AMA’s Digital Health ‘Snake Oil’ Claim Creates Needless Conflict

Earlier this month, the head of the American Medical Association issued a challenge which should resonate for years to come. At this year’s annual meeting, Dr. James Madara argued that many direct-to-consumer digital health products, apps and even EMRs were “the digital snake oil of the early 21st century,” and that doctors will need to serve as gatekeepers to the industry.

His comments, which have been controversial, weren’t quite as immoderate as some critics have suggested. He argued that some digital health tools were “potentially magnificent,” and called on doctors to separate useful products from “so-called advancements that don’t have an appropriate evidence base, or that just don’t work that well – or that actually impede care, confuse patients, and waste our time.”

It certainly makes sense to sort the digital wheat from the chaff. After all, as of late last year there were more than 165,000 mobile health apps on the market, more than double that available in 2013, according to a study by IMS Institute for Healthcare Informatics. And despite the increasing proliferation of wearable health trackers, there is little research available to suggest that they offer concrete health benefits or promote sustainable behavior change.

That being said, the term “snake oil” has a loaded historical meaning, and we should hold Dr. Madara accountable for using it. According to Wikipedia, “snake oil” is an expression associated with products that offer questionable or unverifiable quality or benefits – which may or may not be fair. But let’s take things a bit further. In the same entry, Wikipedia defines a snake oil salesman “is someone who knowingly sells fraudulent goods or who is themselves a fraud, quack or charlatan.” And that’s a pretty harsh way to describe digital health entrepreneurs.

Ultimately, though, the issue isn’t whether Dr. Madara hurt someone’s feelings. What troubles me about his comments is they create conflict where none needs to exist.

Back in the 1850s, when what can charitably be called “entrepreneurs” were selling useless or toxic elixirs, many were doubtless aware that the products they sold had no benefit or might even harm consumers. And if what I’ve read about that era is true, I doubt they cared.

But today’s digital health entrepreneurs, in contrast, desperately want to get it right. These innovators – and digital health product line leaders within firms like Samsung and Apple – are very open to working with clinicians. In fact, most if not all work directly with both staff doctors and clinicians in community practice, and are always open to getting guidance on how to support the practice of medicine.

So while Dr. Madara’s comments aren’t precisely wrong, they suggest a fear and distrust of technology which doesn’t become any 21st century professional organization.

Think I’m wrong? Well, then why didn’t the AMA leader announce the formation of an investment fund to back the “potentially magnificent” advances he admits exist? If the AMA did that, it would demonstrate that even a 169-year-old organization can adapt and grow. But otherwise, his words suggest that the venerable trade group still holds disappointingly Luddite views better suited for the dustbin of history.

UPDATE:  An AMA representative has informed me that I got some details in the story above wrong, and I’m eager to correct my error. According to Christopher Khoury, vice president of environmental analysis and strategic analytics with the group, the AMA is indeed investing in digital health innovation. He notes that in January, the group announced the formation of San Francisco-based Health2047 (www.health2047.com), for which it serves as lead investor. Health2047 is dedicated to furthering the commercialization of digital tools and solutions that help practicing physicians. It also sponsors Matter, a healthcare incubator based in Chicago.

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

6 Comments

  • Unless you are getting as tone deaf as ONC and CMS, there is palpable anger on the street level of front line providers. We are NOT going to take this anymore. We are bombarded by ever changing rules, complexities, workarounds, etc as we are desperately trying to care for our patients. NO ONE IS LISTENING! We are burdened beyond your comprehension. MU ACI PQRS QUALITY MIPS VBM APM AAPM ACO MOC HIPAA you name it, we are burned out before we start our day. We are BEGGING vendors to help us. They are not desperately trying to help providers, they are desperately trying to meet ONC CMS requirements. They could EASILY tell them that we are on the side of the providers and to stop the madness. But they are now the happy business that has made it over the hurdles, why not keep out competition, innovation, that will only make them lose business. Vendors WANT policy lock in. So stop with the “they want to get it right” stuff. They could care less. I am among many that EVERY day talk about the limited time we have left in this mess. And thats too bad, as we are pretty darn good docs. But ONC and CMS and crappy EHR software/vendors are driving us out.

  • It’s been 4 years, but it looks like little has changed.

    See “Healthcare professionals, Repeat After Me (published 2012-05-05”.

    “”I’M AS MAD AS HELL, AND I’M NOT GOING TO TAKE THIS ANYMORE” – I don’t like my EMR, it does not handle my workflow, it does not improve patient care, it does not save time. . . . I refuse to use it.”

    http://wp.me/pzzpB-gT

  • I took away the sense that Dr. Madara was referring to apps that are advocating a closed loop medical advice model. There are several venture backed companies that propose using bots to provide medical advice. Beyond the FDA hurdels , many feel this is a dangerous path and I thnk Dr. Madara was essentially saying “pump the brakes” on these new ventures.

  • Regarding your last paragraph, AMA announced in January the formation and its lead investor status of a new entity in San Francisco, Health2047 (health2047.com) to further the commercialization of digital tools and solutions that also help physicians in practice. Many articles about this new entity and the website is mentioned above. AMA is also a sponsor, since inception, of Matter, a health care incubator in Chicago with over 100 companies focused on health care innovation (not all digital).

  • Thank you for the correction, and I apologize for these omissions. I will update the stor shortly. Meanwhile, if you are with the AMA and can set up an interview, I would love to know more about the association’s digital health investment philosophy.

  • Anne–
    Thanks and look forward to you updating the story to correct. Please email me at christopher.khoury @ama-assn.org and I’ll forward to our media team.

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