KATIE SULETA AND EMILY HEMENDINGER

There have been a handful of recent court cases against people operating in healthcare despite dubious qualifications and defending themselves by asserting their right to f ree speech. The case of Heather Kokesch Del Castillo, who was a self-identified nutritionist and health coach in Florida, was rejected by the U.S. Supreme Court (Saunders 2022). Florida protects the title of nutritionist by requiring specific credentials, training, and background (NutritionEd 2020). Del Castillo was operating outside these requirements and attempted to assert that her f reedom of speech allowed her to operate unqualified in this space. In Mississippi, health department officials have been slapped with a lawsuit asserting that they violated a woman’s f reedom of speech for asserting that she cannot operate as a dietician even though she isn’t one (Ramseth 2020). These two cases are canaries in the coal mine, raptors testing the fences. The wellness industry is exploding and allowing several pseudo-healthcare professions to operate outside the bounds of regulated healthcare.

People have many reasons for seeking alternative medical treatment. For starters, they are displeased with the healthcare system, a sentiment exacerbated by the COVID-19 pandemic.

And on a systemic level, the shortage of physicians (American Medical Association 2022) and mental health workers (Kaiser Family Foundation 2022) and the high cost of healthcare (American Medical Association 2023) are certainly not helping matters. But those reasons—personal and structural—are still not good enough to justify replacing the existing inf rastructure with a different one.

Medicine, admittedly, had a shaky start. Before the scientific method was firmly established physicians were poorly trained (Barry 2019), and treatments were both scary and pseudoscientific (e.g., trepanning, bloodletting). But we’re a long way f rom those days. Physicians, nurses, and other providers are highly regulated (Federation of State Medical Boards n.d.) and require standardized education and training. Of course, as in any field, some incompetent people get through (Caulfield 2021)—but because of this system, we are more likely to get someone good than not. That is, in fact, why the system exists.

Despite all the hard work f rom scientific development to education standards, people still complain of mistrusting trained providers. People turn to the internet to find a solu-