Alternative health education and pseudocredentialing

The next time someone who is not your spouse, lover, or trusted physician asks you to disrobe, spit, or urinate, think twice. And hold on to your wallet or purse. Quackery is going strong on the coattails of alternative medicine and has its own "credentials."

In the healthcare field, a quack is anyone who falsely claims medical skill. Some opponents of health fraud use the word to denote practitioners ranging from nonprofessionals bereft of medical skill who profess it, to physicians who make unfounded claims for methods they employ or preparations they administer. Nowadays, few quacks in the United States pretend to be M.D.s or osteopaths (D.O.s, who are equivalent to M.D.s). Providing fraudulent medical degrees is a high-risk business, and medical licensing procedures are stringent. However, practicing and would-be quacks can become "doctors," or at least diplomates, through a variety of correspondence courses.

Credentials and "Credentials"

The healthcare marketplace is fraught with "credentials," some legitimate, some overrated, some dubious, and some far afield of science. A bona fide credential is any evidence that one is trustworthy or has authority. However, since authority does not guarantee trustworthiness, whether a credential deserves confidence depends ultimately on whether the tenets that underlie the credential are worthy of confidence. "Authority-type" healthcare credentials range from the science-based (e.g., podiatric [chiropodist, or "foot doctor"] licensure) to the controversial (e.g., naturopathic licensure).

Credentials encompass (1) achievements and (2) documents that attest achievements. Many consumers mistake documentary (usually paper) credentials for proof of skill. Often, these are merely proof of past enrollment in an academic program, not proof of erudition or skill. Educational credentials are the professional standard because academic standing is more quantifiable than knowledge or skill. The most commanding educational credential, and therefore the most tempting to would-be misusers, is the doctorate. There are many types of doctorates, but all are categorizable as "traditional" (e.g., a nonhonorary Ph.D. degree), "professional" (e.g., an M.D. degree), and honorary (e.g., a D.Sc. [Doctor of Science] degree without academic status). Some types of doctorates in each category are considerably more doubtful than others. For example, Bears' Guide to Earning College Degrees Nontraditionally (1995) lists as controversial "professional degree titles": D.Hyp. (hypnotism), Graph. D. ("Graphoanalysis"), and H.M.D. or "M.D.(H.)" (homeopathy). Many such degrees are available throughout the United States.

In 1978, Kurt W. Donsbach (pronounced "donsbah"), D.C. (Doctor of Chiropractic), founded Donsbach University, which offered correspondence courses leading to bachelor's, master's, and doctoral degrees in nutrition. Electrical engineer Gary Pace obtained a Ph.D. degree from this nonaccredited school before it was renamed, in the late 1980s, the International University for Nutrition Education (IUNE). Pace practiced as a "nutritional consultant" on Long Island, New York. In 1985, his ad in the Nassau County (New York) Yellow Pages stated that one could determine one's "true vitamins, minerals, enzymes and glandular needs" from such tests as "hair and diet analysis," "herbal saliva," and "computerized urine and vascular analyzer." That year, then New York State Attorney General Robert Abrams filed a civil suit against Pace, accusing him of practicing medicine without a license, false advertising, and illegal use of educational credentials. Abrams said that at least 251 clients had paid Pace an average of $317 in the previous four years. According to the lawsuit, Pace had massaged women's feet, had sometimes performed lengthy and/or private mammary and vaginal exams, and had routinely requested a hair specimen (sometimes pubic). Finally, an injunction prohibited Pace from practicing medicine unlawfully and from publicizing his doctoral status.

IUNE operates as a nonaccredited "distance learning" institution in Chula Vista, California. It offers, for example, programs that lead to a Ph.D. degree in "Clincial Nutrimedicine and Biological Sciences." Majors include "nutri-medical dentistry," "nutri-medical eye and visual health care," "nutri-medical homeopathy," and "therapeutic nutrimedicine." Five of the thirteen members of IUNE's core faculty hold graduate degrees from Donsbach University and/or IUNE.

Also in 1985, a congressman opposed to quackery announced that he had become "Dr. Pepper": Claude Pepper had obtained a Ph.D. degree in psychology from Union University, Los Angeles, the nonaccredited correspondence school from which Donsbach has claimed a Ph.D. degree in nutrition. Pepper said that about half a million Americans had purchased unearned "credentials."