Saturday, October 29, 2005

How to Succeed at Quackery (Without Even Trying): Part 3

Part 1:
Part 2:
Dealing with the Competition (the finale)

Eventually, if you are lucky, you will become successful enough to attract the attention of real doctors, so you need to have a plan for dealing with them. Fortunately, the real doctors are too busy saving lives and eradicating disease to expend too much effort stomping out quackery - they always leave the job half done.

Because of this inherent weakness, you are unlikely to encounter resistance from real doctors until you start to seriously impact their practice. Now, I don't mean that you will cut into their profitability - heck no! In that way, quackery is truly "complementary" to real medicine.

We delay people with real disease getting medical attention, resulting in more office visits or longer hospital stays and more expensive treatments. You'd think that the real doctors would appreciate us pushing up their profit margin, but some people can't see where their own self-interest lies. Clearly, they aren't as smart as those of us in the quack fields.

At any rate, when the real doctors start seeing patients coming to them with more advanced disease states because of our involvement, they are likely to try to shut us down. This is inevitably a wasted effort, since you can always shut your office and re-open it in another city or state. Or you could move it across the border to Mexico (or Canada - but the climate is much more pleasant in Mexico, both for sunbathing and quackery). But in order to avoid the inconvenience of having to start over in a new location, you need to follow a few simple rules.

Heads I win, tails you lose:

The best defense against this sort of business interference is a good offense. For starters, be sure that your patients clearly understand that any problems they may encounter are due to one of the following:

[1] Failure to follow the treatment plan (remember the chicken in Part 2?).

[2] Not treating long enough. Even if you told them it would take a week at first, you can always tell them, "It's working - you're just going through the healing crisis/Herxheimer reaction/die-off phase."

[3] Interference from real medical treatments. "Your cancer would be healed now if your immune system hadn't been damaged by that damned chemotherapy."

[4] Lack of faith. Quack medicine only works if you believe in it - unlike real medicines like insulin and antibiotics, which require no psychic input from the patient.

The key point to remember is that no matter what happens, it's not your fault. If anything bad happens, it's the mark's fault, since they should have gone to a real doctor in the first place if they were sick.

Obfuscation is a quack's best friend:

Never let yourself get trapped into making a definitive statement if you can avoid it. Your diagnoses should be vague and generalized - avoid using names of real diagnoses:

Good: intestinal dysbiosis, immune dysfunction, toxicosis, chronic viral infection

Bad: diabetes, hypertension, AIDS

Likewise, your treatments should be equally - if not more - vague and generalized. This is especially true if you are not in possession of a license that allows you to make diagnoses and prescribe treatments.

Not having a license is not an insurmountable obstacle - in fact, it can be a positive advantage. Not having a license also means that you don't have one of those pesky licensing boards. Clearly, a licensing board is not a bar to quackery - look at chiropractic and naturopathy, both of which have licensing boards - but it adds another level of complexity and expense.

If you don't have a license to diagnose and prescribe, you do have to watch your language. Be sure to make it clear to marks that you can't legally diagnose or prescribe (wink, wink, nudge nudge), but that you'd be happy to suggest what they might be suffering from and discuss what treatments might help. And your fee is for the pleasant conversation the two of you will be having.

"Complementary, my dear Watson":

One very effective way to keep the real doctors off your back is to bill your quackery as "complementary" - which means that it supports or complements real medicine. This requires a bit more of a tightrope walk in the office, since you don't want to tell the mark that real medicine is effective - since that would cut into your business - but you also don't want to cut away your camouflage.

Calling real medicine "allopathic" is an effective technique, since it gives the illusion that you and the real doctors are coming from different but equally valid disciplines. The following phrases may also be of some help - modify them as needed to suit your particular situation:

[1] Allopaths treat disease - I promote wellness.

[2] I treat the whole person rather than an organ or disorder.

[3] My therapies help the body to heal itself.

[4] My treatments remove obstructions to natural healing.

[5] Allopaths only treat symptoms - I remove the disease.

Introducing the jargon from quantum physics (read anything by Deepak Chopra to get ideas) is also a good strategy, since only a small percentage of the population knows enough about quantum theory to tell that you (and Chopra) are peddling moonbeams. For the rest, it makes you sound incredibly hip, slick and cool (or New Age, if you like).

Remember, if you elect to go the "complementary" route, you need to keep open antagonism with real medicine to a minimum. Go the passive-aggressive route. Damn with faint praise - "I suppose that going to an allopaths wouldn't be the worst thing you could do." or "Allopaths are good for emergencies, like car accidents or a ruptured appendix." You get the idea.

Professional Courtesy:

No matter how much you loathe your fellow quacks or think that they have the intellect of a peach pit (after the laetril has been extracted), never, never criticize or question their quackery. This is the classic situation of people living in glass houses. Throwing stones will do nobody any good.

If you want an example of how to behave, go to one of the many quack conventions. There you will see speakers get up and say things that are absolutely incompatible with what the previous speaker has said - but they won't make any mention of it. And if the two are in a panel discussion, they will say only nice things about the other's quackery.

This is in distinct contrast to real medical conferences, where voices are raised, snide comments made and embarassing questions are asked. This sort of unseemly and impolite behavior can only be tolerated when there is real data to support what people are saying. In the world of quackery, that sort of frank discussion and argument would tear apart the delicate fabric of our fortunes. Under no circumstances are you to ever, ever even vaguely suggest that the Emperor has no clothes.

Betrayers and Mutineers:

Occasionally, someone will leave the fold and turn on their brother and sister quacks. These people are to be shunned and ridiculed. Cast aspersion about their character. Question their mental stability and raise vague possibilities of drunkenness or substance abuse. Above all, emphasize the fact that they have changed their minds and are likely to do it again. That's certainly not behavior we want to encourage.

After all, the last thing we want people to do is approach quackery with an open mind or skepticism. We may say that we want people to have an open mind, but what we mean is that we want them to believe us and not the real doctors, scientists and skeptics. A real open mind is deadly to quackery. If one of those damned skeptics shows up in your office, get them out quick! That sort of thing can devastate a quack practice.

Now go out and make yourselves rich!


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.


Saturday, October 15, 2005

Pardon the interruption....

A Photon in the Darkness is back on line (literally!) following resolution of a pernicious technical difficulty. A leaking telephone junction box was causing intermittent service interruption along with a significant and persistent (and maddening) slow-down of Internet bit-rate.

Since I don't blog from work (I don't want anyone to accuse me of shirking my duties to flog/blog the pseudoscientists), this service disruption effectively silenced Prometheus - something that many critics have wanted to do for years.

So, please stand by a little longer for the next installment of "How to be a Quack Millionaire!".


Sunday, October 02, 2005

How to Succeed at Quackery (Without Even Trying): Part 1

Finding a Niche

In medical quackery, a niche is pretty much synonymous with a disease or disorder (or range of disorders). Every type of quackery, whether you’re peddling devices, drugs or diets, needs a disorder to cure (or prevent). And picking the right disorder can make the difference between success and failure.

Keep it simple:

A few people have been successful with quackeries aimed at a broad range of disorders (see HR Clark), but these are risky ventures. A person starting out in quackery, unless they already have a great deal of name recognition, would do better to stick to a single disorder or a small range of similar disorders. This allows you to tailor your approach to the concerns and issues of a specific group of potential marks. Trying to address too broad a range of sufferers can cause you to be less attractive to any of them.

One possible exception to this is “cancer”. To the majority of the lay public, cancer is a single disease, so cancer is one area where the novice quack can safely address a broad range of diseases. In fact, trying to focus on a single type of cancer will often backfire, since that is precisely what the “allopathic” medical community does. By claiming to have a cure for a particular cancer (e.g. melanoma), you lose the “alternative” cachet that is so important to becoming a successful quack.

Keep it vague:

Ambiguity and vagueness are the greatest assets for a budding quack. When you pick your niche, be sure to find a disorder that is poorly defined or difficult to diagnose. Disorders that are not recognized by allopaths are excellent choices, since there is no way that anyone can accuse you of misdiagnosing them. The best are disorders that are purely imaginary, since the marks will be so appreciative when you don’t say that it’s “all in their head”.

Think long and hard before choosing a disorder that has a well-established and unambiguous diagnosis, unless you are willing to put in the time to convince people that the accepted diagnostic criteria are wrong. If you are just starting out, this may be too much work – save it for when you are an established quack. At all costs, avoid disorders that the mark can diagnose themselves – promising a “cure” for freckles will mean that you actually have to deliver on your promise. It is much better to pick complaints that are vague and subjective, like fatigue, malaise or depression.

Good choices: Chronic fatigue, Autism, Gulf War Syndrome

Bad choices: Fractures, Angina, Pneumonia
Likewise, keep your claims vague and hard to quantify – never, ever promise something that can be objectively measured, if you can avoid it. Promise the marks a “50% increase in immune function” or a “200% increase in energy”, but not a “50% increase in red blood cell mass”. Don’t make it easy for the quackbusters (or the FTC) to get a bead on you. If your particular niche makes hard number unavoidable (e.g. weight loss quackeries), be sure to cover yourself well in the fine print.

Pick a winner:

Although there are lots of people who have made it big pretending to treat incurable diseases (like the cancer quacks), you can save yourself a lot of trouble by picking a disorder that is either self-limited, fluctuating or imaginary.

The imaginary disorders are without a doubt the easiest to deal with – convince the mark that you’ve cured them and they’re out the door poorer but happier. That’s why imaginary disorders are the ones most sought after and – as a result – why there are so many quacks treating them. You can either crowd into an already established imaginary disease (or move to an under-served area) or you can make up your own imaginary disease. Either way, it’s more work to get started but a great payoff once you’re established.

If breaking in to the imaginary disease field sounds like too much work, your next best choice is a self-limited disease – something like colds or muscle aches. The main problem with self-limited diseases is that you need to constantly be out on the street hustling for new patients. These diseases are most profitable when you’ve gotten established and have a product on the shelves of the health-food or supplement stores.

The problem is that the window of opportunity – the time between the onset of symptoms and when the disease runs its course – is so short. If they can run to the quack store and buy your nostrum while they’re still feeling rotten, you get the credit (and their money) when they get better. If people are getting better before you have a chance to see them, you lose their business.

In some ways, late stage cancer can also be seen as a self-limiting disease, since the mark will often die (or be too sick and preoccupied with dying) before they realize that your “cure” has failed. And the grieving family will usually not want to take legal action, especially if you’ve done a good job with your bedside manner and hand-holding. It may seem perverse, but the families will often mistake your end-of-life bloodletting (in a monetary sense, if not literally) for a true attempt to save the life of their loved one after all the allopaths had given up. It’s sick, but it pays well.

If imaginary diseases are too much work and self-limiting diseases require too much hustle, then you might want to look into one of the thousands of chronic fluctuating disorders available. This part of the field is truly under-exploited, especially now that the allopaths are helping more people live to a ripe old age. And old age is full of chronic fluctuating conditions.

Almost all of the chronic medical conditions have fluctuating symptoms, better on some days and worse on others. Your job, in this lucrative area, is to convince the mark that you are responsible for the good days and they are responsible for the bad days. It’s as simple as that. If that seems to harsh for your mindset, you can squeeze out a little more profit by telling the mark to use your nostrum or device more often on the bad days, in the certain knowledge that good days are coming. Either way, you’ll look like a regular miracle worker. If you’re really good, your marks may even offer to wash and wax your BMW on their good days out of gratitude.

Next Lesson: Running your Quackery Business