Dr. Oz promises to stop promoting pseudoscience. Should we believe him?

Regular readers of this blog will find it no surprise that I don’t think much of Dr. Mehmet Oz. The reason, of course, is that his daily television show, The Dr. Oz Show, has been a font of misinformation about medicine almost since it began airing six years ago. It’s not for nothing that I long ago labeled him “America’s Quack.” Simply searching for the name Mehmet Oz on this blog will quickly produce examples of the many times when he’s credulously promoted quackery and pseudoscience such as homeopathy (The One Quackery To Rule Them All), faith healing, fear mongering about GMOs, and promotion of antivaccine views (Robert F. Kennedy, Jr., even!). He has even sunk so low as to feature psychic scammers like John Edward and Theresa Caputo as though they might have a legitimate role in health care.

Truly, Dr. Oz has shown that he has no shame.

Over the last few seasons of his show, Dr. Oz became increasingly shameless in his promotion of pseudoscience, in particular various dubious weight loss supplements, such that in June 2014 he was hauled before Senator Claire McCaskill’s (D-MO) committee for his unscrupulous promotion of such unproven weight loss aids. By last fall, it had gotten so bad that Dr. Oz’s social media people tried to do a an “Ask Dr. Oz” segment on Twitter under the hashtag #OzsInbox. Let’s just say that it backfired spectacularly and hilariously, much to the amusement (and schadenfreude) of skeptics everywhere. Most recently, a group of physicians wrote a public letter to Lee Goldman, MD, the Dean of the Faculties of Health Sciences and Medicine at Columbia University complaining that Dr. Oz is faculty at Columbia protesting his continued presence in good standing as a member of Columbia’s faculty. Unfortunately, the messenger was less than pure, having been primarily industry shills provoked by Dr. Oz’s expressed distrust of GMOs rather than his quackery. Predictably, Dr. Oz used his television show to fire back devastatingly. More effectively, a medical student named Ben Mazer used the example of Dr. Oz’s promotion of quackery to drive the passage of a resolution by the American Medical Association designed to develop ethics guidelines for media use by doctors and disciplinary pathways for doctors who abuse media to promote medical misinformation. It might as well have been called the “Dr. Oz resolution.”

Given Dr. Oz’s uneven history (over the last couple of years in particular), I was rather interested to see headlines like After Months of Criticism, ‘The Dr. Oz Show’ Makes Big Changes and Television Dr. Mehmet Oz returning with ‘heal thyself’ goal.

From the first story:

Dr. Oz will focus his entire upcoming season on the mind-body connection and make some changes in his show format to be more inclusive of the audience. (Photo: Getty Images)

After enduring months of intense criticism, Dr. Mehmet Oz is changing the direction of his show.

The entire upcoming season of The Dr. Oz Show — which kicks off Monday, September 14 — will focus on the mind-body connection and feature a partnership with former U.S. Surgeon General David Satcher, MD.

In the past, Dr. Oz has come under fire for the advice given on his show. Now, the newly focused program will use medical and other experts whose advice is based in research.

Imagine that! Using actual medical experts with advice based in research! Where have I heard that before? Oh, yes, right. Dr. Oz promised to do the same thing after his public humiliation on Capital Hill by Claire McCaskill in June 2014. It only took a year for him to actually follow through with his promise, or at least to claim to follow through with it.

From the AP story:

During a self-prescribed listening tour with physicians groups this summer, Mehmet Oz learned just how much it annoyed many doctors when their patients say, “I heard on ‘Dr. Oz’…”

It’s been a humbling stretch for the heart surgeon who built his own successful talk show after being introduced to the world by Oprah Winfrey. Critics, including some in Congress, scolded the hyperactive health evangelist for promoting questionable diet aids he’s since sworn off. In April, a group of 10 doctors urged that he be removed from Columbia University’s medical faculty, accusing him of promoting “quack treatments.” His show has lost half its viewers over the past five years.

Now, there‘s the real reason Dr. Oz is “recalibrating” his show. You can be sure that if his ratings were as good as they were five years ago his producers would be changing nothing, criticism be damned. (After all, who cares about Senate hearings, criticism by physicians, or the AMA targeting you if you have the ratings?) Well, that’s not entirely true. All successful shows have to undergo some changes, or they stagnate. However, if ratings were still good, Oz would be making incremental, evolutionary changes, nothing more than some tinkering, rather than announcing what sounds like major changes to the show’s format. If he’s going to do something, now is the time to do it, because he only has two seasons left on his contract, which runs until 2017. Doing something in the last year of the contrat could well be too late. In the stories, it’s pointed out that Oz’s reputation among consumers has clearly taken a hit and that this season is critical for Oz to determine his long-term viability. He needs to reinvent himself. But can he?

It may also be that, somewhere, way deep down in that lizard heart of his, Dr. Oz still has some professional pride left about his past. We know he’s been stung by the criticism; it’s just that as long as his ratings were good there was no real motivation to change. Be that as it may, remember—and this is something I’ve pointed out many times—back in the 1990s Dr. Oz was a rising star in academic surgery, and before he fell under Oprah Winfrey’s sway and became “America’s Doctor” he was a well-published, respected academic cardiothoracic surgeon. Now he’s still a well-respected academic surgeon, on the surface at least, but his career has taken a turn from serious, hard scientific and clinical investigations to what I like to call quackademic medicine; i.e., the study of “complementary and alternative medicine.” Indeed, there’s a reason why he’s the director of the Integrative Medicine Center at Columbia, although I can’t figure out why he still retains a high-ranking position (vice chair) in the Department of Surgery at Columbia. He does, though. At the very least, his pride has been wounded by all the criticism. That much is clear.

So what did he do about it? This:

He privately sought feedback this summer from doctors’ groups of various specialties. Some agreed to meet with him, some didn’t.

“We’re on the same team of trying to make people healthier, which I think everyone can agree is the case, even if you disagree with how I do it, even if you don’t like the entertainment aspect of it,” he said. “I get all that.”

What he didn’t realize was how he’d become a symbol for a development in health care that many doctors feel threatened by. Patients today often go for check-ups after Googling for information on what ails them or listening to advice from their favourite television doctor. In some respects, it intrudes on the physician-patient relationship, and Oz said he understands how irritating that can be.

Really? He’s just learning now that physicians, particularly primary care docs, have become utterly fed up with Oz’s promotion of pseudoscience, to the point where there are jokes and cartoons in the medical literature how there should be a “Dr. Oz says” billing code that allows a visit to automatically be bumped to the highest billing level because of how much time and effort it takes to counter misinformation that The Dr. Oz Show embeds into patients’ heads? Truly, Dr. Oz was oblivious. However, just because his fellow doctors are annoyed at him is not really an adequate reason to do a science- and evidence-based show. He should do a science- and evidence-based show because if you’re a physician doing a medical TV show it’s the right thing to do. In fact, it’s the only ethical thing to do.

To be honest, the whole claim that it’s because of doctors complaining about the “Dr. Oz says” phenomenon that Dr. Oz is changing his show strikes me as PR-speak for admitting that the show had not been evidence based and had been promoting quackery without actually admitting that the show had not been evidence-based and promoting quackery. After all, if Dr. Oz had been promoting evidence-based information, then I highly doubt many doctors would complain. Instead, they had to spend endless hours trying to explain why Garcinia Cambogia is not a magical fat-burning supplement and why homeopathy doesn’t work. Another interpretation is that he’s not really changing that much but will work on publicizing what he’s going to cover more, so that doctors aren’t caught off-guard when their patients bring it up. After all, most doctors are in their offices or the hospital when Oz’s show airs.

There’s no doubt that I’ve been one of Dr. Oz’s fiercest critics. Indeed, as far as I can tell, I’m the one who coined the term “America’s quack” as a riff on his self-proclaimed (or Oprah-proclaimed) title of “America’s doctor” to describe Oz. Let’s just say that I remain…skeptical. Dr. Oz’s history mandates that skepticism, but I also find the theme of this season to be a bit questionable. The reason is that any time someone like Oz refers to the “mind-body” connection, that’s at least in part invocation of dualism. Moreover, “mind-body” medicine is a category that is full of woo that is claimed to be evidence-based but when examined more closely is not really science-based. By choosing such a topic as a major theme of this season, Dr. Oz’s producers have left a lot of wiggle room to work in pseudoscience should they be inclined to take advantage of it.

Still, my skepticism and previous savaging of Dr. Oz’s promotion of quackery notwithstanding, I would actually love to see Dr. Oz turn away from the Dark Side of quackery and towards the Light of science and evidence. Were he to do that, The Dr. Oz Show could become a powerful educational tool. Actions speak louder than words, though. I need to see this claimed change over a prolonged period of time before I’ll believe that Dr. Oz has actually internalized the message that he needs to stop promoting pseudoscience and quackery. We’ll see.