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Why woo-woo wins

January 19, 2008. The story of Que Te Park (also known as Andrew Q. Park) and his wife Jung Joo Park and their Q-Ray bracelet illustrates what we're up against. Since Jung Joo was not found liable by a court in the marketing and selling of the infamous Q-Ray ionized bracelet, I won't mention her anymore. Que Te Park's companies—QT Inc., Q-Ray, Company, and Bio-Metal, Inc.—market and sell bracelets. They advertise primarily on the Internet and through infomercials. (You may have heard the pitch on the Golf Channel, the Learning Channel, USA Network, or the Discovery Channel.) Q-Ray was also featured at trade shows. Park claims to have sold millions of bracelets. That may be one of only two true things he's said in years. According to the FTC, from 2000-2003 the bracelets had a mark-up of over 650 percent and net sales to consumers were $87 million.

Here are a few of the claims made for the Q-Ray on infomercials and on the Q-Ray website (grammatical errors uncorrected):

--"the world's only ionized bracelet of its kind for balancing your body's yin-yang (positive & negative ions)"

--"energize your whole body and relieve pains the natural way by boosting chi..."

--"The speed of 'chi' in your body is equal to the speed of the light, based on the body electric. So fast, so effective. Not slowly, locally like others"

--"cutting-edge exclusive Ionization Technology for 24 hours Non Stop Performance"

--"the Original Ionized Q-Ray covers the whole afflicted areas of body instantly"

--"Balancing your body's Yin-Yang (Chi) is everything in your competitive Sports Performance and well beings. No Doping Test needed for Q-Ray"

--"provides immediate significant or complete relief from various types of pain, including, but not limited to, musculoskeletal pain, sciatic pain, persistent headaches, sinus problems, tendinitis, or injuries"

--"tests prove that the Q-Ray bracelet relieves pain"

The claims made for the Q-Ray are absurd on their face...to a skeptic. The claims have varied over the years but most of them follow a formula: indicate the bracelet relieves pain by affecting some sort of magical energy. This was a very clever tactic since there is already widespread belief in the myth of the copper (or magnetic) bracelet for arthritis. This myth, of course, is backed up by thousands of anecdotes from rational people who know it works and who know or care little about the placebo effect, logic, or the natural history of chronic pain.

In addition, there is a growing acceptance of the notion that some sort of mysterious "energy" (usually called chi) is at the root of pain, health, the economy, world history, and who knows what else. Media personalities like Oprah Winfrey and her medical mandarin, Dr. Mehmet Oz, are only too happy to spread the superstition across the land. Unfortunately, the court ruled not only that Park is a fraud, but that his marketing claim of a relationship between the Q-Ray bracelet and Eastern medicine is "a disservice to the practitioners of this ancient art." No evidence was provided by the court as to any actual disservice done, however. We are left to suppose that since practitioners of traditional Chinese medicine really believe in chi, they're not going to be charged with fraud. As long as they claim that they are not directing chi with metal jewelry and stick to claims about needles, pressure points, and magical hands they're beyond the reach of the law.

Add to that mix the popularity of non-scientific medicine propped up by scientific jargon and you have a formula for success—if you measure success by your ability "to bilk unsophisticated persons ... in pain from arthritis and other chronic conditions."* The quote is from judge Frank Easterbrook, the head judge of the U.S. Court of Appeals for the Seventh Circuit. The court ruled that Park must pony up a minimum of $22.5 million, representing his companies' profits from January 2000 to June 2003. He's also required to provide up to an additional $64.5 million in refunds to consumers who bought the bracelets during that time period.*

The other true thing that Park said is that there are professional athletes (as well as non-professional non-athletes) who wear and swear by the Q-Ray jewelry. These testimonials seem innocent enough as long as you don't deconstruct them. For example, Gregg Easterbrook of ESPN recently wrote:

Official Brother Frank Easterbrook, a federal appeals judge, upheld a large judgment against the maker of Q-Ray bracelets, saying its claim that "Q-rays" exist and confer fantastic health benefits is "poppycock" and "a form of fraud." Q-ray bracelets supposedly deliver astonishing "bio-energy." Frank found they were just metallic trinkets.

Gregg then segued into a story about how he had once bought his wife a copper bracelet while they were on vacation. She had been experiencing "persistent pain in her right hand, probably from too much keyboard time at work."

I went from shop to shop asking for not just a Native American-made copper bracelet but one that had been blessed by a medicine man. I found one seller, an Arapaho jeweler, who said his work was blessed by a shaman. (Probably later he said to his wife, "Guess what, today I had a customer from Maryland who believes in the medicine-man stuff.") Nan put the bracelet on. Her pain was gone in two days and has never returned. True story.

I don't deny this is a true story, but it shouldn't end here. She'd been on vacation, away from her keyboard....need I go on? There are thousands of stories like Nan's. To the uncritical wishful thinker they are evidence that copper bracelets can relieve pain.

Park's legal troubles began in 2003. Yes, it took four and a half years to get from the day the FTC took Q-Ray to court to the day his companies were ordered to pay back the people they'd defrauded over the years. Not only did Park continue to market and sell his expensive placebo during those four and a half years, he also earned who knows how much selling the fraudulent trinket before the FTC brought charges. (If you're thinking of looking up qray.com on the WayBack Machine, forget it. The site has been blocked.)

Furthermore, Park is not forbidden to continue selling the Q-Ray bracelets, as long as he sells them as bracelets and doesn't make any false claims about ions, energies, ying, yang, chi, rays, or any other health claims. Park could, of course, return to marketing the bracelet as a pain reliever if he could provide proof that it does relieve pain. The kind of proof the courts and the FTC would require, however, is of a higher caliber than testimonials from satisfied customers.

In a sign of just how absurd the situation with woo-woo has become in this country, the Mayo Clinic in Jacksonville, Florida, actually did a double-blind controlled test of the Q-Ray pitted against a placebo bracelet in a test of pain relief. A placebo against a placebo! Anybody familiar with the literature on placebos and the widespread belief in woo-woo could have predicted the outcome of the study, especially if you knew that 80 percent of the 409 participants claimed before the study began that they believed ionized bracelets can reduce joint or muscle pain.

The bracelets were identical and all were supplied by QT, Inc. (A good test might have been for the Mayo folks to have labeled the bracelets and then mixed them, sent them back to QT to see if the folks there could tell the fake fakes from the real fakes.)

Predictably, the result of the Mayo Clinic test was a tie: both groups reported significant pain relief. According to principal investigator Dr. Robert Bratton, the study showed the benefit of placebos to relieve pain. Park's lawyer tried to use this claim to Q-Ray's advantage in court when he argued that the placebo effect should count in their favor as proof that the bracelets really do relieve pain. The court wouldn't buy it. For a placebo bracelet to work, said the court, "the consumer must be duped” and “the advertiser must trick the customer into believing that an inherently ineffective bracelet actually relieves pain."* Judge Easterbrook wrote:

"Since the placebo effect can be obtained from sugar pills, charging $200 for a device that is represented as a miracle cure but works no better than a dummy pill is a form of fraud."

The judge's words might be of interest to many physicians. A non-scientific survey published in the January issue of the Journal of General Internal Medicine found that forty-five percent of the doctors who participated in the web survey recommended placebos to patients in clinical practice. The survey polled a limited number of doctors in the Chicago area, half of whom responded, but the results indicate that many doctors routinely prescribe placebos. If so, the CAM medical community may not  be the only health care professionals committing fraud on a daily basis. Obviously, this raises some ethical questions, but, if I understand judge Easterbrook, it also raises a legal question.

In any case, the Parks continue to sell the Q-Ray bracelet, as a bracelet and not as a medical device. Their companies have filed for bankruptcy, but that may be just a ploy to protect them from having to pay refunds to customers. The law is clearly the ally of the con man, if he thinks big enough. If you try to sell magic bracelets on the street, you'll probably get busted. But if you sell them on television, you'll probably get richly rewarded. By the time the law catches up to you and finds you guilty of fraud, the damage has already been done. The con man has made his millions and a large number of people are true believers in the fraud and will continue to promote it and give testimonials for it. The con man can then either start a new company with a new line line of fraudulent products (or the same line with new names) or he can file for bankruptcy and continue selling his product without making fraudulent claims about it. He doesn't need to. His satisfied customers will make those claims for him. And like the selective memory of water in homeopathic remedies, the selective memory of the magical claims about ions and chi will continue to resonate while the con man silently watches his bank account enlarge at the expense of an ignorant public.

The only hope for reducing woo-woo fraud is education. The law in a free society isn't equipped to handle these kinds of swindles. Our children should be educated in their very early years about the placebo effect and the post hoc fallacy. A little bit of instruction in critical thinking at a very early age might provide a lot of protection to future generations.

It shouldn't be too hard to set up an experiment like Mayo's in the classroom. The kids could learn about randomization and its importance. They could learn about the importance of control groups. They might even set up a control group that consists of those waiting their turn to get into the study (as Bratton didn't do). They could learn about the placebo effect and how belief affects perception. They could also learn why it is nearly impossible to test many CAM claims: there is no way to devise a plausible placebo. Had I been the lawyer for Q-Ray I would have fallen back on the argument I heard in the NOVA program "Secrets of the Psychics." In one segment, James Randi is trying to arrange a test of some sort of healing water that the Russians claim can cure anything that ails you. It turns out that the magical water can't be tested because when it is placed near regular water it magically turns the regular water into magical water. Why not claim that the reason both the ionized and the placebo bracelets were felt to relieve pain in a significant number of participants was that the ionized bracelets had transferred their magical power to the non-ionized ones? Try to disprove that! Judge Easterbrook would call such a claim "blather" and say you might as well claim that "beneficent creatures from the 17th Dimension use this bracelet as a beacon to locate people who need pain relief, and whisk them off to their home world every night to provide help in ways unknown to our science."* Of course, there will be some who will turn to each other—they may be members of your local school board—and say: how did he know?

The students might learn a valuable lesson by trying the experiment and being directed in a discussion led by someone who knows something about these subjects. I wonder if Judge Easterbrook would consider teaching primary students when he retires from the bench. Anyway, would it hurt our children to learn that magical thinking is okay in stories but can be disastrous in real life? Shouldn't we be teaching them that the road to empowerment is lined with hucksters selling every kind of imaginable snake oil? If we truly don't want to leave our children behind, shouldn't we be arming them with critical thinking skills?

further reading

A classic example of why woo wins can be seen in the Airborne case. The company falsely claims its product has scientific evidence that it is effective against the common cold. It is sued and pays out millions of dollars, but its product remains on the shelves with a couple of changes in the wording on the packaging. The ingredients stay the same: it's nothing but a vitamin and herbal supplement (and a dangerous one at that). Read the whole sordid story in Steven Novella's explanation on Science-Based Medicine.