There Are No Naturopathic Emergency Departments

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This entry is part 2 of 2 in the series From the Editor

The Backlash Against Science, Education, and Medicine

In America, we are witnessing an enormous backlash against science, education, and medicine. This didn’t happen overnight—it’s the result of long-standing upstream determinants. We live in a society where choice, autonomy, and quality of life have slowly but steadily declined for the vast majority of Americans.

Ironically, while we carry $1,000 computers in our pockets—paying $25 a month for years—with access to limitless knowledge and entertainment, we are somehow lacking in basic human needs: connectedness, competence, and autonomy, the pillars of Self-Determination Theory.

Selling Autonomy and Sowing Mistrust

When these needs go unmet, people seek ways to reclaim control. Capitalism has provided an incentive to sell this sense of autonomy and competence—often by sowing mistrust in the very institutions that built the quality of life we enjoy. Science, public health, medicine, and education have become targets, while those who undermine them conveniently sell products and promises of empowerment.

The result? A growing movement of individuals who distrust medicine, believe science is corrupt, and undervalue education—especially when they have AI and search engines at their fingertips. This erosion of trust has led to suspicion, but not of those who profit from misinformation. Instead, skepticism is directed at those who work to keep people healthy and safe, rather than those whose means are derived from keeping them sick, uneducated, add under resourced.

Why There Are No Naturopathic Emergency Departments

Yet this skepticism has limits. For example, there are no naturopathic emergency departments. Not because there isn’t a potential market, but because when life and death are on the line, people turn to evidence-based medicine.

It’s not that there is no market for a naturopathic emergency department. One could imagine a hospital where you walk into a room equipped with a computer loaded with every chatbot and AI health app available. That computer would allow you to order any tests, procedures, or operations you desire—essentially giving you full autonomy to research and treat yourself.

But here’s the problem: my suspicion is that more than 90% of individuals who entered that room would never leave it alive, making paying off a credit card statement or hospital bill very challenging. There is a limit to people’s desire to “do their own research.”

Why Medicine and Public Health Became Targets

So why have medicine and public health become the targets of such ire? First, as noted earlier, there is a market for making people feel competent and autonomous. If you have enough credentials and sound authoritative, you can convince people that they too are smart enough to understand their body, science, and medicine—especially with tools like the Internet and AI. Then, if you are capitalistic enough, you can sell them products that promise control over their health.

When these products fail, people rarely challenge the seller. Instead, they turn back to the evidence-based medicine they previously dismissed.

What Caused This—and How Do We Move Forward?

Some factors lie outside the realm of education, science, and medicine. But as citizens, we can advocate for better controls over marketing, greater regulation of the supplement industry, and limits on practices that target vulnerable individuals with unproven products.

This is all addressable through policy—but policy is not where most of us in education, science, public health, and medicine work. So, what can we do?

Start with Introspection

I believe it begins with introspection. How did we get here? How did people start to loathe and distrust us?

First, consider our role as educators. Many of us remember that professor who not only showed us we were wrong but made us feel ignorant—if not stupid. Overly critical, offering little guidance, and believing that “paying your dues” and feeling dumb is part of the process.

You might argue that in the last 20–30 years we’ve overcorrected, adopting a customer-service model of education. But that too is fixable. Scientists also bear responsibility for failing to communicate their work effectively, despite relying on taxpayer support for research infrastructure and funding. We must do a better job of connecting our work to purpose—even if that purpose is simply understanding the world around us.

Public health and medicine share this burden. Public health does a poor job explaining its benefits: clean air, clean water, safe streets, and programs people depend on—yet few understand who we are, how we’re funded, or why we do what we do. Medicine, likewise, could be more patient-centered, more conversational, and more empathetic. Clinicians have historically been paternalistic and condescending toward the patients they treat. But again, this is correctable. There is a way forward—but we must take ownership of what we are responsible for and join others who wish to enact change in areas outside our direct control.

The Broader Context: Economic and Social Forces

We have to acknowledge that our patients and the populations we serve are tired of being told to trust us, because we’re the experts, even as we live in a society that has allowed the dumbing down of K–12 education and the splintering of America’s social fabric.

We’ve supported a system where CEO pay has skyrocketed over the last 30 years while worker wages remain stagnant. We must advocate for conditions that allow Americans to use the services we provide. It’s hard to take ownership of your health by walking a greenway when you can’t afford healthcare, don’t get sick days, lack childcare, lack safe transportation, and can’t rely on public transit.

Ultimately, it will take civic engagement with our political representatives to rein in the forces that have widened economic disparities exponentially over the last half-century. We need to recognize that distrust in education, science, public health, and medicine was sown decades ago—and it may take decades to fix.

People truly believe that American government subsidizes research, when in reality, state taxes and academic research often subsidizes pharmaceutical companies, device manufacturers, and insurance companies. At the end of the day, we must be part of a collective action that starts with ourselves but grows beyond that—because when things are at their worst, the public always comes back to us.

And when they do, the stakes are highest. That’s why we must move upstream, back to primary prevention with evidence-based means, if we are truly to have a healthy, thriving citizenry in this country.

The Path Forward

Rebuilding trust will require humility, better communication, and a renewed commitment to meeting people’s needs for autonomy, competence, and connectedness. It starts with us—but it cannot end with us.

 

About the Author

Justin B. Moore
Justin B. Moore, PhD, MS, FACSM, is a Professor and Vice Chair in the Department of Implementation Science in the Division of Public Health Sciences at the Wake Forest University School of Medicine. He holds joint appointments in the departments of Family & Community Medicine and Epidemiology & Prevention. Dr. Moore also serves as the Director of Dissemination, Implementation, and Continuous Quality Improvement within the Clinical and Translational Science Institute at Wake Forest University. He conducts community-engaged research focused on the dissemination and implementation of evidence-based strategies for the promotion of healthy behaviors in underserved populations. He also conducts epidemiological research examining the determinants of health behaviors and related comorbidities across the lifespan. He serves as the Editor-in-Chief of the Journal of Public Health Management & Practice.

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