February 6, 2020
Science Based Medicine: A Swamp of Medical Buffoonery
Progressive Radio Network, February 6, 2020
Every religion, large institution, political party and scientific and social discipline has its lunatic fringe. Within the practice of medicine in the 21st century the aberrant margins are the far extremes of alternative medical beliefs and the small clique of Science Based Medicine (SBM) within the conventional medical establishment. While the former is completely unsupported by any credible science, the latter is plagued by rampant shortsightedness, professional bias and hubris, and outright disdain towards all medical therapies that do not fall within the purview of its worldview of uncompromising scientific reductionism.
Unfortunately, despite its small following, the leading SBM voices have succeeded in having an enormous detrimental influence over the narrative of healthcare and the freedom of medical choice in the social media, including Wikipedia.
The Society of Science Based Medicine is the brainchild of Dr. Steven Novella at Yale University with the loyal support of his colleagues Drs. David Gorski (an oncologist at Wayne State University) and Harriet Hall. SBM blogs -- the Science Based Medicine blog, Neurologia and Respectful Insolence -- have functioned as clearing houses of opinions for the modern Skeptic organizations to source opinionated and prejudiced essays in their efforts to criticize and debunk alternative and natural medical therapies, including those that have received mainstream acceptance in the field of Complementary and Alternative Medicine (CAM). A brief visit to the SBM blog will reveal that approximately 90 percent of its content is savage, cirumlocutory and scientifically shoddy attacks against non-conventional medicine and those who practice these natural therapies. For the most part its articles represent personal opinions rather than rigorous scientific inquiry. And the site largely serves Skeptics on the internet and Wikipedia to fuel them with ammunition in their anti-CAM campaigns.
SBM's David Gorski's articles are unquestionably the most entertaining albeit flagrantly bombastic. In a recent article sharing his despair over the rise in CAM's popularity within the conventional medical community, he writes,
"As much as I hate to admit it, at times I feel like Sisyphus, pushing the boulder up the hill only to have it roll down the other side, only to have to push it back up the hill and roll down again, over and over and over again for all eternity. Certainly trying to keep track of pseudoscience in medicine and trying to educate why so much of so-called “complementary and alternative medicine” (CAM) is quackery (and the stuff that isn’t quackery is just medicine rebranded as CAM) and why “integrative medicine” involves integrating quackery with medicine can seem like a very Sisyphean task."
This is classic Gorski. Yet perhaps it is an indication that he may suffer from a savior complex. Does he believe he holds a prophetic mission to warn against the very bad bogey women and bogey men in the alternative and natural health communities who are determined to force upon the public vitamins, supplements, medicinal herbs, healthy diets, and alternative and natural medical therapies for personal gain? Rather than allow Gorski to wallow in the self pity of his eternal fate to battle effective natural medical treatments with his quarry, might his burden be lessened by bolting the boulder on his back?
Conspiratorial paranoia, scientific denialism and the lack of critical thought abound in Skeptic and SBM publications. It is witnessed in SBM's unwavering defense of genetically modified foods, fluoride, and vaccines. There's Novella's defense of the endocrine disruptor Biphenol A (BPA), the herbicide glyphosate (Roundup), synthetic chemical sweeteners, and more recently the telecommunication industry's talking points about the safety of electromagnetic radiation from cell phones and the coming 5G "internet of things." Over the years SBM authors have attacked a gluten-free diet (aside from the 1 percent of people who have Celiac disease), state licensing of acupuncturists and naturopaths, plant-based diets, nutritional therapies and the Keto Diet for mental disorders, omega-3 and other dietary supplements, antioxidants, etc. In the SBM universe, with few exceptions, only pharmaceutical drugs and surgery should define the practice of medicine.
Given Novella's positions noted above, it comes as no surprise that we find him serving as an Advisory Board member for the American Council on Science and Health, a pro-industry front organization with financial ties to Chevron and ExxonMobil, Coca-Cola and Pepsi, McDonalds, Bristol Myers, Proctor and Gamble, almost all of the agricultural giants including Bayer, Monsanto, DowAgra, Syngenta and tobacco companies such as Altria, Reynolds American, Phillip Morris and British American Tobacco. Surely this is the real quackery of junk science that poses the greatest threat to public health and costing the lives of millions of the planet's citizens.
Least worrisome is SBM's reliance upon cherry-picked science (often infected by corporate conflicts of interest), its scientific arguments against CAM (largely irrational and based upon the flawed theory of "plausibility"), and an ideological belief system (i.e., Skepticism) that strictly adheres to a dominant medical institution that we now find cracking at the seams. Once SBM's rhetoric is fully understood it echoes as an exasperated last breath effort to keep alive the failures of Herbert Spencer's, Marx's and the founder of scientism August Comte's nineteenth century scientific materialism. And unless SBM receives imperial decree, there is very little chance this fringe movement will gain much popularity nor have any constructive impact within the medical community.
The Skeptic proponents of SBM seem determined to prevent medicine from evolving beyond its current reductionist, materialist perspective. For that reason SBM's followers adamantly oppose funding research that may someday explain why and how alternative healing modalities have been successful for countless people worldwide. Consequently Skeptics are the strongest opponents of the growing trend in CAM therapies entering medical school curriculums and being offered in hospitals and clinical settings. In recent years, the American Medical Students Association has sponsored an Integrative Medicine Day. Novella and Gorski have damned this effort as "quackademic medicine" and have published articles excoriating the study of natural health treatments as a threat to science. Writing for the New York Times, health journalist David Freedman called these medical Skeptics "prickly anti-alternative medicine warriors."
However what is far more vexing is SBM's religious zealotry to discredit any and all alternative medical practices it does not agree with. This is best displayed by these authors' consistent use of demeaning language and exhibiting a narcissistic sense of intellectual superiority. More often, we might find ourselves questioning their state of mind and lack of reasonable integrity. For example, SBM advocates are readily adverse to the precautionary principle. Once they grasp on to a belief, such as the non-toxicity of fluoride or glyphosate, this belief rapidly morphs into dogma despite the evidence to the contrary.
But modern medicine's increasing acceptance of CAM therapies, according to Gorski, is a trend to mourn. In his article "NCCIH Surveys Physicians on Their Recommendations of 'Complementary Health Approaches,' with Depressing Results," he opines over a press release by the NIH's National Center for Complementary and Integrative Health that reported,
"More than half of office-based physicians recommend at least one complementary health approach to their patients, according to a new analysis of data from a nationally representative survey. In addition, female physicians recommended every complementary health approach at a higher rate than male physicians except for chiropractic and osteopathic manipulation."
The remainder of Gorski's article is a criticism of the report's underlying message and then reshaping facts into SBM's own image. It is intellectual alchemy that only unveils a deep seated callowness and animosity towards natural health and those who practice it. Gorksi states that it bothers him "that so many physicians recommend vitamins and supplements," and it bothers him more "that so many physicians recommend acupuncture (22.4%), homeopathy (12.6%), and naturopathy (10.4%)." David, we are delighted you are bothered! Welcome to the evolutionary changes happening within modern medicine that finally woke to the volumes of research Skeptics categorically ignore and deny.
Seemingly Gorski and Novella want to carry medicine back to the days of the Flexner report at the beginning of the last century when modern medicine first turned tyrannical to appease industrial giants such as Carnegie and Rockefeller.
"... if you don’t understand that naturopathy is a hodgepodge of pseudoscience and quackery mixed with some sensible interventions based on diet and lifestyle (although, truth be told, even the science-based interventions used by naturopaths are usually tainted with pseudoscience), you should not be a physician."
Regarding acupuncture, he writes,
"Many years ago, I once thought there might be something to acupuncture. The more I read, the more I studied it, though, the more I realized that it’s just a theatrical placebo and that its only effects are nonspecific placebo effects."
And the more I read SBM articles and these lengthy diatribes attacking the advances in alternative health, the more I realize that Gorski, Novella, et al. may be living in an alternative universe.
Finally David concludes,
"In reality, this study is very much like every other NCCIH study examining CAM usage: Its function is marketing, not “to inform”. Expect it to be used to argue how popular CAM is, how many doctors accept it, and thus to argue to policymakers and insurance companies that CAM should be reimbursable by government and private health insurance plans."
And here we rediscover one of SBM's favorite conspiracies; that is, everyone practicing alternative medicine is a hustler and charlatan selling placebos and snake oil for profit and personal gain. It is beyond belief that these folks fail to consider the possibility that because there are tens of thousands of alternative health practitioners serving millions of clients and patients it might have something to do with the success and effectiveness of these healing modalities. I realize that this may be a difficult stunt for a Skeptic brain to comprehend, but it is a very simple and common sense possibility they may wish to consider.
One among many glaring reasons why there has been a large uptick of interest in CAM, both within the medical profession and among the public, is the loss of trust in conventional medicine. This has nothing to do with CAM advertizing or propaganda as SBM skeptics want us to believe. Instead it is a sign of the increasing failures in our medical system. Drug companies' claims are no longer trustworthy. The federal health agencies consistently betray us by fast-tracking drugs that only shortly thereafter need to be stamped with a black box warning. For decades the industry has become a profitable machine sourcing false promises about the latest medications to hit the market. Its court fines for engaging in unethical or illegal activities grow annually. And conventional medicine's graveyard of victims is many square miles larger than the tiny land plot of casualties that may be attributed to CAM.
If we undertake a thought experiment to carry SBM's principles, criticisms and beliefs to their ultimate conclusion, what might modern medicine look like through the eyes of an SBM Skeptic? SBM imagines itself to be the new paradigm of conventional medicine that will replace the current widely accepted "evidence-based medicine" model. It hails itself as the future paradigm for evaluating medical research and to recommend best practices and treatments. Yet its failure lies in contributing absolutely no original research to improve the practice of medicine. Rather, as I have noted above, SBM is a repository of sarcasm, mean-spiritedness and criticism. It is a harbinger of a medical Inquisition in its witch hunt to defame CAM practitioners and their therapies. Therefore if a curse from the heavens were to fall upon America's healthcare and SBM proponents were to take control over national healthcare policies and medical schools, what might our healthcare system develop into? Based upon what we can surmise and extract from the numerous articles on the SBM websites, what would be our options for freedom of medical choice? How accessible would natural and alternative health therapies be for patients?
Below is the list I compiled that is based upon conclusions I have drawn from SBM articles criticizing CAM therapies and other health-related topics:
- Defund and discontinue the National Institutes of Health's (NIH) National Center for Complementary and Integrative Health (CAM);
- Cease government research grants for alternative health modalities and therapies;
- Discontinue CAM courses in medical schools and discourage education in CAM therapies at universities;
- Chiropractic practice would be limited to only a small number of health indications and would not be covered by insurance plans. Access to Chiropractic services, therefore, would be strictly out of pocket;
- Similarly, acupuncture could only be provided for a small number of medical indications and would likely require a physician's recommendation or prescription;
- Vitamin supplements would be removed as over-the-counter products and put into the hands of pharmaceutical companies;
- Many supplements, or all supplements, would require a doctor's prescription;
- All dietary and nutritional counseling must conform to the terribly outdated standards set forth by the American Dietetic Association, which represents mainstream pharmaceutical interests;
- No state could authorize Naturopathic medical board certifications, and current states that recognize Naturopathic practice would have permissions revoked;
- The large majority of botanical medicines would no longer be available, and likely not purchasable over the counter;
- The practice of homeopathy would be outlawed and the sale of homeopathic remedies would be banned;
- The practice of Traditional Chinese Medicine, Indian Ayurveda, and Energy Medicine (e.g. Reiki, polarity therapy, therapeutic touch, emotional freedom technique) would be prohibited;
- A nationwide moratorium would be set to prohibit the labeling of genetically modified foods (GMOs);
- Water from public utilities and dental products, such as toothpaste and mouthwash, would be required to contain fluoride;
- Vaccination for all children and adults would be mandated at a national level and children could be vaccinated without parental approval. Failure to comply could result in outrageous fines or criminal proceedings.
- Finally, all sites focused on alternative health, plant-based diets and natural nutrition, vaccination hesitancy, dangers of electromagnetic radiation, GMOs risks, etc would be strictly censored.
Undoubtedly, this list may appear to be unduly extreme and perhaps unfair; nevertheless, I believe it accurately reflects the condemnations and hate-mongering found scattered throughout SBM and Skeptic blogs and articles. Skeptics disproportionately ridicule CAM while at the same time fail to critically evaluate their own medical profession's rickety research that finds its way into peer-reviewed medical journals. Furthermore, this is the same scenario subtly being promoted by the Skeptics on Wikipedia's alternative health pages who are in the habit of referencing Gorski, Novella and other SBM authors in addition to SBM's predecessor Stephen Barrett and Quackwatch.
If my list is accurate, it portrays a regime that may best be defined as medical fascism. In my opinion SBM should never be perceived as a champion of public health. Rather it is an ideological cancer. Its authors are master wordsmiths who use the language of science to tailor the illusion of Science-Based Medicine as a new gold standard; nevertheless, it is only a ruse to confuse the public and to restore the dying Flexner paradigm of modern medicine that should be buried alongside its millions of victims.