“Innovation.” You keep using that word. I do not think it means what you think it means. – RESPECTFUL INSOLENCE

A week ago, I wrote about the reaction of COVID-19 vaccine quack Dr. Pierre Kory to learning that the American Board of Internal Medicine (ABIM) had informed him that its Credentials and Certification Committee had voted to strip him of his board certifications in internal medicine, critical care, and pulmonary medicine. Unsurprisingly, Dr. Kory’s reaction was to weaponize legitimate complaints about the ABIM that a number of physicians enrolled in its maintenance of certification program have made regarding its onerous expense and time commitment in order to portray the organization and its president as utterly corrupt and in the thrall of the powers that he views as forcing harmful vaccines and public health mandates in response to the pandemic in order to control the population. He also portrayed himself and his fellow quacks from the Frontline COVID-19 Critical Care Alliance (FLCCC) as brave maverick “innovators” whose “innovation” frightened the powers that be, such as the Federation of State Medical Boards (FSMB) and the ABIM.

As I’ve mentioned many times, quacks often portray themselves as misunderstood geniuses, “brave mavericks” who are “apart from the herd,” and, above all, “innovators” whose “innovation” threatens the established order in science and medicine. The examples are numerous, although octogenarian cancer quack Stanislaw Burzynski usually stands out to me as the example about whom I’ve written the most over the years. Of course, this self-image as masters of “innovation” resonates with the followers of quacks, as well as their fellow quacks, which brings me to a physician about whom I have been meaning to write for a while who goes under the pseudonym of A Midwestern Doctor, which I will henceforth abbreviate as AMD. AMD has a Substack called The Forgotten Side of Medicine, because of course he does. There, he defended Kory in a post entitled (predictably) What Happens To Doctors Who Innovate? It’s subtitled—because of course it is—”Lessons to be learned from the American Board of Internal Medicine.” (Personally, the main lessons I’ve learned from the ABIM are that it’s too timid to do what really needs to be done to deal with doctors like Pierre Kory, but that’s just me.)

You can probably see where this is going, but let’s see what AMD has to say:

Aha! Where Dr. Kory only dealt with what he saw as the “corruption” of the ABIM as the motivation for its war on “innovation” as exemplified by brave mavericks like him, AMD is going to take a broader view of The (Medical) Man’s war on “innovation” and brave maverick like Dr. Kory (and AMD, of course). Quacks also love to emphasize the “doctor-patient” relationship as their justification for their quackery versus science-based medicine, which they portray as cold, impersonal, and, yes, “algorithmic.” They also love to claim that there are “forgotten medical innovations” that they know about but medicine rejects because they “threaten” The (Medical) Man, or, as AMD puts it, the “medical monopoly.” This is a very old narrative, and AMD clearly believes himself to be “apart from the herd as well,” as can be seen by his attack on how education is carried out:

Almost all of my time in the educational system has followed the same pattern:

Information gets thrown at students, like spaghetti being thrown against a wall again and again, in the hope some of it will eventually stick. In my own case, since I tried to learn and understand the information when it first was presented, I “got it” and had the surreal experience of seeing what I was taught in eighth grade be thrown at the wall again and again well into my undergraduate degree.

Because of course he did. Maybe this is true. Maybe it’s just arrogance and an inflated view of himself filtered through the lens of his self-conception of himself as a brilliant medical iconoclast who sees what’s wrong with medicine and deconstructs it. That’s not to say that his criticism is entirely without merit. One piece of advice that he gives in this post actually stands out as good advice:

Whenever I give students advice on what specialty to go into, my advice is always the same: “you will make more money than you’ll ever need regardless of your speciality—pick the one you actually enjoy rather than the ‘better’ one that burns you out.”

That’s actually pretty good advice. Unfortunately, even as he points out how few listen to him, he can’t resist self-aggrandizement:

Unfortunately, most of them never follow my advice. As a result, many of classmates have reached their wits ends with medicine and often share how they are wondering when they can afford to retire, whereas I love what I do, I plan to practice until the end of my life, and I even have the bandwidth to take on the immense side-project of writing millions of words online to help set things right with COVID-19.

Because, to AMD, AMD is just that awesome. It’s tempting to say that I’ve done the same thing and have been at it not just for COVID-19 but for all of science-based medicine for much, much longer. Oh, wait. I just did. But, unlike the case for AMD, that’s all I’ll say about it. Of course, what do I know? I’m one of those subspecialists decried by AMD who’s spent so many years in training and apparently doesn’t have much to show for it, at least not to him:

Yet, the benefits of this proliferation of medical education are somewhat questionable—for example doctors during COVID-19 demonstrated less ingenuity and ability to adapt to the needs of their patients than doctors did a century ago during the 1918 influenza. Likewise, many of us (e.g., Pierre Kory) have noticed that the specialists are less able to help patients than general practitioners and typically all just say the exact same thing—especially within a hospital setting.

Of course, one of the advantages of subspecialization is to learn a specific field far deeply and broadly than the average physician. It never occurs to AMD that perhaps the reason that specialists “all just say exactly the same thing” is because they have deep expertise in their subject matter and try to practice evidence-based medicine. That’s why AMD attacks all of them saying “exactly the same thing” as though it were a bad thing! See also how AMD implicitly brags about how he and his fellow alleged “generalists” supposedly “see” so much more because they are generalists. While it is true that a generalist might see some things that a specialist might not, the real question is: How many of these “things” that they see are scientifically justifiable, rather than correlations that don’t indicate causation or efficacy of treatments? (Ivermectin comes to mind.) Let’s just say that someone like AMD, who recently posted that he found a Mike Adams video—a Mike Adams video!—called Vaccine Zombie to have been “prescient” is not someone who sees connections based in science

Here’s the video, in case you don’t remember:

Yes, I wrote about this video when it was initially published. Let’s just say that if you think Mike Adams is anything but a bonkers conspiracy theorist, you, too, are likely a bonkers conspiracy theorists (or at least well on your way to becoming one). Basically, the overall idea is that vaccines turn you into a zombie, as illustrated by the rather racist imagery of the nurse giving vaccines and the use of a very Michael Jackson-like dancing zombie.

It’s thus not surprising that AMD echoes Dr. Kory’s attack on the ABIM as “corrupt.” Basically, throughout the article, he describes the system of medical education as a “carrot and stick” approach, with the “carrot” being higher income as a subspecialist and the “stick” being sanctions like losing board certification or medical licensure for too much “innovation.” There’s even a whole section that might as well have been written by Dr. Kory all about the salaries of ABIM leaders, how much it charges for maintenance of certification, and its supposedly fascistic control of what doctors can say, leading to “censorship” and “cancelling.” Personally, my retort to this sort of argument is simple. If ABIM is all about such “control,” why did it take two to three years to act against “innovators” like Dr. Kory? Why did ABIM only go after a handful of the most egregious spreaders of COVID-19 misinformation, like Drs. Pierre Kory, Peter McCullough, and Paul Marik?

To AMD, it’s not just the ABIM, either. It’s the NIH and other federal scientific organizations that fund research. In particular, AMD doesn’t like the NIH panel that concluded that Dr. Kory’s “early treatments” were not supported by evidence:

Likewise, there has been a longstanding issue where corrupt panels are appointed to provide guidelines for treating diseases which always end up supporting the interests of the sponsors of those panels. This was best illustrated by the NIH panel that officially decided what treatments were appropriate to treat COVID-19 in the hospital which then became a de-facto law.  In the case of that panel, its members were directly appointed by Fauci (who was heavily invested in remdesivir), most of them had significant financial ties to remdesivir’s manufacturer, and not surprisingly, despite a lot of against remdesivir, they voted for their drug to be the standard of care for COVID-19, a decision that cost thousands of American lives.

Sadly, this is not by any means an isolated case and there are many other cases of corrupt panels pushing unjustifiable guidelines into medical practice (e.g., consider the recent decision to add the COVID-19 vaccine to childhood vaccine schedule despite children having a real risk of a vaccine injury but no risk of COVID-19). Likewise, prior to COVID-19, one of the most impactful examples was paid-off panel that decided everyone needed to be on statins even though an independent group using the same set of studies reached the opposite conclusion.

Hilariously, AMD claims that “Steve Kirsch recently wrote an excellent article highlighting three “scientists” whose guideline recommendations were ultimately responsible for the deaths of nearly a million Americans,” and cites a link is to one of Dr. Kory’s articles ranting about “corruption” in medicine for concluding that ivermectin doesn’t work and presenting the same dubious evidence that quacks have long liked to cite in favor of ivermectin. Again, ivermectin does not work against COVID-19. Even the cell culture data that led to the idea that ivermectin had antiviral activity against SARS-CoV-2, the virus that causes COVID-19, always showed that ivermectin was at best a highly implausible treatment given that the concentration needed to inhibit the virus is 50- to 100-fold higher than can be safely achieved in the human blood stream. Also, Steve Kirsch is one of the most unhinged antivaxxers whom I’ve ever encountered, and that’s saying a hell of a lot. Still, none of that stops AMD from claiming that “corruption” dictates the practice of medicine.

Similarly, AMD attacks scientific consensus:

Throughout COVID-19 we saw consensus-based medicine (CBM) masquerading as evidence-based medicine be forced upon America and had our eyes opened to exactly why EBM is so important the practice of medicine. CBM is why doctors were not allowed to utilize protocols they saw were keeping their patients alive and instead were forced to use protocols created by corrupt committees that killed thousands of Americans and created the urgent need for a vaccine to end the pandemic. Likewise, CBM was why an unproven, dangerous, and ineffective vaccine was allowed to remain on the market, why every doctor who challenged it was cancelled, and why the response to all these concerns was instead to mandate the vaccine and gaslight everyone who was injured by it.

This is basically the same old crank attack on scientific consensus that goes back to the old Michael Crichton quote about how “the work of science has nothing whatever to do with consensus” and there is “no such thing as consensus science,” in which he concluded boldly and foolishly, “If it’s consensus, it isn’t science. If it’s science, it isn’t consensus. Period.” I’ve addressed this nonsense multiple times before; so I’ll provide the TL;DR version: What is a scientific theory but the best, most reliable consensus about how a scientific phenomenon functions? What is evidence-based medicine but an expert consensus on what the evidence indicates to be medical practices most supported by science and evidence? What is science-based medicine but a consensus on what science indicates to be the medical practices most based in science? Science itself is the process by which we come to an agreement, a consensus if you will, about how nature works. Consensus is central to science. That’s not to say that the consensus shouldn’t be questioned. However, if you’re going to question an existing scientific consensus, don’t expect to be taken seriously if you can’t bring a level of science and evidence to support your “challenge”—your “innovation”—strongly enough to lead scientists to question the existing consensus.

Let’s just say that “questioning” of the scientific consensus on COVID-19 and COVID-19 vaccines by the likes of AMD and Dr. Kory isn’t based on anything near the level of evidence required to lead scientists and physicians to question that consensus. While it is true that anyone has the “right” to challenge a consensus, again, don’t expect to be taken seriously if you can’t back up that challenge.

AMD can’t resist citing examples of medical “innovation” that were either later found to be harmful or that were ignored by the medical establishment of the day. Unlike the FLCCC’s list of ways that the scientific consensus in medicine has changed before (and therefore my quackery is a valid challenge to it), which uncharacteristically left out the example of Ignaz Semmelweis, AMD definitely includes him. He also includes examples of frontal lobotomies (because of course he did). Again, it’s the same old tired trope in which quacks cite historical changes in the medical consensus, various medical fads, and examples of medical “innovation” that were later found to be harmful as though they justified their quackery. He also cites his rant against the NIH and the lack of “innovation” in medical research (which might be worth its own response by me), which might well be worth a separate post by me in the future. However, in reality, what AMD’s rant is ends up being nothing more than an attack on Peter Hotez and the NIH, filled with a large dollop of conspiracy mongering about the NIH grant process being a quid pro quo in which only scientists who support the existing power structure, a conspiracy theory that I’ve debunked in detail before. It’s clear to me from his rant that AMD has never served on an NIH study section and likely has never been the principal investigator on an NIH grant.

AMD concludes:

I believe if we allowed doctors who had the best intentions of their patients to innovate, the public would have much more confidence in the medical profession.

Of course he does. Unfortunately, AMD’s definition of “innovation” is the same as that of quacks since time immemorial, namely doing whatever they want, even when it’s not supported by evidence, and portraying themselves as brave mavericks whose “innovation” is rejected not because it has no scientific evidence to support it (or because evidence shows it to be harmful) but because it is a “threat” to The (Medical) Man.

The quack narrative never changes.