Has Dr. Oz Jumped the Shark?

14Feb13

Dr. Oz Jumps the Shark

It was bound to happen. It’s that moment in a television show when the deterioration is irreversible. For the popular 1970′s television sitcom Happy Days, it was when a water-skiing Fonzi literally jumped over a shark. And I think it may finally have happened with the Dr. Oz show. From a scientific credibility perspective, The Dr. Oz show is past the point of no return.

No, it wasn’t the silly green coffee bean “miracle” weight loss cure. Or his absurd clinical trial, that he conducted on his own audience audience without ethics board approval.

No, it wasn’t the “miracle” of longevity, red palm oil, which is anything but miraculous.

Nor was it past episodes featuring faith healing or even psychic John Edward.

The turning point was a few weeks ago, when the medical accuracy of Oz’s show hit a new low, with an episode on homeopathy. That same week, a detailed examination of Oz himself was published in the New Yorker. First, let’s look at the New Yorker piece, as it gives some context for the credibility erosion we’ve seen on the show. Written by Michael Specter, it’s entitled, The Operator: Is the most trusted doctor in America doing more harm than good? It’s the most detailed examination I’ve seen of Oz, with a narrative that goes from inside the operating room to the set of his enormously successful television show. I’ve been very critical of Oz in past posts – how he is an accomplished surgeon who should know better, like when when he has a homeopath as a guest who claims red palm oil prevents Alzheimer’s or reverses atherosclerosis. Yet he not only allows unfounded claims to go unchallenged, he regularly makes absurd, antiscientific comments himself. Spector’s column gives some relevant background:

It didn’t take long for Oz to become convinced that a patient’s state of mind could be important to a successful surgical outcome. With his father-in-law’s encouragement, he began to explore music therapy, energy fields, and therapeutic touch, and he began to offer them to his surgical patients. Here, too, Lisa [Oz's wife] played a major role; she is a Reiki master, and Oz soon became famous at New York-Presbyterian, not to mention within the broader surgical community, for encouraging the practice of Reiki in the operating room.

It should not be a surprise to reader of this blog that therapeutic touch and reiki are pure quackery, just variants of faith healing.  And yet Oz’s wife is a Reiki master, effectively the alternative medicine equivalent of a holding a PhD in magic carpets. There’s no there there. It’s been proven not to exist by a 9-year-old. and yet Oz is credulous enough to promote these practices in the operating room. Spector’s article gives a few more clues about how Oz avoids the cognitive dissonance of practicing reductionist medicine (i.e., surgery) while simultaneously promoting therapies and treatments which at best, lack evidence, and at worst, may be harmful:

He describes modern medicine as a “civil war” waged between conventional physicians and those who are open to alternative cures for maladies ranging from anxiety to cancer; he considers it his mission to walk the line that divides them. But more often his show seems to erase that line completely, with results that may be less benign than Oz and his many viewers realize. “I want no more barriers between patient and medicine,” he explained to me not long ago, as we sat in one of the show’s production offices, just outside NBC’s Studio 6A, in Rockefeller Center. “I would take us all back a thousand years, when our ancestors lived in small villages and there was always a healer in that village—and his job wasn’t to give you heart surgery or medication but to help find a safe place for conversation.”

Which is perfectly consistent with his show, where Oz regularly ignores scientific evidence and promotes treatments which are the antithesis of good medicine. For the casual observer, this is is where the problems lies:  Oz can give good advice, but he regularly combines it with pseudoscience in a way that the typical viewer can’t easily distinguish between the science and the fiction:

Oz often says that he is just trying to present people with all their options, because they are sophisticated enough to make decisions for themselves. But some options are more beneficial than others, and medical experts are morally bound to explain the difference, as David Gorski told me recently. Gorski, an associate professor of surgery at the Wayne State University School of Medicine, is the managing editor of the influential blog Science-Based Medicine. “Oz has a huge bully pulpit, with the entire Oprah empire behind him,” he said. “He can’t simply dispense with facts he doesn’t find convenient.” Scientists often argue that, if alternative medicine proves effective through experimental research, it should no longer be considered alternative; at that point, it becomes medicine. By freely mixing alternatives with proven therapies, Oz makes it nearly impossible for the viewer of his show to assess the impact of either; the process just diminishes the value of science.

  Oz’s own words and actions make it clear that he’s rejecting (if he ever held) a science-based worldview:

Oz sighed. “Medicine is a very religious experience,” he said. “I have my religion and you have yours. It becomes difficult for us to agree on what we think works, since so much of it is in the eye of the beholder. Data is rarely clean.” All facts come with a point of view. But his spin on it—that one can simply choose those which make sense, rather than data that happen to be true—was chilling. “You find the arguments that support your data,” he said, “and it’s my fact versus your fact.”

This really is the crux of the entire feature. If you’re committed to a taking scientific perspective, you cannot pick and choose the data that fits your confirmation bias. Yet Oz believes medicine to be a religion – a faith system, and not an objective, scientific endeavor. Which tells you all about his commitment to his description to scientific accuracy on the Dr. Oz show. It’s a remarkable piece – go read it.
oz
The Dr. Oz Homeopathic Starter Kit
How Spector’s piece came to be released on the same day as Dr. Oz announced his “Homeopathic Starter Kit” is either smart timing from the New Yorker or a a nice coincidence. The fact Dr. Oz was going to feature a show on homeopathy is no surprise – homeopaths have been lobbying for some time, they admit:

Your NCH team has been hard at work seeking ways to promote homeopathy to the nation – with success!!!  Last week we worked diligently with the producers of the Dr. Oz Show to create a show with a special focus on homeopathy. As a result, Dr. Oz is hosting a special show talking about this grand system of medicine on Monday, January 28th at 4pm on CBS stations across America!!! (Check your local TV listings.)  Watch as he interviews Naturopathic Doctor and NCH member, Dr. Lisa Samet, as well as Dr. Albert Levy, MD, FAAFP. Dr. Oz is a University of Pennsylvania trained MD, a well-known television personality, and is a strong supporter of Homeopathy.

I’ve blogged about homeopathy more times than I care to admit, because it’s the perfect case study for how easily both patients and health professionals can fool themselves when it comes to our health. Homeopathy is an elaborate placebo system where the “remedies” are so dilute that they contain no active ingredients of any kind. Homeopathy wasn’t discovered, rather it was invented out of thin air, by a German physician, Samuel Hahnemann. Hahnemann decided (there is no other way to describe it) that “like cures like” meaning that a substance that causes symptoms can also treat those symptoms if diluted sufficiently. This is, of course, false. For homeopathy to actually work, many of the core facts of physics, biochemistry and medicine would have to be wrong. None of this is the case – homeopathic remedies are the alternative medicine equivalent of Jack and the Beanstalk’s magic beans, and homeopaths go to great efforts to decide just which magic beans are best for a patient given their symptoms. (Interestingly, for all homeopaths claim about homeopathy treating the “root cause” of disease, the selection of “remedies” is solely based on patient’s symptoms. No investigations in to “root causes” at all are necessary.) Despite the known facts of homeopathy, its proponents position the practice as grounded in science, despite the fact that the remedies have been studied extensively, and perform no better than an equivalent placebo. Yes, you can find positive studies. But given the poor quality of most studies, it would be abnormal for there not to be the occasional positive study – it’s a simple consequence of the statistical analysis. After 200 years of study, there is no credible scientific or medical debate about the validity of homeopathy. None. Given the serious scientific credibility problems with homeopathy, what better proponent for the practice than Dr. Oz, who seems more than willing to reject the scientific evidence when it fits his confirmation bias?

The segment (preceded by another segment on detox, which is simply another alternative medicine marketing tactic) is online for your viewing pleasure. There’s an accompanying post on the Dr. Oz website:

The basic concept of homeopathy is “like cures like.” Hence, homeopathic practitioners use potentially toxic substances to provoke defense and self-regulatory responses. Hence, something that causes an illness (like vomiting) could cure the illness if it’s served in smaller, less-concentrated quantities.  Homeopathic products can come from plants, minerals, venom of poisonous snakes, or, sometimes, prescription drugs.

Which is actually incorrect, as most homeopathic remedies are so dilute that that there is effectively zero possibility that they contain even a single molecule of the original product. The 30C “potency” is common – it’s a ratio of 10-60.  You would have to give two billion doses per second to six billion people for 4 billion years to find one molecule of the original material. So while Dr. Oz profiles several products, they are, for all measurable purposes, indistinguishable. They are sugar pills – pure placebo.

“My family has been using homeopathy for three generations” – Dr. Oz

So just what gets profiled on the Oz show? Oz starts off with his own starter kit. A naturopath describes five different remedies:

  • Belladonna for fever – “The perfect remedy” says the naturopath. She recommends a 200C “potency”, which means you would have to consume a pile of tablets larger than the entire universe to get a single molecule of belladonna. Not surprisingly, the degree of the dilution isn’t disclosed – the naturopath only calls it a “tiny” dose, which is quite an understatement.
  • Phosphorus for cough – “The person who does well on phosphorus usually craves cold drinks” says the naturopath.
  • Gelsemium for influenza – “The person who is so weak they can’t get out of bed”
  • Pulsatilla for upper respiratory infections – “For lots of yellow mucus.. tends to be sad and needs and wants affection.”
  • Nux vomica for indigestion, bloating and heartburn – “They tend to be chilly, irritable, inpatient”

It’s worth repeating that these “remedies” are chemically indistinguishable. That is, if the labels were removed, there would be no way to differentiate the remedies through testing, as none contain any active ingredients. (James Randi has offered $1 million dollars to anyone that can identify a homeopathic “remedy” versus a comparable “placebo”. No homeopath has yet accepted the challenge.) Oz is effectively endorsing the idea you buy five identical packs of sugar pills to treat medical conditions ranging from indigestion to fever.

Next up? The True Believers – physicians who have “integrated” homeopathy into their medical practices.

“Most doctors schooled in conventional medicine don’t have a lot of faith in homeopathy, because we are still trying to understand why it works” – Dr. Oz

Oz works hard to attach a veneer of scientific legitimacy to homeopathy – if only the Big-Pharma-worshipping-health-professional-sheeple would understand, it’s not “if” it works, but “why” it works! But you don’t need to answer “why” until you answer the “if”. And the “if” has been definitively answered. Oz profiles three physicians, all of whom provide glowing testimonials for homeopathy:

  • Dr. Scott Stoll, who claims success with a product called Guna-Sleep, which according to the manufacturer is “a homeopathic blend of choice herbals and metabolic factors such as melatonin”. The label reveals a dilute mix of herb, animal gland extracts, interleukin and drugs like melatonin, all in a 30% alcohol solution. Evidence it works? Nothing but Dr. Stoll’s anecdotal evidence.
  • Dr. Albert Levy recommends arnica cream and pillules. He claims it helps speed injuries. This remedy has actually been tested, and some versions are not dilute enough to be truly homeopathic. Dilute or not, arnica is no more effective than placebo.
  • Dr. Karlene ChinQuee takes homeopathy to a whole new level, by combining it with another pseudoscience, acupuncture. Voila, “biopuncture” which is essentially injecting “remedies” (read: water) into acupuncture points which she claims will reduce pain and improve mobility. There’s no reason to think that water injections offer anything more than placebo effects to patients.

In the final segment, the naturopath returns to describe Bach Flower Remedies, and highlight “Rescue Remedy” which is, like the other remedies, free of active ingredients. Harriet Hall at Science-Based Medicine summarized the evidence based for Bach Flower remedies quite succinctly:

People Actually Believe This Rubbish

Rescue Remedy has been critically reviewed, and Edzard Ernst published a paper in 2010. His conclusion was also succinct and unambiguous:

 All placebo-controlled trials failed to demonstrate efficacy. It is concluded that the most reliable clinical trials do not show any differences between flower remedies and placebos.

None of this evidence makes its way into Dr. Oz’s glowing profile. And is it any surprise? Oz is a true believer. Thankfully, and to the show’s credits, the printed show notes actually acknowledge that scientific reviews show fail to demonstrate homeopathy has any meaningful effects, though they cite a Swiss health technology assessment as positive evidence when in fact that report has already been thoroughly discredited.

Conclusion

It’s no longer accurate to describe The Dr. Oz show as a health program. This is infotainment, with segments that now look like parodies of sensible health information. How can anyone take the information he offers seriously? He has no hesitation endorsing the use of  sugar pills for fever, anxiety, pain, cough, respiratory tract infections, sleep disorders, and musculoskeletal injuries. By discarding the facts when they don’t fit his confirmation bias, Oz does his viewers a disservice. His show needs a disclaimer. Like horoscopes and psychics, the Dr. Oz show is “For entertainment purposes only.”

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12 Responses to “Has Dr. Oz Jumped the Shark?”

  1. So disappointing… My mother records all his episodes and spurts his crap out all the time… Now I am afraid that when she is going to see this she will now ho back to using this crap.

    But seriously you only think now that he has flipped? Do you know remember the episode where HE HAD A FAITH HEALER ON HIS SHOW!!!

    • I agree, Rayna. My 83-year old mother has heard from a friend about some miracle diet/cure that was promoted (no other word for it) on one of these programs. And believes it…sigh..

      The placebo effect, faith healer comfort, mommy-kiss-it-better boost to a person’s morale when they are ill or in distress is not useless, which is presumably what the likes of Dr. Oz will hide behind. However, to promote it as a positive treatment for what-ails-ya is nasty and exploitative.

      Now how about that nice cup of hot tea?

  2. 3 Matthew

    I think fonzi jumped the shark on a motorcycle.

  3. I’ve taken homeopathic ipicuana for vomiting and it stopped my vomiting! I have tried arnica for bruising and it helped my bruising..there are still many things we do not know about what happens on a cellular level in our bodies..many micro nutrients that are still being studied.. If you take a dose of carbo vegetalis for acid stomach you right away, feel better.
    Didn’t the medical associations of the day take some of Dr Hanumanns Ideas and create what we now know as vaccinations? And..I bet arnica would help rangatangs with their trauma, what with their habitat being burned to the ground for palm oil..

    Poor Oz, he is damned if he does and then if he doesn’t.
    I stopped paying attention to that guy. He is feeding off the desperate, the constipated, the drugged up and overfed..sorry, it is how I see it when they come in my store..
    I am like, “oye, now it’s phosphorus!”
    And the the phones start..with the criteria..”oh, it HAS to be 200c”
    they say it like that..:)

    Homeopathy has been around a long time however, and, you would be surprised at how many people use it. So if it is fake or real, and one feels better and their headache or stomach ache is gone, who is it hurting?
    One can always just go get drugs from their doctor…
    The whole idea is that people must be free to choose what they want. Usually, they study an herb or a treatment before running to the health store..until Oz.

    • 6 M.G.D.

      anastasia – what are the odds that they would have gone away on their own with time anyway? Did the homeopathic product lacking a single active molecule really heal it faster, or was it going to heal naturally at that rate anyway? Eventually bruises fade, eventually nausea subsides. This is why “studies” in one person cannot be trusted. It also explains why people with viral infections feel better within a week of taking (inappropriately-prescribed) antibiotics… not because the antibiotics “worked”, but because the viral illness would be overcome by the body in that week regardless of whether anything was taken. Then again, the brain is a powerful healer, so maybe you’re just especially susceptible to the placebo effect.

      • 7 Sussieq

        Well said. I was searching the internet to see if the Dr. Oz show has a disclaimer. I’ve heard plenty of nonsense come out of Oz’s mouth, advice that is potentially dangerous. Just last week I read that an elderly gentleman was suing Oz because this man suffered damage to his feet.

  4. 9 Joanne Z

    A lot of what Dr. Oz says is pure nonsense. But I have to disagree with you about arnica, and I am a staunch believer in science and facts. I am given arnica by my dr when I receive Botox shots for migraines. The one time I went to a different dr and they didn’t give me arnica I was black and blue all over (I bruise very easily).
    I truly believe in science, but even my physicians recommend non-traditional medicines at time when nothing else works. The issue with Dr. Oz is the blurred line between what has been tried and tested and what hasn’t. Add on top of that an American public who is ill informed, and it’s not the best of situations. If Dr. Oz is encouraging people to eat better, exercise and take better care of themselves, great. If his show causes people to forego vaccinations and other life saving choices, then there is a serious problem.

    • 10 Art Tricque

      It is entirely human to believe that arnica works, but one cannot reconcile it with being a believer in science and facts. The evidence is sparse to non-existent for the effects of topical arnica (see Wikipedia https://en.wikipedia.org/wiki/Arnica#Medicinal_uses); and the evidence is not at all compelling for homeopathic arnica.

      • 11 Joanne Z

        Art, I was not referring to topical arnica, as I have never tried it and have no intention of doing so. I was referring to the tablets, (which I do not take on a regular basis nor would I advise anyone do). They are given to me once at the time of my injections and that’s it. And I don’t end up black and blue. The time I did not have them I looked like I lost a match to Mike Tyson. As I have other health issues, I get bloodwork done every month, so I know the bruising was not caused by any deficiencies, autoimmune disease or changes in my overall health. My medications, both over the counter and prescriptions, have not changed in years. The only difference was the arnica, which I didn’t even realise I had not received until my next visit to my doctor. I have gone for these shots for over three years now and that was the only time I bruised. If you can offer me another explanation, I am all ears.
        As I said, I understand and believe in science and facts- but I also have to find an explanation for what is in front of me. Isn’t that part of the whole spirit of scientific inquiry? Even if we don’t like where the answers may point?
        I am due for shots again in 3 weeks- after this discussion I will request not to take the arnica, and see what happens. If I’m black and blue, then I’m black and blue. Oh well. If not, fantastic, because who really wants to look like that? Either way I will keep searching for my answers.

      • 12 Art Tricque

        Joanne, I think you need to start with finding out what exactly is in these tablets. Then, you need to search Pubmed for evidence supporting its use. I find little supporting its use in humans searching for arnica + oral. The best we can say is that the scientific evidence doesn’t support arnica given orally.



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