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When it comes to the Wild West of miracle sure supplements, diets, detoxes, and other scientifically dubious products, there’s a new sheriff in town—many, in fact. For years, advocates and entrepreneurs working in the ever expanding “wellness” market have had free reign to sell products with lofty claims of eliminating anxiety and depression, improving cognition, boosting metabolism and libido, and even treating cancer. Social media has also successfully cultivated opinions that simply dismiss massive amounts of scientific evidence, such as assertions that vaccines cause autism, psychiatric disorders don’t exist, or cannabis is a completely harmless substance. As these ideas gained momentum and sales of questionable health products soared into the billions of dollars, a desperate bat-signal call for help reached high into the sky, only to be answered by…..nobody, really.
Sure there was some serious eye rolling that took place at scientific conferences when some of these health fads were discussed at cocktail parties, and sure there were established medical societies handing out pamphlets about best-practice procedures, but these things quite expectedly did little to change the tide, especially as revelations regarding the coziness between medical professionals and pharmaceutical companies continued to surface. As trust in doctors waned and regulatory agencies continued to look the other way, pseudoscience flourished, advertisements became even bolder, and the people cashing in on these practices continued to keep whatever kinds of professional license that they had.
Then things began to change, brought on by two important insights. The first was that the general public generally doesn’t read medical journals or go to scientific conferences and instead get their information from sources (like this) on the internet and social media. Consequently, if you want to engage in a debate that people will actually hear about the relative efficacy and safety of, say colonic cleansing, you need to meet people where they are. The second insight is that the presence of reliable evidence-based information about a particular topic is incomplete and ineffective without actively refuting the pseudoscience as well.
The battle was now engaged, but the scientific establishment had a lot of catching up to do. Institutions such as the World Health Organization, National Institutes of Health, and American Academy of Pediatrics began hosting blogs, improving their websites, and rushing to build a presence on social media sites like Facebook and Twitter. Their followings paled in comparison to those of celebrities pitching things like crystal healing or vaginal jade eggs, but at least science was really starting to push back. In fact, whole new organizations from early ventures such as psychiatrist Stephen Barrett’s Quackwatch to McGill University’s Office of Science and Society (whose motto is “separating sense from nonsense”) sprouted up, dedicated to the dissemination of scientifically valid information. As evidence that there is indeed an audience wanting to hear this information, pseudoscience sheriff Dr. Tim Caulfied, teaming up with other officers such as Dr. Jen Gunter and Dr. Joe Schwartz, even got his own Netflix show, A User's Guide to Cheating Death, which is an effective, funny, and smartly produced counterpunch to the enormous amount of false advertising being spent to promote ineffective and sometime dangerous practices made in the name of health and wellness.
No longer can promoters of scientifically vacuous products expect their outlandish claims to bounce through the internet unchallenged. And more recently, even historically sluggish groups like the FDA have begun to clamp down on some grandiose and unsupported ads, made by manufacturers and distributors of cannabidiol, such as statements that it slows the progression of Alzeimer’s Disease.
These no doubt are significant positive steps for consumers and anyone really who respects the role of science in healthcare. Yet as the prominence and reach of the pseudoscience police rises, a few important questions have surfaced.
- How nice and respectful should everybody be? Healthcare professionals typically strive to be civil and courteous even when strong disagreements arise. That decorum, however, is being abandoned by some members of the pseudoscience police who can ridicule, name call, and curse with the best of them. The difference between being an enlightener and an internet troll is not always so clear. In responding to misleading information about vaccines, for example, some worry that tweeting insulting replies only entrench people further, while others are concerned that friendly and welcoming posts are too easily ignored.
- What are the end goals? For some, the best response to the presence of bad information is the presence of good information. Others, however, believe that more directive actions are needed against misleading products and the people promoting them. Should governments crack down on false advertising more? Should purveyors of pseudoscience lose their medical licenses (see one of my previous PT posts for more discussion of that)? These questions have come into more focus since the response by Facebook last month to reduce access to anti-vaccine posts. This action was welcomed by many, although some quietly have worried that it smacks a little too close to censoring free speech.
- Are people getting too skeptical about promising new procedures? Clearly, there is a spectrum when it comes to the scientific evidence for various things all under the broad category of wellness. Between the mountains of evidence for the health promoting benefits of exercise and the complete dearth of support for things like ionic foot detoxes lie activities that might be more deserving of cautious optimism than a hammer of skepticism and ridicule. Mindfulness, for example, could have been easily dismissed years ago as a silly and useless thing that beautiful people did on beaches, but evidence has been steadily accumulating that support its benefits. Today, probiotics might fit that in-between category now as something not quite yet ready for prime time but with some real science behind it that should not be summarily ignored or waved off.
I’m hopeful that we have hit a turning point when it comes to ending the impunity that the pushers of pseudoscience have enjoyed for far too long. Further gains, however, will likely require the pseudoscience police not only to expand but to come up with a strategic plan moving forward. We also will need to stay disciplined to our founding principles of following the data, wherever it may take us.
