A Doctor’s War Against the Right-Wing Medical-Freedom Movement

In the face of these powerful forces, Gorski, motivated by his inner moral compass, had the courage to keep throwing stones. In April 2021, when celebrity doctor Drew Pinsky argued that vaccine passports “segregate people and strip them of their freedom to travel internationally,” his claim sparked a Gorski-Pinsky Twitter tiff. Gorski said that Pinsky was the latest of a growing number of M.D.s who were playing into the hands of the anti-vaccine movement. “These once-respected doctors,” he wrote, “are pathetic shells of their former selves, scientifically speaking.” Pinsky made an effort to reach out to Gorski, but Gorski refused to get on the phone with Pinsky.

To Gorski, the stakes seemed too high for him to be forgiving. In July and August 2021 alone, the health-freedom movement’s success in spreading vaccine hesitance resulted in an estimate of at least 16,000 unnecessary American deaths due to undervaccination in communities. Dr. Peter Hotez, a vaccine researcher and medical doctor, said in a video for the World Health Organization that 200,000 Americans had died in the last half of 2021 and early 2022 because they refused a Covid vaccine. In this context, anything less than full-throated support for vaccines from a person of influence is potentially deadly.

Some leaders in the public health sphere have been working to understand how to prevent those deaths, and have rolled out public health education campaigns, such as those encouraging indoor mask use, that try to cultivate a tone that will be palatable to their target audience. Gorski’s far more bristling approach, birthed in the baptismal fires of Usenet flame wars, is a good representation of skeptic culture, where the quality of the information is far more important than civility.

That attitude might be counterproductive.

Pinsky said he’s “an absolute fan” of website Science-Based Medicine’s goals and overall efforts, but also sees in them “a hubristic attitude that bugs” him. The magician (and skeptic) Penn Jillette called skeptics “one of the most entitled communities ever.” And when philosopher (and blogger) Massimo Pigliucci left the movement, he described “an ugly undertone of in-your-face confrontation … a willingness to engage in public shaming and other vicious social networking practices.”

If the point of medical skepticism is to humiliate quacks in front of a small but appreciative choir, tone doesn’t matter. But if the goal is to expand a movement, the marketing of the message is as important as the message itself.

Gorski is unlikely to overhaul his tone at this point, but his recent reflections on 18 years spent battling misinformation have led him to explore a new tactic of his own. Quacks, he now realizes, “are not a legion of independent frauds.… The more time goes on, the more I appreciate that it’s not enough to debunk various claims. I think it’s necessary to do pre-bunking.”

Pre-bunking? The idea is a sort of Grand Unified Theory of anti-quackery.

“All anti-vaccine claims are based in conspiracy theory. All science denial is a conspiracy theory,” Gorski explained. These quacks rely on the same rotten framework: that a massive network of compromised individuals is working to prop up the medical-governmental industrial complex.

This idea is difficult to debunk, largely because there is a kernel of truth to it. An analysis of public data, published in JAMA Internal Medicine, showed that, between 1999 and 2018, the pharmaceutical and health product industry spent more than $6 billion on campaign contributions, outside groups such as super PACs, and lobbying. And the Center for Public Integrity cited examples of drug companies influencing the committees that advised states on Medicaid by buying members dinners, hiring them for consulting gigs, convincing speakers to give favorable testimony without disclosing financial ties, and even filling out the doctors’ paperwork needed to get costly drugs approved by state Medicaid programs.

But there’s a difference between understanding that corporate lobbying subverts the public interest, and a conspiracy theory, touted by medical-freedom advocates, that the entire system—including a robust network of media and patient advocacy groups—is controlled by shadowy figures that impose harmful vaccines and drugs on the public.

Unlocking the key to exposing that falsehood could help Gorski debunk a thousand quacks in one fell swoop. But for now, the Trojan Horse was admitted, the ghost is in the machine, and the patients are running the asylum. Gorski said that the influence of the health-freedom movement winds up politicizing the decisions of public health officials and M.D.s.

The politics interfere with “doctors and physicians doing their job,” he said. “The misinformation gets into the government, which starts to meddle with what the scientists do based on the misinformation.”

This understanding, shared by many medical science skeptics, creates an odd sort of rhyme with their ideological foes. In their argument, the entire medical ecosystem—doctors, the government, academic researchers, the World Health Organization—is in thrall to alternative-medicine shills, colluding in a plot that keeps people sick to maintain profits.

Gorski persists in his quack-bashing passion, now buttressing his blog posts with a relentless stream of sharp-elbowed tweets. He used to enjoy contradicting a wrong for the sake of it. Now, the project sometimes feels hopeless. A 2018 survey found that 39 percent of Americans incorrectly believe alternative medicine alone can cure cancer; among young adults aged 18 to 37, the number was even higher, 47 percent. And research shows that people who feel positively about alternative health are more susceptible to medical misinformation.

Though he thinks victory may be a generation away, Gorski continues, attacking mountains with a mallet, bailing the tide with a teaspoon. If current trends continue, the standard of truth he is upholding will soon be so out of sync with accepted medical practice that he himself will be fighting for the alternative point of view.