Alternatives and Frauds

This is my second article on evaluating online medical information. To see the first, go back to the August 15th issue of the Recorder. One of the things I learned in participating in Facebook discussion groups for Alzheimer’s caregivers is that many, many people distrust the medical establishment.

There are good reasons for that. The profit motive in the medical industry does lead to some perverse incentives. Certainly large pharmaceutical companies do things that are against the public interest: they engage in price gouging, manipulation of patents, and they use research that is publicly funded for private gain. And, the diseases that are profitable to develop medicines for are not necessarily the ones in most need of treatment. Public health and profit are quite often at odds.

But these companies and the medical industry do have something going for them: their products are tested. Don’t get me wrong; there are problems in which drugs get testing and the approval process, to be sure. But, at least there is testing, some process for ensuing that a drug you purchase is what it is purported to be and will do something for you. A drug must have supporting studies to be approved. Contrast this with the alternative health industry. In concept, there is nothing necessarily wrong with complementary and alternative health practices. Basically, complementary practices are those designed to be used alongside traditional medicine while alternative ones are to be used in place of scientific medicine.

Some of these practices might be of benefit. In a previous job, I worked with people who collected data on complementary and alternative medicine. Ideally, once tested, if these practices prove beneficial, they become mainstream.

But in actual practice, this is not what most of the industry is about.

Let’s start with nutritional supplements. Even the most common ones, like multivitamins, are mostly useless. Unless you are directed to by a physician, it is unlikely that you need, or would benefit at all, from vitamin supplements. They aren’t absorbed well and you will get better nutrition from eating actual, healthy food, especially vegetables.

Most other supplements range from useless to harmful. As long as they don’t make a specific claim that they can treat a specific disease, the companies can imply just about anything they want, most of it without much basis. Some of these supplements can interfere with prescribed medication and some have ingredients that can be harmful, especially in significant doses.

What is worse, many of these products don’t even contain the ingredients stated on the bottles. You don’t know what you’re getting. So, at best, you’re taking something useless; at worst, harmful. And many people don’t tell their doctors or pharmacists about these supplements, so drug interactions go unnoticed.

Ironically, many of the people who worry over the profit motives of “big pharma” ignore those same forces at play in the alternative health industry. Many of those in the field are disgraced doctors who have shady backgrounds. They are often selling products and use scare tactics about mainstream medicine to entice those with legitimate concerns or to exploit desperate people who are eager to latch onto any hope for a treatment, no matter how nonsensical.

One of the surprising perverse incentives comes in the nature of internet traffic and social media practices. Web sites make much of their money through advertising, so they need people to click on their pages. Each page view generates a small amount of revenue, even if the content is useless.

They still need people to see it, so they promote it through social media. These Facebook groups, often with many thousands of members, are ripe for such promotion. Recently, these groups have become overrun by fake accounts that exist for the sole purpose of promoting useless alternative health ‘articles.’

But some are worse than useless as when you click on a link, they gather information about you from your Facebook account. Though Facebook would prefer you not know it, other recent scandals have made it clear that this kind of data gathering is a feature, not a bug of their product.

Much more could said, but the bottom line is simple. Alternative health practices could hypothetically be useful, though nearly all are untested, so it is difficult to know. But many are useless and will only deprive you of your money and time. Some are actually harmful.

Proceed with great caution and in consultation with your doctor.