America’s quack counterattacks by calling his critics industry hacks

Last week, a group of ten doctors led by Dr. Henry Miller, most of whom were affiliated either with the Hoover Institution or the American Council on Science and Health (ACSH)—or both—wrote a letter to Lee Goldman, MD, the Dean of the Faculties of Health Sciences and Medicine at Columbia University complaining that Dr. Mehmet Oz shouldn’t be faculty at Columbia University because of his “disdain for science and for evidence-based medicine, as well as baseless and relentless opposition to the genetic engineering of food crops” and “an egregious lack of integrity by promoting quack treatments and cures in the interest of personal financial gain.” The letter produced a fair amount of media attention late last week; over the weekend my opinion of the letter, which was mildly approving, evolved into disapproval and dismay. The reasons were several and included a profound distaste for threatening letters sent to a person’s employers, admittedly based in part on my own experiences having been at the receiving end of such intimidation tactics, as well as a concern that the letter had been written with no clear purpose behind it other than as a publicity stunt to embarrass Dr. Oz and Columbia. When I learned that Dr. Oz was planning to answer the letter on his show this week, I predicted that this particularly bone-headed publicity stunt would backfire spectacularly.

Now that I’ve seen the show, having DVRed it for watching after getting home from work, I hate to say I told you so, but I told you so. Actually, I don’t hate to say it, but in this case it’s profoundly depressing how badly Miller’s stunt backfired. I suppose it’s little consolation that I accurately predicted Dr. Oz’s line of attack, although I do take some satisfaction in noting that Dr. Oz has officially become Mike Adams, the looniest of quack loons and conspiracy theorists, whose massively unhinged attacks on behalf of Dr. Oz that I noted basically said the same things that Oz ended up saying. Truly, if I thought that maybe Dr. Oz might have had a shred of honor left before, I harbor no such illusion now. Oz is about as despicable as it gets.

Actually, yesterday morning, Oz published an article in TIME entitled Exclusive: Dr. Oz Says ‘We’re Not Going Anywhere’, that was a summary, an outline, if you will, of his planned line of attack, so much so that I thought maybe I wouldn’t have to watch Oz’s actual show when I got home. But, damned that sense of duty—the things I do for my readers—I did watch, and I was amazed at just how low Oz was willing to go.

First, let’s look at the TIME article. Not having science to back him up, Oz goes for the same gambits that quacks and antivaccinationists go for: Appeals to freedom, claims to be “fighting for you,” and ad hominem attacks on his enemies, up to—or should I say down to—the very same ad hominem attack used by Mike Adams in his series of screeds attacking the letter writers. In fact, the TIME article very much resembles Oz’s opening monologue on his “counterattack” show, but the show was a bit more dramatic, as you might expect. The show begins with a variation of the same teaser trailer Oz had released on Wednesday, in which typical announcer guy intones in his most dramatic voice:

You’ve seen the headlines. You’ve heard the controversy. Now, Dr. Oz fires back. He responds to his critics and sets the record straight on the GMO movement, alternative health practices, and his commitment to always fight for you.

[Note added 4/24/2015. You can now watch the segments for yourself: Dr. Oz Breaks His Silence; Dr. Oz Reveals the Truth About His Critics; and Dr. Joel Fuhrman Defends Dr. Oz Against the Controversial Headlines. There was another long segment recapping some of what Dr. Oz has said about GMOs, but that doesn’t appear to be online, perhaps because it consisted mainly of snippets from past Oz shows.]

Then, in his monologue immediately blames “ten mysterious doctors” with industry ties to for trying to shut him up because he criticized genetically modified organisms (GMOs). Then, with a heavy sigh implying a heavy heart delivered with the cheesy portentous manner of an old gunman in a B-grade western forced to strap on his six gun one more time to go into battle—no, Dr. Oz is not a very good actor—he says:

I’ve long believed that doctors should never fight their battles–or each other–in public. But now I believe I must.

Hoo boy. You could smell the cheese. You could also see the lie, as Oz made the claim that “many papers mistakenly claimed my own hospital’s doctors were out to get me.” Oh, really? If there were such stories claiming that it was Columbia doctors going after Oz, I sure didn’t see them. I wonder if Oz will put up some links to those stories. Somehow I doubt it.

Oz also invoked this gambit:

This can lead to confusion and irritation when analyzed by conventional physicians. For example, another daytime TV show and mine were recently noted in a BMJ article for only having proof for half of what we shared with the audience. A similar figure is often used to approximate the amount of randomized clinical trial data underlying conversations in physician’s offices across America. This reflects that natural gap between what is proven in clinical trials and the needs of our patients.

He’s referring to a study I and others blogged about. Oddly enough, I hadn’t been aware that the authors of that study had later said that their data didn’t support the contention that Dr. Oz or The Doctors were “quacks or charlatans or worse.” OF course, no one said that this study did; it simply showed how little of what Oz recommends is evidence-based. For one thing, as I noted, the reviewers looking at the claims were willing to consider case studies as the minimum form of evidence to support a recommendation. I reiterate: That’s a really low bar. By that standard, you could say that there is some evidence to support the idea that the MMR vaccine is associated with autism, given that Andrew Wakefield’s infamous 1998 study—now retracted—was a case series. Actually, since it was retracted, you couldn’t use Wakefield’s study, but there are plenty of other case reports and bad studies by antivaccine-sympathetic doctors and researchers out there that one could cite. In any case, that’s how bad Dr. Oz did, given how low a bar a case study is. When the authors raised the bar and used the slightly higher threshold of “Believable or somewhat believable evidence” then only 33% of recommendations on The Dr. Oz Show met that standard and 53% of the advice on The Doctors. Contrary to what Oz claims, medicine is far more evidence-based than that, as Steve Novella has shown time and time again.

Of course, the only thing that disappointed me about the study was that the authors didn’t look at what percentage of advice from Dr. Oz is based on pure fantasy (such as his episodes on homeopathy, using psychic mediums like John Edward and “Long Island MediumTheresa Caputo) as therapists, faith healing, and the like). That’s the core of the complaint I and many skeptics have against Dr. Oz., not that he does the occasional anti-GMO segment, although those are bad too.

In any case, the TIME article basically described much of the segment’s ad hominem attacks. Oz introduces them, but they were, as Dan Diamond pointed out, “outsourced” to The Dr. Oz Show correspondent Elisabeth Leamy, who enthusiastically performs the requisite hatchet job. Unfortunately, given who Dr. Miller and his fellow cosignatories are, it wasn’t difficult for her. I could have done the same thing as well as she did without even bothering to get my posterior off the couch. (Actually, I already did.) Some “reporter”! She reminds me of Sharyl Attkisson. In any case, here it is, in the TIME article:

With a few clicks and some simple searches, a remarkable web of intrigue emerged—one that the mainstream media has completely missed. The lead author, Henry I. Miller, appears to have a history as a pro-biotech scientist, and was mentioned in early tobacco-industry litigation as a potential ally to industry. He also furthered the battle in California to block GMO labeling—a cause that I have been vocal about supporting. Another of the letter signees, Gilbert Ross, was found guilty after trial of 13 counts of fraud related to Medicaid. He is now executive director of American Council on Science and Health, a group that has reportedly received donations from big tobacco and food and agribusiness companies, among others. Another four of the 10 authors are also linked to this organization.

The segments on Miller and Ross included unflattering photos with graphics worthy of the lowest form of political attack ads, complete with a graphic showing Miller being “put under the microscope” and concluding with jail doors closing in front of Ross. Then Oz interviews Lisa Graves of SourceWatch and executive director of the Center for Media and Democracy, and Gary Ruskin US Right To Know. SourceWatch is a wiki run by the Center for Media and Democracy that bills itself as a “collaborative, specialized encyclopedia of the people, organizations, and issues shaping the public agenda.” Graves explicitly called Miller and the ACSH “shills for corporations,” in the most blatant use of the “shill” argument I can recall having seen in a long time. In the process, ACSH was referred by Ruskin as “rent-a-scientists,” who described this characterization as being “really well-established.” It might well be true that all of Oz’s arguments against his critics are misleading or downright wrong, but, contrary to what has been argued, it actually does matter who Oz’s critics are and that they have massive conflicts of interest. It is not “beside the point.” Maybe on some airy abstract plane it shouldn’t matter, but this is the real world, and to the average person it does matter, as much as we as skeptics might like to wish otherwise.

Meanwhile, Graves cited the words of the judge presiding over Ross’ Medicaid fraud trial, who referred to him as “a highly untrustworthy individual,” emphasizing that “those were his exact words,” before concluding, “I think this is definitely a smear campaign against Dr. Oz and I think it’s a campaign that’s driven by individuals who are connected to big industries.” I note that the term “big industry” was bandied about a lot during Oz’s segment. To be honest, besides its tendency to align with industry interests, I have always been bothered by the ACSH keeping Gilbert Ross in a leadership position, even back when his release from prison was not very far behind him. Yes, it’s true that a person’s past shouldn’t necessarily have any bearing on his scientific arguments, but Oz knows that that’s not how the average person thinks. That’s why his attack was so devastating, particularly the bit where a photo of Dr. Oz is projected next to photos of most of the ten signatories of the letter, and the question is asked, “Who should you believe?” Indeed, Even Ross now regrets having signed the letter because by signing it he foolishly gave Oz and his allies a weapon to attack the letter and the ACSH, and in particular to distract from the criticisms of Oz’s promotion of quackery and pseudoscience on his show.

There was one misfire that made me laugh out loud when I saw it. For whatever reason, the producers of The Dr. Oz Show decided it would be a good idea for Oz to interview Dr. Joel Fuhrman. I’ve mentioned him a few times before. For example, Fuhrman is a raw food faddist who takes a vitalistic view of cooking food in which cooking somehow destroys living antioxidants, phytochemicals, and a variety of other compounds, without which the body can’t be healthy and “must break down.” He describes processed food as “foods whose life has been taken out of them” and makes the claim that, without these micronutrients, cells accumulate “toxins” that need to be “detoxified,” while touting broccoli and various vegetables as having “incredible medicinal power.” Elsewhere, he’s been known to trot out the same old alt-med tropes against chemotherapy, particularly its “barbaric” nature. He’s also been known to make some rather overheated claims for the benefits of diet, in essence claiming that virtually any disease is preventable. No wonder Oz likes him.

Fuhrman serves as Oz’s surrogate and really lays it on thick. He describes the signatories of the letter as “not representative” of physicians and their letter as an “attack against all physicians” (nonsense!), pushing a “dangerous agenda,” and being “anti-American” and, of course, “anti-freedom.”

Of course. Because criticizing quackery is “anti-American” and “anti-freedom.”

Naturally, Oz can’t resist insinuating a conspiracy theory to explain why Miller and his cosignatories decided to send their letter now, referring to it as bullying, which is particularly amusing given the mismatch in media presence between Miller and Oz. In any case, Oz concludes that the reason Miller and colleagues must have decided to choose now to strike is because of a federal bill being considered, the “Safe and Accurate Food Labeling Act,” which would prohibits any mandatory labeling of GMOs by states. Of course, the bill failed to pass last year; so it’s unclear to me why its reintroduction this year would provoke an attack by pro-GMO interests against Dr. Oz, but Oz and crew sure do blatantly insinuate dire conspiracies on the part of big industry to use more glyphosate, which GMOs allow it to do. It’s as though Oz has finally given in to the dark side so much that he’s channeling Alex Jones, Gary Null, and Mike Adams.

He concludes:

No matter our disagreements, one of the goals of this show is to have an honest discussion with diverse opinions. Freedom of speech, my friends, is the most fundamental right we have as Americans. These ten doctors are trying to silence them, and I’m not going to let that happen.

Yes, freedom of speech is one of the most fundamental rights we have as Americans, but freedom of speech does not mean freedom from criticism, nor does it obligate a production company to give Oz a platform or a TV station to broadcast his opinions.

Then, at the very end of the show, Oz shows the video of Elmo urging people to get vaccinated, concluding, “Elmo, the surgeon general, and I all agree: Get vaccinated.” Funny how Oz seems to have forgotten his having had the antivaccine loon Robert F. Kennedy, Jr. on his show just last fall and his less-than-enthusiastic words on vaccines back in 2010 that led many to believe that he hadn’t vaccinated his children.

Of course, few people who aren’t skeptics who’ve been following Oz’s antics for a while are aware of these inconsistencies in his story; so he’ll almost certainly get away with it. In fact, it’s magnificent propaganda that utterly crushes Miller and his letter, just as I predicted that it would. Oz cynically completely reframes the criticisms directed at him from his support of pure quackery by featuring homeopathy, Mike Adams, faith healing, and all manner of other quackery on his show as potentially valid health care options to his being attacked by industry interests seeking to protect their GMO profits. Oz makes a big deal out of the fact that he doesn’t recommend these options as replacements for conventional care. Instead, he advocates “integrating” quackery with conventional medicine, which is actually part of his day job at Columbia as director of its integrative medicine program.

In fact, that’s exactly what I said when I predicted disaster for Miller and his band, and that’s what I say now. Michael Spector gets it, too. The problem is that what Oz promotes on his TV show is not that different from what he probably promotes as the director of Columbia’s integrative medicine program, which is not that different from what is happening in the rest of quackademia, as increasingly quackery is “integrated” with academic medicine to become quackademic medicine. Oz is a symptom, but a big one. There are many other examples, from medical schools as diverse as the Cleveland Clinic and its promotion of reiki, traditional Chinese medicine, and “functional medicine,” George Washington University, the University of Michigan (my alma mater), Memorial Sloan-Kettering Cancer Center, and the University of Maryland.

If you don’t believe me, just check out this op-ed published in USA TODAY yesterday by several Columbia faculty, entitled What do we do about Dr. Oz? In the letter, Dr. Michael Rosenbaum, professor of Pediatrics and Medicine at Columbia University Medical Center, and his co-authors, practically bend over backwards not to be too critical of Oz, praising him for “bringing alternative therapies which are generally under-researched and under-regulated into the public forum,” which nearly made me spit out my iced tea on my computer when I read that phrase, even as the authors lament how Oz’s brand of medicine “unsubstantiated medicine sullies the reputation of Columbia University and undermines the trust that is essential to physician-patient relationships.” The best they can come up with is a proposal for increased governmental scrutiny of claims made on television and other media or, barring that, “Dr. Oz might begin each program with a simple disclaimer: ‘The opinions expressed on this program may not be evidence-based or part of accepted medical practice and have no endorsement from Columbia University.'”

What else can we expect when medical academia becomes medical quackademia? For example, I note that the Columbia University Medical Center’s Integrative Therapies Program for Children with Cancer offers herbal & nutrition counseling and guidance, aromatherapy (quackery), acupuncture & acupressure (quackery), massage therapy & reflexology (super duper quackery), reiki (rivaling homeopathy for the title of The One Quackery To Rule Them All), meditation, exercise, yoga & movement therapy, and a chef program. Yes, Dr. Oz has become a TV snake oil salesman, but selling snake oil is what quackademia increasingly does. Other than the psychics, he’s not doing anything worse than what happens at his own university. That’s the problem that needs to be attacked. Dr. Oz is just the most noticeable symptom.

In the end, all that Henry Miller managed to accomplish is to provide Dr. Oz an excuse to attack and crush his critics. Going forward, I fully expect that he will dismiss legitimate criticism of his promotion of quackery as being somehow affiliated with the ACSH and “big industry” protecting GMOs.