One of the most frequent ad hominem attacks leveled against those of us who try to educate the public about medical quackery, antivaccine pseudoscience, and the infiltration of pseudoscience and quackery into medicine in the form of “complementary and alternative medicine” (CAM) or “integrative medicine” is that we’re shills for big pharma. It’s such a common attack that I even coined a phrase to describe it. (Well, I think I coined the phrase; I could be wrong.) It’s known as the “pharma shill gambit“. The idea is as obvious as it is trite: to cast doubt on what defenders of science say about medical quackery by portraying them as in the pocket of big pharma. My frequent retort goes along the lines of, “Dammit, where is all filthy lucre I’m supposed to be getting doing this? Where is my mansion? Where is my Maserati?” Of course, I have none of these things. Don’t get me wrong. As an academic surgeon I make considerably more than the average person, but I’m just well off, not wealthy, and I don’t even make that much compared to the average surgeon in private practice with my level of experience. (Hell, I don’t even make as much as the radiologists at my hospital.) The point is, no one gets wealthy opposing pseudoscience. They do, however, become wealthy selling pseudoscience, as a recent Washington Post story about Dr. Joseph Mercola demonstrates.
I’ve always viewed the pharma shill gambit as projection that says a lot more about the person using it as an attack than it says about the target. After all, the assumption behind the pharma shill gambit is that no one would defend science-based medicine without a financial interest, rather than because of a deeply held belief that SBM is best and a desire to protect patients from the harms of quackery and medicine from the corruption of infiltrating pseudoscience. Perhaps the shill gambit is more properly turned back on antivaxxers, as you will see, or perhaps particularly when it comes to antivaxxers.
The Washington Post digs into alternative health tycoon Dr. Joseph Mercola’s history and activities
Let’s first look at the dramatis personae of this particular story. They are two people whom I’ve written about many times over the last 15 years, both here and at my not-so-secret other blog. First, there’s Joseph Mercola, DO, a doctor who over the last 20 years or so has built an online alternative health empire. (He’s even appeared on The Dr. Oz Show.) Then there’s Barbara Loe Fisher, whom I like to refer to as the grande dame of the modern antivaccine movement, given that she runs the oldest antivaccine group in existence, the Orwellian-named National Vaccine Information Center, which really should be called the National Vaccine Misinformation Center. In the early 1980s she became convinced that the DPT (diptheria-whole cell pertussis-tetanus vaccine) had caused neurologic injury to her child. Subsequent evidence has shown no link between DPT and neurologic injury, but at the time there were several case reports and a sensationalistic news report, DPT: Vaccine Roulette, which first aired on a local NBC affiliate in Washington DC in 1982, and then ultimately nationally on The Today Show. Three years later, Barbara Loe Fisher and Harris Coulter published a book, DPT: A Shot in the Dark. It was the fear caused by these reports and efforts that led to a tsunami of lawsuits against the manufacturer of the MMR that threatened the vaccine supply and led Congress to pass the National Childhood Vaccine Injury Act of 1986, which established the Vaccine Court.
Now, on to the story by Lena Sun and Neena Satija, “A major funder of the anti-vaccine movement has made millions selling natural health products“:
The nation’s oldest anti-vaccine advocacy group often emphasizes that it is supported primarily by small donations and concerned parents, describing its founder as the leader of a “national, grass roots movement.”
But over the past decade a single donor has contributed more than $2.9 million to the National Vaccine Information Center, accounting for about 40 percent of the organization’s funding, according to the most recent available tax records. That donor, osteopathic physician Joseph Mercola, has amassed a fortune selling natural health products, court records show, including vitamin supplements, some of which he claims are alternatives to vaccines.
In recent years, the center has been at the forefront of a movement that has led some parents to forgo or delay immunizing their children against vaccine-preventable diseases such as measles. Health officials say falling vaccination rates contributed to the infectious virus sickening more than 1,200 people in the United States this year, the largest number in more than 25 years. Measles outbreaks are surging worldwide, including in Samoa — where nearly 80 people have died since mid-October, the great majority of them young children and infants.
How rich has Mercola become selling “natural health” products? Very wealthy, and the NVIC is not the only antivaccine group to which he contributes:
Mercola, whose claims about other products have drawn warnings from regulators, has also given at least $4 million to several groups that echo the anti-vaccine message. His net worth, derived largely from his network of private companies, has grown to “in excess of $100 million,” he said in a 2017 affidavit.
Yes, you read that right. Mercola’s net worth is over $100 million! I must admit that even I didn’t think Mercola was that loaded! When last I wrote about his online health empire in 2012 in response to a previous news story about his links to the antivaccine movement, I drily noted that Mercola is “rich, as in filthy rich, as in ‘rolling in the dough rich, as in ‘raking it in hand over fist rich,’ adding that after all, “he had a spare $1 million lying around to give away to the NVIC and various other quackery-promoting groups.” (Remember, this was 2012. He’s given a lot more to the NVIC and antivaccine groups since then.)
I’ve also mentioned the utter quackery that Mercola regularly publishes on his site, and so does this story:
Last month, Mercola wrote on his website that measles “continues to be a Trojan Horse for increasing vaccine mandates.” A page that was recently removed said that “vitamin C supplementation is a viable option for measles prevention.” Elsewhere on the site, a page about vitamin D includes the headline, “Avoid Flu Shots With the One Vitamin that Will Stop Flu in Its Tracks.”
I do like Mercola’s weaselly pseudo-denial:
He declined to be interviewed and did not respond to questions about how much profit his vitamin D and C supplements generate relative to the rest of his wide-ranging merchandise, which includes organic cotton underwear and pet food. Supplements containing those vitamins are among Mercola’s “top products,” his website says.
In a statement, his media team said the claims on Mercola’s website relate to vitamin D and vitamin C generally and “do not mention Dr. Mercola’s products whatsoever.”
Sure, but there are convenient links to Mercola’s online store all over his website. When looking at someone like Joe Mercola, always consider the profit motive. Much of his site is in reality nothing more than advertisements for his products cleverly disguised through plausible deniability, in the form of no direct mention of his products, as neutral information on “natural health”.
Also, in the interests of full disclosure, a certain SBM blogger was interviewed for this story, and he pointed out how Mercola’s grift works:
“He mixes the boring, sensible health advice with pseudoscientific advice in such a way that it’s hard for someone without a medical background to figure out which is which,” said David Gorski, an oncologist and surgeon at Wayne State University who is widely regarded as a leading expert on the anti-vaccine movement.
I don’t know if I’m “widely regarded” as an “expert” on the antivaccine movement, but I do have 15 years of experience countering it, more if you count my time before I started my personal blog. I guess that counts.
The validity of my “expertise” notwithstanding, the above is the same sort of antivaccine misinformation that Mercola has been peddling ever since I first became aware of him, and certainly long before that. Indeed, Mark Crislip was deconstructing Mercola’s antivaccine misinformation ten years ago, during the H1N1 pandemic. Not long after, Joe Albietz took on his fear mongering about Gardasil and squalene adjuvants. Around the same time, I first noted that Joe Mercola had teamed up with Barbara Loe Fisher and the NVIC to declare November 1-6, 2010 “Vaccine Awareness Week,” which really should have been called “Vaccine Fear Mongering Week”. They’ve done the same thing almost every year since. Back then, they were also using Mercola’s money to buy antivaccine ads to be run on by CBS on the Times Square JumboTron and to include antivaccine “PSAs” on the in-flight entertainment system for Delta Airlines.
Of course, Mercola’s quackery goes far beyond antivaccine quackery to include thermography for breast cancer, misinformation about screening colonoscopy for colorectal cancer, homeopathy, and, most ridiculous of all, Tullio Simoncini’s cancer quackery. Simoncini, some might recall, claims that all cancer is really a fungus because it’s “always white” and treated cancer by injecting it with baking soda. That still remains among the most ridiculous “alternative cancer cures” I’ve ever seen in the 20+ years I’ve been paying attention to such things, and I’ve only touched the surface of the full breadth and depth of the pseudoscience Mercola has been promoting for the last 20+ years.
The rise of a quack tycoon
The story of how Mercola rose from simple primary care DO to alternative health tycoon is a familiar one. It was told in 2012 Bryan Smith for Chicago Magazine entitled “Dr. Mercola: Visionary or Quack?“, which noted:
In 1997, as a way to share what he had found that would be “useful and helpful,” he started Mercola.com. It proved a hit. But because it didn’t charge for content or accept ads, it was also a money drain. In the first three years, Mercola estimates that he spent half a million dollars on the site. To keep it afloat, he says, “I had three options: to get paid subscribers; to sell information, which I didn’t want to do; or to sell products, which is what I wound up doing. . . . The purpose for selling items is to have a revenue stream so we can pay our staff to provide information to educate the public and make a difference and fund [our] initiatives.”
The success of the site gave a significant boost to his practice, Mercola says: “I had people flying in from all over the world. It always puzzled me: when people came in, I wouldn’t tell them anything different than I had written on the site. They could have just as easily looked it up for free. But they had to hear it from me.” (Mercola stopped practicing medicine six years ago to focus on the website.)
It’s actually an interesting issue. I’m sure that the website probably was costing Mercola a lot of money. Bandwidth charges were higher back then. Of course, this is a very seductive trap. If you start selling products to support the website, then it’s very easy for the website to turn into a marketing arm whose purpose is selling product. The two functions feed off of each other, and that’s exactly what appears to have happened over the next few years. In the process, Mercola became incredibly wealthy.
In Satija and Sun’s reporting:
By the mid-2000s, Mercola’s focus was shifting to selling products. “I didn’t want to advertise products and businesses that I didn’t trust or believe in — so I formulated, tested, and sold my own brand of products to support the website,” he said in an email.
Susan Woller, then Mercola’s director of business development, described him in an interview as an “excellent marketer” and “voracious learner” who developed ideas on everything from new protein bars to safer cookware. She said his profit margin increased dramatically as he shifted to marketing products under his own brand. She declined to say by how much.
“He is doing all the research and delivering information to his readers,” Woller said. “When you do that and you marry that with a product that you’ve private-labeled, and people respond to that, you can’t help but make some money off it.”
I love how Mercola deludes himself that the purpose of selling products was to support the website. That might have been true initially, but it’s very clear from his history that selling products soon became the main purpose of the website. After all, your net worth won’t grow to $100 million if you’re just selling enough products to support the cost of bandwidth, maintaining a website, and paying writers for any content that you don’t write yourself. Your net worth can only grow to $100 million over two decades if you’re selling a lot of items at a generous markup, and even then most successful businesses aren’t nearly that profitable. As Satija and Sun report, by the time Mercola stopped seeing patients for good in 2009, his businesses were generating $3 million a month.
Meanwhile, Mercola ran afoul of the FDA and FTC, receiving several letters, first in 2005 and 2006 pointing out that his claims for his supplements were medical claims, leading Mercola to place a quack Miranda warning on his website: “These products are not intended to diagnose, treat, cure, or prevent any disease.
Then:
In 2011, Mercola received another warning from the FDA, this time regarding his claims about thermography, a procedure in which an infrared camera detects patterns of heat and blood flow in the body. The agency wrote that he inaccurately claimed thermography was more sensitive than mammography in detecting diseases such as breast cancer and threatened to impose fines or take other action if those statements were not rescinded.
And:
In 2016, in response to a complaint from the Federal Trade Commission, Mercola refunded nearly $2.6 million to more than 1,300 people who bought tanning beds that he claimed could reduce the risk of skin cancer. The FTC said the claims constituted a “deceptive act,” pointing out that the product could actually increase the risk of skin cancer.
Truly, the grift is strong in this one.
The pivot
A key question examined in this article is: Why? Why would a natural health tycoon like Joe Mercola (and I do think “tycoon” is a good description of him) see advantage in contributing to antivaccine groups like the NVIC?
Satija and Sun correctly note the relationship between the antivaccine and “natural health” movements and the unraveling of what was the key antivaccine claim that vaccines cause autism in the wake of Brian Deer’s reporting revealing Wakefield’s scientific fraud, Wakefield’s being “struck off” by the UK General Medical Council (losing his license to practice, in US parlance), and his subsequent firing from his job as medical director of Thoughtful House in Austin, TX. As a result of this:
The anti-vaccine movement began pivoting to a broader message blaming vaccines for numerous illnesses. That aligned with growing interest in alternative medicine and increasing skepticism about the government’s role in parental decision-making.
The resurgent movement found a handful of wealthy patrons, including hedge fund manager and philanthropist Bernard Selz and his wife, Lisa. The Selzes gave $200,000 to a legal fund for Wakefield in 2012, and they went on to give more than $3 million to anti-vaccine groups, including one that held forums this year in Brooklyn, the epicenter of the measles outbreak, The Post previously reported.
The $2.98 million Mercola has given to Fisher’s group since 2009 came from the Natural Health Research Foundation, a private foundation that is entirely funded by his business and that he leads as president, tax records show.
Over the same time period, as I’ve noted, the antivaccine movement itself pivoted from a message that vaccines were the key cause of autism, whether it was the MMR or the mercury in thimerosal, a preservative used in multidose vials of several childhood vaccines until the CDC recommended its removal in 1999, a removal that was completed by 2002. They had to. Wakefield had been revealed as a fraud, and it was very clear that mercury in vaccines as a cause of autism had become a failed hypothesis in the wake of several studies. It was thus advantageous for antivaxxers to more vocally blame vaccines for more diseases and conditions, ones that they had always considered to be due to vaccines anyway but that had been far less emphasized than autism, while at the same time broadening its claims for autism causation. This is a process that began before Wakefield’s downfall between 2010-2011. Here’s an example.
Back in 2007, Generation Rescue’s website read:
Generation Rescue believes that childhood neurological disorders such as autism, Asperger’s, ADHD/ADD, speech delay, sensory integration disorder, and many other developmental delays are all misdiagnoses for mercury poisoning.
When you know cause, you can focus on cure. Thousands of parents are curing their children by removing the mercury from their children’s bodies. We want you, the parent, to know the truth.
Generation Rescue is, of course, the antivaccine group founded by J.B. Handley and his wife, the group for which Jenny McCarthy served as the public face for many years beginning around this time. Then, sometime in April or May 2007, the message changed:
We believe these neurological disorders (“NDs”) are environmental illnesses caused by an overload of heavy metals, live viruses, and bacteria. Proper treatment of our children, known as “biomedical intervention”, is leading to recovery for thousands.
The cause of this epidemic of NDs is extremely controversial. We believe the primary causes include the tripling of vaccines given to children in the last 15 years (mercury, aluminum and live viruses); maternal toxic load and prenatal vaccines; heavy metals like mercury in our air, water, and food; and the overuse of antibiotics.
Of note, by this summer Generation Rescue had totally rebranded itself in the service of autism grift. Basically, Generation Rescue has deemphasized its antivaccine stance in favor of a more general “natural approach” to treating autism with quackery that’s commonly known as “autism biomed.” There’s way more money to be made there anyway, just as Joe Mercola sees how much money there is to be made by appealing to antivaxxers and selling them “natural” health and “natural” cures.
In the end, the relationship between quacks like Joe Mercola and the antivaccine movement is a symbiotic relationship. Both parties benefit. Antivaxxers benefit from the infusion of cash and the influence they gain among advocates of “natural health”. Similarly, woo tycoons like Mercola benefit from selling their wares to antivaxxers who think that they can “recover” their children with autism, whom they view as having been “stolen” from them by vaccines.
As for the claim that those of us who combat antivaccine pseudoscience are “pharma shills,” let’s just say that, given what I’ve learned about Joe Mercola, thanks to Lena Sun and Neena Satija, I conclude the real shills are those promoting antivaccine misinformation, like Barbara Loe Fisher.