[Discussion] Medical Quackery

This is a follow up to the thread "Medical quackery in the US upsets me very, very much". The aim of this current thread is to take up the discussion on medical quackery (widening the scope since the US isn't the only country concerned), discuss news item pertaining to it and the potential responses to address it.
The definition of medical quackery is not up for debate and includes, among others, homeopathy, vaccine skepticism, naturopathy, crystal healing, psychic healing.

Dr.Ghastly wrote:

...That, that chocolate octave of the sun thing.. That can't be real? Please? Tell me that isn't real.

IMAGE(https://sd.keepcalm-o-matic.co.uk/i-w600/it-s-true-all-of-it.jpg)

I really, really, really wish it wasn't.

LupusUmbrus wrote:

Just going to leave this here: Alternative Medicine Kills Cancer Patients, Study Finds.

I shouldn't have read the comments but unfortunately I did.

As it turns out, the Journal of the National Cancer Institute is now part of the main stream media so it turns out this is all just lies.

Does Breitbart publish scientific articles or where exactly am I to turn to for credible medical knowledge?

We are at the point in our society where I could stand in front of someone, light a piece of paper on fire while we both watch it burn, and they would argue that fire does not cause burning because a facebook article their cousin sent them said fire is cold and regularly applying fire to your eyeballs cures eyebulgeitis. I just don't think I can do it any more. I can't keep arguing against some of the insane things I hear friends and co-workers talk about as though they were "fact". One of my best friends regularly posts that David Wolfe junk and believes every word of it. I'm tired.. so tired.. of just trying to convince people that observable phenomenon and rigorously tested data are real while magical thinking is the stuff of fantasy.

I just don't bother at all. My opinion is worth money to a lot of people. I'm not in the habit of giving it away for free. If they want it, they can pay for it, just like everyone else. Or they can persist in their stupidity and die like Steve Jobs. You truly get what you pay for, in these cases. It's abominable that Wolfe can keep doing business like this, but that's a government regulatory issue.

Kehama wrote:

regularly applying fire to your eyeballs cures eyebulgeitis

As evidenced by the fact that Steve Buscemi has never applied fire to his eyeballs.

I'm just a layman. But I have a passion for science, skepticism, and critical thinking. I feel it's my duty to try and share my limited wisdom with others that need it. But I don't proselytize. I simply state a few poignant facts, and if the person I'm talking to wants to hear more I will gladly steer them towards a source of evidence based information. If they're not interested, I stop talking.

One exception to this is when someone's safety is at stake. In that situation I will be a little more emphatic. Often I will convey the story of Steve Jobs, highlighting the details about how he regretted not seeking evidence based cancer treatments and urged others to do just that.

But if someone is genuinely opposed to hearing the voice of reason, I let it go. The meek shall inherit the earth is a lie. The critical thinkers and their progeny shall inherit the earth. It's Darwinism in action. But it's a slow process.

TLDR - You can't fix stupid.

aside from the whackos pawning quantum magnet bracelets to cure everything the drug companies go and do this... Report: Drug company faked cancer patients to sell drug.

f*ck right off. No wonder people are hesitant to trust 'big pharma' and instead turn to the quackery. I don't know what punishment can happen here but I hope it is severe enough to discourage such behavior in the future. Sadly I suspect instead they'll just add the probable legal fees into their list of justifications for absurd drug costs.

krev82 wrote:

aside from the whackos pawning quantum magnet bracelets to cure everything the drug companies go and do this... Report: Drug company faked cancer patients to sell drug.

Hey, don't leave out the homeopathic magnet bracelets that cause lead poisoning in babies.

krev82 wrote:

aside from the whackos pawning quantum magnet bracelets to cure everything the drug companies go and do this... Report: Drug company faked cancer patients to sell drug.

f*ck right off. No wonder people are hesitant to trust 'big pharma' and instead turn to the quackery. I don't know what punishment can happen here but I hope it is severe enough to discourage such behavior in the future. Sadly I suspect instead they'll just add the probable legal fees into their list of justifications for absurd drug costs.

That is utterly disgusting. I hope they are criminally prosecuted, go bankrupt and any docs who were colluding lose their medical license. Agree this is the B.S. that makes people highly suspicious of pharma.

I'm in full agreement with DocJoe's sentiments. The only caveat I would like to add is to not let this particular case of dishonesty and fraud poison your opinion of the pharmaceutical industry. Most pharmaceutical companies are doing good and honest work.

Good and honest work on drugs that will maximize profits.

If a pharma company exists that uses a portion of its profits to do basic research on non-profitable drugs without being required by law or subsidized to do so, I would love to hear about it.

Medicine and capitalism don't mix.

RawkGWJ wrote:

I'm in full agreement with DocJoe's sentiments. The only caveat I would like to add is to not let this particular case of dishonesty and fraud poison your opinion of the pharmaceutical industry. Most pharmaceutical companies are doing good and honest work.

How confident are you of that? And why?

Because you might have said the exact same thing about Subsys until last week.

Wholly disagree. Medicine and capitalism mix exceedingly well. At least in comparison to our alternatives, medicine and altruism, medicine and religion, or medicine and state interests. Medicine and capitalism is a horrible thing, but it is also the least horrible possible pairing of incentive and health care that we have right now.

Jonman wrote:
RawkGWJ wrote:

I'm in full agreement with DocJoe's sentiments. The only caveat I would like to add is to not let this particular case of dishonesty and fraud poison your opinion of the pharmaceutical industry. Most pharmaceutical companies are doing good and honest work.

How confident are you of that? And why?

In any industry, there will be for profit corporations that break the law to maximize their gains. The pharmaceutical industry is not excluded from this. But the vast majority of corporations do good and honest work.

Subsys committed fraud and got caught. That doesn't mean that every pharmaceutical company is up to no good.

Jonman wrote:

Because you might have said the exact same thing about Subsys until last week.

I was referring to the pharmaceutical industry as a whole. I'd never heard of Subsys before reading that news article. It's been made clear that they're one of the bad guys.

To say that all pharmaceutical companies are up to no good because a few of them have been caught breaking the law, is not accurate. That's a logical fallacy called "poisoning the well."

Jonman wrote:

Because you might have said the exact same thing about Subsys until last week.

Very likely not.

Insys has been in the news since at least mid-2014 with tales of its aggressive sales tactics, including encouraging doctors to use their drug for off-label uses or higher doses to boost sales.

The Southern Investigative Reporting Foundation, a nonprofit founded in response to the financial crisis of 2007-2008 to do in-depth financial investigative reporting of financial institutions and businesses, began looking at Insys in 2015. They were asking basic questions about how a company that was selling a drug that had been on the market for years (and was sold by other companies) could grow their revenues from $15 million to over $220 million in just two years.

SIRF found that Insys did things very differently than its competitors. It created a sales team that was...different. The last job of the guy who ran Insys' New York region was selling aquariums. Prior to that he ran a ticket sales company that was targeted by the New Jersey Division of Consumer Affairs for consumer fraud. The business was closed after he didn't file an annual report for two years.

The head of sales for Insys' Western and later Midwest region was Sunrise Lee. Prior to selling powerful narcotics for Insys--where she was noted to be a "closer"--Lee was dancer at a West Palm Beach strip club. Another Insys sales rep's professional experience boiled down to being on the reality TV show “Beauty and the Geek” and posing in Playboy.

SIRF wrote:

Insys’ apparent practices of hiring women based on their looks, with extraordinary economic incentives to sell the drug, resulted in a good deal of extracurricular sales rep-doctor relationships complicated by sex. None more so than in 2013 when the wife of a high-volume Subsys prescriber found a revealing photograph of an Insys sales executive on his phone. Since she lived not far from headquarters, she drove there and raised a ruckus; she was assured that all appropriate measures would be taken against the rep.

The sales rep was promoted soon after to sales trainer; the doctor no longer prescribes much Subsys.

Insys sales reps were also paid half of what sales reps for their competitors were paid and their compensation structure highly encouraged them to sell more drugs.

The aggressive sales team was coupled with a stable of doctors that paid doctors to promote its drug. SIRF combed through the Centers for Medicare & Medicaid Services Open Payments database to try to figure out why Insys was selling more of its drug than its competitors. (Open Payments is a federal program required by the ACA that collects information about the payments drug companies make to doctors and hospitals).

The SIRF found that Insys was spending millions of dollars, $7.4 million to be exact, on doctors who promoted the use of their drug. That was 7.2% of its selling, general, and administrative expenses. For comparison sake, an Insys competitor spent about $132,000, or 0.4% of their selling, general, and administrative expenses, getting doctors to promote their drug.

In the years since multiple Insys employees, including the company's former CEO and most of its senior management team, have been arrested for fraud, kickbacks, and pushing off-label uses of its drug and charged with racketeering. The FBI got involved in 2016 and is now seeking Insys victims who were prescribed Subsys.

Insys wasn't really ever "big pharma." It was a company that, at its peak, had just a couple hundred million dollars in revenues, mostly from one drug. Real "big pharma" companies have revenues north of $50 billion.

It was also a company that, as the first article link noted, was put on the map by Wall Street:

New York Times wrote:

Medicine aside, Subsys is, much as anything, a Wall Street story. The explosive growth of Insys was fanned first by Wall Street investors betting the company’s sales and share price would rise.

Insys absolutely f*cked up and, in doing so, killed people. But I think the prime trigger of their egregious behavior was the pressure to continue to hit ever increasing Wall Street numbers (coupled, of course, with the inability of its management team to both manage investor expectations and figure out how to legitimately grow their business).

Larger drug companies have multiple products to pad their revenue streams. Insys pretty much had one product, Subsys. When Wall Street expected bigger numbers Insys could only do one thing: figure out ways to sell more Subsys.

And that pressure to meet Wall Street expectations goes beyond the pharmaceutical industry. Early in my career I worked for a mid-sized software company who also caught the attention of Wall Street. The management team couldn't keep up with investors' sales expectations so they decided make our revenues look good by "selling" loads of software to our distributors right before the quarter end. It didn't take long for the SEC to take notice and shut that sh*t down with some jail time for our senior execs.

The point being that what Insys did isn't something that's unique or representative of the pharmaceutical industry. It's still tremendously sh*tty, but it has more to do with greed and an absolute failure of leadership than the drug industry itself.

LarryC wrote:

Wholly disagree. Medicine and capitalism mix exceedingly well. At least in comparison to our alternatives, medicine and altruism, medicine and religion, or medicine and state interests. Medicine and capitalism is a horrible thing, but it is also the least horrible possible pairing of incentive and health care that we have right now.

Eh, I don't know. The US has some of the worst rates when it comes to maternal and infant care (preterm birth as well), not to mention a high mortality in young women with cervical cancer.
I kinda prefer the mix of healthcare and socialism as it currently exists in France and in the UK.

That is, until the money runs out, as it unfortunately inevitably will.

It is a challenging issue and I wonder when we will reach the breaking point. Pharma is in the business of making money but that profit incentive has lead to many of the current breakthroughs in treatment that we now have. And the reality is that the U.S. healthcare system and its lack of any regulation of drug pricing is the engine that makes the whole thing go.

So those with good insurance have incredible access to every available treatment without waiting. If you need a knee replacement it can be scheduled in weeks not months or years. If you have cancer you can get the latest and greatest immunotherapy drug within a couple of weeks from approval rather than waiting months or years as you would in many European countries (or never if NICE gives it thumbs down and you are in the U.K.).

Yet we do terrible for many basics as Eleima pointed out. Which is simply ridiculous but likely to get worse because if you don't have insurance, even the basics can be difficult to access.

So eliminating capitalism from medicine will stifle innovation. Government agencies and academic institutions are just not as effective or nimble enough to shepherd research findings from the bench to market.

So not sure what the answer is. The current system is not ideal nor is scrapping the whole thing.

It's led to breakthroughs in highly subsidized, expensive treatment drugs. But there are a category of diseases that affect huge numbers of people in very poor areas, and these are not going to drive profits for drug companies, so left to their own devices, they ignore them. The category is usually called "Neglected Tropical Diseases". In some cases, companies have been cajoled into donating or providing at low cost drugs to support eradication programs, but in most cases, they make relatively small amounts available for advanced countries, but little to poor countries where these are endemic.

The answer may be decoupling research from the price of drug development, and adding in elements of open source to the process. But that's been proposed and shot down already.

Well, crap.

https://www.humblebundle.com/books/t...

"Essential Oils for Beginners"
Paleo cookbook
"Chakra Healing"
"Essential Oils Natural Remedies"
"Crystals for Healing"
"The Modern Enneagram"

Unfortunately mixed in with a bunch of legit books, too, like one on CBT, a vegan cookbook, homemade ice cream recipes, bodyweight training, and "Sex Positions for Every Body".

crap, I'm tempted to try and write someone at hubmlebundle but I'm skeptical it would do much good.

After their Anime-style TnA bundle I'm not really shocked. Disappointed, but not shocked.

I want a paleo cookbook written from the perspective of a paleolithic hominid.

Also, I like to toy around with the enneagram.

Also, I want homemade ice cream.

BadKen wrote:

Unfortunately mixed in with a bunch of legit books, too, like one on CBT, a vegan cookbook, homemade ice cream recipes, bodyweight training, and "Sex Positions for Every Body".

I don't know if one can legitimize a vegan cookbook while calling a paleo cookbook quackery. They are just alternative diets and both require some effort. I don't dig the whole "paleo lifestyle" fad but eating lean meats , whole vegetables and cutting down on carbs is... actually a pretty healthy way of losing weight.

Edit: On the other hand essential oils as anything other than nice smells can jump off a cliff.

Yeah, essential oils is really popular. My cancer clinic started offering it for patients while they were undergoing chemo because there was such demand and we were trying to be "patient centric". There was also a request to offer color therapy. One of our oncology nurses actually asked why we don't do it universally since the color blue can cure cancer.

I thought health care was really complicated. Who knew it was so easy?

imbiginjapan wrote:
BadKen wrote:

Unfortunately mixed in with a bunch of legit books, too, like one on CBT, a vegan cookbook, homemade ice cream recipes, bodyweight training, and "Sex Positions for Every Body".

I don't know if one can legitimize a vegan cookbook while calling a paleo cookbook quackery. They are just alternative diets and both require some effort. I don't dig the whole "paleo lifestyle" fad but eating lean meats , whole vegetables and cutting down on carbs is... actually a pretty healthy way of losing weight.

Edit: On the other hand essential oils as anything other than nice smells can jump off a cliff.

There are some pretty glaring differences between the paleo diet and veganism. The biggest being that for the vast majority of vegans it's a moral choice not a health related choice.

Still want that ice cream. It's in the 90F range in Chicago today.

https://arstechnica.com/science/2017...

Go EU science! My impression of EU political bodies is that they mostly agree that medicine should have a basis in science and be able to show positive outcomes in well designed and rigorous tests, but I know it's not universal. Would love for the US to catch up there.

I take meds for depression. I had to ditch my nurse practitioner. Her office is an integrated medicine practice. She would push non-evidence based "medication" on me. I knew more than her about newly accepted medical therapies, in her field. And on more than one occasion her demeanor towards me was less than than professional.

I'm not looking forward to wrestling with my insurance co to find a new doc. I'm going to give the insurance an honest review of my former care provider.

RawkGWJ wrote:

There are some pretty glaring differences between the paleo diet and veganism. The biggest being that for the vast majority of vegans it's a moral choice not a health related choice.

As someone who went vegan for health reasons (and then had to back off on being fully vegan at the recommendation of my doctor after a battery of tests said my personal body chemistry needs meat), I'd like to just say that there are people out there who eat vegan diets that are not driven to the lifestyle by moral choices. My experience is that people who each vegan diets for health reasons will just refer to it as a plant based diet or call themselves Nutritarians.

Also, trying to use the health advantages of a vegan diet as common ground between moral vegans and health motivated vegans is one of the most frustrating things I've ever attempted. While the moral vegans agree that there are health benefits to a vegan diet, the ones I spoke with were scary in their instance that the only reason to eat a vegan diet is moral reasons.