Mark Geier: My therapy is unconventional, but it works

17 Jun

Dr. Mark Geier is appealing the suspension of his medical license. The license suspension order includes (as summarized by Kathleen Seidel at Neurodiversity.com):

• In six out of nine of these cases, the board determined that the children were misdiagnosed with precocious puberty. Children were diagnosed with precocious puberty without the benefit of a physical examination; some were too old to qualify for the diagnosis.

• Medical records and medical necessity letters prepared by Dr. and Mr. Geier indicated that children were diagnosed not only with precocious puberty, but also with pituitary dysfunction, insomnia, aggression, mitochondrial disorder, metabolic dysfunction, and “heavy metal toxicity” when neither test results nor parent reports suggested anything of the sort.

• In one case, the only record of the diagnosis of precocious puberty was a code number entered onto a standing order for lab tests. In another, no note was made in the medical records of the date the child began treatment with Lupron. Yet another patient’s file contained no indication that Dr. Geier reviewed any of the results of the numerous, burdensome diagnostic tests he had ordered.

• The order describes claims submitted to at least one insurance company for a psychiatric interview and “prolonged evaluation and management” services that were never rendered.

• The order further describes an occasion when David Geier, who is not licensed to practice medicine, conducted a medical evaluation and diagnostic tests, made diagnoses, and recommended treatments for an autistic boy in Dr. Geier’s absence.

• Additionally, the Board determined that Dr. Geier misrepresented his qualifications as a geneticist, and misrepresented the ability of his Institutional Review Board to conduct oversight of his research.

Dr. Geier has taken his case to the public in an opinion piece in the Baltimore Sun: Autism doctor: My therapy is unconventional, but it works. He certainly has the right to present his case to the Sun, and while I would not have published the letter were I editor, the Sun is within its rights to host the letter. I am within my rights to comment on the letter, and I took that opportunity in the comments as you will see (complete with typos) if you follow the link.

Dr. Geeir opens with a simple statment “If there’s a single statement that everyone who works in the field of autism can agree on, it’s that there is so much that we still don’t know.” This is incomplete: there is much we do know. We know that the theories Dr. Geier has proposed are wrong. We know that the rise in autism is not due to mercury. Certain tests should be performed before a child is diagnosed with precocious puberty. Tests which the charges indicate Dr. Geier failed to do on many occasions. We know that treatment for precocious puberty should stop at an age when puberty is expected. Dr. Geier is charged with initiating and/or continuing treatment in children too old to be diagnosed with precocious puberty.

Dr. Geier has published many papers in the literature, this is true. These papers have been widely criticized by researchers. Not because the ideas are unconventional, but because the ideas are ill founded and the experimental methods are poor. Dr. Geier has been described as “intellectually dishonest” for his work as an expert witness. The Institute of Medicine has referred to Dr. Geier’s papers as suffering from “serious methodological flaws and their analytic methods were nontransparent, making their results uninterpretable”

There is much we do not know. On thing we do know: we deserve better than Mark Geier

Perhaps it is the frustration of having read the recent article by the Geiers in the new “autism science digest”. Perhaps it is the fact that I listened to a podcast interview with the Geiers in preparing my recent response to the article. Perhaps it is just the years of reading bad science and waiting for someone to act against these people, but my patience is worn rather thin, as you will see in the comments.

6 Responses to “Mark Geier: My therapy is unconventional, but it works”

  1. David N. Andrews M. Ed., C. P. S. E. June 17, 2011 at 07:08 #

    Unconventional but it works?

    Pass me a bucket. I want to hurl.

    And then pour that all over that bastard Geier. And his waste-of-a-wank offspring.

  2. Joseph June 17, 2011 at 13:35 #

    That “it works” is an unsupported assertion, either anecdote-based or an outright fabrication. But calling it “unconventional” is the under-statement of the year.

  3. _Arthur June 18, 2011 at 03:38 #

    Geier is doing “research” and providing magik cures at the same time.
    Real researchers are aware, and make their test subjects aware, that the new treatment is experimental, and may not work, or even, endanger the health of the test subject.
    Depending of the protocol, the subjects will be made aware that they may not receive the experimental treatment, but either the standard treatment or a placebo instead.

    But when you’re a quack, all is simple: everyone receive the magik quack treatment, and, if it fails to work, you can claim that the “progress” are due to the treatment, or that the treatment must be maintained until it work…

    So simple!

  4. Vincent Iannelli, MD June 18, 2011 at 13:27 #

    It was interesting how he seemed to imply that the AAP supported what he was doing with the statement that Lupron is ‘supported for use in children by the American Academy of Pediatrics.’ Except that they don’t.

    The ‘Consensus Statement on the Use of Gonadotropin-Releasing Hormone Analogs in Children,’ which was published in Pediatrics, actually calls his research out when saying there was no evidence to support giving Lupron to treat behavioral symptoms in children with autism.

    • Sullivan June 19, 2011 at 04:09 #

      Vincent Iannelli, MD,

      I thought that was rather misleading of Dr. Geier when I first read it.

      The entire piece was strange. He sets out with the title that his work is “unconventional” and then tries to make the case that he is well within the bounds of conventional medicine.

      Leaving all else aside (a difficult task), I find it odd that he has taken this one given that he has no specialty in pediatrics, autism or endocrinology. Why did he not refer his patients to a pediatric endocrinologist if it is so clear that this is the appropriate treatment? Why not at least bring one in to consult on the cases?

      I hope someone from AAP responds in the paper clarifying this misleading statement.

  5. David N. Brown June 19, 2011 at 08:53 #

    @Sullivan,
    “I hope someone from AAP responds in the paper clarifying this misleading statement.”

    If “Dr.” Geier cited the AAP as supporting his treatment when they opposed it, it seems to me it would be feasible to SUE for it. Such misuse of their name could be argued as copyright and/or trademark infringement. Or, they could go for it as a libel claim. They might not win, but it would be a non-trivial addition to the Geiers’ richly deserved misfortunes.

    David N. Brown
    Mesa, Arizona
    http://www.evilpossum.weebly.com

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