Tuesday, October 13, 2015

Off to see the wizard 2

Last week, I got a surprising email from a science-minded colleague who had recently appeared on The Dr. Oz Show. "They are taking the 'sticking by science' thing fairly seriously," he wrote.

This was intriguing. For years, Oz's health show, watched by millions, has been sharply criticized for promoting bad science and bogus health advice. The Federal Trade Commission had found that Oz's producers did the scantest research on the show's guests, which allowed modern-day snake oil salesmen to appear on air hawking bogus products. In April, Oz's colleagues at Columbia University argued the show was so misleading that Oz's professor position was incompatible with his on-air work, so he should be removed from the university's medical faculty.

But perhaps things were changing. This past summer, Oz had embarked on a "listening tour" with health professionals, in an attempt to understand how his brand of TV medicine affects public health — and how he might do better. If my colleague was right, Oz might well have taken the criticism to heart.

So I decided to investigate, randomly selecting 10 of the 20 episodes of his current season, which began on September 14. And what I found was actually refreshing.

In the past, Oz often promoted miracle supplements and fad foods. Now, in the shows I watched, he was focused more on debunking dubious products, explaining how science works, and urging informed consumerism among his viewers. Even some of the more borderline segments, like one on cryotherapy, had a more skeptical tone than shows of the past.

To be sure, The Dr. Oz Show is hardly an exemplar of scientific thinking. Oz still has a tendency to overpromise bold fixes to complex health problems, and he continues to sometimes mishandle evidence. But to his credit, he does seem to be taking seriously his promise to improve the rigor of his show.

Perhaps the best indication of how Oz's show has changed came on Friday, October 9.

The show started by taking a critical look at the flimsy science, which has gone viral in some circles, allegedly showing that kale is somehow bad for you because it absorbs heavy metals through its roots. (I dissected that myth here.) Oz didn't try to stoke the fears. Instead, he invited Holly Phillips, an MD and medical contributor to CBS News, to calmly explain why worries about kale were probably overblown.

Phillips noted that the studies drawing a link between kale and various ailments were mostly observational and not at all conclusive. Then she offered valuable context for this debate: Americans don't eat enough vegetables, period. Too much kale is the least of their worries when the real concern should be too few greens.

What's more, Oz stressed to his viewers that they should be cautious about many popular health claims they see or hear. "Information is pushed around these days," Oz said, until someone's "mom starts sending out letters and our friend kale started taking a bit of a beating." (This was particularly amusing to me, because I'd often written articles debunking wild claims that first appeared on Oz's show after getting emails from my mom about them.)

Courtesy of:  http://www.medpagetoday.com/Transplantation/Transplantation/54066?isalert=1&uun=g906366d4586R5793688u&xid=NL_breakingnews_2015-10-13


  1. A prior submission by the author of the preceding:

    It's a dark and biting March morning on Manhattan's Upper West Side. Lilly is standing outside ABC's brick studio building, waiting to be let in to watch a live taping of Dr. Mehmet Oz's television show.

    "I've been here since 7 am," she says.

    Though the sun is barely out, her phone is buzzing with text messages from nearly every member of her family — all Oz-lovers excited about her peek behind the curtain.

    They're not alone. Dr. Oz is arguably the most influential health professional in America. The Dr. Oz Show, which started in 2009, has an average audience of more than 4 million people each day in 118 countries. He has his own magazine (The Good Life) and syndicated columns that have run in the most widely read periodicals in North America. He has radio segments, about a dozen books, and the show's website — a go-to resource on medical questions for millions. He has millions of followers on his Facebook, Twitter, Pinterest, and YouTube accounts, and a starring role on the new medical reality show NY Med. Across all these channels, he preaches the same message: you can take control of your health with simple tricks and natural remedies...

    After covering Oz for several years, I'm fascinated by him. How did a gifted, award-winning cardiothoracic surgeon with credentials from three Ivy League schools become a TV star who promotes belly-fat busters and anti-aging tricks? I'm also intrigued by the hold he has on his fans. Why do so many people place their trust — and their health — in the hands of a TV personality? What does his popularity say about Americans' attitudes toward science?

    I spoke to dozens of Oz's colleagues, mentors, and other health professionals who have been touched by the surgeon or his work, some who've known the man since his early days fresh out of the University of Pennsylvania and Harvard. I read his early books. I talked to his fans — including my own mother. I found out that the roots of Oz's experimentation with alternative techniques go all the way back to his childhood, and that his departures from evidence-based medicine have gotten more extreme as he's become more famous. I also learned that the making of Dr. Oz says more about America's approach to health than it does about its most famous doctor...(continued)

  2. (continued) Oz has achieved some of the greatest scientific accomplishments of his career at Columbia. While a resident there, he was the four-time winner of the prestigious Blakemore research prize, which goes to the most outstanding surgery resident. He now holds 11 patents for inventing methods and devices involved in heart surgeries and transplants. This includes helping to research and develop the left ventricular assist device, or LVAD, which helps keep people alive while they're awaiting a heart transplant. Oz had a hand in turning the hospital's LVAD program into one of the biggest and most active in the world…

    "When he was young and just starting out," Argenziano said, "[Oz] was practicing what he's now preaching. He was always very committed to preventive medicine, holistic natural health."

    In the early ‘90s, according to Argenziano, Oz could often be found in his lab, studying "alternative medicine, hypnosis, Eastern medicine, all that stuff — guided imagery, acupuncture." Argenziano added, "That was 10 years before he ever went on TV."...

    They also used audiotapes to try to subconsciously relax patients before surgery and brought reiki — or "energy medicine" — into the operating room. Reiki, an ancient Japanese healing art, has never been shown in scientific studies to alter the outcomes of patients. One high-quality study on the effect of reiki on pain in women after C-sections showed that it had no effect. Science-based thinkers have wondered whether it's ethical to continue studying reiki, given that we know it works no better than a placebo and we may be diverting funds from treatments that could actually help people...

    When I asked Argenziano about Oz's turn toward entertainment and the recent criticisms of his use of science, he was dismissive, describing Oz's tactics as a tradeoff for helping people.

    "Mehmet is not immune to the pressures of production schedules, ratings drives," Argenziano said. "You have a daily show millions of people are tuning into. People are wanting and asking for advice on issues like weight loss and health. So does he sometimes use more flowery language than you might if you were looking at something truly scientifically? Maybe."


  3. All that said, there was room for improvement. For example, Oz included a segment on cryotherapy, which involves submerging your body in extreme cold (-200˚F) for the promise of a range of health benefits, including weight loss and faster recovery after exercise.

    There's a lot of debate among researchers about whether it actually works, but the show's "expert" was someone who happens to be a managing partner at a cryotherapy company and wasn't exactly primed to give a critical look at the evidence. So overall, the segment wasn't very balanced at all, and even featuring two cryotherapy fans who talked up the machine as a fountain of youth that made their cellulite disappear.

    Another segment discussed the "short burst diet," in which people severely restrict their calories for five days every month. Right now, there's little evidence one way or the other on whether this works. But the show seemed to veer at times into hype rather than critical thinking.

    Michael Roizen — an anesthesiologist and Oz's partner in crime — talked up speculative research showing that the diet may help people's stem cells reproduce. "It may just help you get real young," he said. He also offered his own made-for-TV science experiment, featuring two women who said the diet worked for them, helping to flatten their bellies and boost their energy.

    To their credit, Oz and Roizen did later point out that many of the short-burst dieting studies have only involved small samples of people, and that the stem cell research had been done mostly on yeast and mice so far. But the audience testimonials and Roizen's plugging probably overshadowed those caveats...

    At first, Oz fought back against these criticisms, even at one point claiming — ridiculously — that his was not a medical show. (For the record, he's worn blue scrubs on every episode I watched.) But he later seemed to soften, and went on a summer listening tour with health professionals across the country. He does seem to be taking these criticisms seriously. All told, there was far more skepticism and talk of science in this season compared with similar episodes in previous seasons. Still, it remains to be seen if he can stick with this new format — while maintaining his popularity.


  4. In 2012, when I started writing about Dr. Oz, I was one of a few critical voices in the mainstream media. (There were plenty of bloggers already criticizing him.) The most comprehensive profile of Oz around that time ran in the New York Times, and it glorified him.

    There were — and still are — plenty of reasons to be skeptical about Oz's medical advice. Oz has long been a proponent of homeopathy, an alternative therapy, despite the fact that it defies the basic laws of science and has been shown in numerous studies to be useless.

    He used his own made-for-TV studies to suggest little kids are getting poisoned by arsenic in apple juice (when the Food and Drug Administration has shown this isn't true), and to promise his audience that green coffee bean supplements "burn fat fast for anyone who wants to lose weight." He has featured discredited research that claims genetically modified foods are harmful to humans, stoking fears about the foods.

    Many guests on Oz's show also endorse questionable health claims, particularly in pursuit of profit. Monica Seles, the star tennis player, recently appeared in a segment about binge eating. At the time, she was a paid spokesperson for the drugmaker Shire, which recently won FDA approval for the binge-eating drug Vyvanse.

    Oz has shared the stage with vaccine deniers, and activists like the Food Babe (known to scientists as "the Jenny McCarthy of food"). Recent investigations by the Federal Trade Commission show that at least one of his miracle-touting guests used the program as a platform to deceive audiences and sell products, capitalizing on the "Oz effect" — or the fact that whenever he so much as mentions a product, stores can't restock it quickly enough.

    At the height of the Ebola panic last year, Oz suggested the virus could go airborne — even though there was universal agreement among virologists that the pathogens have never behaved that way.

    Criticizing Oz is not always a popular position to take. Whenever I write a negative story about him, I get emails from fans explaining how the TV doctor helped them lose weight, eat more fibrous foods and fewer doughnuts, quit smoking, or all of the above.

    Oz's staff, unsurprisingly, doesn't like the criticism either.