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Thursday, March 14, 2013

The Marketing of Hope

6:45 AM Posted by Tiffany Taft , ,
You may have heard the news report about Cancer Treatment Centers of America (CTCA) which exposes the organization's "cooking its statistical books" and reporting positive outcome data that far exceeds national averages.  In essence, CTCA may turn a person away if they have a poor prognosis which includes the elderly and the poor.  Those they do accept have better insurance coverage and the financial means to travel frequently to the center, which depending on geography may entail traveling great distances on a regular basis.  Of these patients, CTCA uses biased sampling in their practice reporting so that their outcomes look stellar, some say misleading patients, many of whom feel desperate for a cure.

Hope Marketing in action.
CTCA does a lot of things that we like, including integrated care that includes psychological support, spiritual support, and other complementary treatments such as acupuncture.  They take a holistic approach to care that may not be readily available in other medical settings, or if it is, covered by insurance.  Patients at CTCA report feeling extremely satisfied with treatment, that they are well cared for and aren't "just a number."  So they do good work, but all is not what it seems.

This is just one example of the marketing of hope.  It's been going on forever; at the turn of the 20th century cocaine was used for everything from colic to a "nervous disposition."  Heck, the father of psychology, Sigmund Freud, was a heavy cocaine user until he was 40.  

Sometimes cocaine is just cocaine.
We like to think we've evolved since those days, and of course in many ways we have.  But spurious claims still abound to cure the currently incurable, or provide relief where most other treatments have failed.  And with the advent of the internet, my goodness they're everywhere.  Then you have Aunt Joan, over Thanksgiving dinner, asking if you've seen that eating switchgrass clears up rheumatoid arthritis.  Or, as in my case, your  boss buying you a container of macaroons because he'd read that coconut is good for Crohn's disease.  

Side effects may include deliciousness and weight gain.
So what can you do to navigate all of this?  Here are a few suggestions.

Do a gut check.  The old adage "listen to your gut" does hold true most of the time.  If you've read about a miracle cure, whether it's in the form of a supplement, a diet, or an entire treatment institution and something doesn't feel right about it, there's probably a reason.

Do an emotions check.  What's driving your information-seeking?  Are you feeling pretty anxious or depressed about your diagnosis?  Do you feel kind of desperate?  We know when we're in these more emotionally vulnerable states, our ability to make sound decisions is reduced.  We're more likely to believe false information and fall for something called confirmation bias, which is seeking out only information that supports our current belief or perspective on a situation.  In other words, we're less likely to seek alternative explanations and information when we're operating under this bias.  We all do it to varying degrees, but when we're emotionally distressed this phenomenon can really take over.

Do the "advice to a friend" trick.  One way to evaluate a decision or thought process is to ask "If my good friend [insert name here] came to me with this idea, what would I say?"  Often times we have a better perspective on things when it comes to others than ourselves.  This simple exercise can help generate some alternative perspectives.

Talk to your physician.  Yes, some MDs are much more open to "alternative" treatments than others.  Depending on who your doctor is, he or she may not be very receptive to this conversation.  Regardless, it's important to keep your MD informed to any treatments that you decide to try, especially on your own.  Doctors rely on good data from patients to make decisions, and regardless of if he or she agrees about the use of a supplement or diet, not knowing all of the variables keeps them from having the full picture.  

Be mindful of the marketing of hope.  There are many people out there who have genuinely positive motives and, well, those who don't.  If it sounds too good to be true, it probably is.

Best,
Dr. T