The parlous state of consumer protection from healthcare fraud

Professor John Dwyer AO highlights
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Almost 60 per cent of adult Australians have a low level of health literacy[1], a circumstance associated with higher use of health services, low levels of knowledge among consumers and poorer health outcomes.

At the same time, Australians are spending billions every year on unproven vitamins and supplements.

According to the ABC, seven out of ten Australians take some form of vitamin or supplement and Australians spend more of their own money on complementary medicines than they do on prescription drugs[2].

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A parlous state of affairs

These facts will be to the fore at the ACEM 2017 Annual Scientific Meeting in Sydney in November, when Professor John Dwyer AO highlights what he believes is the dangerous level of ‘pseudo-science’ penetrating health care delivery in Australia with his talk, ‘The parlous state of consumer protection from healthcare fraud.
An acclaimed immunologist who spent 15 years as Head of the Department of Clinical Immunology at Yale University, John is also a passionate public health advocate.

In 2011 he formed Friends of Science in Medicine (FSM), an independent association to champion evidenced-based medicine and oppose the promotion and practice of unsubstantiated therapies, more commonly known in medical circles as ‘pseudo-science’.

John believes that the spread of pseudo-science in Australia gained momentum when the Australian Health Practitioner Regulation Agency (AHPRA) added chiropractors, Chinese Medicine Practitioners and osteopaths to its register of professions.

“The aim was to protect the consumer by demanding a higher standard from each of these groups, so they were given Boards to regulate quality, set standards and so forth,” John says. “But with the registration came a move by the Chiropractors’ Association of Australia to have themselves called doctors, which they now do, and also a widening of their interests into the primary care space traditionally occupied by GPs.”

Pseudo-science
The result, John believes, has been nothing short of a tsunami of pseudo-science.

“[FSM] found over 700 websites involving over 1200 chiropractors claiming they can treat a range of conditions including pregnant women, asthma, bedwetting, colic and ear infections, simply by working with the flow of energy up and down the spine,” he says. “It’s absolute nonsense and we reported them to AHPRA because they’re breaking the law through false advertising.”

But although AHPRA can restrict false advertising, in terms of consumer protection the laws under which it acts does not allow it to restrict scope of practice, John says.

This means theoretically that chiropractors can tell clients they treat autism and charge for treatments on that basis, even if they don’t advertise it.

“Chinese medicine and osteopathy are in a similar area,” John says. “They’re an affront to our understanding of science.”

Another key factor in the spread of pseudo-science, John believes, has been the enormous success of the supplements and complementary products industry.

“These organisations pay lots of taxes, are big donors to the political parties and they’re screaming for more self-regulation and less oversight by bodies such as the Therapeutic Goods Administration (TGA),” John says. “They’re aided by the pharmacies, which make more money out of selling vitamins than they do out of selling prescription drugs.”
 
Prevention or cure?

The spread of pseudo-science, John says, is closely related to an even bigger problem in Australian healthcare, namely, the disproportionately small – even tiny – proportion of the health budget spent on prevention. 

“We spend less than 2% of our health budget on prevention and we wonder why we have this massive burden of chronic disease,” he says. “An estimated 600,000 admissions to public hospitals can be avoided annually if we increase prevention in the community and improve primary care.”

John doesn’t believe that the will exists in government to make the kind of changes needed to address these challenges. Only doctors can do it. That’s why his presentation is – in essence – a plea for other doctors to get involved.

“I want to spend 20 minutes talking to my medical colleagues who come face to face with a number of the downstream effects of this lack of consumer protection to see what we can do to change things,” he says. “I think ED doctors, because of what they see, are in an excellent position to act and advise patients directly on how they can improve their standard of health, but that doesn’t mean I’m talking only to them.”

“I’m actually speaking to the whole of the medical profession. It’s time for us to speak up and act on behalf of our patients, because we’re the only ones who can do it.”
 
[1] Australian Commission on Safety and Quality in Health Care. Health Literacy: Taking action to improve safety and quality 2014
[2] ABC 4 Corners, Monday 13 Feb, 2017. Swallowing It: How Australians are spending billions on unproven vitamins and supplements.