Should Dr Oz, a Prominent Surgeon, Be Fired for Quackery?

Neil Chesanow

Disclosures

September 23, 2015

Rein It In, Dr Oz

Mehmet Oz, by most accounts, is a talented cardiothoracic surgeon on the faculty at Columbia University's College of Physicians and Surgeons in New York.

But there is a very different Dr Oz, a TV personality with a huge following who endorses plant-based "magic" weight-loss cures; communicating with the dead to reduce stress; homeopathy; "miracle" appetite suppressants; using Reiki, or "healing energy," to help patients survive risky surgery,[1] and many other "magic" remedies and "miracle" cures for which there isn't much or any medical evidence.

Equally controversially, Dr Oz has waged a one-doctor war against genetically modified foods, prompting 10 prominent physicians to write to Columbia saying he should go.

In a Medscape video, Arthur L. Caplan, PhD, director of the Division of Medical Ethics at New York University's Langone Medical Center, examined the ethics of the situation Dr Oz poses for doctors and their patients.

"Many doctors tell me that when Dr Oz endorses something—green coffee beans, some neti pot to cure the common cold—whatever it is, they are going to be asked about it, and their patients run out and buy it," Dr Caplan concedes. But with that power comes responsibility, he says.

"One problem he has is that he is fishing to keep the eyeballs attached to the show, and that is why we see the psychic healers, the psychic surgeons, the people who talk to the dead, and the people who endorse diet regimens, saying, 'Look at the testimonies.' We even see a bit of the antivaccine message. All of this fuels people paying attention to the show."

"It's a fine line, but he has to walk it more closely," Dr Caplan concludes.

"So, Dr Oz, I say keep your job, keep your platform, and keep communicating, but let's rein in the message."

The video sparked over 200 thoughtful, provocative comments from physicians. They largely fell into three groups. The largest group by far was highly critical of Dr Oz's touting of non-evidence-based treatment and cures, but a substantial minority of our commenters were not so sure that Dr Oz had wandered as far off the range as the majority of doctors believe. Several doctors took Dr Caplan to task for, as they saw it, taking a soft line with Dr Oz and letting him off the hook.

"I have seen The Dr Oz Show a few times, and I hear patients listen to it on the TV in my waiting room," an ophthalmologist remarked in a typical comment. "His 'message' and forum have deteriorated over time. He makes ridiculous claims concerning diets and supplements. In addition, there are numerous Dr Oz emails soliciting people to buy these items. He should stop these endorsements."

"Dr Oz is enriching himself by endorsing products that are of no proven medical value," an emergency physician contended. "He is reimbursed by the sellers of those products. This behavior is unethical and violates antikickback laws, at least in spirit."

"Snake oil, magic beans, and fairy dust pay lots better than ethical medicine," a gastroenterologist wrote. "Dr Oz sold out to the nutraceutical/herbal-industrial complex long ago. Celebrity and wealth are intoxicating."

"He started out so well by touting some well-documented 'alternative medicine' studies," a pediatrician lamented. "It is too bad the way success can corrupt. The thing snowballs to where one can never get enough praise or money. So sad."

"Dr Oz is successful because he is attractive to his middle-aged female audience and is endorsed by Oprah, for God's sake," a radiologist opined. "It is a shame, but that is the way it is, and what middle-aged woman doesn't want to be told by a handsome doctor that she can lose weight with magic beans and all of the other foolishness on his show. He is a good entertainer for that audience, but let's not call it'medicine.'"

"'They' keep talking about evidence-evidence-evidence!" commented a general practitioner. "There is no evidence for many of these things because no one is willing to pay to have the research done. Drug companies don't see any value in it because they can't make money with it, and nonpharma companies don't have the millions necessary to do this type of research. So it is very easy to throw stones at all of these things, but the truth is, there is no research either way. The people against what Dr Oz is doing can't prove through research that these things do not work any more than it can be proved through research that they do work. If 'they' are so concerned, then all these people should pool their money together and do the research necessary to either prove or disprove the efficacy of these items."

"The critics of Dr Oz miss an important fact: Whatever special food or vitamin is recommended, there is no way to conduct a valid scientific study to determine its efficacy," an otolaryngologist agreed. "Studies cost money. Should Dr Oz deny information that might help others because it hasn't had a study? I don't think so. When someone like him recommends vitamin X, the listener has the choice of trying it or not. My insistent recommendation for tai chi for dizziness has yet to be proven, but that doesn't mean that I should stop recommending it. Critics of Dr Oz should more correctly focus on the mechanisms of why certain products do have a beneficial effect. Besides, I have no choice. My wife watches his show."

"It is quite shocking and depressing when even a professional ethicist can't be relied on to promote ethics," one doctor wrote. "There's no denying that Dr Oz has promoted quackery. The ethicist here simply says that the practice is understandable due to the need to keep attention. That's like an ethicist saying he understands why a thief has stolen; he really needed the money. Dr Oz refuses to admit that he has done anything wrong. At a time when basic science and basic facts are under attack, Dr Oz is the worst possible example of our profession. He should be fired. It makes no sense for an ethicist to say this shouldn't happen because the guy is popular."

"Making excuses for Dr Oz—'He has to maintain his audience or be driven off the tube'—is simply pandering," a geriatrician believed. "If this is your idea of ethics, you need a refresher course!"

A vascular surgeon suggested a shrewd question we would love to hear posed to Dr Oz himself: "I wonder where he gets the time to sell snake oil and then do cardiovascular surgery?" this doctor asked. "What does he tell his patients before they sign an informed consent before surgery? 'Oh, by the way, the alternative to surgery is this snake oil. Do you want surgery or snake oil?'"

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