American College of Physicians: Internal Medicine — Doctors for Adults ®

 
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Tuesday, February 10, 2015

Anti-vaccine doctors should lose their licenses

Vaccination is a medical no-brainer, a public health home run, up there with clean water. Doctors can help save individual patients, but public health measures can save whole populations. When doctors promote public health, such as vaccination and water fluoridation, we get to improve both individual and public health goals. But that sort of power can also work in reverse.

Since the infamous and, as shown by the British Medical Journal, fraudulent Wakefield study set off the modern anti-vaccine movement, doctors have been fighting to keep our patients on track with their vaccinations. We're put in the unusual position of having to convince people that we actually know a bit more about health than second-tier, has-been celebrities. That's bad enough, but when doctors start teaming up with these celebrities against the health of our children, my angry side won't be held back.

The anti-vaccine movement has been driven by lay people such as Jenny McCarthy, and disgraced doctors such as Andrew Wakefield, the author of the fraudulent autism-vaccine paper. He's no longer permitted to practice medicine. But there have been a few actual licensed medical voices over the last several years fighting to keep our kids sick.

One of the best-known is Dr. Jay Gordon, a Los Angeles County, Calif., pediatrician. He has been fiercely “pro-choice” on vaccinations, and has attracted a practice full of parents who refuse to protect their kids from preventable diseases. His rantings are so incoherent that it's hard to believe he ever passed his pre-med science classes (emphasis mine): Dr. Gordon believes the first shot shouldn't be given until the child is at least three years old, but admits he has no scientific evidence to support his belief. “I have no evidence based medicine, there's no research saying that,” said Gordon. “I have anecdotal data that has told me that. Anecdotal data does not stand up to public scrutiny. It's easy to attack. I have had, as I've said, many parents tell me that their child has been harmed by the MMR.”

In other words, Dr. Jay has an opinion about the MMR (measles, mumps, rubella) vaccine based on nothing. The entire public health community has an opinion too, one based on decades of science and properly-collected data, not anecdotes. Gordon has the hubris to think that his opinions about vaccination are more correct than hard-won facts. He is a disgrace.

Dr. Bob Sears, like Dr. Jay, is a pediatrician in Orange County, which, not-so-coincidentally is the epicenter of the current measles outbreak. Regarding the measles outbreak, Dr. Bob posted this on Facebook: Not everyone is so concerned. In a Facebook post on January 16, celebrity pediatrician Robert “Dr. Bob” Sears encouraged his followers not to “let anyone tell you you should live in fear of” measles. “Ask any Grandma or Grandpa (well, older ones anyway),” he wrote, “and they'll say ‘Measles? So what? We all had it. It's like Chicken pox.’” (From Mother Jones).

His casual attitude about a disease that killed hundreds of Americans every year is horrifying. That this man should be giving advice about child health is a travesty.

The current measles outbreak, having begun in Orange County at Disneyland, has taken a huge toll already, with over 100 infections and a hospitalization rate of about 15% to 25% according to some sources. And because the outbreak began at an international gathering place, the disease is radiating back to people's home states, one of which is Arizona, where about 1,000 kids are being monitored for measles. And what happened in Arizona during this time? The Super Bowl, another international gathering that will bring people close together in bars, planes, hotels and possibly return them home with a disease so contagious that 90% of unvaccinated people exposed to it will catch it. This could turn a public health nightmare into a catastrophe.

This is why our Parade of Shame finishes with Dr. Jack Wolfson, and Arizona cardiologist who thinks measles is just fine. I know lots of cardiologists, none of whom know anything about measles when compared to their pediatric colleagues. Despite his lack of qualification to speak out on infectious diseases he is being given a soap box on the major media networks. From the Washington Post: Amid this outbreak, Wolfson actively urges people to avoid vaccines. “We should be getting measles, mumps, rubella, chicken pox, these are the rights of our children to get it,” he told the Arizona Republic. “We do not need to inject chemicals into ourselves and into our children in order to boost our immune system.” He added: “I'm a big fan of what's called paleo-nutrition, so our children eat foods that our ancestors have been eating for millions of years … That's the best way to protect.”

This advice is dangerous, irresponsible and wrong. In fact it's so disconnected from reality that it's not even wrong. But it is unethical and a threat to public health.

State medical boards are notoriously toothless, but doctors speaking out against vaccination in the midst of an ongoing outbreak should be investigated, warned, and censured. They should have their licenses suspended until undergoing 150 hours of continuing medical education on public health and infectious diseases (except that cardiologist; he should just lose his license).

As doctors we have sworn an oath to protect our patients, and if our ideologies and skills prevent this, it's time to hang up the stethoscope.

Addendum: I have emailed the doctors referenced for comment and will be happy to share any public comments they offer

Peter A. Lipson, ACP Member, is a practicing internist and teaching physician in Southeast Michigan. After graduating from Rush Medical College in Chicago, he completed his internal medicine residency at Northwestern Memorial Hospital. This post first appeared at his blog at Forbes. His blog, which has been around in various forms since 2007, offers "musings on the intersection of science, medicine, and culture." His writing focuses on the difference between science-based medicine and "everything else," but also speaks to the day-to-day practice of medicine, fatherhood, and whatever else migrates from his head to his keyboard.

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1 Comments:

Blogger Matthew Bosley said...

This is from my family's genealogy, re. my great-uncle. It can happen again, any time now . . . 'nuf said:

"Freddie Raymond Bosley; b. Oct 17, 1916 at Pawnee City, Pawnee County, Nebraska, United States; d. Apr 19, 1917;
This note was behind a picture of Freddie taken March 24, 1917, less than one month before he died:
Freddie Raymond was born October 17, 1916
died April 19, 1917 age 6 months & 2 days
brok out with measles March 25
had his picture taken March 24.
he took sick April 5 was sick 2 wks
oh he suffered so bad. Died April 19
buried April 20th at 3 o'clock
songs they sang - Safe in the arms of Jesus, Jewels, God be with you till we meet again
Funeral was preached by Rev. Stitt
Text: Suffer little children lo come unto me."

I've seen the photo--of an amazingly cute, alert, happy, laughing six-month-old with a full head of thick blond hair.

Matthew Bosley, MD, FAAP, MPH (Candidate)
Omaha, Nebraska

February 10, 2015 at 11:21 PM  

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Blog log

Members of the American College of Physicians contribute posts from their own sites to ACP Internistand ACP Hospitalist. Contributors include:

Albert Fuchs, MD
Albert Fuchs, MD, FACP, graduated from the University of California, Los Angeles School of Medicine, where he also did his internal medicine training. Certified by the American Board of Internal Medicine, Dr. Fuchs spent three years as a full-time faculty member at UCLA School of Medicine before opening his private practice in Beverly Hills in 2000.

And Thus, It Begins
Amanda Xi, ACP Medical Student Member, is a first-year medical student at the OUWB School of Medicine, charter class of 2015, in Rochester, Mich., from which she which chronicles her journey through medical training from day 1 of medical school.

Auscultation
Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital.

Zackary Berger
Zackary Berger, MD, ACP Member, is a primary care doctor and general internist in the Division of General Internal Medicine at Johns Hopkins. His research interests include doctor-patient communication, bioethics, and systematic reviews.

Controversies in Hospital Infection Prevention
Run by three ACP Fellows, this blog ponders vexing issues in infection prevention and control, inside and outside the hospital. Daniel J Diekema, MD, FACP, practices infectious diseases, clinical microbiology, and hospital epidemiology in Iowa City, Iowa, splitting time between seeing patients with infectious diseases, diagnosing infections in the microbiology laboratory, and trying to prevent infections in the hospital. Michael B. Edmond, MD, FACP, is a hospital epidemiologist in Iowa City, IA, with a focus on understanding why infections occur in the hospital and ways to prevent these infections, and sees patients in the inpatient and outpatient settings. Eli N. Perencevich, MD, ACP Member, is an infectious disease physician and epidemiologist in Iowa City, Iowa, who studies methods to halt the spread of resistant bacteria in our hospitals (including novel ways to get everyone to wash their hands).

db's Medical Rants
Robert M. Centor, MD, FACP, contributes short essays contemplating medicine and the health care system.

Suneel Dhand, MD, ACP Member
Suneel Dhand, MD, ACP Member, is a practicing physician in Massachusetts. He has published numerous articles in clinical medicine, covering a wide range of specialty areas including; pulmonology, cardiology, endocrinology, hematology, and infectious disease. He has also authored chapters in the prestigious "5-Minute Clinical Consult" medical textbook. His other clinical interests include quality improvement, hospital safety, hospital utilization, and the use of technology in health care.

DrDialogue
Juliet K. Mavromatis, MD, FACP, provides a conversation about health topics for patients and health professionals.

Dr. Mintz' Blog
Matthew Mintz, MD, FACP, has practiced internal medicine for more than a decade and is an Associate Professor of Medicine at an academic medical center on the East Coast. His time is split between teaching medical students and residents, and caring for patients.

Everything Health
Toni Brayer, MD, FACP, blogs about the rapid changes in science, medicine, health and healing in the 21st century.

FutureDocs
Vineet Arora, MD, FACP, is Associate Program Director for the Internal Medicine Residency and Assistant Dean of Scholarship & Discovery at the Pritzker School of Medicine for the University of Chicago. Her education and research focus is on resident duty hours, patient handoffs, medical professionalism, and quality of hospital care. She is also an academic hospitalist.

Glass Hospital
John H. Schumann, MD, FACP, provides transparency on the workings of medical practice and the complexities of hospital care, illuminates the emotional and cognitive aspects of caregiving and decision-making from the perspective of an active primary care physician, and offers behind-the-scenes portraits of hospital sanctums and the people who inhabit them.

Gut Check
Ryan Madanick, MD, ACP Member, is a gastroenterologist at the University of North Carolina School of Medicine, and the Program Director for the GI & Hepatology Fellowship Program. He specializes in diseases of the esophagus, with a strong interest in the diagnosis and treatment of patients who have difficult-to-manage esophageal problems such as refractory GERD, heartburn, and chest pain.

I'm dok
Mike Aref, MD, PhD, FACP, is an academic hospitalist with an interest in basic and clinical science and education, with interests in noninvasive monitoring and diagnostic testing using novel bedside imaging modalities, diagnostic reasoning, medical informatics, new medical education modalities, pre-code/code management, palliative care, patient-physician communication, quality improvement, and quantitative biomedical imaging.

Informatics Professor
William Hersh, MD, FACP, Professor and Chair, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, posts his thoughts on various topics related to biomedical and health informatics.

David Katz, MD
David L. Katz, MD, MPH, FACP, is an internationally renowned authority on nutrition, weight management, and the prevention of chronic disease, and an internationally recognized leader in integrative medicine and patient-centered care.

Just Oncology
Richard Just, MD, ACP Member, has 36 years in clinical practice of hematology and medical oncology. His blog is a joint publication with Gregg Masters, MPH.

KevinMD
Kevin Pho, MD, ACP Member, offers one of the Web's definitive sites for influential health commentary.

MD Whistleblower
Michael Kirsch, MD, FACP, addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.

Medical Lessons
Elaine Schattner, MD, FACP, shares her ideas on education, ethics in medicine, health care news and culture. Her views on medicine are informed by her past experiences in caring for patients, as a researcher in cancer immunology, and as a patient who's had breast cancer.

Mired in MedEd
Alexander M. Djuricich, MD, FACP, is the Associate Dean for Continuing Medical Education (CME), and a Program Director in Medicine-Pediatrics at the Indiana University School of Medicine in Indianapolis, where he blogs about medical education.

More Musings
Rob Lamberts, MD, ACP Member, a med-peds and general practice internist, returns with "volume 2" of his personal musings about medicine, life, armadillos and Sasquatch at More Musings (of a Distractible Kind).

Prescriptions
David M. Sack, MD, FACP, practices general gastroenterology at a small community hospital in Connecticut. His blog is a series of musings on medicine, medical care, the health care system and medical ethics, in no particular order.

Reflections of a Grady Doctor
Kimberly Manning, MD, FACP, reflects on the personal side of being a doctor in a community hospital in Atlanta.

The Blog of Paul Sufka
Paul Sufka, MD, ACP Member, is a board certified rheumatologist in St. Paul, Minn. He was a chief resident in internal medicine with the University of Minnesota and then completed his fellowship training in rheumatology in June 2011 at the University of Minnesota Department of Rheumatology. His interests include the use of technology in medicine.

Technology in (Medical) Education
Neil Mehta, MBBS, MS, FACP, is interested in use of technology in education, social media and networking, practice management and evidence-based medicine tools, personal information and knowledge management.

Peter A. Lipson, MD
Peter A. Lipson, MD, ACP Member, is a practicing internist and teaching physician in Southeast Michigan. The blog, which has been around in various forms since 2007, offers musings on the intersection of science, medicine, and culture.

Why is American Health Care So Expensive?
Janice Boughton, MD, FACP, practiced internal medicine for 20 years before adopting a career in hospital and primary care medicine as a locum tenens physician. She lives in Idaho when not traveling.

World's Best Site
Daniel Ginsberg, MD, FACP, is an internal medicine physician who has avidly applied computers to medicine since 1986, when he first wrote medically oriented computer programs. He is in practice in Tacoma, Washington.

Other blogs of note:

American Journal of Medicine
Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.

Clinical Correlations
A collaborative medical blog started by Neil Shapiro, MD, ACP Member, associate program director at New York University Medical Center's internal medicine residency program. Faculty, residents and students contribute case studies, mystery quizzes, news, commentary and more.

Interact MD
Michael Benjamin, MD, ACP member, doesn't accept industry money so he can create an independent, clinician-reviewed space on the Internet for physicians to report and comment on the medical news of the day.

PLoS Blog
The Public Library of Science's open access materials include a blog.

White Coat Rants
One of the most popular anonymous blogs written by an emergency room physician.

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