Questionable Organizations: An Overview

Stephen Barrett, M.D.

Promoters of questionable health practices often form organizations to multiply their effectiveness. How can one tell which ones are reliable and which are not? There is no sure way, but nine precautionary questions may help:

1. Are its ideas inside the scientific mainstream? Some groups admit that they were formed because their founders felt alienated from the scientific community. One group that made no secret of this was actually called the American Quack Association, whose main purposes were to provide emotional support to its members, poke fun at their critics, and stimulate positive public feelings toward unconventional practitioners. The group was founded in 1985 by Jonathan Wright, M.D., who became its president, and Roy Kupsinel, M.D., a "holistic" practitioner from Florida, who became its vice-president. It attracted about 300 members but no longer appears active.

2. Who are its leaders and advisors? The International Society for Fluoride Research may sound respectable, but it is actually an antifluoridation group. The International Academy of Preventive Medicine (now called the International Academy of Nutrition and Preventive Medicine) numbered among its leaders Carlton Fredericks, Linus Pauling, Lendon Smith, and other promoters of questionable nutrition practices. The Health Resources Council was founded by Gary Null to promote "alternative" health methods.

3. What are its membership requirements? Is scientific expertise required—or just a willingness to pay dues? An organization open to almost anyone may be perfectly respectable (like the American Association for the Advancement of Science), but don't let the fact that an individual belongs to it impress you. The International Academy of Nutritional Consultants, the American Association of Nutritional Consultants, the National Academy of Research Biochemists, and the International Association of Therapeutic Specialists issue attractive certificates, but their only requirement for "professional membership" has been payment of a modest fee. Some "institutes," "research" centers, and voluntary organizations are simply names adopted by an individual or a few people who wish to make their commercial activities sound more respectable. The National Academy of Sports Medicine, for example, began as a private corporation used for marketing dubious products; and the "Noble Research Society" merely marketed a quack device.

4. Does it promote a specific treatment or treatments? Most such groups should be highly suspect. A century ago, valid new ideas were hard to evaluate and often were rejected by the medical community. But today, effective new treatments are quickly welcomed by scientific practitioners and do not need special groups to promote them. The American College for Advancement in Medicine, the main purpose of which has been to promote chelation therapy, falls into this category. Others include:

A few groups promote a mixture of science-based and dubious practices. The American Academy of Otolaryngic Allergy, for example, promotes the concepts of clinical ecology, and the American Academy of Osteopathy espouses cranial therapy. Some groups have even set up their own certifying boards.

5. Does it oppose proven public health measures? Opposition to fluoridation and immunization are tipoffs to extremely poor judgment. The names of such organizations sometimes fail to reveal their true purpose. "Pure water" and "Safe Water" groups nearly always have dishonest opposition to fluoridation as their central focus. The Preventive Dental Health Association is opposed to the use of amalgam fillings as well as to fluoridation. The World Children's Wellness Foundation is a chiropractic group that opposes the immunization of children.

6. Does it espouse a version of "freedom of choice" that would abolish government regulation of the health marketplace? Such "freedom" is nothing more than a ploy to persuade legislators to permit the marketing of quack methods without legal restraints. Consumers for Dental Care, for example, has sought an end toward what it calls "discrimination" against dentists who advise patients to have their amalgam fillings removed.

7. How is it financed? The Council for Responsible Nutrition, despite its respectable-sounding name, represents manufacturers and distributors of food supplements and other nutritional products. Don't assume, however, that funding by an industry makes an organization unreliable. Reliability should be determined by judging the validity of a group's ideas rather than its funding. The National Dairy Council and the Institute of Food Technologists are highly respected by the scientific community for their accurate publications on nutrition.

8. Is it a real organization? Some entrepreneurs simply make up names for the purpose of marketing products, such as weight-control pills, sex enhancers, or various dietary supplements. If an "institute," "clinic," "laboratory," "research center," or professional-sounding "association" uses sensational claims to market products by mail or through the Internet, it is probably a phony. For example, the "American Urological Clinic," which marketed a phony impotence remedy called Vaegra (not Viagra) in 1998, was merely a rented mailbox in Kansas City, Missouri. Scams also exist in which donations are solicited for a phony organization with a name similar to that of a well-known genuine charity.

9. If it is a school, is it accredited by a recognized agency? Accreditation constitutes public recognition that an educational program meets the administrative, organizational, and financial criteria of a recognized agency. In the United States, educational standards for schools are set by a network of agencies approved by the U.S. Office of Education (USOE) or the Council for Higher Education Accreditation (CHEA). USOE or CHEA do not accredit individual schools, but they approve the national and regional agencies that do so. Almost all such agencies are voluntary and nongovernmental. Accreditation enables credits to be transferable from one school to another and is used as a basis for entering various professions. In other countries, schools approved by the Minister of Education tend to be reputable. Degrees from entities that are not accredited or approved should not be regarded as equivalent to those from accredited or approved schools.

Lack of accreditation of a health-related school should be considered a very bad sign. I have never encountered a nonaccredited school that issued health credentials that did not promote misinformation. Of course, neither accreditation nor affiliation with an otherwise reputable university provides any guarantee of reliability. The U.S. Secretary of Education has recognized agencies that accredit schools of chiropractic, astrology, acupuncture/oriental medicine, massage, and naturopathy with little regard to the validity of what they teach. Moreover, many universities promote health-related nonsense in addition to sound science. Temple University's Center for Frontier Sciences and Columbia University's Richard and Hinda Rosenthal Center for Alternative and Complementary Medicine are examples of bad components of basically good institutions.

10. If it awards certifications, how stringent are its requirements? Various types of unscientific practitioners have formed boards through which they certify themselves. In the United States, the recognized standard-setting organization is the Americn Board of Medical Specialties (ABMS), which recognizes more than 100 specialties and subspecialties. Some medical certifying boards outside of this system have high standards, but most do not.

I view the following with considerable distrust. Some are no longer active. If you would like to nominate others for this list, please contact us.

Professional Organizations

Student Organizations

Dubious Certifying Boards

Voluntary Organizations

Government Agencies

Schools, Accredited But Not Recommended

Schools Not Accredited by Recognized Accrediting Agency

Non-Recognized Accrediting/Credentialing/LicensingAgencies

Schools, Outside the United States

Questionable "Research" Entities

Other Academies, Associations, Centers, Councils,
Foundations, Institutes, and Information Services

Trade Associations

This article was revised on July 10, 2014.