Articles

Dr. Oz and the Terrible, Horrible, No Good, Very Bad Day

Not Dr. Oz's usual television audience

Not Dr. Oz’s usual television audience

Dr. Mehmet Oz is one of the most well-known, and possibly the most influential medical doctor in America. The Dr. Oz Show is broadcast in 118 countries and reaches over 3 million viewers in the USA alone. When Oz profiles a product or supplement on his show, sales explode – it’s called “The Dr. Oz Effect”. Regrettably, Oz routinely and consistently gives questionable health advice, particularly when it comes to weight loss products, where Oz regularly uses hyperbolic terms like “miracle” for the products he profiles:

  • (On green coffee extract) — “You may think magic is make-believe, but this little bean has scientists saying they found the magic weight-loss for every body type.”
  • (On raspberry ketone) — “I’ve got the number one miracle in a bottle to burn your fat”
  • (On Garcinia cambogia) — “It may be the simple solution you’ve been looking for to bust your body fat for good.”

Dr. Oz has profiled so many dubious health strategies that “The Dr. Oz Effect” more accurately refers to the wasted time, effort and finances of any consumer that actually follows his health advice and purchases the steady stream of “miracles” that Oz endorses on his television show. Not surprisingly, Science-Based Medicine is probably Oz’s most persistent and tenacious critic. It’s not just that he’s high profile – it’s that Dr. Oz is a bona fide physician who ought to know better, but chooses to ignore science in favour of hyperbole. It’s the antithesis of what a health professional should be doing. And this is the root of the Oz problem: Oz can give good advice, but he regularly combines it with questionable statements and pseudoscience in a way that the casual viewer can’t distinguish between the science and the fiction. So when Oz calls something a miracle – people listen. Even when miracles show up several times per year.

When it was announced that Dr. Oz had been invited to speak by Senate Commerce subcommittee Chairwoman Claire McCaskill (D-Mo.) about weight loss scams, at least one irony meter exploded. A protégé of Oprah, his spin-off television show started in 2007 quickly became a platform for hosting other dubious “experts”, offering questionable health advice, and repeatedly profiling today’s versions of snake oil. So asking Oz to speak about weight-loss scams seemed absurd, given he’s possibly the most influential promoter of weight loss scams in America. A friend of the blog suggested that a better use of Dr. Oz would have been to hold him up as an example of the very problem he’d been asked to speak about.

Well that’s exactly what happened. On Tuesday Dr. Oz admitted that when it comes to weight loss products, hype trumps the evidence, every time. I strongly suspect that Senator McCaskill or her advisors have been reading Science-Based Medicine, as her extended evisceration of Oz (and a reference to, yes, “science-based medicine”) is a true delight to watch:

“The scientific community is almost monolithic against you in terms of the efficacy of a few products that you have called miracles,” she added. “I just don’t understand why you need to go there … You are being made an example of today because of the power you have in this space.” – Senator McCaskill

Senator McCaskill repeatedly grilled Dr. Oz on green coffee beans, one of his most absurd “miracle” supplements that he’s endorsed. Here’s the key excerpt, and I thank friend of the blog, Dr. Peter Lipson, for taking the time to transcribe it:

Dr. Oz: Well, if I could disagree about whether they work or not, and I’ll move on to the issue of the words that I used. And just with regards to whether they work or not, take green coffee bean extract as an example. Uh, I’m not gonna argue that it would pass FDA muster if it was a pharmaceutical drug seeking approval, but among the natural products that are out there, this is a product that has several clinical trials. There was one large one, a very good quality one, that was done the year that we talked about this, in 2012. Listen, I’ve…

Sen. McCaskill: wh..wha..I wanna know about that clinical trial. Because the only one I know was sixteen people in India that was paid for by the company that, that was in fact, at the point in time when you initially talked about this being a miracle, the only study that was out there was the one with sixteen people in India that was written up by somebody that was being paid by the company that was producing it.

Dr. Oz: Well, this paper argue that there was no one paying for it, but I have the, four papers, five papers actually plus a series of basic science papers on it as well. But, but Senator McCaskill, what, if I, we can spend a lot of time arguing the merits of whether green coffee bean extract is worth trying or not worth trying. Maybe the things that we argue you do with regard to your diet are likewise criticizable, I mean should you be on a low fat diet, a low carb diet, we b…I spent a good part of my career recommending that folks have a low fat diet, but we’ve come full circle in that argument now and no longer recommend that now, many of us who practice medicine because it no longer worked for our patients. Now it is remarkably complex, as you know, to figure out what works for most people even, in a dietary program.

In the practice of medicine we evolve by looking at new ideas and challenging orthodoxy and evolving them. So…so when I hold…these are the five papers, these are clinical papers, uh, and we can argue about the quality of them, very justifiably, uh, I could pick apart papers that showed no benefit as well, but, at, at the end of the day, I have clinical subjects, real people, having undergone trials, and in this case I actually gave it to member of my audience it wasn’t a formal trial, it was just an exch…

Senator McCaskill: Which wouldn’t pass…the trial you did with your audience, you would not say that it would ever pass scientific muster.

Dr. Oz: No, I would never publish the paper. It wasn’t done under the appropriate IRB guidance, that wasn’t the purpose of it. The purpose was for me to get a thumbnail sketch, was this worth talking to people about or not. But again I don’t think this should be a referendum on the use of alternative medical therapies ’cause if that’s the case then I’ve been criticized for having folks come on my show and talk about the power of prayer. Now again as a practitioner I can’t prove that prayer helps people survive an illness, I…

Senator McCaskill: Sure, but it’s hard to buy prayer.

Dr. Oz: Hard to buy prayer. That’s the difference.

Sen. McCaskill: Prayer is free.

Dr. Oz: Yes, prayer is free, that’s a very good point.

The episode on green coffee beans is a true case study in pseudoscience, illustrating the woeful lack of evidentiary standards Oz applies on his show. McCaskill is absolutely right: The clinical trials done on green coffee beans have been small and inconclusive and there is no way to honestly make any definitive conclusions about its efficacy. Yet rather than warning viewers to avoid it, Oz did the exact opposite. He doubled-down on this particular miracle by setting up a dubious clinical trials among his audience and didn’t even bother getting IRB approval (something that’s almost certainly unethical and against his university’s rules for experimentation on humans). Demand exploded to the point that green coffee bean is now the subject of FTC action.

As is the habit for Oz, he didn’t stray too far from his usual M.O. on the show – he extrapolates from weak clinical evidence to make grandiose claims by cherry picking the most supportive strands of evidence to give the impression of being evidence-based. Oz is a believer, no matter what the evidence says. McCaskill called him out directly on this:

I don’t get why you need to say this stuff because you know it’s not true. So why, when you have this amazing megaphone, and this amazing ability to communicate, why would you cheapen your show? – Senator McCaskill

What’s most remarkable with Oz is his simultaneous acknowledgement that the products he profiles lack credible scientific evidence and his simultaneous endorsement of those same products:

I actually do personally believe in the items I talk about in the show. I passionately study them. I recognize that often times they don’t have the scientific muster to present as fact, but nevertheless, I would give my audience the advice I give my family all the time, and I have given my family these products. – Dr. Oz.

To Oz, his show is actually about protecting the consumer – not misleading them. He even brought a slide deck to the Senate with that title:

Oz – Not Protecting the Consumer

Oz claimed that he’s backed off from using hyperbolic terms to describe weight loss products for “two years”. McCaskill, clearly having done her homework, quoted Oz from just 3 weeks ago:

Every time you cheat on your diet, I want you to grab one of these tiny, itty-bitty pills. This tiny tablet can push a lot of fat out of your belly. – Dr. Oz.

Part of the problem

What’s most ironic about Oz is that notwithstanding his weak acknowledgement of the problem with his hyperbole, he still sees himself as the victim. He’s not going to stop his breathless endorsements and quick fixes. What’s most irritating to Oz is that promoters are using his name to promote their products – and he’s not recommending a vendor:

You know … the biggest disservice I have done for my audience? It’s that I never told then where to go to buy the products.

Wrong Dr. Oz. The biggest disservice that you have done for your audience is to abuse your title of physician by telling your audience what you think they want to hear, instead of the scientific facts. While Oz may not be directly profiting from the sale of these useless products, he’s using a platform of trust to give demonstrably bad health advice to millions. It may not be illegal, but there’s no question the Dr. Oz show perpetuates the “quick fix in a pill” mythology of weight loss and distracts viewers away from taking sensible approaches to weight loss. It’s the perfect platform for countless weight loss scams, and it was nice to see Oz called out as a big part of the problem.

Posted in: Health Fraud, Herbs & Supplements, Medical Ethics, Politics and Regulation

Leave a Comment (166) ↓

166 thoughts on “Dr. Oz and the Terrible, Horrible, No Good, Very Bad Day

  1. Windriven says:

    “but, at, at the end of the day, I have clinical subjects, real people, having undergone trials, and in this case I actually gave it to member of my audience it wasn’t a formal trial, it was just an exch…”

    Oz channels Steve Rodrigues!!!

    I was never a huge Claire McCaskill fan till yesterday. She went after Oz with a broom like she was after a weasel in the hen house. Great stuff. Probably won’t make a lick of difference but it was the first time something good has happened in the Senate for some time now.

    1. Andrey Pavlov says:

      Probably won’t make a lick of difference but it was the first time something good has happened in the Senate for some time now.

      I wouldn’t be so hasty windriven. The social media and internets has blown up with Oz getting his braying a$$ (h/t) to him. I have literally never seen so much on one single incident get spread around my corner of the internets as much and as fast. I’ve been sharing it like mad. The 1st and 2nd year med students I am friends with have been “liking” and sharing it as well. As have my non-medical friends. I’ve tweeted it and that has been re-tweeted and favorited by entities with large followings. I’ve directly tweeted and FaceBooked McCaskill with kudos. Reddit is abuzz with it and the comments are overwhelmingly what you and I like to hear. And I have been sharing around Michael Specter’s excellent New Yorker on Oz, which a surprising number of people had never seen and the response has been jaw-dropped awe and incredulousness at just how bad Dr. Oz actually is, with that being spread around and shared as well.

      Popular websites, not just science ones, are sharing the video clips and the transcripts of McCaskill’s handiwork. Even Buzzfeed has it. Jerry Coyne over at Why Evolution is True is on it, as is PZ Myers at Pharyngula and even Hemant Mehta at The Friendly Atheist. In other words, huge audiences are getting this featured, and not all of them are strictly science or medicine related.

      The #DrOZ is flooded with references to it, and thousands of people calling him out on his BS. Dr Drew Pinsky (of HLN, a CNN subsidiary) is talking about it. Fox affiliate newscaster John Brown had this snark to say:

      At risk of being hauled in front of Congress, today I am officially endorsing the ‘risky’ weight loss program of diet and exercise. #droz

      Even freakin’ Fox News’ James Rosen has jumped in on it.

      From a quick glance 99% of the #DrOz on twitter since the FTC hearing has been about how much of a charlatan he is, how he promotes pseudoscience, and references and links to the hearing itself.

      America may love Dr. Oz but we also love watching the mighty topple.

      1. Windriven says:

        “America may love Dr. Oz but we also love watching the mighty topple.”

        I’ll keep my fingers crossed. If there was ever an egg sucking dog who needed toppling, Mehmet Oz gets my vote.

      2. Pongo says:

        True–it is getting a lot of media attention, but have you read the comments sections? Dr. Oz defenders are on the warpath. ‘None so blind,’ and all that.
        He’ll no doubt use this episode to build his victim bona fides and increase his appeal to those already inclined to believe CAM practitioners are unjustly targeted.

        The fact that he continues to hold an academic role at Columbia is a bigger mystery to me. Kind of embarrassing for them.

        1. Andrey Pavlov says:

          Dr. Oz defenders are on the warpath. ‘None so blind,’ and all that.
          He’ll no doubt use this episode to build his victim bona fides and increase his appeal to those already inclined to believe CAM practitioners are unjustly targeted.

          True, but at least it gets the conversation going. And folks like us will be asked to comment. I cannot see him escaping this entirely untarnished. True Believers will be true believers. The fence sitters, potential new viewers, and those who had their suspicions but no good reason to ditch him will be benefitted.

          The fact that he continues to hold an academic role at Columbia is a bigger mystery to me.

          $$$$

          A very good friend of mine used to do cell culture work at Columbia before med school. He told me a few times he ran into Oz and spoke with him. Said the guy was obviously arrogant and a prick.

          1. Windriven says:

            “He told me a few times he ran into Oz and spoke with him. Said the guy was obviously arrogant and a prick.”

            (Captain Renault voice:) I am shocked!

          2. Greg says:

            Not surprising – his arrogance is pretty obvious to anyone who takes a critical look at his show. Never liked him from the get-go and will be happy to see his demise.

          3. Frederick says:

            I don’t doubt it, In the new yorker article you linked not long ago, you could see that he LOVES attention, being popular, maybe a little narcissistic side? Dr. Oz show is a personalty cult, that what it is.

          4. Kathy says:

            “Sen. McCaskill: Prayer is free.
            Dr. Oz: Yes, prayer is free, that’s a very good point.”

            Schoolteacher: “That’s a very good point, little Claire. I see you’ve done your homework, you good girl.”

            Umpf.

            1. Petticoat Philosopher says:

              Luckily she doesn’t take shit. The awesome thing about Claire McCaskill is that she looks like this mild, sweet soccer mom but she’s smart as hell and relentless. I would not want to mess with her. And that’s why I love her. :-)

        2. Kaycee says:

          “Dr. Oz defenders are on the warpath.”

          The defenders I’ve seen are countering on social media with the fact that McCaskill took campaign contributions from Monsanto. They play the Monsanto card whenever they can, even when it’s completely irrelevant as it is in this situation.

      3. Shell Bush says:

        When was the New Yorker piece published? My mother-in-law reads it and I would like her to send it to me.

    2. Andrey Pavlov says:

      OK, I have to temper a little bit of my enthusiasm in the comment. Dr. Drew screwed the pooch on this one. I used to listen to him occasionally from his LoveLine days but beyond that never had a strong impression of him one way or another. However, in this clip from his show, he is gratuitously defending Dr. Oz. At least the first person on his panel (I don’t know who any of those people are) just reamed him as well.

      But regardless, despite the fact that Drew is seemingly a fanboy, the point is it is getting play and the segment is not all just osculation of Oz’s raspberry ketoned rump. I’ll still count it as a point in our favor because it gets more people talking about it, just not as huge a point as I had hoped.

      1. Windriven says:

        Jesus. Depressing. I wonder if Drew watched the same hearing as I did?

        1. Andrey Pavlov says:

          Indeed. I actually commented on the page calling him out and using a direct quote from Dr. Oz himself where he straight up said he intentionally used that flowery language.

    3. Frederick says:

      LOL Yeah, when he talks about that My “anecdotal evidence” alert went to the roof
      I told myself : Yeah right buddy!
      And he did sound like SSR.

      Strange he have not show up it here yet.

    1. Andrey Pavlov says:

      Haven’t had a chance yet to listen to the whole thing but I will when I hop on the bike in a little bit.

      Over here is another piece on it from The Examiner that has this great line:

      And while he did not use the words “placebo effect,” Dr. Oz added that supplements such as green coffee extract can provide “the confidence to keep going.”

      Zing!

  2. David Gorski says:

    I don’t get why you need to say this stuff because you know it’s not true.

    In case you’re wondering, yes, Sen. McCaskill just called Dr. Oz a liar to his face.

  3. Andrey Pavlov says:

    I watched the entire FTC hearing. All 90+ minutes of it. 95% of it was surprisingly stunning awesome from McCaskill and actually the other senators grilling Oz as well.

    However, one tiny bit of not-so-great outcome was that it was suggested that Oz officially endorse certain manufacturers of certain products. The main thrust of the FTC at the end was that they don’t care if the supplements are being sold (they can’t, because of the DSHEA it isn’t illegal) but merely that the claims associated with them are appropriate. They want the “fly by night” companies to be shut down. So the mutually agreed upon conclusion was to have Oz create a “master list” of Oz-approved suppliers. Ostensibly this is to have both “high quality” supplements and that these companies will not make hyperbolic claims (and if they do, they can be easily tracked down and sanctioned). Ultimately, I think it will just prove a boon for Oz and those few companies he puts on the master list.

    But, at least he acknowledged and the internet is abuzz with how unscientific his claims are. So perhaps in the future, if he does keep using his “flowery language” it will actively turn people off.

  4. Vasileios Anagnostopoulos says:

    The Holy Scripture is very clear on Mr Oz.

    Leviticus 19:31
    Deuteronomy 18:9-14
    Leviticus 20:27

    I am an orthodox Christian. Science makes mistakes but its human to make mistakes. Charlatans cover mistakes, and this is against God and humans.

    1. Greg says:

      Religion has been detrimental to the advancement of science, so I would hazard a guess that most people on here don’t care what the “Holy Scripture” denotes about Oz. In fact, many religious people are the charlatans of which you wrote.

    2. WilliamLawrenceUtridge says:

      So you need a book to tell you that exploiting grieving people is a bad thing? That’s a little terrifying.

      Also, while I think Oz is a douchebag and a liar, you appear to be advocating violence against him:

      Leviticus 20:27 – “A man or woman who is a medium or spiritist among you must be put to death. You are to stone them; their blood will be on their own heads.”

      While I think Oz deserves to be mocked and disrespected, I do not think he deserves outright murder.

      Say, in your vehemence to support scripture, do you avoid cotton-poly blends, as decreed in Leviticus 19:19? And how many slaves do you keep, as permitted and even encouraged by the Bible (Leviticus 25:44-46). Would you consider Canadians to be “foreign” enough to be enslaved in America? Or is it only brown people who it’s OK to enslave?

      And to be clear – I’m outright opposed to slavery in all forms. This is probably a point we will never agree upon.

    3. Lytrigian says:

      Is it really necessary to verbally assault a guy who’s finding reasons to agree on other grounds?

      1. Windriven says:

        “Is it really necessary to verbally assault a guy who’s finding reasons to agree on other grounds?”

        I’m right on the edge, Lytrigian. I’m a pretty rock-ribbed atheist and when I first read the comment I thought to fire off something snide, then had an impulse much like yours. His argument seems to be that charlatans cover their errors while scientists recognize theirs.

        I’m also wondering if we’re beeing spoofed a little. Read the guy’s last name:

        Anagnostopoulos – Son of an agnostic.

        1. Lytrigian says:

          I’m also wondering if we’re beeing spoofed a little. Read the guy’s last name:

          Anagnostopoulos – Son of an agnostic.

          I think that’s not the correct etymology. The root seems to be “agnos”, meaning defiled or unclean. “Anagnos” is therefore “undefiled”. -tos would turn it into a noun, “Anagnostos”, and “-poulos” is, as you observe, a patronymic. So this is “Son of the undefiled.” Probably.

          It is, in any event, a genuine Greek surname, so it may be coincidence anyway.

          1. Windriven says:

            Lytrigian, Mine is pigeon Greek. Not even, really. Yours appears to be far better and your translation makes lots of sense.

            1. Lytrigian says:

              Mine’s really no better, although as a former Orthodox Christian myself I’ve heard my share of it. I use a number of references when I want to pretend I know something.

      2. Marion says:

        Too bad, Lytrigian. It’s called freedom of speech.

        1. mouse says:

          pfft – This is my pet peeve. I didn’t see Lytrigan attempting to imprison anyone or government sactioned burning of the comments under dispute. (which would be a neat trick…burning web comments). Freedom of speech means freedom from government repression of speech. It doesn’t mean freedom from any negative feedback what-so-ever.

          1. freedom of speech does NOT include freedom from the consequences of knowingly telling outright lies on national TV that you know damn well are going to harm other people in your pursuit of monetary gain.

            When are we going to see “dr” oz stricken from the record like “dr” andrew wakefield for unethical behavior?

        2. Lytrigian says:

          Besides the wisdom from the Mouse, there are other reasons not to be this nasty. There are a great many religious people who would be enthusiastic participants in a great deal of what the skeptic community stands for. Apart from what they do on Sunday — typically with no attempt to legislate their doctrines or impose them on others — they would be pretty much on “our side”. Considering the many public policy issues on which SBM and other skeptical points of view have a thing or two to say, what’s really needed is to get as much of the voting public as possible thinking the right way on these subjects.

          If you choose to insult them every time they show their faces, even as in this case totally missing the point of what they’ve said in order to do it, you’re not doing that. It’s counterproductive.

          A great many skeptics are atheist, but atheism should not be a requirement just to show up.

          1. Kathy says:

            Yeah, take it easy, there’s a lot of Christians (and Jews, Muslims, etc.) out there who decline to use, buy or recommend pseudo remedies. We aren’t necessarily naive or stupid, and it’s unjust to imply that we are because we are religious. If you contend that more religious folk are naive re woo than are atheists, then do you have evidence? Citation please.

            This reminds me of the recent Left Wing vs Right Wing argument on this website … which are more woo-prone? Seemed to me sceptics were just as prone to have favourite beliefs as anyone else. But that’s just my opinion … I have no proof!

            When negative comments are made re Christianity or the Bible, I must either argue or I must shut up and endure it silently. If I wanted to argue with atheists I would go to their websites. So I must put up with this sort of comment on SBM, sans reply.

            This isn’t a religious website, it’s about science based medicine. That’s why I come here, not to discuss religion.

          2. Andrey Pavlov says:

            A great many skeptics are atheist, but atheism should not be a requirement just to show up.

            As a huge fan of the late, great Hitch I can fully and unreservedly agree with this.

            The flipside though is that skepticism is skepticism. And all targets are fair game when they enter the arena.

            For example Reiki is and eastern mysticism version of faith healing. It is not unreasonable to point out both are bunk. Same with the idea of intercessory prayer for the treatment of disease. I’ve drawn parallels between religious belief and CAM belief because I see them there and it is at times a useful point to make. I very seldomly bring up religion around here, but if it is brought up by others I don’t feel I need to be silent on the topic insofar as it at least relates to the science/medicine topic at hand, though I will refrain from derailing a thread over it.

            @kathy:

            We aren’t necessarily naive or stupid, and it’s unjust to imply that we are because we are religious. If you contend that more religious folk are naive re woo than are atheists, then do you have evidence?

            A couple of things I have learned being rather active in skepticism regarding both medicine and religion is that you are absolutely correct. Atheists and theists alike are prone to believing in woo and ridiculous ideas, same as Republicans and Democrats. There may be a propensity for which specific types of woo and anti-science each group has, but it is (to the best of my knowledge) incorrect to say that one group as a whole is more prone to it than another.

            And specifically there are naive and stupid atheists and smart and critically thinking theists. The reality is that there is pretty much always more in-group heterogeneity than between-group heterogeneity.

            The reason for any person to hold incorrect or silly ideas on a given topic is very often because that specific topic is simply not examined with the same detailed rigor as other claims. Humans are very good at maintaining cognitive dissonance. Francis Collins is a handy example.

            So absolutely not – nobody should be lambasted a prior simply because they have a religious affiliation. That person could just as easily be an incisive critically think ally as an atheist or be as useless a woo-meister as many atheists as well.

            That said, I think it is recognized that there is a rather skeptical eye on theological claims and if they come up relevant to the topic at hand should also be fair game for skeptical analysis. But that is identical to any other idea or ideology that any other person (atheist or not) may bring to the table as well. Some brands of veganism, for example, are profoundly unscientific.

            In the very specific example that brought about this conversation, I personally chose to refrain from responding simply because the initial comment didn’t interest me. But if I had, my response would have been along the lines of pointing out that there are good reasons to agree that are more objective and can be agreed upon by everyone, without the need to invoke the Bible as justification. If Vasileios Anagnostopoulos wishes to have those Biblical ideas in addition so be it. In this case it does not have anything directly to do with SBM and as such I find Greg’s comment to be simply… pointless. And that is despite mostly agreeing with his comment.

            1. Windriven says:

              I hadn’t wanted to wade into this because of Kathy’s point that this was about science based medicine but here we are so…

              The issue of religious belief has standing in scientific discussion because religious conviction reflects the antithesis of scientific rigor: acceptance as fact of something without evidence.

            2. Harriet Hall says:

              When a commenter brings religion into the discussion, it should be sufficient to politely remind him/her that this is a science-based blog and that religious texts and beliefs are not scientific evidence.

              1. Calli Arcale says:

                They are not scientific evidence, but there may be other reasons to use them. Not all arguments need be scientific; they can be emotional as well, and I felt the point being made above was that even religious folks should agree — and perhaps should agree even more strongly — that conning people is wrong. And mentioning Eastern Orthodox Christianity is relevant, given where Dr Oz is from; it’s a tradition he likely grew up with, so an admonishment in that context seems worthwhile to me.

                Sometimes you can argue successfully against the fool even on non-scientific ground. It’s a useful way of showing them to be internally inconsistent.

              2. Serge says:

                Or evidence full stop.

            3. Lytrigian says:

              For example Reiki is and eastern mysticism version of faith healing. It is not unreasonable to point out both are bunk. Same with the idea of intercessory prayer for the treatment of disease.

              True enough, but let’s not talk about outliers, as those who attempt to rely on faith healing surely are. No one really relies on intercessory prayer either. You do all the correct science-based medical interventions and you pray. At worst, this results in God getting some credit for, if nothing else, making competent doctors available where and when you need them. I have a hard time seeing the harm here.

              If Vasileios Anagnostopoulos wishes to have those Biblical ideas in addition so be it.

              If that were not his point of view, I have a hard time seeing why he’d even read this blog at all.

              1. Andrey Pavlov says:

                True enough, but let’s not talk about outliers, as those who attempt to rely on faith healing surely are.

                Sure, it’s not relied upon per se. But the NCCAM saw fit to fun a ~$650,000 study on whether intercessory prayer would lower HIV serum titers. I’d take a mere 10% of that and give you the answer over a beer.

                The point being is that I think while Dr. Hall’s suggestion is indeed 99% of what should be done, I personally believe that there is merit to nudging the cultural norms to realize that religion is indeed a silly (albeit understandable) delusion such that it becomes no more justifiable to spend over half a million studying the effects of prayer on HIV as it is to study the effects of Elvis Presley administered Reiki on HIV.

                I have a hard time seeing the harm here.

                I absolutely agree that the harm is minimal. And I can assure you that in practice I would never dream of removing the delusional self assurance a patient in prayer has. I have actually prayed with a patient who grabbed my hand and asked me to while I was working on her as a trauma victim.

                But in less pressing and vulnerable circumstances I am of the opinion that at least a gentle reminder that the ideas of religion/theism and basing arguments on them are indeed silly. I use the word “silly” intentionally because I feel it is negative enough without profoundly offensive connotations.

                I believe that the only way to rid ourselves of the folly of theistic thought is to simply make the prevailing culture one where arguments and thoughts based in it are found to be… silly. It is my own pet bugaboo and I make no apologies for it, though I do try and be restrained and minimal of my discussions of it here. I do not feel that I need to have it be zero or absolutely minimal though. If others disagree, I am willing to listen. If the gracious hosts of this blog ask that I desist, I will respect that.

                If that were not his point of view, I have a hard time seeing why he’d even read this blog at all.

                I will disagree with you here. I’ve recently had a few conversations about this very idea. People may come to the same conclusions on certain topics for very different reasons. At times, there is no reason to rock the boat and cast out (at least temporary) allies. But I believe that the point of SBM and skepticism at large is not about the outcomes but the process.

                As an example, Penn Jillette has shown himself not to be a skeptic at heart. He merely arrived at many conclusions we all agreed with because of a different ideology that led to similar conclusions – his atheism and anti-theism, his “pro-science” stance, and his libertarianism happened to align with many of the same goals and conclusions of the skeptical community. But his atheism was mostly reactionary (religion = bad, no more thought necessary), his “pro-science” stance was about outcomes, not process, and his libertarianism overlapped with our general ethos that people should be allowed to have any and all freedoms that don’t impinge upon the freedoms of others. The problem is that when pushed beyond that core of overlapping, to the outside of the multi-circled Venn diagram, Penn’s thoughts and reactions violently clashed and he lashed out.

                My point being that I don’t see it as necessary that Vasileios Anagnostopoulos’ Biblical ideas are additional to his science based means of arriving at a conclusion. They could just as easily be the only basis by which he arrived at them.

              2. Eldric IV says:

                “No one really relies on intercessory prayer either. You do all the correct science-based medical interventions and you pray. At worst, this results in God getting some credit for, if nothing else, making competent doctors …”

                It is a shame that Protestants dropped Sirach from their Bibles as this point is addressed directly in chapter 38. It would otherwise serve as a prooftext against any fundamentalist objection to medical care being over or against faith in God.

              3. Serge says:

                “If the gracious hosts of this blog ask that I desist, I will respect that.”
                Why the smeg would they ask you to desist?
                I still can’t get my head around why religious beliefs should get such a free ride when all other nonsensical beliefs on this site get shot down in flames.
                SSR gets both barrels over his constant promotion of woo, would or should we all back off if he tried to explain transubstantiation or the virgin birth?

              4. Andrey Pavlov says:

                Why the smeg would they ask you to desist?
                I still can’t get my head around why religious beliefs should get such a free ride when all other nonsensical beliefs on this site get shot down in flames.

                Only because this site has a more specific purpose. Which is why I rarely bring it up, but I also don’t let it get a free pass. However, because of the nature of the site, I don’t feel it entirely unreasonable that they might wish to not let comments turn into atheism vs religion any more than it pertains to the medical science at hand. Which to me, seems perfectly reasonable.

                I do disagree, however, in using bad sources that just happen to align with what the good sources say as a means to persuade people to our cause is a good idea. That may work in the short term, but it not only fails to live up to the standards and processes we aspire to, but I believe will fail in the long run.

              5. Serge says:

                Just don’t allow people an easy out when they throw out the god card. Offence is generally in the eye of the offendee.

              6. Windriven says:

                @serge

                “Offence is generally in the eye of the offendee.”

                Nah. Sometimes it’s in the eye of the offender. I’ve tried everything I know to offend Steve Rodrigues and that offendee just seems unoffendable.

          3. I’d have to agree here. In the case where someone who is religious is not attempting to do something harmful to others via their religion, but is instead attempting to agree with the scientific evidence, there is no need to be nasty.

            I personally am agnostic (i.e. atheist but saying ‘agnostic’ generally draws less arguments from staunchly religious types), but attend a once a month “jam” at a church because my mother likes it, and because the jam is fun and there are nice people there and good food. If we discussed abortion issues and pseudoscience, I wouldn’t attend, obviously, but we don’t. Interacting in a civil manner with religious people is not un-scientific.

            And yes, I realize religion is inherently destructive to humanity. But sometimes you gotta pick your fights carefully because you CAN’T win every fight.

            1. Andrey Pavlov says:

              In the case where someone who is religious is not attempting to do something harmful to others via their religion, but is instead attempting to agree with the scientific evidence, there is no need to be nasty.

              Indeed. No need to be nasty. But I don’t see a reason to not point out the fallacious reasoning in a non-nasty way.

              Interacting in a civil manner with religious people is not un-scientific

              No, but allowing them to use un-scientific reasoning in order to argue for a scientific cause is.

              But sometimes you gotta pick your fights carefully because you CAN’T win every fight.

              Agreed.

  5. Oz reminds me of Timothy Leary. A bright mind transformed into an irresponsible adulation seeking buffoon.

    1. Greg says:

      Yes and he likely believes his own press too

  6. LIz Ditz says:

    I agree with Andrey — there hasn’t been this much glee in many corners of the interwebz in a long time.

    I wonder if if at long last, the thinking public is standing up and shouting about a liar being exposed, especially in light of the ongoing lies from the right over Iraq and the American involvement there.

    (For those not familiar with North American children’s literature, the title of this post is an homage to Judith Viorst’s Alexander and the Terrible, Horrible, No Good, Very Bad Day .)

    1. Thank you over the Iraq comment. I can still be recalled for about 2.5 more years and the thought of going to Iraq over the right wing rhetoric is not one I really want to spend much time on, let alone get sent to Iraq over.

  7. Windriven says:

    By the way Scott, that is a terrific screen shot you have at the head of your post. It says nearly everything that needs to be said about how the day went for Mehmet Oz.

    And am I the only one who thinks a haircut might have been a nice touch before appearing at a Senate hearing?

    1. Andrey Pavlov says:

      Looks like now that he is filthy rich*, he is taking hair tips from Trump. :-P

      In writing that it prompted me to see if his net worth is listed. $14 million. Which, despite being a lot of money, still surprised me that it wasn’t higher.

      But what surprised me even more? Dr. Phil is apparently worth $200 million. $200 million for that fat windbag moron???? Apparently he is second in terms of richest daytime TV hosts only to Oprah! With a $50M annual salary!! Shockingly Oz is #10 on that list.

      Mind = blown

      1. Greg says:

        Dr. Phil is apparently worth $200 million. $200 million for that fat windbag moron????

        LOL – just further proof that the world of entertainment is where you want to be to get rich, Also reminds me of a saying from my younger days – if you can’t dazzle them with brilliance, baffle them with BS.

        1. Andrey Pavlov says:

          if you can’t dazzle them with brilliance, baffle them with BS.

          A certain diamond bespectacled quantum woo-ist has taken that adage very much to heart.

      2. Woo Fighter says:

        I know he makes about $12 million a year just from his TV show, so I’d guess he’s worth much more than $14 mil. total.

        Plus he’s been making a good salary at his “day job” for many years. Who knows how much his wife “reiks” in selling reiki to his gullible minions.

        And now his daughter is a TV personality, an author and a commercial shill for that yogourt that helps you poop.

        Judge Judy is the current highest-paid TV celebrity, at about $45 million a year. She was almost single-handedly responsible for getting Oprah off network TV, as Judge Judy’s ratings were beating Oprah’s by a handy margin in every market in the US. As Oprah’s ratings plummeted, many of her syndicated affiliates dumped the show to pick up Judy or another judge show.

      3. Frederick says:

        Dr. Phil 200 millions… wow.. yeah indeed mindblown. I don’t know a lot about Dr. Phil except that is just some kind of pop-psycho tv doctor. A Psy doing his “job” In front a tv audience is obviously not there to help.

        this blog should have a writer who is a SBM psychotherapist, ( well i don’t remember that there is one) or psychiatrist something like that, There’s a lot of woo in that area too.

        1. Calli Arcale says:

          You have to put “doctor” in brackets there; Dr Phil is PhD, not MD. His degree is at least in clinical psychology, but he is not a medical doctor. He is not currently licensed to practice, having officially retired in 2006. (Presumably the $80 million a year that he gets from his show is plenty.)

          I cannot help thinking of Craig Ferguson’s lovely bit from the episode when he had Matt Smith (the 11th Doctor on “Doctor Who”) on his show. (Though the bit was cut for legal reasons, then broadcast later when the legal stuff got sorted out.) He was describing Doctor Who:

          “Tonight’s show is a little different. Tonight’s show is about a man, only he’s not really a man. He’s a Doctor, only he’s not really a doctor. Like Dr Phil, but awesome.”

    2. WilliamLawrenceUtridge says:

      Ya, that screenshot makes Oz look like a goblin. They must go through a lot of makeup before he puts on his scrubs.

    3. Scott Gavura says:

      That image is courtesy David Gorski. I give him the full credit for capturing that picture-perfect moment.

      1. DevoutCatalyst says:

        Written on his face are the fruits of Transcendental Meditation which Oz commends to all. After years of practice he’s essentially unflappable.

    4. Andrey Pavlov says:

      @windriven:

      My friend from Columbia I mentioned sent me a brief message yesterday re: Oz:

      the university sent a notice out to the residents wiping their hands of any connection with this. he’s on his own vs congress

      Perhaps a sign that they are beginning to distance themselves from him and will hopefully continue. It is unquestionable that he is only kept around (and not thrown out for his violation of human subjects research rules) because of his money and celebrity. If the popular sentiment becomes negative enough, they will have no reason (legit or otherwise) to keep him around. Specter’s article made it clear that he isn’t around because of his ongoing academic and clinical contributions.

      1. Windriven says:

        I have renewed hope for Columbia!

        It will be interesting to watch if and how all of this changes the Oz show. Not interesting enough for me to actually watch it. But interesting to observe from a distance.

        1. Andrey Pavlov says:

          It will be interesting to watch if and how all of this changes the Oz show. Not interesting enough for me to actually watch it. But interesting to observe from a distance.

          Agreed. I still hold out some hope that this is all an early harbinger for Oz. If enough popular sentiment can turn negative and his rating drop, Columbia might actually boot him, which will feed into the downward spiral.

          The funny thing is I actually would really rather that not happen and he actually use his pulpit to speak on legitimate scientific medicine. He has incredible power* and sway and could use that to great benefit. But, given what I know about Oz, he is simply not capable of doing that. I would love to be proven wrong.

          *BTW, just remembered that McCaskill actually quoted Spiderman at Oz during the FTC hearing: “With great power comes great responsibility.” Made me chuckle.

  8. goodnightirene says:

    Sen M was awesome! Too bad Oz is too far gone to realize that the Emperor is butt naked–even when you put a full length mirror in front of him.

  9. chemical says:

    As a skeptic I was pretty happy to watch this on the Senate committee’s website on Tuesday. However, as I have no medical training, I had a few questions about Dr. Oz’s responses, as I am trying to get a gauge on how full of crap this guy really is:

    He is a heart surgeon, right? I would assume that “doctor” is a really vague term for people who are licensed to practice science based medicine. There are heart doctors, cancer doctors, lung doctors, brain doctors. The point is I’m assuming that doctors are specialized in their field of study, “medical research doctor” is a specialty, and there are doctors that don’t see patients but just do medical research.

    A rational person would not trust a doctor to diagnose a disease or perform an operation or other medical procedure outside their specialty. So, why would I trust a heart surgeon to make a critical evaluation of a medical study? I’m asking because I don’t know if real doctors receive the training to do so.

    Also, the comment about not endorsing specific brand names: Wasn’t this one of his few redeeming qualities? Not like the supplements worked anyways, but at least it prevents the supplement companies from stuffing this guy’s scrubs with money. Seems to me like an ethics violation if real doctors endorsed a specific brand name when they write prescriptions, especially if said doctors had a stake in the drug manufacturer’s company (note: not accusing any doctor here of shilling for Big Pharma and I find this website to be a reliable source of medical information).

    Also, anyone know if Dr. Oz still does anything related to medicine? If he just focused on his TV show and didn’t keep up with the medical field of study, wouldn’t his information, even in the field of heart surgery, be out of date?

    1. Andrey Pavlov says:

      He is a heart surgeon, right? I would assume that “doctor” is a really vague term for people who are licensed to practice science based medicine. There are heart doctors, cancer doctors, lung doctors, brain doctors. The point is I’m assuming that doctors are specialized in their field of study, “medical research doctor” is a specialty, and there are doctors that don’t see patients but just do medical research.

      You are correct but it is not quite as easy and clean as that. We do generally get the same toolset in order to evaluate claims and data. So there is nothing that is a priori making it so that a heart surgeon can’t comment on orthopedic surgery, for example. The thing is that generally if you are specialized in something you know more about all the of data and evidence of it so you can put claims into better context. I can evaluate orthopedic literature, but I still defer to my buddy in orthopedics for a final say because he is someone who would know what I don’t know I don’t know (ya know?). It’s also just a question of time – it takes little additional effort to evaluate a new claim in your own field, but more in a different field because you need more background on it.

      But that all only counts for really complicated or really nuanced perspectives. For “easier” topics we all generally (should) have enough to make some general observations and at least ball-park understanding of whether something is legit or not.

      I will ultimately be specializing in lungs and critical care. But that doesn’t mean I won’t have the ability to comment on stomachs and nutrition. The difference is that I will have more credibility in lungs because I will be very specifically trained and have credentials in that field. Without the specific training and credentials there is no a priori way of knowing I did my homework right (heck, even with it there is still no guarantee I did, it is just more likely).

      So basically, yes but… it is messier than that.

      But this:

      So, why would I trust a heart surgeon to make a critical evaluation of a medical study? I’m asking because I don’t know if real doctors receive the training to do so.

      Is more wrong than right. Certainly don’t trust Oz to evaluate a medical study. But all physicians are educated in and have training in evaluating studies. You can’t graduate medical school without it and our board exams have questions on it. In principle at least any physician should be able to evaluate any study. But the specialty thing is simply that certain physicians will be better able to put the study in context and evaluate it better and also be able to point out where the methodology may have been wrong, etc. Basically better able to get into deep nitty gritty on the topic.

      Also, the comment about not endorsing specific brand names: Wasn’t this one of his few redeeming qualities?

      It cut both ways. On the one hand yes, but what it really allowed him to do was say whatever he wanted and pretend like he was just “passing on info” with no stake in it. It added additional undeserved credibility and made people question his motives less. Of course, it didn’t really hurt his bottom line at the end of the day.

      Seems to me like an ethics violation if real doctors endorsed a specific brand name when they write prescriptions, especially if said doctors had a stake in the drug manufacturer’s company

      In general yes, but it there is a point at which it gets fuzzy. There may be very legitimate reasons why I may recommend a specific brand over another. I am also still a person as well as a physician and it stands to reason should profit from my knowledge. But it is unquestionable that financial incentives will always bias and pervert recommendations, even with those of us that are aware and do our best to avoid it. Dermatologists, for example, very often sell their own line or a specific line of products. That’s a gray area. It depends, IMHO, on how they hawk it and how much pressure they put on buying it. It also depends on how much that product is necessary for life and wellbeing and how much is just cosmetic and additional to meeting all the basic needs of a patient (which is why dermatologists have more leeway). We should err on the side of caution and I tend to agree that as few or zero such entanglements is best. But it is not a bright line in the sand either.

      Also, anyone know if Dr. Oz still does anything related to medicine? If he just focused on his TV show and didn’t keep up with the medical field of study, wouldn’t his information, even in the field of heart surgery, be out of date?

      He still does surgery once a week. Which is why his mentor and the guy who hired him at Columbia is on record saying he would not send patients to him – once a week is not enough practice to maintain technical skill and proficiency. But aside from that one can keep up very easily with literature without actually having to be in a hospital doing clinical work. In fact it can be argued that it would be easier since clinical duties won’t be interfering with your ability to read.

      1. steney01 says:

        How much training is there specifically in evaluating research studies in medical school? It seems like the answer is, not enough, particularly when it comes to evaluating statistical methods and spotting logical fallacies. Would you agree?

        If you were recruiting recent graduates for residencies and there was a board exam (as if physician’s need more exams to take) that only tested one’s ability to critically evaluate journal articles, would you place a greater emphasis on that score than step 1? I think I might.

        1. CHotel says:

          I assume that it varies greatly by school, but looking at the curriculum for my own alma mater it looks like it is a major component of the Population Health and Medicine section of their first block (11 weeks long, only has 2 sections), as well as a minor component of a Problem Solving series that is all year for the first 2 years of med school.

          http://umanitoba.ca/faculties/medicine/education/undergraduate/program_overview.html

        2. Marcus says:

          In pharmacy school, we had a semester-long course on biostatistics and another semester long course in EBM applying everything we learned in biostats the previous semester. Beyond that, you’re always being asked to critically evaluate literature in other classes or on rotations or at work (I spend a great deal of time during my residency reading papers trying to answer strage drug info questions). In my interactions with medical students and residents, I don’t have any reason to believe their experiences differ to any great deal.

          It just seems that some people either never really grok the lessons of statistics and EBM/SBM or are simply too quick to throw them out and lean heavily on anecdote and personal experience. And some people are just crooks.

          1. Eldric IV says:

            I went to a three year pharmacy program but my experience was similar. We had four quarters per year and four consecutive “drug info” courses that covered statistics, research design, epidemiology, and literature evaluation. Then, we were expected to put those lessons into practice in all of our other courses, including our Alt Med course.

            In two years of residency training, my drug info muscles have gotten a greater workout than any others. And the medical residents I have worked with have also been highly focused on EBM and evaluation of the data.

            As my drug info professor (an atheist) used to say, “In God we trust, all others must provide data”.

        3. Crankyepi says:

          To add to some of the replies to this question, evaluating medical literature with optimal skill requires sound understanding of the clinical context, research design principles and statistics. You can get a semester or so in biostatistics and/or research design, but: 1) you will most likely not be taught certain advanced methodologies which would be relevant to the papers you are reading; and 2) with statistics in particular, it’s “use it or lose it.” I’ve talked with many physicians who took statistics at either the undergraduate or graduate level and freely admit they don’t remember a lot – how could they? Ideally you would have two people review the paper – a clinical expert and research design/statistics expert.

      2. chemical says:

        Appreciate the response, Dr. Pavlov. Getting reliable medical information today is quite tricky.

        Still hard to believe someone with that level of medical training couldn’t properly evaluate a medical study, but sadly there is pretty convincing evidence to the contrary…

        1. Andrey Pavlov says:

          Appreciate the response, Dr. Pavlov. Getting reliable medical information today is quite tricky.

          Still hard to believe someone with that level of medical training couldn’t properly evaluate a medical study, but sadly there is pretty convincing evidence to the contrary…

          Missed this yesterday.

          Happy to be of help.

          And yes, it is actually downright disturbing how many of my colleagues are woefully underskilled to properly evaluate medical studies and evidence. That is why I am so fiercely passionate about it. I even earning a reputation for it at the hospital with people I’ve never met before approaching me in the hallways and asking me about it.

          The reasons why are myriad, as you may expect. But a lot of it has to do with an inappropriate de-emphasis on the topic. It is on our board exams but one can not only pass but do rather well and get all those questions wrong (so long as you are strong in the other subjects tested). Same goes with medical school. Students find it boring and not “real medicine.” So it is common to just cram biostats and EBM before an exam to get a few points on it and move on, forgetting what little you did learn.

          However, that is changing. The United States Medical Licensing Exam (USMLE) has changed formats. It comes it 3 “Steps” which are merely numbers. Step 1 is considered by far the most difficult and is taken between years 2 and 3 of medical school. Step 2 is easier and taken sometime during the end of Year 3 or beginning portion of Year 4. Step 3 is typically taken towards the end of intern year and signifies full licensure at that point. Steps 1 and 2 have recently (since just before I took them) added in much more biostats and EBM, including questions where they show a pharmaceutical industry ad for a drug or a section of an actual study and then have a series of questions based on it. The Step 3 will be reformatted and do the same beginning November 30 of this year. It is still not the bulk of the exam and I don’t think it ever can be, but increasing the proportion of questions on it will still have an effect, primarily at Step 1. The Step 1 is the single most important factor in determining what kind of residency you will be able to get. It is scored out of 280 and for certain specialties if you don’t score above a 230 or 240 they won’t even look at your application. Getting above a 240 is difficult and getting above a 250 is “rockstar” status. At those higher score levels each raw point on the exam is worth more in the standardized 3-digit score. So adding in more EBM means that if you want to be really competitive you need to know that stuff to squeeze out every point you can.

          Schools are also focusing more on EBM these days. My own school radically restructured its preclinical courses in the year directly after mine having an entire separate course and final exam for EBM such that you must actually learn the topics well or else you will fail the exam and be unable to progress in years.

          But a huge problem is that in many cases the teachers themselves are not particularly good at it, as evidenced by all the “p-hacking” and woefully terrible misunderstandings of what a p-value really tells you. And as more quackery gets brought into schools (my own had pure quackery such as personality affecting your risks and treatment efficacy for cancer as lectures) you can bet that this will be eroded even more. So far, the CAM lectures were just a small part of my curriculum and no exam questions on it were ever given, but there are other schools where students have the option of pursuing more CAM based study.

          But with Oz, the problem is not that he does not know how to evaluate a study. He does. The problem is that he has fundamentally wrong apprehensions about what evidence is, how it does and doesn’t work, and what a study actually means in context and in the real world. He feels it is appropriate to pick and choose whatever evidence you like to tell your story, and as long as the story is good and there is evidence there to back it up, each story is equally good. And that is profoundly wrong and very dangerous.

          1. JD says:

            I think part of the blame can also be placed on those of my ilk, with some statisticians holding the view that clinicians can’t do statistics, essentially maintaining this odd, esoteric hold on the field.

            For example, I cringe every time I hear about how use of propensity scores can make something into a randomized controlled trial, removing unmeasured confounding etc. Or when it is proposed for non-modifiable characteristics. Both of these views are patently false and I can’t help but wonder if such misunderstandings could be prevented if proper use of such methods could be taught in whatever statistics courses clinicians frequent. I feel that such grating phrases as “ask a statistician” are offered instead of presenting the material as if one was going to perform the analyses and studies himself. There is obvious need to consult with an epidemiologist/statistician, but I think the research engine could be revamped substantially if the knowledge could be more effectively shared.

            1. Eldric IV says:

              The unfortunate truth is that there is too much to learn and not enough time to truly grasp the material while in school. Even after residency and individual study, there is still much more for me to learn about statistics. And many students are content memorizing p less than 0.05 and moving on.

            2. Andrey Pavlov says:

              with some statisticians holding the view that clinicians can’t do statistics, essentially maintaining this odd, esoteric hold on the field.

              hmmm…. I think yes and no. On the one hand having a biostatistician makes my papers more bulletproof because they do know what they are doing better than I do. Else a PhD in stats would be pointless. But for basic stuff, I agree. Which is why I actually spent the time to learn how to do some basic stuff and for my last poster completely skipped the biostatistician. And even then, I spent a lot of time learning which tests were likely to be the right ones (for more complicated stuff) but ultimately defer to the statistician for the final call on it.

              But that is because I went above and beyond on my own. The amount of stats learned in medical school is 1/10th of what I sat down and learned on my own. So I think there is a genuine element of need of biostatisticians as well. As Eldric said:

              The unfortunate truth is that there is too much to learn and not enough time to truly grasp the material while in school. Even after residency and individual study, there is still much more for me to learn about statistics.

              Exactly. Most med students and residents are working hard to make sure and not kill people and pass board exams, prepare for residency applications, prepare for specialty boards and fellowship applications, and so on.

              And even if they had the time, as Eldric says, most student don’t like the biostats and EBM modules of school. They see it as the not-being-a-doctor stuff they have to get through to be a doctor. P-value <0.05 = good is about as in depth as they want to get.

              Which is why my med students are going to hate me a bit. LOL. Because I will make them learn what it actually means.

      3. cloudskimmer says:

        Dr. Pavlov,
        Since the conversation has veered a bit into drugs, I’d like to ask you a question. An acquaintance of mine likes to say that Doctors get paid for every prescription they write. Questioning this assertion is hopeless. She has no answer when I ask how–does the pharmacy write them a check? She claims a Doctor told her this. I know that drug company reps visit Doctors, offering samples and coupons. I have a lot of respect for Dr. Crislip’s refusal to accept anything from them; could this marketing be the basis for my acquaintance thinking that they are paid directly by the drug companies?

        1. Windriven says:

          ” An acquaintance of mine likes to say that Doctors get paid for every prescription they write.”

          Absolute and complete horse snot. Some drug and device companies have inappropriate relationships with physicians involving ‘consultancies’ and junkets – but those are much less common today then in years past. But physicians are not paid for writing prescriptions – and to the best of my knowledge they never were.

        2. Andrey Pavlov says:

          Cloudskimmer:

          Windriven is, to the best of my knowledge, correct. I can’t speak as to what it was like “back in the day” but I find it hard to imagine a system wherein doctors are paid for “every prescription they write.”

          What certainly used too happen much too often is that drug reps would provide doctors with fancy dinners, vacations, office lunches every single friday, and even more egregious things. Even in my limited experience I’ve benefitted from all but the vacations and more egregious things. The most expensive dinner I have ever eaten was paid for by Merck*.

          But I can’t see a means by which prescriptions could be counted and kickbacks given. I wouldn’t be surprised if it did happen, but it must have been extremely rare as it would have been very, very difficult to hide with significant consequences on both sides. Perhaps someone of an older generation could comment as well.

          The simple answer to your friend is that this is ludicrous because there are vastly easier and safer ways to bribe doctors. Ways which are systematically being phased out and limited. My institution, for example, has a complete ban on all drug reps in the hospital, no physician employed by them is allowed to accept gifts, and the only “concession” is that groups may have industry sponsored “journal clubs” but they are limited to a maximum of 3 (maybe 4?) times per year, with some hoops to jump through. The last part is, IMHO, shenanigans. But it is a vast improvement over how it used to be.

          *Actually it could have been Pfizer, the group I was with at the time as a mere research assistant long before med school worked with both. As a “thanks” for our data showing how much their drugs helped, each treated the entire group to dinner. As I recall one was slightly more expensive than the other, but they were both in the $3,000 per person range.

    2. WilliamLawrenceUtridge says:

      The New Yorker has an excellent, lengthy article that addresses Oz’s qualifications, past and current, that I highly recommend:

      http://www.newyorker.com/reporting/2013/02/04/130204fa_fact_specter?currentPage=all

      1. Frederick says:

        I second That, it is a good piece, his wife and father in law give my the greeps.

    3. CHotel says:

      Those are both great questions, I’ll do my best to answer them and I’m sure others will correct me if I’m off the mark.

      “A rational person would not trust a doctor to diagnose a disease or perform an operation or other medical procedure outside their specialty. So, why would I trust a heart surgeon to make a critical evaluation of a medical study? I’m asking because I don’t know if real doctors receive the training to do so. ”

      Thisis a bit of a false equivalency, but it’s an understandable one to make if you don’t know the details of medical education (I don’t fully either, being a Pharmacy grad, so this may be where someone corrects/elaborates on my answer). While you’re correct in thinking it would be rather a poor choice to let your ENT do your hip replacement, specialization does not occur until around the post-grad residency level of training. Medical literature appraisal to a certain degree would be part of the standard med school curriculum, along with things like anatomy, physiology, or other essential skills that span all forms of practice. Not all medical students need to learn how to perform surgery, but they all need to learn how to perform research. That being said, once one has specialized and focussed in one area for a considerable length of time it wouldn’t be outrageous to think their knowledge and skills in other areas that they haven’t seen since residency may diminish. So I would trust Mr. Oz knows how to read and evaluate literature, but I’d bet he’d be more comfortable with a cardiothoracic study than a podiatry one.

      Wasn’t this one of his few redeeming qualities? Not like the supplements worked anyways, but at least it prevents the supplement companies from stuffing this guy’s scrubs with money. Seems to me like an ethics violation if real doctors endorsed a specific brand name when they write prescriptions, especially if said doctors had a stake in the drug manufacturer’s company

      Yeah, it was one of the few things I could stand about him as well. I’m not sure if it would be an ethics violation per se unless they did so with a cheaper or more effective alternative available, but it’s a rather sketchy thing to do nonetheless. Strongly frowned upon. Perhaps even illegal by the licensing board, depending on where the physician in question practices.

    4. JD says:

      To preface, I also do not have medical training. But, I think I can address some of your questions.

      The point is I’m assuming that doctors are specialized in their field of study, “medical research doctor” is a specialty, and there are doctors that don’t see patients but just do medical research.

      To my knowledge, in the US, how this works is that one would pursue post-medical school education in line with a particular specialty (ie residency and possibly fellowship). After such education, one would practice medicine in a given specialty. I am not aware of a “medical research” specialty, one would choose to pursue academic medicine after training completion, and depending on the circumstances, may or may not remain in practice, and could continue to see patients while pursuing research. Everyone I work with does both.

      In Oz’s case, he actually has a strong publication history in his specialty and continues to perform surgery (Reference). This makes what he does so frequently on his show such a tragedy. He should and does know better.

      So, why would I trust a heart surgeon to make a critical evaluation of a medical study? I’m asking because I don’t know if real doctors receive the training to do so

      In general, one should obtain this skill in medical school. We try to make damn sure that the students we work with can do this effectively. In Oz’s case, with a research background, he would have some understanding of study design etc. If he puts it to use when assessing studies pertaining to topics on his show is another question.

      And the epidemiologic/statistical tools that would help one to become an apt researcher are not necessarily specialty-specific. I focus mostly on infectious disease, but there have been many instances where methods were also applied to other events, such as cardiac arrest or stroke.

      Seems to me like an ethics violation if real doctors endorsed a specific brand name when they write prescriptions, especially if said doctors had a stake in the drug manufacturer’s company

      This is a tricky question, probably best left to practicing physicians. I know there has been some movement toward reducing the amount of contact between physicians and pharmaceutical representatives. So, there are some protections in place, but determining where a true conflict might exist is difficult because we really do want physicians consulting with the pharmaceutical companies. But, there are surely some instances where these relationships get out of hand.

      In Oz’s case, the request for him to prepare a list seems like an effort to prevent “Steve’s Basement Supplement Company” from seeming legit. Unfortunately, it’s not like the larger supplement companies offer much of a benefit, in any aspect, over someone packing useless powder into capsules at home.

  10. Jeff says:

    On his TV show, Dr. Oz may have oversold the benefits of green coffee bean extract. His website offers a more balanced appraisal:
    http://www.doctoroz.com/videos/fact-sheet-green-coffee-bean

    1. WilliamLawrenceUtridge says:

      …and how many viewers go to the fact sheets (rather than a supplement shill site) after the credits roll?

      That page is a quack Miranda warning as far as I’m concerned – “Oh, sure, we totally lied and misrepresented the science to our millions of viewers – but we’ve got the good information on our website, which gets as many as a thousand, perhaps even ten thousand visits per month. THAT is how we protect consumers.”

      Like many in the entertainment industry, his incentives are structured to attract attention and get eyes on screen – not to be honest while doing so. He does this by building trust, then drama. Honest discussion of the scientific literature generally lacks the latter, and the presence of scrubs and an MD short-circuit the latter.

      I can only imagine the number of GPs who wince and sigh as soon as a patient says “So I was watching Dr. Oz…”

    2. David Weinberg says:

      Jeff:

      I disagree. His website is somewhat less bombastic, but not more balanced. It still presupposes the benefits of green coffee been extract with quotes like this:

      Hence, chlorogenic acid in coffee may be responsible, at least in part, for the reduced risk of glycemic disorders, like diabetes, with long-term coffee consumption. It may also be the source of coffee’s anti-obesity effects. Various studies have suggested that chlorogenic acid slows absorption of fat from food intake and also activates metabolism of extra fat.

      and

      So, who is the green coffee bean extract right for? Most healthy adults, over the age of 18, who want to lose weight.”

  11. tgobbi says:

    Oz: “I spent a good part of my career recommending that folks have a low fat diet, but we’ve come full circle in that argument now and no longer recommend that now, many of us who practice medicine because it no longer worked for our patients. ”

    No longer worked??? WTF! Did it EVER work? And, if it did, why doesn’t it still work?

    My logic meter has popped its cork!

    1. steney01 says:

      maybe by “no longer worked for our patients” he meant patients couldn’t comply with those diets because they require effort and consistency and so he gave up and started pushing miracles instead..

  12. Kiiri says:

    Saw Dr. Gorski quoted in an article on Dr. Oz’s spectacular public shaming but can’t find the link now. Good job doc! I am so happy to see the charlatan called out. Whether or not it will help in the long run I don’t know but I continue to wear my rosy glasses and think good thoughts for the scientific literacy of my peers. Thanks for all that you and everyone else on SBM do.

  13. Fahren says:

    It appears that Dr. Oz is at the pinnacle of modern medicine: he is a full professor at an Ivy League medical school. If he is so wrong about so many things and yet retains his medical authority and academic position, why should we trust the medical profession to dictate who can and cannot offer medical advice and services?

    1. WilliamLawrenceUtridge says:

      It appears that Dr. Oz is at the pinnacle of modern medicine: he is a full professor at an Ivy League medical school. If he is so wrong about so many things and yet retains his medical authority and academic position, why should we trust the medical profession to dictate who can and cannot offer medical advice and services?

      Because most doctors prioritize their patients over their media careers. Dr. Oz does not represent most doctors – one might note that all the contributors to this blog, most of whom are physicians, all think he’s a shameless media whore.

      One can never simply describe all X as Y; while it would be nice if it were true, if exemplars allowed us to make simple decisions about whole groups, this is little more than racism, sexism, or perhaps in this case “professionism”. By seeing Saddam Hussein as a deranged madman, would you then conclude that all Iraqis like torture? If not, then why wouldn’t you assume that Oz is similarly a gross, distressing exception to what is otherwise a very learned, conscientious profession?

      1. Andrey Pavlov says:

        Precisely. There is a reason why we here are so ardently against Dr. Oz. And why McCaskill correctly said that the scientific and medical community is “almost monolithic” against him during that FTC hearing.

        1. Eldric IV says:

          I am just about to finish my infectious diseases residency and already I fear what effect it is having on me. I keep reading FTC as emtricitabine.

  14. chemical says:

    Also thanks to other responders who had answered my questions. I always appreciate learning new things.

    The New Yorker article is really interesting.

  15. R says:

    This article was quoted by the BBC, congrats! http://www.bbc.com/news/blogs-echochambers-27931129

  16. Frederick says:

    This is a good news, and for once, it make me more confident about politician, we have a tendency to distrust them all the time, to think “they are all the same” But Mme Mcaskill give us a good example of rigorous senator with a critical mind. Here in Quebec our news health minister could us some of that.
    Anyway , she is calling a cat a cat, she’s not back off, and I like when she crushed the badly done study to the ground, double thumps up to her. It is a small step, but it is a step. It is a shame that man choose the easy path, if we had a guy like him on our side, with his charisma, and way to do thing, we would have a winner. of course part of his popularity come from the fact that he talk about miracle products, everybody loves the easy way.

    1. Frederick says:

      I’m also really happy that the worries that Dr. Gorski, they were totally justified, had turns out to be positive in favour on science and consumer protection. But Like M, Gavura says, he do not seem to really get it. But I guest he will stop promoting those kind of things, because if he got blame a second time, that will look really bad for him.

  17. RJ says:

    I work in email security and would cringe when I saw Dr. Oz on TV. His show titles and commercial buzzwords read just like the spam that everyone hates in their inbox – never mind the real spam that used his name. Watching that on TV was just like those spam ads you see on the side of some web page such as “lose 10 pounds in a week” or “washboard abs in 2 weeks” which makes us all of us roll our eyes.

    It was refreshing to see someone finally take him to task over that.

    1. Windriven says:

      So RJ, as you work in email security, could you briefly describe your professional opinion of the IRS being unable to recover substantial numbers of e-mails? It seems hard to believe but I have no experience with government data practices. It couldn’t happen in my companies absent 8 planet syzygy and 2 consecutive Powerball wins.

      1. RJ says:

        I could speculate, but prefer to keep from stepping in a pile of politics as it splatters, so I’ll try to keep it high level.

        I will simply say that organizations of any size normally have data retention policies and either keep backups or use archiving solutions that keep copies of emails. If they use backups then perhaps the backup devices have failed. This is more common than you’d think if the backups are never tested.

        1. Calli Arcale says:

          Indeed. I like to read thedailywtf.com and it has many, many stories where the central problem is a failure to test the backups. A backup process on a mission-critical system, performed religiously for ten years, and not once did anyone ever test the backups, and so nobody knew that either the process had a critical blunder, or the tapes they were using were bad, or whatever.

          It’s such a simple thing. Unfortunately, simple things are too easily put off until later.

          1. Windriven says:

            I’m not sure which I think is worse, an attempt to cover up an embarrassing misuse of power or the flat incompetence of not properly managing IT systems, I can tell you with certainty that if I were being audited by IRS and couldn’t provide evidence of income or expenses because ‘my hard drive failed and the backups didn’t work’, I wouldn’t be getting the benefit of the doubt. I would be looking at fines in the best case and prison in the worst.

            1. Calli Arcale says:

              I know at my company, if we were ever found to not be in compliance with the retention times we promise our customers, we’d be in deep doo-doo. But the problem I think is that the IRS doesn’t really have a customer in any normal sense. Accountability is diffuse, and so therefore responsibility is as well. If everybody thinks it’s either somebody else’s problem or something that you’ll totally have time to take care of in six months when we get through this other stuff, then I can guarantee it’ll never happen. No matter how important it might be.

  18. Mick says:

    Check out this brilliant rap smackdown of Dr Oz and co!!

    http://www.youtube.com/watch?v=tvRzWUQQfIg

  19. Kita says:

    According to Dr. Oz his show gives people hope. Hope of eating absolutely everything and exercising absolutely nothing and still be a size zero by popping in pills.

    1. WilliamLawrenceUtridge says:

      Oh snap.

  20. Windriven says:

    Thanks. I was looking for technical insight, not political speculation.

  21. Greg says:

    Dr. Oz should also be called to account for his bad advice regarding his “48 hour cleanse” as profiled on CBC’s Marketplace and proven by CBC that it doesn’t work

  22. MadisonMD says:

    Did anyone click Scott’s second link and notice there are 2,960 miracles listed on Dr. Oz’s website? We need to petition Rome to have the man canonized.

    1. Harriet Hall says:

      Canonized? Does that mean put in a cannon and fired? :-)

      1. DevoutCatalyst says:

        Well, Oz is a circus performer.

      2. MadisonMD says:

        Yes, that’s exactly what I meant. Just imagine.

        1. Windriven says:

          Oh, you meant the sky. I was thinking more along the lines of a target. Maybe painted on a wall using raspberry ketones for paint.

      3. Windriven says:

        I’d be happy to settle for the fired part. The cannon could be metaphorical.

        1. MadisonMD says:

          There are many ways to fire someone…which brings us full circle to canonization with a one ‘n.’

  23. Angora Rabbit says:

    “Now it is remarkably complex, as you know, to figure out what works for most people even, in a dietary program.”

    Dear Dr. Oz,

    No. It’s not complex. As Dr. Marion Nestle brilliantly put it the other day (to paraphrase):

    “The recommendations to lose weight are simple: eat more plant-based products, exercise, and watch your calories. I don’t know why people enjoy making eating so difficult.”

    Dr. Oz, you don’t know boo about nutrition and that’s okay, since it really wasn’t emphasized in your training. But. You’ve chosen to surround yourself with people who don’t know boo about nutrition either. And that’s unforgivable.

    Senator McCaskill, you are one of my heroes. Thank you. Either Dr. Oz is an idiot, or he chooses to misrepresent the data for money. And I have a lot of trouble believing in my first hypothesis.

  24. anthony martignetti says:

    For Dr. Drew (a shill for the completely unproven efficacy of 12 step treatment models . . . where thousands of dollars are squandered to babysit rich people and celebrities who are “trying” to get what millions have reportedly found through belief and effort

    in church basements) and Dr. Oz who soaks millions of believers through his cult of fame (substantiated by an MD degree) I have one question . . . how much pressure does it take to squeeze oil out of a snake without killing it.

  25. Badly Shaved Monkey says:

    Just read the New Yorker article about Oz.

    It emphasises for me something I’ve long thought. There are people in the medical profession who may be gifted technicians but they absolutely are not scientists; talented monkeys but not insightful practitioners of a scientific discipline.

    Oz’s CV has the form of a scientist’s but he appears to lack the intellectual underpinnings. Contrast Oz with the comedian Robin Ince. http://robinince.com Ince has, if I recall correctly, an English degree, but he quite clearly ‘gets’ science. He may lack the facts that a trained scientist has at his fingertips but he quite clearly grasps the methods, which is why his partnership with Brian Cox works so well. https://en.wikipedia.org/wiki/The_Infinite_Monkey_Cage

    It would be handy to define the equivalent of the Turing Test to tease out the difference between the Inces and the Ozes of this world. That New Yorker reporter applied the test to Oz and he failed. Could we call it the Feynman Test? “The first principle is that you must not fool yourself — and you are the easiest person to fool.” To pass the test, you must show that you understand how you may fool yourself.

    I do wonder whether doctors, and surgeons especially, are vulnerable to this ‘talented monkey’ problem. Generations have been taught by weight of expert opinion with the critical thinking discipline of EBM (far yet, SBM) being a rather late entrant to the medical curriculum and, it seems to me, you can go a long way in medicine by being merely a competent technician.

    1. Andrey Pavlov says:

      It emphasises for me something I’ve long thought. There are people in the medical profession who may be gifted technicians but they absolutely are not scientists; talented monkeys but not insightful practitioners of a scientific discipline.

      Medical school does not, in any way, make one a scientist. It is not intended to do so. It is, very much, geared to making gifted technicians. There is absolutely nothing wrong with that. The problem is that most people don’t realize the distinction. Even most physicians.

      1. Calli Arcale says:

        In my own field, I see the same problem. I’m an engineer. Engineers can be very talented, very clever, very creative, and very dependent on scientific evidence . . . but we aren’t generally scientists, and not all of us appreciate that distinction.

  26. Perry says:

    This article should be mandatory reading by anyone who desires to try any maerketed diet/exercise program. The biggest problem with losing weight and getting healthy besides our lack of willingness to change, is getting credible information. Even though Dr Oz doesn’t profit from selling the scams he very much profits by promoting them to his viewers.

  27. Steven says:

    I am a huge fan of Dr Oz and respect him very much, he is extremely Dr, knowledgeable and is dedicated to helping people enjoy a healthy lifestyle. The problem is when he started his new show and is being forced to generate ratings. His show has turned into nothing but a hype promoting endeavor and is tough to watch. He had dumped it down so much and tries too hard to make it entertaining instead of just giving the folks an education in healthy living. That totally disinterested studio audience should be the first thing to be vanquished. Again, not blasting Dr Oz, but when you get involved in the media you lose credibility.

    1. Badly Shaved Monkey says:

      Yeah, maybe.

      But Oz’s statements quoted in the New Yorker do not suggest to me someone being dragged unwillingly into publicly adopting positions with which he may be privately uncomfortable.

    2. He can promote and sell anything he wants in this free market society. He is not allowed to overtly deceive the public under the authority of his MD and oath for rating and for profits.

      He should go to jail.

      1. He and all of his backers of the show, all should go to jail.

        White collar crimes in the name of high profits are seen as not criminal behavior no matter how many die or loose money. So he and his posse will go free to deceive the public again.

        1. WilliamLawrenceUtridge says:

          He and all of his backers of the show, all should go to jail.

          White collar crimes in the name of high profits are seen as not criminal behavior no matter how many die or loose money. So he and his posse will go free to deceive the public again.

          Meanwhile you are doing the same thing (deceiving the public with claims that lack evidence) but for money rather than ratings, and you’re better how? Hypocrite. Oz thinks he is just like you – serving the greater good in pursuing a calling more important than anything like evidence. You both lack evidence to support your advice and you both betray your patients.

          1. @WilliamLawrenceUtridge
            Funny I think the same all of you on this blog; Anytime someone makes a bold statement to the public that as an authority (a practicing licensed MD) should be liable.

            The non-MDs are just playing a game of “know it all” “word games” and “debate.” So you are free to pull opinions out of your stratospheres.

            Little do you know about my low-tech myofascial needle practice but most of my outcomes are positive, curative or a safe treatment option. I try not profess absolute in regards to a therapy!!

            1. WilliamLawrenceUtridge says:

              Funny I think the same all of you on this blog; Anytime someone makes a bold statement to the public that as an authority (a practicing licensed MD) should be liable.

              I’m not a doctor, I don’t have or see patients, I make no money from my activities here, even in the most tangential manner. This is a hobby, I am paid a salary for unrelated work. Dr. Hall is retired, Drs. Gorski, Crislip and Novella are also salaried physicians. The common thread is a contempt for sloppy thinking and impossible health claims, and a respect for good-quality evidence. But I’m perfectly willing to stand behind my statements, and change my mind in the face of good evidence. Do you have any?

              The non-MDs are just playing a game of “know it all” “word games” and “debate.” So you are free to pull opinions out of your stratospheres.

              I get my opinions from the peer-reviewed literature and digests thereof. Pointing out that health claims contradict what we know of human anatomy and cellular biology isn’t a debate, it’s a fact.

              Little do you know about my low-tech myofascial needle practice but most of my outcomes are positive, curative or a safe treatment option.How do you track the patients for whom your practices do not work?

              I try not profess absolute in regards to a therapy!!

              I thought you were never 100% certain of anything except the truth.

              Idiot.

              1. I’m 100% certain
                …that Traditional Medicine is flawed.
                …that CAMs are flawed.
                …Acupuncture is an effective type of surgery but is flawed by the metaphysical, speculative and theoretical but does not invalidate the whole.
                …General Medicine is effective in many ways but is flawed by the metaphysical, speculative and theoretical but does not invalidate the whole.
                …chronic stubborn pain and dysfunction will respond best to TM/CAMs combo therapy.
                …old deeply rooted chronic pain will not go away with just Traditional Medicine, surgery and medications.
                …it is possible to restore to function a “bad knee, hip or shoulder”
                …you, I and the rest are flawed in our logic and are stupid and idiots.
                …you and your crew are not skeptics but cynics and bigots.
                …you and your crew are not looking for what is true but to validate of your bigotry.
                …you and this crew are powerless to stop CAMs from being reintegrated into Medicine.
                …you personally have a lot of hate.

                Dr. Hall should make certain that her personal opinions are stated as such so that her suggestions are not used my unsuspecting patients who will be harmed.

                Drs. Gorski, Crislip and Novella are also salaried physicians should have their contracts carefully deliberated for any conflicts of interest.

                There are many, many questions that need to be conceived and processed but as a group of segregationist, you and your colleagues are not doing any good for human suffering.

              2. WilliamLawrenceUtridge says:

                Acupuncture is an effective type of surgery but is flawed by the metaphysical, speculative and theoretical but does not invalidate the whole.

                Even I know that contemporary acupuncture involves needles, not knives. You’re doing it wrong there champ. You’re practicing acupuncture like it was 2,000 years ago when they couldn’t make thin, filiform steel needles and it was basically bloodletting.

                If acupuncture is effective, why does it fail in controlled trials so often?

                …General Medicine is effective in many ways but is flawed by the metaphysical, speculative and theoretical but does not invalidate the whole.

                Real medicine is purely physical, it doesn’t deal with the metaphysical. If the existence of the soul can ever be proven, and interventions designed to improve its functioning, then it will be physical.

                chronic stubborn pain and dysfunction will respond best to TM/CAMs combo therapy.

                Where is your evidence? And claiming “pain will respond to CAM” doesn’t really help your case – pain is a symptom, which is readily, indeed extremely susceptible to placebo effects.

                old deeply rooted chronic pain will not go away with just Traditional Medicine, surgery and medications.

                How do you know? How many patients come to you completely satisfied with the conventional pain care provided by real doctors? Can’t you see that you might only see those dissatisfied with conventional care, and are thus getting an extremely biased sample?

                you, I and the rest are flawed in our logic and are stupid and idiots. …you and your crew are not skeptics but cynics and bigots. …you and your crew are not looking for what is true but to validate of your bigotry.

                And a while ago you were just saying about how nice you were…also, all we are asking for is scientific evidence to support your claims. Why is this request, ventured repeatedly and politely, so offensive to you? Why are you so incapable of providing any controlled trials to support your dramatic claims? You are making some pretty radical and outrageous statements about what you can do – why do you see us as unreasonable when we ask for something more than just your word?

                you and this crew are powerless to stop CAMs from being reintegrated into Medicine.

                I have no problem with CAM being integrated into medicine once appropriate evidence supporting safety and efficacy exists. Why do you think this is unreasonable?

                you personally have a lot of hate.

                Not hate, contempt. Contempt for your blindness, your arrogance, your inability or refusal to understand the flaws in your reasoning, and above all – contempt for your deceptive attempts to snow us with bullshit that you haven’t even read.

                Dr. Hall should make certain that her personal opinions are stated as such so that her suggestions are not used my unsuspecting patients who will be harmed.
                Drs. Gorski, Crislip and Novella are also salaried physicians should have their contracts carefully deliberated for any conflicts of interest.

                Yup, here’s another reason for contempt – the idea that the only way, the only reason people could object to your evidence-free rants is because they are somehow being bribed. Also, what contracts? With their employers, who aren’t involved with this blog at all? Do you think anything through?

                There are many, many questions that need to be conceived and processed but as a group of segregationist, you and your colleagues are not doing any good for human suffering.

                Segregationists? Nice allusion to slavery there Steve! If you want to alleviate human suffering, test your claims. If you’re right, then your approach can be documented and spread to help millions. If you’re wrong, you can stop charging patients for worthless placebos.

                Why do you see this as an unreasonable assessment? Is it because you make too much money from jabbing people with needles?

              3. This is what real medicine is all about. Helping people despite the dogma that is poured into young minds, the web and the media.

                https://www.dropbox.com/sh/2loq1cklpsf8qd0/AAD_nGXvi8cKgMmjJV3UQZSIa

                I know what you are going to say, “Anecdotal.” But that is what clinical medicine is all about! It is first hand science. When dealing one on one with people all of your data is anecdotal, personal and unique to each case.

                Observations, data collection, investigation, analysis has to first be conceived or perceived way before it can be found true. What you seem to be confusing is animate vs inanimate objects within the scientific methods. That is your fatal flaw making people into numbers, inhuman and static objects.

              4. AdamG says:

                The ‘anecdotal evidence’ that SSR links to are video testimonials that seem to have been recorded over the past couple weeks. Did you have these people’s consent to post these videos publicly?

                The videos are sorted into folders by affected body part. Let’s look at them individually:

                “Hip and Lower Back”: One video, a man who was taking meds for back pain and seeing a chiro and massage therapist. Claims instant relief from the acupuncture. Says “I know it works for me”

                “Knee”: folder empty

                “Lower back”: folder empty

                “Shoulder”: One video, claims severe shoulder pain disappeared after 2 treatments. This was 2 years ago.

                “Shoulder and Neck”: One video, a woman who has minor lower back pain associated with nursing. Very against the use of any pain meds. Neither the shoulder nor the neck is discussed. Says “I don’t see that it is a placebo effect, I see that it actually physically helps my muscles…” then SSR cuts her off.

                So that’s the extent of the evidence that SSR has. 3 video testimonials, and weak ones at that.

                SSR, why are your testimonials different than the countless others that are out there?
                For example, here’s one who claims that only reiki managed his pain after trying chrio, acupuncture, etc.
                https://www.youtube.com/watch?v=wnSSRFJ29sU

                Is his testimonial as valid as the ones you’ve presented? If so, why did acupuncture not work for him? Do you believe his pain was managed by reiki?

              5. Reiki is a valid treatment when used within a set protocol that includes a physician and physical therapist be they Reiki, massage, myofascial release, swim, work hardening or yoga.
                Same with Acupuncture and all of it’s various type.

                The issues are;
                Patients have a right to choice! Let the patient choose which modality they find beneficial.
                YOU are anyone else should not have a say in what treatment get to be included in the list of options. All valid and trusted option should be on the table!

                Here are few who only had 2 options; continued pain or reparative surgery. They all failed miserably and ALL were never given an option of alternatives which make this a miscarriage of justice.

                https://www.dropbox.com/sh/hnojq9d8ig892bo/AAC4wS5oOQxscyVJBFLsYC66a

              6. AdamG says:

                SSR’s just added a folder labeled ‘failed surgeries’ to the dropbox containing photographs of people’s surgical scars. What this is supposed to be evidence for completely escapes me.

                This also seems highly unethical. Did any of these people know you’d be sharing photos of them on the internet in order to further your own agenda?

              7. Andrey Pavlov says:

                This also seems highly unethical. Did any of these people know you’d be sharing photos of them on the internet in order to further your own agenda?

                More than just unethical, that is patently illegal. It actually technically doesn’t even matter if all identifying information is removed. One still must have consent to even take pictures, let alone show them. If he is just reposting pictures already online I think the law is a bit gray but he is probably safe. If they are any people that actually saw him in his capacity as a physician, he is in clear violation of HIPAA.

              8. AdamG says:

                If they are any people that actually saw him in his capacity as a physician, he is in clear violation of HIPAA.

                Some of these photos are mid-procedure, with needles still inserted. One photo even contains a patient’s tattoo…could easily be used to identify that person. These photos are not posted on the ‘testimonials’ section of SSR’s site. the rooms are clearly the same as those in the video testimonials…these were definitely SSR’s patients.

                SSR, I used to think you were just foolish. Now I see you’re both foolish and evil.

              9. WilliamLawrenceUtridge says:

                Responded to Steve here.

              10. Andrey Pavlov says:

                @AdamG and WLU:

                I have carefully documented his Dropbox and downloaded a few items from it such that even if he takes it down I have clear evidence that it was there and what was in it. I then went to the Department of Health and Human Services and filed an official complaint of HIPAA violation, including direct links to his comments here and a PDF of representative images and screenshots documenting everything. I have retained local copies of all that data and have agreed to make myself available to the HHS for further follow up.

                We shall see what happens.

              11. WilliamLawrenceUtridge says:

                Responded to this comment here.

              12. Guys looks at the evidence, the data and draw conclusions as professional!

                I’m just the messenger! killing me is the first step to self imposed ignorance.

              13. WilliamLawrenceUtridge says:

                Guys looks at the evidence, the data and draw conclusions as professional!

                I’m just the messenger! killing me is the first step to self imposed ignorance.

                Nobody is killing the messenger. We’re pointing out that the messenger’s message is nonsense and unsupported by science. If you provided any citations to support your claims, then we might believe you – but you don’t. So we’re left repeatedly saying that. Cite a source if you want us to stop criticizing you.

      2. WilliamLawrenceUtridge says:

        He can promote and sell anything he wants in this free market society. He is not allowed to overtly deceive the public under the authority of his MD and oath for rating and for profits.

        He should go to jail.

        When you point fingers, you realize there are three more pointing back at you? This saying is extraordinarily apt when considering your condemnation of Oz. Why are his shoddily-evidenced claims horrifying to you, when your own are acceptable? You claim that you’ve seen miracles because of your treatments? Oz says the same thing. But he’s an asshole and you’re not?

        Amazing. You have zero insight into your own claims.

        1. @WilliamLawrenceUtridge

          I get it that you disavow my favorite office based surgical tools. It is your prerogative to think and do what you like.

          I get it that you could don’t care about CAMs that can potentially help people in chronic pain.

          As you have noticed, I truly do not take what you say personally :). The few souls who venture hopefully will follow the leads to the wealth of knowledge.

          So I invite you not to waste your time responding to my posts.

          1. Windriven says:

            “So I invite you not to waste your time responding to my posts.”

            We invite YOU not to comment unless you have something to say that has some scientific basis. And you can rest assured, we will respond each and every time you utter nonsense.

          2. WilliamLawrenceUtridge says:

            I get it that you disavow my favorite office based surgical tools. It is your prerogative to think and do what you like.

            It is also my prerogative to point out that what you do is not evidence-based, and when you are asked for evidence, the best you can manage is to try to dump in dozens of irrelevant references that you hope nobody will read. You’ve never responded to that comment by the way – why did you post a massive list of references that were nearly all irrelevant? Why did you drop in a half-dozen references to the history of acupuncture as if it had any relation to the efficacy of acupuncture?

            I get it that you could don’t care about CAMs that can potentially help people in chronic pain.

            I care about helping people in chronic pain – I just think that if CAM treatments work, then this should be demonstrated in controlled trials so more people can benefit. I think offering people unproven treatments and claiming it to be medicine is unethical. What’s wrong with recognizing that medicine should have evidence of efficacy before it is offered to patients?

            As you have noticed, I truly do not take what you say personally :).

            Really? Because earlier you called me a stupid idiot. It’s hard not to see that as a personal insult (and an effort to preserve face and ego considering your ongoing failure to meet my simple request – a list of peer-reviewed, relevant articles supporting what you claim to be an incredibly effective treatment, and a reconciliation of your personal experience with the vast volume of scientific literature showing that acupuncture is indistinguishable from placebo).

            The few souls who venture hopefully will follow the leads to the wealth of knowledge.

            WHAT WEALTH OF KNOWLEDGE? Because if you’ve provided any, I’ve yet to see it. You claim to be able to cure nigh-anything, but everybody else who takes a similar approach in a controlled trial doesn’t seem to be able to replicate your magic. Why do you think that is?

            So I invite you not to waste your time responding to my posts.

            Nope, not my style. I invite you to not make any further vacuous, scientifically-empty claims of magic and miracles. I also invite you to provide me with specific citations that provide empirical support for your claims that acupuncture is effective. It seems like a simple request, why do you keep dodging it, or providing me with long lists of shitty and irrelevant ones?

            1. The segregationist name was used as a way to describe a cult of people (This SBM site) who have a narrow minded view of the world and wish to apply that narrow view to all, even though doing so would cause severe pain and suffering. Application of these narrow views without mercy or reflection and are actively suppressing alternate views.

              1. MadisonMD says:

                cult… segregationist…dogma…vending…narrow… blah, blah ugh.
                It’s no mercy to mislead people with placebo.

                Just provide the evidence. Nobody here takes your word for it. You are not the only one expected to provide evidence. Prove us wrong and rub our faces in it. Show us the data. To make it easier for the unintelligent, describe how the data proves us wrong and you right.

              2. Windriven says:

                Segregationist? SEGREGATIONIST? Screw you. You appear to be old enough to know what that word really means. You trivialize the sacrifices made by untold millions by spooling that word out to prop up your delusional view of medicine.

                What you then call narrow views is exactly the point. A scientific approach does narrow views. They are narrowed by discarding the crap that does not work. Does effing not, Steve. No matter how many times you whine that you know better than all the people who have studied it carefully, the evidence is that IT DOES NOT WORK.

                You have been asked to produce the evidence. You understand evidence, right? Evidence is what moved us from this to this in less than 70 years. Evidence is what eradicated smallpox and cured many leukemias. Hard facts. Provable. WHERE ARE YOURS?

                So show us the EVIDENCE. Your constant drumbeat of meaningless babble is numbing. You are convincing no one of anything except your naked stupidity.

              3. Harriet Hall says:

                There is no point in continuing to ask SSR for evidence, because “evidence” doesn’t mean to him what it means to us. He puts the “evidence” of testimonials above the evidence from controlled scientific studies. I was hoping he would respond to the article I dedicated to him and Dr. Moran, but apparently he hasn’t noticed it yet. It will be interesting to see if he is capable or willing to try to understand my points or if he will just continue to say he knows acupuncture improves the vision of his AMD patients.

      3. Windriven says:

        “He should go to jail.”

        Yeah, huh? What crime has he committed?

        Ethical breach? Absolutely. Criminal offence?

      4. Windriven says:

        “He should go to jail.”

        Yeah, huh? What crime has he committed?

        Ethical breach? Absolutely. Criminal offence?

        Sorry for missing the correct threading on the first post.

    3. WilliamLawrenceUtridge says:

      I am a huge fan of Dr Oz and respected him very much,

      Fixed it for you, judging by the rest of your comment.

      is dedicated to helping people enjoy a healthy lifestyle.

      If that were true, he would think of ways to motivate people to develop and maintain a healthy lifestyle, not host a series of “miracle” weight loss potions that, even if they did work, would probably be as healthy a way to lose weight as methamphetamines. He’s now a shameless media whore for ratings.

      The problem is when he started his new show and is being forced to generate ratings.

      Yes, exactly, and that’s why he’s being criticized now. Because he is now a shameless media whore for ratings.

      The worst part about Oz is the way he uses conventional, real medical knowledge mixed with the utter nonsense horse shit that he uses to put asses in seats and eyes on screens. It means physicians can’t say “he’s a quack”, the mixture of real science with pseudoscience forces them to qualify their statements meanwhile Oz qualifies nothing. Because he is now a shameless media whore for ratings.

    4. Andrey Pavlov says:

      Badly shaved monkey is spot on.

      I agree with Steven that his intentions are fine. He really does want to help people. He just lacks a fundamental understanding of what that really means.

      Where I disagree with Steven is that the show did not change him. It gave him a different forum by which to express what he already believed – hype and magic and BS. Looong before Oprah he had Reiki “masters” casting magic spells in his OR and recommended homeopathy to patients (his wife is a Reiki “master” and believes in homeopathy). He believes – and did long before his show – that any “story” that has evidence to back it up is a valid story and can help people. The money quote is this:

      Oz sighed. “Medicine is a very religious experience,” he said. “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.” All facts come with a point of view. But his spin on it—that one can simply choose those which make sense, rather than data that happen to be true—was chilling. “You find the arguments that support your data,” he said, “and it’s my fact versus your fact.”

      And instead of seeing that means we need better evidence or rigorous logic to see which fact and story and religious experience is true he thinks both (or all) are.

  28. WilliamLawrenceUtridge says:

    In response to this comment.

    This is what real medicine is all about. Helping people despite the dogma that is poured into young minds, the web and the media.

    No, medicine is about using the best evidence available to ensure patients’ time is not wasted, their health is preserved, and scarce resources are put to the best use.

    Using a bunch of unproven remedies that are illogical, require a radically different set of physical laws to work, and are promoted almost lockstep with a denigration of evidence-based medicine, is not real medicine and doesn’t help people.

    Also, you’ve incorrectly used the word “dogma” again. “Dogma” is the insistence on a fact or theory in the absence of evidence. Principles proclaimed by an authority as inherently true without reference to empirical findings. Your assertions that acupuncture works is dogma – you are the authority, and you provide no evidence. What you are asking for is not the abandonment of dogma, but it’s acceptance and reverence based solely on your word.

    All I’m asking for is evidence that your treatments work better than placebo. Why do you see this as unreasonable? Particularly given my repeated willingness to accept, even endorse and promote your treatments in the face of actual evidence. Why do you so strongly oppose the use of good-quality evidence in medical decision-making?

    I know what you are going to say, “Anecdotal.” But that is what clinical medicine is all about! It is first hand science. When dealing one on one with people all of your data is anecdotal, personal and unique to each case.

    Actually, what I’m going to say is there is no way I will ever click on a link you provide. I don’t really trust your integrity.

    The thing is – if you summarize a collection of anecdotes, you still don’t know if your summary of anecdotes accurately reflects, or systematically distorts reality. If you proclaim stage IV small-cell lung cancer to be harmless because “you’ve met lots of people with stage IV small-cell lung cancer, and they were still alive”, well, you’ve rather missed the pont.

    Clinical medicine is not about anecdotes, clinical medicine is the application of the best scientific knowledge available to specific cases.

    Observations, data collection, investigation, analysis has to first be conceived or perceived way before it can be found true. What you seem to be confusing is animate vs inanimate objects within the scientific methods. That is your fatal flaw making people into numbers, inhuman and static objects.

    Science is not about finding “the truth”, it’s about finding the best approximation of reality given current knowledge and methods available. It will always fall short.

    Look – if you take two groups, give one of them your fancy acupuncture and another gets treatment in the same locations but with retracting, non-penetrating needles, and a day, three days, six weeks and six months after the fact they have different (or the same) results, how is that not a meaningful way of testing whether your magic needles actually help or not? Though the controls have to be strong, the design does not require magic or incredible, unreasonable stretches of imagination and thought. Science is ultimately about careful counting, and you can’t come up with any reason why it wouldn’t work. What you’re really afraid of is that it won’t work, and you won’t be able to think of a reason why.

    1. Thank you for your personal testimonial! You should make a video too! :)

      Your testimonial is as valid or invalid as all the other testimonial on the planet.

      But in your case you conclusions are all beyond doubt and are absolute … in your own mind and not in reality.

      The only person I can trust beyond is the patient in front of me. sorry you do not have such an opportunity, insight and experience.

      Yall still do not get it!

      1. WilliamLawrenceUtridge says:

        Yall still do not get it!

        It’s funny, because it’s you who do not get it. Testimonials are worthless. Patients who were bled testified (if they didn’t die – in which case no testimonial) that it worked well and they felt better. Doctors who bled their patients also testified that it worked. People getting B12 shots testify they feel better. The bar has to be higher than “feeling better right after treatment”. If nothing else, long-term follow-up is worthwhile to see if the patient later died, or reverted to their previous condition, or was doing no better than someone who got no treatment.

        Your willingness to accept testimonial (from your patients, strangers on the internet or yourself) shows how profoundly unaware you are of how flawed the mind is, and how poor it is at objectively assessing health. People can feel better from saline injections, sugar pills, and simple reassurance. But real medicine should include more than mere assurance and placebos. That’s my opinion, perhaps you can defend why “feeling better” is superior to objective improvements that last over time.

  29. WilliamLawrenceUtridge says:

    Responding to this comment by Steve-O.

    Reiki is a valid treatment when used within a set protocol that includes a physician and physical therapist be they Reiki, massage, myofascial release, swim, work hardening or yoga. Same with Acupuncture and all of it’s various type.

    Do you know what reiki is? It is literally magic and wishful thinking. While I’ll concede that there is a remote possibility acupuncture could work through mechanical, even possibly biochemical means (though the best scientific research indicates that it’s ineffective), reiki is completely ridiculous. What you’re saying here is “I am OK with charging people for literally useless and impossible treatments as long as they’re getting real medicine”. If someone has to get real treatments in order for reiki to work, how can you be sure that it actually does anything, and isn’t a pure waste of time? If this is your approach to acupuncture, I’m not surprised you think it works – you appear to give it all the credit no matter what the actual treatments given are. Ever considered that maybe acupuncture only appears effective because you are attributing all of the healing to it, rather than conventional care, painkillers, relaxation, massage and time?

    The issues are;
    Patients have a right to choice! Let the patient choose which modality they find beneficial.

    Patient insurance plans and public insurance options should allow an informed choice between multiple valid options. Actual patients should be informed of the risks and benefits of a treatment approach. And for something like acupuncture, patients should be informed that the evidence base strongly suggests it is just a placebo. While choice are good, uninformed choices are bad and some choices should not be allowed. Chosing laetrile for instance, should not be a choice as it is simply poison.

    I don’t argue that acupuncture should be banned, and stop pretending I do. I argue that the evidence suggests it is ineffective, and specifically regarding your practices, that you are ignorant and unaware of the evidence. Don’t pretend I or anyone else here at SBM contributors are some jackbooted thugs coming to shut you down or re-enact the Kristallnacht. What we want is informed patients, a public health care and research system that recognizes the evidence, and a media that ceases to lick the anus of CAM practitioners and instead portrays them as the dishonest quacks they actually are.

    YOU are anyone else should not have a say in what treatment get to be included in the list of options. All valid and trusted option should be on the table!

    I would accept that statement if by “valid” you meant “empirically proven to work better than placebo”. However, ongoing discussion indicates you want “valid” to mean “stuff I believe works and damn the evidence”. So I must disagree.

    Someone must limit the options that public and private systems will pay for, my taxes should not support your ineffective nonsense. And it doesn’t, but that’s geography.

    Here are few who only had 2 options; continued pain or reparative surgery. They all failed miserably and ALL were never given an option of alternatives which make this a miscarriage of justice.

    Miscarriage of justice? Really? People do not have a justice-based right to good health – medicine cannot guarantee it. People should have an honest presentation of options including risks, side effects, success rates and the like. This would preclude the use of acupuncture for anyone who understands science and the evidence base, and would preclude it from inclusion in tax or premium-based care plans. But if people want to pay for it out of pocket, I would consider it a tax on stupidity and leave it to them (but prosecute those practitioners incompetent enough to puncture lungs, leave needles lodged in the body, cause infections or transmit diseases).

    Why do you consider these spare and limited measures to be unreasonable?

  30. Harriet Hall says:

    @SSR,

    Why have you not commented on the article I wrote just for you: http://www.sciencebasedmedicine.org/acupuncture-for-macular-degeneration-why-i-reject-the-evidence/

    It is a response to the link you provided to support treating AMD with acupuncture. Please read it and tell us whether it has any effect on your beliefs about that treatment.

  31. sandy wilson says:

    I don’t think Dr. OZ is an evil man but let’s face it. If someone says there’s a weight lost miracle – run!
    Weight loss is not a mystery, a mystical thing, if I just had a magic potion ind of thing. It’s simple mathematics, eat less, exercise more. How complicated can it be? Eat fruits and veggie, stop eating and drinking high sugar stuff and exercise and you will loss weight.
    I do think Dr. OZ has gotten comfortable making claims he cannot back up. Why don’t you stop putting your faith in Dr Oz and find out on the internet and other places about supplements. Do yourself a favor and do the work for your own health,

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>