In response to Pete Evans’ advice that “calcium from dairy can remove the calcium from your bones”, Dr Brad Robinson used Facebook to ask Evans.
“Can we make a deal? You don’t give medical advice and I won’t tell you how to best shuck oysters. Agreed?”
Sounds reasonable, yet the lines aren’t so clear.
The medical community has been engaged in a long and ambiguous embrace with celebrity chefs, nutritionists and various other popularizers of medical advice. The dietary advocacy of St. Jamie Oliver (aka mockney gobshite), for example, has been lauded in the British Medical Journal for doing “more for the public health of our children than a corduroy army of health promotion workers”.
While it is unlikely that Pete Evans will receive similar praise in the Medical Journal of Australia, the medical community has (along with a host of other actors) contributed to the conditions for celebrity life-guides to flourish.
For instance, medical and public health concern over the health-effects of micro-practices such as playing computer games, microwave dinners, dairy consumption, sugary drinks, feeding infants formula, alcohol consumption, or mode of transportation contributes to the production of a population seeking clear and authoritative guidance.
The sources through which such guidance is disseminated extends well beyond the clinic, but it isn’t wholly divorced from the clinic either.
Lifestyle magazines, health websites, television programs and smartphone apps commonly feature “medical experts” as a means of legitimating the guidance on offer. And the use of these tools, especially apps or m-health, is increasingly encouraged by physicians. For example, the Royal Australian College of General Practitioners states that:
M-Health tools can provide continuous, pervasive healthcare at any time or location. By using m-Health, healthcare professionals and patients have the opportunity to continuously monitor health conditions and access health information outside of the general practice environment.
Considering that a significant proportion of the 3 billion apps available via Google Play or iTunes are health-related, the idea of simple demarcation between legitimate and illegitimate advice is naive at best.
The debate over who can give health-related advice is not new. However, the rise of various technologies, coupled with the dual movement of anxiety and fetishization of food in the present, creates an environment where a clear demarcation of legitimate from illegitimate sources of guidance is hard to find.
The fact that Dr Brad Robinson used Facebook to voice his concerns is revealing – especially as his page seems to largely function to promote the success of his private obstetrics and gynaecology practice.
Of course none of this is to suggest that there is no basis from which to judge different guidance or to highlight the spurious nature of Evans’ advice. The point is simply that the medical community has contributed to the creation of life-guide celebrities and that the contest of over medical knowledge and guidance is more complex than simply saying people like Evans should shut up until he has a white coat and stethoscope.
There is further irony in that what many physicians consider accepted medical knowledge about “healthy lifestyles,” particularly regarding diet and nutrition, tends to be based on epistemic practices that I think a lot of M.D.s would have trouble accepting as “evidence.” National dietary policy has created a default legitimacy–if it agrees with national nutrition policy, it’s “okay” by most physicians–in recommendations whose own origins in politics, ideology, and values are obscured. But it doesn’t take a rocket scientist, or a lot of time on PubMed, to figure out that many of these recommendations are highly contested within the field of nutrition itself (i.e. but otherwise “legitimate” sources); however, this uncertainty is not recognized in policy or (insofar as policy becomes medical training) in the education of healthcare professionals. That leaves internet celebrities to raise these issues (some of which may be spurious and some of which may be valid) and their own celebrity status by championing “alternative” views which may very well appeal to members of the public who have found that mainstream nutrition advice doesn’t translate well into their reality. I think the rise of celebrities (outside of the medical community) dishing up nutrition advice is directly related to nutrition scientist, policymakers, and many healthcare professionals failing to address very real disconnects between what we tell people about diet-disease relationships and how we come to “know” what those relationships are.
Thanks for your comment! I completely agree and have argued elsewhere along similar lines, although not as succinctly. I suspect greater acknowledgement from health care professionals about the uncertainty and ambiguity of the relationship between things like diet and health would go someway to diffusing the situation that gives rise to celebrities like Pete Evans. But there are many health care professionals and policy makers only too willing to step into the void and deliver “authoritative” guidance etc.