Quackery as a Public Health Problem

Quackery is the deceptive promotion of health products, services, or regimens to consumers for financial gain using unsubstantiated claims of safety and effectiveness. The products include tens of thousands of dietary supplements, herbal products, and homeopathic products that are useless or unnecessary. Promoters can be either health professionals or laypersons. They can be either dishonest people who purposely mislead consumers with disinformation or sincere people who truly believe in what they sell but nevertheless misinform consumers. Some of them use buzzwords or euphemisms such as natural, holistic, alternative, functional, integrative, indigenous, advanced, or innovative to give the impression that their offerings are special and worthwhile. They hype their offerings via personal selling, or through either print or electronic mass media. Personal selling involves sales pitches to consumers through direct interpersonal communications rather than via mass media. It includes sales seminars, telemarketing appeals, and pitches by distributors in multilevel marketing businesses to potential customers who are then recruited to be distributors. Promoters often pay mass media outlets to advertise their offerings to consumers. News and entertainment media outlets are often interested in publicizing the kind of extraordinary healing claims made by many quacks. Promoters also use social media to spread false or misleading information to give their offerings the appearance of legitimacy. Terms such as health fraud and health scams have been used instead of quackery by some anti-quackery activists. While these terms may better connote the seriousness of quackery as a public health problem, they can be easily confused with the problem of health insurance fraud (sometimes called health-care fraud). Although quacks sometimes defraud insurance companies, health insurance fraud or abuse typically involves activities other than quackery, such as billing for services not rendered or billing for medically unnecessary services. Quackery is a matter of deceptive promotional claims. It is not a matter of unethical billing practices or of merely providing health care with modalities of unproven value. Quackery is a largely neglected social pathology and public health menace. The harm to consumers can include: (1) direct harm when treatments provided are toxic, (2) indirect harm when consumers are diverted from or delay seeking responsible care, (3) financial harm because of wasted expenditures of time and money, (4) psychological harm due to manipulation of expectations and emotions, promoting self-defeating sickness behavior and somatization, and by the burdens of complying with requirements some quacks falsely claim are necessary to avoid health harms and for healing, (5) social harm, such as when friends and family see exploitation of unwitting victims of quackery, and (6) societal harm, such as undermining public trust in modern medicine and science-based public health practices.