Quacks or Professionals?

 My malnourished, anaemic patient can ill afford to ditch important nutrients or lose weight, but they have just told me that they've stopped eating red meat. Our worried nurse has exhorted me to "please educate" and I am trying, The next patient has forsaken all dairy and the one after that wonders why his sugars are uncontrolled on a "hand-squeezed juice only" regimen.

Restrictive diets are concerning enough but life-threatening issues can arise when patients heed influencers over qualified professionals. It's one thing to be taught by an influencer how to apply eyeliner, do a proper push-up or prepare a healthy lunch but quite another to trust an unlicensed, unqualified person on matters of giving birth, treating depression, curbing addiction or curing cancer.

Quacks on Stage
Netherlandish School
Photo Credit: Wellcome Collection [Public Domain]

When I entered medicine, the term "wellness influencer" did not exist. If it did, I would have innocently considered myself one...

But today's patients are watching Instagram and TikTok reels. And who is talking to them about their health? According to a large US study, few conventional doctors, dentists and nurses (17%). Even fewer mental heath professionals (4%) and qualified dietitians (6%) which is notable given the ubiquity of mental health and diet advice on social media.

Today's wellness influencers are life coaches promising transformation (31%), business owners hawking a product (28%) and a motley crew of chiropractors, authors, activists and "functional" health practitioners (a new one for my lexicon). Indeed, 16% don't even bother to offer credentials, trumpeting instead their "lived experience" of parenting ("ADHD mom" or illness ("Cancer Warrior")...

Who is listening to the influencers? A lot of people. Half of US adults under 50 get their health information from them. Two-thirds of Australian teenagers get theirs from social media. Concerningly, neither kid nor parent knows how to distinguish fact from fiction. Noting that nearly every citizen consumes health-related media, China has banned unqualified influencers from offering health advice..

Young people have the worst mental health and theirs is the generation most influenced by influencers. Meanwhile, I worry that the people with one shot at controlling their cancer are the ones tempted by influencers peddling alternative schemes. And thanks to rampant misinformation, vaccine refusal is on the rise...

To be an oncologist is to see the worst of harm caused by wellness influencers  but I never changed a patient's mind with outrage. Where I have had albeit limited success is by dispassionately explaining the evidence, humbly acknowledging the (many) things medicine doesn't know or do well and gently offering to leave the door open. This may be the best way I know of being a wellness influencer.

(Ranjana Srivastava, The Guardian, 2026)

Throughout history there have been groups of people who claimed they had special healing powers. Quacks sold tonics as miracle cures. Mountebanks drew crowds with music, jokes or acrobatics and sold powders and oils. Pisse prophets examined urine to diagnose illnesses. These performers used charisma rather than evidence and were more persuasive than medical professionals. Today - influencers.