Quackery: What To Look For

“Corona Baba rakes in moolah as coronavirus fear rages”

“Bolivia’s senate approved ‘miracle mineral solution’ — a toxic bleach with no medical use — as a treatment for COVID-19”

“Over 300 killed in Iran after drinking industrial alcohol to save themselves from coronavirus”

“Trump again promotes experimental drug for coronavirus treatment”

When you google “COVID Quackery”, you’ll come across the above articles and dozens more echoing the same. No one is immune to the effects of quackery. Quackery is often far more deadly than the disease that it falsely claims to cure. Quackery indirectly or directly contributes to increased patient mortality and morbidity.

Previously, in most countries, only people from the lower socio-economic class were victims of quackery. Being illiterate or uneducated made them an easy target.  In medical school, we were taught that it was an ‘education problem’. That with improved standards of education, quackery would disappear. And then came COVID-19. Now, everybody from every walk of life is falling for quackery. There was a case of a university professor with a Ph.D. in pharmaceutics who took herbal medicine with arsenic in it. So, basically I want to point out that, with increased desperation, everyone is a potential victim.  Even a president.

What is ‘Quackery’?

Taber’s cyclopedic medical dictionary defines a quack as ‘one who pretends to have knowledge or skill in medicine’ or a ‘charlatan’. Simply put, a fake doctor is a quack, the fake medicine he practices is termed as ‘quackery’.

‘Secret ingredients’ that claim to treat famously incurable ailments like diabetes or ‘miracle cures’ that cost a lot of money are examples of a typical advertisement for quackery. Previously, quackery spread through word-of-mouth and was mostly harmless. But, with the growth of social media (Wikipedia, WhatsApp, and YouTube mainly) this has become an infodemic that preys on the most desperate and the most vulnerable.

Is holistic medicine quackery?

The answer to this question is both yes and no. While I don’t endorse them, I am also hesitant to dismiss them as pseudoscience. Currently, in my home country of India, due to the lack of proper governing bodies, subpar testing, and unregulated manufacturing; their potential for abuse currently surpasses any benefits that they might offer. At present, a lot of untested harmful products are sold in the name of traditional, science-backed medicine, which is a clear case of quackery. The line between quackery and holistic medicine is very thin and often difficult to distinguish.

I believe all drugs and remedies that come under the umbrella of alternative medicine, should be gradually integrated with modern medicine. This not only increases their understanding but also allows them to be subjected to a higher level of research protocols, thereby reducing the abuse potential.

Why is quackery widespread?

• Lack of difference between a ‘doctor’ and a ‘physician’/’surgeon’: The term ‘doctor’ is very commonly used in the 21st century by Ph.D. scholars, holistic medicine practitioners, dentists, etc but it continues to be widely associated with physicians and surgeons who practice modern medicine. Unfortunately, this has led to the term being misunderstood by victims of quackery.
• Lack of proper laws: Most countries do not have proper laws against quackery as it is difficult to outlaw alternative medicine, holistic medicine, and cult medicine as quackery.
• Ignorance: Limited understanding of medical advances has led the victims to fall for exaggerated claims made by quacks. “Groundbreaking stem-cell therapy for autism”, “Scientists recommend this newly discovered miracle drug for cancer”, etc. are some examples of the same.
• Distrust of modern medicine: Millions of conspiracy theories and general lack of trust in the government contribute to decreased trust in modern medicine. Hospitals are accused of overcharging. Physicians and surgeons are guilty of overprescribing antibiotics and painkillers, this has encouraged people to reject conventional medicine and to look for more ‘natural’ remedies. The rising number of anti-vaxxers is an example of this.
• Placebo effect: Decrease in symptoms and an increased sense of well-being that a patient feels after consuming a quack medicine can be easily attributed to the placebo effect. Unfortunately, the patient is more likely to attribute it to the ‘medicine’ itself. This increases the patient’s belief in it.
• Cognitive bias: Diseases are known to be self-limiting. The patient will feel better after a while without taking any medication. But the patient is more likely to attribute the improvement in his health to the quack-drug.
• Faith and religion: Most cases of quackery prey on vulnerable people with deep-rooted religious sentiments. If you come across any organization that claims that their product or activity can ‘cure’ a disease using faith without the use of allopathic medicine, that is a red flag. Sometimes they actively discourage their followers from seeking much-needed medical attention.
• Fear of side effects: While physicians and surgeons have a duty to warn the patient of the potential side effects of any drug or surgery, practitioners of quackery have no such sense of duty. They do the exact opposite. They falsely claim that their product has ‘zero side effects’. This leads to decreased trust in modern medicine and increased trust in alternative remedies.
• Desperation: Modern medicine has limitations. There is no known cure for many chronic health diseases. When modern medicine fails to meet the expectations, patients turn towards other means of cure.
• Pride: A person is unlikely to admit that they spend their money on nothing and have been duped. They will continue to endorse alternative therapies for the sake of their pride. 
• Pop culture: Numerous celebrity lifestyle blogs advocate for alternative medicine. They are publicized as ‘herbal’ or ‘clean’ products found naturally while ignoring that most poisons are also found naturally. Everything found in nature is not always good for you. In the east, most k-dramas and c-dramas use traditional medicine in their storylines.
• Actively promoted by the influential people and media: Prince Charles is known to promote Homeopathy, the Bolivian government has promoted MMS as a cure for COVID-19, President Trump has endorsed controversial drugs, the Indian government is an active promoter of AYUSH, etc.  Celebrities like Gwyneth Paltrow, Jessica Biel, Novak Djokovic, Amitabh Bachchan, etc have spoken out against modern medicine or/and in support of holistic medicine.

How to spot quackery (red flags):

• Products that claim to cure multiple conditions.
• Vague ‘special, secret, or ancient’ remedies that ‘no one will tell you about’.
• Promises of a ‘quick’ cure for chronic diseases.
• Cures for diseases with no known cure like cancer, diabetes, or autism.
• They either charge a lot or charge very small amounts of money. It’s always in the extreme.
• Dubious patient testimonials about how they ‘recommend’ it for everyone and anyone.
• The cures are supported by ‘scientific breakthroughs’ and ‘recent research’ but offer no or doubtful proof of any research.
• ‘Limited time offer’ or ‘specially made for you’ or ‘money-back guarantee’.
• The cures are made ‘naturally’ and have ‘zero side effects’.
• Credentials impossible to verify on official websites.
• Quacks do not display their medical degree because they don’t have any.
• Claim to possess ‘supernatural powers’ or have ‘religious gifts’.
• Wikipedia articles, Youtube videos, and Whatsapp messages are NOT legitimate sources.
• They denounce modern medicine or other practitioners.
• Peddle large-scale conspiracy theories.
• They lack transparency.

Quackwatch

Quackwatch is a website that provides information on various practices of quackery. Furthermore, it also helps in differentiating science from fiction when it comes to controversial topics like autism and AIDS. The website also gives information on court cases pertaining to quackery. It primarily covers the US.

Why quackery is difficult to control:

• Patient autonomy: One of the biggest hurdles in eliminating quackery is patient autonomy. A patient has the right to make decisions about his medical care without the interference of a healthcare provider.
• Freedom to choose: The patient is free to pursue any treatment of his choice regardless of his doctor’s views on the same.
• Freedom of speech: Laws that protect freedom of speech are abused by quacks to sell their products. 
• Quality of research: The quality of research and the significance of results cannot be guaranteed in the case of alternative medicine. Despite various governing bodies worldwide, the quality of research fails to improve and various drugs are released into the market without proper clinical trials.
• Difficulty in policing religious organizations: Regulating religious organizations is difficult due to its controversial nature. It impedes religious freedom. Traditional and holistic medicine are intertwined with one faith or another; Ayurveda and Hinduism, Unani and Islam, Esoteric healing and Christianity, Acupuncture and Taoism/Daoism, Oriental medicine and Folk religions are some examples of the same.
• Publication laws: There are no laws against the independent publication of books recommending alternative therapy over conventional medicine. They denounce modern medicine as a widespread conspiracy to make doctors rich and patients poor. Some examples are ‘Heart Mafia’, ‘Chris Beat Cancer’, etc.

Changes to make:

• Integration of spiritual and holistic medicine with modern medicine: Subjecting all traditional remedies and practices to the same protocols as modern medicine can reduce the adverse effects of quackery and also improve understanding and quality of holistic medicine. Sole dependency on allopathic or traditional medicine forces a patient to choose only one among them. This has been shown to increase patient distrust.
• Proper distinction between professions: There is a lot of confusion about who can legally use the title of ‘doctor’ (I only very recently found out that Jill Biden was not a physician or a surgeon). The title has been abused for a very long time. I suggest a gradual shift towards using ‘physician’ or ‘surgeon’ instead of ‘doctor’ by those who practice modern medicine. The same can also be applied to dentists. This when combined with the above point, creates a gradual distinction between various professions and makes it easy to prosecute quacks.
• Prosecute unlicensed interdisciplinary practitioners: There have been cases of physicians and surgeons practicing in specialties that they haven’t trained in. For example, a psychiatrist doing surgeries, an ER specialist doing rhinoplasty, or a GS treating refractory errors. This decreases patient trust in the profession. Report these individuals to the board.
• Encourage patients to verify their source of information: The Internet is here to stay and most patients would have already looked up their symptoms and treatment options online. Instead of discouraging this habit, encourage them to educate themselves by looking into reliable sources of information. Most research papers are open access and are extensively peer-reviewed prior to their publication. Suggest that they refer to reputed journals like JAMA or Lancet.

Infamous Quacks:

Some of these people are still in practice today and to my extreme disappointment, haven’t been arrested.

• Mohd Ismayil: The infamous ‘corona baba’ of Hyderabad was arrested when it came to light that he created a religious WhatsApp group informing people that he could cure all diseases, including COVID-19, without using any medicines because he had ‘supernatural powers’. He charged upwards of $540 for a consultation.
• Mugo Wa Wairimu: This despicable human being was arrested in 2018 following an exposé and was later released due to ‘insufficient evidence’. This comes after he was filmed sexually assaulting his patients, prescribing dubious medicines, overcharging, self-injecting narcotics, drinking on the job, and openly smoking weed in his clinic. He has yet to show a medical degree. Currently practices in Kenya.
• Giang Phung Tuan: Self-proclaimed Vietnamese ‘physician’ with ‘rich history of 16 generations of traditional medical care practice’, and ‘Asian Record Holder for being the Doctor with patients from most number of countries’. He calls himself a ‘borderless doctor’ and all he has to show for himself are multiple self-made titles and potentially fatal ‘traditional’ remedies and advice. Currently practices in Vietnam.
• Biswaroop Roy Chowdhury: This ‘Internationally Renowned Medical Nutritionist’ doesn’t have a degree in medicine. He is a production engineer with a Ph.D. in diabetes from an unrecognized university in Zambia. He self-published multiple books denouncing current treatment protocols of diabetes, cholesterol, HIV, etc. He is also responsible for convincing 7000+ patients to stop taking their antiretroviral medication because AIDS is a ‘lie’. He has an FIR filed against him for killing a patient. Currently practices in Malaysia, Switzerland, India, and Vietnam.
• Zhang Wuben: Advocate for ‘food therapy’ and the author of a best-selling book, Eat Away the Diseases You Get from Eating, was exposed as a fraud in 2010 but escaped prosecution. He made millions from his practice that charged $450 for a 10-min consult and had a 2yr waiting list. Currently practices in China.
• Louis Daniel Smith: This ‘bishop’ of Genesis II Church of Health & Healing sold industrial bleach as ‘Miracle Mineral Supplement’, a cure for HIV, malaria, hepatitis, flu, common cold, autism, acne, cancer, etc. Despite multiple arrests, this compound continues to be sold. After being advertised as a faith-endorsed COVID-19 cure, it is responsible for poisoning hundreds of patients in Bolivia. Currently lives in the US.
• Tullio Simoncini: A former Italian physician (an actual medical doctor) known for alternative medicine advocacy. He infamously claimed that cancer is caused by the fungus Candida albicans, and can be cured with intravenous sodium bicarbonate. He ended up killing a patient, following which he was arrested in 2018 and had his license canceled.
• Serge Benhayon: Former tennis coach and the founder of a cult named ‘Universal Medicine’ that sells ‘Esoteric healing’ products. The cult makes an excess of $2 million a year by preying on women suffering from breast cancer, among other things. Despite multiple court cases, this organization continues to function. Currently operational in Australia and England.

Conclusion:

I believe, when it comes to infectious diseases, public health should take precedence. All untested remedies and drugs that claim to treat infectious diseases should be banned immediately as they can potentially endanger public health by allowing illnesses to spread untreated to others. Drugs must be extensively tested using proper protocols before coming into the market. 

But, personally, I think that when it comes to non-infectious diseases, patient autonomy should take precedence. In this case, there is no threat to others by the patients’ use of potentially harmful, untested drugs.  However, drugs and remedies that claim to treat non-infectious diseases should also be extensively researched by the medical community and their side effects should be clearly displayed on the packaging to allow the patient to make an informed choice. 

I am aware that the above two statements are somewhat of an oversimplification. For example, take the controversy surrounding vaccines and autism, does it come under infectious diseases or non-infectious diseases?

Patient autonomy vs Public health is a complex and nuanced topic. And there is no correct or incorrect answer to this problem. Both perspectives are justified and both have their benefits and their limitations. The ethical dilemma about the precedence of individual liberty or community health is further complicated when you factor in the multitude of different possible situations and types of diseases.

There is no ‘ideal’ solution here. All I ask is that you exercise caution when it comes to alternative therapies. Please view both sides of the picture. Take expert opinions into consideration. Make an informed choice. Help others do the same.