Thursday, October 27, 2005

How to Succeed at Quackery (Without Even Trying): Part 2

How to Exploit Your Niche (The much-awaited sequel!):

Having picked a niche in "alternative" health care, it is now time to milk it for all it is worth. There are a few critical areas to attend to in exploiting your niche and careful planning and execution in these areas can make all the difference between a pathetic storefront operation in a strip mall and a multi-million dollar (or Euro) operation in the swankiest part of town (or towns).


Insurance - a trough to avoid!:

Whatever you do, do not make the mistake that many chiropractors are making - do not try to get your services covered by insurance plans. This is the kiss of death for "alternative" practitioners. Although getting covered by health insurance plans may yield a better cash flow for the marginal "alternative" practitioner, it is a disaster in the long run.

Just look what insurance coverage did to the "real" doctors . The ones who were getting paid in chickens (when they got paid at all) did better, but the profession as a whole ended up saddled with endless paperwork and red tape. Eventually, the insurance companies ended up telling the doctors how much they would get paid for everything they did. Makes getting paid in chickens and corn look good by comparison.

Bottom line: even if you could do it - stay away from insurance companies (this includes the biggest insurer of them all - the Government). You don't need that kind of scrutiny and you surely can do without the paperwork. After all, if you wanted to fill out forms, you would have become an accountant.

If any of your "clients" ask why you don't accept insurance, there are a number of good answers you can give:

[1] "The insurance companies are a part of the conspiracy to keep people sick - I'm trying to keep people well."

[2] "My therapies are too much on the cutting edge - insurance companies still call them 'experimental'"

[3] "Insurance company policies are too regimented - I treat my patients as individuals."

Or you can think up something that fits your particular style of business.

Adding up the bill:

The final issue about billing is the most obvious: how much you should charge. For this, you need to decide whether your particular niche therapy (and likely mark) is amenable more to the single visit (or a few visits) or the multiple visit strategies.

Classic multiple visit quackeries are chiropractic and reflexology, where the mark is told that their problem will return (and/or worsen) without life-long treatments. This strategy is particularly well suited for dealing with chronic non-fatal illnesses, especially those of an imaginary nature.

If your local market includes an large number of the "worried well" (aging Baby Boomers and Yuppies are a good source), you may be able to adapt this strategy to just about any quackery simply by calling it "health maintenance" (or something like that). Use your imagination! Anything from colonics to herbs to acupuncture to aura alignment can be made into a maintenance program. The lay public knows that preventative maintenance is good for their car, so they'll readily buy into a scheme to maintain their increasingly aged and creaking bodies.

Maintenance or multiple visit schemes work best if the bill for each individual visit is smaller. Look at chiropractors, the past masters of this scheme - they charge much less than real doctors for an office visit because they know that this will impress the mark with how much more economical chiropractic is. What the mark doesn't know is that the $60 chiropractic bill will be repeated ad infinitum without having any lasting impact on their physical health.

On the other hand, some quackeries require more of a "surgical strike" on the mark's wallet. This may be because the disorder you are pretending to treat will rapidly inform the mark that your therapies are useless (e.g. diabetes, glaucoma, heart disease, malignant cancer). Or it may be that the disorder is self-limited and you only have a short time to work with. In either case, the goal is to get the mark in, fleece them rapidly and efficiently, and get them out before they catch on to the fact that they have been "had".

For this sort of "one-off" kind of quackeries, the best financial strategy is to hit them hard and fast. Clearly, this will take a bit of a buildup - you can't tell the mark that just walking into your office will cost them $800 for an hour of pleasant conversation. You have to be more vague - if they ask (and most won't), tell them that you charge according to what is needed. Emphasize the "individuality" of your clients - this will lull most of them back to sleep.

Start by scaring the mark - tell them that they are on the brink of death (or wrinkles - adapt it to the particulars of your quackery) and that they came to you just short of too late. Emphasize the need to act quickly - and without thinking of the cost. Tell them that they can pay you in installments and by all means tell them that you are more interested in saving their life (or skin) than in making money - they all want to believe that.

After you've gotten the mark well lathered up over their impending death (or wrinkles), lay out the "treatment plan". If you want to really drive home the deal, ask them if they'd like to take some of the few days (or hours) they have left to get a second opinion. Be sure to itemize your bill and go over it with the mark before they leave - and be sure to use confusing jargon and talk as rapidly as you can.

In almost every case, the mark will eagerly agree to your plan of treatment (and billing). After all, you're saving their life (or their youthful glow) and that's certainly worth more than money. One final tip - cash the checks immediately!

Bedside Manner

It is impossible to over-emphasize the importance of a good line of patter when working the quack medicine scam. People are coming to you in large part because the real doctors are too overworked to do a good job of hand holding and "there, there"-ing, the way that Marcus Welby did on TV. Of course, if you're gasping for breath because of your asthma, you really aren't that interested in hand holding - you want someone who knows what they're doing so that you can breathe again. However, for the worried well and those people who have disorders that modern medicine has yet to find a good treatment for, the hand holding and "there-there"-ing are critical. And that's where the quack comes in.

Waiting rooms and waiting:

People hate waiting in doctor's offices - surveys have shown that over and over. And the reason they have to wait is that real doctors are treating real diseases that don't always follow the rules of a fifteen minute office visit. Since the quack is either treating imaginary diseases or is giving imaginary treatments, the quack office can run on a much tighter schedule. Your job is to make sure that it does.

Make your waiting area look like a nice living room - you won't have to put too much furniture in it since people won't be waiting there very long. Make sure the plants look healthy. Casually place literature about your niche quackery where people can read it. Have you office staff learn the marks' names, if they can. Be casual. But above all, don't make them wait!

The first impression

Plan on a long first visit - an hour or so. This will give the mark the chance to tell you the whole sad story of their life. Don't try to keep them on the track or interrupt them with questions. It doesn't matter if they spend the whole hour talking about how their boss doesn't appreciate them, because it will have no impact on what you do - your treatment will be the same no matter what they say.

Take a few notes on anything vaguely medical they mention so that you can tie it in with your niche quackery. Practice having a concerned and interested look on your face so that you can formulate your pitch while they are telling you about how their eyes burn when they watch DVD's but not when they watch wrestling on cable. This will pay off in the end.

Toward the end of the hour (place a clock where you can see it without looking away from the mark), help them wind down their monologue and give them your pitch. Tell them that all the other doctors have missed the real problem, that their lack of energy isn't due to the extra 300 pounds they're carrying but is really the result of [fill in your niche disorder] which you propose to treat with [fill in your niche treatment]. Or that their doctors were wrong about their metastatic lung cancer being incurable. Whatever.

Just be sure to emphasize three points:

[1] All the doctors they have seen in the past were incompetent (they may have already told you this)

[2] You know exactly what is wrong with them - and it's not due to anything they did, like smoking or overeating. Blaming the government or large multinational corporations can be useful at this juncture.

[3] You are the only person (or one of a select few) who can cure them (or at least return them to health and the need for a life-long maintenance program).

Just the fact that you listened to their entire tale of woe without interrupting them will be enough to sell most marks on your scheme. If that isn't enough, be sure to make a follow-up call the next day or so, just to "check up" on how they're doing. This will fool them into believing that you really do care about them.

What to do when the treatment fails

Face it, even the best quackery will have a few failures - it's not like you're actually using an effective treatment! So planning for failure is an important part of the game. Fortunately, there are a number of time-tested answers for marks when they complain that your quackery isn't working for them (or their deceased relative):

[1] "You (or your deceased relative) got to me too late for the treatment to work."

[2] "You will get worse before you get better." This works better when it is mentioned at the first visit than as an afterthought. Call it a "healing crisis", "Herxheimer reaction" or make up your own name.

[3] "Did you follow my directions exactly?" Yet another reason to make your treatment as complex and incomprehensible as possible - "Did you place the dead chicken in an unbleached paper bag and whirl it over your head exactly three times precisely at midnight?"

[4] "You are clearly also suffering from [fill in imaginary disorder] - we'll need to treat that as well." At an additional cost, of course.

Well, that should get you well on your way. Feel free to contact me (at my 1-900 number) if you have any further questions.



Anonymous Skeptico said...

Brilliant! Even better than part one.

27 October, 2005 11:21  
Anonymous Wanda Knowmore said...

"Did you place the dead chicken in an unbleached paper bag and whirl it over your head exactly three times precisely at midnight?"

Was that clockwise or counter clockwise?

Why are you giving this stuff away for free?
I suggest an informercial to played on late night television. I bet you can get a celeb like... Tom Cruise ... maybe someone who plays a doctor on television...

28 October, 2005 00:37  
Blogger JP said...

[2] You know exactly what is wrong with them - and it's not due to anything they did, like smoking or overeating. Blaming the government or large multinational corporations can be useful at this juncture.

Actually, the health quacks tend to suggest lifestyle changes as well. However...they say that without their magic potion or device that you will never be able to undo the damage already done to your body.

Nope, just losing weight or smoking won't restore you to optimum health - you've still got too many toxins in your body that you need to purge with a high colonic. In fact, they'll sometimes argue, a colonic a day will reduce your desire to smoke or overeat.

Just a nit, though. Otherwise, brilliant again.

28 October, 2005 09:44  
Blogger John said...

Can you add a link to the first edition at the top of this post? Be good to backtrack!

28 October, 2005 10:13  
Blogger Alyric said...

Take a bow!

Great stuff.

28 October, 2005 20:17  
Blogger Prometheus said...

John - Done!

JP - Point taken. However, as you said, the emphasis of the quacks is not on lifestyle changes so much as it is on their particular therapy, nostrum or delusion.

Besides, it was much funnier that way.


29 October, 2005 00:27  
Blogger Francois Tremblay said...

I am interested in reproducing your article for Insolitology ( Please email me at if you'd like to give me permission.

29 October, 2005 13:28  
Anonymous Anonymous said...

Unfortunatly, I was seeing a QUACK for about a year. After I told her I would no longer take any more of her herbal supplements that she kept selling my husband and I, and I told her that if it was bad enough and warranted it, I would take a prescription drug, she suddenly lost interest in us being patients. I even discovered that she with held information from CT scans that proved what she was saying was causing my pain was not the case.Probably to keep me coming in for more and more visits at exhorbant fees. Not to mention the crazy prices of the supplements. I am glad to be out of her clutches.

30 October, 2005 16:46  
Anonymous Blue Cross of California said...

Great blog I hope we can work to build a better health care system. Health insurance is a major aspect to many.

29 November, 2005 11:26  

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