Consumer Receptive Alternative Preparations (CRAP)

A very funny, and interesting take on CRAP (Consumer Receptive Alternative Preparations) by Dr Liam Farrell published in the British Medical Journal.

Joe was a veritable cornucopia of symptoms and a technicolour array of risk factors, and I looked out the window in the despairing hope that the clouds might form themselves into a plausible diagnosis. They did their best, amusingly shaping themselves into a pair of rather ripe and Rubenesque buttocks that might have tempted even a post-therapy Tiger Woods, but I had just about given up when a bus rolled by with a big advert on the side, and I stood like stout Cortez, silent upon a peak on Darien.

Aristotle and Spinoza believed that all human behaviour is self referential, and boy were they right. I was being selfish; I had kept Joe all to myself. It was time to share; he had delighted me long enough.

“Have you considered trying a health food shop?” I asked.

“I heard they sold crap,” he said.

“Perhaps,” I said, “but not just any old CRAP, it’s brightly coloured, attractively packaged CRAP. Even better, according to the ads, it’s half price CRAP.”

“I note,” said Joe perspicaciously, “that the word ‘CRAP’ is a recurring theme; you have used it three times already.”

“What I tell you three times is true,” I protested.

“Presenting Carrollian nonsense instead of a solid evidence base is not a persuasive argument,” said Joe.

“Look,” I said, not giving up, “Go into any high street pharmacy and you will see row upon row of homoeopathic preparations, vitamin and mineral supplements, and flower remedies, some of them used for thousands of years by a rainforest tribe who survive on a diet of honeydew and possum sweat. Now remember, because this is important: pharmacists are highly trained healthcare professionals, and surely it would be against their ethical code to stock and thereby give implicit approval to treatments that have not been proved to be effective.”

“And yet,” said Joe, refusing to display an open mind, “the pharmacists claim that there is a consumer demand for these products. So they stock
homoeopathic products purely because they sell, not because they work.”

“But you can’t overdose, and they’re very safe,” I tried one last time.

“Yes,” Joe admitted grudgingly, “You can’t have too much CRAP.”

Consumer Receptive Alternative Preparations (CRAP)
Liam Farrell, general practitioner, Crossmaglen, County Armagh
[email protected]

Published 12 May 2010, doi:10.1136/bmj.c2492
Cite this as: BMJ 2010;340:c2492

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