There is a JAMA article out that is very telling: Medical Conspiracy Theories and Health Behaviors in the United States. It is a must-read article for anyone who wonders why the public does not seem to advocate for themselves when it comes to their medical care in the US.

The first theory studied in the article states that the FDA is purposely preventing the public from getting natural cures for cancer and other diseases because of pressures from drug companies. 37 percent of those surveyed were believers in this theory.

Even for pessimists like me this was a hard pill to swallow. But that old phrase, “Just because you’re paranoid does not mean that you’re crazy,” came to mind. I don’t think any amount of medical education would convince these people otherwise. Simply because the fundamental flaw in their thinking is based on trust not on logic. And it does not take a genius to realize that there are all kinds of reasons not to trust medical care these days.

Drug companies may be hardest hit for public mistrust. After all, we do ask patients to put the pills in their mouth and swallow. Since most patients aren’t medically trained, they have to be able to trust that what they are swallowing is actually doing more good than harm. One can look only as far as a pharmaceutical commercial to see a litany of risks that terrify most consumers. Most people are not educated enough to understand but clearly people are perceptive enough to realize that these drugs are being marketed to them and big profits are to be made.

Obamacare has not helped with trust either. Even just incompetency in web design have been enough to deter people from signing up. The lack of people signing up likely has to do with trust — or lack of it — in addition to the heroic efforts having to wade through the bureaucratic difficulties. Opponents of the ACA spend inordinate amounts on fear-based commercials to dissuade anyone in the public who may be on the fence about getting Obamacare and trusting the government. The average American has no concept of the inner workings of the business of health care and how manipulated they have been. They just know that they can’t afford it, many lack any decent sort of access to it, and it is just not to be trusted. After all, they know this much: Corporations with fat Wall Street stocks and greedy CEO’s are involved. Note to self: It is hard to effectively fight or lobby for one’s health care when you are paranoid of the system itself.

Let’s talk oncology since that is the first medical conspiracy theory that resonates with the most believers. People can see the medical system dysfunction and corporate greed which fuels their mistrust. Many may not know that hospitals charge facility fees, but in the major 5 star cancer medical centers, they can see the impressive hotel-like structures that are called hospitals where Steinway player pianos in the entrance may greet them. True, many people in more rural or poorer areas of the country may be spared this visual feast, but they are aware of huge profits in the medical industry that they believe can exploit them. Haven’t gotten to the topic of oncology yet? Neither have they.

The theory that the FDA is “suppressing” natural treatments available for cancer certainly is frustrating for any oncologist. Cancer treatment is certainly extraordinarily complicated with all kinds of risks, and it is hard for the average person to conceptualize. But intuitively I think their distorted logic makes a bit of sense. If you really can’t trust medical care because intuitively (whether you can verbalize it or not) you feel they do not have your interest at heart, then the only course of treatment is to figure it out yourself. Many people have the erroneous idea that “natural” means it is completely “safe.” Your mother might even have given it to you at one point.

Access is key. Perceived “natural” cures may be available for use, compared to the major cancer centers many of whom are unavailable through the narrow networks via Obamacare. Even if you have access to the cancer center, the severe generic drug shortages of cheap effective cancer drugs just might not be available for you anyway. Many state of the art cancer centers complain about the shortages.

And if you watch enough lawyer commercials you would definitely not want to see a doctor. Faulty hip implants, vaginal mesh lawsuits and of course drug scares fill the airwaves. And has anyone forgotten the fungal filled steroid spinal injections that killed and seriously debilitated back pain patients? The FDA looks ineffective to the public they are supposedly protecting.

Perhaps it is not surprising that there is a lack of trust in the FDA. The first conspiracy theory tells us so. The FDA is incompetent to protect: I doubt the public and this particular group in general has completely forgotten the FDA’s role in a simple steroid injection fiasco. If they can’t protect your “back” from steroids then how will they ever do with cancer?

Their thinking that the FDA is hiding natural cancer treatments likely indicates their belief that the FDA is not protecting them from drug companies’ “harmful” and “unnatural” cancer treatments. Perhaps there is something out there that is “natural” and is not harmful (according to this group). It certainly is a wish by the public not to be harmed by their medical care. Imagine that.

The question I have is what kind of cancer are they referring to? Adenocarcinoma, Hodgkin’s lymphoma or the cancer that is killing the US health care system? Although it may be difficult to make any sweeping generalizations from this small study, I think that it certainly raises the question of whether the American public is struggling with trust of its own health care system.

“Deceased, MD” is a physician.