Antivaccine Pseudoscience at the Cleveland Clinic: That’s What Happens When You Allow Magical Thinking to Take Hold [Respectful Insolence]

Over the weekend, a most unusual social media firestorm erupted in response to a blog post by Daniel Neides, MD, MBA, Acting Medical Director of the Tanya I. Edwards Center for Integrative Medicine, Vice Chair and Chief Operating Officer of Cleveland Clinic Wellness, as well as the Associate Director of Clinical Education for The Cleveland Clinic Lerner College of Medicine (CCLCM), where he oversees all clinical activities during years three through five of the medical school. The reason for the social media uproar was that Dr Neides’ post, entitled Make 2017 the year to avoid toxins (good luck) and master your domain (Google cache version here, as long as it lasts.), was basically an antivaccine rant, full of pseudoscience about “toxins” and fear mongering about vaccines and autism.

The full story is related at a blog that you are probably familiar with in a post by someone you might know, complete with a deconstruction of the antivaccine nonsense in Dr. Neides’ post. Others, including Skeptical Raptor and Tara Haelle, have also begun the deconstruction, while ZDoggMD posted an epic rant to Facebook:

For purposes of this post, I’m less interested in the specific antivaccine misinformation, pseudoscience, and lies contained in Dr. Neides’ post than I am in a bit of a broader question. Before I get to that, I do feel obligated to relay a bit more about what happened over the weekend after the rant was posted. On Sunday, Dr. Neides issued a very unconvincing apology, saying that that he “fully supports vaccination” and was only trying to open a conversation about their safety, not question their use. Later, through a Cleveland Clinic spokeswoman, he issued this statement:

I apologize and regret publishing a blog that has caused so much concern and confusion for the public and medical community,” the statement said. “I fully support vaccinations and my concern was meant to be positive around the safety of them.

Given that Dr. Neides’ post was full of loaded language about how angry he was about “toxins” and featured his likening vaccination to people being “lined up like cattle and injected with an unsafe product,” I had a hard time believing that the good doctor was entirely sincere, if you know what I mean. After all, his imagery of cattle going to the slaughter is a common one used by antivaccine ideologues. The only positive thing I could say about Dr. Neides’ original post was that at least he refrained from using the word “sheeple” to describe those being vaccinated. Given the spittle-flecked screed he produced, I can only imagine this took extreme self-restraint on his part.

Also on Sunday, The Cleveland Clinic released a statement:

Cleveland Clinic is fully committed to evidence-based medicine. Harmful myths and untruths about vaccinations have been scientifically debunked in rigorous ways. We completely support vaccinations to protect people, especially children who are particularly vulnerable. Our physician published his statement without authorization from Cleveland Clinic. His views do not reflect the position of Cleveland Clinic and appropriate disciplinary action will be taken.

This is, of course, the bare minimum The Cleveland Clinic could have done, but I rather suspect its leadership is waiting until today to figure out what to do.

In most of the Tweets and blog posts, the main concern was with deconstructing everything that was wrong in Dr. Neides’ post (and there was plenty that was wrong), castigating The Cleveland Clinic for having someone like that on its faculty and staff, and demanding that The Cleveland Clinic do something, in particular fire Dr. Neides and clean up the quackery. That’s all well and good, but I also noted that there were Cleveland Clinic physicians who, seemingly shocked that this sort of thing could have emanated from faculty at their institution.

Indeed, I do feel for the science-based physicians and scientists who work for the Cleveland Clinic, and there are a lot of them. I really do. They’re there, working at an institution they view to be evidence-based taking care of patients as well as they can using evidence-based guidelines and doing clinical research to advance the field, blissfully unaware of what really goes on at the Edwards Center for Integrative Medicine and the Wellness Institute affiliated with their institution. Like most physicians who don’t take a interest in combatting quackery or in just how much quackademic medicine has infiltrated medical schools and academic medical centers, they have no clue just how bad it is. Then something like this happens, and they can’t believe it. Their first instinct is to go on defense. Indeed, Amrit Gill, the patient safety officer at The Cleveland Clinic, took to Twitter to defend her institution:

@tarahaelle one doctor does not represent all of @ClevelandClinic. Overwhelming majority docs support vaccines and evidence based medicine.

— Amrit Gill (@amritgillmd) January 8, 2017

A cutting response followed:

If that’s true, then why do @ClevelandClinic docs tolerate rank quackery like reiki, functional medicine, and TCM at the Wellness Institute? https://t.co/TyLV5Wrtwh

— David Gorski (@gorskon) January 8, 2017

Another Cleveland Clinic doctor, quite understandably, protested:

Dr Cosgrove is himself very big proponent of vaccination and flu shot so definitely not CCF position by any means @tarahaelle @CleClinicMD

— gursimran kochhar (@GKochharMD) January 8, 2017

He’s referring to Delos Cosgrove, MD, the president and chief executive officer of Cleveland Clinic. As such, Dr. Cosgrove must have at least signed off on the creation of the Wellness Institute and the Edwards Center for Integrative Medicine, if not been actively involved in their creation. He must have signed off on the creation of the Clinic’s traditional Chinese medicine herbal clinic. Surely he must have approved the expansion of integrative medicine in the pediatrics department. Surely he must have been involved in the recruitment of Dr. Mark Hyman and the creation of his Center for Functional Medicine at the Clinic. Surely he must be pleased that this clinic has been so successful that it’s expanding rapidly, planning to double to accommodate a waitlist of over 1,000 patients.

I also can’t help but wonder if Dr. Cosgrove knew at the time The Cleveland Clinic recruited Dr. Hyman that Hyman was well known for attributing autism to toxicity from vaccines. OK, that was several years ago. So let’s see about something more recent. I wonder if Dr. Cosgrove knew that, at the time of his recruitment, Dr. Hyman had just co-authored a book with antivaccine crank, Robert F. Kennedy, Jr., Thimerosal: Let the Science Speak: Mercury Toxicity in Vaccines and the Political, Regulatory, and Media Failures That Continue to Threaten Public Health. He should have, as the book was published before the Center for Functional Medicine was announced, and Hyman had appeared on The Dr. Oz Show with his co-author less than two weeks before the center was announced.

If Dr. Cosgrove is very much pro-vaccine, it apparently wasn’t enough to keep him from hiring a doctor who had just co-authored a book fear mongering about thimerosal in vaccines, probably contemporaneously with his recruitment, to run a major new center at The Cleveland Clinic. I thus call bullshit that Dr. Cosgrove is truly pro-vaccine. At least, he’s not pro-vaccine enough to actually do anything about it when it interferes with potential profits, such as putting the kibosh on recruiting Dr. Mark Hyman. It needs to be emphasized to Dr. Cosgrove that if you, as an institution, cultivate an institute where the culture is steeped in magical thinking, you should not be surprised if that magical thinking won’t necessarily stay limited to areas where it’s not harmful. It will spread and metastasize. The Cleveland Clinic has for the last 10 or 15 years actively cultivated quackery in its Center for Integrative Medicine. Given how much of the quackery being “integrated” shares DNA with antivaccine quackery, it’s really no surprise that there are at least two antivaccine physicians, Mark Hyman and Daniel Neides, high up in the food chain at The Cleveland Clinic.

There’s no way around it. In the end, it must be pointed out that the Cleveland Clinic brought this PR debacle on itself. It was basically inevitable that antivaccine pseudoscience would eventually rear its ugly head in some form or another the moment the Clinic embraced quackery wholeheartedly for its Wellness Institute. Indeed, I welcome this PR meltdown, because I hope that it will finally shine a light on the utter quackery that has been promoted by the Cleveland Clinic over the last decade at least and how that quackery is inseparable from the antivaccine quackery promoted by Dr. Neides in his post. I also hope that this debacle shines attention on Dr. Hyman as well, who has largely gotten a pass.

This is what happens when medical academia coddles quacks. The magical thinking will not be constrained.