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What makes a physician become an antivaxer?

Even though they should know better based on their training, too many physicians embrace the dark side and become antivaccine. How does this happen? What personality traits common among physicians can facilitate a descent into pseudoscience?

Being a surgeon and physician, I’ve always been puzzled at how my fellow physicians and surgeons can become ensnared by pseudoscience and quackery to the point where they become proponents of various forms of irrational thinking. Examining “docs gone bad” has been an intermittent recurring theme of this blog going all the way back to at least 2005. Leaving aside obvious quacks, such as some of the cancer quacks I’ve discussed over the years, I’ve discussed a number of doctors who don’t accept the validity of evolution, the most commonly discussed being Dr. Michael Egnor, the creationist neurosurgeon who has laid down some astoundingly ignorant nonsense about evolution while trying to refute it. Of course, it can be even worse. Dr. Egnor was known for advocating the “intelligent design” flavor of evolution denialism (or, as I like to call it, creationism). That’s a form of creationism that concedes, at least, that the earth is very old. More disturbing was the time I encountered a medical student who was a young earth creationist. That was 11 years ago, which means that this young earth creationist is now almost certainly a fully trained physician, having finished medical school and residency—and possibly even subspecialist training. How a physician can believe that the earth is only 6,000 years old and that all creatures were placed on earth in their present form then is beyond me. Indeed, so frustrated do such docs make me that for a while I had a bit of a shtick in which I put a paper bag over my head in shame. That bag later turned to a Doctor Doom mask because the stupid became so thick that a paper bag wasn’t enough.

All of this is just a say of first showing how physicians can be as irrational as any other human being as a means of getting to the main thing I want to discuss, which is my continued bewilderment and irritation how physicians can become antivaccine. The list of antivaccine physicians is long and shameful, including, for example, Dr. Suzanne Humphries, “Dr. Bob” Sears, Dr. Mark Geier, Dr. Mayer Eisenstein, Dr. Jeff Bradstreet, and, of course, Dr. Andrew Wakefield, among all too many others. (And don’t go on about how Wakefield isn’t a doctor because he’s had his UK medical license stripped; he still has the degree, and that makes him a doctor, albeit a delicensed one. That’s a pet peeve of mine.) Then there are what I like to call “antivaccine-sympathetic” doctors, doctors who might not be full-on antivaccine but who pander to the antivaccine fringe and express beliefs bordering on antivaccine, if not outright antivaccine. Dr. Jay Gordon is a good example of this latter type of physician.

What’s always interested me about antivaccine and antivaccine-sympathetic doctors is how they got that way. How did they come to abandon what they were taught in science classes and in medical school to come to conclusions about vaccines that are not just contradicted but very strongly contradicted by science. I can sort of understand doctors falling for creationist pseudoscience. As much as I might wish it were otherwise, evolution is not an emphasized topic in medical school, and it’s quite possible to become a physician without knowing much more about evolution than would be taught in a 100-level biology class. Vaccines, however, are another matter. Vaccines only represent the most successful public health intervention in the history of medicine, an intervention that has arguably prevented more deaths than every other intervention combined. The evidence is overwhelming that they do not cause autism, sudden infant death syndrome, autoimmune diseases, or any of the other conditions that antivaxers blame on vaccines.

So it was with some interest that I encountered Dr. Douglas Mackenzie, a plastic surgeon who has aligned himself with antivaxers, so much so that he’s done video interviews for the antivaccine propaganda film VAXXED in which he pontificates about how physicians are “ignorant” about vaccines. (Time to get the paper bag out again.) For example, here is an appearance he made in February:

And here is a more recent appearance, which is of more interest to me because he basically tells his “conversion story” (as I like to call stories about how people embrace pseudoscience, given the religion-like character of many of such stories):

Before I discuss Mackenzie’s “conversion story,” here’s a bit about him now. He describes himself thusly on the most Orwellian-named Physicians for Informed Consent website:

Dr. Douglas J. Mackenzie graduated from Johns Hopkins University School of Medicine in 1989, and completed a general surgery residency at Cedars-Sinai Medical Center in 1994. He received his plastic surgery training in New York City at New York Hospital/Cornell University Medical Center, and then attended Portland’s Oregon Health Sciences University for a hand surgery fellowship. After completion of his training, he stayed on staff as Assistant Professor in the division of Plastic and Reconstructive Surgery at Oregon Health Sciences University. In addition to his busy clinical practice, he was active in teaching plastic surgery residents, conducting clinical and basic science research, and co-directed the hand surgery fellowship.

Dr. Mackenzie is a member of several societies including the American Society of Plastic Surgeons, as well as the American Society for Aesthetic Plastic Surgery. Dr. Mackenzie participates in the American Board of Medical Specialties Maintenance of Certification in Plastic Surgery program. Additionally, he was named to U.S. News and World Report’s Top Plastic Surgeons.

It turns out that Mackenzie is not only the treasurer of the group, but a founding member. In fact, the board and founding members of this antivaccine group include another bunch of physicians who are antivaccine. There he lays down nonsense like this:

A few years ago I began to grow curious about the issue of vaccine safety when I noticed the degree of vitriol that the topic would trigger in many physicians. In addition, doctors never seemed to be able to back up their claims of vaccines being universally safe and effective. One of the first books I read on the subject was Dr. Suzanne Humphries and Roman Bystrianyk’s book, Dissolving Illusions. I was stunned to learn that death and morbidity from vaccine preventable infectious diseases (and the ones for which there were no vaccines as well) plummeted prior to the advent of their respective vaccination programs. Unfortunately, I also found that so many of the vaunted studies that underpin mandatory vaccination legislation are deeply flawed or even fraudulent.

Let’s just put it this way. If you can take anything Dr. Humphries writes about vaccines seriously, you have a serious blind spot, as well as a hole in your critical thinking abilities that you could pilot an aircraft carrier through. This is a woman who routinely describes vaccines as “disease matter” while spewing the most easily refuted pseudoscience about vaccines on a regular basis. Clearly, Dr. Mackenzie has that blind spot, which allows him to provide misinformation like this to antivaxers:

…I think it’s, it’s more that physicians are just simply, they they’ve been brainwashed from the first day of medical school and It’s just that they don’t get the alternative views and they don’t read the huge amount of science that supports the dangers and risk of vaccines and what’s in the vaccines. They just, they just don’t know about this stuff . . . or they’ll, they’ll quote, they’ll just quote the AAP guidelines, or they’ll quote the CDC, or they’ll quote Paul Offit and they’re not doing their own reading or their own analysis of these things . . .

I have to wonder if Dr. Mackenzie is a member of the Association of American Physicians and Surgeons (AAPS), the John Birch Society disguised as a medical professional society that worships being a “maverick” above all and absolutely despises anything that resembles “going along with the herd.” Not surprisingly to the AAPS, part of “not going along with the herd” often includes buying wholesale into antivaccine pseudoscience. Certainly contemptuously describing other physicians as “brainwashed” because they accept that vaccines are safe and effective (and don’t cause autism) is very AAPS-like.

In any case, in the video above describing how he supposedly “weighed both sides” and became an antivaxer because he thought the evidence supports that position, Dr. Mackenzie credulously repeats a number of antivaccine myths, such as the claim that unvaccinated children do not get autism and that there is virtually no autism among the Amish, who don’t vaccinated, the latter of which is a myth created by the late Dan Olmsted. (There is, and the Amish do vaccinate.)

It gets even worse, though. Andrew Wakefield was someone who influenced Mackenzie to become antivaccine. I find it very telling that one of the first things Mackenzie mentions is how the media was “all in a froth” about Wakefield’s claims, which makes me think that what made Wakefield appealing to Mackenzie was that he, too, wasn’t “following the herd.” So Mackenzie read Wakefield’s book (I assume it was Callous Disregard), describing it as “kind of when the lightbulb went off.” This led him down the rabbit hole to reading Suzanne Humphries’ book and its revisionist history.

In fairness, he also says that he read Paul Offit’s books, Seth Mnookin’s books, and blogs such as Science-Based Medicine, leading him to say that he “knows both sides” and that he “doesn’t have a dog in this hunt.” He paints himself as being open-minded, with no ax to grind, but it’s obvious from his statements that he is open-minded to the point of his brain falling out. For instance, he castigates the “bad epidemiology” out there supporting vaccine safety and efficacy. Is he an epidemiologist? How much epidemiology has he studied? He’s a plastic surgeon, and I can tell you that few are the plastic surgeons who have much of a background in epidemiology. Certainly I can’t find much evidence that Mackenzie has been exposed to more than the very, very basics. Near the end, he also pontificates about law, and it’s clear that he doesn’t know what he’s talking about with respect to law, either.

This leads him to repeat yet again his oft-repeated charge that physicians are “brainwashed from the first day of medical school,” while he himself throws around terms like “healthy user bias” while clearly not knowing what those terms mean or how they apply to the epidemiological studies of MMR that he criticizes. Particularly embarrassing is how he has no clue about the rationale for the birth dose of the hepatitis B vaccine. No, wait. Even more embarrassing is how he doesn’t even know that it’s not nearly as easy as he thinks it is to do a “vaccinated/unvaccinated” study, and he doesn’t seem to realize that it’s a myth that such studies don’t exist. (Hint: They tend to show no health differences between vaccinated and unvaccinated children—or, in one case, that vaccinated children have a lower risk of SIDS.) Not surprisingly, Mackenzie is also into conspiracy theories. He buys into the “CDC whistleblower” conspiracy theory and spends a fair amount of time castigating conflicts of interest at the CDC. It’s all basically the usual, run-of-the-mill antivaccine rhetoric.

Reading Dr. Mackenzie’s writings and watching him in action in these videos, what I see is a massive case of the Dunning-Kruger effect resulting in the utter arrogance of ignorance. I’ve discussed this more times than I can remember over the years, but physicians in particular seem particularly prone to the Dunning-Kruger effect, which is the inability to recognize one’s own ignorance and shortcomings in a subject and subsequent overconfidence about one’s beliefs about an issue. Worse, although I don’t have any objective evidence to back up this observation, my impression is that surgeons tend to be prone to the Dunning-Kruger effect than the average physician because the personality type attracted to surgery (action-oriented, self-confident in one’s abilities) is the perfect personality type to be prone to Dunning-Kruger. (As a surgeon, I’d love to be proven wrong about this, but I suspect that I won’t be.)

Think of it this way in Mackenzie’s case. He’s a plastic surgeon. He has little or no expertise in immunology, epidemiology, statistics, autism, neurobiology, or other relevant sciences to vaccines. His practice consists mainly of cosmetic surgery. He is not a primary care doctor; he doesn’t do family practice. Yet he feels confident enough to reject the scientific consensus based on “doing his own research” (four of the most dangerous words in the medical lexicon, after “in my experience”) and to come to the conclusion that his fellow physicians have been “brainwashed” since day one of medical school. He’s basically denigrating his professional colleagues as mindless drones who just accept and do what they’re told, while portraying himself as being so much better than that. That’s what it really boils down to. Those are the personality traits common in doctors that lead them to be seduced by antivaccine nonsense, just as they make physicians prone to creationism, climate science denialism, and a wide variety of other antiscience beliefs. Dr. Mackenzie might be a perfectly competent plastic surgeon—an excellent one, even—but his knowledge of vaccines, immunology, and autism is superficial in the extreme.

Sadly, he doesn’t recognize that. Even more sadly, there are a large number of physicians like Dr. Mackenzie.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

118 replies on “What makes a physician become an antivaxer?”

Good grief! How did I manage to miss the news of Dan Olmsted’s death?

I can’t speak for others, but my niece, who just received her PhD in biostatistics, was convinced by her mother that any mentions of evolution in her coursework were to be ignored. She did a very good job of simply figuring out what the professors wanted to hear, but refuses to believe any of it. The goal was simply to get the credentials without actually coming to believe what she was supposed to be learning if such conflicted with her predetermined “worldview”.

I think there may be more of this happening than any of us want to believe.

I thought we knew why Wakefield went anti vax, he was being paid to. I suspect many others are also motivated primarily by cash, although its hard to see how that applies to Mackenzie.

@ Harold Gaines
For her exams and Thesis, she could also use formulas without knowing what it means. Who is to blame, except the university?

State medical boards have completely failed in their duty by doing nothing to discipline anti-vaccine physicians for the clear harm they do to public health (which constitutes physician misconduct as a publicly AV doctor is by definition a threat to the health of his/her patients and the health of the public in general. This inaction leads to even more numpties like Mackenzie to join a very dangerous movement.

As a pediatrician, if I have a parent tell me they’re not vaccinating because of what some loon like Jenny McCarthy or Mike Adams says–well, I’m not sure what I can do for a parent so easily taken in by a loon whose non-expertise they accept over mine. But when a parent tells me they’re not vaccinating because of what Bob Sears, Jay Gordon, or now this misnamed “Physicians for Informed Consent” group says, I have a much harder time refuting my so-called colleagues–which is why medical board must step up and discipline these quacks.

I agree with you Chris Hickie. However, I do not think it is too late for physicians to start working to remove licensing an credentials from woo-spouting, science-denying physicians. I also think nurses, and the states that license them, should be doing the same. Denying basic science, counseling patients to refuse vaccines when there is no medical indication to do so, or putting their patients at risk by refusing immunizations for themselves, should be grounds for termination of employment and loss of license. Medical practitioners should , at the very least, not put public health or vulnerable patients at risk.

“What makes a physician become an antivaxer?”

-Getting tired of lying.

Perusing the Physicians for Informed Consent website, it became obvious that the physicians and others listed there all have some kind of grift going. In my experience it’s the mediocre ones who have delusions of grandeur who are attracted to this “maverick” ideology.

-Getting tired of lying.

Speaking of which Jake, how is that whole Thompson PLOS ONE study coming along? And also Brian Hooker’s NVIC case vs. reality?

“Speaking of which Jake, how is that whole Thompson PLOS ONE study coming along? And also Brian Hooker’s NVIC case vs. reality?”

-What the hell are you talking about, Camille?

Heh.

3 days ago, Jake accused our host of being a coward, because our host banned Jake from commenting. And yet, here’s Jake, making accusations of lying on this very blog.

http://www.autisminvestigated.com/william-shatner/#comment-272972

I guess he’s taking a page from Orange Thinskin – if you spew enough lies, people will ignore some of them, just because they can’t call you out on all of them.

The Gnat might be mistaking moderation for banning. The Gnat has never been banned, but occasionally he does use links or words that trigger the moderation filters. Given his misogyny, pseudoscience, antivaccine quackery, and sheer unpleasantness, he is one of the best teaching tools we have to demonstrate why antivaccine beliefs are pseudoscience. So why would I ban him, especially given how infrequently he appears?

Let’s just put it this way The Gnat is so odious that Travis hasn’t even impersonated him yet.

“What’s always interested me about antivaccine and antivaccine-sympathetic doctors is how they got that way. How did they come to abandon what they were taught in science classes and in medical school to come to conclusions about vaccines that are not just contradicted but very strongly contradicted by science.”

The story we are often told is that the big revelation(s) occur after physicians conclude on the basis of limited personal experience/anecdote that a cornerstone of evidence-based practice is wrong – but their colleagues aren’t buying it. Instead of reexamining their flawed conclusions, they rebel against “brainwashing” and (with surprising speed) come to enjoy their maverick/outcast role.

Suzanne Humphries appears to fall into this category, at least by her own accounting (“discovering” that flu vaccination caused renal failure and not being taken seriously, then plunging headlong into a swamp of pseuomedical delusions. In her case (judging by reviews of her recent book “Rising From The Dead”, a call to Jesus is also involved).

I can’t buy this progression from practice revelation to full-on quackery promoter. There has to be a fundamental critical thinking deficiency and/or personality disorder involved, just waiting to break out (perhaps once the med school debt is paid off and the practitioner feels secure enough to plunge into the alt universe).

@RedBlues #7 –I and one other poster here today have been very active at petitioning state medical boards on these quacks. We get either no response or told that doctors have a right to express AV views publicly as doctors under some “First Amendment” protection. And no doctors groups such as the AMA, AAFP or AAP have had the guts to take a stand against these quacks, either. It’s very sad.

-What the hell are you talking about, Camille?

Aww poor Jake, having difficulty keeping your bollocks and people straight? Where is this study you proclaimed William Thompson was going to publish last year in PLoS ONE? How do you reconcile Hooker’s ridiculous claims with what is in his NVIC decision? While we’re at it, how’s that Wakefield re-licencing going? Given the content of your blog, you’re hardly a purveyor of truth. How are those pre-lims going? You’ve been a PhD student for an awfully long time now.

Young Mr. Crosby doesn’t take criticism very well.

His response to my pointing out that his public posts making him unemployable was particularly vile.

So Mackenzie read Wakefield’s book (I assume it was “Callous Disregard”), describing it as “kind of when the lightbulb went off.”

This phrasing by Dr. Mackenzie is rather revealing. He stopped thinking and blindly followed what Wakefield et al. were telling him. He should just take off. (Thank you. I’ll be here all week. Remember to tip your server.)

This is a fascinating example of an articulate, highly intelligent person questioning medical-science based partly on a “feeling”.

Here’s my take on Dr. Mackenzie’s “feeling” induced epiphany.

Dr. Mackenzie disclosed that he is starting a second family after a divorce.

I suspect his second wife/partner questions the safety and efficacy of vaccines.

In my opinion, love is always more persuasive than logic.

I like it when Orac posts every other day in that the quality increases exponentially.

@ Orac,

Do you make less $ if you post every other day?

I guess doctors need confidence to be able to do their job, but it’s sad to see someone overreach this way.

Mr. Crosby’s strong opposition to moderation filters must have made his blogging career with AoA a constant ethical dilemma. Assuming he applies his views consistently.

Unlike at AI then Jake, where you moderate every post, and, like Age of Autism, don’t allow them through if you don’t like them.

Hypocrite.

Unlike at AI then Jake, where you moderate every post, and, like Age of Autism, don’t allow them through if you don’t like them.

Hypocrite.

Exactly! Even more stupidly, he goes on about liberal special snowflakes but hurt Jake’s fee fees and he refuses to allow comments.

Or he just blatantly abuses his position & access to information to dox people.

I’m sure it’s been pointed out before, but let us remember that like the black conservative and the emeritus science-denier, the anti-vax doctor has available great adulation and esteem from certain quarters; this adulation and esteem are not available for honest and competent people.

I don’t think that in most cases, this aspect is consciously chosen. But it’s very attractive to have people listen to you and say you’re good and just and smart, simply because you are willing to say certain pieties.

Is it just me, or does that top photo of Dr. Mackenzie make him look like the second runner-up in a Vladimir Putin lookalike contest?

Pre-programmed censorship.

From what I have observed, the following things will land you in moderation:
1. Being a first time poster. Orac wants to make sure you are an honest commenter, not a troll or a spambot.
2. Putting multiple links in a post. This is a frequent tactic of spammers. The nature of the links is irrelevant.
3. Using one of the Seven Words You Must Never Use on Television. This is a family blog.
4. If Orac determines that you are a troll, but not so trollish as to rate the banhammer, he will put you on automatic moderation. But he generally explains why he has taken this step, and unless such a poster does something to merit the banhammer, he almost always lets such posts through eventually.

The last of these is the only case where the moderation is Orac’s decision, not the software’s.

To my knowledge, Orac only bans posters for one of two reasons: sockpuppetry (commenting under multiple handles), and making concrete threats of violence against other commenters. The former is what got Travis of the many aliases banned. And credible threats of violence are one of the handful of exceptions to free speech rights in the US.

Also, thanks to Travis, I’ve been forced to keep new commenters in automatic moderation for a while because Travis would often post a benign or even reasonable comment first in order to get past first time commenter moderation, after which he’d let his freak flag fly. So new commenters stay in moderation until I’m satisfied that they’re not a Travis sock puppet. It pisses me off that Travis made such a measure necessary.

What a hypocrite – not only does Young Mr. Crosby moderate every single post on his site, but he also – as noted by Rebecca above, edits responses as well.

As a long time lurker and as a Pediatrician it infuriates me that non Pediatric MD’s are spouting this belief. Yes I admit it is worse when it is a Pediatrician. I want to know when Dr.Makenzie last diagnosed pneumococcal meningitis. Has he seen a difference since the prevanar vaccine? How about rotavirus and Hib? Those of who trained before some of these vaccines have seen our response to fever and fussiness completely changed. We used to do blood work and spinal taps all the time. Since prevnar, if a baby has a fever we check a urine but hardly do blood work or a spinal tap. Obviously he has never had to talk to families about these diseases or see them in patients much less comfort a family whose child has died of pneumococcal menningits – I have.

Re censorship

The vocabulary of nurses is one that could put a sailor to shame. Hence, I from time to time get caught by Rule #3. I count myself lucky Orac has never told me to go wash out my mouth with soap.

I don’t feel put upon because Science Blogs and RI expect respectable language from the commenters. Is it censorship? Yes. But the 1st Amendment only applies to government interference with speech. From a social standpoint, my peers are entitled to assign consequences for inappropriate speech and behaviors.

Which Jake seems to have in spades.

I always wondered who the Gnat was before this. I couldn’t figure out which commentator Orac was talking about. No day in which you learn something new is a wasted day 😉

I don’t think that in most cases, this aspect is consciously chosen.

I have long been suspicious that for some it is very consciously chosen.

It is hard work to be a physician or nurse. The vast majority will spend their entire careers doing good work but remain nearly unknown outside of their circles of friends, patients and proximal colleagues. Those with a desire to rise to notability beyond these circles have to do something out of the ordinary. Making a big research “breakthrough” is one way, but those don’t come often. You can spend your life doing research and making valuable contributions, but still remain relatively unknown. And research is more hard work. Publishing books that become widely used in medical education is another way – more hard work with uncertain outcome. Of course most people doing research or writing books are quite happy to make worthwhile contributions, even if there is little fame attached.
If you announce that you hold a position contrary to those that are broadly accepted you have a chance of being noticed without actually having done much of anything. This seems to be especially true in medicine, where the popular press jumps on such things and there are substantial numbers of noisy, typically relatively ignorant people who are likely to notice because your claims support their notions. They may even send you money. If you are getting on in years and not content with your lack of fame, it’s a much easier and more certain way to get noticed before you expire.

I’m pretty convinced the anti-vax thing among a small number of doctors and nurses amounts to a plea of “Lookitme! I’m smarter than the sheep.” Not terribly different from small children or a couple of RI’s resident trolls/kooks and a notably non-resident troll.

An aspiring epi called Gnat
Wanders from spat to spat,
..Flinging fecal matter is his schtik,
..but vulnerable to a well-aimed flick,
Bzz bzz bzz, then splat.

@ DB

It’s just you. In the poster frame of the FB video, he looks like a cross between Chevy Chase and J. K. Simmonds.

Another feature of anti-vaccine doctors is that they will almost *never* be in a position to treat a child sickened by a vaccine-preventable disease. Most don’t seem to see patients anymore at all. Instead, they make movies and write books about how enlightened they are- while leaving the real work to anonymous pediatricians. Those that actually see patients, generally see worried, rich people who pay large cash fees.

I wish every anti-vaccine doctor had to spend an hour in an ICU for every hour they spent on stage or in front of a movie camera. Maybe they’d have an ounce of humility then.

My father went through some surgery a few weeks ago, and I was surprised to hear his family doctor spewing some stuff about how the world governments were controlling the weather. I asked him how much energy was required to get a liter of water to boil. He said he didn’t know. Then I asked him how much energy it would take to get a storm system (which is steam coming into contact with cold air, basically) going. He didn’t know. We agreed that it would be a lot of energy. “So where is all that energy coming from? Who is producing it? How do they concentrate it enough to get a storm going where they want it to go?” He didn’t have the answers.
Just like regular people, physicians are subject to the same cognitive biases that we’re subject to.
A few days later, he sent me a text message that he had looked into how much energy is required to get a hurricane going, and he agreed with me that it’s highly unlikely that a government or governments would waste that much energy given how much they fight over oil… WHICH IS STILL BEING PRODUCED BY THE EARTH.
Oh, boy…

I believe that there are multiple reasons why some physicians turn to The Dark Side (apart from the cookies). Orac and the “commentariat” have outlined them nicely.
MJD actually makes a good point that “love” (lust?) may be a significant influence. Is it more than a coincidence that the odious Dr Wolfsohn is married to a chiropractor? I can speculate about a couple of other antivax professionals who should know better but I will not name names.
Smart men can do stupid things when they let their hormones do the thinking.

Yvette:
Nailed it. The antivax loudmouths gravitate towards office-based, cash-only, banker’s hours (or less!) practices. No ICU coverage, no weekend or night call, no hassles with hospital politics. Nice work if you can deny reality or your conscience.

-Pre-programmed censorship.

Oh the ironing.

The way Jake runs his blog is to not allow a critical post until he has thought of a response to it. If he can’t think up a response to the point made, he will edit the post to make a different point that he can respond to or not allow the post at all.

Yet he complains when he can’t write whatever he wants to write on everyone else’s blog.

That behaviour tells you all you really need to know about Jake.

I’ve found that it is those who most pride themselves in bucking “political correctness” in comparison to “special snowflakes” expecting everyone to cater to them who are frequently the least able or willing to tolerate dissent or criticism. In fact, many, if not most, such people are the specialest snowflakes of all and go into paroxysms of rage when anyone has the temerity to criticize their viewpoints. What they really want is to be able attack speech they don’t like while and indulge in their misogyny and racism without any repercussions. I’ve also found that this goes at least double for Donald Trump supporters.

As to why physicians go anti-vaccine? In my opinion this is all about ego. They come up with some stupid idea* and when they are told it is a stupid idea fail to accept that. After all they had come up with the idea and because they have a brain the size of a planet the idea must be right. Then they do some research on Google University and find out that they were correct all along. After that they discover the unstinting adulation and the fact that grifting requires little hard work when your marks are so gullible. And down the rabbit hole they go. A few skip the bit about the idea, but even for them it is all about their ego.

*Heck we all come up with stupid ideas. The difference between normal people and the pre-grifters is that normal people accept that some or more of their ideas could actually be stupid.

“If he can’t think up a response to the point made, he will edit the post to make a different point that he can respond to or not allow the post at all.” -Horseshit.

We agreed that it would be a lot of energy. “So where is all that energy coming from? Who is producing it? How do they concentrate it enough to get a storm going where they want it to go?”

Haarp modulates the auroral electrojet giving a gain of billions as if nature, if ‘sung’ to right, acts a super beta transistor. It is really useful for low frequency global ground penetrating radar.

https://www.google.com/search?q=aroural+electrojet+modulation+haarp&gbv=1&sei=LQX5WP-IDMz8mQH1-KLACw

This article reads like satire, with an air of desperation about it. “They go anti-vaccine because they actually pay attention to evidence they’ve clearly been told not to. Don’t they know people like me will deride them?” LOL. The vaccine paradigm is doomed if this darned trend of independent thought continues. 😀

A relevant psychological trait to these quacks is a reaction formation: where a person avoids one position by taking a polar opposite position. It explains why quacks reject vaccines, the vitamin K shot, cancer treatments, and much else, while at the same time blindly accepting turmeric infusions and coffee enemas. They have a simple heuristic- if mainstream medicine supports it, they reject it, and if mainstream medicine rejects it, they support it.

I promise that if vaccines were banned tomorrow, quacks like Humphries would rush to embrace them a suppressed miracle cure.

Don’t worry NWRO, once there is a measles epidemic on one of these anti-vaxer communities, you’ll see vaccination rates go through the roof again.

I forgot to mention…the comment section seems just as satirical, with a similar air of desperation–in spite of the steady stream of pats on the back from the team. 😀

And the only “desperation” involved is our concern about the health and safety of children, whom are being put in harm’s way by the unintelligent decisions of their parents.

NWO Troll: “LOL. The vaccine paradigm is doomed if this darned trend of independent thought continues.”

Hmmm… and yet, Ginny, you have never shown any evidence of independent thought. You just keep repeating some of the same stuff my crazy aunt droned on about forty years ago.

[Jake Crosby’s] response to my pointing out that his public posts making him unemployable was particularly vile.

If I may steal a line from Popehat, Jake’s blogging “resume-wise, is the equivalent of a facial Nickelback tattoo.”

If you call 20 – 25 people chanting in front of the White House in the pouring rain, the “collapse of the vaccine paradigm,” then you obviously have a different set of definitions than the rest of reality.

That’s true, HDB & I won’t even din to a formal response, other than to say that it does show his hypocrisy.

It explains why quacks reject vaccines, the vitamin K shot, cancer treatments, and much else, while at the same time blindly accepting turmeric infusions and coffee enemas.

I see this explained better by crank magnetism. Once you have believed six impossible things before breakfast it is easier to just keep doing it.

There is also a strong element of ‘the enemy of my enemy is my friend’ thinking as well and an abhorrence of criticism that gets bound up in all of this. Which makes some of the echo chambers strange, strange places.

In a world where “literally” is used to mean”figuratively”, I guess it isn’t too surprising “independent thought” is used to mean “regurgitated unsubstantiated received opinion”.

This article reads like satire

That’s an odd thing to say given that your own site rather painfully demonstrates that you don’t understand the concept.

We now live in a world where the Internet (and social media) has created the idea that “all opinions are valid.”

Except, they aren’t – just because you believe something, doesn’t make it real, unless you can back up that belief with actual facts.

NWRO obviously “believes” a great many things, but has no facts to back them up.

It appears to me that a large number of people, such as the gnat and NWOR, have come believe the world around them is built to be what they expect it to be. That is the theme from Heinlein’s short story them.

His response to my pointing out that his public posts making him unemployable was particularly vile.

Linky?

“If he can’t think up a response to the point made, he will edit the post to make a different point that he can respond to or not allow the post at all.” -Horseshit.

Are you denying you wouldn’t let my perfectly respectful comments through challenging you on some of your claims? Where’s the PNAS paper Jake? How reliable is your source Hooker given his clear departure from reality?

“If he can’t think up a response to the point made, he will edit the post to make a different point that he can respond to or not allow the post at all.” -Horseshit.

Given you have done both of these to posts I have made on your blog, I don’t accept your disclaimer.

@ScienceMom – I’m not going to link back to his site, but if you check out the article about his failed attempt to troll the BBC & scroll down in the comments, you’ll see what I’m talking about.

“If he can’t think up a response to the point made, he will edit the post to make a different point that he can respond to or not allow the post at all.” -Horseshit.

I see that Jacob L. Crosby, MPH, chose to sign his post with a new pseudonym that he apparently prefers to “The Gnat.”

NWO Reporter probably also believes modern popular music is doomed, since the big bands will be coming back any day now. 🙂

The extra sad thing about this particular anti-vax doc is that he got his degree at Hopkins, one of the birthplaces of scientific medicine.
And the fact that Dr anti-vax plastic surgeon seems to have developed this after working at OHSU makes me concerned for my family that lives in Portland. Is there something in the water that makes people there even more woo-inclined (it can’t be the fluoride, that’s not in the water)?
Or is it the entire state? (Hello Ashland!)
Maybe it’s just the coastal bits, but like most of the West Coast the coastal bits are very very different from the inland bits. Like, different countries different.

me: “Flinging fecal matter is his schtik”
gnat: “Horse****”

Poetry speaks the truth.

“If he can’t think up a response to the point made, he will edit the post to make a different point that he can respond to or not allow the post at all.” -Horseshit

Remember we’re in the era of Alternative Facts™.

When confronted with an observed fact, all you have to do is say “Horseshıt”, and everybody is supposed to say: “Oh, well then–that settles that.”

Bahahaha. That is the standard strategy. Except the usual synonyms are “pseudoscience,” “quackery,” “debunked,” “discredited” and the like. I guess it lends “horseshit” an air of sophistication, to which everyone is supposed to respond: “Oh, well then–that settles that.”. 😀

Ha! I remembered to censor my comment–but not Jake’s that I was quoting. Oh, well.

One should not discount a major motivation that is common to all sorts of people—the desire for recognition and respect (let’s call it Fame & Glory). In my experience, that’s a more potent narcotic than mere money. The most excited I have ever seen scientists get is when they believe that they are on the track of a novel discovery that will overturn some long accepted paradigm and cause the textbooks to be re-written. They will gain F & G and maybe that coveted Trip to Stockholm (a Nobel prize). Judging from the Nobelists that I have met, the actual money is unimportant compared to the almost automatic status that one gains.

Plenty of physicians get Nobels, of course, but only those who do actual research. In the good old days, a non-research clinician could get his/her name immortalized by hanging it on a new disease, body part, medical device or sometimes a treatment. Unfortunately, one’s name is mostly spoken only amongst a narrow group of medical professionals, and having it associated with a disease is decidedly a mixed blessing. I suspect that we’ve reached the limit on new body parts, and even a popular treatment rarely gets a Trip to Stockholm, as Dr. Heimlich could attest.

The other way to gain F & G is to separate oneself from the crowd by developing a contrary opinion, gaining a following from those who are dissatisfied with the status quo, and getting notice from the media and an invitation to the Oprah or Oz shows. What puzzles me is not that doctors do this, but how many of them are truly convinced that their particular brand of bovine excrement actually smells good.

What puzzles me is not that doctors do this, but how many of them are truly convinced that their particular brand of bovine excrement actually smells good.

It’s that whole “speaking truth to power” schtick.

Orac writes,

Reading Dr. Mackenzie’s writings and watching him in action in these videos, what I see is a massive case of the Dunning-Kruger effect resulting in the utter arrogance of ignorance.

Because Orac and Dr. Mackenzie are both certified physicians, if Dr. Mackenzie loses business because of Orac’s slanderous article could Dr. Mackenzie sue Orac for defamation of character?

I hope Orac is safe from legal prosecution, although, if not I’d like to be part of a class action lawsuit. 🙂

I know I’ve lost book sales because of Orac’s over-enthusiasm, especially minion book sales.

Careful, guys. Jake can take your words, twist them around, and mail your employers with a request that you be disciplined for being a big old meanie to him. You don’t want Jake angry, calling you a “cancer” (like he’s called Black Lives Matter, Feminism, and Neurodiversity), do you?

There’s something ironic about the combination of railing against every legitimate authority and then trying to invoke it to get your critics silenced. It’s almost more paradoxical than attacking everyone with harsh language at the same time as being unable to deal with any criticism aimed at you.

In the good old days, a non-research clinician could get his/her name immortalized by hanging it on a new disease, body part, medical device or sometimes a treatment.

I cannot claim credit for the Bimler Orthodontic Appliance.

Orac

“physicians in particular seem particularly prone to the Dunning-Kruger effect”

Having Dr. Mackenzie advising on vaccination seems a bit like having Dr. B. Carson teaching Egyptology. I have noticed the famous diet book “Wheatbelly” is write by a cardiologist.

Perhaps we could have a contest between physicians, economists and physicists for the Dunning-Kruger Award?

like @PediatricianMom I am a pediatrician. I cannot figure out why the American Academy of Pediatrics allows the likes of Drs. Sears, Gordon and Thomas to continue to be fellows of their academy. In Portland, Oregon there are enough parents who are anti-science. We don’t need pediatricians (Dr. Paul Thomas) and Plastic Surgeons (Dr. Mackenzie) to help. These “pediatricians” put their patients and their communities at unnecessary risk and should not have the honor of FAAP after their names.

I’d say willful blindness to science that is contrary to ones own interests, and smug pretension, are much more pervasive problems than “anti-science” views among your colleagues. You can be Exhibit A. 🙂

Ren: Assuming Jake can figure out who I work for, he’s welcome to try.

If academic freedom doesn’t apply, my union rights do.

Assuming of course my Dean just doesn’t laugh herself silly. She’s a sharp gal, and knows a fool when she meets one.

As much as I might wish it were otherwise, evolution is not an emphasized topic in medical school, and it’s quite possible to become a physician without knowing much more about evolution than would be taught in a 100-level biology class.

I knew a biochemist graduate student who absolutely, vehemently denied evolution. Evolution was part of the curriculum. She used genetics to design protein constructs and mutants all the time, yet she absolutely could not tolerate evolution. I don’t know if this belief persisted after she got her PhD, but I know that this does happen. Good thing that science is about consensus instead of what that lone maverick decides is ‘correct.’

I think it’s pretty understandable how evolution denial, in particular, persists. If you can still use the codified tools of molecular biology, it really doesn’t necessarily kill you to not want to believe the bottom line. With this kind of denial, it really is not an immediate, existential threat to the person who denies. Vaccine denial comes close to being an existential threat, but you can still overlook that at a case-by-case level if you really don’t want to believe it because it just isn’t 100% likely to snap back in your face and kill you if you get it wrong. Admittedly, I never truly appreciated vaccines myself until I realized that I used to get flu on about a yearly basis working at a germ-mill 30,000 student university… vaccinating against flu on a yearly basis has literally made my life more liveable…. but it’s hard to see that on an illness-by-illness level (you can’t always know that you could’ve avoided _this_ one).

Admittedly, I never truly appreciated vaccines myself until I realized that I used to get flu on about a yearly basis working at a germ-mill 30,000 student university…

There are a lot of influenza-like illnesses; nearly yearly bona fide influenza would be a pretty distant outlier.

Almost entirely off topic, but –

CNN is running a story about a measles outbreak in Italy.
http://www.cnn.com/2017/04/20/health/measles-outbreak-epidemic-italy-romania-us-travel-warning/index.html

A few select quotes –

An outbreak of measles is spreading across Italy, with more than 1,600 cases of the disease reported in 2017, across 19 of the country’s 21 regions.

The outbreak adds to concern among European health officials who have been monitoring an ongoing outbreak in Romania, where almost 4,800 cases have been reported since the start of 2016. The country has also seen 21 deaths, according to the World Health Organization.

Almost 40% of cases in Italy were admitted into hospital and the median age of those affected was 27 years, according to the country’s Ministry of Health.

The European Center for Disease Control state most cases were in patients older than 15 years of age, meaning babies and young children are not the ones becoming infected but instead people who failed to be vaccinated as children.

Of the 1,603 cases reported this year, as of April 16, 88% are known to be unvaccinated.

In 2015, WHO data shows coverage in Italy at 83% for those who received a second dose of a measles vaccine. Some regions within Italy are as low as 70%, said Butler.

Butler believes the fall in confidence towards vaccines is fueled by both a rise in the anti-vaccine movement across Europe as well as complacency towards the disease, with some not receiving vaccinations due to lack of concern about the risk of contracting measles.

“Measles is the first thing you will see after non-vaccination, said Larsson. “Because it’s so highly infectious.”

There are several more good quotes in the article (“Doctor” Wakefield comes up), but copyright and all.

I hope Orac is safe from legal prosecution, although, if not I’d like to be part of a class action lawsuit.?

I know I’ve lost book sales because of Orac’s over-enthusiasm, especially minion book sales.

Most message boards will ban anyone threatening the board administration with legal action.

Truly, our host is most benevolent.

@ScienceMom – I’m not going to link back to his site, but if you check out the article about his failed attempt to troll the BBC & scroll down in the comments, you’ll see what I’m talking about.

Good grief he’s completely off the rails. I also see what Becky was referring to as well (he changed her name to Brian Deer) because oh my, there can be only one anti anti-vaxx Brit. His content prior to starting his own blog was questionable; his sexism, outright misogyny and flagrant white supremacy and bigotry are surely going to tank his employment prospects for good, if not derail his PhD. I can’t help but wonder if that is not the case already given he’s not even a candidate by now.

…surely going to tank his employment prospects for good, if not derail his PhD.

I should think that as long as mommy and daddy have enough money, Jake will continue his studies somewhere.

I hope Orac is safe from legal prosecution

Section 230 of the CDA granted your wish a long time ago.

NWO Troll: “I’d say willful blindness to science that is contrary to ones own interests…”

This comment makes absolutely no sense. First you do not even have a clue of what the word “science” even means. And then it goes down hill.

Do you even have a point?

Maybe I should have written “blind trust in psyence.” But I’m pretty sure that would have challenged your comprehension skills just as much, if not more. 🙂

Unfortunately, Tucker Carlson (who has been elevated to replace serial sexual harasser Bill O’Reilly at Fox News) clearly knows nothing whatsoever about genetics in particular, biology in general, or autism. This is a problem because Carlson lobbed softballs at serial liar Andrew Wakefield today in an interview on Fox and Friends–a program that our scientifically-challenged president Donald J. Trump thinks is not “fake news.” Sad.

NWO Troll: “Maybe I should have written “blind trust in psyence.””

Oh, Ginny, that is probably the most lame thing you have written. Do you even understand what is involved in science? Or are you just too occupied trying to figure out why those with different usernames repeat the same things?

Perhaps it is because those things are “facts” known by most intelligent persons who actually understand science… and not the conspiracies cooked up by idiots decades ago that you just keep repeating.

Again, Ginny, you have neither demonstrated independent nor original thought. But keep it up, you do provide for some good laughter. And yes, we are actually laughing at you.

Also, if you do have a serious problem with actual science please toss your smartphone into the trash. Then make sure you never access any kind of computer, or teh internets! Plus refuse to use any kind of sanitation facility… back away from that toilet (its very existence requires too much science for your conspiracy laden brain to comprehend).

Wait! Are you wearing clothes? How dare you! Don’t you know that not only is most cotton is genetically engineered, but it was sewn on machines that use electricity! This technology includes magnets. How do magnets work?

Yes, Ginny, around here you a joke.

OMG! I was called a ‘joke’ by ‘Chris’–a recognized anonymous authority in the field of vaccine propaganda! I’m devastated! 😀

Aargh, why is it that the moment you hit the “Submit Comment” button you see the blatant typo?

Any it was supposed to be:

“Yes, Ginny, around here you are a joke.”

(though perhaps I subconsciously wanted to make that point with more emphasis… oooh, is that psychology or neuroscience… who knows?)

Just had a conversation with dear hubby… we are definitely now going to our local Science March instead the going away open house of some gaming friends.

While I will put Euler’s Formula on my shirt, I am debating which Surly Amy pendant to wear. The one with the Greek Pi, or the one that says:
“You are entitled
to your own
opinions
not to your own
FACTS”

Which I am wearing right now. Hmmm… the full Euler’s Formula does not include pi (it is a special case)… maybe, somehow both?

What to do? Fire up my embroidery machine! Stitch more words with a machine that uses both science and numerical methods! Woot!

My favorite Surly Amy pendant had mushrooms on it. I have a couple other more sciency ones, but they are with my stuff back in Michigan.

I plan on attending the Marcg for Science in White Salmon, WA, but I imagine the crowd will be rather thin.

I assume our crowd will be quite large. I just hope we can get on the light rail by Husky Stadium, which is only one stop from the Science March start in Seattle.

The King County Metro system now knows to increase service at peak times. Hubby found out that they go more frequently in the morning on the two days he had to report to jury duty. So we might be okay.

With the greatest of respect Orac, I have to disagree with your statement about Wakefield. I suspect that your view has occurred because of a minor misunderstanding about the differences between “England” and “America” derived medical qualifications.

“Wakefield isn’t a doctor because he’s had his UK medical license stripped; he still has the degree, and that makes him a doctor, albeit a delicensed one.”

Wakefield has the degree MB BS. It’s a Bachelor degree in Medicine and Surgery, not a Doctorate.

I have a Bachelor of Medicine and Surgery, MB ChB, from a different Medical School to Wakefield (in NZ) that was also derived from the “England” medical tradition.

Even though I had obtained my degree, I was not entitled to the honorific “Doctor” until the Medical Council of New Zealand awarded me it. My degree is not a Doctorate, although it is educationally equivalent to the “America” derived MD. I believe it is the same for Wakefield.

In NZ the MD (or DCh) requires several years more university study beyond the basic medical degree. I understand it is the same in the UK.

My view is that Wakefield is similar to myself. He has a Bachelor degree, not a Doctorate. The General Medical Council, not his university, awarded him the honorific of “Doctor” and now have withdrawn that privilege. He is plain Andrew Wakefield, MB BS.

(I do not call him “Mr” as that is another honorific, allocated by the Royal College of Surgeons when he became a Fellow. As an example of that honorific, if you worked here in NZ, or in the UK, there would be only the deepest of respect meant when a colleague referred to you as Mr Orac).

I knew that someone, somewhere, wouldn’t get the message and would latch on to something I mentioned as a pet peeve. I knew it. Guess what? I don’t care. In the US, his degree makes him a physician and doctor. Period. One of the greatest surgeons I knew was “only” an MBBS. I will discuss this no more. As I said, it’s a pet peeve.

@Stuartg: However, since Orac is a surgeon, wouldn’t he still be referred to as Dr Orac? (USAian here, so not totally clear on UK/NZ/Oz references to physicians)

@ Dangerous Bacon — a lot of pediatric practices have gone to a strict vaccine policy that only accepts medical exemptions for not vaccinating (like Dr. Ginsberg’s). That was in part, I suspect, why the AAP finally adjusted their stance last year on this (which had been not to fire electively non-vaccinating families)–too many pediatricians didn’t give a damn what the AAP was saying and were sick and tired of non-vaccinating families dragging measles, pertussis and varicella into their clinics and exposing infants and other medically fragile patients. I know I was and I did that with my practice several years prior. The AAP clearly either doesn’t have a clue or doesn’t give a damn or doesn’t have a spine (perhaps all 3) when it comes to actually standing up against anti-vaccinationism.

@MJD: You should learn the difference between slander and libel, and what those terms really mean.

Slander is spoken. Libel is written. And even without the DCA, if what was written or spoken is true, there is no slander or libel.

Since I have no doubt Orac’s assessment of your “book” is spot on, you haven’t a leg to stand on.

On the idea posed by Crosby of moderation being pre-programmed censorship:

Lies aren’t protected speech, hence the existence of libel, slander, fraud etc as civil and criminal offenses.

Panacea (#108) writes,

You should learn the difference between slander and libel, and what those terms really mean.

MJD says,

Thank you, although, I may make similar mistakes in the future in that I’ve personally tried to avoided such behavior.

It’s 9 am and Orac hasn’t posted an article today.

I’m hooked on Orac’s RI, do I need therapy?

There’s a measles outbreak in Minnesota. The index case and majority of victims are of Somali ancestry. Why? Because Fakefield went to Minnesota, years ago, and terrified parents about the safe and effective vaccine.

So far, all of the cases are among unvaccinated children. They have something else in common too: The affected children are all part of Minneapolis and St. Paul’s Somali-American community. According to a health department official, Minnesota’s Somali immigrant community has been a particular target of the anti-vaccination movement, colloquially known as “anti-vaxxers.”

“They’re very much engaged with and targeting this community,” Kris Ehresmann, infectious disease division director at the Minnesota Health Department, said in a phone call Wednesday.

According to Ehresmann, anti-vaccine groups began to target the Somali community around 2008, amid concerns about autism among Somali-American children. Anti-vaccine groups started reaching out to the Somali community and showing up at community health meetings, she said, disseminating misinformation linking autism to the measles, mumps and rubella vaccine, or MMR.

https://mic.com/articles/174489/anti-vaxxers-targeted-minnesota-s-somali-community-now-they-have-a-measles-outbreak#.qQfVjmSS5

Lies are protected speech. Otherwise, we could sue most anti-vaccine groups into oblivion for their lies about us being pharmacy shills, part of the illuminati, reptilian, etc.

Orac @103

I apologise.

New Zealand law allows only the Medical Council to convey the honorific of “Doctor”. I made an unwarranted assumption that circumstance also applies in other jurisdictions.

A side effect of the law is that it is illegal for a naturopath or chiropractor to call themselves “Doctor” here.

MI Dawn @104

If Orac worked in NZ/Oz/UK, he could be referred to as either Dr or Mr Orac. The Mr would be specific recognition of him as an esteemed surgeon as well as a Doctor.

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