White Coat Underground

Do quacks prey on vulnerable groups?

Posted by PalMD on February 23, 2009
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A while back I wrote about a naturopathic “physician” who was specifically preying on the Latino community. This is troubling for a number of reasons, some of which I mentioned. In my zeal to rant about the quackery, I may have not delved deeply enough into some of the other important issues.

For example, Hispanics have rates of diabetes and stroke well above the white Anglo population. These are conditions for which we have very effective science-based treatment. Proper treatment of high blood pressure in diabetics reduces the rate of heart attack and stroke by 35-50%. Proper foot care, which can be as simple as regular foot exams at the doctor, can prevent amputations by 45-85%. The list goes on—we know how to treat diabetes, and prevent the devastating micro- and macro-vascular complications.

Anything that stands in the way of proper treatment will naturally increase the rates of diabetes-related illnesses. Quacks that encourage “alternatives” to science-based medicine are dangerous no matter whom the prey on, but for American Latinos it is a double hit. By percentages, more Latinos will need diabetes care than Anglos, and they may have less access to proper care, either for cultural, economic, or linguistic reasons.

When I call out the quacks on their unethical behavior, I’ve had commenters come back with, “but your medicine gave us Tuskegee!” This is of course irrelevant. Unethical behavior is unethical behavior, no matter who perpetrates it. The Tuskegee experiment damaged the lives of hundreds of individuals, and damaged the relationship between the health care system and an entire ethnic group. But that doesn’t invalidate the science-based medicine which we strive to practice today.

When they target minority communities, practitioners of cult medicine such as chiropractic and naturopathy are perpetrating a dangerous form of racism. By hanging out a “se habla espanol” sign, they invite Latinos in for a chat, a hug, and a glass of horchata, and then very gently separate them from their money, leaving them no healthier than they were when they walked in. These quacks might believe they are doing good, but then, so did the teachers at the Native American relocation boarding schools. Good intentions do not mitigate the effects of a harmful, racist practice.

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  1. #1 The Perky Skeptic
    February 24, 2009

    Hear, hear! And it promulgates a dangerous form of sexism, too. A lot of quacks tell women what they want to hear– that their innate intuition is always right, that they are more capable of attuning themselves to the creative, generative, and healing principles of the universe, and that the dumb ol’ Patriarchy (usually somehow represented by science or medicine, for some reason) wants to keep the woman DOWN, and she can RISE UP ABOVE by BUYING MY PRODUCT!!!!!

  2. #2 Donna B.
    February 24, 2009

    Pregnant women and new mothers are vulnerable too. I’m really quite glad the WWW wasn’t around when I was pregnant, because the women’s magazines were bad enough.

    I just found out there are chiropractors who specialize in treating pregnancy back pain. One woman I’ve become ‘net friends’ with was waxing poetic about how much better she felt after having her pelvis realigned.

    Since I’m not a doctor, I don’t know if there’s value there or not, but it sure sounds fishy.

  3. #3 Caitlin
    February 24, 2009

    This is really interesting and informative. I hadn’t noticed things like these happening, but it makes sense now that I think about it. I didn’t know that hispanics have higher diabetes and stroke rates so much higher than the white Anglo population. It’s really sad how they prey on those who have less access to proper care, for whatever reason.

  4. #4 PalMD
    February 24, 2009

    Bonus points if you name the ethnic group in the US with the highest rate of diabetes.

  5. #5 LanceR, JSG
    February 25, 2009

    Umm… Native Americans overall, Caucasians in the youth? I could be wrong.

    (Google is my friend! I love the Google!)

  6. #6 Donna B.
    February 25, 2009

    Without Googling, I’d say Native Americans. I live near Oklahoma and have quite a few relatives on the ‘rolls’ though there’s apparently no Native American blood in my ancestry.

    However, it’s plausible that there may be an even higher rate of diabetes where Hispanic (itself a mix of Spanish and Native S. Americans) and Native N. Americans have mixed, say in northern New Mexico. What is the diabetes rate of Navajos compared to Choctaws?

  7. #7 PalMD
    February 25, 2009

    Pima Indian (Colorado River Res)

  8. #8 antipodean
    February 25, 2009

    Ben Goldacre seem to think that quackery in the UK is concentrated in the middle-class who have humanities educations – they have money but couldn’t think their way out of a paperbag.

    And I have seen actual data showing that the use of CAM is positively correlated with eduction (up to a point).

    Sometimes I think it would be easier to just make up some shit, hang a shingle out somewhere and bilk the wealthy and ignorant for the rest of my comfortable life. Science is just so hard by comparison (sigh).