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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