COMMENTARY

Is the Wellness Industry Friend or Faux?

Arthur L. Caplan, PhD

Disclosures

November 19, 2019

This transcript has been edited for clarity.

Hello. I'm Art Caplan. I'm at the Division of Medical Ethics at the NYU Langone Health Center. If you've been in practice for any amount of time or if you're conscious on Earth, you will know that the wellness industry has taken off like a rocket ship.

Victoria Beckham just announced that she's going to start developing a line of wellness products. Gwyneth Paltrow has a gigantic corporate entity, Goop, that is selling a variety of wellness interventions and allegedly helpful dietary and behavioral products, making tons of money.

The wellness industry, whether it's mindfulness, aromatherapy, or using stones to improve genital health, is worth over $4 trillion—this is gigantic. It's an enormous area, and in many parts of the country you can presume that your patients are going to be a part of it.

You can probably presume that in addition to using these wellness products, most of which have not been tested or verified to do anything, your patients may be looking at their horoscope, visiting a fortune teller, or reading tarot cards to decide the best day for an appointment. There's a whole rebirth of, let's say, the more quackery psychological sciences, and patients are deeply, deeply involved with some of it.

Now, the question is, do you have to be an exorcist to be a doctor? What are you going to do when people show up spouting odd beliefs or putting their faith in products that celebrities endorse? How do you respond?

I think the first thing to be aware of is that it's likely that many of your patients are going to be interacting with the health food store and the mindfulness mental health side of it, and watching television shows with doctors prescribing blueberry diets, and on and on. Presume it.

Second, it's important to take a look once in a while at websites that sell some of these products. It's good to know what your patients are looking at so you are in a better position to interact with them.

Some people say, "Well, if it doesn't hurt, let them do it." There are even many cancer centers around the United States and Canada that offer some of these wellness approaches, such as Reiki therapy or aromatherapy, as part of what's given on the menu to cancer patients. And they do it saying that it won't hurt; if they want it, [let them have it]. It may make them feel a little bit better in the short term to have a massage, so what's the difference?

You have to be careful because many of these products are bunk and ripping people off. Particularly, when patients are sick, you don't want them to become financially drained in addition to being beaten down and hurt by the disease.

I'm not saying that there's no value in having a massage, and I don't mean to say that some people don't feel better if they use certain wellness products or grooming products; their appearance may matter greatly to them.

I think you have to broach the subject with your patients and say, "Look, there's not much data supporting the claims for many of the diseases that afflict people, such as cancer or diabetes. These products aren't going to help you."

In terms of trying to decide a good day to visit the doctor, any day is good in terms of scheduling a checkup, getting dental care, or deciding to get that blotch on your skin checked out. You don't really have to visit the astrologer to get an answer.

I think medicine has to stand for science. It doesn't have to be aggressive about it, but it also shouldn't be tolerating nonsense. If a patient asks, I would answer frankly what you know and what you believe about the evidence base for this gigantic industry.

When people are complaining about the high price of prescription medications and medical services, you might point out that they don't seem to complain quite as much about spending $4 trillion that goes into the pockets of celebrities. Why is that?

I'm Art Caplan at the Division of Medical Ethics at the NYU School of Medicine. Thanks for watching.

Arthur L. Caplan, PhD, is director of the Division of Medical Ethics at New York University Langone Medical Center and School of Medicine. He is the author or editor of 35 books and 750 peer-reviewed articles, as well as a frequent commentator in the media on bioethical issues.

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