Digital-Quackery: An Emerging Malpractice in Public Health

"नीम हकीम खतरा ए जान" - anonymous

In a country like India where doctor population ratio is reported to be 1:811 which the union health minister claims to be better than the standards set by the World Health Organization’s 1:1000 (PTI). It is a matter of concern that medical malpractice is still in place and is not effectively controlled by the Government and regulatory bodies. Indian Government is putting exert efforts to strengthen healthcare system by empowering regulatory bodies and improving healthcare education and also promoting and regulating alternative medicine through AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homoeopathy). However, as various cultural healthcare practices are widely accepted in India, which in turn shelters the 'Quack' i.e. a charlatan or someone who pretends to have medical expertise or untrained practitioners that are not formally educated in any system of medicine or alternative medicine. Quackery is still growing due to lack of awareness among public, that it can be dangerous and life threatening to them. In India, we usually refer such practitioners as Jhola Chhap (झोला छाप). A news article specifies 2.5 million such people practicing medicine in India without formal training (Pulla).

The term “online health information seeking” (OHIS) refers to the deliberate search for health-related information on the Internet, typically via search engines, health websites, forums, or social media (Zhao et al.). As the Internet is increasingly becoming an important source for health information seeking. It offers the users many benefits such as privacy, convenience, anonymity, and immediacy of information searching (Jiang et al.). A researcher reports that OHIS has been found to enhance medical knowledge, empower patient participation in decision-making, and improve health outcomes (Fitzpatrick). Contrary studies are also present and state that excessive OHIS can lead to health anxiety and problematic internet use (PIU) i.e. excessive and compulsive internet use that leads to significant distress or impairment in daily life (Pettorruso et al.). A study involving 430 adults from United States (U.S.) found that individuals whose health anxiety intensified after online health searches were more likely to experience PIU (Fergus and Dolan). This I turn underscores the potential negative psychological impacts of online health information seeking at individual level. Globally, the internet has both positive and negative effects on healthcare (Ahmead et al.). It facilitates patient education, supports public health initiatives, and enables professional networking. However, there are challenges such as spread of misinformation, concerns about privacy, and a decline in trust in healthcare providers (Denniss and Lindberg). The health-related rumours being spread online pose further challenges, emphasize the need for digital literacy and fact checking resources. A survey by The Healthy Indian Project (THIP) Media revealed that 62% of Indian respondents feel unprepared to identify reliable health information online, making them susceptible to misinformation (Healthcare Radius).

In the pre-internet era, medical training was the result of rigorous formal education, and access to health information was limited to libraries, textbooks, and certified practitioners. Today, anyone can access medical content online, interact with supposed healthcare experts, or even crowd-source diagnoses - often without verifying legitimacy. This democratization of information, while empowering in some cases, has opened the floodgates for misinformation and digital malpractice.

The term “Digital Quackery,” that is originally coined and conceptualized by Dr. Rajendra Pratap Gupta, a renowned public health expert and founder of the International Patients Union, describes this modern-age menace in which unqualified individuals exploit digital platforms to mislead the public with unscientific medical claims. In agreement with his fundamental notion, and in response to the escalating issue of online health misinformation and self-taught, unqualified individuals delivering medical treatments, we furthermore suggest the name ‘Digital-Quack’ as an umbrella term that captures this broad digital-age phenomenon.

Individuals covered in this phenomena misuse the internet to offer medical advice, diagnosis, or treatment. Digital-Quack blends traditional quack-like behaviour with modern digital tools, giving rise to new apprehensions in public health. Within this broader construct, two distinct subtypes can be identified:

•Cyberquack

•Cyberdidact-Quack

First type of Digital Quacks is a "Cyberquack"; it is essentially a "Quack" operating in the cyberspace. They might spread misinformation, promote unscientific treatments, or sell ineffective products online, often targeting vulnerable individuals seeking health information. "Cyberquackery" refers to fraudulent or misleading healthcare malpractices and scams that occur online, exploiting digital technologies for deceptive purposes, often targeting unsuspecting individuals or organizations.

Dr. Rajendera P. Gupta, in his online article call ‘Cyberquack’ to be the new age digital quacks. He explains that unlike traditional quacks who operated in secrecy or within small groups, digital quacks are visible to the public'(Gupta). He further exemplifies that many of them present themselves as health coaches, wellness experts, or practitioners of alternative medicine, often without any formal medical education '(Gupta). They use social media platforms such as YouTube, Instagram, TikTok, and Facebook to spread unverified treatments, make exaggerated health claims, and even promote harmful medical misinformation (Gupta).

Second type of Digital Quacks is "Cyberdidact-Quack". The word ‘Cyberdidact-Quack’ is a combination of words ‘Cyber’, ‘Autodidact’ and ‘Quack’, whereas Cyber means something involving, using, or relating to computers, especially the internet, it often refers to online or connected environments. The word autodidact means a self-taught person without formal schooling. As per (the Medical Definition of Quack at) RxList 'Quack is a person who suggests the use of substances or devices for the prevention or treatment of a disease that are known to be ineffective and pretends professionally or publicly to have medical skill or qualifications which he or she may not actually possess'(RxList). The word Cyber & Autodidact can be combined to Cyberdidact i.e. person taught by internet. Further after combining the meaning and qualities of above given words ‘Cyberdidact-Quack’ can be defined as “a practitioner of one or more system(s) of medicine or alternative medicine without a formal and necessary training, skills and qualifications, who offers of diagnosis, treatment of symptoms and prevention to self or prefessionally to others, by exploiting online health information seeking.” A Cyberdidact-Quack may be posing as medical practitioner through social media platform(s) or in an actual clinic running with his own name or falsely pretending to work under the name of some credible and legitimate practitioner(s). This practice being done by a ‘Cyberdidact-Quack’ is to be called ‘Cyberdidact-Quackery’. 

A quack may have gained his/her knowledge of a system(s) of medicine while assisting an actual practitioner of medicine or alternative medicine, the Cyberdidact-Quack’s major source of gaining knowledge and skills is Internet apart from miniscule of other literature. Both are deemed to be incapable and unacceptable to practice by law as they pose more harm than benefit to the patients and public.

There are number of healthcare providers and health academicians with formal education, necessary skill-set and qualification which is gained through institutions recognized by appropriate  regulatory bodies. They also suggest/offer and publish diagnostic, treatment and preventive information through internet and in person are exclusion to Cyberdidact-Quack, until the practice is relevant to their subject of study and the information or skill is not majorly reported to be gained through random online health information seeking behaviour.

Recently it has been observed that on various social media platforms there is a lot of content available, where Digital-Quacks (Cyberquacks or Cyberdidact-Quacks) advise people to use unverified and untested treatments (as discussed in following cases). They might pretend to be experts of particular systems of medicine and advertise themselves through direct-to-consumer (DTC) healthcare marketing strategy. To mark their credibility among public and patients, a Digital-Quack may suggest the treatment regime for diseases and disorders that are otherwise difficult to treat, and boast about their success stories (usually false) that how they have treated number of patients with the same treatment regimen. 

There are many cases of such malpractices in healthcare, where individuals from or not belonging to healthcare professions used internet to diagnose or treat themselves or others. Let us go through related stories retrieved from popular and news media.

In 2024, R.K. from Uttar Pradesh, India, allegedly attempted to remove his own appendix at home after viewing DIY (do it yourself) surgery videos on YouTube. After being found in severe condition, the man was taken to a hospital, where emergency surgeons were able to save his life. This instance exemplifies a troubling pattern in which people are, emboldened by false or exalted online health information (The Indian Express; The Economic Times; NDTV).

In another terrifying example highlighting the advent of Cyberdidact-Quacks and the reckless reliance on unverified internet medical content, a sad incident in Bihar, India, occurred in 2025 that stunned both the medical and legal sectors. KK, a 15-year-old kid, was the unwitting victim of an incompetent individual's tragic effort to conduct surgery based on learning from YouTube videos. AP., the culprit, claimed to be a medical professional despite having no professional medical or surgical training. According to reports, Mr. AP was emboldened by studying online surgical videos, and decided to do the procedure himself on young KK, who had complained of abdominal pain. The procedure was performed in an unregulated and unclean facility that lacked proper medical instruments, sterile circumstances, and emergency backup. KK's condition quickly deteriorated following the treatment, most likely due to internal bleeding and septic shock caused by the crude surgical intervention. In a panicked bid to save the boy, he was put into a vehicle and rushed to Patna for expert medical treatment. Unfortunately, he passed away on the way to hospital as a result of the injuries caused by the poorly performed surgery. In the immediate aftermath, AP fled the scene, abandoning both the facility and all responsibility for his conduct. But after receiving extensive media attention and pressure from medical and civil society leaders, AP was eventually captured by local police and charged with several offenses under the Indian Penal Code, including practicing medicine without a license, impersonation, and culpable homicide not amounting to murder (Deccan Herald; Business Standard).

Recently a soul stirring case also from Owerri, Imo State of Nigeria came up to social media and news. A husband alleged that a person who was said to be a doctor operated caesarean section on his pregnant wife after watching surgery videos on YouTube. In result that lady and the unborn child both died. The hospital owner was arrested; the "doctors" escaped and are still being pursued by law enforcement. This case of Cyberdidact-Quackery has sparked widespread outrage and raised serious concerns about medical negligence and the regulation of private healthcare facilities in Nigeria (Tribune Editorial Board; Punch; The Citizen).

Mr. B., a controversial self-proclaimed doctor known for making spectacular and scientifically unproven health claims, sparked a significant public health crisis in Andhra Pradesh in 2022. Through his social media channels, especially YouTube, Mr. B. advertised purported “miracle cures” for long-term conditions including diabetes, frequently presenting himself as an informer uncovering pharmaceutical scams. A herbal regime that he claimed could permanently treat diabetes was one of his most widely shared claims, leading thousands of people - many from Andhra Pradesh and other regions of India - to stop taking their prescribed treatment. The consequences were severe. Hospitals began reporting a significant increase in cases of hypoglycaemia, diabetic comas, and other emergencies. In certain cases, individuals had irreversible organ damage as a result of postponing necessary medical care. Authorities started looking into B.'s activities after YouTube finally took down his channel due to the growing number of complaints. This instance highlights the serious risks associated with Cyberquackery, especially when false material is propagated by digital platforms with no control while disguising as medical expert (Christopher, N.; BBC).

In a disturbing incident that highlights the dangers of Cyberquackery—even in developed nations, Miami authorities arrested 58-year-old MJ in April 2025 for practicing unlicensed cosmetic surgery at the New World Medical & Mystic Cosmetic Centre in Miami. According to the Court and law enforcement records, MJ posed as a licensed plastic surgeon, soliciting clients via his personal Instagram account. One of his victims, an Orlando woman, travelled to Miami in September 2024 after discovering him online; she got a breast enlargement treatment and later developed serious infections. Tragically, her nipple was completely lost, a disfigurement that authorities later described as permanent. Following her loss, MJ allegedly provided no valid medical help or referrals, as prosecutors claimed when charging him with practicing healthcare without a license causing serious bodily injury; a second-degree felony. This example reveals how 'Cyberquacks' the unqualified individuals can use social media platforms to falsely identify themselves as legitimate medical practitioners, putting naïve consumers at danger (People; NBC 6 South Florida).

These cases collectively illustrate the urgent and global need to recognize, regulate, and respond to the rising threat of Digital-Quacks (Cyberquacks & Cyber-didact Quacks). As internet access expands and digital platforms increasingly mediate health information, individuals are more likely to encounter unverified, misleading, or outright dangerous medical advice. These examples reinforce the need for clear policy frameworks, public education on digital health literacy, and cross-platform regulation to protect vulnerable populations from the consequences of cyber-enabled medical malpractice.

CAUSES OF DIGITAL QUACKERY:

Easy Access and Abundant Availability of Online Health Information: When we search for health information online we find plethora of information which becomes overwhelming for commoners. Cyberdidact-Quacks can use this information to train themselves and also may contribute to information available online by posting what they have learned on webpages and social media.

Internet Algorithms:  Internet algorithms unintentionally promote Cyberquackery by rewarding content that is captivating emotional, or viral, even if it is untrue or harmful. Without rigorous regulation and platform responsibilities, these automated systems continue to spread unsubstantiated health advice to millions of people, increasing public risk and undermining legitimate medical Science.

Lack of Digital Health Literacy:  Lack of digital health literacy makes people more vulnerable to Cyberquackery, as they cannot judge whether online medical advice is reliable or not. They often trust viral content, fake testimonials, or unlicensed influencers, leading to poor health decisions and faster spread of misinformation.

Post Pandemic Misinformation boom: As per the directives of the Government and dread of Covid-19 people were not able to move outside their homes during the pandemic. Healthcare system was already overloaded, taking this opportunity such individuals started promoting their magic remedies among the masses through digital platforms. Under pressure and fear, people were trying anything that could work to pacify their anxieties related to detrimental effects of Covid-19. This caused the health misinformation boom which is still prevailing and people are seeking more and more health information online than ever. 

Perceived Cost: Amidst medical inflation in India; doctors seem to charge handful of fees and pharmaceutical cost is also rising. Digital quacks might seem to be very accessible and cheaper to the people; if we ignore that how dangerous and ineffective their treatments are. In search of treatment in low cost people may turn to these people.

Desperation of Patients: People with a serious disease, or who have been told by their practitioner that their condition is "untreatable", may react by seeking out treatment from these Digital Quacks, disregarding the lack of scientific proof for its effectiveness, or even the existence of evidence that some method they might use could be ineffective or even dangerous.

Vulnerability: Fear of impending disability or untimely death in patients with serious medical conditions empower the digital quacks. This vulnerability may help these digital quacks to catch up with these patients and even the patients.

Pre-existing Cyberchondria: People with pre-existing Cyberchondria also share their disease-related knowledge with others, which negatively affects the lives of others as well (Nadeem et al.). Possibility of cyberchondria to develop into Cyberquackery and Cyberdidact-Quackery may be studied further.

Fame, Money and Fraud: These false practitioners despite the awareness of inefficacy of their treatment might fraud people for money and fame.

CONSEQUENCES OF DIGITAL QUACKERY:

Misdiagnosis: Symptoms of many diseases and disorders overlap among others that even well-trained and qualified professionals find it difficult to diagnose them and eliminate differential diagnosis in time. It takes huge brainstorming for differentiating one problem from the other but these Digital Quacks are often very confidant with the accuracy of their diagnosis.

Wastage of Precious Time: In some diseases, starting treatment timely is very crucial. For example, in disease like cancer, if diagnosis is not confirmed and treatment is not sought in time, cancer progresses to next stage which is even more difficult to treat. People who are lured by these digital-quacks may lose their precious time and if not turned back, their lives too.

In-effective Treatments: While some home-remedies are believed to be effective for minor symptoms; it doesn’t mean that for serious illness treatments that are untested and not established through clinical trials should be promoted. There have been incidents where these people have promoted such treatments in the given examples.

Selling Dangerous Substances: Apart from ineffective treatments Digital Quacks might be selling tons(Adj.) of dangerous substances and making big profits. They often circumvent the principle of Non-Maleficence for their own benefit.   

RECOMMENDATIONS:
Legal Actions: Such practices are unlawful under India's new Bharatiya Nyaya Sanhita (BNS) 2023 and existing laws, such as the IT Act of 2000. Offenders may face imprisonment for impersonating as medical practitioner in public or online (under BNS Section 316 and IT Act Section 66D), causing harm or death through negligence (Sections 106 and 121 of BNS), or marketing bogus treatments online (under the Drugs and Magic Remedies Act of 1954). These laws aim to curb the rising threat of digital medical misinformation and protect public health against fraudulent practices shared on Digital platforms. Furthermore; specialized anti-digital quackery laws may be introduced by the Government for stricter control over such practices.
Regulatory Framework and Control over Online Health Information: Government has not yet put strict control on health information available online. It could be filtered or controlled by the authorities. Only informative and brief health information could be made public and deep knowledge may be limited to educational institutes; as misinformation without supervision causes more harm than benefit.
Advisory by Stakeholder: National and international regulatory bodies may publish and promote their position statement on the issues to aware the public. In general, P public awareness about this fraudulent practice is necessary, general public may be advised to verify the qualification and credibility of the person they are being treated from.
Improved Medical Facilities: Improved medical facilities should also be made available in rural areas at lowest cost possible. This will curb the growing digital quacks, if any; in those areas.

Conclusion: Digital quackery is a new frontier in public health malpractice, blending conventional quackery with current technology. As the threat expands, there is an urgent need for informed policy action, community education, and regulatory vigilance that will safeguard the health and faith of people navigating online health care ecosystems.