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A Skeptic In Oz

UPDATE 4/27/2011: Here’s the online video of Dr. Novella’s appearance on The Dr. Oz Show:

  1. Controversial Medicine: Alternative Health, Part 1
  2. Controversial Medicine: Alternative Health, Part 2
  3. Controversial Medicine: Alternative Health, Part 3

I must say I was a bit shocked two weeks ago when I was contacted by a producer for The Dr. Oz Show inviting me on to discuss alternative medicine. We have been quite critical of Dr. Mehmet Oz over his promotion of dubious medical treatments and practitioners, and I wondered if they were aware of the extent of our criticism (they were, it turns out).

Despite the many cautions I received from friends and colleagues (along with support as well) – I am always willing to engage those with whom I disagree. I knew it was a risk going into a forum completely controlled by someone who does not appear to look kindly upon my point of view, but a risk worth taking. I could only hope I was given the opportunity to make my case (and that it would survive the editing process).

The Process

Of course, everyone was extremely friendly throughout the entire process, including Dr. Oz himself (of that I never had any doubt). The taping itself went reasonably well. I was given what seemed a good opportunity to make my points. However, Dr. Oz did reserve for himself the privilege of getting in the last word—including a rather long finale, to which I had no opportunity to respond. Fine—it’s his show, and I knew what I was getting into. It would have been classy for him to give an adversarial guest the last word, or at least an opportunity to respond, but I can’t say I expected it.

In the end I decided that I had survived the taping of the show and did fairly well. After watching the final version that aired I feel that the editing was fair. They allowed me to make my major points, and did not change anything significant about the discussion. Again, the real problem was that Dr. Oz controlled the framing of the discussion and made many fallacious points at the end that I was given no opportunity to respond to.

What are you afraid of?

But enough about the process—let’s get to the meat of our discussion. I knew that no matter what happened on the show, I would have the opportunity to give my unfettered analysis here at SBM—so here it is. I knew going in that the biggest challenge would be the way in which Dr. Oz framed the debate, and right at the beginning this was evident. The name of the segment was “Why your doctor is afraid of alternative health.”

David Gorski has already pointed out the obvious – we are not afraid of anything. Dr. Oz tried to make it seem as though doctors are afraid of the controversy, because it will result in professional criticism. He accused me (he spent a lot of time arguing against straw men of his own creation) of not wanting to discuss so-called alternative medicine, either professionally or with my patients.

Here is where being a skeptic who deals with a wide range of issues comes in handy. We get the same exact nonsense from believers in alien visitation, psychic phenomena, ghosts, or whatever – they naively and self-servingly assume that anyone who disagrees with them must be afraid of something. The reality is we are just interested in the truth. With respect to medicine, we want to do our professional due diligence to make sure that the treatments we recommend to our patients are based upon the best scientific evidence available. We take the dictum “first do no harm” very seriously – and the only way to be sure that you are not causing harm is to rely on objective, high-quality evidence. It is always about the scientific evidence. But proponents of modalities that are not backed by evidence, like Dr. Oz, desperately want to make the debate about something else. So they invent issues that don’t exist, such as being afraid.

It is also patently untrue that my colleagues and I don’t want to discuss alternative medicine. Quite the contrary: if anything, we are accused of discussing it too much. We spend a great deal of time acquiring expertise in a long list of sectarian and controversial treatments, so that we can discuss them with authority. I talk to my patients all the time about treatments considered “alternative” (if you haven’t figured it out yet, this is a term we do not like because it encourages a false-dichotomy and is a distraction from the key question – whether it is safe and effective). They ask me questions, and I give them evidence-based answers, without judgment or fear.

I find that my patients greatly appreciate that I have taken the time to understand the research on such topics and can give them accurate, no-nonsense information they can use. This is essential for informed consent, which is part of medical ethics.

In short, we are not afraid of anything. We want there to be open debate and discussion. We want to shed as much light as possible on controversial and “alternative” methods, because we feel the public and individual patients will benefit from having all the information. SBM is largely dedicated to providing that information. Our criticism of Dr. Oz and others who promote such modalities is that they give the public partial or distorted information – often grossly so.

A recent example is an episode a few weeks ago in which Dr. Oz uncritically promoted homeopathy. He told his audience that the evidence shows that homeopathy works, even if the mechanism may be mysterious. He stated this as a non-controversial fact, which was very misleading. Every objective review of the clinical evidence demonstrates that homeopathic products do not work for any indication.

A Stent and a Statin

Another example of the dissemination of biased or partial information comes from the other guest appearing on that segment with me, Dr. Mimi Guarneri. Her schtick is that she is an interventional cardiologist who became disillusioned with mainstream medicine and was drawn to the focus on preventive measures in alternative medicine. This, of course, is complete fiction – nothing but marketing hype by promoters of dubious treatments.

On the show she summarized the mainstream approach to heart disease by saying that, as a conventional doctor, the only tools she had in front of her were a “stent and a statin.” This is nice alliteration, and I’m sure it plays well with her target demographic, but it is highly deceptive. Calling such a statement “unfair” is being charitable.

I pointed out during taping that science-based medicine has identified and actively promotes many modalities for preventing heart attacks, in addition to stenting blockages and using statin medication to lower blood cholesterol. These include diet for weight and cholesterol control, exercise, controlling diabetes, controlling high blood pressure, and using ‘blood thinners’ like aspirin.

I could have added that scientific studies are also looking into the role of chronic anti-inflammatory treatments (perhaps it is the anti-inflammatory effects and not the anti-platelet effects of aspirin that are most effective in preventing heart attacks). There are frequently published studies examining every aspect of diet to see which factors are most helpful. A diet with excess simple sugars may also be detrimental, although its exact contribution remains controversial. And just about every vitamin has been looked at for its preventive effects (which turn out to be modest, and high doses of vitamin E may actually increase heart disease risk). The benefits of stress reduction have been clearly established by scientific studies, and is also part of standard recommendations.

Modern medicine has examined every nook and cranny of heart disease prevention, and continues to do so as new ideas come to light. Where are the great innovations to cardiac disease prevention brought by so-called alternative medicine? They appear to be non-existent – except for dubious claims made for superstition-based treatments that were rejected long ago by science.

This is the kind of ideologically-driven misinformation that has earned Dr. Oz our criticism.

Heads I Win, Tails I Win – Now Stop Being so Dismissive

If there were any doubt where Dr. Oz is ideologically, he removed it during this episode. He clearly staked out the anti-scientific ground that most defenders of alternative medicine use to dismiss criticism of their claims. Make no mistake – at its heart the disagreement between defenders of science-based medicine and promoters of alternative medicine is an ideological struggle over the role of science in medicine. We have made our position at SBM clear (which also reflects the consensus opinion in the medical profession) – science is the best method for determining which medical interventions are safe and effective and which are not.

Promoters of alternative medicine only pay inconsistent lip-service to science, but the core of their philosophy is that science is optional. They rely upon the fact that to many non-scientists, the word “science” is sufficiently arcane that they can use the term to generate confusion.

What we mean by “science”, however, is simply rigorous methods of observation. Good science looks at all the evidence (rather than cherry picking only favorable evidence), controls for variables so we can identify what is actually working, uses blinded observations so as to minimize the effects of bias, and uses internally consistent logic.

So when promoters of alternative medicine claim that science is not always the best method to test their claims, which part are they willing to reject? Perhaps they want to dismiss inconvenient evidence, or use logical fallacies, or sloppy research methods, or just make things up as they go along.

Dr. Oz played this game during the show as well. He claimed that for many “alternative” modalities there is scientific evidence to back them up. But he focused on herbal therapy to make his point. This a bit of the bait and switch (and why the false category of “alternative medicine” is counterproductive). Herbal remedies are not really alternative – they have been part of scientific medicine for decades, if not centuries. There is even a research specialty focusing on pharmacognosy – or using natural sources for drug development. Herbs are drugs, and they can be studied as drugs. My problem is with the regulation and marketing of specific herbal products, because they often make claims that are not backed by evidence.

But there is no a priori reason to think that any particular herbal drug will or will not be safe and effective. It just needs to be properly studied.

For modalities where there is some evidence of efficacy, Dr. Oz is all in favor of science. But when the discussion turned to acupuncture, where the evidence is largely negative, Dr. Oz suddenly characterized reliance on “Western” science (another false dichotomy) as arrogant and dismissive. Western science, he argued, cannot wrap its collective head around something as Eastern and mysterious as acupuncture (although he recoiled when I characterized this approach as mysticism – again, he seems to want to have it both ways).

This is a clearly anti-scientific attitude. When studies are positive, science is great. When studies are negative, Western science cannot fathom alternative medicine and relying on research is “arrogant.” Heads I win, tails I win.

Never mind that much of the acupuncture research is designed in cooperation with, and executed by acupuncturists. They signed off on the research and certainly would have claimed support if the studies turned out positive. In fact, they’ve even tried to claim, as ‘positive,’ studies that were completely negative – another example of deception in the world of alternative medicine.

I wish I’d had the opportunity to ask Dr. Oz exactly what is it about “Western” science that makes it incapable of detecting any real physiological effect from acupuncture or a similar method. This is the same intellectual failing as claiming that Bigfoot can turn invisible at will, to explain why there are no good pictures of him. Or that psychic powers do not function in the presence of skeptics.

This is a logical fallacy (special pleading) with which we are very familiar. Ironically, it is a very dismissive attitude – the casual dismissal of scientific evidence simply because it contradicts a pet belief. The scientific approach, of course, is to look fairly at all the evidence – a process that Dr. Oz unfairly characterized as “dismissive.”

Conclusion

In the end I am glad for the opportunity to expose science-based medicine to a wider audience. Despite the accusation that we are “afraid” of alternative medicine, we are anxious to address it head on. Honest and open intellectual discourse is the way to work out such differences of opinion and approach, and we are confident in our ability to defend science-based medicine.

I wonder if Dr. Oz is as confident. I was happy to go into his forum, where he and his producers controlled the conversation. In return I invite Dr. Oz to continue our discussion, either in written form here at SBM or on my podcast, the Skeptics’ Guide to the Universe. We have interviewed those on the “other side” before, and have given them essentially an unedited forum to express their opinions and answer questions. I passed this offer to Dr. Oz through his producer (but I don’t know if he actually received the invite, and I was not given the chance to make it directly during the taping of the show).

So I repeat the offer here in public. There is a lot to hash out about so-called alternative medicine and the role of science in medicine. Let’s continue the discussion, on SBM or the SGU – you have an open offer, Dr. Oz, and you obviously know how to contact me.

Additional commentary:

  1. Alternative Medicine: The Magic of Oz
  2. Dear Dr. Oz: I Just Think it’s Very Dismissive of You to Reject Reality
  3. The Dr. Oz Show: The Price is Right of Medical Woo
  4. Steve Novella goes to Oz
  5. Steve Novella on Dr. Oz
  6. Steven Novella on Dr. Oz
  7. Dr. Steven Novella vs. Dr. Oz

Posted in: Acupuncture, Herbs & Supplements, Homeopathy, Science and the Media

Leave a Comment (224) ↓

224 thoughts on “A Skeptic In Oz

  1. Sc00ter says:

    Until a better copy gets posted, here’s a quick and dirty link to the video of the entire segment with Steve – http://www.youtube.com/watch?v=GDrUEazNdAo

  2. ColinJagoe says:

    I have never watched that show, and likely never will again, but your 15 minutes were very good. You made some solid points. I did feel that he grandstanded a bit in his speeches and didn’t really address your concerns. He called you ‘dismissive’ and then dismissed your points. Typical I guess. But kudo’s Dr. N! Well done!

  3. rlquinn1980 says:

    When I first heard about this, I was worried (for reasons that have already been stated), but you did an excellent job!

    And, Happy Audubon Day, Dr. Novella! :)

  4. Spurll says:

    I would love to hear Dr. Oz interviewed on the SGU. I’m not optimistic, however.

  5. Watcher says:

    Dr. Oz keeps making the statement that Steve is being dismissive, to keep an open mind to other avenues of affect not available to SBM. I find it interesting that he in turn is dismissive of the majority of evidence that shows things like acupuncture and homeopathy as no better than placebo effect.

  6. Harriet Hall says:

    Your response could have been titled “Why Dr. Oz is afraid of science-based medicine.”

    You went on his forum; in all fairness, he should now come on yours.

  7. superdave says:

    I think you did a great job and it’s a shame you couldn’t plug this site directly. When watching debates like this I always wonder what someone totally unbiased might think. Your logic seemed pretty flawless to me. I don’t see how anyone could disagree with anything you said except by calling you an outright liar.

  8. tmac57 says:

    All things considered, given the time constraints,I was satisfied by the amount of time you were given to make your case,and it didn’t appear to be overly edited.Having said that though, 15 minutes was far too inadequate for a discussion as contentious as this one,and had they allowed the entire hour to be on this topic,it would not have been enough.But good job Dr.,you came off as confident and knowledgeable.
    I hope that Dr. Oz will accept your offer.By the way,someone on Oz’s discussion group for alternative medicine made this comment:

    Dr Oz recently (Tuesday, April26/11), had a doctor on who was against all alternative medicine. He made sweeping statements about all the evidence that disproves everything from acupuncture to meditation to supplements. Apparently the millions of people around the world who have benefitted from acupunture, for example, have all imagined their improvements. Wow. The biggest problem with doctors who are willing to negate these medicines and treatments is what nobody talks about: many doctors work for universities that are heavily funded by the pharmaceutical industry, and alternative treatments profoundly infringe on the profits from the drugs that they push.

    and then concluded with

    I wonder how much money Yale has received from pharmaceutical companies, which is where this quack is from.

    Yeah,that’s you Steve…the big pharma shill ;)

  9. tmac57 says:

    Well damn!Sc00ter scooped me.That’s what I get for not practicing in typing school :(

  10. Jann Bellamy says:

    I’ve already commented on Dr. Gorski’s post, but here’s another thought: I’ve created a natural therapy for Dr. Oz’s patients. It avoids drugs and surgery but has the same benefits. I call it quantum synergy functional energy healing holistic cardio-thoracic-vascular-pulmonary mind-body touch therapy. It has no plausible basis in science and no evidence of effectiveness. I hope Dr. Oz is not afraid of my new therapy and won’t be dismissive of it.

  11. rlquinn1980 says:

    You went on his forum; in all fairness, he should now come on yours.

    Dr. Hall, would you (or anyone else) mind sharing the link? I’m having trouble finding it and would love to read Dr. Novella’s entry.

  12. Victor says:

    “Apparently the millions of people around the world who have benefitted from acupunture, for example, have all imagined their improvements. “

    Well … yes. That is that case.

  13. Richard says:

    Bravo, Dr. Novella! And congrats on your new position as Senior Fellow of JREF. I tried to post at their discussion site, but I didn’t see my post when I was finished. I am blind and use a screenreader, so maybe it didn’t post or maybe all posts are moderated before they appear publicly. I tried to post this Website on their discussion forum, but it may not have worked.

  14. rlquinn1980 says:

    Oh, wait. Forum in the dictionary sense. Never mind.

    ^ is what happens to mah brainz after a graveyard stint at the hospital and no sleep.

  15. Smed says:

    You did a fantastic job Steve!

  16. The Blind Watchmaker says:

    I just read the link provided by scooter and tmac57. Logical fallacy 101 really needs to be taught in middle school. Apparently, when doctors do not support methods that have been proven worthless or dangerous, we should not trust them because some doctor claimed that milk is good, while the milk industry funded his university. What???

  17. The Blind Watchmaker says:

    Bravo and thank you Steve.
    I think TV audiences need “The Skeptologist”. They are not ready for it, but they need it.

  18. decius says:

    Sc00ter, many thanks for taking the trouble, much appreciated. There’s little chance that this would air in Europe, I suppose.

  19. llewelly says:

    Thank you for your writeup of your experience.
    I continue to have mixed feelings about skeptics agreeing to appear in environments framed by anti-skeptics; they build environments inimical to the pursuit of truth, and few skeptics fare well there. Not having this show (will it be available online somewhere?), I will accept your word that it went well, but many of these events turn out very badly for the skeptic; they are largely about rhetorical skill and emotional manipulation.
    I hope some fraction of Dr. Oz’s audience takes the trouble to look for your blog(s), and your podcast, and read and listen to your arguments, and those of the others involved with SBM. (This I think is likely.) I hope that fraction will be greater than the fraction whose opinion of skeptics and science-based medicine is lowered by Dr. Oz’s deceptive framing. (This I think is unlikely.)

    Is there any way the audience could be scientifically studied for some clue as whether the there was an overall shift in opinion one way or another?

  20. Sastra says:

    Watcher wrote:

    I find it interesting that he in turn is dismissive of the majority of evidence that shows things like acupuncture and homeopathy as no better than placebo effect.

    Dr. Oz would probably have welcomed a reference to the “placebo effect,” since he (like most alt med advocates) seems to confuse it with a mysterious but powerful “mind/body connection” that defies material analysis.

    I don’t think Dr. Novella brought up the placebo effect, or explained its connection to regression to the mean, etc. Not sure if this was because he knew he wouldn’t have the time to do it properly, or because he was concerned Oz would use it as either a springboard for mind/body medicine, or an opportunity to complain that science-based doctors routinely deny the patient’s own experience of “getting/feeling better.”

    Harriet Hall wrote:

    You went on his forum; in all fairness, he should now come on yours.

    Harriet made a funny. You and your wry sense of humor…!

  21. Sastra says:

    By the way, although you weren’t given any opportunity to mention the Science-Based Medicine site (IIRC), there were 3 (!) screen shots of titles at Orac’s Respectful Insolence. It will be interesting to see if there’s any additional traffic in either place, as a direct result of the show.

  22. Spurll says:

    You did an excellent job, Dr. Novella: well done! It really bugged me that you specifically called out that there is a large body of evidence that these therapies don’t work, but Dr. Oz and his Munchkins insisted on responding as if you’d said that there isn’t any evidence that the therapies do work. Argh!

    But seriously, the editing seemed very fair and you came out sounding eminently reasonable. I look forward to a discussion of the experience on the next SGU!

  23. decius says:

    Steve, your eloquence and expertise shone through the hostile fog and you did very well indeed.

    I had read a few comments earlier in a private skeptical forum and I think I could pass on this bit of advice from a dear friend, who usually has some valuable insights.

    “Novella failed to connect with the audience in any way and that’s what it’s about. I agreed with every word Novella said, of course, but if he’s going to be doing this sort of thing he needs coaching so that he doesn’t look defensive. Maybe it was Oz’s fault for sticking Novella in what looked like an uncomfortable chair.”

    Without her alerting me to the more physical aspect of your performance, I wouldn’t have noticed that you also probably shouldn’t nod so much to flaming kooks as they vomit their crap. It can easily be mistaken for agreement and that impression couldn’t be corrected at the end, when you were deprived of a chance to reply.
    Perhaps both my friend and I are excessively concerned with inconsequential details, but you might consider showing the video to an expert on public speaking.

  24. WilliamLawrenceUtridge says:

    It’s a personal beef whenever people say “acupuncture/homeopathy/reiki is only in your/their/his/her head”. This implies that the change is purely psychogenic, that people are just being stupid by thinking their pain is less. Pain itself is an intrapsychic event, and it’s no surprise to think that other intrapsychic events can modify this – witness the Sun Dance where hooks are placed through the pectoral muscles to induce a fit of ecstasy, or the Indian festival of Garudan Thookkam. In both cases, there is rarely expressions of pain. The placebo effect is powerful, the mind’s ability to dissociate from pain when necessary is remarkable.

    What should be specified, is that the treatment has no direct effect – not that it’s ineffective. It’s very effective, just due to neurology rather than chemistry. I know about the placebo effect, I’ve read up on it, studied it, commented on it on this blog, edited the wikipedia page, bought the t-shirt. But I still benefit from it every time I take aspirin, ibuprofen, or even talk to my doctor, I feel better well before any intervention has any direct effect.

    The placebo effect affects us all, it’s just a matter of what triggers it. And we shouldn’t criticize people who benefit from interventions that could be tailor-made to maximize the placebo effect. T’ain’t right.

  25. Skeptic says:

    “The placebo effect affects us all, it’s just a matter of what triggers it. And we shouldn’t criticize people who benefit from interventions that could be tailor-made to maximize the placebo effect. T’ain’t right.”

    We should always point out when people are benefiting by placebo effect as opposed to treatment which is better than placebo. Not pointing it out “T’ain’t right.”

  26. llewelly says:

    I went and watched the clip Sc00ter provided (thank you, Sc00ter). It sounded much better than I expected. I heard a certain amount of seeming agitation in Steve’s voice, which I fear will bias many viewers against him. Interesting how Dr. Oz manages to frame the “$35 billion” spent (yearly?) on “alternative medicine” as a positive thing. I was very interested to see Orac’s classic headline “Dr. Oz’s journey to the Dark Side is now complete” appear while Dr. Oz is saying “From time to time, even I’ve been taken to task …”
    I am glad Steve started out by attacking the false framing introduced by the term “alternative medicine”.
    I did notice something of a (modest) Gish Gallop effect; Dr. Oz and his ally deployed more claims than Steve could readily address. Steve was given only a small portion of the total time.
    Dr. Oz’s arguments were well-voiced, but full of nonsensical leaps; (13:39) “Maybe we can harvest our immune cells to control cancers. Maybe you don’t want to know that; that’s darn hard to study. So my advice to everybody is customize therapy for yourself …”
    If something is hard to study, that does not imply that customization is the answer. On the contrary, it is much harder to understand what is happening if every patient is treated in a different manner. Where it works, customization has value because no two bodies are identical, not because some things are “darn hard to study”.
    And I won’t even try to decode “harvest our immune cells to control cancers”. WTF?

  27. rlquinn1980 says:

    decius’s friend said:

    I agreed with every word Novella said, of course, but if he’s going to be doing this sort of thing he needs coaching so that he doesn’t look defensive.

    He did not appear in any way defensive to me (although I’ll admit to possible bias on my part). He addressed each of Oz’s questions clearly and plainly, and never took any of the bait to turn it into an emotional or offensive-defensive contradiction. There’s any number of verbal and nonverbal cues he might have given that television viewers were never given the opportunity to see. Dr. Novella mentioned getting a laugh out of the audience. Even a single instance of this is enough to show some connection with the audience—at lease enough that the audience did not perceive him as “the enemy” not worth affording their humor.

    decius said:

    Without her alerting me to the more physical aspect of your performance, I wouldn’t have noticed that you also probably shouldn’t nod so much to flaming kooks as they vomit their crap. It can easily be mistaken for agreement and that impression couldn’t be corrected at the end, when you were deprived of a chance to reply.

    I’m willing to put real money down that Dr. Novella certainly did no such thing. A nod or two meaning “I understand,” sure, but if you watch his segment, a lot of the nods are edits. Count how many are given while the speaker is *not* in the same shot with Dr. Novella nodding. One in particular is very obvious: a long shot of Dr. Novella sitting normally in his chair, followed by a bust shot of him leaning forward, nodding, while someone’s woo is running on the audio.

  28. JPZ says:

    @ llewelly

    Theoretically, one could harvest naive T-cells (not easy in adults) and sensitize them against antigens expressed on the cancer cells that are not sufficiently antigenic to allow typical control of foreign proteins. Give them the proper proliferative signals and reintroduce them into the patient. I am not sure if anyone has done this successfully, but it is not bad science. The rest of it may be though. ;)

    @ Steve

    Steve, thanks for taking on your critics with rational discussion and science. I am still trying to find a clean copy of the show to see how it went.

  29. GLaDOS says:

    Good jorb Steve! Especially when you clarified that you weren’t dismissive; that you’d spent time reading the literature on acupuncture. I also liked your point about “alternative” medicine as a false category used to justify a double-standard.

    Sometimes your nods seemed ambiguous. I decided you meant, “Ok yeah whatever, go on…” but I imagine some viewers might think you meant, “yes, agreed.”

  30. addisontree says:

    Just watched the segment. Dr. Novella’s intelligence, rationality and good manners really contrasts the cheesiness of Oz and the others.

    If nothing else, that segment has to be setting up a little cognitive dissonance in at least a few of Dr. Oz’s fans. Put Dr. Oz on screen with someone who actually exercises their mental faculties and it’s astounding how obviously trivial Dr. Oz appears.

  31. decius says:

    Good points, rlquinn. As for the nodding, I kind of took for granted Steve’s concession that “the editing was fair”. Personally, I wouldn’t have said that if my nods had been pasted out of place.

  32. Larry Sarner says:

    Your appearance in the Land of Oz whetted my appetite for more. Confrontation that is.

    Oz (or his producers) made one critical mistake in their set-up (frame-up?) about the issue of CAM. They had Oz say that CAM was at its “tipping point” and strongly implied that Dr Oz was the major actor. He concluded with his main selling point (emphasis on “sales”): “Don’t let them take it away from you.” He was mobilizing his audience for Armageddon. They are spoiling for a fight.

    The mistake? Harpo Productions has made CAM front-and-center now. Believing their little TV show is on the front line of CAM imperial ambitions in the Culture Wars, and that Oz is an accomplished player, they are all in — and they have dragged all of CAM with them to the brink.

    So CAM’s gauntlet has been thrown. Steve, you of course know that they will never take you up on your offer to appear on SBM or SGU. That offer can, and will, be ignored with impunity. So instead, they should be given an offer they can’t refuse. Take up their gauntlet, but bring matters to the fore. If this is really the tipping point as they say and their man wants to be the Big Cahuna, challenge him to a joint appearance on “Charlie Rose” (or another equally prominent, but neutral venue). Let it be Game On.

    Thank you, Steve, for putting your head in the lion’s mouth. And I am relieved, but not surprised, to see you weren’t decapitated.

  33. LionDancer says:

    Thank you sir. We need more of this. You did an excellent job. Thank you.

  34. Very interesting article. I’m glad you went on the show.

    I would suggest that the term “Western Science” should be rejected on the basis that some of our best scientists come from Asia. Wikipedia has a nice list of 73 famous Chinese scientists:
    * http://en.wikipedia.org/wiki/Category:Chinese_scientists
    as well as 80 famous Pakistani scientists:
    * http://en.wikipedia.org/wiki/Category:Pakistani_scientists
    and so forth.

    In my own field, Statistics, some of the best researchers come from Japan (Akaike, Ishikawa, Taguchi) and India (Basu, Bose, Mahalanobis, Rao, Roy).

    So to attach a label of “Western” to scientists is almost racist in its ignorance of the great work done by scientists in the Eastern hemisphere.

    Steve Simon, http://www.pmean.com

  35. BenAlbert says:

    Good on you Steve. Your bravery, confidence and clear thinking are a wonderful example for us all.

    -Ben

  36. GLaDOS says:

    Larry Sarner,

    I’m feeling a little uneasy with the “bring it!” angle of your comment above. The battle we’re in has been raging for decades and will continue long after we’re gone.

    Here’s my view:

    1. Either the human beings catch on, more or less, to the basic method we use for sorting fact from fiction, or they do not.

    2. If they don’t catch on, we’re f_cked.

    3. If a critical mass of rationalists can emerge from the sea of humanity, the causal factors driving this emergence must be robust.

    4. A robust process is independent of the behavior of any single person.

    5. Pop some popcorn, relax, and enjoy the show.

  37. Reductionist Nurse says:

    Fantastic job Dr. Novella, you walked directly into the best trap that sCAM promoters could muster. You proceeded to calmly defused it while delivering a message to the masses that was loud and clear: It doesn’t work. It doesn’t work. It just doesn’t work.

    You avoided every pitfall and your statements completely obliterated the very nucleus of Oz and his quacky-lackey’s evasive arguments. They came off dumbstruck, sounding like redundant politicians regurgitating a clumsily memorized speech, whereas you came off as purely natural and collected. If any Oz viewers were opened up to the wonderful world of science-based medicine because of this, please let us all know.

  38. Sastra says:

    I thought one of the main tactics Oz and friends were using consisted of the usual bait ‘n switch — making reasonable claims about ‘alt med’ therapies or treatments that aren’t unscientific at all (diet, herbs, exercise, meditation, massage, and so forth) — and that most of Steve’s nods were to say “yes, yes, this part is fine, no problem here.” Then, when they’d drop something weird into their litany of claims or go too far, it would look like he’s still in agreement, since he had been nodding agreement.

    At least, that’s the way it seemed to me at the time. Oz was playing a variation of “Gotcha,” wherein he wanted Steve to express disapproval — or seem to express disapproval — of something vague or innocuous, like “herbs sometimes have benefits” or “relaxation helps with pain perception,” thus convincing the audience that they’re dealing with an extremist. If Steve avoided that trap, the rapid delivery and switch of topic made it look instead like Steve was either agreeing with the woo parts, or gratefully accepting new information. Win/win for Oz.

  39. Larry Sarner says:

    GLaDOS,

    While I may have used oblique references to athletics and games (e.g., “Game On”), to me this is not a spectator sport, but matters conducted in deadly earnest.

    I cited the evidence I saw that *they* believe they are engaged in an end-game (e.g., “tipping point”). They’ve made the move; they’ve chosen their forum. I think they’ve miscalculated, giving the guys in the white hats an opportunity.

    If I’m right, this development could be dispositive. If I’m wrong, well, lean back and watch the fun.

  40. halincoh says:

    I feared the worst and didn’t get it.

    But, bottom line is he had an agenda; he knew how you would answer; as the host he controlled the conversation. Though he didn’t cut you off he phrased the questions in an orderly manner so he could make HIS points. There was no thrust parry thrust. Only thrust and parry. He had final say. He understood his agenda and yours. And though you weren’t overly edited he got what he needed from you.

    Harriet is right. He should come onto the SGU. My suggestion would be that you keep that interview as close to one on one as possible, physician to physician. He should never feel that he was outnumbered. Only out evidenced.

  41. anneymarie says:

    Wow, I’m catching up on the oldies of SGU and this reminded me of the Wallace interview. It’s so frustrating to hear someone accuse someone else of their exact actions while denying them.

  42. weing says:

    The question is not why doctors are afraid of alternative medicine? As a doctor, I am not afraid of it at all. The question is why patients should be afraid of alternative medicine? If I was a patient, and someone tried to treat me with it, then I’d be afraid. I bet if Dr. Oz had a pneumonia or bladder infection, he’d be afraid if all he was offered was reiki or acupuncture.

  43. We’re all proud of you, Steve. You took a risk, and honestly I think it came out as well as it could. Getting skeptical viewpoints into mainstream media will ALWAYS be a messy task, and someone’s got to take the first steps. Thanks.

  44. EmilH says:

    As I am based in Sweden I had only heard about Dr Oz through SBM. After watching Sc00ter’s clip (thanks btw) I wondered if it was a show for kids, as Dr Oz spoke to his audience in (as I interpret it) a manner used when talking to children. I of course recognize the mannerism from shows like Oprah but it still baffles me (^^).

    Anyway, good job Steve!

  45. Ian says:

    “Herbs are drugs, and they can be studied as drugs.”

    But that can’t be. It says so right on the bottle of melatonin, that it is all 100% all-natural and drug-free!

    (Seriously it did!)

    Its funny to see all the typical alti-med BS on a bottle of melatonin, a legit drug with several positive studies and is regulated as a prescription drug in Europe. It’s a hormone we share with plants, so you can get it from food products which gets it pushed into lala land.

  46. relativitydrive says:

    Steve,

    May I thank you for your positive and continually conciliatory attitude towards everything: Quacks, Charlatans, Alt-Meders, Chriroquactors, Reiki Healers, Herbalists, NDs, Liars and the self-deceived.

    Not only have you gone up (didn’t think it was possible) in my estimation but I feel you’ve done the same for SBM, Skeptics and those of us who are often dismissed because of our ‘but that’s not the truth’ response to the pervasive BS that is banded about constantly…I have a friend who is so into the UFO/Alien bit that even his children fall about laughing when he starts.

    Need I say keep it up?

  47. Daniel M says:

    relativitydrive, Do you really think Dr. Novella’s attitude toward quacks and liars is continually “conciliatory”? I do not think that word means what you think it means.

  48. relativitydrive says:

    #Daniel M.

    I scurried off to check the meaning…and yes, I think I used the correct term. Steve uses humour (at the ridiculousness of their beliefs in the face of overwhelming evidence to the contrary) then an open attitude to discuss it (air-time on the SGU, responses to blog comments and into the lion’s den here) without resorting to ad hominems etc. once past the humour phase.

    I wish I could be so.

  49. Adam_Y says:

    The placebo effect affects us all, it’s just a matter of what triggers it. And we shouldn’t criticize people who benefit from interventions that could be tailor-made to maximize the placebo effect. T’ain’t right.

    Except you have no clue how the placebo effect works. If you actually go back and read the archives of this blog you would realize that this is another fantasy myth that most people have about the placebo effect. In fact there was a paper that showed that the placebo effect doesn’t work.

  50. pasulj says:

    Steve Novella: You are my hero. Cannot WAIT for the video to be viewable in Australia, took a few days for the preview to work and even that make me want to punch Dr Oz in the face…

  51. Harriet Hall says:

    Re: herbs are drugs.

    I suffered through the entire Oz show. After the interview with Dr. Novella, he went on to recommend herbal remedies for headaches and he told the lady from the audience she should take these because she “wouldn’t want to take a pill” every time she got a headache! As he showed a bottle of herbal pills! He did a demonstration to illustrate that flower odors cause headaches and that some odors like peppermint cure headaches: he let the audience lady rub peppermint on his temples. He did an experiment showing that if you create a vacuum in an aluminum can, the outside air pressure will crush it, and he claimed that that explained why people get headaches after thunderstorms when the barometric pressure changes. Oy vey! The lack of logic and science was enough to give me a headache.

  52. chaos4zap says:

    Clearly, the most important part of this whole dialog taking place is that the dialog took place at all. Does anyone ever remember a time when Oprah invited a critic onto her show? I don’t (not that I watched much Oprah). She would barely even acknowledge them and their criticisms when she wasn’t “on-air”. The very fact that Steve was invited on the show at all clearly demonstrates that SBM and the message and writings of its staff are getting attention. First, the meeting with the NCAM and now OZ. Rather or not it changes anyone’s mind (and by change minds, I really mean, encourage people to look into the matter for themselves) it truly is a testament that the time and work that the SBM staff put into research and writing is paying off. I find the way the Dr. Oz’s and Oprah’s of the world treat the general public slightly de-humanizing. It’s as if they are saying, not in so many words, that they think you are dumb and here is the dumb “entertainment” you deserve. Someone even mentioned above how OZ talks to his crowd like they are children and that is exactly my point. It is far easier to play to the least common denominator and exploit people’s gullibility, than it is to maintain any real sense of professional integrity. In this interview, OZ was truly a logical fallacy MACHINE (appeal to antiquity, appeal to popularity the most prominent) and it seemed very divisive the way he formatted the show. First he had another woo promoter, whom which Steve had to share his time with (not to mention the pre-filmed “what your doctor say’s” segments) and then OZ split it up woo into three different categories (each very broad themselves) and instead of being able to speak generally about CAM, Steve had to try and formulate substantive and very short responses to each of the three categories. I wish OZ would have actually addressed Steve’s points.

  53. Josie says:

    Stephen Simon, Thanks for pointing out the East vs West false dichotomy.

    One of the really great things about science as I have experienced it (in the US) is the diversity of perspective.

    In Biotech our innovations come as frequently from workers in the far east as the east coast or anywhere in between. Even progress made within our borders can’t be strictly defined as “western” because our scientific community has remarkably open doors with the rest of the world. I cannot remember a time when I worked in a research group comprised only of Americans.

  54. Dpeabody says:

    Finally got around to watching it.

    Great job Steve!

    You can tell they realized there was some threat with allowing you to speak in the way that Oz would make a final point and then switch topic immediately….. Next time bring a BullSh3t sign you can hold up.

    Just wow at Oz’s final point on choosing your own therapy. That was plain irresponsible.

  55. chaos4zap says:

    The ancient Chinese used swords in battle. Maybe we should let the military know that we do not need guns and ammo anymore. Think of the money we will save! yeah, the East vs. West thing is just another example of the false dichotomy/marketing song and dance they use to sell, sell, sell. I know a recent study showed a large portion of the population in the U.S. take supplements in the US, is the usage of these so called “eastern” interventions even used by a significant portion of the eastern population anymore?

  56. @ Steven Novella, Just listened to the interviews… I have to admit, I was very close to not listening, because I just hate talk shows and I was dreading some sort discussion full of shouting where no one intelligent gets to finish their sentence.

    But, I think you did awesome. I do see that Dr. Oz seemed to do a lot to distract from your points without really addressing any of the concerns you brought up, but I think a viewer who’s is genuinely just trying to figure things out could see what he’s doing.

    You gave those viewers the opportunity to see the value of the science-based approach.

    You know what they say, ‘You can lead a horse to water, but you can’t make them drink.’

    Cheers!

  57. David Gorski says:

    The video of Steve’s appearance has been posted at Dr. Oz’s website. Predictably, the producers did not link to this blog:

    1. Controversial Medicine: Alternative Health, Part 1
    2. Controversial Medicine: Alternative Health, Part 2
    3. Controversial Medicine: Alternative Health, Part 3
  58. kulkarniravi says:

    There are a few big elephants the so-called Science Based Medicine ignores. I am neither a logician nor a doctor, but I will try to state my case.

    Healthcare professionals make a big deal about the assertion that conventional medicine is based on science – yes science is a big deal. But the present system is so heavily loaded against the interests of an individual that it needs to be thrown out and replaced with something that makes sense.

    - Diseases can be treated in isolation. I know people will protest and say they consider other factors, but for the most part, the entire focus is on the disease and not the whole person. Drug discovery and development is no better. Root cause analysis is not a strength of the medical profession today.

    - Results obtained by a small sample of people can be extrapolated to an entire species. There are simply too many differences in diets, cultures, genetics and not to mention gut-bacterial types (recent development). Statistics can be made to lie and pharma companies do it – often. All the medical community says is a collective “oops”.

    - Diet is the biggest contributor to most chronic diseases (don’t have any citations, but seems like commonsense) and yet most doctors have very little knowledge of nutrition.

    - Environment is also a major factor in health, and yet, very little attention is paid to it. All the food additives are totally ignored as if they cause no health issues – FDA said so.

    - Doctors do precious little to prevent things from happening in the first place. Perhaps we need to invest more in nutritionists and dieticians and a lot less in doctors. After all prevention is better than a “cure” – not that conventional medicine cures any major disease.

    - Pharma companies have little incentive in finding cures anyway. They want the entire populations to become dependent upon the drugs they invent. I hardly find any studies performed on supplements and herbs – no one can make much money on those. Then the doctors turn around and say there is little evidence that this or that helps – well duh!

    The system is rigged against the common man no matter how you look at it. FDA is a revolving door for the pharma and insurance executives, doctors, and their lobbyists. AMA is only interested in the welfare of the healthcare professionals. It is time the society wake up and take control of healthcare.

  59. Harriet Hall says:

    @ kulkarniravi

    “the present system is so heavily loaded against the interests of an individual that it needs to be thrown out and replaced with something that makes sense.”

    You have presented arguments that have already been addressed and debunked on SBM. You are confusing science with public policy.

    I don’t agree that science works against the interests of an individual; but even if it did, what could possibly replace it?

  60. kulkarniravi says:

    Harriet,

    Actually I am not against science. I am just questioning the claim that healthcare is an exact science. Only the clinical study part is “scientific” though even that depends upon incomplete science. I will make an attempt to see the debunked arguments and get back.

  61. vicki says:

    kulkarniravi: “Doesn’t cure any major disease”? I suppose tuberculosis is minor. As are all the infections that we now cure early enough so that they don’t look major.

    As for not preventing things, I suppose your doctor never vaccinated you against potentially disabling or crippling diseases such as polio, measles, and tetanus? (Much of that may have happened before you remember, of course.) Never asked you how much you exercise or checked your blood pressure? Asked whether you smoke, or offered help to quit if you do?

    If your doctor never did any of those things, you should probably get another doctor. If s/he did, give your doctor some credit for doing the right thing.

  62. Harriet Hall says:

    @kulkarniravi,

    ” I am just questioning the claim that healthcare is an exact science.”

    Straw man argument. No one is claiming that.

  63. Josie says:

    “I am just questioning the claim that healthcare is an exact science.”

    Pretty sure no one here makes this claim.

  64. chaos4zap says:

    @Kulkarniravi

    No one here thinks that Science Based medicine is flawless or and “exact science”. The argument here is that we have a system to determine safety and efficacy and it isn’t perfect, but it is certainly much better than having no system or requirements for efficacy and safety (which is currently the case with alternative medicine). You make sweeping assertions and conspiracy theories about the medical establishment being corrupt and only out for money. This is a pretty argument unless you have something to back that up. You are ignoring the research and drug development that go on independent of pharmaceutical companies and your assertion implies that the majority of researchers out there only see dollar signs and don’t have a genuine desire to help mankind. As you will find stated elsewhere on this blog, the “there is no money in the cure” argument is simply ridiculous. Any pharmaceutical company that developed a cure for just one of the major ailments today (diabetes, any of the cancers, etc…) then they would quickly become the wealthiest company in the world, not only that, but they would never have to beg for research money again…it would be thrown at them. If you think the people selling alternative medicines only think about making money on the same scale as anyone else, then you are naive at best. They use this “they only care about money and we care about you…the whole you” is marketing non-sense and apparently it is working. Simply asserting that Diet is the largest contributor to most chronic diseases is simply baseless. The fact that you state that it is just “commonsense” demonstrates clearly that you don’t really care much about pesky things like evidence. Results obtained in small sample sizes can’t be extrapolated to larger populations? That’s strange, because that is exactly what Alternative proponents do. Small studies, little or no controls, ignore the results that contradict the outcome you desire…and then use that to promote whatever it is to whoever walks in the door. SBM on the other hand, acknowledges that large studies that are well controlled and replicable are a basic requirement before the intervention is deemed ethical and worth consideration. Again, the bulk of your statements are the typical big pharma conspiracy nonsense that is not supported by any real evidence. Ironically enough, guess who is started to get into the supplement industry in a big way? You guessed it, the pharmaceutical companies. Why spend billions of dollars researching, demonstrating safety and that it works when you can just put anything in a bottle, not worry about quality control or safety and people like you will buy it? It’s a no brainer for the pharmaceutical companies. They will take advantage of you using the same methods the “alternative” crowd does. I’m not sure you would find a medical professional anywhere that would deny that environmental factors are important considerations (what exactly to you even mean by environmental factors anyway? Toxicology?). Are you saying that “food additives” are causing a lot of disease? I don’t suppose you have a citation for that study? I thought not…just more mindless assertions based on ideology instead of reality, logic and most importantly…evidence. If you go to a doctor that knows very little about nutrition, then you just need to find another doctor. This is the exception rather than the rule.

  65. chaos4zap says:

    In reading my post, there are a few typos and it is all over the place. I appologize, but I just had to quickly respond and there was plenty of ground to cover. Could Kulkarniravi possibly be our first Dr. Oz-ian?

  66. weing says:

    Science based medicine is not an exact science. It is being constantly revised, updated, and improved upon. CAM is more of an exact science. It doesn’t need revision or updating, except in marketing.

  67. weing says:

    “Results obtained by a small sample of people can be extrapolated to an entire species.” Really? Who says this? You can get into a lot of trouble if you do that. No researcher worth his salt would do that. If you do extrapolate like this, be ready to correct your over-generalization.

  68. weing says:

    “I hardly find any studies performed on supplements and herbs – no one can make much money on those.” Do you mean the people peddling herbs and supplements are not raking in the dough? Very interesting.

  69. David Gorski says:

    Actually I am not against science. I am just questioning the claim that healthcare is an exact science.

    Massive straw man. No one here has ever claimed that health care is an exact science. Seriously.

  70. MOI says:

    It was by marvelous happenstance that I watched this episode today. You did awesome!! I was incredibly nervous about your appearance but your points were well-made and not properly addressed by Doc Oz. I hope that others watching noticed the strawmen, bait n switch and special pleading thrown around by the host. Bravo Dr. Novella!!

  71. Daniel M says:

    relativitydrive, the word conciliatory describes a placating aptitude, accommodating a person’s position, or being willing to compromise, it doesn’t have to do with humor. I wouldn’t describe Dr. Novella as conciliatory toward woo; he wants to show why it is wrong and get people to reject it, not compromise so others are placated. If you think he is conciliatory that’s fine, but I get the impression you don’t really think he is an accommodationist on the issue.

  72. kulkarniravi says:

    Josie says:

    “Pretty sure no one here makes this claim.”

    I beg to differ. Arrogance and contempt for the lay people is quite common among the healthcare professionals. This attitude comes from the same belief that they know what’s best for everybody and they know it because science supports it. Perhaps the same attitude is seen in the title of this blog.

  73. Regarding the argument that SBM doesn’t cure any major diseases.

    I am also not a medical person or a scientist. But I do have an extremely sore throat. Have had for about five days. I’m pretty happy knowing if I go to the doctor and test positive for strep*, there’s some lovely antibiotics to help me. I find I like the higher chances of a quick recovery, lower risk of rheumatic fever or death.

    It’s a similar story for the Mycoplasma pneumonia my daughter had, the Bartonella, that my kitty had and many other diseases that medicine deals with these days. I like not dying or losing loved ones from bacterial diseases. I think it’s really cool.

    *of course, Murphy’s law says if I go to the doctor tomorrow, it won’t be strep, it’ll be viral and I’ll just have wasted time. If I don’t go to the doctor tomorrow, it will be strep and I will feel stupid for not having gone to the doctor sooner. I think I have Schrödinger’s cat in my throat.

  74. kulkarniravi says:

    “Could Kulkarniravi possibly be our first Dr. Oz-ian?”

    I am no more Dr Oz-ian than a (Deepak) Choprian. I believe in doing my own research. I don’t believe all supplements are good nor that you have to take a lot of them to be healthy. Is that a strawman?

  75. vicki says:

    Kulkarniravi:

    The question isn’t whether some health care professionals are contemptuous of lay people. (It;s also not whether some lay people are contemptuous of health care professionals.) The question is whether people at this blog are making the claims you are arguing with.

    More seriously: science is a set of techniques that are available to everyone in the world. Why do you think it is contemptuous for the bloggers here to say that these methods are a good basis for medicine?

    If medicine shouldn’t be based in science, what should it be based in? Guesswork? The shapes of plants? Taste?

  76. kulkarniravi says:

    Let me clarify my stand on conventional medicine. I strongly believe that if our lifespans have increased recently, it is primarily because of vaccines, judicious use of antibiotics and improvements in personal hygiene. Diagnostics tests are a great achievement as well.

    But the reckless use of antibiotics is also now backfiring. So it is a double edged sword. The less one says about many modern drugs the better. Is the cure better than the disease is a question that’s often left unanswered.

  77. kulkarniravi says:

    Vicki,

    I am for science. Just make sure when you develop drugs and procedures, you consider the whole person, not just the symptoms. Both approaches are scientific, and yet one does not reach the right conclusions. It is not the fault of the science, but a result of the premises you start with.

  78. Harriet Hall says:

    @Kulkarniravi,
    “Just make sure when you develop drugs and procedures, you consider the whole person, not just the symptoms.” That sounds like a great idea! Just how would you go about that? Can you give us an example?

  79. nybgrus says:

    kulkarniravi: Seems the rest are addressing your gish gallop of strawmen pretty well, but I would like to further stress that not only has no one here ever made the claim that medicine is an exact science, many articles have been devoted to exactly why medicine can never be an exact science. It should be based in science, hence the title of this blog.

    Arrogance and contempt for the lay people is quite common among the healthcare professionals. This attitude comes from the same belief that they know what’s best for everybody and they know it because science supports it.

    That is also a straw man – has nothing to do with science. The fact is that it is a true statement – most physicians know more than most lay people vis-a-vis medicine and science and as such often do know best and we do, in fact, know it because science backs us up. That is simply called “being an expert” and it is why we train for essentially over a decade to be able to justifiably be called such an expert. The fact that some physicians can be arrogant on snobby about it is an indictment of their personality not of the fact that our knowledge is based in science. And as has been raised before… what else would you have us base our expertise in? If I was your physician and you came to me and I said “Take this treatment for your condition because my astrologer said it would be a good one because Jupiter is in the house of the moon today” would you be happy with that? Or would you rather I say “Take this because a number of studies have been done showing it to be effective in people of your demographic and the mechanism has been worked out by biochemists and it works 90% of the time.”

    Drug discovery focused on the disease instead of the person…. of course it is! When you are talking about a drug and how it acts you are looking at molecular biology and the interactions at that level. Especially today in cancer drugs and even antibiotics effects are very narrow and precise. How that translates to clinical practice is dependent on the studies done and a whole host of other things. But to claim that drug development should be based on the whole person is nonsensical. Drug application should be and is based on the whole person.

    don’t have any citations, but seems like commonsense

    Often commensense leads us astray, hence the need for science. To say that diet is the basis for “most” chronic disease is overly simplistic and downright wrong. In developing countries, yes – malnourishment. In developed countries… diet certainly contributes to chronic disease (to varying extents depending on what disease you are referring to) but very rarely is it the sole cause of said disease. Any time one claims that X is the cause of or cure to a vast array of diseases, then the claim is almost certainly false.

    Environment is also a major factor in health,

    The toxins gambit. Suffice it to say, that stuff is thought of and worked on.

    Doctors do precious little to prevent things from happening

    You’ve been taken to task for this one already. Lets see… anti-hypertensive (prevents stroke, heart attack, heart failure), anti-platelet therapy (same), vaccines (pretty preventative there), diet and lifestyle counseling (exercise, eat better, stop smoking)…

    Pharma companies have little incentive in finding cures anyway

    This is so hackneyed it barely raises an eyebrow for me anymore, but that is a massive “Are you serious??” comment. I mean really – you think that if a drug company came up with “the cure” for, say, colon cancer they wouldn’t make gazillions of bucks on it? If there was a single pill that could wipe out a disease, whatever it is, that would be a friggin blockbuster drug worth kajillions of zillions of bucks. People who make that claim seem to think that one a pill has come out to cure something it will somehow make the disease go away instantly and the company stupid enough to invent it will be out of business. Would a cure for cancer stop cancer from happening or would it mean that now everyone who has that cancer will be beating down the doors to pay good money to get that cure? Antibiotics cure bacterial infections… do you see those going the way of the dinosaur? Nevermind that diseases and disease processes evolve so new drugs will have to be developed even after a “cure” is made available. Please, correct this faulty logic that a “cure” from a pharmaceutical will spell anything buts massive dollar signs in the eyes of the CEO.

    AMA is only interested in the welfare of the healthcare professionals. It is time the society wake up and take control of healthcare.

    Sounds a bit paranoid doesn’t it? The AMA is interested in best outcomes for patients and that is why it regulates physicians. Yes, we are self regulated and that is a privelege. Why do we have such privilege? Because unless you spend a decade of your life learning the relevant knowledge to be an expert it is darn near impossible to properly regulate and create guidelines. Would you like a painter to be head regulator for particle accelerators? Or would you rather have an expert in the relevant fields do it? If you need to blow up a building for demolition would you prefer to listen to an explosives/pyrotechnics expert or an award winning chef? So why is it that when it comes to healthcare, people think we should listen to the opinions of people completely untrained and having no knowledge of the relevant fields? When you get a “second opinion” you get it from another doctor, not a plumber. How do you propose that society at large “take control of healthcare?” Would you like a democratic vote as to the acceptable guidelines for surgery and neo-adjuvant therapy in breast cancer? Perhaps we should have a popular vote to determine which treatments hospital should offer and which they shouldn’t? Perhaps everyone who applies should get a license to practice medicine and make their own guidelines? Or perhaps, we should recognize that an expert in a field is there for a reason and when it comes to your water lines a plumber is the expert of choice, for dinner you want a good chef, for your particle accelerators a physicist would be handy, and for medicine a physician is the expert of choice.

  80. hgkelley says:

    First, let me thank you for posting this video. I have been a fan of SGU for a couple of years now and have almost caught up with the backlog of shows while caring for my Mom at home. I know Dr. Guarneri well because she treated my Mom from 1994 to 2009. Therefore, I have good reason to say that Dr. Oz presenting Dr. Guarneri as representative of CAM practitioners is an example of the same strategy CAM proponents employ when discussing treatments: an umbrella of useful treatments, such as tested herbal medicines, diet and exercise, is presented as “CAM” to camouflage useless, or even harmful, treatments, such as homeopathy and chiropracty. In this case, Dr. Guarneri is the reasonable, caring, scientific umbrella camouflaging a multitude of quacks who care only about making money off patients’ desperation and gullibility. In my experience, Dr. Guarneri always practiced science-based medicine, supplemented, not replaced, by well-documented, psychologically soothing treatments. During the entire time my Mom was under Dr. Guarneri’s care, or in her Healing Hearts program, she was prescribed science-based medication and underwent science-based tests, exercises, and procedures. The only “alternative” part of her treatment was meditation and counseling to help motivate Mom and aid her in dealing with the general anxiety and stress over being ill. As you have frequently pointed out, these so-called “alternative” treatments are generally accepted by science-based practitioners because their psychological benefits are well documented, so they really are not outside the mainstream of modern medicine. I watched the entire segment, and did not once hear Dr. Oz defend any CAM treatment that is not also documented by good, science-based research. Even with acupuncture, he did not defend the claim that it actually healed any illness or injury. Instead, he stressed the agreed ground that soothing treatments can make people feel better about their condition. So, the segment was a debate between a physician who believes all medical treatment plans should be supported by appropriate research and a physician who uses treatments supported by appropriate research. I just hope true believers don’t take this as legitimizing the undocumented treatments that Dr. Oz did not want to discuss with you. Anyway, it was good to see you in action. I believe you acquitted yourself well, speaking directly and making several good points regarding science-based medicine accepting any treatment, but only those treatments, that can stand the test of well-planned research.

  81. Odie says:

    Hey, someone wanted to hear from a former “Oz” watcher, and I hereby present myself. I stayed at home for many years raising (great) kids, and turned Oz on quite frequently. I thought that I was learning some good stuff from him. I mean, he was a “doctor”, after all, right? Couldn’t be THAT crazy!

    Luckily, the thing that tipped me off to his limits in reasoning and intelligence was the constant stream of games that he played on his shows, and the funny demonstrations that he used to explain things to the women (another clue that his show was non intellectual, sorry, haus fraus), which are explained as if to an audience of grade schoolers. The women swoon and act like idiots, generally, and sorry but to me he’s not the most handsome thing I’VE ever seen. My “woo detector”, if I can steal that term, became activated when he had the faith healer on, who was a Catholic. Being a Catholic myself, this really caught my eye. It made me question Oz.

    Oz luckily stopped all of my questioning, and proved what an idiot he is when he had the fake “psychic” John Edward on his show. I couldn’t believe it. I mean, can we say “sucker”??? What the heck happened to his medical degree? He must have graduated bottom of his class, at a horrible medical school. Is he an astrologist as well?

    I watched the segment with Steve on the show, and it was ridiculous and insulting how Oz disrupted the conversation, and had the final say. Steve held his own, and I was impressed. I felt a little victory that someone was speaking the truth on the show, and was not getting tripped up, such as when Oz said that he was being dismissive. “No”, he said, “I am not being dismissive because I said that I have studied it in depth..” or something to that effect. I really wish that the critics such as Steve and you people who follow this stuff, would speak up more and be more public, such as in a forum as Dr. Oz’s. As Americans, we are judged by the mentality on this show. I really think that stay at home moms can do so much better, mentally, and not fall for this crap. Where is the real education and thoughtful reasoning on TV, without the idiotic games and waste of time? My eyes were opened, and I am sure that they weren’t the only ones. Keep up the good work here, people, and thanks for this opportunity to speak.

  82. Chris says:

    kulkarniravi said:

    Actually I am not against science. I am just questioning the claim that healthcare is an exact science. Only the clinical study part is “scientific” though even that depends upon incomplete science.

    Josie and other responded with variants of “Pretty sure no one here makes this claim.”

    To which, kulkarniravi responds with:

    I beg to differ. Arrogance and contempt for the lay people is quite common among the healthcare professionals.

    Please provide the evidence you used to make the statement that “healthcare is an exact science” was ever made by one of the authors on this blog. Post which article made that claim. Make sure it is the one with the most arrogance and contempt for the regular readers who are lay people (like me).

    You made a claim, now support it.

    I will state that the part that says “Only the clinical study part is “scientific”” was amusing. I guess the medical researchers don’t need those petri dishes, PCR machines, fancy labs and other superfluous things I read about in books like Emperor of All Maladies, The Great Influenza, Polio, an American Story, The Immortal Life of Henrietta Lacks and on and on.

  83. rlquinn1980 says:

    Computer-mediated communication (CMC) is the branch of communication/psychology research that deals with how people communicate through the internet, whether by email, blogs, comments, or phone texting.

    One of the first lessons learned in CMC is how heavily recipient-based a communication is, due to the lack of other cues (e.g. facial expression, tone of voice, etc.). Readers will tend to make up for these missing cues by exaggerating what cues are present or imposing their on assumptions on the sender, which is highly subject to halo effects or their negative counterparts.

    If kulkarniravi believes the writers of SBM (and in particular Dr. Novella) are arrogant, I would like to see in which blog entries he finds evidence of this trait. Unless he can back such a claim, the arrogance he perceives is inference, not implication.

    For those interested in finding articles on CMC, do searches for Walther, Lea, Spears, and Postmes; these are some of CMC’s most prolific and long-standing researchers.

  84. pasulj says:

    I love how everyone else got to talk as much as they want but Steve only got 2 words in. Means you were gettting to them Steve :) Total champion!!

  85. weing says:

    “I beg to differ. Arrogance and contempt for the lay people is quite common among the healthcare professionals.”

    Let’s see. If I get into a 757 cockpit and tell the pilot to step back and let me do the flying and he won’t allow me, is he being arrogant and contemptuous of a lay person? Or am I being arrogant and contemptuous of the training and experience of an expert pilot?

  86. weing says:

    Wasn’t the great and powerful Oz a charlatan anyway? I mean, his heart was in the right place but he was still a charlatan and he knew it. Pay no attention to the man behind the curtain.

  87. Reading Frame says:

    Dr. Novella, you have positively glacial patience. Congratulations are in order for your accomplishment. You argued gently and persuasively, so much so that no amount of editing would have made you into the bad guy. I suspect that this is why they didn’t bother to over-edit your interview. I do wish you’d gotten more time to speak, however. You were certainly more interesting to listen to than all three of your ‘opponents.’

    I was annoyed when Dr. Oz asked the so-called supplement ‘expert’ about your points on studies you’d read. It’s not that there aren’t any studies; it’s that the studies have shown no efficacy. Two very different arguments.

    You must have deeply intimidated him if he felt the need to have two other individuals to counter your expertise.

    I would love to have a much more open forum for the two of you without the so-called ‘experts’ and with a bit more time.

    Bravo, sir.

  88. daedalus2u says:

    Weing, the Wizard of Oz was a very bad wizard, he was also not a good man. He claimed to be a “very good man”, but no good person would send a young girl on what could only have been described as a suicide mission to try and kill the most evil and most powerful Witch in Oz.

    He knew he didn’t have any ability to send Dorthy back to Kansas, yet he sent her on this suicide mission to kill the Wicked Witch of the West. Good people don’t do that.

    He is no different than Gonzales, who puts cancer patients through an impossible trial, a gauntlet they can’t possibly do, so he can claim that the failure of his treatment is because it wasn’t followed.

  89. weing says:

    I don’t know about that. He did visit her after she got back from Oz. Anyway, who could blame him? Dorothy is a girl who runs away from home, comes to a new land and immediately kills someone, the Wicked Witch of the East. She then teams up with 3 strange guys and comes to Oz. She’s obviously dangerous. Why not send her to get rid of the Wicked Witch of the East and kill 2 birds with one stone?

  90. weing says:

    The second witch is of the West not the East.

  91. kulkarniravi says:

    Weing,

    “Let’s see. If I get into a 757 cockpit and tell the pilot to step back and let me do the flying and he won’t allow me, is he being arrogant and contemptuous of a lay person? Or am I being arrogant and contemptuous of the training and experience of an expert pilot?”

    Poor analogy. A pilot knows a lot more about his aircraft than you do. On the other hand, I know a lot more about my body, my habits and my history than anyone else.

    This is what I mean by arrogance. Healthcare professionals (and worse patients too) seem to think they understand human body a lot better than they actually do. The fact is that it is still a big mystery with a little clarity here and there. So a lot of what goes in the name of diagnosis and prescription is pure guess work. But they insist the science is on their side…

  92. weing says:

    “Poor analogy. A pilot knows a lot more about his aircraft than you do. On the other hand, I know a lot more about my body, my habits and my history than anyone else.”

    Really? So the pilot will not fly a new airplane, just the one he is used to? Practicing medicine is a partnership between the patient and the physician, otherwise it is veterinary medicine. I will agree that you know more of your body sensations than anyone else. What you attribute the sensations to is definitely less accurate. For example, the ancient Egyptians thought the brain was useless and their sensation of self was localized, I can’t remember which, liver or heart. Your habits and history are definitely helpful to me as the maintenance history would be to a pilot. I would not say that the factory worker that builds or employee that repairs or services the airplane is qualified to fly it either.

  93. weing says:

    “This is what I mean by arrogance. Healthcare professionals (and worse patients too) seem to think they understand human body a lot better than they actually do. The fact is that it is still a big mystery with a little clarity here and there. So a lot of what goes in the name of diagnosis and prescription is pure guess work. But they insist the science is on their side…”

    I will say that I understand the human body better than you do. It is a mystery, but I think there is more clarity than you think there is. If I don’t know what’s going on, I look for help from others who may know. If I have several hypotheses about what is going on, I explain that to the patient, and use a systematic approach to reach the final diagnosis. I would not call that pure guess work.

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