when doctors catch a really dangerous case of chemophobia

While it may be soothing to think that quacks and cranks who vilify one of the most effective disease prevention programs in history are restricted to the web or shady offices of people who pretend to be doctors but aren’t, but unfortunately, you can find them in places that should theoretically be more or less immune from them. A recent example is a family doctor and COO of the Cleveland Clinic who took to a local news site to uncritically regurgitate the pseudoscience spread by “anti-toxin” alt health gurus. Not only does he fearfully lash out at the “80,000 chemicals present in our environment” but recites long debunked junk science that vaccines cause autism and ADHD. I honestly couldn’t tell the difference between his screed and that of the Food Babe were their names removed from the bylines, that’s how utterly brain-meltingly unscientific his views were. And because he’s a doctor and has an inordinate amount of power at a prestigious medical system, all of his ideas are downright dangerous for millions of present and future patients.

The gleeful anti-vaxxers in the comments will jump up and down to tell you that his views are indeed dangerous because they threaten to upset the Big Pharma money train that is mandatory vaccinations for many day cares and schools, as they always do on cue. However, according to the WHO, vaccines are far from a cash cow for pharmaceutical companies because they make up less than 3% of these companies’ global market. Sure, the $24 billion in sales sounds like a lot but it’s not nearly as impressive when you consider that the industry’s overall annual sales hover around $1 trillion. Anti-vaxxers charge that such stats obscure the true conspiracy behind vaccines, that they might be just a tiny part of Big Pharma’s business overall, but the side-effects that cause autism and ADHD generate far more. But that notion also falls flat on its face because there are no drugs intended to treat autism and the market for prescription stimulants to treat ADD and ADHD peaked at $9 billion, less than half the size of the already very small vaccine market.

So where does Big Pharma actually make its money? Primarily it’s through sales of oncology treatments, and drugs to help manage chronic conditions like diabetes, pain, anxiety, and depression. Those products accounted for over $486 billion in revenues in 2015, and much of the rest consists of over the counter medications, and treatments to battle various infections. Add to these basic numbers the fact that autism is now clearly understood to have genetic causes, and the rise in diagnosing it seems to be a combination of diagnostic substitution and an overall awareness that it is in fact a very real and identifiable neurological condition, not just bratty kids needing a firm hand from the parents to learn how to behave in public, and you can see that the whole premise doesn’t make any sense, financially or scientifically. Even the anti-vaxxers’ own custom designed and ordered studies failed to show that any of their hypotheses cause any kind of neurological damage, making all other arguments irrelevant because the whole premise is bunk, though they refuse to accept the results of their own experiments.

And since the premise is wrong, virtually every argument brought up in the op-ed in question is wrong by extension. There is no scientific debate about vaccine schedules or toxicity. Not only are the schedules presented by anti-vaxxers outright lies, but the existing schedules are carried out with purer, more advanced vaccines that lowered antigen loads by 95% from 30 years ago. There is also no debate about herd immunity, or whether sanitation is what finally led to the massive drop in childhood diseases. We know that it exists, and we also know that while sanitation played, and still plays a huge part on stopping new cases of measles, polio, smallpox, mumps, and more than a dozen other diseases we’re on the verge of eliminating, the massive reductions only happened after the introduction of vaccines. A doctor who doesn’t understand the elementary basics of immunology and ignores very clear and confirmed evidence in favor of vaccination is not going to help his patients, and is bound to try to lead his colleagues astray.

This extends to his chemophobia as well. Telling people that there are over 80,000 chemicals in the environment means nothing because nature is made of chemicals, and if you look hard enough, you will find traces of just about anything and everything in your body. Which people do before they rush off to risk their health and waste thousands “detoxing” themselves. It’s true that not all chemicals we get exposed to are benign, and there have been rather unsavory corporate shenanigans which tried to hide certain pollutants we’re sure cause cancers, birth defects, and neurological damage. But dose makes the poison, so the vast majority of people aren’t in any danger because they are very seldom exposed to harmful quantities of these chemicals. Again, a doctor who doesn’t know such basic facts and is ready to send patients on an expensive, unnecessary, cargo cult science regimen of detoxing from all the evil chemicals because he simply can’t understand the concept of dosages, is doing them a serious medical and financial disservice.

Anyone who rants about the evils of poison in a white coat, using his or her medical license in lieu of actual proof is not a trustworthy doctor. There’s a good reason why anti-vaxxers and chemophobes typically gather in the cozy echo chambers of mommy blogs, and sites where businessmen dismiss any scientific credential or research as inferior to their experience in accounting and sales rather than have leadership positions in prestigious hospitals. They are not interested in science or evidence, only preaching from their terrified and anti-intellectual soapboxes, claiming to speak truth to power and expose conspiracies by evil pharmaceutical companies and doctors they blame for all that’s wrong with the world. And it appears that Dr. Daniel Neides wants to join them, echoing every anti-vaxx trope debunked by everyone and their grandma for the last decade, adding not a single new argument or idea, as if he outsourced the whole thing to the cranks at Age of Autism and refused to proofread it. So if you are ever a patient at the Cleveland Clinic, it may be a good idea to ask your physician what he or she thinks about vaccines. And if you get chemophobic fearmongering in reply, ask for someone else…

Update: another important note is that Dr. Nides is the medical director of the Cleveland Clinic Wellness Institute, a new hotbed of what many skeptic, evidence-based doctors call quackademic medicine. Dr. David Gorski has his trademark longform dissection of the Clinic’s flirtations for alt med if you’re interested in more context on the subject.