Medical Science

Everything is moving so fast. The media reports on new research, studies and discoveries daily. People are living longer, healthier lives due in part to medical advancements.

 

I expect that this endless parade of seemingly miracle cures drives people to look beyond medical science and put their faith in so many unproven remedies. Scientific-sounding sales pitches, ancient wisdom or endorsements by friends, relatives and celebrities lure them in. Then all it takes is a little placebo effect to convince them that they have made a great discovery, and they too spread the word. 

 

Americans throw away countless millions of dollars in pursuit of relief from their latest aches and pains. Here are a couple more examples from reliable sources.

 

The first is about acupuncture. Many people believe acupuncture is an effective and safe alternative to mainstream medicine. Safety is not really the issue here. In the category of complimentary and alternative medicine, most of the pills and procedures are safe because they don’t do anything. The question in this case is whether it works.

 

If acupuncture works, it seems reasonable to assume that acupuncture points really exist and that experts or experienced practitioners can find them. Otherwise it would be random needling, a technique that would fly in the face of a theory based on the existence of qi and its meridians accessible at particular acupuncture points.

 

Journal of Acupuncture and Meridian Studies after looking at 14 separate studies found “’considerable variation’ in localization of acupoints among qualified medical acupuncturists.” They admit that accurate point location is a significant factor in effective treatment, but the various methods of finding them yield highly inconsistent results. 

Furthermore, my original source points out that the depth of the needles to access the point is not specified; and if the points were real, “wouldn’t they vary in location [from person to person] just as other anatomical structures” like blood vessels do? So many unanswered questions throw considerable doubt on the practice.

 

The second example concerns chiropractors charging thousand of dollars, not covered by insurance, for spinal decompression on a special device to alleviate back pain. One such device is “a mechanical table attached to Space Age-looking controls that its manufacturer claims can stretch the disks of the vertebrae.” (Medieval torture chambers had a similar table but without the space age-looking controls.) 

 

A group called Fair Warning, “based on review of lawsuits, scientific studies, government documents, chiropractic websites and interviews with experts, found that the claims of success for spinal decompression stretch the truth,” and that the treatment “has never been proven [to be effective] in scientifically rigorous studies.”

 

While Internet advertising and participating chiropractors rave about success, insurance companies describe the machines as experimental and investigative. While the promoters boast of success rates of 86% to 90%, investigators found their studies “lacked scientific rigor” and that “no definite conclusions could be drawn.”

 

A professor from Oregon Health and Science University and an expert on the subject of lower back pain says, “Eight in 10 people with back pain get better on their own.” The marginal difference with this machine, even if true, hardly seems like a good investment, especially since it has also resulted in serious injury.

 

Both cases are scientifically very dubious. Unfortunately, science means nothing to Americans unless it supports their preconceived notions. Climate change is real, based on science; but nuclear power is dangerous, based on emotion.

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Is Chiropractic Effective Against COVID-19?

Everyone wants to take advantage of the pandemic; some offer products and services that lean toward quackery and others less so, but they are trying to lure in customers by playing on fear. Sometimes the connection is dubious. For example, CNN reports that the World Health Organization (WHO) “called on tobacco and nicotine industries across the world to stop taking advantage of the global pandemic and marketing directly to children and teens.” (How anyone can use the pandemic to put a positive spin on teen smoking is very puzzling, but WHO is worried.)

As another example, many chiropractors are posting information on their websites similar in wording to this one: “Regular chiropractic adjustments have been proven to boost your immune system. This is accomplished by improving the state of the nervous system which in turn improves the immune system.”

The International Chiropractic Association (ICA) found these claims troubling. Concerned with the credibility of their practice, they tried to clarify in March with a 15-page bulletin stating in part: “There are no vaccines, no drugs, no natural remedies, no alternative therapies that have been tested and the outcomes peer reviewed to meet any credible evidence-based standard in science. This includes chiropractic.” They had “previously provided clear reminders to its members of the importance of not advertising” such abilities.

Where would hundreds of chiropractors get this idea? They believe that straightening a patient’s spine positively affects the nervous system by reducing stress. Stress reduction is loosely linked to immunity. As explain in the Annals of Vertebral Subluxation, which tracks chiropractic research, “It is well established that the nervous system controls and coordinates all functions and systems of the human body including immunity and the immune system.” This theoretical connection feeds an assumption that it is ethical to advertise chiropractic as a treatment and prevention during the pandemic. But it’s not.

This train of thought – less stress to nervous system to immunity – has never been proven to exist. This site quotes another ICA report warning, “there exists no credible, scientific evidence that would permit claims of effectiveness for conferring or enhancing immunity through spinal adjustment/manipulation to be made in communications by chiropractors.” Furthermore, last month “more than 150 chiropractic researchers from eleven countries criticized [any suggestion] that chiropractic care (primarily spinal manipulation), can have a meaningful impact on immune function.”

At the end of the 15-page ICA report, they make the lack of evidence clear by asking for more funding to support “necessary clinical research required to validate the role of doctors of chiropractic in promoting health and vitality by stimulating a healthy immune response.”

As these renegade chiropractors advertise viral immunity, along with several other questionable benefits, they undermine the credibility of the profession, providing more ammunition to the naysayers. Numerous skeptical publications, including this one, describe chiropractic as teetering precariously on the edge between science and pseudoscience.

Such advertising trying to get away with unsubstantiated claims, reinforces the need for critical thinking. Many chiropractors, naturopaths and others claim all sorts of peripheral health benefits. Patients walk in expecting miracles and walk out with placebo-effect satisfaction telling their friends. But wild claims and customer endorsements don’t constitute evidence. Eventually, the professional associate must move to protect the reputation of the profession before the FTA steps in to protect consumers. But none of this would be necessary, if critical thinking prevailed.

Another Health Scam

With the coronavirus leading every news broadcast, the networks have begun also to highlight the prevalence of false claims, fake cures and scams. To make the point that this is not new, CBS Sunday Morning (4/26) addressed the history of fake medicines and cure-alls, but was disappointingly vague on some of the current scams, ones people fall for every day, probably from fear of offending both promoters and viewers. They did, however, include a few comments from Dr. Stephen Barrett who pulls no punches in his criticism of modern scams.

In one of his latest investigations into junk medical science, Dr. Barrett addressed a process known as bioresonance hair testing. Practitioners use a device "based on the pseudoscience of radionics to analyze hair samples mailed in by customers" to "detect nutritional deficiencies; overexposure to heavy metals; and food and environmental intolerances” to serve as a “roadmap to better health.” He calls the practice preposterous, in that “hair analysis is not reliable for evaluating the nutritional status of individuals” as well as giving several other reasons why it doesn’t work.

An earlier article on the same subject he warned its use by “chiropractors, nutrition consultants, physicians who do chelation therapy, and other misguided practitioners who claim that hair analyses can help them diagnose a wide variety of health problems and can be used as the basis for prescribing supplements.” 

Since bioresonance is based on radionics, it gets even more “preposterous.” These theories supposedly rely on quantum entanglement, a central principle of quantum physics where information can be transmitted instantaneously at a distance apparently violating the speed of light. Quantum physics is arcane and incomprehensible to non-scientists, yet many questionable products use it to explain action at a distance to add a scientific-sounding aura to their sales pitch. But it's all bogus.

Then it gets more unrealistic. According to this site, “Radionics can be used for humans, animals and agriculture by means of radionic instruments which amplify and 'balance' the subtle energy field of the subject” by using “a photograph, hair snippet or other biological sample.” It works best with a good quality digital photograph because “the image stores the information of the subject and a digital file cannot be contaminated like a biological sample can,” and the light “creates a crystallization of the energy matrix of the subject.” 

Another site says, it’s “a method of healing and diagnosing at a distance using the unique extra-sensory faculties of the operator supported and amplified by a physical instrument, device, geometric pattern, energy or substance.” Since “every person's energy patterns, frequencies, signatures, vibrations or rhythms are as unique to them as their fingerprints,” they can easily detect and help correct any type of “illness, injury, infection, stress, pollution, malnutrition, or poor hygiene.”

In summary, “patients” send a full digital picture or some strands of hair. "Doctors,” using their powers of ESP, run it through their energy detection machine, make a diagnosis based on an individual energy matrix, vibrations and rhythms and recommend supplements to cure what ails them, all using the magic of quantum physics. Remember, the same technique applies to their pets or their houseplants – with a separate charge for each.

But that’s not all! In some cases, their house may be causing the problem due to the presence of “geopathic stress,” which messes with the occupants’ health. That, too, can be cured at a distance by sending a photograph and using the above technique.

This seems so outlandish that I can’t help wondering who would be taken in by it. Then I see the statement that radionics can be a “supplement to other complementary and Subtle Energy therapies especially Homeopathy, Acupuncture, Reiki,” and it all becomes clear.

CBS might mock citizens of the nineteenth century for buying Stanley’s snake oil concoctions or for making a millionaire of Albert Abrams (1864-1924), developer of devices that were the precursors of today’s radionics, but they needn’t look far to find twenty-first-century parallels.

Arthur C. Clark wrote, “Any sufficiently advanced technology is indistinguishable from magic,” but come on, people! These scams are packaged as advanced technology and sold to people who want to believe in magic.

Appropriately Skeptical

From time to time I see an ad from a local doctor promoting stem cell therapy for pain. It includes one endorsement telling how the office was so easy to work with and how the pain went away. For some time now I have been skeptical about the validity of this promotion. I thought stem cell research was not yet in the mainstream of medical practice, and I know that endorsements are not reliable evidence. It seemed suspicious, so I decided to look into it.

The promotional material on line states in part: “Stem cell therapy uses your body’s most powerful and flexible cells to promote natural regeneration in damaged joints.” It claims to be effective for a list of conditions: surgical wounds, tendon damage, severe muscle strain, arthritis, damaged cartilage, torn meniscus and many other joint and soft tissue injuries and conditions.

“The stem cells … come from your own body … a small quantity of bone marrow from your large hip bone.” (Using the recipient’s own stem cells avoids the need for FDA approval.) The on-site lab processes the harvested cells. The doctor then can “precisely inject your stem cell mixture where you need it … where they morph into new cell types” and provide “long-lasting relief” for “many [but not all] patients.”

My first stop was WebMD with a sub-headline reading: “Unproven, Risky Treatments Mislead Patients to Seek Cutting-Edge Therapy.” International Society for Stem Cell Research (ISSCR) “advises patients to seek only stem cell treatments being tested in clinical trials approved by the FDA”… or some approved smaller studies.

There is a lot of information on the site but it is summarized like this: “Every treatment has some risks. So the question comes down to whether the benefits outweigh the risks. And those studies haven't been done yet.” 

This Healthline report from about 18 months ago says that stem cell therapies are being promoted for a wide variety of conditions, but “very few of these applications have any scientific backing, [however] stem cell therapy for knees has been the subject of quite a few promising studies.” It would be a big improvement over knee replacement, but promising studies hardly qualify a procedure for routine outpatient application. They list the cost of this treatment at “approximately $3,000 to $5,000 per knee, depending largely on geographical location.” 

The FDA gives much of the same information. “Stem cell products have the potential to treat many medical conditions and diseases. But for almost all of these products, it is not yet known whether the product has any benefit—or if the product is safe to use.”

Consumer Reports chimes in with a sub-headline: “A new industry is booming. But critics worry that the treatments are ineffective and dangerous.” Here is a very brief summary: “Stem cells are special cells with the potential to repair damaged tissue and organs.” But “not all of them are possessed of equal power.” According to the current scientific consensus, the therapeutic potential of stem cells taken from fully developed tissues, adult cells, is believed to be much more limited. (Does this include marrow from hipbones? I wonder.)

That Consumer Reports piece is a long article with many warnings about the confusion in the field and the inability of regulators to keep up with the proliferation of clinics, both legitimate and otherwise.

Another reason I am skeptical is that the same doctor offers many other questionable services including platelet-rich plasma (PRP), calling it “one of the most powerful natural healing methods available today.” Some conditions include dry eyes, hair loss and erectile dysfunction.

The Pain Science website opinion published earlier this year describes it this way: “injections bathe troubled cells in a concentrated mixture made from your own blood. Hopefully this stimulates healing where it is otherwise failing … but no one really knows for sure yet.” Regardless, it’s not hard to find someone willing to do it for you, but it’s not cheap. “Without any clear evidence of benefit beyond placebo, PRP is now being marketed aggressively as a cure-all for sports injuries.”

I did this research not because I would consider going to a pain specialist unless I was referred by my primary care doctor. I did it just to show how careful we need to be to avoid spending a lot of money on dubious treatments. 

I didn't name this doctor because I'm sure there are similar ads running all over the country. I am not demonizing any doctor who may truly believe in such treatments, but it is a warning to patients everywhere. 

It is nearly always better and safer to be appropriately skeptical.

Flashback – Why So Much Bad Advice

[This message was originally posted over six years ago, but since then the dynamic of bad information driving out the good has only gotten stronger with more fake news, advertising weasel words, political spinning, echo-chamber exchanges, media bias and health fads without any scientific basis.]

Why do bad ideas and bad advice seem to persist in a society with easy access to good science? One reason may be the tendency to cling to beliefs then look for evidence to support them, instead of accepting the conclusions of well-designed experiments. In his book The Righteous Mind Jonathan Haidt proposes that feelings and emotions come first, and that most reasoning works to justify rather than to test beliefs, that our “intuitions tend to drive our later reasoning.”  John Stuart Mill presented the same thought more than 150 years ago:  (paraphrasing) the more you argue, even while making clear, rational points, the deeper others dig in to protect long-held beliefs. Adding to the sad situation are the effects of scientists and doctors who would rather become famous as authors or TV stars by promoting popular beliefs than risk challenging them, as they should, with the truth.

One case that comes to mind is the persistent belief that artificial sweeteners are dangerous. Simple research is reassuring, but the belief is ingrained in our culture. The National Cancer Institute states clearly and unequivocally: “There is no clear evidence that the artificial sweeteners available commercially in the United States are associated with cancer risk in humans.” The Mayo Clinic’s view is that “there's no sound scientific evidence that any of the artificial sweeteners approved for use in the U.S. cause cancer or other serious health problems.” So who do Americans trust, these authoritative sources or a Facebook friend who watched some guy in a halloween costume on YouTube with scary stories?

Likewise folk remedies of all kinds continue to circulate. One longstanding belief is that magnetism has magical healing powers, leading people to buy bracelets, insoles and other magnetic devices. This is odd because over the past 15 years the FTC has ordered Magnetic Therapeutic Technologies, among others, to stop advertising magnets as a cure for numerous diseases or even as a pain reliever. No credible evidence exists of healing powers, and none can be claimed in their advertising. One recent well-designed test of such devices confirms this fact concluding: “Wearing a magnetic wrist strap or a copper bracelet did not appear to have any meaningful therapeutic effect, beyond that of a placebo, for alleviating symptoms and combating disease activity in rheumatoid arthritis.” Does that slow the sale of magnetic shoe insoles? – Not for people who don’t let the facts get in the way of a good story, a persuasive ad or a celebrity endorsement.

It’s your money to use as you please. You can save it for college and retirement, give it away to companies selling you magnetic health devices, or even flush it down the toilet. Two of those choices make the same amount of sense, but as Paul Simon sang, “A man hears what he wants to hear and disregards the rest."

Medicare for All – Part 2

With all the campaign promises about Medicare for all, I took the opportunity about two months ago to explain how Medicare actually works. Politicians give the impression that it’s a totally free health insurance program. Just walk into the doctor’s office or emergency room, tell them your number, get fixed up and leave with no expectation of receiving a bill. 

Real Medicare today is not like that at all. Why would they spend time on TV and in mailings advertising supplemental insurance that “helps pay some of the health care costs that Original Medicare doesn't cover, like: Copayments, Coinsurance, Deductibles”? Those extra costs can only be avoided by paying money up front as a premium for the additional insurance.

From recent news, though, it’s clear that this misimpression is not the only problem. Medicare fraud is another big issue. Sometimes this is a critical thinking issue where patients are lured in as unwitting participants. Sometimes it goes deeper.

Late last month, thirty-five individuals associated with dozens of telemedicine companies and laboratories were charged with fraudulently billing Medicare more than $2.1 billion for expensive cancer genetic tests. Nine of the defendants are medical doctors. “In addition, the Centers for Medicare & Medicaid Services, Center for Program Integrity (CMS/CPI), announced…adverse administrative action against cancer genetic testing companies and medical professionals who submitted more than $1.7 billion in claims to the Medicare program.”

One of the defendants in this case, who cost taxpayers more than $1 billion in illegal Medicare reimbursements, “has been under near-constant federal scrutiny for the past five years and was supposed to have been deported more than a decade ago.” That was billions lost to fraud as a result of only one investigation, due in part to government inaction.

Meanwhile, the U.S. Department of Health and Human Services Office Inspector General has issued an alert to the public about other genetic testing schemes. Medicare eligible patients are offered a free genetic screening for undetected conditions, but the real motive is to get their Medicare information “for identity theft or fraudulent billing purposes.” The screenings are unnecessary and are usually denied by Medicare. When they are, the individual could be responsible for the entire cost of these useless tests, sometimes thousands of dollars. 

They get nothing but the promise of some new information about their health with the selling point that, as Medicare recipients, it may be free to them. This promise of something for nothing – free testing or free devices all paid for by Medicare – is used so often it’s beginning to sound stale, but it must be working.

Advice from the Inspector General is to not volunteer any information to these genetic testers, don’t stop at their booths at health conferences, ignore their ads, and return unopened any testing kits received in the mail.

Medicare fraud is a huge problem. The AARP reported in March of last year “roughly 10 cents of every dollar budgeted for the giant health insurance program is stolen or misdirected before it helps any enrollee. Looked at another way, about $1,000 is lost per Medicare member through theft or waste each year.” That estimate is based on government reports, but a leading expert from Harvard University believes the real number could be much higher, 20% or more.

AARP used the figure of $60 billion in fraud for the 2018 calculations cited above. Other sources show exactly the same estimate for 2015 and 2011. The number hasn’t changed in eight years. Apparently as fast as they can lock people up or put them out of business, more fraudsters spring up to take their place.

Would the general public as a whole be less likely to become victims of Medicare-for-All fraud schemes? That’s doubtful, and it leads to so much waste. 

Ancient Chinese Folly

There is something fascinating about ideas that are ancient and Chinese. They are in the same category as all-natural, sustainable and organic. People take them on faith, feeling that research is unnecessary, while risking the loss of time and money; and sometimes putting themselves at risk.

Take acupuncture for example. I am always skeptical of treatments that boast a cure or relief from multiple conditions. Just one example is listed here. “Health benefits of acupuncture include relief from chronic pain, arthritis, anxiety, insomnia, depression, migraine, nausea, postoperative pain, and obesity.” 

This other website adds to the list: nausea, sciatica, sinus congestion, stress, tinnitus and tobacco addiction. But then they go on to describe several recent research results in not very glowing terms. In 2017 authors reported limited evidence that acupuncture is modestly effective for acute low back pain. A 2016 review of 22 previously published trials concluded that adding acupuncture to standard treatments for migraines “may reduce the frequency of episodes, however the size of the effect is small when compared to a sham acupuncture treatment.” A 2016 review of 12 trials found that it may help people with frequent tension headaches. And another analysis “it appeared to provide only short-term(up to 13 weeks) relief” for people with chronic knee pain.”

One puzzling comment was that after the treatment “some people feel relaxed (or even sleepy), while others feel energetic.” One treatment with opposite outcomes may indicate a strong placebo effect.

Not many sources list the side effects of acupuncture. Since it’s ancient and Chinese many will automatically assume that it is only beneficial. But the treatment “can cause serious adverse effects, such as infections, nerve and blood vessel injury, complications from needle breakage or remnant needle pieces, punctured organs, central nervous system or spinal cord injury, hemorrhage, and other organ and tissue injuries resulting in death. Punctured pleural membranes around the lungs can lead to collapsed lungs.”

A study from China in 2015 claiming acupuncture is effective for treating the symptoms of angina was published only a few weeks ago. It received a harsh critique based on the time delay, lack of studies replicating the result, failure to use a double-blind design, the subjective nature of the results and that all authors were affiliated with schools of acupuncture or Traditional Chinese Medicine.

A report from 2013 states that “after decades of research and more than 3000 trials, acupuncture researchers have failed to reject the null hypothesis, and any remaining possible specific effect from acupuncture is so tiny as to be clinically insignificant.” Since then as we see above, evidence of effectiveness continues to be weak.

I always wonder why so many people, who mock those that don’t agree with them on climate change as being as unscientific as flat-Earthers, unquestioningly put their faith in these treatments and cures, some even crazier and more dangerous than acupuncture.

The BBC reports on a case from the Journal of Obstetrics and Gynaecology Canada of a 62-year-old woman who, on the advise of her traditional Chinese doctor, sustained severe burns when she tried vaginal steaming in an attempt to avoid surgery for a prolapsed vagina. “Vaginal steaming, which involves sitting over a hot water and herb mix, has seen a growth in popularity” and is “now available at some salons and spas.”

The practice began to gain popularity in 2010 and has been endorsed by Gwyneth Paltrow as a detox and cleansing treatment – those two words alone should scare off clear thinking Americans. Last year Chrissy Teigen, who tweeted under a picture of herself trying it, “no I don’t think this works but it can’t hurt right?” No, wrong! Ask a doctor rather than a model or movie star and you will get the opposite answer on all claims.

Once again, lapses in critical thinking are so obvious. There is no such thing as alternative medicine. There is only medicine that works and medicine that doesn’t. In the war between science and fairy tales, the fairy tales are winning.

Keeping an Eye on the Doctors

Over the past few weeks a number of shady healthcare situations have come up. There is often not a lot patients can do about doctors with bad intentions or to recognize their illegal behavior, but there are usually clues.

The first case involves medical fraud. A cardiologist was convicted on two counts of fraud for double billing insurance companies and using a procedure to treat problems it was not designed for.

The doctor administered an outpatient treatment known as External Counter Pulsation (ECP). “ECP involves the use of a specialized bed equipped with pressure cuffs, which exert pressure upon patients’ lower extremities as a means to increase blood flow to the heart.” Insurers only reimbursed doctors when this treatment is given to patients with angina and only when a physician is present.

The doctor operated 25 beds at numerous locations in three states where, in many instances, no doctor was supervising. Even for his patients who never experienced chest pain, he “instructed his employees to indicate that every patient had disabling angina on billing sheets that were used to support false insurance claims.”

Although they couldn’t do anything about the billing, the patients should have been very suspicious. It came out at the trial that in order to acquire new patients he advertised the procedure “as ‘the Fountain of Youth,’ claimed that it made patients ‘younger and smarter,’ and offered the treatment for a range of ailments other than disabling angina, including obesity, migraines, high blood pressure, low blood pressure, diabetes, and erectile dysfunction.” When a single medicine or procedure is advertised as curing so many unrelated ailments and uses come-ons like Fountain of Youth, patients should smell fraud miles away – not insurance fraud, but someone definitely trying to sell them snake oil.

In another case at the behest of the FDA, a judge issued a permanent injunction against a stem cell company “to stop...illegal behavior after several attempts to provide the clinic and the individual defendants the opportunity to work with the agency to come into compliance with FDA regulations and protect patients from harm.” In an inspection the government  found “significant deviations from current good manufacturing practice requirements” including failure to establish and follow procedures to prevent microbiological contamination. “The FDA has not approved any biological products manufactured by [the company] for any use.”

Again the patients cannot know all the details, but the products were being administered “to treat a variety of serious diseases or conditions, including Parkinson’s disease, amyotrophic lateral sclerosis (ALS), chronic obstructive pulmonary disease (COPD), heart disease and pulmonary fibrosis.” [Emphasis added.] 

These too-good-to-be-true qualifications should be a warning signal to everyone seeking medical help, even the most desperate. For every two that the authorities catch up with and go through the long, legal process of shutting down, there are probably two hundred still operating and advertising. As long as this kind of outrageous advertising continues to attract patients, the practice will continue.

It is not surprising that insurance companies cause frustration by being as careful/fussy as they are even about reasonable practices. Some healthy skepticism and critical thinking on the part of patients are our best, and sometimes only defense against fraud.

Scams and Near Scams

Prepaid cards: It seems like once a week network news comes along with the story of a person, usually elderly, who has lost money to a phone or Internet scam. 

They probably use the elderly as examples because they are closer to the age of the people who actually watch network news, but the fact is that they are not the most vulnerable. About a year ago a survey revealed that Millennials are more likely to become the victim of a scam artist than any other generation.

In any case, almost every time, their money disappeared by way of a prepaid card. They may have been informed of a relative in trouble or that they had won some money but had to pay a service charge to collect. The creativity of scammers is remarkable. The caller or e-mailer presented them with the problem and told them to buy and mail a prepaid card to handle the matter.

This should be a clear give-away, a red flag as big as their house, but scammers keep calling until they find a victim. Obvious defenses include not answering the phone unless you recognize the number. Valid callers can always leave a message; scammers rarely do. (This also works as a defense against telemarketers and robo-calls as I have mentioned previously.) Likewise the written return address on an email should correspond with the actual email address that shows up when the cursor moves over it. But the biggest warning sign is the request for a prepaid card. 

Toxins: In all my years of researching miracle drugs in the form of dietary supplements and other health products, I have yet to find one that lists detoxing or cleaning the body of toxins to be legitimate. They do not and cannot prove that there are toxins in the body that the body does not naturally and safely get rid of on its own. The science that debunks all these claims is consistent on that point.

Despite this easily available evidence, the products just keep on coming. They promise to detox your body and magically make you feel so much better. Their celebrity endorsers and satisfied customers back these claims. But always in the fine print at the bottom of the ad is the required paragraph about how none of these claims have been approved by the FDA and how the product is not meant to treat or cure any disease. I even commented a while ago on shoe inserts that somehow had detoxing qualities – by supposedly causing wearers to use the bathroom more often.

This is beyond crazy, but it remains a big business. Detox, like prepaid cards, should be a clear sign of a pending scam. In this case, however, customers can always convince themselves that they really do feel better, but they are still out the money for a product that relies on the power of suggestion rather than on the power of science or real medicine.

Science and the Game of Telephone: When youngsters play telephone, they sit on the floor in a line. The leader whispers a sentence in the ear of the first, who repeats what he’s heard to the second, and so on down the line. When the last person relates what she heard it often bears no resemblance to the initial message. It’s a common analogy for miscommunication, but I recently heard it to explain science reports.

A scientist writes a scholarly article about a real finding. Even if she includes all the possible flaws or conditions that still need to be investigated, by the time it becomes an article for a popular magazine may be downplayed. The next iteration, a short news or “health minute” segment, omits most details. Finally, it hits social media, where all subtlety is lost, but people like and repost without a second thought. 

For example, how many stories have we heard about whether or not breakfast is important? Is it OK to skip it? In 2012 it was declared optional. Around 2014 there were some studies saying skipping it leads to weight gain, and others saying it wouldn’t. One in August 2017 said how important breakfast was for kids. Last year, everyone in a particular study gained weight, but the breakfast eaters gained a little less. This year a study says skipping breakfast is bad for your heart. 

Which study are we to believe? – How about none of them until the scientists actually pin something down. Until then, the news media will continue to report each one that comes along as if it is the definitive answer and social media will keep us all “informed.”

This degradation of scientific findings as they pass down the “telephone line” is not really a scam, but it’s something to be very wary of. Unfortunately too few people research the validity of posts before passing them on.

Getting Smart About Your Health

A recent edition of the Consumer Health Digest in my email was a real eye-opener! It illustrated the primary reason for the need for consumer protection: many Americans are not using the slightest bit of critical thinking or scientific understanding when dealing with personal health issues. They are looking for magic answers and falling for the most outlandish promises with paper-thin backing.

The first article was about a New York University Psychology Department review looking for what they called “drift” from the core mission of social work. It asked: “Should social workers be engaged in these practices?” By systematically searching the Internet for practitioner websites, they identified many offerings that “fall beyond those fuzzy borders” of the defined mission and in fact, “might appear highly questionable.”

Looking at the accompanying table, there is no “might” about it. The long list includes such services as: a course in miracles, angel card reading, Aura-Soma®: Color and Aromas, Auricular Detox, Awakening Your Light Body and Radiance, Biofield Tuning, Certified Cuddle Party Facilitator and Certified Intuitive Healer. And those just brush the surface at the beginning of the alphabet!

These and many others on the list have the distinct color and aroma of pseudoscience, superstition and scams using mysterious-sounding methods to lure in customers. It leads to calls for a “concerted national effort to stamp out pseudoscience in all of healthcare.” But people are wasting their time and money of their own free will. We don’t need a national effort; we need a critical thinking population, because it doesn’t stop there.

Next I read about a former massage therapist explaining, “Why I quit my massage therapy career.” The author tells about disputes with his regulatory body and the hate mail from colleagues as he tried, through his writing, to call attention to all the unproven therapies passed off in that field of practice. He concludes, “Massage therapy has a deeply pseudoscientific character overall, defining itself mostly in opposition to science-based or 'mainstream' health care, where rejection of science is actually celebrated by many practitioners, probably a majority."

Again, the problem is not all the false cures, but that so many people fall for these deceptive practices with the hope that they have found the easy and magical way out of their various health problems.

Finally, in that same newsletter from that week: “The Federal Trade Commission (FTC) has announced that – as a result of a settlement – [the company] is mailing 227,995 refund checks totaling more than $6 million and averaging $26.57 to consumers who purchased health products from three individuals and the 19 companies they controlled—collectively known as Tarr, Inc.” Refunds included products for weight loss, muscle building and wrinkle-reduction. The company was accused of marketing their products with “unsupported claims, fake magazine and news sites, bogus celebrity endorsements, phony consumer testimonials, deceptive offers of 'free' and 'risk-free' trials, and enrollments of people without their consent in programs that charged them for additional products each month.”

But for every one the FTC catches, how many others slide by with similar schemes using endorsements in place of evidence, self-conducted so-called clinical trials, weasel words like “results may vary,” and the usual other tricks I warn of frequently? The only way to avoid these traps is to wise up, be skeptical and use critical thinking.

As an added note, not all the people that promote such treatments are charlatans. As I was training as a yoga teacher, I ran into a fair number of serious, devoted practitioners. They have a selective acceptance of science, where they want to pick and choose what to ignore and what counts as medicine, therapy and healthy practices depending on how their aura or chakras are aligned. Arguing the facts isn’t worth the time. (I’m sure many a shaman was equally sincere as he hurled virgins into the volcano.)

Children Are Dying Of Parental Ignorance

I had just finished writing a closing comment last time about how science is often ignored in the courtroom. This is especially true in jury trials where each member of the jury arrives with individual prejudices and faulty beliefs. The following day I ran across two recent articles related to that subject.

The first was about an anti-vaccine activist who was hiring himself out as an expert witness in child abuse cases. As he testified about the case the prosecutor began questioning him about his other beliefs in an attempt to undermine his credibility.

Among the ideas he admitted to believing was that “Gavi, the Vaccine Alliance, a charity funded by the Bill and Melinda Gates Foundation to increase vaccination rates in poor countries, was committing genocide” by promoting vaccination of children. He also admitted believing that “Gavi – along with the World Health Organization, the Gates Foundation and UNICEF – were using vaccinations to force sterilization on people in third-world countries.” He likewise blames the rise in autism cases on the increased use of vaccines.

As justification he cited a 1972 report and a 1974 study “warning about the dangers of population growth” saying that it was “ ‘no leap of faith’ to believe that vaccination is being used to carry out this agenda.” But it is a huge leap of faith – in fact it is completely wrong and  unscientific to ignore the benefits of vaccination over the last century. Smallpox, diphtheria and polio, to name just a few, have been all but eliminated. The Centers for Disease Control and Prevention (CDC) states, “studies have shown that there is no link between receiving vaccines and developing ASD” (Autism Spectrum Disorder). The World Health Organization (WHO) agrees.

So his credibility should have been destroyed. Such a stance should be laughable to any educated, well-informed jury. But he has been called as an expert witness in over 80 child abuse cases, despite the fact that he trained as a radiologist, not a pediatrician.

I have posted a complete explanation of why the anti-vaccine activists are wrong, how it is based on faulty and fraudulent science, discussing the risks of such an idea. For a review of the evidence, see here from a year ago and here from 2015.

The second article was from the BBC reporting on the latest data about measles. They call it a devastating, “highly contagious disease that in severe cases can lead to complications such as blindness, pneumonia and infection and swelling of the brain.” WHO saw a 30% increase in cases in 2017 among children from the prior year, including 110,000 deaths. They expect the same for 2018. Some cases even arose in countries where it had been considered wiped out.

According to WHO experts, the primary reason behind this measles increase in developed countries has been that “vaccine hesitancy” is becoming more of a problem. "In some groups, this is driven by religious beliefs but in quite a few populations it is spread by false concerns about the safety of vaccines" often on social media where people like and re-post without any attempt to verify facts. A major challenge facing healthcare providers is how to counter such misinformation.

Many facets of this subject are scary: that superstitious people, led by some superstitious doctors and celebrities, promote this dangerous belief; that lawyers try to pass off as an expert witness someone who has not trained in the field and has demonstrably erroneous beliefs in closely related areas; and that the general public is blinded to scientific facts by social media misinformation. Anyone who really cares about child abuse should shudder at the death of 110,000 from a single preventable disease due to parents’ intentional or negligent inaction.

A More Complex World Requires A Wiser Approach

A couple of years ago, CNN began an investigation based on a government mail fraud case against a Canadian company accused of processing payments for many rip-off artists from around the world with millions of victims in the US. “Many of the schemes are remarkably similar. They prey on the desperate, sick and elderly -- sending out letters that trick people into thinking they've won the lottery or found a psychic adviser who will turn their lives around.” Every year the scammers stole millions and laundered it through that company.

As follow up and as research for a book on the subject, they wanted to meet and interview a famous French psychic whose name is at the bottom of letters that appeared to be handwritten and personally signed. Addressed to the elderly, sick and lonely, "the letters promised that Maria Duval would use her powers as a world-renowned psychic to help solve their problems. They could recover from ailments, avoid terrible misfortune, win the lottery.” They only needed to send her money first. “At least 1.4 million Americans fell for the scam.”

To be convincing, the “letters contained personal details, like a recipient’s name, age or hometown” but this information is easily obtained on line. They bought mailing lists of people who would likely fall for such a scam. These people would then send in about $40 for each letter giving them guidance from the psychic along with lucky numbers and magic charms. The total collected in this one operation is estimated at over $200 million.

This continued for more than 20 years, but was only the tip of the iceberg. When they got an interview with the psychic, they found that she sold the rights to her name for a fraction of the proceeds. The psychic letter ploy along with other similar scams had become big business with professional copywriters and marketers scattered around the world and linked together by the Canadian payment processors.

It’s true that not enough Americans understand that psychic powers don’t exist. Those that can’t distinguish coincidence from the universe sending messages (or some such nonsense) are easily taken in. It’s true that some Americans don’t understand that you can never win a lottery that you haven’t bought a ticket for. But that’s not the main point.

There is a broader issue here. More sophisticated Americans, who scoff at the victims of these scams, follow fads and trends, are taken in by advertising for products of dubious value and respond with fear to manufactured crises. 

Their lack of critical thinking is evident and somewhat frightening. On one hand, they argue that climate change is real, based on the testimony of so many scientists. On the other, they will reject scientific consensus on many other subjects like the safety of genetic engineering, glyphosate (brand name Roundup) and irradiation of food. They will buy into the concept that locally grown and organic produce is always superior. They put their families on a gluten-free diet when there is no medical reason to do so. They believe there is something magical about sea salt. They put their faith in all sorts of untested dietary supplements. Experts warning against these actions are considered corporate shills or just mistaken. They buy products based on nothing more than endorsements from friends, strangers or celebrity spokespersons. They flock to purveyors of “secrets” that drug companies, doctors, credit card companies, Wall Street and the government “don’t want you to know.”

All this goes on as the world gets more complex every day. Incredibly fast communications bring real and false offers and threats. Advanced robots, AI and autonomous vehicles lurk in the near future, while hackers try to steal our identities and influence votes. Are Americans ready for the future? Behavior shows that today far too many are struggling, victims of scams and their own poor decisions.

More Junk Science

Almost everyone is interested in making money and possibly even becoming rich. One way to do this is to offer others a product or service that makes their lives easier.  We buy bread at the store or at a bakery because we save the time it would take to bake the bread and the people who work there are usually better at it. The same general concept applies to almost all grocery items, entertainment, furniture and household appliances, vehicles, and everything else we buy. By exchanging goods and services in this way, we are really exchanging talents, each doing something for others thereby allowing them to use their talent to our benefit.  We use money to keep track of most of these exchanges.

Economic understanding leads to the conclusion that we can all be better off, enjoying a higher standard of living. By this talent exchange, everyone playing his or her role, the economic “pie” gets bigger and everyone benefits.

Another way to get rich is to fool people into thinking that a product or service will make their lives better, selling them something of little or no value for a price that is justified only by the hype. This is widespread, but is particularly common in the areas of health and diet. It is also not new. Medicine men and snake oil salesmen date back centuries.

When we patronize these businesses, we are parting with money that could be used for a real benefit and getting nothing of value in return. How can the standard of living improve when people are spending on lies and false hope? Somebody is getting rich, but they are not doing it by making lives better. Their talent is persuasion, and they employ all the tricks.

I am reminded of this when I see articles represented by this series of headlines from a newsletter called Consumer Health Digest, which is published weekly to warn of medical frauds and to expose some of the wrongdoers.  Here is just a sample:

• “Former holistic nutritionist confesses" that what she had learned in school and practiced for many years was based on “limited education” and a “lack of respect and understanding for real science.”

• “QLaser marketers sentenced” to 12 years in prison for selling “medical devices with false and misleading labeling in order to defraud consumers,” in one case to the tune of at least $16,669,015.

• “Funeral homes failing to disclose pricing information” – some do not offer the information as required by the FTC intended to keep them from taking advantage of grieving families.

•  “Beautician sentenced for illegal buttocks enhancement injections” to 24 months in jail for “receiving and delivering an adulterated and misbranded medical device” while charging thousands of dollars per treatment.

• “Studies Show that Liberation Therapy for Multiple Sclerosis Doesn't Work.”

•  “Discredited, alarmist HPV vaccine study retracted” – A journal retracted an article incorrectly blaming the vaccine for side effects such headaches, fatigue, and poor concentration based on a few anecdotal reports.

This is just a sample from 3 weeks of newsletters, but should serve as a reminder of the importance of critical thinking in the area of healthy living and medicine.  There are people out there, just as there have always been, more than willing to take your money based on false promises and magical answers.  As technology moves forward we get more real cures and procedures that seem miraculous, but that opens the door for even more sophisticated charlatans ready to take advantage of the desperate, the lazy, the unscientific and those who put their faith in unproven methods.  We can’t and shouldn’t expect the FDA or the FTC or some consumer protection organization to have our backs in every case. Sometimes critical thinking is nothing more than looking out for yourself.

Science, Medicine and Snake Oil

Snake oil is a derogatory term used to characterize fake or fraudulent medical devices, pills, tonics or ointments.  It is based on true events in American history when a man named Clark Stanley did very well for himself selling to credulous consumers his liniment, supposedly (but not really) made from the fat of rattlesnakes.  He claimed it cured any number of medical conditions.  Later the government fined him, declaring the product worthless.

Today the same thing is going on but with a slightly more sophisticated presentation. Last November an Ontario chiropractor appeared on a CBC program, Dragons' Den (known as Shark Tank in the US) to pitch the idea of wearable clips to a panel of venture capitalists.  Called Neuro Connect, these clips were said to “improve a person's balance, strength and joint function almost instantaneously” through a process called quantum entanglement, which is a real term used by scientists but has nothing to do with balance or strength.  After a live demonstration he raised $100,000 in exchange for a 30% share of the company.  (The parts of this article where the inventors explain that they don’t know how it works – it just works, are pretty funny reading.)

The investigative journalist and scientists were more skeptical.  They set up a real test:

“With the help of experts at the University of Toronto's Institute of Biomaterials and Biomedical Engineering, 10 participants were asked to do two tests: a static standing balance test and a grip strength test to measure whether the clips had any effect. 

 “Each participant did the strength and balance test three times — once with Neuro Connect clips, once with a set of name tag clips and once with no clips. It was double-blind — neither those conducting the test nor the participants were told which clips were being used.”

They found no difference in any of the tests and declared the product “snake oil.”  In light of these findings the inventors are not backing down promising to do their own tests.  But since then Health Canada has forbidden the company from selling three other products.

See how the University of Toronto went about their test.  It’s a good example of how science should be done.  They set up a double-blind experiment, based on measurable outcomes, not on a clever sales pitch using fancy scientific-sounding terms and a single demonstration.  They did not rely on personal endorsements.

This should be a concern to all Americans interested in protecting their health and savings.  Sure, this example came from Canada, but in the US the same kind of activity is rampant.  Just last August on BuzzFeed a sub-headline read: “Analysis by BuzzFeed News found that more than half of the most-shared scientific stories about autism published in the last five years promote unevidenced or disproven treatments, or purported causes.”

Look at some reviews of a website called NaturalNews.com with 6.5 million hits per month.  The Skeptoid says: It’s the #1 "worst anti-science website".  Steven Novella, M.D. and assistant professor at Yale University School of Medicine adds: The author is "a dangerous conspiracy-mongering crank."  From Oncologist David Gorski: It’s “the wretchedest, scummiest, and quackiest" website on the Internet.  Another cites it for “pseudo-scientific insanity." Everyone must be more careful, despite the tendency to believe that Natural = Good.  That’s just marketing, not evidence.

Don’t stop there.  The popular Dr. Oz Show, which just ran it’s 1500th program and a related show The Doctors are not without their critics.  After a thorough investigation of the content, one critic wrote:

“The recommendations made on these shows only occasionally follow evidence-based guidelines. Often, we couldn’t find any literature citation (such as a medical study) to confirm the claims made on the show. The costs and harms of the suggested treatments were often overlooked. And, the hosts on the show frequently hawked products made by companies that advertise on the show.”

 So if Americans watch these shows for medical advice rather than entertainment, it’s best to get a second opinion to distinguish valid medicine from snake oil.  A little critical thinking goes a long way.