It has long been my belief that physicians who are antivaccine and spread antivaccine misinformation, especially antivaccine pediatricians, should have their medical licenses taken away by state medical boards. One of the most sacred responsibilities of a physician is to prevent disease wherever he can, rather than just treat it. Preventing suffering and death by preventing disease is so much better than just waiting for disease to happen and then treating it it when it occurs, and vaccines are the most powerful disease preventers every devised by the human mind. This is doubly true for pediatricians, because we now have the tools to prevent the number one cause of childhood mortality. Over the last 100 years, childhood mortality has plummeted such that it is no longer common to lose a child (or children) to infectious disease. Indeed, it is now very uncommon, if not rare, to lose a child to the diseases that were the scourges of prior generations of children, largely thanks to vaccination. Diseases like polio, whooping cough, smallpox, diptheria, the measles, and several more, that once were the scourges of children everywhere. Even in my father’s generation, childhood mortality was not uncommon. Indeed, my father lost siblings to what are now vaccine-preventable diseases. That’s why antivaccine pediatricians like Lawrence Palevsky absolutely infuriate me and I sincerely believe that they all should lose their medical licenses, along with every other antivaccine physician.
But especially antivaccine pediatricians.
I haven’t written much about Dr. Palevsky on this blog. I first noted him nearly eight years ago, when he appeared in the antivaccine propaganda film disguised as a documentary that preceded the more recent (and infamous) antivaccine propaganda film disguised as a documentary, VAXXED. I’m referring to the 2011 antivax opus, The Greater Good. As I noted at the time, in this quackumentary, Dr. Palevsky spent much of his screen time promoting a litany of anti-vaccine pseudoscience, including the “toxins” gambit, conspiracy mongering about pharmaceutical companies, and claims that vaccines aren’t adequately tested. Late in the movie, he’s even shown speaking to the American College for Advancement in Medicine (ACAM) and using the most brain dead of anti-vaccine gambits, claiming that because mortality from various infectious diseases was falling before vaccines for those diseases were introduced it must mean that vaccines are useless. It’s the very same intellectually dishonest gambit that Raymond Obomsawin made himself famous for. Elsewhere in the film, Dr. Palevsky is shown speaking to a bunch of parents talking about how amazed he was to discover that there was mercury, aluminum, formaldehyde, antibiotics, and preservatives in vaccines, all gambits that we’ve discussed many, many times on this blog. Only a chemically illiterate person, full of innumeracy and Dunning-Kruger, could be “amazed” at such false “discoveries.” Of course, it never ceases to depress me that such a fool could make it through the NYU School of Medicine.
When last we met Dr. Palevsky, however, he was doing his best to make measles great again in Rockland County, NY by speaking to a group of Orthodox Jews and trying to convince them not to vaccinate. He’s now being called out for his activities in a Business Insider article by J.K. Trotter entitled This New York doctor has been publicly urging parents not to vaccinate their children in the midst of a measles outbreak. Why is he still allowed to practice medicine? It’s an excellent question, one I’ve been asking for years about antivaccine doctors. Here’s how the article introduces him:
On May 13, hundreds of parents packed into a catering hall in Monsey, New York, for an event billed as a “Vaccine Symposium.” Monsey is a hamlet in Rockland County, which is struggling to contain an unprecedented outbreak of measles. But the event’s organizers weren’t there to educate the crowd on how vaccines can halt the spread of the illness, which can be fatal. They were there to promote a pernicious and discredited message that health officials have blamed for the outbreak: that vaccines endanger young children.
Hardly any of the symposium’s speakers, which included a YouTube host and a Washington lobbyist, practice medicine. The exception was a 57-year-old pediatrician named Lawrence Palevsky, who sees patients in Manhattan and the nearby Suffolk County on Long Island. His clinic’s website promises “personalized, comprehensive consultations” to address “children’s wellness, and acute and chronic illnesses.”
This is an important point. Many of these antivaccine pediatricians are “holistic” doctors or practice “integrative medicine,” or, as I like to call it, the integration of quackery and pseudoscience into medicine. I’ve been meaning to look at Dr. Palevsky’s website (and into his activities) for a long time. Thanks, Mr. Trotter, for giving me the pretext!
Here’s Dr. Palevsky’s self-description on his practice website, Northport Wellness Center:
In his current pediatric practice, Dr. Palevsky offers well-child examinations, consultations and educational programs to families and practitioners in the areas of preventive and holistic health; childhood development; lifestyle changes; nutrition for adults, infants and children; safe, alternative treatments for common and difficult to treat acute and chronic pediatric and adult conditions; vaccination controversies; mindful parenting; and rethinking the medical paradigm. Additionally, he teaches holistic integrative pediatric & adolescent medicine to parents, and medical and allied health professionals, both nationally & internationally, and is available for speaking engagements worldwide.
I can’t help but note that when I wrote about the antivaccine quackumentary The Greater Good, I related what his description of himself on his website read back then, in 2011:
In using his “whole child” wellness philosophy, Dr. Palevsky recommends and incorporates the teachings and therapies of nutritional science, acupuncture and Chinese Medicine, chiropractic, osteopathy, cranial-sacral therapy, environmental medicine, homeopathy, and essential oils, along with natural healing modalities such as aromatherapy, yoga, Reiki, meditation, reflexology, and mindfulness.
Yes, Dr. Palevsky offered pretty much every form of quackery you can think of, up to and including even The One Quackery To Rule Them All, homeopathy. It was worse than that, though. Dr. Palevsky has clearly cleaned up his website since the days of his “holistic advantage,” where he laid down some serious, serious quackery:
Acute symptoms, such as fever, vomiting, diarrhea, rash, cough, runny nose, mucus production and wheezing, are all important ways in which children discharge stored accumulations of wastes or toxins from their bodies. These toxins enter and are stored in their bodies from repeated exposures to in utero, air, food, water, skin, nervous system stress, and injected materials, that for whatever reason, don’t easily exit their bodies through the normal means of detoxification. These toxins are too irritating to children’s bodies and must be removed. Eventually, a critical level of the toxins is reached, and children get sick with symptoms to purge them. Children, therefore, must be allowed to be sick, in order for them to get well.
In his practice, Dr. Palevsky encourages parents to allow children to express their symptoms when they’re sick. No one wants children to “feel” sick. Parents can learn to use remedies, however, that help children feel better and heal more effectively, without altering the important physiology which is helping them cleanse their systems. Letting children have their symptoms, without suppressing them, can be a challenging process both for parents and health care practitioners. We often come face-to-face with our own discomfort when children experience discomfort from their illnesses. It’s hard for us to watch them “suffer”, so we reflexively give them something to bring immediate relief. This reflexive response to suppress their symptoms, however, weakens them and delays their healing process.
WTF? That which does not kill the child makes him stronger? Really? This is some seriously depraved thinking!
Reading this, I can’t help but come to the belief that Dr. Palevsky is a monster. He seems to have believed that children should suffer, that their suffering shouldn’t be relieved, that children should be “allowed to be sick” because to do otherwise would be unnatural and prevent them from “cleansing” and “healing” their systems properly. I also can’t help but note, as others have, that there is a distinct strain of germ theory denialism here. You see, it’s not so much the bacteria and viruses causing fever and disease. It’s the toxins. He’s even explicitly said it, as others have documented. No wonder Dr. Palevsky has earned the “honor” of a place in the Encyclopedia of American Loons. He’s also posting links to antivaccine sites on his Facebook page:
His latest newsletter includes antivaccine propaganda galore. (Come to think of it, that document might make a good target for some future Insolence.) Does anyone think he doesn’t still believe these things? Of course he does:
It is important for all of us to begin learning about new scientific information that explains why children must experience their symptoms and illnesses as a necessary rite of passage, thus, allowing their immune and nervous systems to grow, mature, and develop appropriately. The expression of these symptoms may not always be caused by infections from bacteria and viruses. Instead, these symptoms and illnesses may develop as a sign that our children are healthy; that their bodies are strong, and working to bring to the surface, and cleanse, any accumulation of wastes that are deep inside them, having accumulated due to their exposure to varying stressors in their lives. In many instances, the process of bringing these wastes to the surface of the body is aided by the bacteria and viruses already living inside of them, and is a necessary step for them to become well.
Dr. Palevsky feels we are harming children with the constant use of over-the-counter medications, antibiotics, drugs and vaccines that treat and suppress common and necessary childhood symptoms and illnesses. He has come to understand that the use of this dominant treatment approach, that drives wastes deeper into our children’s bodies when we suppress symptoms, is directly contributing to the development of many of the chronic childhood illnesses we see in pediatrics today. After all, chronic symptoms develop as a result of a chronic accumulation of wastes and toxins, something we contribute to every time we don’t allow children to have their symptoms.
As I said, Dr. Palevsky is a monster. He might have started expressing his monstrous beliefs a bit less monstrously, but they’re still monstrous. He is, in my estimation, a horrific quack.
It becomes very clear, reading the 2011 and 2019 versions of Dr. Palevsky’s website, why Dr. Palevsky is an antivaxer. He’s laboring under the delusion that the natural suffering that vaccine-preventable diseases cause is good for the child. One wonders if he thinks that children dying of vaccine-preventable diseases is acceptable because, obviously, their detoxification systems must not have been adequate. What does he do when his “allowing children to experience their symptoms” leads to a child experience the symptoms of acute cardiovascular collapse and impending death? Inquiring medical minds want to know.
I could go on and on and on about Dr. Palevsky. For instance, predictably, he does not believe there is such a thing as herd immunity (or, as it’s now more commonly called, community immunity). but I’m more interested in the more general question raised by the article about him, namely, why do antivaccine doctors still have medical licenses? One of the most disturbing aspects of the antivaccine movement to me is how many pediatricians have betrayed their profession and their duty to children by pandering to antivaxers or even becoming antivaccine themselves. It’s particularly frustrating because MDs and DOs should know better. Their training should have, if you’ll excuse the term, immunized them against the pseudoscience, misinformation, and lies of the antivaccine movement. However, pediatricians are humans too, and humans are prone to the same sort of cognitive issues that lead others to confuse correlation with causation and as a result become mired in confirmation bias in which they remember every case or bit of information that reinforces their preexisting views and ignore or dismiss cases or bits of information that contradicts those views. Because humans are subject to these cognitive biases, though, does not mean that we should excuse doctors who fall prey to them. That’s why we need standards and medical boards to enforce standards of science-based medicine when doctors’ all-too-human tendencies lead them astray, as has happened with Dr. Palevsky.
That’s why I’m with Dr. Arthur Caplan, when he’s quoted in the Business Insider article:
Arthur Caplan, a professor of bioethics at New York University’s School of Medicine, said Palevsky’s conduct was incompatible with his role as a healthcare provider. “I absolutely believe New York state should revoke Palevsky’s license, because he’s advocating breaking the standard of care and spreading misinformation, putting children and the public at risk,” he told INSIDER. “It’s especially important in an outbreak, which could turn into a full-bore epidemic.”
“There are standards of care created by medicine, created by pediatricians, by experts,” he added. “If you violate those, you should lose your license.”
Precisely. The standard of care in pediatrics, supported by copious science, is to vaccinate according to the CDC schedule, or something close to it. Not vaccinating according to the CDC schedule is bad, and not vaccinating at all, as pediatricians like Dr. Lawrence Palevsky and Dr. Paul Thomas do, is even worse. It would be one thing if any of these physicians could construct something even vaguely resembling a rationale based on good science, but they can’t. They all rely on a sampling of the same mass of antivaccine pseudoscience that antivaxers routinely cite to justify their refusal to vaccinate, such as pseudoscience and bad science claiming to find that vaccines cause autism. They also rely on a sampling of the same mass of antivaccine misinformation that all antivaxers draw from. It’s not even subtle, and worse still is their use of their status as physicians to spread antivaccine misinformation that encourages parents not to vaccinate, because physicians are automatically viewed as more credible when holding forth on matters of medicine. This is particularly so when physicians speak on their area of specialization, which makes antivax pediatricians particularly dangerous to public health. After all, childhood vaccination is a large part of pediatric practice.
Yet, according to the BI article:
It would be difficult, and probably unprecedented, to strip a doctor of a medical license solely for expressing anti-vaccine views.
It may seem like a no-brainer to revoke the license of a physician who regularly spreads false, discredited information that, if relied on, could result in preventable injury or death. But state health departments, which license doctors and regulate the medical industry, have traditionally drawn a bright line between what doctors say in public and how they treat their patients. Regulators monitor what happens in the exam room or surgical theater, but they leave doctors free to speak their minds everywhere else.
And that’s the problem. Physicians hold a highly privileged position in society. As a surgeon, I like to illustrate this using an intentionally provocative image. As a surgeon, I am granted the power and privilege by society to forcibly rearrange—or even remove parts of—a patient’s anatomy because society assumes that our training allows us to do this anatomical rearrangement for therapeutic effect. If I started to say in lectures that, for example, breast cancer can be treated without surgery and that chemotherapy kills, I would be spreading harmful misinformation and thus betraying my specialty. I could even be leading women to their deaths by persuading them not to have their potentially curable breast cancers properly treated. It’s no different for antivaccine pediatricians. Not only are they not providing proper medical care to their own patients, but they’re also persuading parents of children who aren’t even their patients to medically neglect their children by withholding a preventative measure that protects them against potentially deadly infectious diseases.
Before I get to the last issue I want to discuss, let’s first look at how the New York State Department of Health responded to Trotter’s questions regarding Dr. Palevsky:
In a statement to INSIDER, the New York State Department of Health was careful to distinguish between Palevsky’s public statements, which it regards as beyond its purview, and his patient care.
While “the New York State Department of Health will continue our extensive public outreach campaign to educate people on the facts about vaccinations and to counter misinformation that has fueled this outbreak,” the department spokeswoman Jill Montag said, “the First Amendment protects an individual’s right to speak and express opinions about controversial topics without fear of government retaliation. Matters involving specific patients in the practice of medicine may, however, become the subject of an investigation.”
While I have some mild sympathy for this argument, being very much a free speech advocate, ultimately I view it as a cop-out. Here’s why. Physicians who are antivaccine and speak out regularly against vaccines are quacks, not just because they are antivaccine. Basically, being antivaccine is just one manifestation of their being a quacks. Rarely is it the only form of quackery in which they indulge. Dr. Palevsky is an excellent example. Look at the quackery he uses: cranial-sacral therapy, homeopathy, essential oils, aromatherapy, Reiki, reflexology, and more. That’s not even counting the modalities that are quackery but unfortunately often recognized by many states, such as acupuncture and traditional Chinese medicine, chiropractic, and naturopathy. Dr. Palevsky’s antivaccine views are just a part (albeit a very significant part) of the overall package of his quackery.
If there’s an exception to my rule of thumb that every antivaccine physician is into more quackery than just antivaccine quackery, I haven’t found it yet. Certainly Dr. Palevsky is far from the only example. For instance, there’s Kelly Brogan, an antivaccine psychiatrist who’s also into cancer quackery and mental illness denial. There’s Sherri Tenpenny, who runs one of the highest trafficked antivaccine Facebook pages and who once asked whether the flu vaccine killed Prince and has claimed that measles is not a disease. Like Dr. Palevsky, she flirts with germ theory denial, but she goes him one better and explicitly denies that microbes are the cause of infectious diseases. In her practice, she uses homeoprophylaxis instead of vaccines (that’s homeopathy, people) and advocates the uunproven modality of thermography to diagnose breast cancer and other diseases. Another antivaccine physician, nephrologist Dr. Suzanne Humphries, describes vaccines as “disease matter” and routinely spews the most easily refuted antivaccine tropes. She’s also a germ theory denier (are you seeing a pattern here?) and heavily into high dose vitamin C quackery. For instance, she thinks that vitamin C is a good treatment for whooping cough and that it should be studied as such.
You get the idea. I could go on and on about this. There’s Dr. Bob Sears, who, to be fair, is probably the least quacky of the antivaccine pediatricians outside of his antivaccine quackery, but that didn’t stop the Medical Board of California from sanctioning him for, in essence, shoddy record-keeping plus providing vaccine exemptions without properly examining the patient. (Who knew? Antivax doctors tend to be sloppy about medicine in more than one area.) There’s Dr. Paul Thomas, a rising star in the antivaccine movement in Portland who’s contributing to the massive measles outbreak across the Columbia River in Clark County, WA. Unsurprisingly, he has a pediatrician on staff in his practice who’s “certified in Classical Homeopathy, and trained in herbal medicine, nutrition and energy medicine.”. There’s Dr. Gary Kohls, who’s not just antivaccine but prone to a whole ecosystem of conspiracy theories. (Fortunately, he is retired.) In fact, there’s a whole advocacy society of antivaccine physicians, Physicians for Informed Consent, which invited Robert F. Kennedy, Jr. to speak at its March conference.
All of them who are still licensed to practice should lose their medical license.
Basically, if a physician is antivaccine, you can, with a high degree of confidence, be sure that antivaccine quackery is not the only form of quackery that that physician is practicing. An antivaccine physician who is out there giving talks frightening parents out of vaccinating is certainly at the very least not adequately vaccinating his own patients and is highly likely to be treating them with a variety of other quackery. Thus, while a physician has a First Amendment right to go around publicly expressing antivaccine views, the fact that a physician is doing so is a huge red flag for other forms of quackery. Unfortunately, most state medical boards rely on complaints about individual patients, either from the patient, the patient’s guardian, a worker at a physician’s practice, or someone who knows the patient. In addition, it’s rare for such complaints to be made except in the case of really egregious misconduct (e.g., physicians sexually assaulting patients during exams or under anesthesia or physicians with substance abuse problems) or if clear harm has resulted to the patient, after which it’s rather too late.
Worse, thanks to the rise of “integrative medicine,” in which it is becoming increasingly acceptable for physicians to “integrate” rank quackery into their practices, thus blurring the line between quackery, state medical boards seem more reluctant than ever to judge what is acceptable medical practice, and don’t even get me started on the failure of medical professional societies to kick antivaxers out. (American Academy of Pediatrics, I’m talking to you in particular.) Add to this how chronically underfunded and understaffed state medical boards are, and it’s amazing they manage to get rid of even the most dangerous physicians. This is not a problem just with antivaccine physicians, but for incompetent surgeons who’ve caused harm to many patients, doctors selling quackery like unproven stem cell treatments, or Dr. Stanislaw Burzynski and his antineoplastons.
That doesn’t mean that they shouldn’t use a history of antivaccine propagandizing and profiteering as a red flag suggesting that a doctor might be practicing dangerously below the standard of care not just with respect to vaccinations but other areas. If a few antivaccine physicians were to lose their medical licenses or to be sanctioned severely because their antivaccine speeches, YouTube videos, blogs, and Facebook pages drew unwanted attention their way, I bet that would make a lot of the others think twice about peddling antivaccine nonsense. The First Amendment might protect physicians’ right to spew antivaccine misinformation wherever they wish, but it shouldn’t protect their ability to practice far below the standard of care and to use quackery to treat their patients.