Raising awareness of risks is not fearmongering

Another day, another term: “Fearmongering” is the deliberate and unjustified arousal of public concern, usually to serve an ulterior motive, like getting elected — one of the oldest of all stupid human tricks.

In healthcare, the ulterior motive is almost always marketing: concern about something (dehydration, say) is fanned specifically to sell a cure for it (like a water cure). But fearmongering is also often just careless, serving only as a source of drama and emphasis. It may be powered by good intentions, intended to push patients towards earnest treatment recommendations.

I am often accused of fearmongering because I express concerns about potentially dangerous procedures, especially in alternative medicine, like digital motion X-ray, spinal manipulation, brutally intense massage, unnecessary/premature spinal MRI for back pain, or dry needling (paywall). My alleged ulterior motives for scaring people are my skeptical agenda, and being a shill for big pharma.

How do I plead? Not guilty, of course!

I aim for nuance and balance whenever I write anything that might spook anyone. Raising awareness of genuine hazards and poor risk/benefit ratios is not fearmongering — it’s valuable public health education. It would be fearmongering if I was making an issue out of nothing, but it’s never about “nothing.” For instance, spinal manipulation is a mainstream treatment, provided by many physical therapists as well as all chiropractors, that millions of patients accept without any idea of the potential hazards or the relationship between risk and reward. That’s a mountain, not a molehill.

“You’re not paranoid if they’re really after you,” and it’s not fearmongering if concern is rational.