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When Should We Call A Quack A Quack?

It is not uncommon for Science Based Medicine to receive complaints about the tone of our writing. Some people feel that it is indelicate to use the “q” word (for the uninitiated, “q” is for “quack”) when describing practitioners who promote disproven therapies with jubilant fervor. Others believe it unkind to lump “well meaning” alternative medicine experts in with those who are engaged in overtly illegal activities.

We are all affected by the tension between wanting to call a spade a spade and respecting our cultural need to be polite. Perhaps one of the clearest examples of this inner conflict is Orac’s Respectful Insolence blog. As the name implies, Orac is both thoughtful and brutally honest – he expresses our communal reticence to make waves, but follows up with a reasoned hostility that is quite understandable, given the circumstances described in each post. Respectful Insolence is fun to read because it is educational, persuasive, and expressive – and it captures how many of us feel about various forms of hucksterism. However, snake oil salesmen and their sympathizers are unlikely to enjoy the blog.

Here at Science Based Medicine, readers find a wide range of expression with a common commitment to science and reason. Just as physicians have different practice styles (some are more nurturing in temperament, others offer “tough love”) so too do we authors vary in tone. For those readers who favor one style over another – I hope you’ll find the voice that suits you and return regularly for more. Please don’t assume that one particular post is representative of the entire blog, and please don’t be offended by the legitimate exasperation of writers who have suffered through decades of observing swindlers swindle.

As for me – I learned that one approach doesn’t fit all.  In his recent book, “Quit Digging Your Grave With A Knife And Fork,” Mike Huckabee attributes his extraordinary weight loss to the brutal honesty of his primary care physician. His physician sat him down one day and explained exactly how he would most likely die from diabetes if he did not radically change his lifestyle. He described the vascular disease that would (if left unchecked) cause vision loss, kidney damage, skin ulcers and potential limb amputations, heart attacks and stroke. He was so shocked by this message that he embarked on a new way of life – and lost over 100 pounds with diet and exercise. His blood sugar levels returned to normal, and he is not currently at risk for diabetes-associated health complications. Quite amazing.

Several years ago I had an obese patient who was in a similar predicament. I sat her down and explained how serious her condition was, and how she had the ability to make a brighter future for herself through weight loss and regular exercise. I pleaded with her to lose weight, and counseled her on how to do so safely and effectively. I was firm with her, but encouraging. She left my office that day and never returned. Apparently my advice was not appreciated. I was crestfallen.

Tough love doesn’t work for everyone, and calling out pseudoscience and quackery is not always welcomed. But for those who have ears to hear, the message is important and powerful – and in some cases, life-saving.

Dr. Emil Freireich, winner of a recent lifetime achievement award for his contributions to leukemia research, told me that Houston, Texas is home to a cottage industry of alternative medicine practitioners who sell expensive miracle cures to patients who have not found success at MD Anderson Cancer Center. The practitioners prey on the hopes of dying patients, fleecing their families out of thousands upon thousands of dollars with potions that include everything from mere water to concentrated urine. I’m not sure what we should call such individuals, but “quack” seems awfully kind.

Science Based Medicine is committed to encouraging honesty, integrity, and scientific accuracy in healthcare. We shine a light on misleading claims and explore areas of ethical conflict wherever pseudoscience is found. Some of us do this with bold strokes, others with gentle persuasion. The goal is to empower patients, enlighten our peers, and move us all towards better health via sound science and thoughtful analysis.

And if you doubt that we’re actually a very affable bunch, why not join us at the upcoming Science Based Medicine conference?

Happy reading…

Posted in: Cancer, Science and Medicine

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