of identifying nutritional deficiencies. In fact, I can’t recall one question along those lines. The patient vignettes that I suffered reading through were all the same—the patient was taking multiple drugs and I was asked one obscure question about the drug therapy prescribed to the patient. I actually felt bad for the poor patients in the vignettes as they were having their biochemistry poisoned with multi-drug prescription cocktails.

One wonders what Dr. Brownstein means by “nutritional deficiencies.” What “holistic physicians deem a nutritional deficiency is often related to what science deems a nutritional deficiency solely by coincidence. All too often, “holistic medicine” involves identifying and “correcting” nutritional “deficiencies” that aren’t through a battery of expensive laboratory tests and supplements. Indeed, there’s a whole branch of “holistic medicine” devoted to just that; i.e., functional medicine, or, as I like to call it, making it up as you go along. Guess where I found Dr. Brownstein’s CV? At the FMU website. FMU stands for Functional Medicine University, which is an online school, and Dr. Brownstein appears to be featured in several online video classes there. In any case, the problem with “holistic” medicine is that its practitioners attribute near magical—strike that, just magical—healing abilities to diet. There’s no doubt that diet and exercise are important to good health, but if you believe some alternative medicine practitioners, you’d think that diet can cure everything. I have little doubt that part of the problem Dr. Brownstein had with his recertification examination is that he shares this inflated view of the power of dietary interventions to cure just about anything.

I can’t help but also mention that he’s a graduate of the Desert Institute School of Classical Homeopathy, which makes his lecturing anyone on science...problematic. In other words, I remember that when I read this broadside of Brownstein’s:

I am amazed that the AAFP does not even acknowledge the importance of diet and nutritional support in their exam. Yes, there may have been a few token questions (but I can’t recall one), but they were few and far between. I guess the AAFP believes that prescription drugs can cure all that ails. It is too bad that the medical research does not support this idea.

And I am amazed that an actual physician who graduated from my beloved medical school where I am on faculty could believe enough in homeopathy to have take a class on it and potentially incorporate it into his practice. I find it simultaneously hilarious and pathetic that someone who offers acupuncture, EFT, NAET, and so many other unscientific and pseudoscientific treatments and have the temerity to lecture the AAFP, or anyone else in medicine, about science and the proper treatment of patients. It’s also not true that the American Academy of Family Physicians (AAFP) doesn’t consider diet important; it’s published a whole lot of monographs on nutrition. Its own recommended curriculum for family practice residents is peppered with statements like:

  • “Nutrition is one of the most powerful interventions available.”
  • “Nutrition counseling that targets dietary risk factors as primary prevention has the potential to significantly reduce mortality and morbidity throughout the life cycle.”
  • “Nutritional interventions have the potential to reverse certain disease processes. Additionally, proper nutritional status can positively support medical interventions.”

One of the learning objectives is described thusly:

4. The role of nutrition in the prevention and treatment of specific diseases, including:

a. Cancer
b. Cardiovascular disorders
c. Dental disease
d. Endocrine disorders
e. Gastrointestinal disorders
f. Hematologic disorders
g. Renal disorders
h. Respiratory disorders
i. Bone and rheumatic disorders
j. Neurologic disorders
k. Skin conditions
l. Gynecologic disorders
m. Obesity

The list goes on. Read it for yourself.

Basically, Dr. Brownstein’s blog post amounts to a whole lot of sound and fury, signifying nothing. He postures about never taking the family practice recertification examination again, painting it as a principled decision when in reality it is mere petulance disguised as principle. Indeed, he doesn’t need to be board certified because he doesn’t take insurance or have hospital privileges and will need it even less, if at all, in ten years, when he will be much closer to retirement age. Then he whines because the test didn’t have on it what he thinks it should have on it and doesn’t encompass the way he practices medicine because, from my judgment of his website, he doesn’t practice science-based medicine.

You know what. Maybe Dr. Brownstein shouldn’t have taken the recertification examination. Science- and evidence-based medicine clearly isn’t for him.

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Well, I have two physicians who give me treatments to “support normal physiology,” with one prescribing metoprolol succinate extended release 50 mg BID, the other methimazole 10 mg, BID.
Why, with those, my blood pressure is in a normal physiological range, rather than stage 3 hypertension and my thyroid hormones are very close to normal range.
See what I did there? Nothing at all like that idiot does.

However, I'm in a rather unique position as to recertification testing and even CE unit documentation.
Back in the year 2009, I had taken my certification test for Security+. In the year 2010, the certification requirements changed to require CE units being documented and recertification testing.
I, along with others who certified prior to that change were grandfathered in and we don't have those requirements.
When my employer began to track those certifications, as part of a DoD mandate, that caused no end of initial consternation with our intern! I gave him a brief history lesson of DoDI 8570.01, DoDI 8570.01-M, the reasons for those instructions, the history of Security+ and other similar programs that later changed to require recertification and continuing education unit tracking.
After all, interns are there to learn, a well rounded education also involves history education. ;)

I this the same Dr. Brownstien?

The Iodine-mongering Dr. Browstein??

The 50mg/day of KI and I₂ Dr. Brownstein???

This asshole owes me a new thyroid gland.

By Richard Clarke (not verified) on 15 Aug 2016 #permalink

@Richard Clarke, if you need some, my thyroid's on overdrive, you're welcome to a lobe or so of it. :)

By Wzrd1 (not verified) on 15 Aug 2016 #permalink

In reply to by Richard Clarke (not verified)

Here’s the dirty little secret about “holistic” medicine: If an herbal “natural” medicine “works” it works by functioning like a drug, which means that it, too, is a cellular poison.

Oh yes.
**insert usual list of drugs derived from herbal or animal extracts - up to 60% of our modern pharmacopoeia**

Heck, our own hormones and all the hormonal lookalike could be described as working "by disrupting the body’s physiology and biochemistry by poisoning enzymes and blocking receptors".

By Helianthus (not verified) on 15 Aug 2016 #permalink

@Helianthus, if you recall, I mentioned two drugs that restore my metabolism to a sustainable, healthy level.
Methimazole inhibits the enzyme thyroperoxidase, thereby blocking a necessary step in the synthesis of both T3 and T4 hormones. (The full explanation is well explained in the Wikipedia article on the drug.)

Metoprolol is a selective B1 receptor blocker, in short, a beta-adrenergic blocking agent. B1 receptors are primarily in the heart and kidneys, selectively blocking those lowers heart rate and contractile function in the heart, thereby lowering both pulse and blood pressure.

Heck, we're interfering with two families of hormones function or formation with two different poisons!
Still, it beats letting my heart rate and blood pressure staying so high, as my left ventricular hypertrophy could regress to normal and my aorta may just require watchful waiting, rather than emergency, likely to be doomed to fail emergency surgery to repair a ruptured abdominal aortic aneurysm.
You know, dead.
Which is what I'd be if I let that holistic quack mistreat me.

By Wzrd1 (not verified) on 15 Aug 2016 #permalink

In reply to by Helianthus (not verified)

"We simply don’t know if it is safe to inject our children with over 70 vaccines before they are adults."

If you wait to see how long the test group lives, monitoring them for health all their lives, before releasing a vaccine to the general public, we'd STILL be having polio epidemics.

I was in the Salk test group as a child and - aside from a notable lack of polio - have better health than my mother or aunts did at this age.

By Tsu Dho Nimh (not verified) on 16 Aug 2016 #permalink

"If you wait to see how long the test group lives, monitoring them for health all their lives, before releasing a vaccine to the general public, we’d STILL be having polio epidemics."

Hell, we'd *still* have smallpox epidemics.

Still, I'm willing to compromise. Everyone who wants to do that moves, with their family and other volunteer families, to a quarantined island and all vaccine preventable diseases, counting smallpox and rabies are released there. We'll test one per lifetime and if approved, survivors will get the vaccine that's already well known to be well tested in the rest of the world.
I a few thousand years, their survivors will be permitted to rejoin the world's population.

By Wzrd1 (not verified) on 16 Aug 2016 #permalink

In reply to by Tsu Dho Nimh (not verified)

Vaccines for mumps that don't even work?
Vaccines for measles that can give you super-measles?

Umm, no.

Trade those fun childhood diseases for the vaccine-induced diseases such as SIDS, Gullaine-Barre, POTS, Polio, Autism, and Acute Flacid Paralysis?

Nope. I'll just take the chance of getting some trivial sickness.

By Ms. Mia Wallace (not verified) on 16 Aug 2016 #permalink

Very well, go to the suggest island and leave my family away from your filthy, disease ridden children.
Since you're not one for civilized things and behavior, we'll go to uncivilized behavior. Infect my family members that cannot yet be vaccinated, I reserve the right to terminate yours.

By Wzrd1 (not verified) on 16 Aug 2016 #permalink

In reply to by Ms. Mia Wallace (not verified)

Ms. Wallace, surely you jest?

Polio doesn't exist in the US anymore because of vaccines. A little research of history and you would see that huge chunks of the population were killed or crippled by that annually pre-vaccines. Same with mumps, same with measles. These diseases aren't "trivial." Yes, other medical advancements besides vaccines have improved our ability to diagnose, manage and treat the illnesses, but that does not mean they are trivial.

Oh, and you're wrong.

No. You can get polio from polio vaccines. It happens all of the time.

By Ms. Mia Wallace (not verified) on 16 Aug 2016 #permalink

Do show us a single case, just one, of IPV causing polio, I'll show that you're a liar.
OPV has reactivated, on rare occasions. That said, the only place where OPV is used is where polio epidemics are already present. I guess you'd prefer unterrupted, universal polio infections to the rare occasion that the virus manages to repair itself, in an environment where the vaccine has already begun immunizing the population.

By Wzrd1 (not verified) on 17 Aug 2016 #permalink

In reply to by Ms. Mia Wallace (not verified)

Ms Mia Wallace, please describe the mechanism by which measles vaccine can cause super measles.

By Julian Frost (not verified) on 16 Aug 2016 #permalink

Brownstein took the recertification exam, but did he pass it?

By Science Mom (not verified) on 16 Aug 2016 #permalink

Trade those fun childhood diseases for the vaccine-induced diseases such as SIDS, Gullaine-Barre, POTS, Polio, Autism, and Acute Flacid Paralysis?

A whole bunch of P.R.A.T.T.s in one easy to dismantle comment. Vaccines do not cause SIDS. This has been looked at by researchers at Bristol University, including perhaps the World's foremost expert on SIDS. Guillane-Barre was 17 times more common in people who got the flu than in people who got the vaccine. The "vaccines cause autism" theory has been investigated and disproven.
As for "fun childhood diseases", everything we vaccinate against can kill, and can cause other negative sequelae like lung damage, organ damage, brain damage, sterility, deafness and blindness.

By Julian Frost (not verified) on 16 Aug 2016 #permalink

That dates back to 1980. In addition, I could only view the abstract. Would you provide a link to the full article so I could read it for myself?

By Julian Frost (not verified) on 16 Aug 2016 #permalink

Your not a member of JAMA? You get subscribe.

By Ms. Mia Wallace (not verified) on 16 Aug 2016 #permalink

No, I'm not a member of JAMA. And I'm not going to subscribe just to look at one article.

By Julian Frost (not verified) on 16 Aug 2016 #permalink

That dates back to 1980. In addition, I could only view the abstract. Would you provide a link to the full article so I could read it for myself?

This harkens back to Thingy's MO. If I recall correctly, it wasn't the vaccine but rather the failure of the vaccine to protect against the disease. Molecular techniques weren't available to detect that and the killed measles vaccine didn't work well at all.

By Science Mom (not verified) on 16 Aug 2016 #permalink

Oooh, a live one. Popping popcorn.

OK Ms Mia Wallace. We're talking over 30 years ago. A much older (killed) vaccine, followed by apparent doses of live vaccine but with no additional dosing information. And this was 4 siblings in a family. A Case Study, in other words. Maybe the family has a history of immune issues. And I love the way you made it "SUPERMEASLES" when the abstract makes it clear it was just an atypical presentation of measles.

NOTE: I HAD measles and mumps, but never developed immunity. Fortunately, I did develop immunity to rubella.) And the MMR just gives me a booster that lasts a few years. Why? Who knows. But they weren't "simple illnesses" and my mother, a doctor's daughter, was very concerned about me.

If you are going to post anti-vax tropes, please don't be boring and post the same stuff that's been refuted thousands of times. Give us something new to look at.

Oh, and Ms Wallace? Don't assume all readers are in the US. Why would a physician in the UK, Australia, or the EU be a member of JAMA? They wouldn't even be eligible.

I am just a wee bit skeptical about Dr. Brownstein's claim that virtually all questions on the family practice board recertification exam are about drugs - or that they're even focused almost exclusively on treatment. Nothing at all about diagnosing disease? No questions about socioeconomic or documentation/electronic medical record/privacy issues? Zero on ethics?

I suspect Brownstein is either very forgetful about a test he supposedly spent seven hours on, or is making stuff up to the delight of Ninnytown News readers.*

"I’ll just take the chance of getting some trivial sickness."

Another message board I post on has a thread about a woman who was recovering from "stomach flu" when she developed leg tingling and weakness. Turns out she had Guillain-Barre and required hospitalization to get that bad 'ol allopathic therapy.
Wonder if Ms. Mia ever heard of GB contracted through the more common pathway of non-vaccine induced immune dysfunction.

*my favorite was the poster who declared that plumbers have saved far more lives than Allopathic Physicians. Next time the Code Blue team races by, I'll look for the guy carrying the plunger.

By Dangerous Bacon (not verified) on 16 Aug 2016 #permalink

@Orac: I know, but one can hope for SOME originality from the swarm.

If I still lived in Michigan, I'd be tempted to go to Dr Brownstein just to see how many laughs I could get out of an appointment. I'd happily point out that his herbs and vitamin treatments *ARE* all drugs. And I'd offer him some homeopathy from my thermos. :)

By the way, being a "JAMA member" (I think Ms. Mia means being an A.M.A. member) does not qualify you to see the complete article. When I signed in, all I got was the abstract and references (apparently 36-year-old articles are not necessarily archived). One reference turned up the information that "atypical measles" does not equate to "supermeasles", but was described as a combination of measles developing years after killed virus vaccination when antibody titers had declined and the individual was exposed to measles, plus had a delayed hypersensitivity reaction due to prior immunization.
Since for many years we've used the MMR (a live virus vaccine), and measles thankfully is an uncommon disease (if herd immunity is kept up), "atypical measles" seems to no longer be an issue. Immunity following the MMR is very long-lasting.

Ms. Mia needs to keep up with the science, which left her and fellow meme-chanting antivaxers in the dust long ago.

By Dangerous Bacon (not verified) on 16 Aug 2016 #permalink

People Mia Wallace/Michelle/Richard Clark are Fendelsworth.

By Science Mom (not verified) on 16 Aug 2016 #permalink

@ Dangerous Bacon

Dr. Brownstein’s claim that virtually all questions on the family practice board recertification exam are about drugs

He did mention "token questions". Which I could read as "one quarter of the questions".
Also, I'm sure any question about ethics or medical records in which a drug is mentioned has been pushed under the "drugs" umbrella.
Selective memory is a good bet, I think.

I’ll look for the guy carrying the plunger.

I understand Phelps has one on retainer.

By Helianthus (not verified) on 16 Aug 2016 #permalink

over 70 vaccines before they are adults

No, no, no, no, no. Why is this such a hard thing to grasp. The current schedule has, at most, 53 doses of vaccines. There are even fewer doses if combination vaccines are used. Ugh, so annoying.

@Todd W #30, I think that 70 is just about right, for US military personnel who are deploying to certain regions overseas repeatedly over a career. ;)
You know, smallpox, yellow fever, plague, dengue, cholera, typhoid, anthrax, with boosters. I think we had, off of the top of my head.

By Wzrd1 (not verified) on 17 Aug 2016 #permalink

In reply to by Todd W. (not verified)

I pulled the article at my university.

It's a 2 page primary research (with opinion) paper. N=4 kids testing with live measles after immunization. One kid developed symptoms 16 years after that were "atypical" of measles which could also be mistaken for Rky Mtn spotted fever, even though having consistent titers, serum antibody was deficient.

We also know that measles mutated, necessitating a revision in vaccine around 1989, and the vaccine around 1970-74 was not adequate for coverage. Well after the paper published, but certainly the authors could be describing the beginning of that period, where measles mutated. Anyway,

The sibling in question became infected with a natural strain 16 years later. The one thing they did document was frequent community infection of measles occurring on an annual basis, which was behaving atypically. "Sibling 1 had unknowingly been exposed to measles, although the disease has been reported in the family's city of residence each year." Sibling 2 & 3 "several years previously...Their postexposure, early disease and convalescent titers are high and similar to those described in atypical measles." This was noted to occur after natural measles exposure in the community.

No genotype to suggest anything of "super-measles" because of the vaccine, i.e. no support to anything in the article of the vaccine causing "super-measles."

Point being, if you pull an abstract, at least read the f'n article to see what actually happened.

On "atypical measles", from what I've seen, that generally is used to describe a course of illness that is milder, presents altered symptoms, or altered timing than your average case of measles infection. I don't recall ever seeing it as a description of a more virulent case.

Back on topic, I would be rather surprised if the exam did not have a lot of questions about drugs (e.g., indications, dosing, interactions, contraindications, etc.). I would be very worried to have a physician who did not know those details, because they could very easily kill or seriously harm their patients if they did not know enough about the drugs they're prescribing.

In fact, I'd go so far as to say that the exam should also include questions about drug-drug interactions where at least one of them is some "herbal remedy" (e.g., St. John's Wort) or dietary item (e.g., grapefruit). Those have known, significant effects on certain classes of drugs that doctors should be aware of. And we really need to know more about how all of the various "dietary supplements" and "herbal remedies" affect other drugs that people may be taking. But we never see anyone like Dr. Brownstein doing that kind of research.

People Mia Wallace/Michelle/Richard Clark are Fendelsworth.

That reminds me: Could you mail me the IP addresses used at your place?

Unless I missed something, did Dr. Brownstein actually pass the board recertification exam? One wonders how he accomplished this, being a Non-Poison-Drug-Practitioner, seeing that virtually all exam questions purportedly dealt with drugs.

I can see multiple possibilities - that Dr. B _does_ prescribe a lot of Dem Evil Drugs in his practice, that he crammed madly beforehand at a board prep course, that he knows a ton about drugs by Doing His Own Research (but only in order to denounce them), that he wildly exaggerated the number of drug questions, that he's a really good guesser, or that he flunked the exam.

By Dangerous Bacon (not verified) on 16 Aug 2016 #permalink

^ emailed you.

By Science Mom (not verified) on 16 Aug 2016 #permalink

FWIW, I find these docs that are actual MDs and behave no better than you average naturopath to be the worst. I get such a sense of them being traitors because, quite simply, they should know better. It really grinds my gears because of the harm they can and do cause, given the extra weight their recommendations carry with people because of that MD that follows after their name. Never mind the fact that it totally undermines us legitimate docs out here, updating the way we practice based on the best evidence in an effort to give the best care we can (and, yes, taking Board exams to show that we are up to date).

Now that I think about it, many state medical boards have pretty strict standards about medical websites advertising, rather than providing medical information. I would bet the Dr. Brownstein's website crosses that line. Anyone in Michigan want to write a letter?

By Dr. Chim Richalds (not verified) on 16 Aug 2016 #permalink

Somewhat off topic

I HAD measles and mumps, but never developed immunity.

I have been wondering for a while what the percentage of non-responders (failure to develop immunity) is, following wild virus disease in measles, mumps, and chickenpox.

I've looked in Pubmed and in The Vaccine Book but haven't found clear answers.

Narad, check your email again.

By Science Mom (not verified) on 16 Aug 2016 #permalink

For what it' worth:

Ms Mia Wallace:

No. You can get polio from polio vaccines. It happens all of the time.

It rarely happens with the OPV, which is a live-virus vaccine. It never happens with the IPV. OPV is only needed if extirpation has not been achieved. Which means if enough people follow your advice and decline IPV, countries without polio will get polio back, and we'll have to start using OPV again. Your advice doesn't even suit your supposed goals.

By Calli Arcale (not verified) on 16 Aug 2016 #permalink

Oi, Mia Fendlesworth, where's that time machine that Kanner and Asperger had to go forward in time to pick up the vaccines that they then (obviously) gave to all those bairns that they worked with/studied in order to describe classic autism and Asperger's Syndrome (as Lorna Wing eventually labelled it)?

Still trying to figure out how "atypical" gets translated into "super".

Last I checked atypical just means that the symptom list is different from the typical symptom list. Often it will be missing a symptom, often whatever one is the most characteristic of the disease. Like not getting the rash that usually comes with measles.

Now for somethings atypical might and has an additional symptom not usually seen (which could be "super") but that would be, IMO, atypical of atypical presentations. Usually it more something didn't happen and often tends to be more common in milder presentations.

Gee, even if the vaccine didn't prevent the disease it may have caused it to be milder...oh the horror!

I can access the JAMA paper through my university account, but I don't know if this link will work for anyone else: file:///C:/Users/srauclai/Downloads/jama_244_8_022.pdf

As has already mentioned, the paper is about an old, killed measles vaccine that is no longer in use. The siblings who are the subject of the paper were initially vaccinated in 1963, and contracted measles during an outbreak at their high school in 1973. Of the three siblings who were exposed, one didn't get sick at all, one had mild illness, and one had severe illness. To quote the paper:

He remained severely ill for more than seven days, with daily temperature of 40 °C, abdominal, muscle, joint, chest, and head pain, dry cough, upper respiratory tract symptoms, and nausea with occasional vomiting.

In short, similar to a "baddish" case of regular measles, but not even close to being the worst measles can do. Both of the infected siblings recovered completely with no complications. Some "super-measles!"

@Julian Frost #18 "No, I’m not a member of JAMA. And I’m not going to subscribe just to look at one article."

The choice seemed clear: Either quit the Ph.D. or illegally obtain copies of the papers. So like millions of other researchers, he turned to Sci-Hub, the world’s largest pirate website for scholarly literature. Rahimi felt no guilt. As he sees it, high-priced journals “may be slowing down the growth of science severely.”

http://www.sciencemag.org/news/2016/04/whos-downloading-pirated-papers-…

Oh,oh; No working links?

Sci-Hub remains reachable via alternate domains, IP address and a .onion Tor Hidden Service scihub22266oqcxt.onion

https://en.wikipedia.org/wiki/Sci-Hub

Yes, one of the first things I was taught in physiology and pharmacology in medical school is that nearly all drugs are cellular poisons in that they tend to block the function of some protein or cellular function or other to achieve their effect.

I don't think of this statement is close to being true. It doesn't apply to ascorbic acid for scurvy, the oral polio vaccine, insulin, human growth hormone, etc.

By Mark Thorson (not verified) on 16 Aug 2016 #permalink

What a doofus.

Since Brownstein undoubtedly thinks that Ebill Drugz are "one of the leading causes of death", you would think he would welcome the opportunity to review his knowledge of "one of the leading causes of death". In addition, a lot of his patients will have a history of prescription drug use, or will currently be using them. Knowledge of said drugs might be handy when assessing these patients. Know your enemy, after all.

Apropos of nothing, it's interesting how many of these so-called Holistic Practitioners operate on a cash-only basis. They may be catering not only to the "worried well", but also to the "worried wealthy".

Someone in my family had the "supermeasles" when she was 2 yr old. (This was the 1940s, well before the vaccine.) The fever was so high that even though she survived, the docs feared at first that she had brain damage. Before the illness, she had started to talk a little, but after that she had regressed and could barely walk. She regained the lost ground, thankfully, but that must have been scary.

By Irène Delse (not verified) on 16 Aug 2016 #permalink

Someone in my family had the “supermeasles” when she was 2 yr old.

Still not "super measles", just measles and that's what it does even now.

By Science Mom (not verified) on 16 Aug 2016 #permalink

@Sarah A #42:

but I don’t know if this link will work for anyone else: file:///C:/Users/srauclai/Downloads/jama_244_8_022.pdf

That link will only work on your PC (and possibly not even for other users of your PC, if there are any), but that's a good thing because you really, really don't want to make your C: drive available to the Internet. Thank you kindly for the thought, though.

By Rich Woods (not verified) on 16 Aug 2016 #permalink

there's really nothing worthwhile in the article anyway (speaking in the context of our current understanding as to what worthwhile means).

no "supermeasles"

I did read The Stand -- it had a "superflu" maybe that's what she meant

A question from an ignorant's point of view. At this point Dr. Brownstein has been in practice for a while and has an established costumer base sympathetic to his promotion of alternative medicine - that's at least my impression. What's the advantage to him from taking the certification exam, which would require him to - as you show - memorize and repeat things he doesn't apply in his practice? Why would he bother? What is the advantage?

By Dorit Reiss (not verified) on 16 Aug 2016 #permalink

"At this point Dr. Brownstein has been in practice for a while and has an established costumer base sympathetic to his promotion of alternative medicine – that’s at least my impression. What’s the advantage to him from taking the certification exam, which would require him to – as you show – memorize and repeat things he doesn’t apply in his practice? Why would he bother? What is the advantage?"

Same advantage gained by Jay Gordon in paying dues to the American Academy of Pediatrics. Jay gets to put FAAP after his name at every opportunity. There are patients who might think Brownstein has more credibility if he advertises that he's board certified.*

*to be designated a fellow of the American Academy of Family Practice (which requires a finding of achievement/community service by your peers) has considerably more cachet than being a fellow of the American Academy of Pediatrics, where you only have to pass your boards like practically every other pediatrician.

By Dangerous Bacon (not verified) on 16 Aug 2016 #permalink

I too took the Family Practice Boards this summer, and I distinctly remember a number of diet and nutrition questions -- including one about the proper way to diagnose Vitamin D deficiency (hint: not a saliva or urine test). I would also wager that there were more diagnostic-related questions than medication-related questions. If I had any complaint about the test, it would be that there were too many OB-related questions as the vast majority of Family Physicians no longer practice OB.

By politescott (not verified) on 16 Aug 2016 #permalink

Serum 25-hydroxyvitamin D (abnormal <20ng/mL)

I got one on possible increase autism risk in OB (hint, not vaccination) -- Severely early gestational maternal hypothyroxinemia --- must be said 5x fast while tap dancing.

I was seriously f***ed over by mumps. Any time I hear someone talk about how fun and harmless mumps are I tend to get violent. No decent human being wants their kids to go through what I went through. Do you really want to learn how dumb you're being the hard way? How many children do you think should get mumps before 'less than 1%" means "I ruined that kid's life" to you?

By Christine Rose (not verified) on 16 Aug 2016 #permalink

Vaccines contain MSG now? That is weapons grade fuckwittedness.

By Guy Chapman (not verified) on 16 Aug 2016 #permalink

@ Dorit #50: I think you are on to something. Brownstein likely never intended to re-certify anyhow. But--he has used the premise of re-certifying to further his quackery--as in "I'm smarter than all this nonsense". This probably boosts his aura with those gullible enough to fall for his schtick. BTW, you do have to be board-certified in pediatrics to be an FAAP (hence why Bob Sears whined recently (albeit not so loudly) when he was studying for his board exam). Jay Gordon has to whine not a bit because he's old enough (read: retire already) that he is "grandfathered" in to never have to re-certify to stay board certified and FAAP.

By Chris Hickie (not verified) on 16 Aug 2016 #permalink

@ Mark Thorson 44

I don’t think of this statement is close to being true. It doesn’t apply to ascorbic acid for scurvy, the oral polio vaccine, insulin, human growth hormone, etc.

Vit C for scurvy is more about nutritional deficiency. I would call it more food than drug.

As I pointed above, hormones do work by blocking some cellular functions and enabling others. I grant you it's a bit of a a stretch to call them poisons, especially since the hormones' effects are usually transient and reversible, but so are most other drugs.
In excess doses, hormones definitively are poisons. Death by insulin overdose is a thing.

In a similar vein, the OPV is also a bad example. Live-attenuated virus vaccines are going to "poison" a few of your cells with viruses and kill them. That's that makes these vaccines so efficient at creating a strong immunity.

By Helianthus (not verified) on 16 Aug 2016 #permalink

I was seriously f***ed over by mumps. Any time I hear someone talk about how fun and harmless mumps are I tend to get violent. No decent human being wants their kids to go through what I went through.

Preach it, sister. (Not my actual sister, but you know what I mean.)

I've told the story on RI in the past, but -

I came down with the mumps at about 13. My balls swelled up to the size of my fist. Both of them. That wrinkly skin, that was my ball sack, wasn't. It was stretched tight. The only good thing about it is that I was delirious for most, but not all, of it. I wound up missing more than two weeks of school.

Why, no, I don't have any kids that I know of...

Sure, my case was a bit worse than average. My sister was a but more typical - good bit of crying, some pain and fever, a week or so at home from school - she was just sick.

To H-E-double hockey sticks with anybody that wants their kid to have a chance to go through what I went through, or even my sister's experience.

I actually have my own mumps story myself, but I don't really want to make the details public. Suffice to say, it was not a good experience. So I'm with you when it comes to being really ticked off about antivaxers discounting mumps as a "minor" or "routine" childhood illness.

My experience with mumps was not so fun... and according to my mother it was the second time to get it! Apparently the "friend" whose mother cared for me because my mother worked told me that I was annoying because I moaned all the time.

Um, yeah... sorry I don't remember that, I was in pain.

Which was only eclipsed a couple years later in another country when I got bitten by an aedes aegypti mosquito that gave me dengue fever. That was two weeks of bone break fever. Kill the aedes aegypti... wipe them off of this earth!

Orac: "So I’m with you when it comes to being really ticked off about antivaxers discounting mumps as a “minor” or “routine” childhood illness."

I will now mention again that I had to take care of a six month old baby with chicken pox. Sure a baby will cry a few moments after a vaccine, now try for ten days covered with painful itchy pox without any kind of real relief. Creams were useless and no sane person gives a baby lots of Benadryl.

Lots and lots and lots of crying for ten solid days.

I am not very fond of sadistic fools who think children should suffer from varicella because they think it helps prevent shingles (which is wrong, wrong, wrongety wrong). Full grown adults should not expect children to suffer just because they can't be bothered to get a shingles vaccines.

The only childhood disease I had was chickenpox. One week of itchiness, a scar near my shoulder, and periodical mouth ulcers whenever I'm stressed. And I know I was lucky and my case was very mild.
I never got measles, mumps or rubella, and I don't recall anyone I was at school with getting them either. And reading the above stories, I'm grateful for MMR.

By Julian Frost (not verified) on 16 Aug 2016 #permalink

@Chris: Creams were useless and no sane person gives a baby lots of Benadryl. Yeah. I was "fortunate" in that my kids were older. But it wasn't fun to have to give a 5 year old opiates (Tyl #3) for pain either. I was SO PISSED when the vaccine became available only a few months later.

@MI Dawn, our kids were part of the testing for the Varicella vaccine.
One had an extremely mild case, the youngest had a milder case as well. Good thing too, as mom never had chickenpox, although she does show antibodies today.
Along with all other sorts of antibodies (she had her first rheumatologist's appointment last week).

By Wzrd1 (not verified) on 17 Aug 2016 #permalink

In reply to by MI Dawn (not verified)

I had measles as a baby. I was hospitalised for ten days, very ill; my mother told me she was terrified for me the whole time, as she'd lost a sibling to measles when she was a child.
I recovered, though my optician tells me that the virus could well have been responsible for the damge to one retina that left me nearly blind in that eye. On that account, I consider myself very lucky.
When i was seven I had German measles - rubella. It wasn't as bad as the measles, I was just pretty sick for a week or so. It didn't help that the local mothers all sent their young daughters around to crawl all over me, so as to get infected. This was years before there was a rubella vaccine, so infection was the only way to get immunity and 'measles parties' were common.

By Mrs Grimble (not verified) on 17 Aug 2016 #permalink

Guy @57: And now MSG is "toxic" too! Better tell Dr. Brownstein that there's MSG in his tomatoes (and Parmesan, and soy sauce, and mushrooms). What a maroon!

By JustaTech (not verified) on 17 Aug 2016 #permalink

Wait, MSG? This guy is scared of a little MSG? Monosodium glutamate? The monomeric, salt form of a molecule that makes up 1% of the human body by mass? He's scared of it? Are you sure he's actually a doctor?

no sane person gives a baby lots of Benadryl

Why not? It sounds like a good way for both you and the baby to get some sleep, but I'm old enough to remember getting baby aspirin (Reye's Syndrome panic wasn't a thing yet) and babies getting alcoholic teething liquid.

I was five when I had chicken pox, and I remember being ridiculously miserable from the itching and the headache.

By Interrobang (not verified) on 28 Aug 2016 #permalink

Key word in that sentence: lots

There are specific doses, and too much can cause death. When a parent is sleep deprived it can become very easy to forget you have given a dose.

Richard Clarke.. Id like to know more about the circumstances surrounding the thyroid gland Dr. Brownstein owes you.

I had chicken pox twice, severe both times, at 7 and 12. In retrospect, maybe it was a sign that my immune system was not going to last.

By Darthhellokitty (not verified) on 15 Sep 2016 #permalink