Miscellaneous Quackery-Related Comments
From David Russo, DO/MPH student
Texas College of Osteopathic Medicine
University of North Texas Health Science Center
My interest in health fraud and quackery was stimulated by some experiences I had as a research assistant on a multiple sclerosis study. I was responsible for patient screening and recruitment and was amazed to see how many patients had been robbed by quacks or had tried "alternative treatments" during the course of their illness. On the one hand, some of these more "benign" treatments (yoga, different kinds of diet fads, etc) seemed to have a positive affect in terms of increasing a patient's "feeling in control" of their illness and its management. Sadly, it was more common for patients to become extremely depressed and demoralized when the latest fad "didn't work." It's my opinion that most Americans with chronic illnesses do believe that "something is missing" from conventional/orthodox western medicine. Still, I believe that most alternative medical practitioners cynically manipulate these kind of patients and only provide a cheap substitute for the "missing something."
From Steven Lewis,
Penn Valley Community College
Kansas City, Missouri
When I was a child I believed in Santa Claus, the Tooth Fairy, and Superman. As I matured, my standards of evaluation grew more factual, critical, science-mathematical. The laws of science have been built up over centuries, verified and reverified by some of our most rigorous evaluators. If someone comes along and says they can fly like Superman, I would be a fool not to be skeptical. But I would nevertheless ask, "Please demonstrate this in a context that I can be assured no trickery is being used." If in return all I get are excuses, I would write off the individual as a fakir.
From Ken Phelps, D.D.S.
Ladysmith, B.C., Canada
There is a seemingly endless supply of unproven therapies. Homeopathy touches a particularly raw nerve with many of us for two reasons. First, it is such an enormous claim. If it the principles of homeopathy are true, this is a discovery that requires a paradigm shift orders of magnitude larger that those stimulated by Galileo, Newton or Einstein. It's not impossible. Second ...This monumental discovery is supported by what? The ramblings of a 19th century quack? The Believers that come into my practice wanting all their teeth pulled because their homeopathic practitioner has used dowsing to test the toxicity of their partial denture? Guys on the internet who hear about things in India?
Does every field have to put up with this crap? Do engineers constantly have to argue with people who BELIEVE, in the face of all testable evidence that bridges and highrises could actually be built from toothpicks and cream cheese if only the engineers were more open-minded and better informed?
San Francisco, California
Anybody charging exorbitant and unjustifiable prices for a treatment that is not undergoing serious scientific study is suspect. Careful thinking is needed here to separate genuinely promising, but expensive, therapies from those which are both expensive and unwarranted. Some unavoidably expensive but legitimately promising therapies, such as passive immunotherapy, are made unofficially available by some doctors well before trials are completed. Such treatments stand on legitimate, if not totally proven, ground, and there is at least a rational explanation of the high costs. In general, the more a treatment costs, the more evidence you should demand that it's likely to work. If no legitimate trials have been done or are underway, find out why. The explanation had better be good: any variation on "it's too much trouble," "we don't have the resources," "we can't wait, we're too busy saving lives," or "the system is totally biased against us" should set off an alarm. Similar rationalizations, word for word, have been the war cry of medical amateurs and con-artists for nearly a century. There are legitimate processes available for determining what works and what doesn't; treatments that never enter (or even try to enter) the normal drug-development process (with all its flaws and delays) will never be proven and never be widely accepted or available. Why would any ethical doctor leave a genuinely hopeful treatment in this limbo?
From Honorine C. Woodward
Graduate Student (English)
Weight-loss in the U.S. is a multimillion-dollar business pushing products that don't work. Unlike our friends who push dubious herbal products, the industry's immunity lies not in FDA loopholes but in the guilt, shame, and low self-esteem of those it exploits. The big players are Weight Watchers, Jenny Craig, and Diet Workshop. The small players would be the chromium picolinate people and other "fat burner" scammers. Perhaps the most dangerous are the various surgeries, which have horrible side effects—and all too often are impermanent. There's a lot of money out there, floating out of the pockets of desperate and unhappy people—and all it really buys is the self-image propping of "Well, at least I'm *doing* something." Study after study shows over 90% of dieters regaining the weight in five years; many gain even more weight than they lost.
Sadly, many physicians push their patients to diet and then scold when failure follows. The single best advice on the topic I've ever heard came from the University of Wisconsin Eating Disorders Clinic: "Live a reasonably healthy lifestyle, and accept the body that results." In other words, focus on fitness, not your weight! Yet millions of people (most of them women, most of them mildly overweight at worst) are locked into spending hundreds of dollars on membership fees, meeting dues, special foods—and then, when they fail, they berate themselves and do it all over again. Why don't they spend a fraction of the money and join a health club? I've heard no good reasons (some sad ones: muscle makes one gain weight at first). Heaven knows working out is less trouble for *me* than dieting was, and, ironically, this way I've lost some and kept it off.
Anyway, the whole system of preying upon people's insecurities and masking basic scientific information (when calories drop too low, metabolism drops too and weight loss becomes far more difficult) seems to be in the fraud arena.
From Rosemary Jacobs
One of the major reasons that people turn to quacks is that quacks lie. They promise cures when they know that they don't have any. They claim that they have the answer to questions where none exist. They offer certainty where there really isn't any. They make people feel good by deluding them for awhile. My advice is to not believe salespeople. Investigate. If you don't have time, realize that you are taking a risk of being harmed and/or robbed. If someone makes a claim, ask how he knows that it is true. Be a good consumer. There are crooks in this world who will do anything to get your money, and there are a lot of gullible people that believe their lies and repeat them. Lots of the salespeople are good people who believe lies because they are trusting and haven't bothered to investigate.
From Scott L. Replogle, M.D.
Associate Professor of Surgery (Plastic Surgery)
University of Colorado Health Sciences Center
The analogy is not perfect, but I like to compare "alternative medicine" to "alternative rock music." The latter is music that few have heard of, appeals to a limited audience (many of whom like it solely because it's alternative), and represents (and thereby defines) non-mainstream music. As soon as any of it becomes popular, like Kurt Cobain and his group Nirvana, it becomes mainstream. But much of it remains alternative for a reason—it's lousy.
In medicine, most "alternative medicine" is not mainstream for good reason. If it's truly effective it will become mainstream and no longer "alternative." If it remains alternative, it belongs there.
There will always be alternative medicine. Let those who want it have it. The problem is when the rest of us have to pay for it through our insurance premiums and government health programs. If you want aromatherapy, therapeutic touch, reflexology, etc., you pay for it, but don't require me to subsidize you.
New York City
I find it interesting that when people tout the benefits of alternative medicines as being used for centuries by whomever, they seem to conveniently forget that human life expectancy during those centuries was roughly one-half to two-thirds what it is today. If the alternative meds are so terrific, why didn't people live longer back then?
Peter Moran, MB, BS, BSc(Med), FRAC, FRCS(Eng)
Ipswich, Queensland, Australia
Blind Freddy has looked at all the claims, and then all the evidence for them, and says that the most that has been proved for "alternative medicine" is that some herbs have minor pharmaceutical properties. And perhaps some supplements have preventive properties, but other lifestyle changes may be cheaper and of equal worth. He thinks the rest is all hype, until proven otherwise.
George C. Slusher
It is up to the proponents of a treatment to prove that it works, not to someone else to prove that it does not work. The burden of proof is on the claimant. If I say that my Toyota Celica can reach a speed of 900 mph on a road (measured relative to the road, of course), is it up to you to prove that it can't, or up to me to prove that it can?
Dean Edell, M.D.
In homeopathic medicine, there is no real medicine, so the most incredible things can be sold. You'll see homeopathic products even in drugstores. Homeopathy is based on the belief that the drugs that bring on the symptoms are the drugs to take. This is supposed to make your body stronger in its fight for wellness. There is no evidence to support the theories of homeopathy. . . . All these companies are riding the wave of homeopathy to sell you a bunch of crap.
William M. London, Ed.D., M.P.H.
William Lutz wrote in Doublespeak: "Doublespeak is language that pretends to communicate but really doesn't. It is language that makes the bad seem good, the negative appear positive, the unpleasant appear attractive or at least tolerable. Doublespeak is language that avoids or shifts responsibility, language that is at variance with its real or purported meaning. It is language that conceals or prevents thought; rather than extending thought, doublespeak limits it." An example would be to say that the U.S. Army "services a target" when killing an enemy. The terms "complementary medicine" and "integrative medicine" are doublespeak because they (a) imply that standard care is deficient and (b) conceal the fact that adding worthless methods to valid ones produces substandard care.
Arnold S. Relman, M.D.
Former editor, The New England Journal of Medicine
There are not two kinds of medicine, one conventional and the other unconventional, that can be practiced jointly in a new kind of "integrative medicine." Nor, as Andrew Weil and his friends also would have us believe, are there two kinds of thinking, or two ways to find out which treatments work and which do not. In the best kind of medical practice, all proposed treatments must be tested objectively. In the end, there will only be treatments that pass that test and those that do not, those that are proven worthwhile and those that are not. Can there be any reasonable "alternative"?
Harriet Hall, M.D.
Retired family physician
I read nonsense about removing "toxins" all the time, but I have never seen any identification of what those "toxins" are supposed to be, much less any evidence that anything is removed by the recommended treatments, which include herbal remedies, diet regimens, bowel cleansers, massage, footbaths, electronic gadgets, you name it! Those "toxins" are as mythical as the Tooth Fairy. In fact, the Tooth Fairy makes more sense: I have some evidence for the Tooth Fairy, because, as a child, I saw the money under my pillow. I haven't seen a "toxin" yet.
Lauren Eve Pomerantz
Medical doctors (MDs) can
provide quackery just as easily as naturopaths (NDs). However, NDs are
taught to provide quackery, whereas MDs have to learn it on their own.
California Space & Science Center
Kimball Atwood, M.D.
Science-based Medicine Blog
Practitioners of pseudomedicine band together to create pseudomedical pseudoprofessional organizations, complete with pseudo-legitimate names, pseudo-legitimate conferences, pseudo-legitimate appearing websites, pseudo-”board certifications,” protocols for pseudo-therapies, patient brochures hyping pseudo-therapies, pseudo-consent forms for pseudo-therapies, pseudo-Institutional Review Boards to approve pseudo-research, pseudo-journals to publish reports of pseudo-research, very real contributions from pseudoscientific corporations to help pay for very real advertising, very real lobbying, very real legal representation, and more.
David H. Gorski, M.D., Ph.D.
Cencer Surgeon and researcher
Science-Based Medicine Blog
Medical science is not decided by "public debates." It is decided by evidence, experiments, and clinical trials.
This article was revised on March 6, 2011.