COMMENTARY

Baseless Medical Advice Thrives With Few Repercussions

Jeffrey A. Lieberman, MD

Disclosures

April 06, 2021

This transcript has been edited for clarity.

Hello. This is Dr Jeffrey Lieberman of Columbia University, speaking to you for Medscape.

Today I want to talk about the quality of information we're receiving through all sources — certainly in professional scientific journals, but also more significantly through the media. This affects not only healthcare providers but, perhaps more important, the population at large.

Think of information as the air we breathe. We need oxygen to function. If the atmosphere becomes polluted, or the concentration of oxygen decreases as it does at higher altitudes, this impairs our ability to function. Similarly, we need information to function, to know what decisions to make, how to plan, what to buy and eat, where and from whom to receive healthcare, and what medicines to take.

For this reason, I'm concerned about the quality of information that has permeated our broadcast, print, internet-based, and social media. This comes largely in the guise of advertising but also in the form of infomercials and even the so-called objective news media.

It's my opinion that the standards of veracity, authenticity, and reliability we may have once assumed were in place have declined or dissolved altogether. It now seems that anything goes, that anything can be said or claimed without regard for the truth or evidence. It's not a matter of free speech or expression or even caveat emptor, in which people can say anything and the buyer has to beware. Rather, it's a question of who's responsible for holding accountable the people, organizations, and companies that are purveying this misinformation, and what the consequences are for not doing so.

Medicine's Bad-Faith Marketplace

Many of us encounter phony healthcare products in the form of advertisements on television, radio, and the internet. Prevagen is promoted for cognitive enhancement and improved memory and focus. For diets, there are products like LeanSpa, FatFoe, and Sensa salts, as well as a cognitive therapy for achieving weight loss called Noom. There are products with proposed energy-enhancing qualities such as Thermo Energy Booster, Nugenix (basically a form of testosterone), beet crystals, and apple cider vinegar. We also have products for aging and longevity, for baldness and hair replacement, and for prostate treatments.

Such products are not just questionable; they're absolutely bogus. What is the evidence for these? There's none in the medical literature that I'm aware of. This is the equivalent of snake oil, which comes with unfounded claims of effectiveness and accuracy. And how are people to know whether these claims are correct?

There are even doctors who collude in this, acting as spokespersons or directly promoting themselves as the people to go to for various maladies. Now, I can't generalize that all of these doctors are really snake-oil salesmen or charlatans, but I'm skeptical of the motives and credentials behind the advertisements that we see. I'm personally proud to have helped to expose two of the most disreputable members of our mental health care and psychiatry profession, Drs Keith Ablow and Daniel Amen.

I don't know whose responsibility it is to monitor the quality of information that comes across the airwaves or the internet, or the media organizations that promote and pay for these ads, infomercials, and infotainment — the Federal Communications Commission? The Federal Trade Commission? Whoever it is, they should know that the public is being indiscriminately and detrimentally exposed as a result of their oversights.

In many ways, this is similar to ongoing debates in the public arena and in Congress about social media platforms such as Facebook and Twitter, and what their responsibility is for the material that's posted. This is mainly being done in the political vein, but it also pertains to ads for healthcare products.

Legal Hucksterism and the Risks of Diminishing Standards

I've also noticed another disturbing media trend. Maybe I'm watching television or am on the internet too much, but I see a torrent of ads by personal injury law firms and lawyers, much more so than I did in the past. These ads seem to be trolling for cases in a way that can incite people to make claims which may or may not be justified.

Apart from ostensibly providing remuneration to people for injuries or illnesses that have occurred because of malpractice or mistakes made in hospitals or by doctors, this also has the effect of causing doctors to practice defensive medicine. This, in turn, drives up healthcare costs and ultimately results in higher insurance premiums. So, in the end, the costs are passed on to the public.

In medicine, we're held to objective empirical standards: Patients die, complications occur. In science and research, published findings that cannot be verified through replication and repetition simply don't hold up in the literature and don't become standards of care.

This is the standard we're measured against and there's no way around it. If patients die, if patients have complications, this affects our medical reputations. If data that we find as researchers are not replicated and do not hold up, any findings, claims, or hypotheses built up around them go away and our scientific reputations are impacted as a result.

Why aren't similar objective standards applied to the information to which the public is exposed through the media, on both the public airwaves and on the internet? Somebody needs to hold accountable the people and organizations purveying this information, as well as the companies that are being paid for the advertising and the airtime.

I'm Dr Jeffrey Lieberman of Columbia University, speaking today for Medscape. Thank you for listening.

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