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When’s the last time a patient asked you to advise on whether you knew of a ‘tonic’ they could take to boost their energy levels or put a bit of pep back in their step? They could be asking for themselves as a TATT —‘Tired All The Time’ — patient (my favourite medical acronym after ‘I GET SMASHED’, by the way) or for their little one, who they feel is constantly picking up illnesses at the local crèche.
What do you tell them? That no, there is no magical elixir, we need to rely on our natural immunity, a balanced diet, exercise, sleep, medical treatment where appropriate, common sense? Well, you may be sticking to a pragmatic and evidence-based approach in your day-to-day practice, but there’s a staggering amount of self-anointed experts out there on social media, TV and magazines who aren’t — and your patients are buying what they’re selling. This is nothing new really, and those of us who have practiced in rural areas may be familiar with ‘the cure’, which I have never really understood to be anything more than regional voodoo, handed down from generation-to-generation, with one of the secrets of its ‘effectiveness’ being that you must never divulge the details of said ‘cure’. The first rule of Fight Club, etc.
You may ask, ‘well, so what? If people feel a teaspoon of whatever elixir that a sports or media personality are flogging will help them get through that exam, through a period of work or life stress or make them feel a small bit better about themselves, then what harm?’ The only problem with a relaxation of attitudes towards ‘treatments’ that may not have proven health benefits is that they are more likely to harm those individuals who are most vulnerable, who have most to lose when it comes to their health, people with active health conditions who may feel that traditional medicine has failed them, or those who are searching for answers or reassurance in all the wrong places.
What stops medical professionals from dispensing unproven or untested advice or treatments is a shared acknowledgement of the principles of our training, medical ethics and regulation. What stops those who do not possess any medical qualifications and are thus not under the observation of any regulatory body? Nothing at all.
I’ve seen bloggers, media ‘nutritionists’ and Gwyneth Paltrow, the high priestess of modern alternative ‘health advice’ for middle-class women everywhere, advocate everything from intravenous turmeric infusions, cutting out whole food groups to treat cancer and manage anxiety, jade eggs (look it up), expensive tests to screen for causes of chronic fatigue and hormone rebalancing treatments.
People can argue that if you want to spend your money on a month’s supply of dried vegetables, then that should be your choice, but I’d contend that all of this represents the thin end of a very wide wedge in an age when we are witnessing an increasing worldwide distrust of medical professionals and science in general. For example, the drop in HPV and childhood vaccination uptake rates internationally will have far-ranging and long-term consequences for entire populations, long after the naysayers have exited the room. It feels at times that we are up against people and companies who have far glossier and savvier marketing strategies than we could ever hope to and who often stand to gain financially from promoting ‘health products’ on social media.
The genius of social media as a marketing tool is that companies often pick successful individuals who have cultivated a large and loyal following on various outlets and who are well trusted by their legions of fans. They are ‘real people’ with an ‘authentic’ voice and thus people trust them to dispense advice on everything from reproductive health, nutrition, treatments for cancer and mental health.
By all means, I welcome anybody opening up legitimate discussions on any of these areas, but I draw a firm line at promoted ads for charm bracelets to increase mental health ‘awareness’. Who really benefits from this?
Trust should be the hard-earned foundation of any patient/doctor relationship and indeed, as a profession, we still broadly enjoy the privilege of that trust on a daily basis. But we should be vigilant in maintaining it and should be aware that the days of patients obtaining their advice from ‘traditional’ sources and their acceptance of research and evidence alone are long gone. There is nothing wrong with a holistic approach to managing one’s health — indeed, it is fundamental — but when the lines are blurred by people or companies with often vested interests in maintaining our ‘wellness’, then we need to be ready to challenge this robustly.