When in doubt, call yourself a doctor

April 21st, 2006 by Ben Goldacre in alternative medicine, bad science, mail, media, nutritionists, PhDs, doctors, and qualifications | 45 Comments »

Ben Goldacre
Saturday April 22, 2006
The Guardian

So here’s a tangled web, and frankly I don’t think anybody comes out of it looking too good, including me. Yes We Can Cure ADHD, read the Daily Mail last week. Now I know what you’re thinking. Like a magnificently drunk girlfriend, you’re shouting: “Leave it, he’s not worth it”.

And yet, something caught my eye. Controversial cures come from controversial people, whereas this was written by “neurologist Dr Robin Pauc”. That authority card really stands out. Authority is so important with health information, and neurologists are so immaculate, so ruthlessly pedantic.

So I check, and “neurologist Dr Robin Pauc” does not appear on the specialist register for neurology held by the GMC. But neurologist Dr Robin Pauc is a doctor of chiropractic, with a career, I grant you, in the neurological aspects of chiropractor stuff.

Now, the General Chiropractic Council’s code of practice says: “Chiropractors who use the title of ‘doctor’ and who are not registered medical practitioners must ensure that they make it clear that they are registered chiropractors and not registered medical practitioners.” And the word chiropractor does not appear in this authoritative 2,000 word promotion for Dr Robin Pauc’s new book and cure for attention deficit hyperactivity disorder.

But is it so bad? By law, unlike “protected titles” such as nurse or physiotherapist, anyone can call themselves a doctor or a neurologist. Amusingly, on the other hand, you cannot call yourself a chiropractor, as Dr Robin Pauc can, because that is a protected term.

So I call neurologist Dr Robin Pauc, upon which he rather pulls the rug out, and simply denies writing the article, which is a further surprise. He says it was written by two people from the Mail, and he had no control over it. So now, not only is the author of this article, “neurologist Dr Robin Pauc”, not a neurologist (to my naive interpretation of the word) but suddenly he’s also not the author of the article.

Was I supposed to just assume all this? Am I preposterously naive? Are newspapers like this outside of the health pages too? You can see how writing the column gets a bit confusing sometimes. Pauc denies ever claiming to be anything other than a chiropractic neurologist. He denies offering any cure for ADHD. Then he gets angry and puts the phone down. Like you would.

But one thing he said sticks in my mind: that I cannot address his theories, because I have not read his book. And on this occasion, I will not. Authority is a shortcut to reliable information. You take stuff on faith because reading, critiquing and checking that academic references are valid and represent the material they refer to, and more, is very time consuming. I started out dubious about his claims. And after an afternoon in this hall of mirrors, I am in no sense motivated to spend my time reading a whole book on them. Like I said, I don’t think anybody comes out of this one looking too good.

: Please send your bad science to bad.science@guardian.co.uk

Ironically, given the question of Pauc’s copy being changed, the Guardian actually changed my article too, cutting it for space reasons, removing the bits where I allude to feeling a bit conflicted about chasing the story which upset Pauc so inevitably. The above version is without those cuts.

You could say this was a minor change, but still I feel slightly uncomfortable reading it myself: partly because writers will always feel like that about cuts that they cannot check or control; partly because it makes me look a marginally more horrible person; but mostly because the most interesting thing to me about this whole situation wasn’t that some bloke’s qualifications were slightly misrepresented (for whatever reason), but rather that these slight misrepresentations of qualification and authority are small but incredibly common, and troubling yourself over tracing them out and trying to dissect right from wrong can feel petty and disproportionate, perhaps because they are now arguably a cultural norm.

I still can’t decide if it was an okay thing to write about, or if I have distressed this man for no good reason.


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45 Responses



  1. stever said,

    April 22, 2006 at 12:03 am

    both versions are great.

    you should sort out a word length with the guardian and get some agreement not to cut it. editors seem obligated to cut things whether they need it otr not.

  2. Ben Goldacre said,

    April 22, 2006 at 12:07 am

    yeah, it’s basically my fault, the column’s longer now (600 not 400 since moving to saturdays) but i always file about 100 words too many, just can’t help myself. actually i think 400, 800, and 1600 are perfect word lengths for articles, in a weirdly numerological vein: quick joke, quick story, or quick argument, in ascending order of length.

  3. AitchJay said,

    April 22, 2006 at 5:22 am

    Yeah, that is a dilemma, but to edit out your uncertainty may leave you open to all sorts of criticism too..
    Maybe you should have mentioned the names of the authors of the article as well.

  4. bluekieran said,

    April 22, 2006 at 7:34 am

    This may be commonplace, but I don’t think it is commonly understood to be so. Poor journalism of this type is so insidious and harmful, I for one would be very glad to see it flushed into the open – and preferably beaten down with a big stick!

    There really should be some body equivalent to the ASA with power to punish this sort of thing.

  5. pseudomonas said,

    April 22, 2006 at 7:54 am

    equivalent to the ASA with power to punish this sort of thing.
    Equivalent to the ASA == with the power to tell someone that we really don’t like what they’re doing and that we’d really rather they stopped and that if they don’t we’ll be very very disappointed.

  6. Roger Macy said,

    April 22, 2006 at 8:16 am

    Ben,
    Now you’re out in the main section, is your editor the Science Editor, the Features Editor, or what ?
    Roger

  7. BobP said,

    April 22, 2006 at 8:32 am

    I think Dr Pauc is worthy of your attention, Ben. His main website is www.tinsleyhouseclinic.co.uk/ and it is hard to work out from the website a) that he is not a medical doctor, or b) that his claims to be a qualified neurologist and knowledeable neurophysicist are based on a qualification from a chiropractic institute. Hes has published a couple of books which are listed in Amazon – again, no clarification of his qualification here, although he has gone to the trouble of adding an “Author’s Note” to the Amazon listing.

    There are claims that they can treat a range of childhood behavioural disorders, using “afferentation” to exercise your neurons – which is a word I have never seen before. However if you can afferentiate your neurons, it makes them generate more protein, they have better internal structures and more neurotransmitters. I have never seeen neurophysiology explained in these terms before – do we have a qualified neurophysiologist in the house who can comment on this?

  8. potsy700 said,

    April 22, 2006 at 8:40 am

    The Daily Mail already has a cure for ADHD. Every few months some wag writes into the Mail letters page with

    “In my day we had a cure for ADHD. It was called…..x”

    where x = a slap /a clip round the ear/ the cane / the birch / the slipper / the noose

    And when they’re not running those, they write articles about how ADHD does not exist anyway.

  9. Wiretrip said,

    April 22, 2006 at 9:13 am

    Just like to draw attention to a rather prescient comment (I think) made some moths ago :-)

    “…is there any legisaltion to cover the use of bogus, questionable or just plain irrelevant qualifications in order to gain ‘authority’ over the public? (Start of slightly off-topic rant) Having spent a number of years slaving away to gain a PhD by pure hard, soul-destroying work myself, I find it increasingly annoying to see the title ‘Dr’ used by people:

    1) Who have bought their PhD from some bizarre, unacredited certificate shop. Here, of course, I refer to a certain well known TV coprophiliac amongst others.
    2) People who have received their doctorates in the time-honoured exchange for endowments and funding.
    3) Certain radio DJs and Rap artists…

    Generally, these people (except maybe the third group) are cynically using the title to gain a hold over the public (and the humanities graduates – but not postgrads in order to foist upon them everything ranging from stuff they just don’t really know anything about to snake-oil style quackery in general. Actually, I suppose I am mainly referring to the first group- this is becoming a bit like the ‘Spanish Inquistion’ sketch in reverse The bottom line: I think that it should be as illegal to sell yourself by employing false or irrelevant titles as selling goods using false descriptions…

    Apologies if there is already a section devoted to this. Could we have a name-and-shame page, maybe called “Experts” (including the quote marks), with a simple table listing these people? ”

    I was pointed in the direction of the “PhDs qualifications” etc. section which does pint to some instances of this. But this is a bit wishy-washy… I think what we really need is a *simple table*, or a register if you like, of people who are using their qualifications to gain authority fraudulently. We could have the following fields (I include the name here maybe in jest):

    Name:

    Prof Sir David King (how many titles does one person need?) :

    Actual Expertise:

    Surface Chemistry

    Last actual academic publication:

    don’t know this one…

    Assumed Expertise:

    Veterinary Science (foot and mouth cockup, avian flu)
    Climate change (actually message seems sound but still, why him, whay do we not listen to the actual experts?)

    What about it ?

    Maybe there could be a ‘defence’ column where the candidates could justify themselves…

  10. harry said,

    April 22, 2006 at 9:55 am

    The word count of the body of the original article was 502, trimmed to 420 in the Guardian. Have I missed something here?

  11. Pete said,

    April 22, 2006 at 10:56 am

    As a parent of a child recently diagnosed with Dyspraxia, I think anyone who preys on our problem should be slapped down, I’ve had a look at Dr Pauc’s web site and he promises miracles, although I’m sure there would be a hefty fee.

    Incidentally, to give you an idea of how bad things are, my child is still unable to form the majority of words with any degree of clarity, he’s 6 (nearly 7) and no-one outside the family has much of a chance of understanding him, we struggle ourselves, and the frustration and pain in his eyes when he can’t make himself understood to his daddy is heartbreaking.

    If I had come across Tinsley House Clinic without your warning about Dr Pauc I would easily have been taken in by it so I say keep it up.

  12. briantist said,

    April 22, 2006 at 11:21 am

    It makes me wonder why you are Dr Ben when I receive an email from you, but you are doctor-less in the Guardian!

  13. briantist said,

    April 22, 2006 at 11:41 am

    Never mind the Daily Mail, you should see the BBC’s defence of it’s confused reporting of medical and scienfic news and surveys. news.bbc.co.uk/media/avdb/news_web/video/9012da68003fc60/bb/09012da68003fed3_16x9_bb.asx

  14. briantist said,

    April 22, 2006 at 11:46 am

    news.bbc.co.uk/nolavconsole/ukfs_news/hi/bb_wm_fs.stm?nbram=1&news=1&nbwm=1&bbwm=1&bbram=1&nol_storyid=4932718

    www.ukfree.tv/bbc_mce/09012da68003fed3_16x9_bb.wmv

  15. briantist said,

    April 23, 2006 at 12:37 pm

    Looks like the beeb are trying to make it a week of bad science!!

    “Shock! Devices that operate using radio waves can be detected using a simple radio receiver”

    news.bbc.co.uk/1/hi/programmes/click_online/4930210.stm

    (yes, square radio waves are worse for you than sine waves, it seems)

    “Let’s ignore the second law of thermodynamics”

    news.bbc.co.uk/1/hi/programmes/click_online/4929594.stm

    (let’s make money by making a small reading and then multiplying it by a huge number!)

  16. Pedantica said,

    April 23, 2006 at 1:10 pm

    “http://news.bbc.co.uk/1/hi/programmes/click_online/4929594.stm

    (let’s make money by making a small reading and then multiplying it by a huge number!) ”

    Multiplication isn’t scientific?

  17. Michael Harman said,

    April 23, 2006 at 1:20 pm

    From Briantist’s second site in his post of April 23, 12:37 Goldacre time:

    “If a million PC users switched to a more efficient power supply, it would save almost the equivalent of 250 million litres of gasoline a day.”

    By my arithmetic, this means that a single PC on standby uses the equivalent of 250 litres of gasoline a day. Running rather hot, I’d say.

  18. briantist said,

    April 23, 2006 at 2:19 pm

    Not when you just pick a figure out of the air. Check the TV version of this…

    “John’s device is useful because the way that systems draw standby power can be very difficult to monitor – there is a commerical version being put together by these people – a group called DIY Kyoto”

    Let me get this right – your domestic electricity meter can charge you for the power, but you need John’s device to read it properly. Classic bullshit.

  19. briantist said,

    April 23, 2006 at 2:23 pm

    Let me name the other bad scientist, he’s called ALASDAIR PHILIPS and he’s the inventor (sic) of the ELECTROSMOG DETECTOR.

    I built one of these when I was about nine years old, it’s a crystal radio!

    (sci-toys.com/scitoys/scitoys/radio/homemade_radio.html)

  20. pinguin said,

    April 23, 2006 at 8:08 pm

    That’s just brilliant.

    “The inventor of the electrosmog detector, Alasdair Philips, describes it as effectively a very simple radio.”

    Effectively? No, it is actually literally just a very simple radio.

  21. emmie28 said,

    April 24, 2006 at 3:29 pm

    “I still can’t decide if it was an okay thing to write about, or if I have distressed this man for no good reason.”

    I think Dr Pauc should be more distressed that a national newspaper is misrepresenting his work and mistakenly attributing articles to him, than by you ringing him up to ask about it.

  22. tomh said,

    April 24, 2006 at 6:40 pm

    Re Michael Harman
    Hm, I thought that they had editors that were ment to catch that kind of thing, still, at least they have corrected it now, so it now works out at 4l of petrol a day. Bit on the high side perhaps, but at least a lot more beleavable.

    now the other bbc artical:
    “If you take an uncooked egg and lay a hammer on it, it doesn’t break; but if you tap it gently it smashes, and we think that the tapping is interfering with the body’s internal communication systems.”

    I don’t know about you, but I’ve just taped an egg and it didn’t break (just tried it), so thats wrong for starters, and how exatly are electromagnetic waves meant to be tapping me, I don’t feel anything…

  23. briantist said,

    April 25, 2006 at 12:38 pm

    I just pulled this page up in an internet cafe, and it says “You must bee (sic) logged in to post a comment.” buuzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz?

  24. Crispy Duck said,

    April 25, 2006 at 1:31 pm

    The thing which people *always* ignore when banging on about standby power is that it’s only a problem for six months of the year (or less) in the UK. All this “wasted” standby power isn’t wasted at all, it’s helping to heat your house. If everyone turned off all their standby devices, the central heating boiler would have to run a little bit longer to warm the place up. I regularly have three machines running in my study and it’s the warmest room in the house by far :-)

    Granted, in the summer I have to open a window and get rid of all that heat.

    Here’s a significant waste of energy that I want the gummint to do something about…. how many people, after boiling their potatoes / rice / cabbage etc, drain the boiling water straight down the sink? What a waste. You should leave the boiling water on the stove to cool down and heat the house. Maybe there should be a saucepan tax, and there could be satellite tracking devices fitted to all saucepans to catch offenders…

  25. kim said,

    April 25, 2006 at 6:41 pm

    I did a quick Google on Dr Pauc and discovered this:

    www.gm.tv/index.cfm?articleid=20066.

    I was immediately struck by this para: “But Dr Pauc believes you can cure these youngsters by boosting spindle cell development with tailor-made exercises for the brain – maybe walking up three steps with your eyes closed and your hands by your side, or brushing your teeth with your left hand while standing only on your left leg.”

    Sounds strangely familiar, doesn’t it?

  26. Aspiring Pedant said,

    April 25, 2006 at 7:50 pm

    I found this on Amazon – It would appear Dr Pauc is not as innocent as he pretends and any confusion is not the fault of the Daily Mail. In fact if he denies that he claims to have found a cure to ADHD then he is lying. Maybe Ben should have had a look at his book after all. This is classic pseudoscience – I love the bpoptosis bit.

    —–

    Is That My Child?: A Parents Guide to Dyspraxia, Dyslexia, ADD, ADHD, OCD and Tourette’s Syndrome of Childhood
    Robin Pauc

    From the Author
    Although primarily written for the parents of children with learning/behavioural difficulties and educators, this book is a must for every parent and would-be parent. Why? Because it brings together a host of research to form a theory that is truly ground-breaking. This book will change your child’s life. Is That My Child? explains why every human baby is born prematurely by months, how four months after birth a second-wave of brain cells develop and how if these cells under-function, learning and behavioural difficulties will result. This book also states boldly that dyslexia, dyspraxia, ADD, ADHD, OCD and Tourette’s of childhood simply do not exist. That is, they do not exist in isolation as they are only symptoms of this underlying problem and are not conditions in their own right. The good news for every concerned parent is that the discovery of bpoptosis – the name I have given to the development and maturation of the second-wave of brain cells – means!
    we now know what causes the symptoms and therefore can effectively treat any developmental delay.

    From the Inside Flap
    At least one child in five experiences some form of learning difficulty, but: learning difficulties as we understand them do not exist; they are not diseases just symptoms; these symptoms never appear alone; and they are treatable and avoidable. Dr Robin Pauc, an expert in child neurology, approaches learning difficulties, including Dyslexia, ADD, OCD, ADHD, Dyspraxia and Tourette’s syndrome of childhood, from a truly ground-breaking perspective. All human babies are born prematurely and develop special new brain cells four months after birth. Every human’s development in the womb and particularly in these early stages of life can, therefore, be affected by developmental delay, which can blight childhood and marginalize a child at school. Since our brains continue to grow, however, the symptoms can also be treated. Is That My Child? explains the background to human developmental delay and contains: advice on how to get the best assessment for your child and an explanation of what the examination must include; the effects – good and bad – of certain foods on the brain; exercises and computer programs that you can use to expand your child’s neural function; and case histories of children on whom this plan has worked. In the single biggest breakthrough in the history of learning difficulties, Is That My Child? explains the cause of Developmental Delay Syndromes, uses simple, easy-to-follow tips to show you how to greatly reduce the risk of your child suffering, and gives advice on what can be done to treat those children that do.

    About the Author
    Dr Robin Pauc is a specialist in child neurology and runs his own private practice in Hampshire. He lectures on behalf of the prestigious Carrick Institute for Post-Graduate Studies at Cape Canaveral and is author of several academic texts.

    —–

  27. j said,

    April 25, 2006 at 8:44 pm

    re. the chiropractor’s code of practice, I wonder how clear chiropractors are meant to make it that they’re not medical doctors. A quick google shows that, on his clinic’s website, Pauc is described as “a Diplomate of the American Chiropractic Neurology Board and an Assistant Professor of Clinical Neurology at the Carrick Institute for Post-Graduate Studies, Cape Canaveral, USA. He has been in clinical practice for 30 years and now specialises in the treatment of developmental disorders in children.” (www.tinsleyhouseclinic.co.uk/about-us.htm). Maybe I’m being dense, but to me that could easily give the impression that he was a proper MD as well…

  28. j said,

    April 25, 2006 at 8:45 pm

    sorry, I should have said that the website refers to Dr Robin Pauc.

  29. superburger said,

    April 26, 2006 at 9:03 am

    From the link kim posts

    “He says humans are the only animals with a significant number of spindle cells, and are also the only species with behavioural problems, so concludes there is a link between the two.”

    So, how does the doc conclude there is a link? I mean, humans are the only animals to wear clothes, so maybe making your child wear clothes causes behavioural problems.

    Where are his stats that allow him to draw this unique conclusion.

    I thought that animals in small cages / poor environments in zoos showed behaviuoral problems (pacing endlessly, banging heads etc.)

    If I was a serious / genuine scientist who thought I’d been misrepresented by the Daily Hate Mail I wouldn’t slam the phone down on a fellow scientist, I’d thank him for the adivce and be on the phone to my lawyer to sue for libel/ defamation.

  30. superburger said,

    April 26, 2006 at 9:07 am

    PS I can’t believe this thread has got this far without mentioning the world’s most famous “Dr”…. Ms Gillian McKeith!

  31. hatter said,

    April 26, 2006 at 3:49 pm

    “means that a single PC on standby uses the equivalent of 250 litres of gasoline a day. Running rather hot, I’d say”

    I’ve switched to running mine off a nuclear reactor to conserve gasoline.

  32. Martin said,

    April 27, 2006 at 7:06 am

    250 litres of gasoline a day equates to approximately 100kW. If your computer is using 100kW when on standby, I suggest that you probably should switch to a more efficient power supply.

  33. Aspiring Pedant said,

    April 27, 2006 at 9:08 am

    There’s nothing wrong with Michael Harman’s arithmetic but he’s got his figures wrong: –
    “If a million PC users switched to a more efficient power supply, it would save almost the equivalent of 250 thousand litres of gasoline a day.”
    So, the figure the BBC site implies is 250ml per PC day which is equivalent to around 100 Watts.
    However, the statement quoted above is a bit vague; I’m not sure it’s actually referring to avoiding leaving PCs on standby. Does anybody know of a more efficient power supply to use?

  34. Adam said,

    April 27, 2006 at 10:57 am

    Without wishing to rain on anybody’s parade, the article actually says a million PCs turned off completely would save 250 *thousand* litres of petrol, so a quarter of a litre per PC per day.

    That sounds a bit more reasonable to me, if still a little on the high side.

  35. Delster said,

    April 27, 2006 at 3:35 pm

    a quick quote from that bbc news article on electrosmog

    “Alasdair adds: “Also, they’re not pulsing. We’ve had FM radio transmitters around for years and there isn’t the evidence that FM radio is a problem.

    “If you take the electrosmog detector near an FM radio you won’t hear anything. It isn’t pulsing on and off, and we believe it’s the pulsing on and off that matters. ”

    well not to put too fine a point on it but ….duh…. a home radio set is a receiver not a transmitter!

    Also the 250 thousand liters in the other article, is what would be saved by changing to a more efficient power supply not by stopping using standby, quote below. So this includes actual useage time too.

    “If a million PC users switched to a more efficient power supply, it would save almost the equivalent of 250 thousand litres of gasoline a day.”

  36. Richard said,

    April 27, 2006 at 9:58 pm

    Favourite quote from the article on electrosmog:

    Alasdair adds: “Also,[TV or radio masts are] not pulsing. […] If you take an uncooked egg and lay a hammer on it, it doesn’t break; but if you tap it gently it smashes, and we think that the tapping is interfering with the body’s internal communication systems.”

    You see, your central nervous system is like an egg. And electro-magnetic radiation is like a hammer. If you hit an egg repeatedly with a hammer it will smash and get yolk everywhere, and EM radiation acts on your brain in the same way. QED.

  37. Shackleford Hurtmore said,

    April 28, 2006 at 10:52 am

    Mr Field has developed a device to show how much power something is using? That sounds awfully like the “clamp meter” that I use at work; we use it to work out how much power computers are using, so that we can plan power capacity and cooling of computer rooms. Mr Field could save a lot of energy by not re-inventing the wheel.

    Ben, thanks for the column… I read it every week – it saves me watching TV and reading newspapers, by reminding me how crap most reporting is. I feel better adjusted now that I don’t really know what is going on in the world, and I know that I don’t know.

    So I think you are saving me more electricity in my house than anything Mr Fields is doing.

  38. Michael Harman said,

    April 28, 2006 at 7:41 pm

    Re the petrol equivalent usage of PCs, I can’t swear to it but I’m virtually certain that I cut and pasted from the Chris Long article “Energy cost of PCs on standby”. Is it possible that the article has been amended/corrected?

  39. Robert Carnegie said,

    May 3, 2006 at 12:03 am

    In other news, apparently a doctor in Shetland isn’t raking in £300,000 a year by reluctantly working a large patch solo – it was a hoax.

  40. p356a said,

    July 6, 2006 at 1:46 am

    So your all very eager to badmouth Robin Pauc, seemingly because: A- his title isn’t up to scrutiny B- he denounces an article about in the (my god we’re overrun be imigrants) daily (we’ll make it all up) mail.
    Has anyone read his book? Ben, there are too many journos who just can’t be bothered to read up and do some proper research into stories. If you read the book you will see that Pauc does not claim to cure ADHD as he regards it as one of many symptoms of a disorder he describes as delayed development syndrome. At last someone is doing something about these increasingly common problems and getting results.

    Go on I dare you READ THE BOOK!

  41. hrb said,

    March 6, 2007 at 1:46 am

    this makes me angry, i have ocd and i am dyspraxic too, nobody realised i had ocd until i did this year and i think had i got the help i needed young enough ocd wouldnt have messed me up in the way it did.

    you cant compare ocd and dyspraxia they’re totally different disorders, dyspraxia is something ive almost completely grown out of, ocd is not and i’ll always be dealing with it for my whole life

  42. suej said,

    March 30, 2007 at 2:37 pm

    www.tinsleyhouseclinic.co.uk/clinic-near-you.htm

    We were lucky enough to find a Tinsley House Clinic just an hour’s drive away. I had no expectations but I understood the basic science from my own experiences. What had we got to lose? I’m still taken by surprise when I notice my son has taken a big step forward after a visit. I never did get round to reading the book, other than a quick skim – but try it out with a real live chiropractor and you may be glad you did! Autism and all these other learning disabilities are symptoms of developmental delays. You can wait until your child is 30 or 50 to catch up with the rest of the world and that’s OK – or you can save yourself a lot of worry and give your child a better quality of life much earlier.

    Just my experience.

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  45. Macdrifter » Blog Archive » Doctor of Social Imagineering said,

    April 23, 2011 at 3:42 am

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