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Common Misconceptions About Quackery

Stephen Barrett, M.D.

Although most Americans are harmed by quackery, few perceive it as a serious problem and even fewer are interested in trying to do anything about it. Many misconceptions appear to contribute to this situation:

Misconception #1: Quackery is easy to spot. Quackery is far more difficult to spot than most people realize. Modern promoters use scientific jargon that can fool people not familiar with the concepts being discussed. Even health professionals can have difficulty in separating fact from fiction in fields unrelated to their expertise.

Misconception #2: Personal experience is the best way to tell whether something works. When you feel better after having used a product or procedure, it is natural to give credit to whatever you have done. This can be misleading, however, because most ailments resolve themselves and those that don't can have variable symptoms. Even serious conditions can have sufficient day-to-day variation to enable quack methods to gain large followings. In addition, taking action often produces temporary relief of symptoms (a placebo effect). For these reasons, controlled scientific studies are usually necessary to establish whether health methods actually work.

Misconception #3: Most victims of quackery are easy to fool. Individuals who buy one diet book or "magic" diet pill after another are indeed gullible. And so are many people who follow whatever fads are in vogue. But the majority of quackery's victims are merely unsuspecting. People tend to believe what they hear the most. And quack ideas -- particularly about nutrition -- are everywhere. Another large group of quackery's victims is composed of individuals who have serious or chronic diseases that make them feel desperate enough to try anything that offers hope. Alienated people -- many of whom are paranoid -- form another victim group. These people tend to believe that our food supply is unsafe; that drugs do more harm than good; and that doctors, drug companies, large food companies, and government agencies are not interested in protecting the public. Such beliefs make them vulnerable to those who offer foods and healing approaches alleged to be "natural."

Misconception #4: Quackery's victims deserve what they get. This is based on the idea that people who are gullible should "know better" and therefore deserve whatever they get. This feeling is a major reason why journalists, enforcement officials, judges, and legislators seldom give priority to combating quackery. As noted above, however, most victims are not gullible. Nor do people deserve to suffer or die because of ignorance or desperation.

Misconception #5: All quacks are frauds and crooks. Quackery is often discussed as though all of its promoters are engaged in deliberate deception. This is untrue. Promoters of mail-order quackery are almost always hit-and-run artists who know their products are fakes but hope to profit before the Postal Service shuts them down. But most other promoters of quackery seem to be true believers, zealots, and devotees whose problem is lack of criticism -- a failure to apply skepticism to the favored therapy, very much like a religious person who blindly accepts "the faith."

Misconception #6: Most quackery is dangerous. Quackery can seriously harm or kill people by inducing them to abandon or delay effective treatment for serious conditions. It can also wreck the life of people who are so thoroughly misled that they devote themselves to promoting the methods and welfare of the quack. Although the number of people harmed in these ways cannot be determined, it is not large enough or obvious enough to arouse a general public outcry. Most victims of quackery are harmed economically rather than physically. Moreover, many people believe that an unscientific method has helped them. In most cases, they have confused cause-and-effect and coincidence. But sometimes an unproven approach actually relieves emotionally related symptoms by lowering the person's tension level.

Misconception #7: "Minor" forms of quackery are harmless. Quackery involving small sums of money and no physical harm is often viewed as harmless. Examples are "nutrition insurance" with vitamin pills and wearing a copper bracelet for arthritis. But their use indicates confusion on the part of the user and vulnerability to more serious forms of quackery. There is also harm to society. Money wasted on quackery would be better spent for research, but much of it goes into the pockets of people (such as vitamin pushers) who are spreading misinformation and trying to weaken consumer protection laws.

Misconception #8: Government protects us. Although various government agencies are involved in fighting quackery, most don't give it sufficient priority to be effective. Moreover, the agencies involved lack a coordinated plan to maximize their effectiveness.

Misconception #9: Quackery's success represents medicine's failure. It is often suggested that people turn to quacks when doctors are brusque with them, and that if doctors were more attentive, their patients would not turn to quacks. It is true that this sometimes happens, but most quackery does not involve medical care. Doctors should pay attention to the emotions of their patients and make a special effort to explain things to them. But blaming medicine for quackery is like considering the success of astrology the fault of astronomy. Some people's needs exceed what ethical, scientific health care can provide. The main reason for quackery's success is its ability to seduce unsuspecting people. Several years ago a survey done in New Zealand found that most cancer patients who used "alternative" therapies were satisfied with their medical care and regarded "alternative" care only as a supplement.

Misconception #10: "Alternative" methods have moved toward the scientific mainstream. In 1991, Congress passed a law ordering the National Institutes of Health (NIH) to establish an office (now called the National Center for Complementary and Alternative Medicine (NCCAM) to foster research into unconventional practices. It remains to be seen whether any useful research will be done as a result. Meanwhile, of course, "alternative" proponents have been labeling the very establishment of the NIH office as "scientific acceptance" -- and media outlets have been repeating this claim without bothering to investigate whether it is true.

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This article was revised on August 30, 1999.