Defending Dr. Bob Sears: On the affinity between “integrative medicine” and antivaccine views

It’s been nearly three weeks since we learned that the Medical Board of California had initiated disciplinary proceedings against the most famous antivaccine physician not named Andrew Wakefield. I’m referring, of course, to “Dr. Bob” Sears, author of The Vaccine Book: Making the Right Decision for Your Child and creator of an “alternate” vaccine schedule that “spreads out the vaccines.” Unfortunately, it’s a book that’s been very influential, in particular promoting the idea of “too many too soon” and claiming that delaying vaccines will reduce a child’s risk of autism. Basically, the medical board accused Sears of failing to live up to the standard of care in two instances with one patient: Not doing a detailed neurological examination when she presented to him with history of headache two weeks after having been supposedly hit on the head with a hammer by her father and writing a letter supporting a medical exemption to school vaccine mandates based on a rationale that was not based in science and not accepted as the standard of care. Since then, antivaccine activists have rallied around Sears and portrayed the impending disciplinary hearings against him as “persecution.”

Of course, “Dr. Bob” has a long history of pandering to the antivaccine movement, a history I’ve documented extensively right here on this very blog. For example, he’s likened SB 277, the new California law that eliminates nonmedical exemptions to school vaccine mandates, to the Holocaust, basically going full Godwin on it and letting his antivaccine freak flag fly. I was also surprised that the Medical Board of California didn’t actually look at Dr. Sears for his more blatant selling of medical exemptions, including exemptions based on an online form.

So it amuses me to see the latest volley fired to defend Dr. Bob from the nefarious depredations of the evil Medical Board of California. It comes from Jennifer Margulis, PhD, who claims that long history of antivaccine posturing. If you don’t believe me, just check out her website, which is chock full of posts “standing with Sears” and promoting Andrew Wakefield’s antivaccine conspiracy propaganda piece VAXXED. So, not surprisingly, her defense of Dr. Bob invokes the views of some rather dubious physicians. First, she begins by quoting the charges against Dr. Bob, where the board points out that the “standard of care requires that a physician evaluating a patient for possible reaction to vaccines obtain a detailed history of the vaccines previously received as well as the reaction/reactions that occurred” and that, based on that information, “the physician should provide an evidence-based recommendation for future immunizations.” This is, of course, perfectly true, and it’s pretty darned obvious that if the the board’s list of charges are correct Dr. Bob failed in that.

Not according to Margulis:

But, say several doctors and supporters of Sears, according to the Medical Board’s own documentation, this is exactly what Sears did.

When Sears saw the toddler for the first time on April 3, 2014, he was told by the boy’s mother that her son had had two concerning vaccine reactions.

The boy “shut down stools and urine for 24 hours with 2 month vaccines and [was] limp ‘like a ragdoll’ lasting 24 hours and not himself for a week after 3 month vaccines.” In a letter dated April 13, 2014, excusing J.G. from future vaccines, says Sears indicated that “the patient’s kidneys and intestines shut down after prior vaccination and that at three months the patient suffered what appears to be a severe encephalitis reaction for 24 hours, starting approximately ten minutes after his vaccines, with lethargy, limpness, and poor responsiveness.”

“Based on the symptoms the child suffered after previous vaccinations (as described by the mom in the accusation), I would say Dr. Sears was being grossly conscientious,” asserts Shira Miller, M.D., a Los Angeles physician who is board certified in internal medicine and has been practicing medicine for 14 years via e-mail.

I dealt with that claim before the second time I discussed Dr. Bob’s impending disciplinary proceedings before the board. To summarize, when confronted with a new patient whose mother claims she had a serious vaccine reaction such as what was described in the records, a competent and responsible pedaitrician would look into exactly what vaccines the child had before the alleged reaction and, if possible, obtain the patient’s medical records to see exactly what form the alleged reaction took. Heck, a truly “grossly conscientious” pediatrician would have picked up the telephone and given the pediatrician who cared for the patient at the time of the claimed reaction a quick phone call. After all, if the reaction were as dramatic as claimed, most likely the pediatrician would remember it and would have reported it to the VAERS database. From the documentation available, we know that Dr. Bob did none of these things. He just wrote a letter of support for a vaccine exemption because the mother wanted one, requesting exemption for all vaccines. Even if the child did have a truly serious reaction to a vaccine, that doesn’t necessarily mean she should have been exempted from all vaccines. It might, but it might not. Dr. Bob didn’t even try to figure it out.

I had never heard of Dr. Shira Miller before; so I did a quickie Google search, which brought up her website. I expected a family practitioner, but what I got was an “anti-aging” doctor who runs the Integrative Center for Health and Wellness. She appears to specialize in menopause, particularly “bioidentical” hormones, “anti-aging” medicine, and, of course, “holistic” medicine. Her profile states that she has practiced “integrative, functional, alternative, holistic, nutritional, wellness, age management, and anti-aging medicine since 2006.” Of course, functional medicine is pseudoscience involving making it up as you go along.

Next up:

Deborah Gordon, M.D., an Ashland, Oregon, family physician who has been practicing medicine for 30 years, including five years in California, agrees. Gordon says the kind of reaction described by J.G.’s mother was “absolutely cause for concern.” A three-month-old baby who remains limp for 24 hours immediately after being vaccinated, Gordon says, is suffering from a neurological insult.

“That shrieking cry or high fever isn’t because the spot of the vaccine still hurts,” Gordon points out. “It is because an inflammatory reaction is going on in the child’s system, including in the brain.”

Um, no. A three year old remaining limp for 24 hours after being vaccinated, if that is indeed what happened, does not necessarily suffer from a neurologic insult. The differential diagnosis is much longer than that, but Dr. Gordon zeroes on on the one thing she can think of as a cause. I checked out Dr. Gordon’s website as well. She’s big into diet to treat disease, which is not a bad thing, if her approach is evidence-based, but somehow I doubt it is, even without delving far into her website. Why? Because she embraces homeopathy, working with a naturopath to provide homeopathic care to Ashland, OR. From my perspective, any physician who embraces the quackery that is homeopathy automatically forfeits pretty much all credibility in any other medical area. After all, if Dr. Gordon’s mind is so “open” that she can administer homeopathic remedies, I have to wonder how “open” it is to other forms of pseudoscience—almost certainly very. No wonder she thinks that Dr. Bob acted responsibly.

I could go on and on, but let’s see who else “stands with Sears”:

Basically, they all repeat the same tropes that I’ve discussed before, claiming that what Sears did was not gross negligence because they basically believe whatever they’re told by parents. I’m rather surprised Margulis couldn’t scare up an actual pediatrician or two to “stand with Sears.” After all, there are antivaccine-friendly pediatricians out there like Dr. Bob. I mean, wasn’t Dr. Jay Gordon available? Of course, the reason why the tropes are the same is because there’s been a set of talking points that’s solidified since the charges against Sears were first made public and after antivaccine blogger Levi Quackenboss first enumerated them a few days later.

Of course, one of the reasons Margulis’ article caught my attention is not because a lot of antivaccine docs are disturbed by the Medical Board of California actually doing its job and trying to put a stop to Dr. Bob, who is, as far as I am concerned, a menace to public health in California. Rather, it’s to show the affinity between “integrative medicine” and antivaccine views. There isn’t a single mainstream physician—especially a mainstream pediatrician—defending Dr. Sears’ behavior. It’s all “integrative” physicians practicing woo like functional medicine, homeopathy, and a whole lot of other dubious medicine. They’re the only ones defending Dr. Sears. That’s just another thing that should disturb you about “integrative medicine.” The proponents of integrative medicine sitting in their ivory towers of academia will swear up and down that integrative medicine is not antivaccine, but damned if a survey on the ground doesn’t suggest otherwise.