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What would Elvis do?

By Timothy Cocks Science and the world 19 Feb 2014

Are we hard-wired to follow celebrity medical advice?

A paper published in the Christmas edition of The BMJ asks why so many people follow medical advice from celebrities when so much of it is ill-informed and some of it is potentially harmful.

Researchers from McMaster University in Canada looked at how celebrities gain credibility as medical advisors and why the public can fall under their influence when making important health decisions. They analyzed economic, marketing, psychology and sociology studies from 1806 to the present day.

The researchers give several explanations for how celebrities gain credibility as medical advisors.

One explanation is “herding,” which is people’s natural tendency to make decisions based on what others have done in similar situations.

Another explanation is celebrities’ “halo effect” which, as the researchers say, gives celebrities a “cloak of generalized trustworthiness which extends well-beyond their industry or expertise.” Wanting to follow in their favorite celebrities’ footsteps, consumers ignore other information and instead imitate the celebrity’s health choices.

Celebrities also portray themselves as having an authentic connection to the product or behavior they are promoting. So are perceived as having greater credibility than their non-celebrity counterparts, despite having less medical knowledge and experience.

Any one remember the media frenzy way back in 2004 over Gwyneth’s spots? I can recall a few people coming into the clinic back then and asking if I did cupping.  Somehow over time it even morphed into a secret beauty therapy.

It’s not just movie stars and people famous for being famous.  As desperate as ageing celebrities are to hang on to their looks, sportspeople are to recover from injuries and maximise their performance.  I’ve seen the flow on effect first hand working as a sports trainer when I was a student physiotherapist. I worked at a state based football club that had a number of players in and out of teams at the national level (SANFL and AFL for any fellow Aussies). The young, up and coming players at the SANFL club idolised the guys from the AFL clubs and would follow any bit of advice they gave. It was quite popular at the club to get the biggest and heaviest trainer (he was truly a mountain of a man) to take out his “magic wand”- a short length of broom handle with sports tape wrapped around one end for better grip,  and apply brutal pressure to a “Piri” or “glut” “trigger point”.

When doctors become celebrities, the power to influence is increased by orders of magnitude. There was a lot of consternation about Shane Watson’s hamstring prior to the recent summer of cricket in Australia:

Shane Watson says hamstring injury is ‘not too bad’
A scan on a sore hamstring will determine if the all-rounder gets the all-clear for the Ashes opener at the Gabba starting on November 21 but he was optimistic on his return from India on Monday, describing his latest injury concern as “not too bad”.

He is expected to resume working closely with Australian team doctor Peter Brukner, the former head medico at Liverpool Football Club, in the lead-up to the first Test and says the highly respected sports physician’s techniques, including acupuncture, have been key to allowing him to overcome similar fitness hiccups this year.

“If it wasn’t for Doc Brukner and his techniques I wouldn’t have been able to play the consistent cricket that I have because the niggles I have had would have put me out for one or two weeks, whereas now I am able to manage it and play through them,” Watson said. “The techniques he has got like acupuncture, dry-needling to release the tension in my muscles . . . it’s part of my routine every day when I’m playing all the time. It has made a huge difference to my body.”

Anyone out there been asked to dry needle some tight hamstrings?

At it’s worst, it can lead to this.

But perhaps all is not lost, with the researchers in the original link offering some hope

The study says health professionals can counter celebrities’ negative influences by speaking to their patients about the validity of celebrity advice and cement themselves as sources of reputable health information. “We need to rethink and better understand where people obtain their health information and what makes them act upon it,” said Hoffman. “Understanding why people follow celebrities’ medical advice represents a good start.”

Anyone who has dealt with people in pain, people in real trouble, will know just how desperate they can be to find relief. As therapists or clinicians of any kind, we therefore have an enormous responsibility to be prepared with evidence- and science- based approaches, sound clinical reasoning, critical thinking and up to date knowledge to confidently counter celebrity endorsed woo, while having the empathy and humility to do it without ridicule, and gently when necessary.

But it’s hard work. I know for certain that I have lost numerous patients over the years to the “person up the street” who was all too happy to embrace the latest fad, shamelessly promote it with celebrity endorsement and then move on to the next thing when the shine and attention wore off.

As always, we’d love to hear your stories, successes and opportunities for learning in the comments below.

Elvis? It just struck me that the “Elvis Diet” never really took off.

– Tim Cocks

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  1. As someone who competed against top quality athletes ( I wrestled and got my butt kicked by some of the best), it is important that most are genetically different from most of us. You do not get to be an elite level athlete unless you somehow heal differently, move better, and psychologically deal with injury differently. To compare healing in most of us with healing in an elite athlete, I recall a quote by I believe was a famous baseball player ( I forget his name) but it goes something like this: ” you can take a mule and train it perfectly, feed it the best food, and give it the best care- but it ain’t going to win the Kentucky Derby”. Somehow I think that quote applies here. JOhnb

  2. Hi Tim,

    You say “we therefore have an enormous responsibility to be prepared with evidence- and science- based approaches”. But I’m not aware of any Physio techniques that outperform placebo. Are there any? I haven’t used a scientifically proven technique in over 15 years and I think the same would be true for most private practice physios. Please let me know if there’s something that actually works!!

    I think the public realize that the highest performing athletes are “different” to the rest of us, and in a good way. Here I’m talking about the superstars, not the average back pocket player. To reach the superstar level requires an athlete to be able to regularly enter the zone*. Being able to access that state will imbue him with some small degree of wisdom and healing ability. Small but noticeable. This is why such people are asked to attend children’s wards. Such a presence is typically much more healing than what the average health professional can provide. In general, such athletes will not have the intelligence to understand the process, and they get sucked into promoting useless products. But I don’t see too much wrong with that, so long as the product isn’t expensive. I don’t think we can take the higher ground unless we have some sort of solid evidence for a particular technique.

    We can learn from the great athletes. To be able to quiet the mind in the midst of activity is a great knack, and very therapeutic. If I had the choice of employing Gary Ablett or a Physio with a bunch of post grad degrees and published papers, it would be a VERY easy choice. I’m quite serious with that comment. I could teach Ablett how to apply IFT and push on someone L5 in a week, but I could not teach the average Physio how to be fully present with a patient.




    1. timcocks0noi

      Hi EG, I think Explaining Pain has good evidence behind it and GMI has over a decade of science supporting it with some strong evidence emerging. There have been some great posts, discussed at length, over at BiM about the ethics of placebo treatments as well as techniques that work and don’t; I think an evidence based approach embraces all of this information to provide a less shaky foundation for what therapists do. Adopting a science based, and hence naturally and inherently sceptical (but not cynical) approach to therapy could give clinicians the right to claim the higher ground – especially compared to high profile sports people promoting magical, holographic bracelets.
      Equally, I think you make a great point in that there is much to learn from those who seem able to access unique, high performing states and have an impact upon those around them The field of psychoneuroimmunology is still young, but might yield some explanations as to why a hospital visit by a “superstar” might have measurable, beneficial effects. I wonder what might happen during election time when all those politicians like to drop in to hospital wards?

  3. And here lies the crux of the matter……how do we teach the art of “Presence” and it’s fellow “Awareness” the most powerful modalities in our repertoire…..Elvis had a beautiful voice but it was nothing compared to his presence……

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