Another Fellow of the American Academy of Pediatrics who should know better

With the current outbreak of measles centered around Disneyland, we’ve been paying a lot of attention to what 2014’s Douchebag of the Year, Dr. Robert “Bob” Sears had to say about vaccines. As it turns out, it’s nothing but a bunch of whining and finger-pointing at us “stupid” people. We’ve also been watching “pediatrician to the stars” Dr. Jay Gordon, MD, FAAAAAAAAAAAAP. (Too many A’s?) He’s been more reserved in what he’s had to say about measles, but there are strong hints that he may or may not have believed BS Hooker’s horrible attempt at epidemiology.

Today we got a tip that there is another pediatrician out there. By “out there,” we mean out there in outer space when it comes about medicine. This is yet another pediatrician who should know better, but doesn’t seem to. It’s another person who committed themselves to the healing arts and then just apparently threw reality out the window and went with the quackery. What follows is from his “about” page, and it contains plenty that should make you shudder at the thought of him having a say in anyone’s healthcare:

“Dr. Palevsky is a renowned board certified pediatrician, sought-after lecturer, and published author, who utilizes a holistic approach to children’s wellness and illness. In his current practice, Dr. Palevsky provides patients and their families with personalized, comprehensive consultations to address their children’s wellness, and acute and chronic illnesses.”

The key word in that paragraph is “holistic.” While it is a good idea to treat the whole person and not just the one symptom when dealing with a patient, the word “holistic” has taken on a different meaning as of yet. It’s kind of like the word “gluten.” It used to mean something that certain people could not eat because of an allergy. Now it means absolute poison. (Spoiler alert: Corn is “gluten free” because it’s corn, not because it ever had gluten in it.) Lately, “holistic health” has come to be synonymous with a wide array of Supplements, Complimentary, and Alternative Medicine (or S.C.A.M., for short). But let’s keep reading:

“He offers 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.”

Did you catch it? “Vaccination controversies.” I wonder what that is all about? Here’s what Dr. Palevsky had to say to fellow quack Dr. Joseph Mercola:

“When I went through medical school, I was taught that vaccines were completely safe and completely effective, and I had noThey’re (sic) reason to believe otherwise. All the information that I was taught was pretty standard in all the medical schools and the teachings and scientific literature throughout the country. I had no reason to disbelieve it.

Over the years, I kept practicing medicine and using vaccines and thinking that my approach to vaccines was completely onboard with everything else I was taught.

But more and more, I kept seeing that my experience of the world, my experience in using and reading about vaccines, and hearing what parents were saying about vaccines were very different from what I was taught in medical school and my residency training.

… and it became clearer to me as I read the research, listened to more and more parents, and found other practitioners who also shared the same concern that vaccines had not been completely proven safe or even completely effective, based on the literature that we have today.

… It didn’t appear that the scientific studies that we were given were actually appropriately designed to prove and test the safety and efficacy.

It also came to my attention that there were ingredients in there that were not properly tested, that the comparison groups were not appropriately set up, and that conclusions made about vaccine safety and efficacy just did not fit the scientific standards that I was trained to uphold in my medical school training.”

Yes, ladies and gentlemen, Dr. Palevsky appears to have abandoned what he was taught in an accredited institution of higher learning, what was based on verifiable evidence and gone through the rigors of scientific discovery, and exchanged it with anecdotes and hearsay from like-minded people. Evidence be damned. If the people around you say something that jives with your way of seeing the world, that must be correct and not what we know from centuries of scientific knowledge. If something “appears” to be wrong, then don’t learn why it’s wrong, just write it off altogether. If something is not “completely” safe and “completely” effective then it is worthless.

Alright, so we know he’s anti-vaccine. What else does he say about himself on his about page?

“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.”

We’re going to just go ahead and stop right there. We don’t need to read any further to know that Dr. Palevsky has abandoned everything that made him a pediatrician and seems to now be embracing the magical arts. After all, that is what homeopathy, Reiki, and reflexology are… They’re magic. It’s pure and unadulterated magic that has failed time after time to stand up to scientific scrutiny. Seriously, there hasn’t been any evidence that any of it works beyond the placebo effect.

As Dr. Mark Crislip has stated, adding apple pie to cow dung doesn’t make the apple pie taste better. Likewise, adding a thin veil of medicine through the letters after his name doesn’t make Dr. Palevsky’s quackery any more legitimate. It makes his claims of being a man of medicine worthless.

To seal our indictment of Dr. Palevsky (and we’re using “doctor” very loosely at this point), here’s an excellent piece-by-piece rebuttal of his statements by “Sullivan” at Left Brain Right Brain. In that rebuttal and in this page on Dr. Palevsky’s website, you’ll notice that Dr. Palevsky seems to have abandoned Germ Theory:

“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.”

Really? Then why does Dr. Palevsky recommend the following in a different page?

“If your child is less than 3 months old and has a fever, please go to the nearest emergency room.

If your child has a fever and a rash of little dots under the skin, please go to the nearest emergency room.

If your child has a fever, neck pain and the light is bothering him/her, please go to the nearest emergency room.

If your child has a fever, along with urinary complaints, swollen joints, inability to walk, or other complaints that concern you, please seek immediate medical attention.

If along with your child’s cough, your child is having difficulty breathing, is breathing rapidly, is wheezing, has a mental status change (see Pediatric Checklist), or is an infant below 4 months of age with a cough, please seek immediate medical attention.”

Why, Dr. Palevsky? Why go to the nearest emergency room if these are all just things that the child’s wonderful self-cleaning, self-healing body will take care of? I think he wrote this as a cover-your-ass set of recommendations because the bullshit he spills previously can get him in hot water if a child ends up having meningitis or measles and the parents go with “cranial-sacral therapy,” whatever the hell that is.

The most telling part of his website is the following statement found all the way at the bottom of most pages:

“Disclaimer: All material on this web site is provided for educational purposes only. Consult with your health care provider regarding the advisability of any opinions or recommendations with respect to your individual situation.”

In other words, “I’m not saying what I’m saying, I’m just saying.”

We at The Poxes believe that it is about time that the American Academy of Pediatrics take a really long, hard look at some of its members (the physicians with the “FAAP” after their name) who have abandoned science and embraced magic and attempt to use that magic to convince people that scientifically proven preventative and therapeutic measures like vaccines and antibiotics are not necessary. Because, with “fellows” like these, the AAP doesn’t need any enemies.

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Child mortality rates by the numbers

Another one of the things that anti-vaccine and alternative medicine (which is not medicine, by the way) use to justify their corrupted way of thinking is the fact that the United States is not at the bottom of the list when it comes to infant mortality rates. If you look at the headlines, the US has the highest infant mortality rate in the industrialized world. Maybe. To the anti-vaccine activists, it’s because the US has a robust vaccination program. To the alt med crowd, it’s because we rely so heavily on medicine to, you know, get cured from disease. I’m almost willing to bet that it’s because we drive too many cars to the environmental activists and because we have too many Mexicans to the anti-immigration bigots. That’s how bias works. You see something and attribute it to the thing you hate.

But why did I write “maybe” up there? Continue reading

The trouble with democracies and religious parents

I traveled to Central America when I was in college. It was quite an eye-opening experience when it came to healthcare. They had socialized medicine, where the state handled everything: the hospitals, clinics, who got to be a doctor, and how much doctors could charge for taking care of you. It seemed to work better in the smaller countries because a centralized healthcare system is more closely overseen by a centralized government. Also, the people had little to no say in their care. Whatever the doctor said was done, and woe be upon the patient that refused. You’re very much willing to accept any intervention if you’re threatened with the bill if you refuse.

There was also the matter of education. Physicians and nurses were the most educated people around, so their patients deferred to them when it came to care. Patients had no access to websites to tell them that all physicians are in the pockets of Big Pharma. Or, rather, “Grande Farma.” They were also not fed lies about other things like vaccines or chemotherapy. Unfortunately, there was also not a lot of oversight when it came to quacks. The quacks would just label themselves “traditional healers,” and the government pretty much left them alone. I remember seeing a homeopath’s office with a line that went around the corner because he would see you the same day, as opposed to waiting for months under the government care plan.

I wonder how many people ended up losing limbs or dying because they chose to take care of their diabetes with homeopathy? But I digress… Continue reading

The many and the individuals

The thing about public health and public health workers is that we are not healthcare providers in the strictest sense. While some of us may be nurses, physicians, or physician assistants, most of us never even come into direct contact with the people we’re serving. Even those who do “treat” people, e.g. give a vaccine or administer post-exposure antibiotics, are not in charge of the continuing care of the individuals. On the one hand, we’re protecting the health of the people. On the other, it’s not entirely up to us.

This causes some friction, especially when a provider thinks that he or she should be the final arbiter of what to do with their patients. Take, for example, a certain pediatrician to the stars. This pediatrician has said over and over that his decades of experience in medicine and his gut feelings dictate his approach to immunizations. He believes that some vaccines undoubtedly cause bad things, and that vaccines should be spaced out as much as possible, if they are to be given at all.

For his individual patients, that’s fine. It’s really between he and his patients how he is to tend to their healthcare needs, so long as he practices a standard of care that is not negligent and does so in the best interest of his patients. However, for the population at large, this is not a good thing. It’s not good to erode herd immunity against things like measles or mumps. It’s not good under any circumstance.

There was once a kid in a very large university who came down with bacterial meningitis. He had been at a party and allegedly “hooked up” with several young women that night. We did our best to track down those contacts, and everyone else at the party. When we did, we notified them of a possible exposure to bacterial meningitis, and we advices them to go into their local health department to be given antibiotics or to go see the university’s health providers, or to go see their own physician. Well, there was one physician who saw one of the young ladies in question and refused to give her antibiotics. He said that she said that the case and her never really hooked up. They just sat on a bed in a room at the house where the party happened and talked, nothing more. So the physician took her word for it.

This triggered a huge discussion on what to do with her. Would we ask the physician at the local health department to give her the antibiotics anyway? Would we respect her physician’s decision, albeit a questionable decision? What to do?

In the end, the local health department staff reached out to her and explained to her the situation. She was told that she could be in danger if there was any chance that she and the case shared any spit, even incidentally, at the party. (He had fallen most ill about a day after that party, so he was very infectious when he went to it.) She opted not to chance it. Days later, her physician apparently complained about being overruled.

And that’s not the only example I’ve seen or heard of where private practice providers clash with public health practitioners and workers. It seems to be a constant struggle. I don’t see it as a bad thing, though. There must be an interest in providers to take care of their patients, even if jealously so. And the must be a willingness of public health workers to do their due diligence, even if that means stepping on the toes of private practitioners. All as long as we’re all doing it in the best interest of the patient.

So how do we deal with people who refuse vaccines even though they’re licensed healthcare providers who should know better? Or those who refuse to give vaccines and whose action, or inaction, may lead to an outbreak of a serious disease in the community?

I don’t know. It’s above my paygrade to figure out those things. But I have passed this discussion on to a friend who is about to enter a Doctor of Public Health program. I hope his education in that program covers these issues because we need answers. We need guidance. We need to figure out who supersedes whom when it comes to serious disagreements like vaccines, fluoridation, or even antibiotic use.

I’d like to say that evidence supersedes all personal or professional opinions, but the world doesn’t work that way, sadly. In this world, we need to deal with each other, work with each other, and do it all in the best interest of the public and their health.