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Are You Ready For the Oz Manifesto

“Medicine is a very religious experience. I have my religion and you have yours. It becomes difficult for us to agree on what we think works, since so much of it is in the eye of the beholder. Data is rarely clean. You find the arguments that support your data, and it’s my fact versus your fact.”

- Mehmet Oz

The above quote is from a recent article for the New Yorker by Michael Specter about Dr. Oz, the most currently popular TV doctor. Specter described this sentiment as “chilling.” To me it sounds like a manifesto – a postmodernist attack on the scientific basic of modern medicine.

In my experience, this sentiment is often at the core of belief in so-called complementary and alternative medicine (CAM). In order to seem respectable and infiltrate the institutions of medical academia, proponents of CAM will say that their treatments are evidence-based and that they are scientific. They have a serious problem, however – their treatments are not evidence-based and are often grossly unscientific. Whenever someone bothers to look at their evidence and examine their science, therefore, they start to backtrack, eventually arriving at their true position, a postmodernist dismissal of science resembling Oz’s statement above. I have heard a hundred versions of the Oz manifesto from CAM supporters.

As with the postmodernist critique of science itself, there is a kernel of truth to the notion that science has its limits (which makes the sentiment more insidious). Scientists are humans, they have their biases and flaws, scientific studies are imperfect and often conflict, and there are often multiple opinions on specific clinical practices. Where postmodernists fall off the cliff, however, is in concluding from this that science has no legitimacy, that it is entirely a culturally-determined narrative with no special relationship to external reality.

This view, while flirted with by philosophers of science, has been rejected because it neglects the fact that science uses a valid method of justification. The process may be messy, but over time scientific evidence can objectively resolve differences of opinion. Experts can eventually agree on what works and what doesn’t, and from that a standard of care emerges. High quality evidence can become so overwhelming that there is no room left for personal opinion.

Short of a solid consensus, science-based practitioners can follow a hierarchy of evidence – we can base our practices on the best evidence currently available. CAM practitioners also fail to follow such a hierarchy of evidence. This observation was echoed in the New Yorker piece by Dr. Eric Rose, Oz’s surgical mentor:

But I think if there is any criticism you can apply to some of the stuff he talks about it is that there is no hierarchy of evidence. There rarely is with the alternatives. They have acquired a market, and that drives so much. At times, I think Mehmet does feed into that.”

Oz, at least, acknowledges the lack of evidence for some of the treatments he offers or recommends.

I told Oz that I was aware of no evidence showing that Reiki works. He cut in: “Neither am I, if you are talking purely about data. But this is one of the fundamental disconnects between Western medicine and what people often refer to as complementary medicine. Not everything adds up. It’s about making people more comfortable. I offer things like massage therapy, and offered Reiki if people wanted it. I did not recommend it, but I let people know it was their choice.”

The above statement is the Oz manifesto put into practice. “Western” medicine (always a red flag for quackery when that term is used) deals purely with data. Oz, however, blithely dismisses data by stating that “not everything adds up” therefore he can offer whatever people want. He then tries to cover himself by stating that he is only offering such treatments, not recommending them. This is thin cover, however – when a physician offers a treatment to their patient, that is a recommendation. Oz tries to walk this line on his show as well, stopping short of outright endorsement of many of the CAM modalities he presents on his show. He often lets his guest do the promotion.

Sometimes, however, he crosses over that line. In a recent segment Dr. Oz promotes homeopathy as a “natural” and “gentle” alternative to “Western” medicine. You can view these segments online, where it states:

Looking for an all-natural solution for your aches, pains and common colds? Dr. Oz reveals how you can replace your over-the-counter medications with homeopathic solutions. Plus, medical doctors reveal their favorite homeopathic remedies!

Oz flat out endorses homeopathy in this segment, stating that his family has used it for three generations. He then invites a naturopath, Lisa Sarnet, to discuss homeopathy. She repeats all the old CAM propaganda talking points – homeopathy is natural, Western medicine only treats the symptoms and not the cause of disease, and that homeopathy is “holistic.” Oz asks her if homeopathy can be used in conjunction with Western medicine, and she states that she uses homeopathy to transition patients off of their medications. That sounds like using homeopathy instead of evidence-based treatments. Oz accepted this without comment.

We have discussed homeopathy many times – it is a pre-scientific superstition that has been utterly rejected by modern science. Its principles have no basis in reality, and clinical studies show that it simply does not work. Viewers of the Dr. Oz show, however, were offered the recommendation to throw out their medications and replace them with magic potions.

Being unscientific and ineffective is not a problem, however, if you follow the Oz manifesto – cherry pick your facts, dismiss inconvenient science as religion, and do what feels good. That, it seems to me, is the enduring legacy of Dr. Oz.

The Oz Manifesto also highlights a point we have been making at SBM for years – CAM is nothing short of a full-frontal assault on the scientific basis of modern medicine. Its proponents are often coy and evasive on this point, at least those who know how such statements will be perceived by academics. There is simply no other way to interpret their agenda, in my opinion. Oz gives us a glimpse into this agenda – medicine that is based on what feels good, which often means what sells well in the marketplace, not on science and evidence.

Posted in: Homeopathy, Science and the Media

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71 thoughts on “Are You Ready For the Oz Manifesto

  1. nybgrus says:

    So the real question is why can’t an actual science based physician have the popularity that Oz does? Obviously it is multifactorial, but I think a large part of it is because that is what the media big-wigs like to push. It is easy, cheap, and garners huge profits. I’m convinced though, that the right person could make real science and medicine popular as well. After all, it was back in the Cold War era – the space program was intensely watched and the pilots and crew were literally heroes and celebrities. We had the Cold War as motivation for people to value it. Now we have easy lazy lifestyles and general apathy.

    But I think that if you frame it right, actual medical science could be popular. We are facing hard economic and social times and I think it is reasonable to say it will get worse before it gets better. A message along the lines that actual science based medicine and critical thinking will not only help you feel better, live longer, be healthier (for realz!) but also save you money that you would be otherwise wasting on garbage like homeopathy and reiki could be powerful and popular. Rather than focus on easy solutions, focus on real solutions with the specific intent of showing people how to save money and time in the process – after all real science shows us what is effective and efficient. Consumer Reports is a widely read and well regarded source. And I have skimmed through a few issues and seen that they take exactly that same slant – and are nearly always spot on with the actual science – when it comes to health advice. Creating a popularized TV show version of Consumer Reports focused on health and science seems like a good idea to me.

    So rather than touting the latest fad diet or BS supplement, you teach people how to read food labels and cook (and the cooking can include fun science of gastronomy a la Alton Brown). Stuff like that.

  2. nybrus – that’s a great idea. Now convince a senior TV executive. Seriously – it’s not like we haven’t been trying to do this. The problem is selling it to the people that matter.

    Or – if you want to hand us a few million dollars we can produce it ourselves :)

  3. mousethatroared says:

    nybrgus – how many young people watch OZ? How many people of the general population get their health information from TV versus the internet? Oz is certainly popular in the TV world, garners advertisers, but is he leading or following the market? I keep hearing that broadcast TV and news are dying out. When I see my friends commenting on FB, they don’t talk about science on TV, often it’s a program on NPR or a link to an interesting blog…maybe that’s just my friends, they are mostly tech folks of some kind.

    So, I guess my point is first, before investing a few million dollars, choose your venue wisely. Second, consider the audience you are trying to reach. Can you really reach Oz’s audience with science? Or is it like suggesting that we just need the right programing to teach the viewers of Fox News the basics of good economics?

    I don’t know the answers here, just throwing out a few thoughts that occurred to me.

    Lastly, I’m going to be petulant and point out that whenever I mention what I find to be an enjoyable science venue on this blog, like science fridays NPR or RadioLab, it’s pretty much dismissed as too mainstream or mistaken in small details, but the venues that are often admired here (various podcasts interviews) I find dry and mired in more detail than I’m interested in and often amateurish in production values and communication skills. Possibly the science crowd focuses too much on what they think others should know and not enough about what people want to know and how they can best digest it. The later is a skill that a good journalist has mastered. But we know how this blog feels about journalists. :\

    Hum, maybe I’m not in a very good mood this morning, but I’ve made the effort to type it and not incline to delete. It’s possibly worth considering, whether it is entirely correct, entirely incorrect or somewhere in between.

  4. jdl83 says:

    @nybgrus I’m thinking a show like MythBusters; CAMBusters? MythBusters: Medical Edition? I wonder what Bill Nye is doing these days…

  5. stanmrak says:

    @# nybgrus
    “But I think that if you frame it right, actual medical science could be popular…. A message along the lines that actual science based medicine and critical thinking will not only help you feel better, live longer, be healthier”

    That’s a nice ad slogan, but medicine doesn’t offer these benefits, as far as many of us are concerned. Their approach is entirely about treating symptoms — not actually improving health. There’s a big difference. Treating symptoms with prescription drugs is not the ticket to a longer, healthier life — just a longer one.

  6. SkepticWolf says:

    The consumer sez:

    “CAM is cool/hip/edgy/ etc. Regular doctors are boring and dusty. I’m a special snowflake and I want medicine thats “tailored to ME” like Dr Oz talks about! I’d much rather have someone explain the “cause” of my symptoms with an animated movie that doesn’t make me feel like I’m a regular human being like everyone else. Learning how the body actually functions is way too much work, and I can’t talk to my friends about it over coffee (because they don’t want to do that work either). Talking about how ASEA worked for Marcia’s sister Jill is much more fun. It’s like medical gossip!!”

  7. Janet says:

    @nybgrus

    PBS has NOVA, Nature and some other science programming, (which is pretty much at a basic level), but when I mention these programs I usually get an eye-roll or a comment that it is too hard to “understand”, or just not “interesting”. Go to a bookstore chain and look for the minuscule science section way over on the far wall and compare that to multiple displays of pseudoscience hokum “diet” books and other self-help on prominent view just inside the entry.

    Since our media system is based on profit, I don’t see much hope for your ideas (ideas I share and have discussed elsewhere); they simply won’t generate the profits that are required. It’s very sad, and there are efforts being made, but we are addicted to entertainment and any kind of popular programming presents science as “geeky”, “nerdy”, and unavailable to the average person. My daughter wanted me to watch a series called “The Big Bang Theory”, and while it does include a lot of science jargon, it is mostly about how socially inept the science-y kids are and how different they are from the scantily-clad waitress/actress neighbor (a “normal” person). I’m pretty sure this show has way more viewers than anything on PBS, short of Downton Abbey (possibly), that hackneyed re-hash of Upstairs, Downstairs.

    @Mouse

    I would recommend “Science Weekly” from The Guardian if you want something with a little higher production value. Alok Jha is a very engaging host, as well as an informed scientist. He makes a habit of checking other regulars’ attitudes when they get a bit too high-handed. I agree about some of the other podcasts, in that some I just can’t listen to regularly because they are done over crackly phone lines or they devolve into little insider chats that fail to bring the listener into the conversation. Most of the BBC podcasts are very well done, although lately they are falling into the “tell both sides” pit on some medical issues.

    I also think that the disdain for journalists that you see here is much-deserved and is symptomatic of our general science illiteracy, although I sympathize with you on a certain smugness that I sometimes see here. Standards need to be tightened or we simply fall further into Ozdom. Part of what has landed us where we are is the profit motive of the media (with no real public network to counteract it), and the idea that learning something must be entertaining. Not saying we should throw out efforts to be engaging, but some things just need to be imparted to everyone (by rote, if necessary) so that we have basic literacy.

  8. DevoutCatalyst says:

    It was interesting to see Oz’s surgical chops being called into question in the New Yorker piece, maybe his antics will catch up with him there. Oz might not even care.

    Mouse, have you tried the BBC’s podcast ‘The Life Scientific’? Strong production values, fascinating interviews. Have you read American Scientist magazine ? (americanscientist.org). There have been articles published there that have stayed with me for years. Both are detailed and lively — you might enjoy these.

  9. mousethatroared says:

    Janet, thanks for the recommendations. I’ll check it out. I have to admit I’ve haven’t followed much British press lately, I think I burnt out on BBC when I was in Kazakhstan and my only two forms of english speaking TV were BBC and Hallmark channel. It’s been nine years now, I suppose I could give it another try (not the Hallmark channel, though – never the Hallmark channel).

    Totally agree on the profit motive issue.

  10. estockly says:

    >>>how many young people watch OZ?

    That is hard to say. Nielsen doesn’t publish a lot of details on the syndicated audience.

    Among syndicated shows, Dr. Oz ranks 24 nationwide. That’s pretty good. He’s behind Judge Judy (3) Dr. Phil (15) and a few others among daytime programs. He does much better than “The Doctors” (53) which is usually more skeptical, but they have their issues too. He’s usually weekday/daytime, so probably not a lot of school kids watch. (Big Bang reruns were the highest rated syndicated show the most recent week).

    Neilsen Syndicated ratings week of 1/14
    15 DR. PHIL SHOW 3638 4270
    24 DR. OZ SHOW 2992 3429
    53 THE DOCTORS 1542 1711
    – First number is rank, second is number of households, third is number of people watching (age 2 and up).

    Sanjay Gupta also has a show:
    Saturday 1:30 p.m. CNN

    Sanjay Gupta, MD
    Dr. Gupta discusses medical issues. (N)

    Can’t really say if it’s any better or worse, I haven’t watched it. No ratings available.

    ES

  11. Narad says:

    I would recommend “Science Weekly” from The Guardian if you want something with a little higher production value.

    “Quirks & Quarks” from the CBC remains a pretty classy joint.

  12. mousethatroared says:

    @DevoutCatalyst – Thanks, also for the recommendations. Hey, who’d of thought being petulant would result in such rewards. :)

  13. The Dave says:

    As an anecdote to the difficulty of getting skeptical programming on national TV, hasn’t Brian Dunning, of Skeptoid fame, been trying, with no success, to get his show concept “The Skeptologists” picked up for a while now?

  14. Chris says:

    A few more good science podcasts would be the one from Nature (and it also has a once a month “Futures” where one fiction story from their back page is read), the BBC Discovery podcast and then the collection of one minute podcasts from Scientific American. Oh, I alsmost forgot! The Naked Scientists are back.

  15. daughternumberthree says:

    Bill Nye is working on climate change, so I think he’s kind of busy, but someone of comparable appeal would be good. How is Harriet Hall on camera?

  16. weing says:

    “That’s a nice ad slogan, but medicine doesn’t offer these benefits, as far as many of us are concerned. Their approach is entirely about treating symptoms — not actually improving health.”

    That sounds like a great myth that needs to be busted.

  17. Quill says:

    It is interesting to me that Dr. Oz’s expression of his medcial-religious experience is so purely Protestant Christian and seems to expect that to be enough for everyone. It’s also odd he wasn’t clever enough to make himself indispensable in this religious experience by taking a more Catholic stand and making himself akin to a Priest, whom the faithful must rely upon for so many things. All this tells me he is likely a True Believer in his manifesto and seeing it put into practice in the quote about Reiki also tells me he is going to let possibly dangerous and fraudulent things through his office in service of the idea of comfort.

    Given his attitude expressed in this article and his growing wealth, it shouldn’t be long before a patient and their clever lawyers sue the daylights out of him when something goes wrong. Will be interesting to see if he loses his religion then.

  18. Harriet Hall says:

    @daughter,
    Harriet Hall is not good on camera and wants nothing to do with TV. She is good at one thing, writing, and intends to keep her efforts focused there.

  19. mousethatroared says:

    ^also an amazing knitter.

  20. BobbyG says:

    “Data is rarely clean.”
    __

    And ever more rarely plural.

  21. cervantes says:

    Data can be construed as a collective noun and therefore as grammatically singular, although most people are unaware that it is a plural form.

    Anyhow, now that’s out of the way . . .

    There might well be an audience for a science-based medicine show on a niche cable channel, but that’s not going to compete with mass market entertainment, which is what Oz is all about. Remember that Dr. Hall was briefly employed as a medical beat writer for the Puffington Host (IIRC) and they dumped her because she was undermining their stars such as Oz and Chopra. Someone with the talent and tools to give scientific medicine mass appeal would have to find an outlet with a big audience that was willing to invest in what to their execs would seem a pretty wacky idea.

  22. BobbyG says:

    “Data can be construed as a collective noun and therefore as grammatically singular”
    __

    And wrong.

    I know, I’m fast losing that fight.

  23. David Gorski says:

    Someone with the talent and tools to give scientific medicine mass appeal would have to find an outlet with a big audience that was willing to invest in what to their execs would seem a pretty wacky idea.

    Or they could just find a way to blow things up at the end of each show, the way the Mythbusters do. :-)

  24. David Gorski says:

    I know, I’m fast losing that fight.

    So stop fighting it, at least here on SBM. :-)

    If you’d like to join up as a copy editor, then just say so. Just realize that we often finish our posts minutes before they go live; so keeping up would be very hard. And, of course, you’d have to spellcheck and grammar check Mark Crislip’s copy.

    Besides, you don’t want to become known as the Grammarian variety of Flame Warrior, do you?

  25. cervantes says:

    “Or they could just find a way to blow things up at the end of each show, the way the Mythbusters do. ”

    Viagra?

    Oh, I guess that’s not what you meant by blowing things up.

  26. windriven says:

    “[A]nd it’s my fact versus your fact.” – Mehmet Oz

    “Bullsh|t.” – windriven

    Opinions do not equal facts. Dr. Oz is welcome to his opinions – though I’d far prefer he keep them to the doctors’ lounge. But he is not entitled to label wishes and pipe dreams facts. Except on ABC.

  27. stanmrak says:

    “That sounds like a great myth that needs to be busted.”

    What myth? The US spends more than double what any other Westernized country spends on what we call ‘health’ care, yet we rank dead last among those countries in most of the categories that measure health. Clearly, our healthcare system does not work as well as other countries, even though we allegedly have the “best” science.

  28. BobbyG says:

    @David Gorski on 30 Jan 2013 at 3:15 pm

    Lighten up. I wasn’t quoting you. I was point to Oz’s statement.

    I’m an unapologetic crank over the proper use of “data,” particularly within venues purporting to extoll “science.” Sorry. Has nothing to do with lexical flaming (nor “grammarian”).

    It’s just my quixotic “agendum.”

    :)

  29. BobbyG says:

    @stanmrakon 30 Jan 2013 at 3:49 pm

    “The US spends more than double what any other Westernized country spends on what we call ‘health’ care, yet we rank dead last among those countries in most of the categories that measure health. Clearly, our healthcare system does not work as well as other countries, even though we allegedly have the “best” science.”

    Some folks are perfectly fine with that. The CEO of United Health Group was paid $49 million in 2011.

  30. David Gorski says:

    Lighten up. I wasn’t quoting you. I was point to Oz’s statement.

    I know that. It’s annoying anyway. And I was being light. Didn’t you notice that I offered you a job as a copy editor? :-)

    Besides, I rarely, if ever misuse the word “data,” anyway.

  31. mousethatroared says:

    stanmrak ““The US spends more than double what any other Westernized country spends on what we call ‘health’ care, yet we rank dead last among those countries in most of the categories that measure health. Clearly, our healthcare system does not work as well as other countries, even though we allegedly have the “best” science.”

    I’m not aware that we have different “science” than other countries with better health outcomes. We do have a dramatically different health insurance system than many countries that have better outcomes. IMO it’s not our medical science that’s the problem, but our economic approach.

  32. Narad says:

    If you’d like to join up as a copy editor, then just say so. Just realize that we often finish our posts minutes before they go live; so keeping up would be very hard.

    If it weren’t for the obvious turnaround issue, I’d have put in for this gig some time ago.

  33. The Dave says:

    Bill Nye is working on climate change, so I think he’s kind of busy, but someone of comparable appeal would be good. How is Harriet Hall on camera?

    Dr. Hall might not have any interest, but I would be willing to step in the line of fire, and, with a little practice, might even be able to gain some appeal. Heck, I’ve already got my white lab coat, and that’s important, right? We could call it Health-busters, featuring Dr. “The Dave” and, with a little review of basic chemistry, I’m sure we could find plenty of things to blow up, or otherwise demonstrate flashy reactions… :)

  34. nybgrus says:

    My oh my. I write something off the cuff with my morning coffee and then leave for clinic and come back to a plethora of commentation (is that the correct grammatical usage of my obviously cromulus word?).

    Stanmrak is, of course, ridiculous and has received all the attention I plan on giving him.

    @Dr. Novella:

    I will most certainly keep that in mind for some future times when I have millions to bankroll you guys :-D

    @mouse:

    I agree, but while his viewership may not be the end-all be-all source of information and the singular direct force of marketing and “knowledge” his reach is far more wide than just how many people tune in every day. The articles referencing him, the store shelves picked clean after his latest “miracle” supplement is announced, and the general ability to reference him as a popular – and credentialed – individual touting whatever woo-du-jour has significant impact. The reality is that in the general population, citing studies doesn’t convince people. Citing Dr. Oz does. And we have nobody to cite back to refute him. Is it scientifically correct to have a battle o’ celebrity to settle an issue? No. Does it make practical sense? I think so.

    Just look at when he got called out on the apple juice and arsenic shenanigans. They had a doctor come on Good Morning America and flat out call him unscientific and the study BS. Did it do anything? Sure, some and I laud their nod to actual science. But in reality it became “random doctor says nasty things” vs “Dr. Oz, America’s Doctor (™) who really cares about you and has a winning smile says different!”

    @Janet:

    I am well aware, and feel your pain. I went to the Barnes and Noble in my town to look for science books as gifts for friends (that’s the company I choose to keep) and was flummoxed when I found that the entire science section was smaller than the section devoted only to bibles!. That didn’t count the additional sections devoted to “Religion” and the extra sections on “Religious Fiction” (which I found as redundant a statement as I could fathom).

    So what happened? I really don’t know the answer. But I remember growing up with Mr. Wizard and Bill Nye the Science Guy and The Magic Schoolbus. Maybe not everyone liked watching them as much as I did, but everyone at least knew about it. We used to have the entire government pushing STEM as the wave of the future, a way to better our lives, and yes, a way to beat the Ruskies (full disclosure, I am not American, my first language was not English, and was born a Soviet citizen). Was that common enemy really the only thing supporting the US general population’s desire for scientific advancement? How did our political rhetoric change to be so openly anti-science? And the biggest question: what can we do about it? (I think a lot is being done with the upsurgence of the skeptical and atheist movements, making it unfashionable to be anti-science and pointing out the ludicrious stupidity of our elected leaders in their anti-science rhetoric).

    @jdl83:

    I like the idea. Mytbusters was my favorite show and still is one of them. Did you know that at the end of the first season, Jaime was so convinced the show would be an utter flop that he sold the beater car they had bought for one of the myths and then had to re-buy it once the show was renewed? Just goes to show that science and skepticism can sell if framed right. Funnily enough – as mouse commented – it has dropped in my list of faves (and my fiance’s as well) because they became less technical and more entertainment. But I still think they do an invaluable service of popularizing science.

    Of course, they have the added benefit of being able to light stuff on fire, blow stuff up, and do crazy stuff with heavy machinery which makes it much more appealing. It is for that exact reason that I teach my nephews how to blow stuff up and make rockets out of matches and aluminum foil to spark their interest in science (my sister tolerates it, lol).

    Showing people doing molecular biology would be vastly less interesting. But there must be a way to popularize it. Medicine in general is actually a very popular mass media target – just look at shows like ER, House, Gray’s Anatomy, Scrubs, etc. There must be some way to create a hybrid show to teach actual medicine and skepticism with popular appeal like those shows. I’m just not nearly creative enough to come up with it.

  35. David Gorski says:

    If it weren’t for the obvious turnaround issue, I’d have put in for this gig some time ago.

    Indeed. Paul does the best he can given the mess we produce, but it would be great if he had some help.

  36. Narad says:

    Indeed. Paul does the best he can given the mess we produce, but it would be great if he had some help.

    Have him drop me a line and we can talk turkey. You know my proper E-mal address.

  37. “Medicine is a very religious experience. I have my religion and you have yours. It becomes difficult for us to agree on what we think works, since so much of it is in the eye of the beholder. Data is rarely clean. You find the arguments that support your data, and it’s my fact versus your fact.”

    One thing I find odd about such statements is they seem to ignore that fact that a large number of people on this planet (past and present) don’t have such casual attitudes about their religions and faiths. In fact, throughout history and still into present times, people have been willing to kill and die with the conviction that their faith is the only one true and valid faith and all that differ are false religions/faiths that must not be tolerated under any circumstances.

  38. mousethatroared says:

    I’ll help!

    A week of copy editing from me should be punishment enough to silence any recalcitrant grammar critics.

    (Actually, what a nightmare. I’m putting Paul on my list of people to buy a beer for)

  39. denisex says:

    Among the people I know – who are mostly fairly intelligent and well-educated – I believe the number one reason for receptiveness to woo is a deep cynicism about the pharmaceutical industry. People believe that the research is manipulated and some concealed to make drugs appear to be much more effective and less dangerous than they actually are. I think there are unfortunately good reasons for people to feel this way.

    Once you decide that drugs are poison and that doctors are only going to push them on you, you are primed to look for alternatives. Every time a drug is proven dangerous and taken off the market, every time there is news that a drug has turned out to be less effective than the manufacturer claimed, another bunch of patients turn off medicine and start going to acupuncturists.

  40. Proofreading is harder than it seems, especially (in my opinion) when proof reading your own material, since you inherently know what you meant to say or what you thought you said. I typically spend as much time proofreading my modest blog posts as I do composing them. I read through the post about two or three times before publishing, and then I continue to proof read and edit them for a about half hour or so after publication. That would take the better part of a work day with a David Gorski or Kimball Atwood post. :)

    I too would love to assist with proofreading, but I couldn’t consistently guarantee availability and turnaround.

  41. Mark Crislip says:

    Hey. There is no datum existing to suggest my posts are more worser than other posterers.

  42. Narad says:

    Proofreading is harder than it seems, especially (in my opinion) when proof reading your own material

    It can be extremely difficult, depending on how the task is circumscribed. I may have pulled another erratum out of the fire just last week: two mismatches between figures and text (one indisputable, the other maybe just in need of clarification). The corresponding author, the senior author, and reviewers all missed them. Might have slipped in with figure revisions, which is pretty common. “Fresh eyes” are a moving target.

  43. mousethatroared says:

    By the way folks, Thanks for all the science programs suggestions. I work in the studio alone quite often and like to have something engaging to listen to or reading take breaks with. It’s like Christmas.

  44. David Gorski says:

    Hey. There is no datum existing to suggest my posts are more worser than other posterers.

    Be careful what you wish for. We could do a study to test the hypothesis.

  45. windriven says:

    @BobbyG

    “Some folks are perfectly fine with that. The CEO of United Health Group was paid $49 million in 2011.”

    Indeed, insurers are a significant problem. But I would offer hospitals as a bigger problem still. Hospitals consume more of our healthcare spending than physicians and other professional services, dental services and home healthcare services combined.* Pharmaceuticals, the pariah of health care, isn’t even in the same league as hospitals as a percentage of healthcare spending.

    Hospitals are eagerly buying up physician practices while they (hospitals) successfully lobbied to keep hospital reimbursement for outpatient tests and procedures higher than the reimbursement to physicians’ practices for the same services. Hmmmmmmm…

    *http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/downloads/highlights.pdf

  46. Sialis says:

    nybrus – that’s a great idea. Now convince a senior TV executive. Seriously – it’s not like we haven’t been trying to do this. The problem is selling it to the people that matter.

    Why have the TV executives been turning you down?

    nybrus and Sialis need to go to Washington and gain support for such a TV show or at least a mini-series. Maybe with more support, there will be TV executives interested. I have medical story that many medical experts agree is worth at least one blockbuster movie. No joke.

  47. Jacob Riis says:

    Some very good points in post and comments.

    Another TV show I would like to see is a ‘reality-type’ show that challenges the beliefs a group of people who actively and proudly reject evidence and evidence hierarchies in healthcare, by testing these notions in some other area. For example by doing mock trials in a justice system built on their values:
    - “So your son cannot have raped and murdered the girl? He was with you, in a different city at the time? Aha. Are we to accept that a person can’t be two places at once? Really? Can you prove that beyond a doubt? Have you not heard of quantum teleportation?
    - “So your Western science DNA test shows an extremely low likelihood of it being him. Ok. On to our next witness: a psychic who will testify the dead girl says it was definitely him!”
    etc

  48. evilrobotxoxo says:

    Off topic, but data is a singular “mass noun.” It is not a plural – that is simply an affectation that is completely inconsistent with actual use. I’ve been in science for many years, and I’ve never heard anyone use the word “datum,” nor have I ever heard anyone say “I have three data,” or “How many data are in that paper? Five or six.”

    When scientists want to refer to a “datum,” we use terms like “data point” or “data set,” because the word “datum” has no unambiguous meaning.

    This web site has a more comprehensive argument:

    http://nxg.me.uk/note/2005/singular-data/

  49. miclair2013 says:

    The allure of Oz and his ilk and also a lot of our healthcare system (including the SBM variety) is that they offer a quick one stop solution to whatever the current problem happens to be. This is the problem in our society in general. Nobody wants to hear that the problem is complex and needs a slow labored process to solve it. “Do you want to lose weight? Here take this pill. You don’t have to learn to eat properly or exercise – just take this pill.”

  50. mousethatroared says:

    nybrgus “I agree, but while his viewership may not be the end-all be-all source of information and the singular direct force of marketing and “knowledge” his reach is far more wide than just how many people tune in every day. The articles referencing him, the store shelves picked clean after his latest “miracle” supplement is announced, and the general ability to reference him as a popular – and credentialed – individual touting whatever woo-du-jour has significant impact. The reality is that in the general population, citing studies doesn’t convince people. Citing Dr. Oz does. And we have nobody to cite back to refute him. Is it scientifically correct to have a battle o’ celebrity to settle an issue? No. Does it make practical sense? I think so.”

    Maybe I’m not saying what I’m trying to get at very well. I’m trying to say that the media creates it’s own buzz about it’s talkingheads and it manufactures controversies that it’s “experts” can then “address”. I’m not saying that the viewing public doesn’t buy into this. I’m just saying that I’m skeptical of taking the same media source’s word on the influence level of one of their money makers. I’ve seen clients throw lots of money into following potential mirages like this, so I’m cautious. Particularily since I seldom hear Oz’s name come up in conversation. Sanjay Gupta’s name occasionally comes up and then people talk mostly about sources they know. Their doctor, chiropractor, friend, friend who is a doctor or THEM (you know, “They say that…).

    Which is not to say that Oz is NOT influential or that his format isn’t a good model, only that if my goal is to influence people in a particular direction, I’d want to see actual non-bias surveys of what is currently influencing people on that topic. Or, more accurately, I’d want to hire a talented strategist to do that for me and advise me on how to accomplish my goals.

  51. mousethatroared says:

    I think the approach would be different if you just would really like to see more interesting science programing on TV and you have an idea for a good program. I’m really not sure who you would turn to for that…connections and maybe a entertainment agent? I’m completely clueless in that regard.

  52. Some patients (or parents with a sick child) who might otherwise be skeptic, sometimes fall into “thinking” about other treatments for certain conditions. As a new parent myself, when my infant son came down with a cold, i know antibiotics are not needed and that the symptoms usually subside within 10-12 days. But after 4 days, you start to worry… I’ve found myself taking deep breaths and thinking clearly, eliminating those “unscientific” thoughts. It’s only natural for a parent to want to do everything they can for their child.

    My wife and I are both highly skeptical, science-based dentists. If a thought of giving something that we know does not work to our child has crossed our minds…. imagine someone who has no scientific or medical training.

    This is where Dr. Oz is wrong in what he does. It is the job of the doctor to inform the patient… to EDUCATE the patient and let him know what works, what does not work, how it works, and why. And this is why parents should not treat their child either… luckily for us, I’ve got three very nice Science-Based Pediatricians whom I can consult whenever I want.

    It’s hard to sell truth on cable tv. People like tabloids… why do you think Fox News, NYPost, National Enquirer and the like are so popular? They exaggerate the truth.

    Maybe in the future we could have a YouTube channel, or Hulu webisode for on-line/streaming programs…

    http://www.periopr.com

  53. cervantes says:

    Just to be clear:

    It is not grammatically incorrect to construe “data” as a mass noun and apply a singular verb. By analogy, for example, “mathematics” and “physics” are construed as singular even though they were originally the plurals of count nouns. I can legitimately say, for example, “This data is unreliable,” referring to a data set. To say “These data are unreliable” might even be incorrect, because some of the (singular) data elements in the set could well be reliable; but the unreliability of some of them renders “the data,” as a singular mass, unreliable.

    This is a perfectly normal feature of English grammar and occurs with many other originally plural forms. Anyone who aspires to copy editing needs to learn about this and many other nuances.

  54. evilrobotxoxo says:

    @cervantes: I would make a simpler argument for why using “data” as plural is incorrect, which is that nobody, not even the people who claim to believe that “data” is plural, actually use the word that way consistently. They might say “These data indicate…”, but they will never say “How many data are on this flash drive? Three million data.” They say, “How much data is on this flash drive? Three megabytes of data.”

    There are words that can be both a count noun and a mass noun, e.g. “coffee.” I ordered two coffees at Starbucks vs. I bought two pounds of coffee. One could make an argument that “data” has two legitimate uses, which I disagree with, but even if one agrees with that, it’s clear that the singular mass noun form is the dominant one, and the plural form is the one whose validity is debatable.

  55. cervantes says:

    I wouldn’t go that far. Data can still be plural. I don’t have a problem with saying “These data show that . . . ” particularly if you want to draw attention to a multiplicity of data points or multiple sources of evidence. And the word “datum” is still useful if we want to refer to a single observation. But definitely, the insistence that “data” is plural is insufferable pedantry. Language evolves. And “data” is as you note most commonly used as a mass noun because that is the sense in which it is most often applicable.

  56. evilrobotxoxo says:

    I have never, ever heard a person use the word “datum,” and I’ve been in science for a while. There are some contexts in cartography or something where they use “datum” to mean something slightly different, but then they consider the plural to be “datums.” One area where I disagree with you is that I don’t think the word “datum” is useful at all. It has no meaning. “Data point” has meaning, “data set” has meaning, “bit” has meaning, “single observation,” as you point out, has meaning, but “datum” does not. If I tried to use the word “datum” in a scientific paper, the editors would make me take it out because no one would know what I was talking about.

  57. WilliamLawrenceUtridge says:

    homeopathy is natural, Western medicine only treats the symptoms and not the cause of disease, and that homeopathy is “holistic.”

    How is taking a material, grinding it finely and diluting it a 100 times in any way natural?

    How is homeopathy, based on matching symptoms, not treating symptoms? How is it holistic? Because it uses more symptoms in its diagnosis?

    That’s a nice ad slogan, but medicine doesn’t offer these benefits, as far as many of us are concerned. Their approach is entirely about treating symptoms — not actually improving health. There’s a big difference. Treating symptoms with prescription drugs is not the ticket to a longer, healthier life — just a longer one.

    Vaccination doesn’t treat any symptoms. Antibiotics eliminate bacterial infections. Surgery to remove tumors improve health, treat symptoms and address the root cause of disease (the tumor). Insulin to treat diabetes addresses a root cause as best it can (until we can grow new pancreases). Chronic conditions are lifestyle conditions, which doctors urge patients to address through lifestyle changes. The fact that prescription medications are used to treat these lifestyle problems when patients do not follow basic medical advice can not be blamed on doctors.

    What myth? The US spends more than double what any other Westernized country spends on what we call ‘health’ care, yet we rank dead last among those countries in most of the categories that measure health. Clearly, our healthcare system does not work as well as other countries, even though we allegedly have the “best” science.

    Again, one must distinguish between lifestyle conditions, pills and compliance with preventive advice. Not to mention the US essentially doesn’t have a national heatlh care system. The US clearly has excellent science, scientists and scientific medicine for those who can afford it, but most can’t and further, much of the country doesn’t follow the recommendations of those scientists. Medicine involves drugs, but medicine is not solely drugs.

  58. The Dave says:

    (until we can grow new pancreases).

    Would the proper plural be pancrei? :)

  59. cervantes says:

    Sheesh, what a bunch of doofi.

  60. mousethatroared says:

    WLU “Chronic conditions are lifestyle conditions, which doctors urge patients to address through lifestyle changes.”

    Of course we are basically in agreement WLU – but – only SOME chronic conditions are lifestyle conditions. It is true that most people think that you should be able to treat ALL chronic conditions with lifestyle changes, but you can’t.

    Chronic: “A chronic condition is a human health condition or disease that is persistent or otherwise long-lasting in its effects.[1] The term chronic is usually applied when the course of the disease lasts for more than three months.[1] Common chronic diseases include arthritis, asthma, cancer, COPD, diabetes and HIV/AIDS.”

    http://en.wikipedia.org/wiki/Chronic_(medicine)

    I only say this because I get tired of folks trying to get me to go off medication for my chronic condition(s) and treat it with ‘lifestyle’ changes.

  61. Narad says:

    Would the proper plural be pancrei?

    Pancreata, if you must know.

  62. WilliamLawrenceUtridge says:

    Of course we are basically in agreement WLU – but – only SOME chronic conditions are lifestyle conditions. It is true that most people think that you should be able to treat ALL chronic conditions with lifestyle changes, but you can’t.

    Chronic: “A chronic condition is a human health condition or disease that is persistent or otherwise long-lasting in its effects.[1] The term chronic is usually applied when the course of the disease lasts for more than three months.[1] Common chronic diseases include arthritis, asthma, cancer, COPD, diabetes and HIV/AIDS.”

    http://en.wikipedia.org/wiki/Chronic_(medicine)

    I only say this because I get tired of folks trying to get me to go off medication for my chronic condition(s) and treat it with ‘lifestyle’ changes.Heh, I’ve edited that wikipedia page.

    Science treats every condition as specific – so while “healthy lifestyle” will be good for many conditions and keep many people healthy, it won’t be good for all of them and scientific reasoning will never suggest they would be. Stan’s nonsense claims are the usual gross-oversimplifications and sometimes outright lies that characterize the pharma-fearing SCAM crowd. He’s not interested in specific or evidence, he just wants to pimp his woo (specifically vitamins I believe).

    So yeah, my statement was a gross oversimplification; some chronic conditions are lifestyle conditions, some aren’t. Type I diabetes is at a coincidentally unique situation in that it shouldn’t be a lifestyle condition (yo pancrease be ded) but can be treated through lifestyle measures (diet and exercise – before insulin was readily available, the only way to treat hyperglycemia due to type I diabetes was exercise)!

    It really comes down to a false dilemma – Stan wants medicine to fail, or be “bad” so his preferred form of woo therefore is good, and damn the real evidence. Makes for a simple story but a lot of unnecessarily dead people.

  63. WilliamLawrenceUtridge says:

    Damn you blockquote fail.

    My comment starts at “Heh, I’ve edited that wikipedia page” and everything before is a quote of Mousethatroared.

  64. Sialis says:

    @WLU, I was going to ask you to expand on your comment that chronic conditions are lifestyle conditions. It seems like some people are of the opinion that all chronic diseases can be prevented by making lifestyle changes. Some chronic conditions are due to poor lifestyle choices, but not all of them. Some chronic conditions are merely exacerbated by poor lifestyle choices.

    There are some chronic conditions that are chronic because of the patients inability to obtain an accurate diagnosis, and what may seem to be their poor lifestyle choices may actually be a manifestation of their untreated disease process. When patients are given no accurate diagnosis and fall into a dustbin of ‘something’s wrong, but we don’t know what it is, so we can’t treat it’, are left basically twisting in the wind they have little choice other than do the best they can with what they’ve got. In general I get tired of people who too quickly label others as making poor lifestyle choices, such as diet and not enough exercise. What do you do if you have a recognized and established disease process which greatly effects your ability to exercise or cook, grocery shop, or work and you are left without treatment to care for yourself?

    Sedentary lifestyles lead to weight gain. Do people consider those with undefined and untreated chronic disease as always merely making poor lifestyle choices? It seems that too often people judge others without knowing all the details of their conditions. They see people with heart, weight, muscle or other problems, and assume is preventable and solely due to poor lifestyle choices – exercise more and eat better and everything will be fine. Sorry, but I just get tired of hearing that some days.

  65. mousethatroared says:

    @WLU -I understand that you were arguing against Stanmrack’s misconceptions, but doing so by reinforcing another prevalent misconception may not be so helpful. ;)

    @Sialis – Too true…and it’s not just folks with undiagnosed diseases either. I’ve know several relatives of folks with Rheumatoid Arthritis who express beliefs that the sufferer “doesn’t need all those drugs, they just need to exercise more and eat better.” Of course it’s true that a good lifestyle can help elevate some of the problems with RA, but it’s not “treatment”. Jeez, I even know a guy with Polycystic Kidney Disease (now transplanted and doing well) who took criticism from friends and family about his “poor” diet and exercise (all that time on dialysis is no reason to slack off on the exercise, I guess.)

    Okay, nuff said. I don’t want to beat a dead horse.

  66. WilliamLawrenceUtridge says:

    Thanks for clarifying my sloppy terminology folks :)

  67. The Dave says:

    Would the proper plural be pancrei?
    Pancreata, if you must know.

    Buzzkill :)

  68. Sialis says:

    @Mouse – Are you sure that diet can’t effectively treat the symptoms of Rheumatoid Arthritis? The way I hear it is that Rheumatoid Arthritis is treated with dietary changes – ASEA! That’s how a doctor around here is treating it. You mean that’s not “treatment”, uh oh, I wonder if he’ll get in trouble for promoting ASEA to treat his RA patients? ;-)

  69. paleskinnerd says:

    Interesting discussion- I too have had it up to ‘here’ with Oz fawning over Mercola (and his glorified $3000 tanning beds) and agree wholeheartedly that the narrative needs an update..clearly you need to fight fire with fire.
    But I think you could be overlooking a credible health care journalist who has already demonstrated a keen interest in seeing past the smoke and mirrors… Bridget Huber at FairWarning is making a difference!

    http://www.fairwarning.org/writer/bridget-huber/

    —————————————————————————————————————————————–

    California Lawmaker Seeks Federal Probe of New Tanning Industry Group

    By Bridget Huber on February 7, 2013

    A California lawmaker is urging federal regulators to investigate a new tanning industry group he says is using “junk science” to mislead the public about the risks of sunbeds.

    http://www.fairwarning.org/2013/02/california-lawmaker-seeks-federal-probe-of-new-tanning-industry-group/

    —————————————————————————————————————————————–

    New Tanning Industry Campaign to Dismiss Skin Cancer Threat Draws Fire from Doctors’ Group

    By Bridget Huber on January 22, 2013

    A new campaign by the tanning industry to promote the safety of sunbed use has come under fierce attack from a national doctors group.

    http://www.fairwarning.org/2013/01/new-tanning-industry-campaign-to-dismiss-skin-cancer-threat-draws-fire-from-doctors-group/

    ————————————————————————————————————————————-

    Burned by Health Warnings, Defiant Tanning Industry Assails Doctors, ‘Sun Scare’ Conspiracy

    By Bridget Huber on August 23, 2012

    The $4.9 billion tanning salon industry repeatedly has faced charges of misrepresenting health risks. So how is the industry responding? By going on the offensive with an audacious campaign to blunt skin cancer fears by discrediting physicians and health groups as members of a ‘Sun Scare’ conspiracy. Using tactics that seem cribbed from Big Tobacco’s playbook, the industry has challenged widely accepted scientific findings and funded advocacy groups to spread its message that sunbed use is a healthful source of vitamin D.

    Quote “Yet the close ties between the tanning industry and the web of nonprofit groups that promote the health benefits of Vitamin D often are not readily apparent. The website for the Vitamin D Foundation, for example, discloses no industry affiliation, though 2010 tax documents reveal that its top personnel were all people in the business. In addition to Levy, they include the CEO of Beach Bum Tanning, a chain with 53 salons, and the president of the Joint Canadian Tanning Association, who also owns a large chain of salons.

    These groups raise money at salons by selling tanning lotions, wrist bands and T-shirts. Then they funnel the funds to vitamin D researchers and organizations that reinforce the industry’s claims about the vitamin’s health benefits, while directly or indirectly promoting the idea that tanning is healthful. One such organization is the Breast Cancer Natural Prevention Foundation, which promotes vitamin D for breast cancer prevention.

    The founders include Dr. Sandra K. Russell, an obstetrician-gynecologist who appeared in advertisements for Smart Tan wearing her lab coat and a stethoscope.”

    http://www.fairwarning.org/2012/08/burned-by-health-warnings-defiant-tanning-industry-assails-doctors-sun-scare-conspiracy/

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