America’s Quack Dr. Oz and the failure of medical academia, revisited

Election Day is finally here. By tonight or tomorrow, it’s quite possible that something I never would have dreamed of a decade ago (or even a couple of years ago) will have come to pass. America’s Quack Dr. Mehmet Oz might well be Senator-Elect Oz from Pennsylvania, because the polling as of today for his race against the Democrat John Letterman is too close to call. Never mind that Oz has spent his life since the 1980s in New Jersey and run his practice and The Dr. Oz Show from Manhattan, only moving to his in-laws’ house in Pennsylvania when his ambition led him to think that he could be a U.S. Senator. If Dr. Oz wins, he will join Rand Paul as the a quack turned Senator.

Longtime readers will remember that back in the heyday of the time when this blog was on ScienceBlogs I often referred to Dr. Mehmet Oz, who, I would admit, had at one time been a promising academic cardiac surgeon with dozens of good quality papers to his name as well as one major patent, as “America’s Quack.” I don’t know whether I coined the term or not, given that adding the term “quack” was a very obvious riff on the title of “America’s Doctor” bestowed on him by Oprah and that Dr. Oz even trademarked the term “America’s Doctor,” but it sure feels like it. The reasons were many but mainly centered on how Oz had turned into an advocate of “integrating” quackery into medicine (i.e., “integrative medicine“) and, after having become Oprah Winfrey’s go-to physician for dubious medicine, was rewarded by her with his own daytime “medical” talk show host (and I use the term” medical” loosely).

I last wrote about Dr. Oz less than a month ago, when I lumped him in with Dr. Joseph Ladapo, another academic physician turned quack turned government flack, specifically using both of them as examples of how medical academia had failed medicine by tolerating such purveyors of medical misinformation. So why revisit Dr. Oz so soon, other than because today is Election Day and I hope fervently that he loses? The reason is that I just so happened to come across an article in the The Eye by Megan Lunny entitled How Do You Solve a Problem Like Mehmet? The Eye is the online magazine of The Columbia Daily Spectator, and thus a publication of Columbia University, where until recently Dr. Oz had been a professor of surgery and vice chair in its department of surgery. The reason this article caught my attention is that it argues much the same thing that I have argued: Columbia University has long been complicit in boosting Dr. Oz’s career and supporting his promotion of quackery on The Dr. Oz Show over the years and, if Dr. Oz becomes Sen. Oz, will have played a significant role in that unfortunate development as well.

Columbia University: Enabling Dr. Oz

One complaint that I’ve long had regarding Dr. Oz and his relationship with Columbia University is how his affiliation provided him a patina of scientific respectability, even after he had embraced quackery as part of his quest to promote “integrative medicine” and then even later, after he had become a TV personality promoting snake oil. Lunny notes early in the article:

Throughout the election cycle, Columbia has stayed silent on Oz, whose campaign office did not respond to requests for comment. But the University has also gone further, quietly scrubbing Oz from its webpages and directories in what has struck many as a secretive attempt at disaffiliation. The recent changes come after years of criticism of Columbia by the medical community for maintaining ties to Oz despite his promotion of pseudoscience and misinformation on his influential talk show.

Now, for the first time since the surgeon rose to fame in the early aughts, the University might finally be distancing itself from Oz. But the belated and bizarre manner in which it has set about the task, and the context of Oz’s Trump-endorsed Republican Senate run in Pennsylvania, raises questions about whether the University is trying to erase its long history of enabling Oz.

I discussed this very occurrence earlier this year, noting too how Oz had quietly disappeared from a lot of university-affiliated websites. Noting that just over a year ago, not long before he announced his Senate candidacy, Dr. Oz had been teaching cardiac anatomy to medical students—including his own son, who was a second year medical student at Columbia—at at Columbia’s Vagelos College of Physicians and Surgeons, Lunny goes on to ask:

So, what was a talk show host doing at Columbia just one year ago, teaching medical students about the anatomy of the heart? Who is Dr. Oz—both at Columbia and outside of the University gates—and why, only now, might the University be trying to erase public ties to him?

It’s not as though Dr. Oz’s continued affiliation with Columbia after he had become so well known for promoting dubious medical advice, dietary quackery, and even outright quackery on his TV show didn’t ruffle some feathers:

Indeed, for more than a decade, Oz’s Columbia ties have long been a source of confusion and frustration for many doctors and academics, according to Arthur Caplan, GSAS ’73, GSAS ’75, GSAS ’79, the Drs. William F. and Virginia Connolly Mitty professor of bioethics at New York University. Caplan says that many in the field wonder why Columbia did not cut ties much earlier and more decisively. “I think, inside baseball, many doctors of academic centers are aware that he’s on the Columbia faculty and feel angry about it,” Caplan said.

And, technically, Dr. Oz still is Columbia faculty, as when he left the university earlier this year he left as an emeritus professor, a title often granted to long serving faculty who retire or step back to a part time role. (Indeed, I hope that when I finally retire my department will let me do so as an emeritus given that I will have been with the department at least 20 years by that time.)

What’s interesting about this article is that it goes back to Dr. Oz’s early years at Columbia. Interestingly, it’s not as straightforward as you might think to find out much about these earlier years, beyond the hagiography and Dr. Oz’s self-promoting narrative. In fairness, it is clear that, after starting a residency in cardiothoracic surgery at Columbia in 1986 after having graduated from medical school at the University of Pennsylvania, Dr. Oz quickly distinguished himself as a a promising surgeon and academic researcher. It’s not for nothing that I have over the years described him during his early career as a resident in the 1980s through his early academic career in the 1990s as a rising star in academic surgery. He was definitely that, as Tully notes:

Oz first came to CUIMC as a cardiothoracic surgeon in 1986 after receiving his medical degree, along with an MBA, from the University of Pennsylvania. Mentors and colleagues who knew Oz during his first years at Columbia have recalled him as a gifted surgeon. Sharp-minded and energetic, Oz was a prolific contributor to research in his field. He is listed as an author of hundreds of articles on heart transplantation, surgical techniques, and ventricular assist devices published during his first ten years at the hospital and in 1989 co-developed a since-abandoned patent application on a new method of welding tissue.

Of note, on his old Columbia Department of Surgery webpage (archive here), it used to say that Dr. Oz had as a resident won the prestigious Blakemore Research Award four years in a row, from 1988-1991, but a perusal of the actual Blakemore website shows him as only having won it once, in 1991. (Maybe someone more familiar with the prize can explain this discrepancy to me.) It’s still a very prestigious award, and I noticed a fair number of names that I recognized on the list of winners since the 1980s. It makes me wonder if there are second and third place prizes, but, then, none are listed on the website.

In any event, back in the day cardiothoracic residencies were at least seven years, five years of general surgery followed by 2-3 years of cardiothoracic surgery residency, three if a research year was elected. (Today there are six year integrated programs that decrease the general surgery component.) That means that the earliest that Dr. Oz could have finished his residency was 1993, although he very likely did take the research year and didn’t finish until 1994. (I can’t find a good source that states when he finished his residency., and most residency websites don’t go back past around 2000.) Whenever Dr. Oz actually finished his residency and joined the surgical staff of Columbia University Irving Medical Center, he rose rapidly. For example, in 1994 Dr. Oz was awarded a Florence and Herbert Irving scholarship at Columbia to study patients’ quality of life, and the same year he co-founded with registered nurse Gerard C. Whitworth the Complementary Care Center at Columbia Presbyterian to study diet, meditation and hypnosis, and manual therapies like massage and energy medicine. It was around this time that Dr. Oz started to make news for letting reiki masters into his operating room to do reiki on his patients before he started his surgeries. Interestingly, Lunny reports something that I had not previously known before about this part of Dr. Oz’s history:

A prospective program, the center never appeared in any official listings with CUIMC, where it was housed, and did not receive University funding. Whitworth and Oz’s initial goal for the center was to produce a substantial enough body of research to make a strong plea for funding from Columbia. In the meantime, Whitworth invested $100,000 of his personal wealth into the center, in addition to receiving some donor funding, he told the New Sun in 1999.

Oz’s tenure at the center was characterized by his relentless efforts to garner media attention for the nascent research program. Monique Class, who worked at the center as a family nurse practitioner, told Vox in 2015 that Oz’s infatuation with the media undermined the center’s operations. According to Class, Oz frequently did not prepare for consultations and would ask for case information when he wanted to be recorded with a patient by a visiting camera crew.

“He was always acting,” Class told Vox about Oz.

Oz was always acting even as a freshly minted heart surgeon? Quelle surprise, as I like to say. Also, consistent with his later career, in which a famous and/or wealthy patron promoted him, even back in 1994, Dr. Oz was relying on money and the spotlight from those with money in order to promote himself and his work.

As Julia Belluz reported in 2015:

It wasn’t uncommon, Class said, for Oz to say some version of the following to her or to the other employees: “Give me a patient because the cameras are coming in, and tell me what I need to know.”

Class said, “He was always acting. He didn’t know this patient. He was not connected to this patient. We’d give him a two- or three-minute sound byte and he’d sit there in front of the cameras like he’d done this work and had this deep connection.”

It rather sounds as though, even 25+ years ago, Dr. Oz was training to be a TV personality.

It’s particularly interesting to read this New York Times account of Dr. Oz’s activities from 1995 through the lens of what has happened since. In the account, Dr. Oz was described—nauseatingly—as “probably the most accomplished 35-year-old cardiothoracic surgeon in the country,” although in fairness, by all accounts he was really, really good back then. Indeed, he was quite extraordinary, with a patent for an organ transplant preservation solution and two more patents pending, including one for an aortic valve that can be implanted without open-heart surgery. By 1995 he had contributed chapters to eight books, written 56 abstracts and 135 papers, while performing 250 heart operations a year. These accomplishments led the reporter to gush:

Mehmet Oz is one of those rare beings who seem incapable of sloth. “He’s doing a heart transplant right now,” his secretary says on the phone, “and he’s got a double-lung transplant waiting, and those are in addition to his two regularly scheduled open hearts, and then at 3 he’s supposed to fly to Boston to deliver a lecture.” So exceptional is Oz’s energy that some of his colleagues use him as a benchmark, correlating their own vitality as a fraction of a “full Mehmet unit.”

The problem with Dr. Oz in the mid-1990s wasn’t so much his surgical skills, his research or his work ethic. All appeared stellar. Rather, it was his embrace of quackery even then, an embrace that the NYT reported portrayed as brave and groundbreaking, as this account of his surgery on a woman named Joyce Donadio:

At the invitation of Oz and his patient, there were two other people on hand in surgical gowns and masks: a second-year medical student named Sally Smith, stationed at Donadio’s feet, and a 52-year-old healer named Julie Motz, who was standing at Donadio’s head. As volunteers in Oz’s Cardiac Complementary Care Center, they worked for free through the operation, seldom moving except to reposition their hands. As Oz requested sutures and clamps and units of lidocaine, Motz called softly to Smith to move her hands from the small toe of Donadio’s right foot to a point on the sole known as “the bubbling spring.”

What they were doing no one else in the operating room knew how to do, or had ever seen done during a coronary bypass, or had ever thought worth doing, even as an experiment. In this ultimate theater of scientific medicine, the women were using their hands as kings once did to treat subjects with scrofula and as Jesus is said to have done and as shamans and mothers and Chinese qi-gong practitioners still do. They were using their hands to run a kind of energy, which science cannot prove exists, into Donadio’s “kidney meridian,” which also may or may not exist.

I will give the reporter some credit. Whether he realized it or not, he did “get” the essence of reiki, which is that it is faith healing—a laying on of hands—that substitutes Asian mysticism for the Judeo-Christian beliefs that undergird faith healing in the US and Europe. The problem is that this realization was not treated as a bad thing—quite the contrary. Also, kidney meridians do not exist.

Similarly, the belief in alternative medicine led Dr. Oz to do clinical studies whose glaring flaws—I hope—even my readers can spot:

They obtained the consent of 22 patients scheduled for surgery at the hospital. Nine were designated a control group; the remaining 13 were taught self-hypnosis. The instructors focused on helping the patients to relax their jaw and throat muscles in hopes of lessening the stress of having a breathing tube inserted down the throat. They suggested that the patients try to extend their hypnotic state to the surgery itself, in essence to program themselves to minimize their bleeding, maintain normal blood pressure and, in some unknown, subliminal way, reduce their experience of pain and discomfort. After their operations, the patients were to concentrate on healing quickly. The goal was to see how hypnosis changed the patients’ quality of life — an outcome Oz and his colleagues assessed by having patients check off their levels of stress and depression on a standard psychological-mood inventory.

The results, which Oz hopes to publish in the Annals of Thoracic Surgery, suggest that patients who were taught self-hypnosis were significantly less tense after the operation than patients who didn’t have the training. Their scores for depression and fatigue were also lower.

Can you say no blinding? Can you say no control for placebo effects?Sure, I knew you could. Never mind, though. Dr. Oz was a brave maverick, even in 1995:

Oz wasn’t interested in leading a revolution. Many notable doctors from Bernie Siegel to Deepak Chopra had been advocating alternative therapies for years. Dean Ornish’s pioneering program to reverse heart disease through exercise, a vegetarian diet and daily meditation is now so respectable that a dozen insurance companies have embraced it as a viable alternative to bypass surgery. If there were new approaches that might improve the quality of life of cardiac patients, Oz was willing to raise some eyebrows to evaluate them and do what he could to nudge a major medical center in new directions. More than willing — he felt ethically obliged.

Because of course he did.

But back to the question of how Columbia could have or should have solved a problem like Dr. Oz.

America’s Quack, or: The Oz problem

Over the years, I’ve written a lot about the quackery promoted on his show, and I’m not just talking his dubious diet supplements. I’m also talking quackery as bad as The One Quackery To Rule Them All (homeopathy) and even faith healing, as well as the promotion of the antivaccine views of Robert F. Kennedy, Jr., and even psychic scammers like John Edward and Theresa Caputo. In addition, he’s promoted unproven (and almost certainly nonexistent) links between cell phones and breast cancer, GMO fear mongering,  By 2014, Dr. Oz’s reputation for quackery had gotten so bad that he was increasingly facing less than adoring press and was hauled before Senator Claire McCaskill’s (D-MO) committee for his unscrupulous boosterism for unproven weight loss supplements, where he was soundly humbled. All of this happened long before the pandemic hit. Indeed, Dr. Oz even once had Mike Adams—yes, that Mike Adams, founder of Natural News!—as a guest on his show.

There was also the dishonest and biased treatment of actual experts who made the mistake of agreeing to be on The Dr. Oz Show. Lunny reports about one aspect of Dr. Oz’s grift with which I had not been familiar:

In the fall of 2012, Dr. Alison Van Eenennaam and Dr. Martina Newell-McGloughlin appeared on The Dr. Oz Show. Both highly accredited, well-respected researchers, Van Eenennaam and Newell-McGloughlin were aware of the show’s record of scientific delinquency, especially when it came to their own fields: Oz had been waging a campaign against genetically modified organisms for years despite scientific consensus contradicting his claims of the overwhelming harms of GMOs. Van Eenennaam worried that an appearance by a pair of scientists might confer legitimacy on what she considered “a science-fiction show,” but when producers reached out to her and McGloughlin saying that Oz intended to host a good-faith debate about the effects of GMOs, they agreed to appear.

However, during initial conversations, it became apparent that the show’s producers had misrepresented its intentions. The show had arranged for the anti-GMO side of the debate to be represented by CEO of organic yogurt company Stonyfield Farm Gary Hirshberg, who bore no scientific credentials. What Hirshberg did have, however, was a vested financial and political interest in an upcoming California referendum on GMO labeling. Oz, too, had a financial interest at stake; his show was sponsored by a number of organic food companies, and his wife Lisa Oz, was actively involved in campaigning for GMO labeling in the California referendum.

I say again: Quelle surprise. It turns out that behavior like this on his TV show was very much of a piece with his academic behavior, which in retrospect strikes me as a warmup for his TV grift. Perhaps the most disturbing issue to me has been the recently revealed scandal about mistreatment of animals in Dr. Oz’s research program at Columbia. First, by around 2000, the first iteration of Dr. Oz’s Cardiac Complementary Care Center shut down due to disagreements between Whitworth and Oz, but that didn’t stop Dr. Oz, who just Oz rebranded the program as the Cardiovascular Institute and Integrative Medicine Program, and continued it under CUIMC.

Then:

During the time that Oz operated the center, he was implicated in a research scandal in which Columbia paid a $2,000 settlement to the U.S. Department of Agriculture for a series of studies in which the USDA alleged that dogs and primates were mistreated, with some dogs injected with expired drugs. The incident has recently resurfaced on Twitter, where posts denouncing Oz, who was the principal investigator on the studies, as a “puppy killer” abound, and in campaign ads against Oz. Such language contains a degree of exaggeration: As a PI, it is unclear whether Oz was involved in the daily operations of these studies, although PETA records claim that Oz had direct physical involvement in carrying out research on the dogs. Despite the alleged animal abuse and the USDA lawsuit against the University, Oz and others published findings from the studies in five papers between 2007 and 2009.

In the years that followed the incident, the National Institute of Health declined to fund Oz’s research. By the end of 2007, the Integrative Medicine Program was absent from the list of Vagelos and CUIMC centers, departments, and programs in Columbia’s annual report, though it had previously appeared in this list every year since its creation, and never returned to the list. For years to come, however, Oz’s name, appearing in media publications, would be accompanied by the title of co-founder and director of the Cardiovascular Institute and Integrative Medicine Program, although the program had apparently gone defunct.

When I first heard of this incident, my first reaction was simple. When you are principal investigator (PI) of a grant, you are responsible for everything about the research in that grant. If the animals were mistreated or had substandard veterinary care as part of that research, you are responsible, period. It matters not one whit if you ever personally had any contact with the animals. You are responsible. The attempts by Dr. Oz and his apologists absolve Dr. Oz of responsibility for the treatment of the dogs are, quite simply, dishonest. Personally, I was shocked that Columbia was. only fined $2,000. That’s not even a slap on the wrist.

Despite Dr. Oz’s fall after such a promising start to a career in academic surgery in the 1990s, Columbia nonetheless stuck by him. Tully notes that even after two unsuccessful research programs, and accusations of animal abuse, Dr. Oz nonetheless continued his rise at Columbia, where he was appointed the vice-chairman of the department of surgery at New York-Presbyterian Hospital/Columbia. Moreover, after his show started, Columbia apparently accommodated him with a much less rigorous clinical load. in 2010, Dr. Oz was still operating on as many as 200 patients a year. However, three years later he was only performing one operation per week.

Even after Dr. Oz’s promotion of quackery and embarrassment on national TV in front of Sen. McCaskill’s committee, the relationship continued:

In the years that followed, Oz continued to be entrenched in the University, not only on an academic level but in the University’s public presentation.

Between 2014 and 2018, Oz appeared in at least five promotional videos for the Department of Surgery. In 2021, Vagelos included him on a diversity panel; on October 19, 2021, a Facebook post shows him attending a showing of Moulin Rouge with “a dozen” other Columbia faculty members. In 2021, the University was also still advertising Oz as one of CUIMC’s “prominent faculty” on admissions pages.

And, at the height of the COVID-19 pandemic in 2020, Oz went on Fox News and misleadingly suggested that he was initiating a study at Columbia about hydroxychloroquine—the anti-malarial drug that Trump touted, without evidence, as a COVID-19 treatment. He offered the University a donation of 2,070 doses of hydroxychloroquine, along with $250,000 to fund a study of the drug, which the University eventually declined.

Yes, Dr. Oz did indeed promote COVID-19 misinformation early in the pandemic. He latched onto Didier Raoult’s poor quality studies promoting hydroxychloroquine as a cure (or at least highly effective treatment) for COVID-19. He was forced to apologize for having suggested that reopening schools was a “very appetizing” opportunity because it was estimated that it would “only” increase the number of COVID-19 deaths by 2-3%. And yet Columbia apparently only finally moved to severe ties with Dr. Oz after he had announced his plans to run for the Senate in Pennsylvania. All the previous scandals didn’t lead to at least a questioning of whether it was a good idea to keep Dr. Oz on its faculty or not. I don’t know if he had tenure (although I assume that he did), but there’s one thing about tenure in medical academia. It doesn’t mean nearly as much as it does for other academia, mainly because tenure only guarantees a physician’s academic salary and most academic physicians’ salaries derive more from clinical revenue than from their universities.

What the Dr. Oz story does demonstrate is what I’ve been talking about all along. Universities are far too tolerant of faculty who promote pseudoscience. After quoting a physician complaining about how Columbia had “enabled” Dr. Oz, Tully notes:

Some maintain that the University should have pressured him to resign, if not dismissed him outright. Allyse, who has called Oz a prime example of the loopholes in the medical profession’s ability to self-regulate, said that she would not have expected Oz to “do the right thing” and resign from Columbia. “I do think I would have expected Columbia to generate enough pressure. And so the fact that either they didn’t try, or they didn’t try hard enough—or Dr. Oz just has a really good lawyer, I don’t know—but there’s ways in which Columbia could have made known that they didn’t support him,” she added.

What this might have looked like in effect could have included challenging Oz on the disclosures that faculty are required to make to the University on outside commitments. Oz’s main external commitment, The Dr. Oz Show may have created conflicts in several categories that the University could have challenged him on: conflict of interest or of commitment, inappropriate use of the University name, and, above all, effect on academic judgment.

That’s one thing I never understood. The Dr. Oz Show was at least a half-time job; that is, if one assumes that the producers did most of the work and that Oz mainly just showed up to tape the show and did a small amount of prep work. It could easily have been a full time job, though, as Dr. Oz was clearly heavily involved in planning what his show would feature.

However many hours per week Dr. Oz put in doing his show, however, I was always gobsmacked that any university would continue to employ him as full time faculty, much less as vice chair of a major department when he had that extensive of an outside commitment, and a very profitable outside commitment at that! Meanwhile, his patient load had fallen to a very low level, and he wasn’t doing any significant research anymore. The three pillars of medical academia are teaching, research, and patient care. If you aren’t doing very much of two of them, then you’d better be doing a lot of the third. There’s little evidence, though, that Dr. Oz was doing any significant teaching during his years on TV, his yearly session teaching anatomy of the heart to medical students notwithstanding.

The beginnings of Dr. Oz the carpetbagging politician who embraced MAGAism in the name of power can be seen in the ambitious young surgeon of 30 years ago. The thirst for fame and power was there, as was the willingness to deny or distort reality, which has only gotten worse with time. While it’s easy to understand why Columbia supported Dr. Oz 30 years ago, given his track record then, it became harder and harder to understand as his performance as a rising star in academic surgery drifted further into memory, to be replaced first by the believer in reiki faith healing and other alternative medicine and then by America’s quack hosting a grifting TV show. Unfortunately, come January 1 he could well be the new Senator from Pennsylvania, and it couldn’t have happened without Columbia University’s support.

Even if that happens, he’ll still be America’s Quack, although maybe I’ll call him Senator America’s Quack.