Facts, not Fantasy

Wednesday, October 07, 2009

The Rise of the Citizen Doctor

Welcome to a new age of amateur scientists and quack healers. Thanks media!
By Shannon Rupp, 5 Oct 2009, TheTyee.ca

While mass media are filled with discussions of the powers and perils of "Citizen Journalists," little is written about a much more valuable trend: the rise of the Citizen Doctor.

Vaccination-denier Jenny McCarthy fits the bill. She's the former Playboy Playmate who built a new career, on CNN's Larry King and elsewhere, claiming her son's autism is the result of the MMR vaccine (measles, mumps, rubella). She's busy insisting that your child could be next despite the fact that the cause of autism is unknown and other parents of autistic children consider her to be a nutty loose cannon.

Oprah fits the bill. She provides cheerleading and a platform for the likes of McCarthy and enthusiastic cougar Suzanne Somers, whose stay-young-forever campaign features hormone therapies linked to cancer. Newsweek went to town on Lady O in the spring with "Crazy Talk: Oprah, Wacky Cures & You."

Sniffles? Bend over please
The Huffington Post, which runs the words of the ambitious willing to work for free, is like the bible for Citizen Doctors. A (very cranky) Rahul K. Parikh offers an M.D.'s view on this in his Salon piece discussing how the Huffpo advocates practices like giving enemas to prevent flu. (Suddenly vaccines look attractive.)

Closer to home, Citizen Doctors can get training in the magical thinking of their choice at public institutions. The Vancouver School Board, for example, has offered courses in "aura reading" and "face reflexology" which can be cobbled into a certificate and gives Citizen Doctors a kind of authority.

Credentials are important to non-celeb Citizen Doctors, I've noticed. So supplying the amateurs with pseudo-academic cred has become big business for continuing education departments in universities and colleges, as well as in the private degree mills.

Bringing down public health costs
In B.C., the Health Professionals Act covers many of the Citizen Doctor groups, all of whom seem to be lobbying to expand their "scope of practice." In April, B.C. was the first province to grant naturopaths -- who practice, among other things, a form of magic known as homeopathy -- the right to prescribe those science-based drugs they used to despise.

It's genius! Naturopaths charge users about $100 a visit. In effect, people who were clogging up the public medical system are being directed into a user-pay system -- and with the enthusiastic support of some of the public, no less. (I bet the move even earned the Liberals a few votes in the last election.)

Kudos to the government strategists on this one. And with that in mind, I say we include all the Citizen Doctors under the umbrella of this act. Just think of the benefits to provincial coffers if we embrace those privately funded "wellness" experts currently on the fringes, like colonic-cleansers and shamans (shamen? shapersons?).

Survival of the fittest
Although I wonder whether chiropractors should remain in that pool, given that they may actually be costing the healthcare system money. Last year an Alberta woman with post-neck-cracking paralysis launched a half-million dollar class action suit against chiropractors and the province. Her claim is based on a decade of research connecting chiropractic neck adjustments to strokes.

In July, the Alberta court decided the provincial government can't be added to the suit -- and personally, I hope the courts kick this whiner to the curb. Since the hazards of the subluxation crowd are well-publicized, she shouldn't be surprised at the "treatment" she received when she opted for spinal manipulations in service of "wellness".

Friends and colleagues consider my enthusiasm for quack therapy a betrayal of my expensive, publicly-subsidized education, but really it's the result thereof. Embracing Citizen Doctors makes sense in terms of both economics and evolutionary biology.

Consider the sort of people inclined to use "complementary medicine". Exactly. Not only does encouraging them to go for bone breathing shorten the medical queues for the rest of us, but it will also ultimately improve the gene pool.

"You little eugenicist you!" my friends snap. (They're exaggerating: I prefer the term logician.)
Think about it: Citizen Doctors are a clever solution to everything from surgery waiting lists to over-population. Not to mention reducing the pressure those greying Boomers are about to put on pension plans.

Band-aid and comfort
I'll accept that the rise of Citizen Doctors is creating a kind of two-tier medical system -- one I can celebrate because its participants are self-selecting.

Of course taxpayers should demand that public healthcare dollars be restricted to funding therapies that work -- for one thing, they tend to cost less than quackery. But if consumers like myth-and-magic, why shouldn't they have easy access to merchants who sell nonsense? No one prevents diet companies from seducing the public. Or cosmetics companies. They trade in fraud too. Or perhaps "hope" is better word? But it amounts to the same thing.

We all know the facts. Doctors brandish overwhelming evidence that avoiding smoking, booze and other drugs, getting proper nutrition along with adequate exercise, being vigilant about preventative health care such as vaccines and check-ups for fatal-but-treatable diseases will give most of us a healthy 75 years. (No one said anything about happy, people, just disease-free.)
Which is what I reminded an acquaintance who ventured that my "opinion" about her quack therapy of choice (reiki) was wrong. (I have no more of an opinion about reiki than I have about the flatness of the earth. I've never done experiments to confirm whether the earth is round, but I trust the evidence of people whose life's work it is to have done the research.)

"I feel reiki is important to my wellness," she said.

I'm sure she does. But I asked her why, if she's concerned about her health, she doesn't lose 30 pounds and stop guzzling wine like it's water -- there's hard evidence both practices would improve her so-called state of wellness.

I didn't get an answer.

Road to wellness too steep?
On the bright side, maybe time spent getting reiki distracts her from drinking? And that's just the kind of benefit I feel quack therapy can offer. Without alternative medicine to support her ostrich-like stance, she would be in her GP's office regularly, demanding meaningless MRIs, whining about feeling lousy, yada yada yada. Costly. And pointless. She doesn't want to do the hard work necessary for good health. But she is willing to pay for the illusion she's doing something productive. So why shouldn't we empower the sellers of such socially-useful deceptions?

Hail Oprah and bring on the bone breathers, I say. Not only will Citizen Doctors improve our fitness as a species, they'll save us a few bucks while doing it.

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