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Antivaccine pediatrician Dr. Bob Sears finally faces discipline from the Medical Board of California

Antivaccine pediatrician Dr. Bob Sears has been disciplined by the Medical Board of California, complete with a requirement for medical educations, ethics courses, and a practice monitor to make sure he doesn’t practice outside the standard of care. I wonder how his patients’ parents will like him now that he has to administer vaccines according to the CDC schedule.

It couldn’t have happened to a nicer guy than Dr. Robert Sears, better known as Dr. Bob Sears, the antivaccine pediatrician who first made a name for himself with his book recommending an evidence-free “alternative” vaccination schedule.

You remember “Dr. Bob,” don’t you? I haven’t written about him in a while because he hasn’t been in the news much and he hasn’t been sending out antivaccine dogwhistles that disguise antivaccine views as “freedom” and “parental rights.” When last I considered “Dr. Bob” in any level of detail, he was defending himself against an action taken by the Medical Board of California for “gross negligence” in writing a non-evidence-based letter in support of a two year old’s medical exemption from California’s vaccine mandate. Not surprisingly, antivaccine activists rallied around him, painting him as a victim of persecution. Don’t they always? Of course, it is important to note at this point that, during the run-up to and after the passage of SB 277, the California law that eliminated non-medical exemptions to school vaccine mandates, Sears led the way in monetizing strategies for antivaccine parents to avoid the mandates. Indeed, a reader showed me evidence that Dr. Bob was selling letters in support of nonmedical exemptions online without ever actually having seen the patient.

Like this one:

Dr. Bob Letter

And this one:

In any case, the Medical Board of California’s action commenced nearly two years ago, and yesterday we learned that a decision has been rendered. Basically, a consent agreement has been negotiated, and it’s pretty onerous for poor, poor Dr. Bob. Before we get to the terms of the agreement, let’s review the charges, which I described in detail here but will just summarize here.

First, from the original complaint:

On April 3, 2014, two-year-old J.G. presented to Respondent for the first time. He was seen by Respondent for what medical records describe as a “two year.” The visit of this date includes a summary of the patient’s history with a brief description of J.G.’s prior vaccination reaction, as described by the patient’s mother. Her description included, “shut down stools and urine” for 24 hours with 2 month vaccines and limp “like a ragdoll” lasting 24 hours and not himself for up to a week after 3 month vaccines.

Respondent wrote a letter dated April 13, 2014 excusing patient J.G. from all future vaccinations. The letter indicates that the patient’s kidneys and intestines shut down after prior vaccinations 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.

The letter dated April 13, 2014 was not maintained in patient J.G.’s medical chart in Respondent’s office.

There’s more, including other visits to Dr. Bob. Dr. Bob also saw the child in June 2014 for headache with a history of being hit on the head with a hammer by Dad two weeks prior to visit. According to the Board, there was also a mention of a split lip prior to the hammer incident. However, the physicial examination indicated “no residual marks now.” The Board also noted that no additional physical examination, including the all-important neurological examination (in cases of head trauma), was performed and no assessment with plans recorded. I used to do trauma, including pediatric trauma, and I know that this is a grossly inadequate evaluation for what might be a concussion, based on symptoms and timing, after having been hit in the head with a blunt object. Child protective services was involved, as well. Dr. Bob then saw J.G. a few times for various medical issues. One of those issues was how he dealt with the child’s head injury. The other issue that drew the attention of the board was this:

The standard of care requires that a physician evaluating a patient for a possible reaction to vaccines obtain a detailed history of the vaccines previously received as well as the reaction/reactions that occurred. Based on that information, the physician should provide evidence-based recommendations for future immunizations.

Respondent was grossly negligent and departed from the standard of care in that he did not obtain the basic information necessary for decision making proior to determining to exclude the possibility of future vaccines, leaving both patient J.G, the patient’s mother, and his future contacts at risk for preventable and communicable diseases.

Based on Dr. Bob’s granting of the medical exemption to vaccinations for J.G. and his failure to do a neurological examination of the child when he presented with persistent headaches after head trauma, the Board listed the first cause for disciplining Dr. Bob as gross negligence. The second cause for discipline was repeated negligent acts, given that there were two instances of gross negligence included in the complaint. The third cause for discipline was failure to maintain adequate and accurate medical records.

Fast forward from 2016 to 2018. First, we learn from the decision that Dr. Bob has waived his right to contest the charges against him, accept probation, and to be bound by the Board’s probationary terms.

First:

It is hereby ordered that Physician’s and Surgeon’s Certificate No. A60936 issued to Respondent Robert Williams Sears, M.D. is revoked. The revocation is stayed and the Respondent is placed on probation for thirty-five (35) months on the following terms and conditions.

This is big. Basically, Dr. Sears’ license is already revoked, and the only way he can keep that revocation from taking effect after his term of probation is to do everything the board requires to the board’s satisfaction. But what is the board going to require of Dr. Bob? Here’s one thing:

1. EDUCATION COURSE. Within 60 calendard days of the effective date of this Decision, and on an annual basis thereafter, Respondent shall submit to the Board or its designee for its prior approval educational program(s) or course(3) which shall not be less than 40 hours per year, for each year of probation. The educational program(s) or course(s) shall be aimed at correcting any areas of deficient practice or knowledge and shall be Category I certified. The educational program(s) or course(s) shall be at Repsondent’s expense and shall be in addition to the Continuing Medical Education (CME) requirements for renewal of licensure.

I wonder what classes Dr. Bob will be required to take? Vaccine courses? Definitely? Courses in basic pediatric trauma? Absolutely. Courses on vaccine-preventable infectious diseases? Without a doubt. He will need all of these.

Next up:

2. PROFESSIONALISM PROGRAM (ETHICS COURSE). Within 60 calendar days of the effective date of this Decision, Respondent shall enroll in a professionalism program that meets the requirements of Title 16, Celifornia Code of Regulations (CCR) section 1358.1. Respondent shall participate in and successfully complete that program.

Yes, Dr. Bob could surely use some help in the area of professionalism and ethics. The problem, of course, is that he almost certainly knows what is ethical. He simply chooses not to do it. He chose to sell bogus nonmedical exemptions to school vaccine mandates. He chose to publish a book with an “alternative” vaccine schedule with no scientific basis. He chose to flirt with the antivaccine movement and become a hero.

And he definitely needs monitoring:

3. MONITORING – PRACTICE. Within 30 calendar days of the effective dates of this Decision, Respondent shall submit to the Board or its designee for prior approval as practice monitor(s) the name and qualifications of one or more licensed physicians and surgeons whose licenses are valid and in good standing, and who are preferably American Board of Medical Specialties (ABMS) certified. A monitor shall have no prior or current business or personal relationship with Respondent, or other relationship that could reasonably be expected to compromise the ability of the monitor to render fair and unbiased reports to the Board, including but not limited to any form of bartering, shall be in Respondent’s field of practice, and must agree to serve as Respondent’s mentor. Respondent shall pay all monitoring costs.

Monitoring physician(s) must submit quarterly reports to the Board that including an “evaluation of the Respondent’s performance, indicating whether Respondent’s practices are within the standards of practice of medicine and whether Respondent is practicing medicine safely, billing appropriately, or both.” There are a number of other stipulations. For instance, Dr. Bob can’t supervise physician’s assistants or nurse practitioners while on probation, must report activities, if he leaves the state for more than 30 days, if he ceases practice for more than 30 days, and a number of other things, including:

Failure to fully comply with any term or condition of probation is a violation of probation. If Respondent violates probation in any respect, the Board, after giving Respondent notices and the opportunity to be heard, may revoke probation and carry out the disciplinary order that was stayed.

Of course, Dr. Bot must pay all costs associated with probation monitoring as designated by the Board. The order was signed on May 1.

This is pretty serious business. Dr. Bob, perhaps for the first time since he finished his pediatrics residency, must practice to the proper standard of care and will be supervised to make sure that he does. Assuming the Board is smart enough not to let Dr. Bob pick a monitor with “integrative medicine” proclivities or antivaccine proclivities himself (no Dr. Jay Gordon, please!). Thankfully, Dr. Bob won’t be able to pick his father or brother as monitors because they are family and thus have a conflict of interest. Dr. Bob will have no wiggle room. He’ll have to administer vaccines on time and on schedule for his patients. He’ll have to try to persuade parents who don’t want to vaccinate that they should. He’s really, really not going to like that.

I bet that his patients aren’t going to like it very much either. Indeed, I can’t help but wonder if his practice can survive. After all, Dr. Bob’s entire practice model is based on catering to the vaccine-averse and the antivaccine parents living near San Diego and other parts of southern California. How many of them are going to keep taking their children to see him now that he’s going to be forced to adhere to the CDC schedule of recommended vaccines? He can no longer delay, space out, or omit vaccines, and, assuming the board doesn’t let Dr. Bob pick a monitor who’s also an antivaxer or who also caters to the vaccine averse, there won’t be any easy way for him to practice the way he used to practice and get away with it.

I find the prospect of that…very satisfying.

On the other hand, there is another possibility that is less satisfying: Dr. Bob will pick an integrative medicine or functional medicine quack (and there are many in southern California) who’s squishy on vaccine mandates; the board won’t object; and he’ll practice as before, only less blatantly antivax. He’ll scale back or suspend his public appearances speaking out against SB 277 for three years but keep publishing his book. When it’s all over, he’ll be free and clear to go back to the way he was before. It could happen if the Board veto any monitor that Dr. Bob picks who isn’t clearly pro-vaccine. I never could figure out why most state laws allow the disciplined physician to pick his own monitor, subject to Board approval, rather than having the Board pick the monitor, allowing the doctor to object only if there is a clear conflict of interest or interpersonal conflict, but that’s the way it is. Getting to pick his own monitor could be the loophole through which Dr. Bob slithers out to escape. Here’s hoping the Medical Board of California is savvy enough not to let Dr. Bob get away with that, but there’s no guarantee that it is.

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]

131 replies on “Antivaccine pediatrician Dr. Bob Sears finally faces discipline from the Medical Board of California”

Some havie testing, some do not. The Disciplinary Order includes a testing requirement and specifies that the educational requirements be met in addition to CMEs. My interpretation is that this wouldn’t rule out taking Dr Offit’s Current Issues in Vaccines, as long as the monitor or Board approved.

Yes. Dr. Offit is an expert. He published extensively on vaccines, and is one of the authors of the professional textbook on the topic.

And yes, he has no current conflicts of interests.

I would call someone who spent decades doing actual vaccine research to be an expert, why wouldn’t you?

Also, no more charging outrageous prices for basically being lazy and not doing much work. Just like he didn’t do a decent exam on that patient. Used to charge thousands of $$ to parents for group “meetings” with his nurse, and “testing” so he could sell some worthless supplements. he has run a racket for years. Thankfully, there is some justice in the world.

Dr Bob needed a wake-up call. a good shaking. I hope this achieves that end.

If he gets a good shaking and has neurologic symptoms after, will he blame it on vaccines?

Excellent – Given how brazenly people like “Dr Bob” and Dr Paul Thomas have been operating I was beginning to lose faith that the licensing boards actually gave a rats ass about ensuring that doctors upheld such trivial things as their duty of care. My faith is now somewhat restored.

I’m not sure the BOM had much of a choice here. Sears had been getting too big for his britches quite publicly for years, and his activities were attracting too much attention just as a major measles outbreak was gaining national attention.

Had the Disneyland outbreak not happened, I have to wonder if the BOM would have acted.

This is a good start.

I’d seen mention of this a few hours ago elseweb, and posted a comment about it before refreshing the screen here. Of course the blinky box not only already knew about it, but had prepared a post.

You hit the nail on the head.
Sears isn’t stupid – he already knows about medicine and ethics, and will just choose to ignore the education he receives as part of this program.
The chances of it inducing some Damascene conversion is nil.

Why do I have this terrible feeling he’s going to figure out a way to profit from this?

I share your fears.. and he might have already profited. I seem to recall when the disciplinary action started back in 2016 he/his “fans” were asking for monetary “gifts” to be sent directly to him in order to fund his legal defense (and any excess was to be spent at his sole discretion).

If he loses his license he’ll probably just take up residence on the vaxxed bus/conspira-sea cruise and start flogging biomed rubbish.

He probably would find that more fun than actually doing patient care. He can’t enjoy his work, given how hard he works to avoid doing it.

While it seems good on paper I’ll not be celebrating and remain skeptical.
As Orac alludes to – Sears will merely get one of his stealth anti-vax Integrative/Functional Medicine cronies to be his probation monitor. Then it will be ” the game is the same under a different name” time.
.
For some reason these slippery sleazes always seem to evade justice.

Yeah. I can’t figure out why the law in most states lets the disciplined doctor pick his own monitor, subject to state medical board approval. The medical board should pick the monitor, allowing the doctor to object only if there is a clear conflict of interest or interpersonal conflict. That is what I fear, that Dr. Bob will pick a functional medicine or integrative medicine quack as his monitor and the Board won’t object.

That Sears belongs to the anti-vaccine group Physicians for Informed Consent along with a lot of his functional/integrative medicine cronies will hopefully disqualify all of them from being his mentor.

In addition to what Dr. Hickie has noted about his association with PIC, Sears used to list “vaccine friendly (anti-vax) doctors” as a resource for the anti-vaccinationists to use. I wonder if his listing of doctors that he was/is recommending his readers patronize is enough of a business association to make all of those ineligible to be mentors as well. He is, after all, throwing business their way with his recommendations.
.
If so, that would eliminate a large number of alt-med/integrative/functional anti-vax doctors in Sears’ circle.
As you said – “We can only hope.”

Licensing board’s generally have pretty limited resources and the idea of supervision by a “board-approved” supervisor places the onus on the licensee to find someone close by willing to take them on. It is not unusual to bring the prospective supervisor to a board meeting to discuss the reasons why the licensee is under probation so that they can direct the supervision along the lines of the transgressions. I hope this is what the CA Medical Board does.

Call me a pessimist on this action by the CA Medical Board. No surprise I would have preferred seeing Sears lose his license for all the damage he’s done to public health from all the pertussis and measles outbreaks he’s caused with his anti-vaccine activities, along with their resultant injuries and deaths.

If the mentor is truly doing his/her job, then yes, Sears will have to advocate in his clinic for vaccines per the CDC schedule. That doesn’t mean the parents that come to him have to follow vaccinate on that schedule and they’ll know he’s merely giving lip service because he’s required to. Presumably the mentor will keep him from handing out “medical” vaccine exemptions like candy–but that won’t stop his fellow quack anti-vax physicians (like Gordon and all of Sears’ cronies from Physicians for Informed Consent) from handing them out for Sears. His practice is cash only, so if he suffers in volume, he could compensate by raising his prices–something doctors who accept health insurance could not do. Also, Sears is not the only one anti-vaccine at his location–he shares space with the other Sears doctors (Bill, Jim and the physicians they hire). While Bob was the mouthpiece for their anti-vax crusade, the other Sears docs clearly ascribe to the same anti-vax views as all “Sears Family Library” books revised since Bob’s “Vaccine Book” came out in 2007 now refer to and recommend doing vaccines per Bob’s “Vaccine Book”. Sadly, there is no one watching the rest of the Sears Family Quacks for this next 35 months.

Sears has to make it through 35 months of this. I suspect he has the resources. If he does survice, he can likely go back to his slimy anti-vax ways as before. And in the meanwhile he’s still free to work as part of PICC (which I think is even more dangerous to public health than Sears) still keep selling his “Vaccine Book”. And now he’s a martyr as well–Sears might even make more money off increased sales of his “Vaccine book” based on this publicity he will now get in anti-vax circles.

It would be far better if state medical boards would go after anti-vax doctors based on the damage they cause to public health through their public anti-vaccine advocacy which drives down vaccination rates. Yes, legally there’s a “free speech” issue here, but when a physician uses their MD or DO after their name to tell parents not to vaccinate, they have become a danger to the public, which is a condition all state medical boards recognize as grounds for discipline–but have so far refused to pursue.

I’m a neurologist. I’ve seen many cases of encephalitis but never one that includes as symptoms/signs “limp like a rag doll” for 24 hours. It doesn’t appear that he did any of the standard tests for confirming the diagnosis. Making up a scary-sounding diagnosis to fit a vague report from a parent, without confirmatory evidence, is also negligent.

Disclaimer: I work for a pharma company, but not one that makes vaccines to prevent infectious illnesses.

Apparently it is quite common for the anti-vax to claim their child had encephalitis. My kid had seizures, so I ask them what were they told when they got to the emergency department (a trip my kid got by ambulance). They then claim that they did not go to the hospital, they diagnosed the encephalitis on their own because the child was crying for a long time.

Um, no. That is not quite the same.

In short, after calling 911 more than once for my kid, I have very little patience with those who do not when their child is in crisis. Or claiming the kid had some dire thing when it was a case of crying for longer than they expected.

It seems to have become an article of faith that there is a special Encephalitis Cry, unknown to the cry-research literature but instantly recognisable by antivax parents.

Uncle Smut, help jog my memory: did you do work on infant cries, or any i just remembering highly amusing blog posts of yours about other people doing it?

BTW, Mr. Constant Snuggles Kitty says hello.

“Encephalitis Cry”

Well there is Purple Crying, which is just normal. Frustrating, but normal, so parents need to be warned so they don’t shake the baby:
https://www.dontshake.org/purple-crying

Then there is colic.

Babies cry. The early evening bit is annoying, and it happened with my first child. I knew it was not encephalitis because I remembered what it was like when he had seizures and got to spend the first week of his life at a Children’s Hospital.

There are clearly defined clinical, radiological, electroencephalographic and histological criteria for the diagnosis of encephalitis.
I’ve never encountered an antivaxer whose child has ever had any of them (and that includes Cia Parker, who is the queen of “My baby cried, therefore encephalitis”)

Oh, FFS.

Crying is a symptom of practically every childhood ailment out there, especially before the kid is really talking–it’s the only way the kid knows to communicate their distress to their parents.

Why yes, it was the initial topic for one of my attempts at a PhD, before I discovered that baby cries have evolved to be highly aversive stimuli, and i switched to researching how other people experience baby cries.

And then you had one.

Personally my reaction is to run to them and pick them up and cluck over them. If it is a stranger’s baby, I may say or think, “Aw, somebody’s having a hard time.” Unless I’m in an overnight flight or something, but then I just wish the kid would stop.

To David the neurologist – as a general ped I would have sent any possible cases to the ped neurologists, of which there are plenty in OC. Bob Sears’ attempts to use some goofy term to define a reaction, shows not only that he thinks he knows it all, but that he knows nothing.

Exactly. Our family doctor sent me to a ped neurologist. Getting a sleep EEG was not fun with a three year old.

Great news!
I checked all of the usual suspects and still, no word of this development.

Since I’ll be in CA soon, I’ll have a drink to Dr Bob’s new status! ( Well, it’s not exactly the US equivalent of STRUCK OFF but still pretty damning)

The board did at least reserve the right to strike Dr. Bob off if he doesn’t abide by the terms of his probation.

From what I know of the case, it looks like Dr. Bob botched the neurological aspects of a case that had come to the attention of CPS. Fair enough that the California medical board nailed him on that.

How they got Dr. Bob on his anti-vaccine activities has a rather Al-Capone-tax-evasion feel to it. The specific charge is that he failed to keep a copy of the exemption letter he wrote for the kid in the kid’s file. I suspect that Dr. Bob’s punishment would have been much less if he had taken the simple precaution of keeping that letter (since that offense is what justified the “repeated negligence” charge). It’s better than him getting no punishment at all for his anti-vax activities, but it’s on a technicality rather than the substance of what he has been doing. And it doesn’t give me as much confidence as it otherwise would that the monitor (if there is only one, why does he have any say at all in who it is?) will enforce care standards with respect to vaccination.

Hi, Orac. I’m a physician. I don’t see in the ruling that Dr. Sears can’t offer modified vaccine schedules, or how the Boardi would enforce it if he did because surely he can’t be penalized for patients just not showing up for a visit. Can you clarify that for me?

Dr. Mike, I know you didn’t ask me, but I might be able to offer some clarity.

I don’t think the issue at hand is that he offers vaccine at a different timeline to patients who miss their normal scheduled visits. I think the issue is that he actively promotes an alternative vaccine schedule (through his book and other media) over the CDC recommended schedule. His alternative vaccine schedule is not evidence/science-based and leaves children unnecessarily vulnerable to diseases. Instead of reassuring parents of healthy children that vaccines are in the best interest of their child and the public health, he actively encourages doubt and fear of vaccination.

I don’t believe it’s specifically spelled out as Orac presented but look at section 3, bottom of page 5 to top of page 6. Sears is required to practice medicine within the standard of care.

I wonder about what standard of care means , Science Mom-
when they say “monitored” to they mean that someone will watch every single action he takes: checking each chart, reviewing each rx/ vaccine or lack thereof, maybe even questioning the patients’ parents?
Would they look that closely?

I don’t know but it seems like there’s a lot of wiggle room and snakey folks like Dr Bob adore wiggle room because it suits their nature.

If Dr. Sears has a monitor who is doing their job, they will force Sears to offer the CDC or AAP recommended schedules on time, and to recommend catch up vaccinations on every visit.

The parent doesn’t have to go along, of course. But Sears has to offer, and it has to be in the medical record that he offered.

As Orac points out, many of his current patient base won’t like that and may go elsewhere.

I recall having some anti-vax parents when I did my peds rotation in FNP school last summer. We didn’t twist parents arms, or argue, but we did say, “We do strongly recommend vaccinating on schedule. The risk of serious side effect is very low.” We didn’t engage in anti vax tropes or argue about it. That’s all Sears has to do.

Is that so hard?

“…sending out antivaccine dogwhistles that disguise antivaccine views as ‘freedom’ and ‘parental rights.'”

When you have to defend something based on “freedom” and “rights” instead of “being well-informed” and “showing social responsibility” you know you’ve already ceded the argument.

I’m not sure that’s true, but in any case – let’s stop letting the bullies pretend that freedom and rights are at odds with information and responsibility. They are not.

Freedom is a good thing. Rights are a good thing. Vaccine mandates are not a limitation on freedom – they are an interpretation, an enhancement, of freedom. We are more free when we can live as we see fit; we can live as we see fit if we can live. Removing completely avoidable danger thusly increases freedom.

Don’t let the bigots have these words, please.

Following your ludicrous argument to its logical conclusion, having a “Motor Law” criminalizing the driving of a car (reference: Rush “Red Barchetta”) would also not be a limitation on freedom, it would be an even more significant “interpretation”…even “enhancement” of freedom. Right? Cars kill a lot of people.

Well pertussis kills babies, and measles is deadly. Why should you have the freedom to let your kid infect a child under the age of one with measles or pertussis?

By the way, where are those PubMed indexed studies by reputable qualified researchers that shows the American MMR vaccine that has been in use since 1978 causes more harm than measles?

David, I had a hard time following your comment, but let me see if I understand: you don’t like seat belt or car seat laws either? Or speed limits or impaired driving laws? Because those impose upon a driver’s freedom?

Unfortunately, RJ, I think that rightists have already co-opted words like “freedom” and “rights”

See Natural News for Mike’s interesting usage of “patriots”:
his recent swill will be showcased on his new video service which will include lots of stuff for sale : his own and contributors’.

Nice strawman there, David.

Of course, you ignore that governments have required safety features to be added to cars for years, with a subsequent significant reduction in automotive deaths. Cars haven’t become like stills during Prohibition, or whatever you think regulations on safety would produce in regards to vaccine mandates.

And of course, vaccine mandates only apply to kids attending public schools. Don’t want to vaccinate your kids? Home school them, or send them to a private school stupid enough to accept them (there are a few out there). No one is coming to your house to do it by force, any more than you have to hide a banned car in your uncles barn.

Well, I see Sears’ fellow anti-vaccine quack pal Gordon managed to weasel his way into the LA Times article. Why do these reporters use someone as incompetent as Gordon for a source?

It was an effort to be “balanced.”

Journalists really need to figure out that being balanced doesn’t mean giving airtime to crackpots.

Well, that should boost his antivax street cred. Now he’s can play the martyr card about being persecuted for following his good conscience. Can’t fight for health freedom without a conspiracy working against you. Should stand well in the same room as Wakefield.

Yes but…

I get the feeling that Sears is going to keep a low profile at least during his probation. He’s arrogant but not stupid.

I sure hope the CA Medical Board sees Dr. Bob’s statement on Facebook:

“Case number five involves siblings to whom I did not give vaccine exemptions to, but a parent somehow reported me to the medical board anyway. I don’t know why yet. Should be interesting.

It alarms me to see any medical board questioning exemptions that are given to families who have suffered severe vaccine reactions. It should alarm everybody. More doctors need to stand up for their patients, especially the ones who are the most vulnerable. I’m going to continue to stand for these children.”

Seems as if revocation is warranted when one flaunts the judgement they have accepted.

Wow. Well, here’s to hoping the CA medical board has a spine regarding his utter lack of remorse for his all the harm he’s done. He’s clearing giving the CAMB and DRE with his 3rd finger.

Well I stand corrected. He’s quite the fool considering all the cases pending against him. Guess he’s taking a page out of Burzynski’s book as far as trying to sic his sycophants against the medical board.

Wow. I read the comments.

The cray cray is just amazing, including some from alleged other health care professionals.

I weep.

“The child came in complaining that he had been hit on the head with a hammer. I checked him out thoroughly, performed a complete neurologic exam, but you know what? I didn’t write down all aspects of the exam. I documented everything else but that one detail.”
If a child being struck in the head with a hammer and having a split lip before that isn’t a yellow alert to inquire for signs of abuse, then he really is violating the standard of care.

I made two errors:
He did report to child protective services, and the findings relating to injuries should be a red alert, not a yellow alert.

As a Doctor of Public Health (ehem!), I agree with this ruling 90%. The other 10% would have been them explicitly telling him to cut it out with the bullsh*t.

With all this emphasis on “Public Health”, why aren’t our children actually healthier? We have the sickest generation of children in over 50 years.

Does every family in the United States of America have health insurance, or even access to medical care? Please tell us how a child who gets measles or pertussis is healthy.

Right after you provide us the PubMed indexed studies by reputable qualified researchers that the MMR vaccine that has been used in the USA since 1978 causes more harm than measles.

How many children are currently in an iron lung in the USA? How many children are deaf or blind due to infectious disease? When was the last time children were struck down and cities paralyzed by a smallpox outbreak? How many times this year have you had hookworm?

Yeah. A lot has changed, for the better, in the health of children in the last 50 years. In the health of everyone.

Based on what metrics?
Fifty years ago there were more diseases we can now prevent and would prevent if not for AV morons.
Fifty years ago we were not saving preemies at 20 weeks.
Fifty years ago the fast food industry was in its infancy, not the monster of unhealthy consumables it is now.
Fifty years ago more people worked outside for more hours.
Fifty years ago dinner plates were 6-8″ in diameter, now they are 12″.

“Based on what metrics?”

The mythical ones that trouble the worried well.

By the way, kids are in more danger in the USA due to idiotic congress critters reducing health care is a thing. Oh, and then there are stupid gun laws:
https://www.vox.com/health-care/2018/1/8/16863656/childhood-mortality-united-states

It is going to get worse if more restrictions are put on women’s health care. Apparently old white guys who who don’t want health insurance to cover contraception and maternity care do not understand how all those kids came into existence.

I suspect Mr. Foster suffers from the same lack of basic education. He has already demonstrated that he cannot click on an embedded link in the above article.

Perhaps Mr Foster was using ‘sick’ in the skateboarder sense of ‘extremely accomplished’.

In the last fifty years we have found more and better ways to find heritable conditions, prevent stillbirth, treat prematurity, to deal with perinatal complications, and to keep children alive in the face of catastrophic or chronic disease.
With more children able to survive in the face of insult, injury, and congenital disease, there may be higher numbers of ill children, but on the whole, children are healthier on average today.

It is clear from the comments below that for these folks the word “healthy” only refers to the lack of communicable disease. No wonder we get the “public health” policies which neglect to take into account the numerous chronic conditions which have all increased exponentially over the past 20 years, and refuse to consider any possible iatrogenic causes.

When taking into account chronic neurodevelopmental disorders and immune-system dysfunction, it is clear that we have never had a generation of children as unhealthy as we do now. Talk to any teacher who has been in the classroom for more than 10 years and they will tell you the same thing. We have never had 1 in 5 children with some chronic disability, autism over 1 in 60, just about every chronic disorder one can think of is at an all-time high and climbing.

Mr. Foster: “When taking into account chronic neurodevelopmental disorders and immune-system dysfunction, it is clear that we have never had a generation of children as unhealthy as we do now.”

Uh huh. I see you have not provided any PubMed indexed studies by reputable qualified researchers to to support your claim.

So what do you call measles induced blindness, deafness and paralysis? Then if your kid recovers from measles unscathed they still have a reduced immune system for several years. How about the results of Hib meningitis when if fails to kill the kid? How about Congenital Rubella Syndrome, a known cause of autism along with blindness, neurodevelopmental disorders and heart disorders.

Again, for the third or fourth time I ask you to provide the PubMed indexed studies by reputable qualified researchers not funded by the Dwoskins that show the vaccines on the present American pediatric schedule cause more harm than the diseases.

“Talk to any teacher who has been in the classroom for more than 10 years and they will tell you the same thing”

Has every teacher done a proper statistical study of every child in their district? Why would we care about a random opinion, when we keep asking for actual verifiable scientific evidence.

” We have never had 1 in 5 children with some chronic disability, autism over 1 in 60, …”

Here is a question you might want to answer: I was told in 1991 by the child neurologist that my non-verbal three year definitely did not have autism because he smiled. Yet, the same person was given a diagnosis of Autism Level 2 when he was twenty six years old.

What changed? It is the same person, but now he has a diagnosis, where as before it was just a ever changing list of random speech disorders. Explain it to us.

When I was a kid, I was just a difficult and strange kid, and if enough Freudian therapy was thrown at me, or I at it, it would all come right.
When I was 50, someone managed to connect my nature with the relatively recent rediscovery of (murdering fucking Nazi Hans) Asperger’s Syndrome, much to my relief over finally finding an explanation and my grief at so much wasted time and lost opportunity.
And so I played my humble part in the “explosion” of autism diagnoses. I am pretty sure there must be thousands, possibly hundreds of thousands or even millions with similar stories, which means that if we could have been diagnosed in our childhoods between, say, the 1940s and the 1970s, that “explosion” would be less an explosion than a damp firecracker.

Talk to any teacher who has been in the classroom for more than 10 years and they will tell you the same thing.

This reliance on “Anecdotes from imaginary teachers” as dispositive evidence seems to be common among antivax bumblefucks. Sometimes they don’t even bother to vary the wording.

Rachel Temple DECEMBER 27, 2017 AT 10:00 AM
Re comment below, that autism is just being better diagnosed — you are obviously living in some kind of nether world. Talk to any teacher in any school and they will tell you that something bad is happening to our children.

Smut Clyde DECEMBER 27, 2017 AT 3:03 PM
I talk most Friday nights to the new-entrant teacher in Clyde Quay School (we are drinking buddies from way back). She does not “tell me that something bad is happening to our children”. Thus Rachel Temple is refuted.

Félication Docteur Najera !!! Metric ton of congratulation Dr Najera !!!

Alain

David,

It is clear from everything you post that you love strawman arguments.

No one is ignoring the problem of chronic diseases. The problem is, it has nothing to do with vaccination, which is actually the topic here.

Certainly we’re aware there are problems with obesity, and so on in children. Those are public health issues. So is vaccination.

Failure to vaccinate for dubious or false reasons is a major public health problem. We can’t ignore that, and we’re not ignoring the other problems but advocating for parents to do a simple, easy step to provide for the health of their children.

I also wondered what part of the Board order prevents Sears from continuing to offer his “alternative” vaccine schedule.

I agree that the most likely monitor that Sears picks will be a doc who incorporates alt med into his own practice, and is sympathetic to Sears’ antivax inclinations although not known for promulgating them himself. The problem with getting a fellow “vaccine skeptic” to oversee probation, even if the Board would allow it, is that this person might fear Board scrutiny of his/her own practice and decline the honor of being Sears’ mentor.

This action is a rather stinging slap on the wrist, even if a number of Sears’ patients view it as a badge of honor.

You claim that someone showed you “evidence that Dr. Bob was selling letters in support of non-medical exemptions online without ever actually having seen the patient”, and then as your “evidence” you simply post one of the exemption letters. How is this evidence that Dr. Sears is: (1) is selling these letters; or (2) providing these letters without ever seeing the patients? Please be specific. Otherwise it just sounds like you are slandering the man based on something someone told you.

As usual what you say is not nearly as important as what you choose to omit.

Why did you not mention the fact that for this specific case, it took ** over a year ** to get access to this child’s medical records? Dr. Sears was excoriated for granting a medical exemption without having seen these medical records, however in Dr. Sears’ judgement the child was in imminent danger from further vaccination and decided to grant one based on what the parent had told him. That doesn’t seem to me to be inappropriate. First Do No Harm, remember?

On a more general level, how can pediatricians possibly protect children who…I don’t know…actually just might need protection from vaccination which s/he feels might harm the child, when it can take over a year simply to get access to medical records? What was more important in this case, protecting the child from a possible vaccine adverse reaction based on history provided by the parent, or preventing Dr. Sears from granting medical exemptions?

You clearly didn’t click on the link I included just before the letter. Here, I’ll help you:

https://www.respectfulinsolence.com/2016/07/29/after-sb-277-online-medical-exemptions-to-school-vaccine-mandates-are-now-for-sale/

I’ll even provide the relevant excerpt:

What I don’t talk about that much on this blog is how often people write to me about the issues I discuss on this blog. Sometimes it’s just abuse from people who don’t like my point of view on alternative medicine, vaccines, and science. Sometimes, it’s people asking for medical advice, which I really can’t give, except in general terms. Sometimes it’s people telling me their stories about encounters with quacks. Of these, reading stories of patients whose family members have chosen, for example, Gerson therapy instead of real medicine are the hardest to read and steel me to continue what I do. Sometimes people let me know about something that I might want to blog about. This was one of those times, as it was the story of a parent and Dr. Bob’s vaccine exemptions that demonstrates how bogus these exemptions are.

I won’t tell you whether this was a male or a female, and I’ve stripped all potentially identifiable information from the genuine letters generated by Dr. Bob’s office in support of medical exemptions for their children. I’m going to refer to this parent as “he” for convenience and based on the default to male pronouns in English. Basically, this story developed out of, unfortunately, divorce, where the person who wrote me is not the custodial parent. He describes himself as formerly antivaccine but now pro-vaccine, which, as described, caused a rift in the marriage to the point where his spouse left. This is, unfortunately, a story I’ve heard too many times. In any case, this person who wrote me wants the children vaccinated. His spouse, however, does not, and his spouse stymied him by getting a medical exemption from Dr. Sears. Basically, his spouse filled out an online history form, paid a fee of $180 per child, and Dr. Bob’s office spit out these two boilerplate exemption letters. Nothing about them has been altered, other than to white out the names, dates of birth, and the date of the letter. (I wouldn’t want Dr. Bob to be able to figure out who it was based on the reasons for exemption and the date issued. Let’s just say that it was within the last four months or so.) Here are the letters (click to embiggen):

Dr. Bob Letter

Note the bogus reasons:

  • Family history of Autoimmune Disorders, Inflammatory Bowel Disease, Neurodevelopmental Disorders, Psychiatric Disorders.
  • His own current medical problems.

My reader described how he showed these letters to the children’s regular pediatrician, who was appalled. By e-mail (and, by the way, I’ve saved every e-mail), I urged him to report Dr. Bob for what, in my opinion, is highly unethical behavior and failure to meet the standard of care. After all, Dr. Bob never actually examined the patient and appears never to have verified even the medical history. Basically, he appears to have an online form that a parent can fill out and get a medical exemption for pretty much any condition. I was assured that a report to the Medical Board of California has been filed.

As I said, I still have the emails and the originals.

It still amazes me how excruciatingly nitpicky you can be about requiring hard evidence for anything which does not support your position on an issue, yet how your standards are clearly much more relaxed for anything which does support your position. This is why I refer to you and your ilk as Pseudo-Skeptics, this is one of the hallmark definitions of the pseudo-skeptic.

http://www.debunkingskeptics.com/characteristics.php

Case in point, your “evidence” provided here. If the person who was providing you with this information had been the other parent…so the parent who had actually filled out this supposed online Get Your Medical Exemption from Dr Bob form and obtained ME’s supposedly with no doctor visits…I would have been much more inclined to believe you. And for the record, there is nothing wrong with being nitpicky, but it becomes problematic when one’s degree of standards of evidence depends upon what that evidence supports.

So what you have provided here is basically a recently divorced parent who is angry because the other parent obtained a medical exemption for their children. Did it ever occur to you that this person’s anger might be leading them to draw unwarranted conclusions? Have they provided hard evidence that Dr. Bob never examined the children and/or their medical records? If this mythical online exemption form actually exists, can you show it to me? Does anyone have a screenshot? Are all of you really this bad at investigative reporting that you cannot find such a form?

Also for the record, if someone can well document that any pediatrician is providing medical exemptions for children without examining them or their medical records then I would be in favor of sanctions against them. What I’ve seen from you so far is nothing more than hear-say, something you would shoot down in an instant under most circumstances.

Lets also keep in mind that when Gov Brown signed SB277 he made it very clear, in writing, that the basis for medical exemptions will be based solely on the discretion of the medical provider, and can include such things as family history of auto-immune disorders and/or severe vaccine reactions. This was also promised, repeatedly, to the legislators by those advocating for SB277, including Dr. Pan himself.

@David Foster:

Have they provided hard evidence that Dr. Bob never examined the children and/or their medical records?

You haven’t read what Orac posted. There is an absence of evidence that Dr. Bob examined the children.

Mr. Foster: “This is why I refer to you and your ilk as Pseudo-Skeptics, this is one of the hallmark definitions of the pseudo-skeptic.”

Why do you think insults are a valid form of scientific evidence? You keep making claims, yet you refuse to support those claims with any kind of verifiable scientific evidence. Plus you have refused to answer several questions.

Here are some of them again, try this time to honestly reply with verifiable documentation supporting your answers:

You claim American kids have been the sickest in decades, so I asked you if every family in this country is covered by health insurance. That requires a simple “yes” or “no” answer. It should not be difficult to find the answer.

You claim there is an epidemic of childhood autoimmune and other chronic disorders. These are things that are often caused by surviving certain vaccine preventable diseases. So just the list the PubMed indexed studies by reputable qualified researchers not on the Dwoskin payroll that any vaccine on the present American pediatric schedule causes more harm than the diseases.

Earlier you made a claim of a great increase in autism during the last eighteen years. Well I looked at the vaccine schedule and about the only real change to the age group most likely to get diagnosed with autism was the addition of the rotavirus vaccine (which has neither thimerosal, nor an aluminum adjuvant and is taken by mouth). So what part of the vaccine schedule increased the number of autism diagnoses? Remember to post that qualified PubMed indexed paper.

Then I mentioned I was told that I was told my kid was definitely not autistic by a neurologist when he was a non-verbal three year old. Apparently smiling was not part of the criteria, even if it is done at inappropriate times (the random out of nowhere laughter was kind of weird, but in 1991 not enough for a diagnosis). The young man got diagnosed when he was twenty six years. So what changed? Did it take that long for the vaccines to do the damage, even though he was stimming, lining things up and other things when he was in preschool.

Please explain clearly why it has to be changes in the vaccine schedule and not the DSM with added awareness. Provide some actual factual numbers.

By the way, if I wanted to do tit for tat on your little “pseudo-skeptic” jab, I could honestly label you as a “pseudo-scientist.”

Look Foster, you are really trying to be a professional idiot, at least, to me but also, to a really big number of peoples, some whom comment here but also other who read here. Can you learn a lesson here? You may insinuate that SBM pediatrician vaccinate according to the CDC schedule to make more money but it is really clear cut here, after having read the details from Orac below your comment (and on top of mine) that antivaccines docs such as Dr Bob are also in it for the money. The fact that you fail to envision how they are in it for the money nowhere mean they are not in it for the money, it is primarily from a lack of some intelligence[1] on your part. You might improve the situation here by asking questions to Dr Bob about child abuse potential regarding being a child being hit by a hammer and verify the answer given with other pediatrician doctors.

[1] == There’s many form of intelligence.

Alain

Do you have anything to actually contribute to the discussion (other than a crude insult posing as a non sequitur)?

Your comment about “antivaccines [sic] docs such as Dr Bob” being “in it for the money” is truly ironic, given that the vast majority of the money that most pediatricians makes is from well-child visits when vaccinations are provided. On top of that some receive “incentive” moneys if they vaccinate a high enough percentage of their clients.

“…given that the vast majority of the money that most pediatricians makes is from well-child visits when vaccinations are provided.”

You really need to come up with the financial records to support that assertion, perhaps from Kaiser-Permanente. Because any bold statement without evidence, can be ignored until you provide that evidence. Oh, and no random websites from one of your friends.

By the way, where are those PubMed indexed studies by reputable qualified researchers that any vaccine on the present American pediatric schedule causes more harm than the disease? I am also curious why you think it is cheaper to let kids get sick instead of preventing vaccine preventable diseases.

Foster,

Who’s making more money? antivax pediatricians or SBM pediatrician?

SBM pediatricians may earn most of their income from well-child visits including vaccination but it does not mean they are making more than antivax pediatrician.

Let’s drill down the number, how much pediatricians are given for each vaccine given?

How much antivax pediatrician earn for each child visits?

Ever examined the tax statement from both groups of physicians?

Alain

More absolute drivel from the uninformed — It has been at least 25 YEARS since docs have made any $$ off of vaccines. First off, salaried physicians, as many are now (and increasing #’s every day) make no extra $$ for giving vaccines. And the company itself has to be careful it doesn’t LOSE $$ from vaccines! Medicaid doesn’t pay much of an administration fee, at all, so that is the doc office or company paying staff to give those vaccines “for free”. And back when HMO’s used to pay pediatricians a set amount of $$ per month, and a new vaccine would get approved, the pediatricians would be on the hook for the extra $$ that those vaccines cost, because the HMO’s would shrug their shoulders and say “that’s the breaks”. This doesn’t happen too much anymore, thanks to laws, but it was a menace a few years ago.

There is something called “P for P” or “pay for performance” where docs are paid a stipend by HMO’s (I haven’t heard of PPO’s doing this or Tricare, etc.) for a patient having a mammogram, colonoscopy (age appropriate of course), not prescribing antibiotics for a simple cold, ordering Hemoglobin A1C’s for their diabetic patients, etc. Some of these “P for P” are for vaccines. But they make the hoop ever higher to jump through. They now include flu in the group of 7, or 10, or whatever vaccines one needs to give, in order to meet their standard, and if the patient refuses a flu shot (which often happens), the doc doesn’t get credit. This isn’t some big bonanza, though. Most P4P is actually due to reduced reimbursement for regular exams etc. (or else, no increased reimbursement with inflation). So docs end up making the same. And even a doc who encourages vaccines, often doesn’t make the standard, because the standard is purposely made to be difficult to attain.

If anything, I probably make less because I spend time trying to encourage patients to be immunized — that’s time that takes away from other patients and from my productivity. If I was just an ATM machine like Dr. Sears, I would say oh well, they don’t want to immunize, not my problem, next? and not spend much time at all discussing it with the patient.

And Dr. Sears and other assorted noodleheads who are/were giving out these letters for a “fee” — along with his other moneymaking schemes like the one I posted with his “group” meetings with parents of autistics — they often make much more than rank and file pediatricians.

the vast majority of the money that most pediatricians makes is from well-child visits when vaccinations are provided

“Pediatricians are paid, therefore the vaccine industry is corrupt”.

Sorry, house going through some massive repairs, though this has the same tone and intent of Smut Clyde’s response: Carpenters are paid, therefore lumber companies are corrupt.

Actually, the carpenters are lovely. A few weeks ago I was in danger of falling through my deck. They are doing a lovely job of replacing it, and fixing some of the very weird things that the less than competent carpenter did twenty five years ago.

What a load of non-sequitors.
Right now, I really miss both Krebiozen and lilady. They each would have boned and gutted your ludicrous “arguments” with ease.

There are contraindications which would dictate a longterm medical exemption for a specific vaccine and precautions which may require delaying a specific vaccine or vaccination in general.

https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html

The child’s own pediatrician who supervised administering previous vaccines would be most familiar with their medical history and would not need to wait a year to obtain their medical records to justify an exemption. But Dr Sears is not the physician for people applying for exemptions online.

If Dr Sears were seriously concerned about protecting this patient, he would have performed and documented a neurological examination himself and probably reported the case to CPS. And he would protect the child and other children they interact with from the know harms of disease including immediate death and SSPE by only granting medical exemptions that are truly justified, advising parents that vaccines are extremely safe (much safer than many activities they and their child routinely engage in without thinking) and much safer than the diseases they protect against.

And what you choose to omit is that you repeatedly advocate that vaccines cause autism, despite considerable evidence to the contrary and that the majority of cases of ASD are genetically caused and that vaccines actually protect against ASD by preventing fetal rubella syndrome.

Wow. His facebook statement shows that he is completely arrogant and unrepentant. This probation, unfortunately, will not solve the problem.

Why is where stripping this menace of his license would much more clearly send the message that he is so far gone that it is not safe to let him be a physician.

In the category of “pop culture references to make antivaxers seethe” was the 1950s episode of “Have Gun, Will Travel” I heard on classic radio yesterday.

Paladin helps a beleaguered frontier doctor (an ex-girlfriend) thwart a smallpox epidemic. The plot involves holding unwilling cowboys at gunpoint on the ranch because they’ve been exposed to smallpox, until a shipment of vaccine can arrive. 🙂

I wonder if there was an antivax version of this episode in which the epidemic is halted by getting all the cowboys to bathe (good hygiene) and eat nourishing snacks.

Wonder how different things would have been if some of the Brady bunch got realistically taken out by measles.

Wonder how different things would have been if some of the Brady bunch got realistically taken out by measles.

“It’s a television sitcom! Just because somebody had to go to the hospital in a sitcom doesn’t mean it hapened in reall life!”

@ Julian Frost

You’re right. They use the argument of the sitcom, to show measles is not a big deal, but as soon as a sitcom would show something different, they will argue it’s just a sitcom. It’s always the same. Distrust any source that says something they don’t agree on and trust the source if it’s telling them what they think already. Big pharma is bad, big vitamin is good.

Tell them the story of the daughter of Roald Dahl and they still will argue that measles is not a big deal for a healthy child, if it’s fed well, thus blaming the parents of the dead child, because they had an unhealthy child and didn’t feed it the right things.

I can’t help but wonder what this consent agreement will do to Dr. Sears’s malpractice insurance rates. I doubt his insurer looks too kindly on the CABM dinging him for not adhering to the standard of care.

And god help him if he ever gets sued for malpractice. That consent agreement will stay on his record with the Board for ever and will be leverage for a plaintiff’s attorney seeking a large settlement.

Good news is, he’ll have to explain that consent agreement if he tries to get a license in another state.

There’s actually a good chance Sears doesn’t have malpractice insurance, given that he is a cash-only practice. If you take health insurance as a physician, you will have to show proof of insurance for an insurance plan to offer your a contract–and same thing if you want privileges to see patients in the hospital. But if you are an outpatient only doctor who takes no insurance, you are not required to carry malpractice insurance. Nor are you required to carry malpractice insurance in Californian and California does not require doctors to disclose whether they have malpractice insurance or not (surprisingly few states require this BTW). I guess the bright point would be if he has no malpractice insurance and gets sued, it could completely wipe him out.

Wow. What an idiot. That won’t protect his assets if he ever does get sued. He could lose everything.

I guess he must be counting on the magical thinking of anti-vaxxers to protect him.

Rene’!

Congratulations.
Keep up the good work.

Best,

Jay

Dr. Bob could get around a lot of this by having one of his family members see his anti-vaccine caseload for the next 3 years, while Dr. Bob whips up the fans on facebook. If Dr. Bob doesn’t see a lot of patients over that period, he can’t get in much trouble, the cash will keep still rolling in and Dr. Bob could use the time to write another book. Once it is all over, it can be business as usual.

Excellent point. The consent decree stipulates he must practice medicine to avoid the revocation so the monitor can produce the quarterly and final reports. It doesn’t stipulate how many patients he must see, or who. But the objective is to prevent him from simply shutting down altogether to ride out the probation, then going back to business as usual.

Still, if most of his practice is the anti vax crowd, it could so drastically reduce his case that the monitor may question things–if he gets a monitor who is actually going to do the job.

Thank you Orac for posting the evidence of Bob Sears’ “cash for exemption letters” scheme. How these people continue to defend him is beyond me. I have a copy of the protocol for “Dr. Bob”s group autism meetings — ka-ching! This was in 2008. Here are some excerpt$:

“Groups. Group size will vary between 10 and 15 new families (possibly more). One or both parents should come, but due to the nature of this approach the children with autism should NOT attend the meeting.” ….. “Additional one-on-one autism appointments: If you feel you would like a personal appointment, that can be arranged if Dr. Bob feels your child has unique challenges that don’t fit in well with the group approach. Because Dr. Bob generally is not taking new individual patients with autism, availability for these visits is limited. Price varies for such appointments, but is about $300 for a half-hour appointment. Please be aware that enrolling in this group program does NOT necessarily guarantee Dr. Bob’s availability for an individual appointment.

Cost. Each meeting costs $250. Dr. Bob will spend between 1 and 2 hours with you during the meeting. He will often spend additional time in between meetings organizing charts and labs and problems as they arise. His assistants, Melissa and Suzi, will also spend countless hours coordinating your care and getting you set up for your next meeting. Be aware that Dr. Bob is not contracted with any insurance (except TriWest Military insurance). You will bill your insurance yourself for this “out of network” service and can expect about $200 reimbursement from billing your insurance. Some insurances won’t reimburse you at all. That is between you and your insurance. Since Dr. Bob isn’t contracted with any, he is not subject to any payment discounts or guidelines your plan may have.

Pre-payment is required. Your $250 non-refundable fee is required at least one week prior to each meeting (mail in a check or use a credit card over the phone). This is so we can ensure a good turnout and make the most of each meeting. If you can’t make the meeting and notify us at least 24 hours in advance, one-half of your fee ($125) can be applied to a future meeting or any type of visit in our office.”

And here — he violates HIIPPA with impunity: “Patient Confidentiality. The normal rules of patient confidentiality can’t apply to this type of group setting. Your child’s medical history, current problems, lab results, and treatments will be openly discussed by Dr. Bob and the group. You will be in good company though, as many children share these common problems. You will gain the benefit of mutual support knowing that you are not alone in this. Of course, all the normal rules of patient confidentiality apply in that your child’s medical care stays within the office and is not shared with outside sources without your written permission.”

So 10-15 families, each paying $750 for a series of 3 meetings — he made an easy $7500 to $10,000+ — without even seeing or examining these patients! His office is a $$ racket and of course he charged for those letter$.

Actually, this is not a HIPAA violation. If the parent willingly discloses this information in a public setting, HIPAA is not violated if the doctor answers questions based on that information.

But it certainly sounds like a racket. He can’t possibly give medical advice without examining the child. It sounds more like a rah rah you can do this type of thing; a cheerleading session more than anything, under the guise of medical care. It may not be illegal, but it certainly sounds fishy.

One of the anonymous meeting type (alcoholic anonymous, narcotic anonymous, etc..) is way cheaper and I’d guess that they provide better care than Dr Bob’s meetings.

Al

I don’t see why Dr. Bob doesn’t just close his practice and go full-time onto the wingnut circuit like Andrew Wakefield. It’s got to be much easier than working for a living.

I tried to extract an argument from Foster’s sentence. The best I could come up with is “Paediatricians need well-child appointments to stay in business; paediatricians would not be able to arrange well-child appointments without the excuse of vaccination; therefore they still have a vested interest in the vaccine schedule, even if the immediate profit is non-existent”.
All that is missing is evidence.

My children have reached an age when they have had more well-child visits without vaccines than those with. Perhaps because that’s because I care about their health and growth.

I’m also fairly certain that the office has received more in co-pays from us for illness and injuries.

And now we will be held hostage to the pediatrician for yearly sports clearances, without at vaccines involved at all.

ACTUALLY, I can see a way that vaccines can “make money” for national health care services and/ or insurance companies because IF KIDS DON’T GET VPDs doctors, hospitals, pharmacies/ drug companies don’t have to be reimbursed.
Also parents may not lose pay/ vacation time.

My Medical Aid not only lets me get the flu vaccine for free, it awards me points for getting it. I read soomewhere (I don’t remember where) that every Rand/Dollar/Pound spent on flu vaccination pays for itself several times over.

Exactly right.

Businesses lose millions every year from lost productivity when their workforce gets the flu, or when their workforce’s kids get the flu.

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