I was thrilled when my other website, Heart Sisters, was recently awarded Health On The Net Code certification. The HONcode certifies trustworthy health information, and requires that health website publishers disclose all potential conflicts of interest, provide credentials for authors relaying medical information, and reference the source of the information presented.

This international certification program is funded by the Geneva Ministry of Health and the European Union.  Celia Boyer, executive director of HON, explains:

“The HONcode is a way to improve the quality of information on the internet. Given the critical nature of health information and the unregulated environment of the internet, web surfers need all the help they can get.”

It’s a good system, but occasionally some groups either sugarcoat information or straight-out cheat. For example, some websites display the HONcode seal but have either never been accredited or have been long-since discredited. And that’s where Dr. Stephen Barrett comes in.  According to Time magazine, the retired psychiatrist and editor of Quackwatch has organized a campaign to improve compliance with this code, particularly for questionable complementary and alternative medicine websites.

He says these sites’ shortcomings may seem innocuous, but ultimately promote quackery by describing dubious therapies without critical scientific analysis.

What’s a quack? They are usually defined as charlatans, or those who are presented falsely as having curative powers, characterized by pretentious claims with little or no foundation. As Marilynn Larkin in the British medical journal The Lancet described quackery:

“It’s no secret that the Internet is recognized as a robust source of reliable medical information, but it is also home to promoters of a spate of dubious diagnostic devices and treatments. But anti-quackery crusaders like Dr. Stephen Barrett and his ‘Quackwatch’ site are also using the Web to expose these purveyors of health frauds.”

Dr. Barrett himself defines quackery as the promotion of unsubstantiated methods that lack a scientifically plausible rationale. He adds:

“Promotion usually involves a profit motive. Unsubstantiated means either unproven or disproven. Implausible means that it either clashes with well-established facts or makes so little sense that it is not worth testing.”

He has been exposing bogus health claims since the late 1970s when he first surveyed health-related mail-order ads in national magazines and discovered that none of them lived up to their claims. His findings spurred legislation that now authorizes the government to levy penalties of $25,000 a day on repeat mail-order offenders. His work focuses mostly on consumer protection, medical ethics, and scientific skepticism.

According to an interview in Time magazine, Barrett is “underwhelmed by today’s New Age celebrities”. For example, he believes that:

• Dr. Andrew Weil is “very slick but makes glaring errors and hardly ever admits anything is quackery.”
• Deepak Chopra is a purveyor of “Ayurvedic mumbo jumbo.” (Chopra, for his part, calls Barrett “a self-appointed vigilante for the suppression of curiosity”)
• although he sees some benefit in chiropractic manipulation, he wonders about “a whole profession based on an idea – subluxations – that isn’t true”
• homeopathic remedies are “worthless”.

Barrett retired from his psychiatric practice in 1993 to devote himself full time to quackbusting. Along the way, he honed his communication skills and now considers himself an investigative journalist taking full advantage of the power of the internet. He told Time:

“Twenty years ago, I had trouble getting my ideas through to the media. Today I am the media.”

He is also remarkably generous in support of others who are likewise cautiously skeptical about miracle cures and medical breakthroughs – the ones “your doctor doesn’t want you to know about!”

For example, when I was threatened with legal action last fall by the mega-law firm of Skadden, Arps, Slate, Meagher and Flom (who took exception to their celebrity physician client being mentioned in one of my online essays here on The Nag), I decided on a whim to turn to Dr. Barrett for his expert take on the legal threat, given that he is apparently no stranger to being sued by people who don’t like what he writes about them. And although he doesn’t know me at all, he took the time to review the essay that had so excited these lawyers and their client, as well as their two-page threatening letter to me, and then offered me invaluable and comprehensive advice on how to proceed.  (Thanks again, Dr. Barrett!)

On Quackwatch.com, he explains why consumers seem to be so vulnerable to claims made by non-credible sources.

1. Lack of suspicion – Many people believe that if something is printed or broadcast, it must be true or somehow its publication would not be allowed. They tend to believe what others tell them about personal experience. Many are attracted by promises of quick, painless, or drugless solutions to their problems. False and misleading information is offered in the media, often sensationalized, stimulating false hopes and arousing widespread fears. Radio and television producers who promote unsubstantiated health claims are providing entertainment and have no ethical duty to check the claims.

2.  Belief in magic – Some people are easily taken in by the promise of an easy solution to their problem, like those who buy one fad diet book after another.

3.  Over-confidence – Some people believe they are better equipped than scientific researchers and other experts to tell whether a method works.

4.  Desperation – Many people faced with a serious health problem that doctors cannot solve become desperate enough to try almost anything that offers hope. Victims of cancer, arthritis, multiple sclerosis, and AIDS can be vulnerable in this way. Some squander their life’s savings searching for the “cure.” Many suffer from chronic pain or other symptoms for which medicine cannot offer clear-cut diagnoses or effective treatment. The more persistent the condition, the more susceptible the sufferer may be to promises of the “cure.” Many people in this category fall into the hands of doctors who make fad diagnoses such as hypoglycemia, “candidiasis hypersensitivity,” or “multiple chemical sensitivity.” Fears of social unacceptability or growing old (wrinkles, loss of hair and sensory acuity, decreased sexual potency, and incontinence) can also lead consumers astray.

5.  Alienation – Some people feel deeply antagonistic toward scientific medicine and are attracted to methods represented as “natural” or otherwise unconventional. They may also harbor extreme distrust of the medical profession, the food industry, drug companies, and government agencies.

Dr. Barrett’s detractors, not surprisingly, are those he is most likely to criticize.  For example, Tim Bolen, self-described Health Care Crisis Management Consultant and champion of what he calls the Health Freedom movement, openly calls Dr. Barrett “a loser” with “a lack of basic intelligence”, adding:

“Health leaders consider Barrett and company to be running a subversive organization working to suppress leading-edge health care in North America. No studies have ever been done to determine the level of suffering and death inflicted on Americans because of the actitivites (sic) of these conspiritors (sic) — yet.

“We in the Health Freedom movement outnumber the quackbusters 100,000 to one. We’ve got more money than they do, and we’ve got better, more talented people. We also have better lawyers. It is time to use our advantage to destroy them.”

Read “The Man Who Loves To Bust Quacks”, the Time magazine article about Dr. Barrett, or visit his site, Quackwatch.  And if you’d like to learn specifically how to spot quacks out there, read How To Spot a ‘Quacky’ Website.