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Hostility Towards Scientists And Jenny McCarthy’s Latest Video

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I’ve been fairly quiet about Jenny McCarthy’s campaign against childhood vaccinations, partly because Dr. David Gorski has covered the issue so thoroughly already, and partly because of my “do not engage” policy relating to the deeply irrational (i.e. there’s no winning an argument with “crazy.”) But this week I was filled with a renewed sense of urgency regarding the anti-vaccinationist movement for two reasons: 1) I received a personal email from a woman who is being treated with hostility by her peers for her pro-science views on vaccines and 2) a friend forwarded me a video of Jenny McCarthy speaking directly to moms, instructing them to avoid vaccinating their kids or giving them milk or wheat because of their supposed marijuana-like addictive properties.

Anti-Vaccination Views Are A Status Symbol?

I was surprised to discover that some pro-science moms are being mocked by peers who are uninterested in evidence, choosing to believe any dubious source of health information that questions the “medical establishment.” This concerned mom writes:

I am the mother of two young children, and I live in the trenches of the anti-vax woo.  In my circle of about 14 mothers, my anecdotal analysis is that the rate of complete vaccination hovers around 60%.  The mothers in this group are all very well educated, middle-class or affluent, predominantly stay-home mothers. One problem is what they consider reliable sources of information.  They rely on anecdotes and dismiss scientific evidence in part because they are very anti-medical establishment.  The group is self-validating and many shared values (and myths) increase in intensity over time.

Many of the mothers practice “Natural Family Living” which has some appealing aspects, but also harbors elements of a cult.  In this environment, anti-vaccination becomes a very powerful status symbol… I have lost friendships and been partially ousted from this circle because of my views.

This note struck a chord with me, since I experienced similar hostility in the past for voicing my concern about pseudoscience and misleading consumer health information. I was accused of being “paternalistic, narrow-minded, a dinosaur – part of a dying breed, a racist against complementary and alternative medicine, and a Bible school teacher, preaching evidence-based medicine,” insulted for my desire to be accurate about what was known and not known about treatment options, and my expertise, training, and academic credentials were called into question publicly on many occasions. I endured all of this primarily at the hands of someone who supposedly believed in “natural healing” and the “art of kindness” as an integral part of patient care.

I am troubled by the mounting antagonism towards those of us who’d like to use critical thinking and scientific reasoning to learn what we can about medicine and our health. I’m not sure what to do about it except to encourage one another to stand strong for science and reason – to expect all manner of attacks and insults, and to be firmly committed to the objective quest for truth. It shall set us free.

Jenny McCarthy – Inaccurate, Unhelpful And Dangerous Advice

Although I find Jenny McCarthy’s advice and opinions painful to watch, I committed myself to viewing her recent video at my friend’s request. In order to spare you similar discomfort, let me simply summarize what she said so you can get a high level overview of the sort of bizarre and misinformed claims she promotes (feel free to check out the video for yourself).

“Autism is not primarily a genetic disorder, but caused by vaccine-related toxins (including mercury, aluminum, ether, anti-freeze ,and human aborted fetal tissue) and pesticides.”

“Kids get ‘stoned’ by wheat and dairy toxins. Giving them wheat or dairy proteins is like giving children marijuana.”

  • There is currently no evidence that any diet improves or worsens the symptoms of autism spectrum disorders.  In fact, whole grains and dairy products are an important part of a healthy diet for most children.

“Food allergies are like Iran and Iraq. Glial cells (they’re like chef cell) provide food to the neuron kings. Glial cells can turn into Rambo to fight Iran and Iraq. If a child is allergic to everything, the Rambo cells stop feeding the neurons and the neurons starve. That causes the symptoms of autism.”

  • I don’t know what to say about this strange analogy – clearly no science-based information here.

“To treat autism, you need to give your child supplements to fight off the yeast in their bodies. I recommend Super Nathera, Culturelle, Cod Liver Oil, Caprylic Acid, CoQ10, Calcium, Vitamin C, Selenium, Zinc, Vitamin B12, B6, and Magnesium.”

  • There is no evidence of efficacy for any of these supplements in the treatment of autism.

“You need to consult with a DAN! Practitioner.”

  • DAN! Practitioners recommend chelation therapy for the treatment of autism. There is no evidence that chelation therapy has any benefit for children with autism, and in fact, can be fatal.

“Whatever you think becomes your reality. Imagine your child going to his/her prom and he’ll be cured.”

I think it’s pretty clear that Jenny McCarthy’s recommendations range from ineffective (imaginary healing) to harmful (malnutrition related to absent dairy and wheat in the diet, excessive levels of vitamins) to deadly (chelation therapy with DAN! Practitioners). Will mothers watching her new show on Oprah fall for her pseudoscience and poor advice?

I was pleased to see this open letter to Oprah from one concerned mom. Here’s an excerpt:

To me, it is clear that a significant number of people look up to you, and trust your advice and judgment. That is why it is such a huge mistake for you to endorse Jenny McCarthy with her own show on your network.
Surely you must realize that McCarthy is neither a medical professional nor a scientist. And yet she acts as a spokesperson for the anti-vaccination movement, a movement that directly impacts people’s health. Claims that vaccines are unsafe and cause autism have been refuted time after time, but their allure persists in part because of high-profile champions for ignorance like McCarthy. In fact, ten of the thirteen authors of the paper that sparked the modern anti-vaccination movement retracted the explosive conclusions they made due to insufficient evidence. Furthermore, it is now clear that the study’s main author, Andrew Wakefield, falsified data to support these shaky conclusions.

We have come close to eradicating life-threatening and crippling illnesses because of vaccines, but are now struggling to prevent outbreaks because of parents’ philosophical beliefs that vaccines are harmful. Realize this: when someone chooses not to vaccinate their child, they aren’t just putting their own child at risk, they are putting everyone else around them at risk. Diseases with vaccines should normally be of little concern even to unprotected individuals due to herd immunity – with the majority of the population immune, unprotected individuals are less likely to come into contact with the pathogen. Unfortunately, herd immunity disintegrates as fewer people are vaccinated, putting everyone who hasn’t yet been vaccinated at greater risk for infection. Now, the rates of infection by diseases for which we have safe and effective vaccines are climbing, thanks to anti-vaccination activists like Jenny McCarthy.

You reach millions of people everyday and your words and endorsements carry an incredible amount of weight. If you say to buy a certain book, people will buy it. If you do a segment on a certain charity, people will contribute. And if you say that what Jenny McCarthy is saying has merit, people will believe you…

Conclusion

A certain segment of society appears to be emotionally invested in medical beliefs that are not based on science, but rather anecdotes, conspiracy theories, and magical thinking. Those who recommend a more objective method of inquiry may be subject to ridicule and hostility by that segment. Nonetheless, it is important (for public health and safety purposes and the advancement of science) for critical thinking to be promoted and defended. While some celebrities, like Jenny McCarthy, are committed to misinforming the public about their children’s health – parents who recognize the deception are speaking out against it. Perhaps the best way to combat Jenny’s propaganda is to boycott Oprah. Refusing to support the promotion of dangerous pseudoscience may be our best defense.

*This blog post was originally published at Science-Based Medicine*

Being Right Versus Being Influential

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On May 9th I had the pleasure of lecturing to an audience of critical thinkers at the NYC Skeptics meeting. The topic of discussion was pseudoscience on the Internet – and I spent about 50 minutes talking about all the misleading health information and websites available to (and frequented by) patients. The common denominator for most of these well-intentioned but misguided efforts is a fundamental lack of understanding of the scientific method, and the myriad ways that humans can fool ourselves into perceiving a cause and effect relationship between unrelated phenomena.

But most importantly, we had the chance to touch upon a theme that has been troubling me greatly over the past couple of years: the rise in influence of those untrained in science on matters of medicine. I have been astonished by the ability of “thought leaders” like Jenny McCarthy to gain a broad platform of influence (i.e. Oprah Winfrey’s TV network) despite her obviously flawed beliefs about the pathophysiology of autism. Why is it so hard to find a medical voice of reason in mainstream media?

The answer is probably related to two issues: first, good science makes bad television, and second, physicians are going about PR and communications in the wrong way. We are taught to put emotions aside as we carefully weigh evidence to get to the bottom of things. But we are not taught to reinfuse the subject with emotion once we’ve come to an impartial consensus. Instead, we tend to bicker about statistical analyses, and alienate John Q. Public with what appears to him as academic minutiae and hair-splitting.

I’m not sure what we can or should offer in place of our “business as usual” behavior – but I’ve noticed that being right isn’t the same as being influential. I wonder how we can better advance the cause of science (for the sake of public health at a minimum) to an audience drawn more to passion than to substance?

I would really enjoy your input, dear readers, because I’m at a loss as to what we should do next to reach people in our current culture, and with new communications platforms. What would you recommend?

*This blog post was originally published at Science-Based Medicine*

Give me a break (a summer break, that is)!

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School is almost out and your child will soon be on his way to sleep away camp.  By the number of camp physicals I have been filling out recently, I can tell you that a lot of kids are sleeping away from home this summer.  Most are so excited that they are counting the number of days and hours until they leave.   And, believe it or not, their parents are excited, too.  A whole week, or two, or three without being a maid or chauffeur.  Only in my dreams!

Some kids, however, are a little less than enthusiastic.  Summer camp can be a great experience and most kids love it – but only when they are ready.  If your child really doesn’t want to go and has a hard time separating from you, he may not be ready yet.  And, as much as you would love to get a break, you may want to wait until next summer.  Remember that there is no law stating that your child must attend a sleep away camp before becoming an adult.  There are plenty of kids who never go to camp and, guess what?  They grow up to be wonderful, successful, adventurous adults!

However, before you throw away your much needed break this summer, there are some things you can do to make it more likely your less-than-willing child will want to go to camp and will end up loving it.  Below are a few things you can do to ease him into thinking about camp and making him feel less homesick if, in the end, everyone decides to give it a try.
·  Start by having him sleep over at a friend’s or relative’s house.
·  Invite a friend over who has been to sleep away camp and have him tell your child all about it
·  Look for a camp that doesn’t last too long and isn’t too far away from home.
·  Try to find  a friend or a sibling who wants to go with your child
·  Go visit the camp (if possible) and show your child where he will eat, sleep, and do various activities
·  Find a camp that has similar interests to your child’s
·  Send your child to camp with a special shirt, stuffed animal, or something else from home
·  Mail letters and packages early and often so your child knows you are thinking of him (you can even send one in advance so it is there the day your child arrives)

If and when he decides to go, chances are he will have a great time and want to go longer  next year (so be careful of what you wish for!)

Medbloggers As Press: Second Class Citizens Or New Media Elite?

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dr_val_jones_163I’ve been covering a lot of health and medical conferences lately, and experiencing a wide range of reactions to my work. For those in the media who “get” blogging – I’m treated with honor and respect. One conference organizer kindly lined up the key note speakers for me to interview, not allowing them to leave until I’d asked them all the questions I desired.

A different conference PR team forbade me to Twitter during the conference believing that “Twittering” was code for recording the conference and selling it to those who didn’t want to pay the high attendance fees. One CEO enthusiastically beckoned me over to speak with him (seeing my bright green press ribbon) and then looked at my title “blogger” and said in an irritated voice, “oh, you’re not real press.” At yet another conference I was invited as press and then asked to pay $30/day for Internet access. When I asked if I could interview the keynotes I was told, “I’m sure they won’t want to talk to you.”

As you can see, my experience has varied from being treated like a second class citizen, to being critical to the PR strategy. As a physician and a member of the National Press Club, I find it amusing to be “shattering the categories” in all kinds of ways. Most people find it hard to reconcile that I’m a “real doctor” who is also a full time blogger. I see patients once a week, and I cover conferences/conduct interviews/evaluate news on my blog the rest of the time. “But you can’t be a real doctor,” they say, peering at my press badge, “you don’t look like one.”

For PR and communications strategist in the know, medical bloggers are powerful way to reach their target audience. Better Health, with its partner sites and blogger network, reaches over 11 million unique viewers per month. As the CEO, I have been invited to speak at AMA sponsored conferences, on CBS and ABC news, at the National Library of Medicine, and have been quoted by the Wall Street Journal, and LA Times. A PR executive told me recently, “forget the Today Show, Better Health reaches a larger and more targeted health demographic.”

And yet, blogging and new media are ahead of industry, traditional PR, and communications efforts in healthcare in terms of reach and influence. Very few have figured out how to work with medical bloggers in any consistent way, even though there’s a great new channel to do so: the Better Health network.

As I have often said, blogging is upstream of mainstream media. It’s a great place to be, though misunderstood by some. I’ve grown a thick skin and expect confused looks – because I know that in a year or so, medical bloggers will be an integral part of health conference coverage, probably upstaging their current mainstream counterparts. One day soon blog networks like Better Health will be in a position to hire journalists as part of a new hybrid team of reporters and scientists, better able than ever to communicate the significance of health news.

Imagine getting immediate commentary from a researcher who understands the complex science behind a medical breakthrough? Even the best health writers are often ill-equipped to know how to interpret author spin or biostatistics. But by combining those trained in journalism with those trained in medicine – and producing content that is conversational and accurate – readers gain access to a deeper understanding of health information. The old journalism mantra “we report, you decide” becomes “we interpret, you decide.” And for those without a medical background, the interpretation can add tremendous value.

As the world adapts to the Internet age, watch for a fundamental shift in the way health information is reported. Adding physician, nurse, and scientist writers into the mix will only enhance the quality of what we read. In a world grieving the loss of newspapers and health beats, I remain optimistic – because I believe we’re on the verge of a rebirth in health communications, and we’ll all be better for it.

Cash-Only Physician Practices Could Save You A Bundle

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When most people think of “cash-only” medical practices, plastic surgery and dermatology procedures are top of mind. But there is a small contingent of primary care physicians who offer low-cost “pay-as-you-go” services. Yearly physicals, well-child visits, screening tests, vaccinations, and chronic disease management are all part of comprehensive primary care options available. And this costs the average patient only $300 a year.

It is estimated that 75% of Americans require an average of 3.5 office visits per year to receive all the medical care they need. If the average office visit is 15-20 minutes in length, then that averages out to 1 hour of a physician’s time each year. How much should that cost? Dr. Alan Dappen (founder of Doctokr Family Medicine, a cash-only primary care practice in Vienna, Virginia) says, “$300.” But insurance premiums are often closer to $300 per month for these Americans, and that doesn’t include co-pays for provider visits.

So why aren’t people buying high deductible insurance plans, saving thousands on premiums per year, and flocking to cash-only primary care practices?  Dr. Dappen says it’s a simple matter of mindset – “People have been conditioned to believe that if they pay their insurance premiums, then healthcare is ‘free.’ In reality, their employers are taking out $3600 or more per year from their paychecks for this ‘free’ care. But since employees don’t see that money, they don’t miss it as much.”

A high deductible health insurance plan (where insurance doesn’t kick in until you’ve paid at least $3000 out of pocket in a given year) costs about $110/month for the generally healthy 75% of Americans (you can check rates at eHealthInsurance.com). That’s a savings of at least $2280/year for those who switch from a regular deductible plan to a high deductible plan.

What are the odds that the average, reasonably healthy American will outspend $2280/year? I asked Alan Dappen how many of his 1500 patients spent more than $2000 on his services per year. The answer? Three.

“Most Americans who buy-in to low deductible plans pay a lot more in premiums than they’ll ever use. They’re essentially betting against the casino, and we all know who wins on those bets.”

So I asked Alan Dappen if “the casino” was making most of its money on the “healthy” 75% of its enrollees to subsidize the cost of the sick 25%.

“Sure they are. And I suppose if enough people saw the light and switched to high deductible plans with cash-only physicians, it might force change in the health insurance industry.  Perhaps the government would use our taxes to help subsidize the sicker patients.

The bottom line is that at this very moment, 75% of Americans could be saving thousands of dollars per year on their healthcare costs – and have their very own cash-only primary care physician available to them 24-7 by phone, email, home visit, or office visit. The cash-only doc can afford to offer these conveniences because they are paid by the hour to do whatever the patient needs done, without forcing the relationship to conform to insurance billing codes. In fact, the physician saves a bundle on coding and billing fees – and can pass that on to the patients.”

I wondered about the outrageous costs of laboratory fees and radiology charges for people who don’t qualify for the insurance company negotiated rate. Dappen explained:

“My practice has negotiated similar rates with local labs and radiology groups. Screening tests and x-rays are very reasonable.”

I asked Dr. Dappen who uses his services.

“I see both ends of the spectrum. The high-powered executives who don’t have the time to wait in a doctor’s office and enjoy the convenience of handling things with me via phone or house call. For them, time is money, and by losing half a day or more traveling to a doctor’s office and waiting for their 15 minute slot, they might lose $5000 in billable work time. On the other end I see patients with no insurance or high deductible plans. They enjoy the same conveniences, and end up paying an average of $300/year for their healthcare. This is high quality care that they can afford.”

I guess the only thing preventing this model of healthcare from taking off is the courage of individuals to try something new. I myself have switched to a cash-only practice with a high deductible health insurance plan, and have saved myself thousands a year in the process. I love the convenience of knowing that my doctor has all my records in his EMR, I have his cell phone number, and he can renew my prescriptions with a simple email request. I can’t imagine why more people aren’t doing this.

Alan Dappen says, “They just have to wake up out of the Matrix.”

**For more in-depth coverage of the rising trend in cash-only practices, check out MedPage Today’s special report.**

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