INTRODUCTION
Raw (untreated) water is selling out in California stores, despite risks of contracting deadly diseases. 1 Actress Gwyneth Paltrow sells Kegel exercise jade eggs on her lifestyle website, Goop. Gynecologist Dr. Jen Gunter warns, “Jade is porous: the egg could act as a fomite and bacteria can proliferate.” 2 Kim Kardashian touting placentophagy as a cure for postpartum depression has led to an Internet industry devoted to creating capsules from a woman’s dehydrated placenta. At least one infant has acquired repeat Group B strep infection from a mom consuming such capsules. 3
So why does “Dr. Gwyneth” hold more influence over patients’ health than Dr. Smith in a Canadian emergency department (ED)?
We are practising on shifting sands. The mobile revolution took off in 2007 with the invention of the iPhone. In the ensuing decade, our lives have been irrevocably altered. Patients often arrive in the ED with expectations based on Internet research. “Dr. Google” holds more answers in the palm of its hand than any real-life physician. To an untrained eye, an opinion or anecdote from Reddit or Facebook is as valuable as that from the Mayo Clinic or The Hospital for Sick Children.
In the 1960s, Canadian philosopher Marshall McLuhan coined the phrase: The medium is the message. McLuhan states: “Societies have always been shaped more by the nature of the media by which men communicate, than by the content of the communication.”Reference McLuhan 4 A Jenny McCarthy interview suggesting vaccines cause autism carries more weight in the collective consciousness than a hundred years of infectious disease science.
Chiropractors, naturopaths, and Facebook groups promise magic cures. If the explanation seems plausible with some scientific jargon thrown in (e.g., adrenal fatigue), people will chase after it. Curiously, when the public pays for an alternative therapy, there seems to be an inherent validity to it, compared with “free” advice from the doctor via Medicare. The allure of magic treatments to cure the stresses of modern life beats boring advice to exercise, eat nutritious food, meditate, and get enough sleep. Finally, in his book titled The Death of Expertise, author Tom Nichols explains that, in many areas such as medicine, law, politics, and economics: “The acknowledgment of expertise as anything that should alter our thoughts or change the way we live, has died.” 5 The cognitive bias driving the public towards celebrity “scientists” is the Dunning–Kruger effect: “You don’t know what you don’t know.”
As you pick up your next chart, beware, thanks to Gwyneth et al., emergency medicine has become the new Wild West.
