Andrew Weil
Dr. Weil is often seen as the smiling “mainstream” of alternative medicine. He’s a real doctor (unlike, say, Gary Null), and much of what he advocates is standard and uncontroversial nutritional advice. But Weil illustrates the two biggest problems with so-called alternative medicne: once you’ve decided science is dispensible, the door is open to anything, no matter how insane; and no matter how altruistic you may start, sooner or later you start selling snake oil. Most doctors out there are working hard to help their patients prevent and overcome disease use the available evidence.  Others decide that science is too constraining and start practicing at the periphery of knowledge, throwing plausibility and ethics to the wind.

The fact that Weil claims to donate to charity all of his ill-gotten gains does not mitigate the harm he causes.

The flu pandemic has been challenging to all of us who practice medicine.  We try to keep up day to day with the latest numbers, evidence, and best practices, while trying not to worry about getting ill.  And since the vaccine isn’t widely available yet, we also worry about our family’s health.  So we go about our work every day, wearing masks when appropriate and washing hands frequently.  If the numbers reach a certain threshold, we will implement sophisticated pandemic plans.

All of that is rather hard, though, so perhaps we should just throw caution to the wind and start selling flu snake oil just like the smiling Dr. Weil.

The FDA and FTC have let Weil know in very clear terms that his fake flu remedies are being marketed illegally.  Weil has taken the site down, but here’s a relevant screen shot.

If you’ll recall, quacks are allowed to market just about any health product as long as they use their “get out of jail free card”, the Quack Miranda Warning.  The warning itself is a travesty, allowing any kind of absurd claims.  But Weil apparently forgot to use it recently. The FDA’s letter, dated October 15, 2009, states:

This is to advise you that the United States Food and Drug Administration (“FDA”) and the United States Federal Trade Commission (“FTC”) reviewed your website at the Internet address www.drweil.com on October 13, 2009. The FDA has determined that your website offers a product for sale that is intended to diagnose, mitigate, prevent, treat or cure the H1N1 Flu Virus in people. This product has not been approved, cleared, or otherwise authorized by FDA for use in the diagnosis, mitigation, prevention, treatment, or cure of the H1N1 Flu Virus.

That’s bad. What language did they object to?  The CDC has asked the FDA and FTC to help protect consumers from medical fraud due to flu fears.  The letter lays out all of the specifics, but  basically Weil claimed that some particular supplements that he sells will prevent the flu.

Worried About Flu? Dr. Weil’s Immune Support Formula can help maintain a strong defense against the flu. It contains astragalus, a traditional herb that boosts immunity. Buy it now in one click, and start protecting your immune system against flu this season.

[…]

[L]earn more about Dr. Weil’s Immune Support Formula, which contains astragalus – an herb Dr. Weil recommends to help ward off colds and flu.

This is bad. The altmed folks often complain that the medical community doesn’t have much evidence to support some of our flu claims. One intervention frequently targeted is the use of masks, for which data is limited. But why be picky about masks, vaccination (for which data isn’t limited) and oseltamivir, while at the same time boosting a botanical with no evidence behind it’s use? There are two reasons. One is financial. The multi-billion dollar alternative pharmaceutical industry like it’s profits, and uses them to protect their market share through the support of such friendly officials as Tom Harkin and Orrin Hatch.

The other is religious.  The altmed community believes in this stuff.  They take it on faith that various botanicals will be effective, whether or not testing confirms this.  They object to the modern approach to health that eschews shamanism and demands professionalism.  They see it as elitist, exclusionary, and unfair. They want personal wisdom to be taken seriously as an alternative to science-based medicine. This wisdom can and is taken seriously.  That’s how we come up with hypotheses to test.  But if an hypothesis doesn’t pan out, it’s time to move on.

Or, you can just ignore the evidence and use a current health scare to promote your beliefs and sell a product.  Bravo, Dr. Weil, and welcome to the Dark Side.

Posted by Peter Lipson

Peter A. Lipson, MD is a practicing internist and teaching physician in Southeast Michigan.  After graduating from Rush Medical College in Chicago, he completed his Internal Medicine residency at Northwestern Memorial Hospital. He currently maintains a private practice, and serves as a teaching physician at a large community hospital He also maintains appointments as a Clinical Assistant Professor of Medicine at Wayne State University School of Medicine and at Oakland University William Beaumont School of Medicine, the first being a large, established medical school, the latter being a newly-formed medical school which will soon be accepting its first class of students.  He blogs at White Coat Underground at the Scientopia blog network. A primary goal of his writing is to illuminate the differences between science-based medicine and everything else.  His perspective as a primary care physician and his daily interaction with real patients gives him what he hopes is special insight into the current "De-lightenment" in medicine.  As new media evolve, pseudo-scientific, deceptive, and immoral health practices become more and more available to patients, making his job all that much more difficult---and all that much more interesting. Disclaimer: The views in all of of Dr. Lipson's writing are his alone.  They do not represent in any way his practice, hospital, employers, or anyone else. Any medical information is general and should not be applied to specific personal medical decisions.  Any medical questions should be directed to your personal physician.  Dr. Lipson will not answer any specific medical questions, and any emails and comments should be assumed public. Dr. Lipson receives no compensation for his writing. Dr. Lipson's posts for Science-Based Medicine are archived here.