A “holistic” doctor throws a hilariously disingenuous tantrum over board recertification [Respectful Insolence]

In the early days of 2016, my attention was drawn to a local antivaccine doctor of whom I’d heard before but never really paid much attention to. What caught my eye was a blog exchange between this “holistic” family practitioner and former Scienceblogs blogger, friend, and local internist Peter Lipson over this physician’s blog posts attacking a local Jewish summer camp for children for its new requirement that campers must be up to date on their vaccinations as a requirement for attending. Not surprisingly, Dr. Lipson took the side of science and refuted the antivaccine nonsense that had been laid down by this local “holistic” physician, leading to a response to Dr. Lipson entitled The Great Vaccine Debate in which he tried to refute Dr. Lipson and failed miserably, to amusing effect that I couldn’t resist blogging about in order to provide a heapin’ helpin’ of some Not-So-Respectable Insolence.

That was the last time I paid attention to Dr. David Brownstein, the “holistic” doctor in question. I had noted that his website was chock full of antivaccine misinformation and tropes, and that Dr. Brownstein embraced antivaccine pseudoscience enthusiastically. Indeed, just for yucks, I perused his website again in writing this introduction and found newer articles with titles like Vaccines, Autism, and our Do-Nothing U.S. Congress; Congress Should Be Shamed: The Vaccine Crises Continues; Censorship is Alive and Well in 21st Century America; and CDC Cover-Up of Autism and Vaccine Link Continues. Yes, Dr. Brownstein, credulous and, apparently, not too bright fellow that he is, totally buys into the “CDC whistleblower” manufactroversy and all the lies about it in Andrew Wakefield’s and Del Bigtree’s movie VAXXED. And, yes, he’s still laying down sheer antivaccine idiocy like:

Folks, the truth of the matter is that the claim that vaccines are safe and effective is an example of a platitude that is continually repeated. Vaccines have not been properly studied and many vaccines simply don’t work. The truth of the matter is that the vaccine schedule has never been studied. We simply don’t know if it is safe to inject our children with over 70 vaccines before they are adults.

I can assure you of one thing: It is not safe to inject our children (or any living being) with toxic additives such as mercury, formaldehyde, aluminum or MSG. It is not rocket science to predict that people injected with toxic items that negatively affect the human body will suffer neurological and immunological problems.

Simply repeating that vaccines are safe and effective does not make them so. Watching our young people suffer with so many chronic illnesses should make anyone question the validity of injecting more toxins into them.

All of these are lies and misinformation that I’ve debunked on more occasions than I can remember over the last 12 years. (You’ll just have to take my word for it this time; debunking them all again will make this post much, much longer than you probably want to read, even by my standards.) What it did remind me of is the reason I was going to write about Dr. Brownstein again anyway. Specifically, it led me to the question of how “holistic physicians” like Dr. Brownstein can remain board certified in their specialties. What made me ask that question again was a post on that repository of all things conspiracy, quacky, libelous, and just plain dumb, Mike Adams’ NaturalNews.com, which reposted an article written by Dr. Brownstein under the title After 7-hour medical board exam about prescription drugs, holistic Doctor decides to skip board certification, which turns out to be a reposting of the article from Health Impact News entitled After 7-Hour Medical Board Exam on Drugs, Holistic Doctor Decides to Give up Board Certification, which turns out to be a reposting of the original post from Dr. Brownstein’s blog in April entitled Family Practice Exam: Drugs, Drugs, and More Drugs.

Poor, poor pitiful me, Dr. Brownstein is saying. The test is all about drug treatments. One wonders what he expected. Before I delve a bit deeper into Dr. Brownstein’s whining, first let me point something out. Dr. Brownstein is most definitely not giving up his board certification. What he said is that he was so disgusted that his taking the recertification exam in family practice “will be the last time I put myself through something as ridiculous as that endeavor!” In other words, Dr. Brownstein’s posturing is the rhetorical equivalent of the brown, stinky stuff that comes out of the hind end of male bovine creatures.

Why do I say this? First, I looked at Dr. Brownstein’s picture and figured that he’s probably roughly my age. A search for his CV revealed that I was correct; he graduated from college a year later than I did. Also, depressingly, I learned that Dr. Brownstein went to medical school where I am faculty now and before that attended the University of Michigan as an undergraduate, which means we were on the same campus for three years. Of course, he was a psychology major and I was a chemistry major; so I probably never encountered him. It does disappoint me that the same schools I attended and am on faculty at failed Dr. Brownstein so miserably that he became the “holistic” doctor he is now. Be that as it may, that means that Dr. Brownstein is probably roughly my age, which means he’s probably 10-12 years from retirement, give or take; that is, if he retires at age 65. Board certification lasts ten years and very likely he’s taking the exam a year or two before his current board certification expires, meaning that, assuming he passed his exam, he’s probably good for another 11-12 years. See where I’m going with this? He’ll be good until the time he’s ready to retire or at least close to it.

This leapt out at me because I’ll be facing a similar situation soon. My board certification in general surgery will expire at the end of 2018, but this year I got a notice that I could take the recertification examination in November or December. Unfortunately, I didn’t get the notice until May and that my practice is super-specialized in breast cancer, which means reviewing all of general surgery will be a daunting task that I couldn’t manage in only six months as well as submit multiple grant applications this fall to keep my lab going. The bottom line is that I decided to spend all of 2017 reviewing and take the test in late 2017, a decision I’m comfortable with. More importantly, assuming I pass the recertification examination next year, that means my board certification will be good until the end of 2028, when I’ll be 66. You see where I’m going. Will it be worth it for me to recertify when I’m potentially that close to retirement? I have no idea. I might want to practice until I’m 70 or older if things are going well and I’m still enjoying it, or I might want to retire then, following the example of the professor who was most responsible for hiring me who retired last year at age 66. Who knows?

The point is that Dr. Brownstein is posturing most ridiculously. in 11 or 12 years he’ll be in basically the same position I will be: Close to retirement. Moreover, unlike me, since he isn’t associated with a hospital and doesn’t accept health insurance of any kind, he could easily keep practicing a few years after his board certification expires. Heck, he even admitted that he had considered not recertifying this time:

I have been Board-Certified in family practice since I graduated from my residency (with a short period where I missed taking the exam). I last recertified 10 years ago and when my letter came informing me that I would have to sit for another exam, I debated whether to do it.

You see, over the last twenty years or so, I no longer practice conventional family practice. Now, I practice holistic medicine. I still use much of what was taught to me in my training, but now, I primarily rely on items that support the body’s physiology and biochemistry and I strive to avoid using items that poison and block the body’s pathways. Unfortunately, nearly all of the drugs currently used in conventional medicine work by disrupting the body’s physiology and biochemistry by poisoning enzymes and blocking receptors. I have written about this extensively in my books, Drugs That Don’t Work and Natural Therapies That Do and The Statin Disaster.

This is, of course, a false dichotomy. Yes, one of the first things I was taught in physiology and pharmacology in medical school is that all drugs are cellular poisons in that they tend to block the function of some protein or cellular function or other to achieve their effect. Here’s the dirty little secret about “holistic” medicine: If an herbal “natural” medicine “works” it works by functioning like a drug, which means that it, too, is a cellular poison. It’s an adulterated drug whose potency will vary from lot to lot, but it’s a drug nonetheless. As for “supporting the body’s physiology,” what does that even mean? Take a look, for instance, at what sorts of treatments Dr. Brownstein offers:

• Acupuncture
• Massage Therapy
• Polarity Therapy
• Manipulative Medicine
• N.A.E.T.
• Micro-current Facials
• J.M.T.
• N.M.T.
• Emotional Freedom Technique (E.F.T.)
• Vitamin and Mineral Supplementation
• Intravenous Vitamin and Mineral Therapies
• Elimination and Allergy Diets
• Body Composition Analysis (B.I.A)
• Electro-Dermal Screening (E.D.S.) Full Bio-Profile Reports

I’ve written about several of these before, particularly acupuncture and intravenous vitamin therapies, both of which are, in my opinion (and that of pretty much every doctor with an understanding of science), pure quackery based on pseudoscience (intravenous vitamins) or prescientific beliefs (acupuncture) that in no way “support the body’s physiology and biochemistry.” I ask the same of emotional freedom technique, which is a treatment designed by a New Age energy healing guru who eliminated the need for all those nasty needles in acupuncture and claimed to cure people by tapping “meridians” with his fingertips. He also claims to be manipulating “subtle energies.” Another, NAET, which is described as a “non-invasive, drug free, natural solution to alleviate allergies of all types and intensities using a blend of selective energy balancing, testing and treatment procedures from acupuncture/acupressure, allopathy, chiropractic, nutritional, and kinesiological disciplines of medicine.” In other words, NAET is clearly nonsense. Electrodermal screening reminds me, more than anything else, of using a Scientology e-meter. No wonder Harriet Hall refers to it as “fooling patients with a computerized eight ball.”

The claim that any of these therapies, all of which are quackery other than massage therapy, “support normal physiology,” is risible in the extreme.

Dr. Brownstein further complains:

In my SEVEN (miserable) hour board exam today, I found myself getting more and more irritated. Nearly every question was about a drug—how it is used, the side effects associated with it, and how it interacts with other drugs. There were virtually no questions about the importance of diet or the importance of identifying nutritional deficiencies. In fact, I can’t recall one question along those lines. The patient vignettes that I suffered reading through were all the same—the patient was taking multiple drugs and I was asked one obscure question about the drug therapy prescribed to the patient. I actually felt bad for the poor patients in the vignettes as they were having their biochemistry poisoned with multi-drug prescription cocktails.

One wonders what Dr. Brownstein means by “nutritional deficiencies.” What “holistic physicians deem a nutritional deficiency is often related to what science deems a nutritional deficiency solely by coincidence. All too often, “holistic medicine” involves identifying and “correcting” nutritional “deficiencies” that aren’t through a battery of expensive laboratory tests and supplements. Indeed, there’s a whole branch of “holistic medicine” devoted to just that; i.e., functional medicine, or, as I like to call it, making it up as you go along. Guess where I found Dr. Brownstein’s CV? At the FMU website. FMU stands for Functional Medicine University, which is an online school, and Dr. Brownstein appears to be featured in several online video classes there. In any case, the problem with “holistic” medicine is that its practitioners attribute near magical—strike that, just magical—healing abilities to diet. There’s no doubt that diet and exercise are important to good health, but if you believe some alternative medicine practitioners, you’d think that diet can cure everything. I have little doubt that part of the problem Dr. Brownstein had with his recertification examination is that he shares this inflated view of the power of dietary interventions to cure just about anything.

I can’t help but also mention that he’s a graduate of the Desert Institute School of Classical Homeopathy, which makes his lecturing anyone on science…problematic. In other words, I remember that when I read this broadside of Brownstein’s:

I am amazed that the AAFP does not even acknowledge the importance of diet and nutritional support in their exam. Yes, there may have been a few token questions (but I can’t recall one), but they were few and far between. I guess the AAFP believes that prescription drugs can cure all that ails. It is too bad that the medical research does not support this idea.

And I am amazed that an actual physician who graduated from my beloved medical school where I am on faculty could believe enough in homeopathy to have take a class on it and potentially incorporate it into his practice. I find it simultaneously hilarious and pathetic that someone who offers acupuncture, EFT, NAET, and so many other unscientific and pseudoscientific treatments and have the temerity to lecture the AAFP, or anyone else in medicine, about science and the proper treatment of patients. It’s also not true that the American Academy of Family Physicians (AAFP) doesn’t consider diet important; it’s published a whole lot of monographs on nutrition. Its own recommended curriculum for family practice residents is peppered with statements like:

• “Nutrition is one of the most powerful interventions available.”
• “Nutrition counseling that targets dietary risk factors as primary prevention has the potential to significantly reduce mortality and morbidity throughout the life cycle.”
• “Nutritional interventions have the potential to reverse certain disease processes. Additionally, proper nutritional status can positively support medical interventions.”

One of the learning objectives is described thusly:

4. The role of nutrition in the prevention and treatment of specific diseases, including:

a. Cancer
b. Cardiovascular disorders
c. Dental disease
d. Endocrine disorders
e. Gastrointestinal disorders
f. Hematologic disorders
g. Renal disorders
h. Respiratory disorders
i. Bone and rheumatic disorders
j. Neurologic disorders
k. Skin conditions
l. Gynecologic disorders
m. Obesity

The list goes on. Read it for yourself.

Basically, Dr. Brownstein’s blog post amounts to a whole lot of sound and fury, signifying nothing. He postures about never taking the family practice recertification examination again, painting it as a principled decision when in reality it is mere petulance disguised as principle. Indeed, he doesn’t need to be board certified because he doesn’t take insurance or have hospital privileges and will need it even less, if at all, in ten years, when he will be much closer to retirement age. Then he whines because the test didn’t have on it what he thinks it should have on it and doesn’t encompass the way he practices medicine because, from my judgment of his website, he doesn’t practice science-based medicine.

You know what. Maybe Dr. Brownstein shouldn’t have taken the recertification examination. Science- and evidence-based medicine clearly isn’t for him.