Ready to take on the wellness warriors?

Greetings all,

5 days to go until the early bird registration ends for MedicineSocial, and such a pertinent time to reflect on why doctors and other thought leaders in health must embrace social media for good.

We all have our degrees, expertise and experience in our particular crafts. We believe that because patients come to see us they take on board what we have to say as the truth. In many situations, this is the case. In my craft, psychiatry, this may not always be the case.

How many of you ask your patients what they think might be wrong with them or if they have researched their symptoms, or even you on sites such as Google before attending the appointment? Increasingly. the answer is yes. And that is OK if it means patients are trying to learn as much as they can about how to manage their illness, or believe they may not have one.

But the opposite may be true. For example, despite global campaigns and public health messages about vaccination, the majority of information on social media may actually attract parents to anti-vaccination lobbyists.  Known as keyboard warriors, these people despite different motivations spend a great deal of their day uploading content that is ill-founded but plays upon the vulnerabilities of new parents. Sometimes they can play dirty. Often they use motivations such as fear and shame to endorse their message. What they are good at is knowing how to drown out a debate regardless of truth by saturating common search engines and staying on message.

And then there are those with the ‘quick fixes’. Once again a varied bunch who may actually believe they are onto the right thing. At least 2 or 3 times a week, I am asked by patients if I have heard of a recent cure for schizophrenia or anxiety. Not because they don’t believe in their care, they simply hope that there could be something more benign than the potent medications we prescribe with sub-optimal efficacy. Recently, I told a patient that if I believed high doses of folinic acid cured anxiety I would be the first to promote it. I don’t like prescribing medications with intolerable side effects but I also don’t like seeing patients suffer from severe mental illness.

What enrages us all is those who don’t have any training in health, who deceive the public for overt secondary gain (financial) and delay others from getting help until it’s too late. Recent ‘wellness warriors’ have been vilified for this, and at times been excused for having a mental illness. In particular, these warriors are said to have Munchausen’s syndrome.

Now, Munchausen’s syndrome is extremely rare and involves the development of the sick role to foster care, nurturing and attention. That is the secondary gain. We see this in extremely traumatised individuals who perhaps have not been cared for in childhood years, or even abused. Their behaviour is conscious but the gain is to keep people close.

What I fear is those who do not have Munchausen’s syndrome may be seen to have it without a clear understanding of the true definition. Again, the behaviour is conscious but the secondary gain is fame and financial. This is called fraud or malingering.

Why do patients then fall for these claims and not listen to health professionals? Because the perpetrators of the claims are very good at manipulating basic human behaviour. For example, if you were faced with a blizzard and had to go the to supermarket, would you walk or drive? You would weigh up the quickest, most appealing option, and if the correct amount of spin was placed on this option you would take it.

What doctors and health professionals don’t understand is that we no longer live in a world where many accept medical advice with a degree of scepticism and inquiry. That’s understandable when information is so readily available. But what we have to do is be as savvy as the wellness warriors and campaigners, deliver our messages unique to our craft and fight fair. Because if we are left behind, patients will work with what they have and our crucial evidenced based public health messages will be diluted by the snake oil merchants.

Dr Helen Schultz is a consultant psychiatrist and blogger in Melbourne, Australia. She has organised Medicine Social to educate and inform doctors and health professionals about the importance of being a leader in social media and medicine. 

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