Dr Oz Critics Spur AMA to Corral 'Media' Doctors

June 26, 2015

In what might be called a thinly veiled rebuke of Mehmet Oz, MD, the House of Delegates of the American Medical Association (AMA) earlier this month adopted two resolutions that seek to hold physicians accountable for the advice they dispense through mass media.

One resolution, sponsored by medical students along with residents and fellows at the AMA's annual meeting in Chicago, called on the association to issue a report on the professional obligations of such physicians and how wayward ones might be disciplined by regulatory bodies. The resolution also directs the AMA to go on the record denouncing the spread of dubious information and affirming the need for physicians in the media to adhere to evidence-based medicine.

A second resolution sponsored just by the residents and fellows section of the House of Delegates encourages physicians who make public statements about health and science to disclose whether their positions "are based on published peer reviewed evidence, standard of care, or personal opinion."

The two resolutions did not mention Dr Oz or his television show, but deliberations leading up to the votes did, owing to the "whereas" preambles that accompanied each measure. The whereas section of the joint resolution from the medical students and residents originally called out The Dr. Oz Show for dispensing mostly unproven advice and generally not disclosing potential conflicts of interest. However, these references to Dr Oz and his program were removed before the House of Delegates voted, according to a medical school delegate in attendance.

The whereas section of the other resolution noted that the Senate held hearings last year on "false treatment ads by the popular TV show The Dr. Oz Show." This point made it to the conference floor intact, although delegates adopted only the resolution per se. According to the AMA, the whereas section of a resolution isn't part of the vote because it reflects merely the sponsor's opinions.

The AMA policy deliberations, set off by a youth movement in organized medicine, cap a springtime of flak for the cardiothoracic surgeon-turned TV health guru. In April, 10 physicians from across the country urged Columbia University in a letter to fire Dr Oz from his academic post there for allegedly ditching evidence-based medicine on his show and irrationally opposing genetically modified foods. Later that month, eight members of the Columbia faculty opined in USA Today that Dr Oz's "unsubstantiated" advice on TV sullies the school's reputation. They did not call for his ouster, however.

Dr Oz issued a bristling response to the physicians who wanted him dismissed from Columbia, calling some of them shills for Big Agriculture. He was more conciliatory toward his Columbia colleagues, and that tone characterized his response to the votes by the AMA House of Delegates.

"I am encouraged by any dialogue that seeks to improve healthcare in our country," he said in a statement emailed to Medscape Medical News. "Indeed the goals they have expressed are the same goals I have held for my own show since our very first episode."

Dr Oz said he would continue to collaborate with major medical societies and his colleagues to "share credible information with patients more effectively."

Dr Oz spokesperson Tim Sullivan told Medscape Medical News that "if the AMA is saying that doctors in the media should be accurate, we fully support that idea."

Difficult Conversations With Patients

The resolution cosponsored by the AMA's medical-student section represents a 2-year odyssey for Benjamin Mazer, a third-year student at the University of Rochester School of Medicine and Dentistry in New York. Mazer, the resolution's coauthor, persuaded his state's medical society in 2013 to propose a similar measure to the AMA House of Delegates, but it went nowhere.

Benjamin Mazer

"We're a profession and a profession needs to self-regulate," Mazer told Medscape Medical News. "The public is only going to trust us if we call out doctors who are harming others."

Mazer said that he began to look askance at The Dr. Oz Show when he encountered patients who would refuse standard medications for chronic conditions such as diabetes and hypertension because they put their faith in Oz-endorsed products, such as green coffee bean supplements for losing weight. In a settlement with the Federal Trade Commission, one seller of green coffee bean supplements who had appeared on the show agreed to stop making weight-loss claims until they were proven.

Patient beliefs about what treatments worked best "produced some difficult conversations," said Mazer. "It was hard for us to connect."

The problem with alternative treatments promoted on The Dr. Oz Show, he said, is not that they're necessarily harmful in and of themselves, but that they distract patients from "proven medications."

Mazer said he agrees with Dr Oz that proper nutrition and exercise are building blocks for well-being, but objects to how Dr Oz lumps these health virtues together with unproven alternative treatments in the same breath. "He conflates reasonable interventions with frankly crazy interventions," Mazer said, adding that the craziness is getting worse. He points to several episodes on The Dr. Oz Show last year titled "How You Can Use Angels to Heal."

The medical student operates a blog called Doctors in Oz that aims to expose "quacks in the media."

"As medical professionals we are coming together to tell the public about the real harms we are witnessing," the blog states on its mission page.

Although Mazer helped write the resolution submitted by the AMA's medical student and residents/fellow sections at the group's convention in Chicago earlier this month, his school schedule prevented him from attending. However, other medical students such as resolution coauthor Joy Lee politicked for the resolution's passage in person. They talked up the issue of media physicians with various sections and caucuses of the House of Delegates as well as state medical society delegations, said Lee, a third-year student at Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey.

Lee told Medscape Medical News that she agreed with a decision by AMA staff to omit references to Dr Oz and his television show in the whereas preamble of the resolution before the vote.

"We didn't think it was appropriate for the AMA to call out a single doctor in a non-disciplinary forum," she said. "We're not trying to crucify anyone. We're looking to set a standard of practice for future physicians going down this road."

Nevertheless, Dr Oz's name came up during testimony on the resolution, Lee said. "It was generally understood that this resolution was prompted by the media controversy that has surrounded him."

The resolution passed with an overwhelming voice vote, she said.

Oz Show Announces New Steps to Strengthen Ties With Physicians

After getting criticized publicly by physicians inside and outside his university, Dr Oz announced earlier this month that he was hiring preventive medicine specialist Michael Crupain, MD, a staffer at Consumer Reports magazine, to head the medical unit of The Dr. Oz Show. Dr Crupain directs the magazine's Food Safety and Sustainability Center.

A news release from Dr Oz's program described Dr Crupain as a proponent of evidence-based medicine who would "lead efforts to enhance the show's ongoing dialogue with the medical community."

Earlier this week, Dr Oz spokesperson Tim Sullivan disclosed two initiatives aimed at improving this dialogue. The show's website this fall will feature a section called "Clinician's Corner" that presents the scientific evidence for each segment aired. Sullivan noted that individuals often misquote information from the show in conversations with their physicians. "“Clinician's Corner" will set the record straight.

The television show also will start sending out a weekly email newsletter to subscribing physicians announcing what Dr Oz will discuss on future episodes. This heads-up can help physicians prepare for the inevitable questions from patients who watch the show.

Unexpected patient questions stemming from The Dr. Oz Show have "caused a lot of consternation" among physicians, Sullivan said. "We don't want to surprise anyone."

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