This is just a fun post. A little exercise in “misery loves company”. I just thought I’d discuss the question of how are we supposed to compete with…magic?
First, and for the record: Not all “good medicine” is based on pure laboratory science and double-blinded placebo-controlled studies. There’s much to be said for experience, practice, and figuring stuff out. Many of those “peer-reviewed studies” are big pharma-financed garbage. I’m a Gen-X skeptic if ever there was one. Show me some evidence, I’m always willing to think differently and rage against the machine. But sometimes, I just go full “expressionless emoji” 
while I contemplate the imminent apocalypse.
Today was one of those times. One of my partners has a patient with trigeminal neuralgia. He offered her treatment, and she replied with “No, I scanned my face with my energy scanner, and that’s not what’s wrong with me.” For context: a member of this family recently left the hospital AMA when hospitalized with viral encephalitis during pregnancy, for the safer waters of homeopathy.
Here is a link to a reddit post about this “energy scanner” product, the “AOScan,” (which, the best we can tell, is no longer being sold.) It was basically a smartphone with a sticker over the logo. It is (was?) expensive, and requires a monthly $150 fee, too. The user simply waves the device over his or her body, like the Star Trek Tricorder or whatever it was called that Dr. McCoy used. This miraculous tech scans your body’s frequencies. Then it corrects the frequencies and spits out a 5-page report demonstrating all the stuff it fixed, that looks like this (Yay! Less red!):
But that’s not the best part. This device also features, basically, alchemy. That’s right. Alchemy. You can wave this “Scanner” over a pill (say, a hydrocodone tablet) to “scan it”. Then you wave it over a different pill (say, an ibuprofen tablet), and it uses powerful energy frequencies to “transform” the latter into the former.
Oh, and it’s also a MLM (multilevel marketing) scam somehow too.
YOU CAN’T MAKE THIS STUFF UP, FAM.
I’d suggest that there is not anything new here; this is just high-tech snake oil. How do you deal with this? Of course, we all have different approaches to this. I thought I’d share mine: Brutal honesty. Full candor.
I simply say something supportive but honest: “At the risk of making you angry, I am obligated to tell you the truth. Remember, friends tell you the truth. Enemies lie. You pay me to tell you the truth and to provide the healthcare you NEED, not the care you WANT, and they’re not always the same thing. This is not real. This is just a scam. High-tech snake oil, and a waste of your money. If the placebo effect kicks in with this, and makes you feel better, and you think it’s worth your money, then I don’t care if you keep using it. But I won’t have your magic wand replace my training and experience.”
The graphic at the top of this post, Galatians 4:16, is on a 2×3′ poster in front of our scale. All my patients see it when they’re checked in. I’m not their enemy if I tell them the truth.
It takes time getting used to the discomfort that comes with dishing out brutal honesty. But it’s worth learning how to get comfortable with because it can’t fail in my experience. It has one of two consequences usually, and either is a positive outcome:
- It makes them mad and they leave. Nobody’s losing sleep over that, because we don’t want to be mis-trusted by patients who trust scam artists more than us. Such patients will not be compliant, will not tell you what they’re doing, and it’s a minimally therapeutic relationship.
- They appreciate the candor, and listen more and more over time. They like knowing you’re honest and truly want the best for them. And now the door is now open for lots of beneficial honesty: “You need to __________.” (Stop eating carbs, lose weight, take a shower, quit smoking, stop watching all cable news networks, consider not having double-digit sexual partners, drink less alcohol, drink more alcohol*, etc.)
In my experience, in DPC, I have plenty of time to spend with patients, which allows a level of communication where most patients in this cohort take the 2nd option, which is a good thing.
*For the record, I wouldn’t suggest this advice–well, you know, usually.