PalMD is a practicing internist in the Great Lakes region of the U.S.. Aside from the great joy he finds in his family and his work, he likes communicating some of that joy to others. He has a special interest in the ways patients---and we are all patients at one time or another---are deceived by charlatans. He aims to change the world, one reader at a time. Previous writings can still be found 
Yes, I know, it may seem we're beating this to death, but it's time to stand back and think. Yesterday I issued a challenge, one to write HuffPo and tell them what you think about their health reporting. I think that's a better idea than sending them lots of comment traffic. Still, it's unclear what kind of response would help. Orac and Dr. FreeRide have weighed in with some analyses of the situation. Here's my "stand back and review" analysis.
The Problem
A mainstream (in a publishing, not ideological sense) media outlet which bills itself as an online newspaper continues to put out dangerous and incorrect health information under its masthead. Some is frank infomercial, but not labeled as such. Some is celebrity vanity writing, a sort of, "well, I'm good at [politics, acting, being famous] so now it's time to try medicine." This is phenomenally wrong.
I'm not a journalist, and I don't know much about journalistic ethics, but I'm sure that journalist do have a code of ethics of sorts. I'm sure honesty is somewhere in there. When people read about politics in HuffPo, they know they're reading a left-leaning paper. You can argue about the Times, WSJ, WaPo, but HuffPo has a clear political slant. It's their niche. That's fine.
Medicine is different from politics. Politics is hardly about "truth". Medicine is all about truth---there are facts that affect real lives; real, testable truths that we deal with every day, and that lives depend upon. Lying to our patients is forbidden. In health reporting I think something similar should apply, since sectarian medical practices can be dangerous.
The solution(s)
I don't know. Good science writing to counter bad. Writing the editors. Getting the word out. All of these are options. This issue is much bigger than HuffPo; we have a whole blog devoted to it.
We must focus not only on the bad content, but most especially on the ethical issue of it. It is simply wrong. In political reporting, an analogous situation would be making things up...say, reporting constantly that Obama is a non-citizen and crypto-Muslim, or reporting during the election that John McCain is "riddled with cancer" (both assertions patently false and widely reported).
Our strength is the truth, and the moral high ground. Their strength is that people don't really like truth, and morals aren't a lot of fun.
We may be at this a while.
Medicine & Health
Comments
I like the idea of mocking them for acting like Republicans (and not just because I generally like mocking people). By rejecting medical science as elitist, haven't they basically taken the Joe-the-Plumber approach to medicine? Isn't taking Jenny McCarthy's word on vaccines like going to Sarah Palin for advice on politics?
Yeah, it's a cheap rhetorical trick.
Posted by: Blake Stacey | May 1, 2009 6:44 PM
Here's one part of the problem, how much interest is there in a headline that reads 'Area child completely immunized on schedule, fine'? Doesn't sound like a story that has legs, but it's happening every day, if this event were a disease, it would be epidemic, no?
Further, I have read that doctors offering to discuss these things normally are being shut out of places like Oprah, etc., where it does seem people get their info (maybe not, maybe I underestimate). Then there's Jenny McCarthy's performance on Larry King shouting BS at Harvey Karp, who seems like a reasoned and caring person, but not a larger than life personality, who's getting the attention? The rude blond. Maybe there needs to be a rude blond doctor on these shows, I don't know.
That said, I don't think that the whole medical community is really as up to speed on what a problem this is. I wonder how much this discussion comes at professional meetings and conferences. My personal experience is that doctors simply don't know what their patients don't know, but think they know about any given issue.
Vaccines are the easy example. Prior to becoming pregnant, I'd never heard of vaccine refusal aside from cases where a child had cancer or something. Then I got pregnant, started to read parenting websites and, hey, maybe this is something I should discuss with a doctor. Oh the doctor has never heard of this concern and the parenting website has, seems a bit dicey either way, what to do?
My most recent thing is probiotics. I have a ton of people telling me to use them on my two year-old to help with constipation. Yet, everything I have looked up says it's not used for constipation, rather it's for diarrhea and why would I want to do something to counteract diarrhea which is already what my daughter is experiencing. If I weren't somewhat knowledgeable about where to look for the information, I'd just do what HippyDippy on babycenter said worked. I called the nurse line at my docs office and all they said was it can't hurt. They just don't know or seem to want to know what people are doing outside of evidence-based science.
At my own job, which is regulated differently in different states, my clients are constantly coming in with questions about a piece of advice a relative in another state has. The question often doesn't apply to our state's laws, so I have to explain where the hearsay is coming from and why it doesn't apply in our situation. It took me a little time to get up to speed on what was going on, but now I have a cursory knowledge of how things get done elsewhere for these questions arise. Could it hurt a doc to be up to date on some the crazy things people are saying to each other? or are they being weighed down by insurance requirements and administration tasks that there isn't enough time for this kind of research? I don't know, I am asking?
Posted by: WonderingWilla | May 1, 2009 6:59 PM
# 1 - probiotics Wondering Willa, wander over to 33 Files, Dr. Bryan Vartabedian's blog -- he's a pediatric gastroenterologist & has some wisdom in the area.
http://www.33charts.com/parenting_solved/nutrition/
#2 -- Every time I wander over to Huff Po, I stumble across ANOTHER woo-ful blogger. This time it is Lisa Sharkey -- she even has the "what most doctors won't tell you" schtick going. Honestly.
n times of stress, what gets me through are the natural healing remedies I've been using for more than fifteen years. I have relied on complementary and alternative medicine with tremendous success. When I ran the medical news department of Good Morning America for the first half of this decade, I always relied on top medical experts for help in sorting through all sorts of stories and also produced many segments on alternative medicine, which Americans spend billions of dollars on each year.
As a mother of three children, who mostly go the doctor for their annual physicals and rarely take antibiotics, I've been fortunate to know some of the best doctors and alternative medicine experts in the world. So with my tendency to mom-panic, I've reached out to the natural healers to scream "help!" as I already know that there's not much my pediatrician can do for my family even if I do want a bottle of Tamiflu in the cabinet "just in case"!
What can I do to keep my family safe? How can I boost our immune systems now and what complementary medicines can I begin taking immediately, regardless if I ever come in contact with the dreaded Swine Flu?
Dr. Joseph Mercola, who has the worlds most popular natural health on line newsletter says he's never seen so much traffic, with his visitors all clamoring for this information. He told me how we can begin to protect ourselves now without drugs or needles.
http://www.huffingtonpost.com/lisa-sharkey/what-most-doctors-wont-te_b_193614.html
Honestly, HuffPo is racing Mercola to the bottom of the quackery ladder.
Posted by: Liz Ditz | May 1, 2009 8:21 PM
I'm not sure there are any formal ethics in journalism, or whether there ever has been. Some may say they are, but I challenge them to offer any evidence they have ever been followed.
It comes down to three methods, IMHO -- (1) persuade your audience, (2) entertain your audience, or (3) sell something to your audience. There's certainly overlap among the three.
You're looking for #4 -- tell your audience the truth as closely as you can discern it? If you are looking at journalism, I think you will almost always be disappointed. The exceptions are not the norm. Science journalism is not an exception.
There are some great science writers out there and I think the public is quite capable of understanding what they are writing. Perhaps it's editorial reluctance to acknowledge the capability of the average Jane and Joe? Perhaps not...
Anyway, I've written of my journey to semi-scientific literacy at least half the time on my blog. Maybe that will give someone an idea.
Posted by: Donna B. | May 1, 2009 11:29 PM
I have had my two closest friends die in hospital this year, under extended care for illnesses they should have recovered from. People I love dearly and would have given my life for, if I could.
It's important to recognize with humility that the standard of care practiced by medical professionals is not "truth" but "the best we can do". Don't try to abstract double-blind studies as some sort of platonic ideal.
Posted by: Matthew | May 2, 2009 3:36 AM
Janet Stemwedel's commenter JohnV illustrates another problem with the HuffPo's health & wellness coverage
I am not sure what the correct course is -- but the full-court press from ScienceBlogs can't hurt.
Posted by: Liz Ditz | May 2, 2009 12:34 PM
Matthew, providing today's post-modernist attack on science: "It's important to recognize with humility that the standard of care practiced by medical professionals is not "truth" but "the best we can do". Don't try to abstract double-blind studies as some sort of platonic ideal."
Our best (and ever-improving) approximation of "truth" is science. All other supposed sources of "truth" are not based on evidence, and thus are pulled out of their proponents' asses.
I am sorry that your friends passed away. Please don't reject science and medicine because of these tragedies.
Posted by: bob | May 2, 2009 9:17 PM
@Matthew - Matthew you are quite correct in your criticism and it is the most dangerous flaw of modern standard medicine, which has provided so many life saving innovations and discoveries, that they feel the necessity to adapt this "holier than alt" "evidence" based nonsense in order to create an aura of scientism which is instead doing exactly the opposite - it undermines all their great accomplishments and actually weakens the reputation of the highly skilled MD's and other professionals who are part of that system.
@Bob
This can be seen quite clearly (see my comments above to Mathhew)
who commits the most serious and egregious fallacy by proclaiming ..."ALL OTHER SUPPOSED SOURCES OF "TRUTH" ARE NOT BASED ON EVIDENCE...".
Now professors of either Philosophy or Epistemology could have a field day with this guy, kicking Bob's head around like the flawed soccer ball that it symbolically represents based on the above quoted flawed sweeping fallacious assertion. But, for the present
it will suffice to say that people like Bob, well meaning and devoted to science that they may be, or think that they may be, are instead committing the most serious intellectual deprecation of the philosophy of science by stupidly repeating such nonsense.
Laboratory controlled experiments do NOT form the basis of modern medicine, though its proponents like to pretend that it does, precisely because most of the major standard medicine procedures cannot and ethically would not allow such tests on human beings.
Likewise, in pharmaceutical drug testing, the regular occurence of drugs such as Vioxx, after successfully passing their supposedly scientific test procedures and human trials, is fully indicative of the approximative and statistical reasonings that form the basis of their pretend "science". In other words, much of modern medicine is an educated "guess" reinforced by case history and clinical reports, refined by their MD and other experts in praxis. Exactly the same as with alternative medicine and their doctors.
The assertion of "evidence" based medicine was, in fact, specifically created within the last several years, in a vain and stupid attempt to demonstrate superiority over standard medicine and block its, by now well known, resurgence and popularity.
Check out the "disclaimer" they give you to sign before having surgery done - "Medical science is not exact... and the results cannot be guaranteed..."(paraphrase).
Also, standard medicine proponents are understandably nervous over the coming health care reforms in the U.S., as well they should be at the public outrage over the unhealthy and unholy cross connections and alliances between pharmaceutical drug manufacturers, med schools, the FDA and other $pecial intere$t$.
I would advise Bob to double check whatever it is he is calling "evidence" before casting ass-persions on the proponents of alternative systems of medicine. The "evidence" is against him.
Posted by: ScepticsBane | May 3, 2009 8:36 AM
"The assertion of "evidence" based medicine was, in fact, specifically created within the last several years, in a vain and stupid attempt to demonstrate superiority over standard medicine and block its, by now well known, resurgence and popularity."
Er... make that "vain and stupid attempt to demonstrate superiority over alternative medicine"...
ScepticsBane needs some some coffee - the "evidence" indicates it!!
Posted by: ScepticsBane | May 3, 2009 8:41 AM
Boy, I'm really worried about the philosophical beat-down coming my way ... mainly because I hate the smell of red herrings. Vioxx was found to increase the risk of heart attacks after long-term use. Two important points: (i) this was discovered via scientific evaluation of evidence, and (ii) it was a long-term effect and thus couldn't be observed prior to extensive long-term usage.
Let me know when you're ready to have a serious discussion about this. Also, good luck washing that hypocritical egg off your face. Wrongly accusing someone else of logical fallacies when your own writing is full of them has to be pretty embarrassing, especially for someone calling themselves scepticsbane.
That's to say nothing of the other garbage in your comments. You accuse MDs of a "holier than thou" attitude, and then you smugly imply that people could treat my head like a philosophically flawed soccer ball. You accuse me of fallacious reasoning, and then you bust out a false dichotomy (medicine is wrong because it's not perfect). Finally, you bring up a ridiculous conspiracy theory for no reason whatsoever.
Your comment not only makes no sense, it's not even internally (in)consistent. Do you call yourself the bane of skeptics because you champion what they strive against (illogical arguments, unreasonable claims, faith over evidence, pseudoscience, etc)?
Posted by: bob | May 3, 2009 12:19 PM
"Now professors of either Philosophy or Epistemology could have a field day with this guy,"
Sure, they might be able to argue rings around him when talking about a theory and abstractions. Funny how little those abstractions apply to the real world. It's good and important to think and debate about complex ideas and concepts but philosophical 'truth' bears no relation whatsoever to physical reality truth. They are the same word but have entirely different meanings, each valid in it's own context. Half smart people such as ScepticsBane can't wrap their heads around the idea that they are, in fact, different things.
Posted by: Rev Matt | May 4, 2009 1:39 PM