Wile E. Coyote or Dr. Henry Miller? You be the judge!

Wile E. Coyote or Dr. Henry Miller? You be the judge!

Those of you who read my not-so-super-secret other blog (or who follow the news) familiar with this, but I feel that what happened over the last couple of weeks with respect to a man to whom I like to refer as “America’s Quack” is worth posting right here, in modified form.

Last week, a group of ten doctors led by Dr. Henry Miller, most of whom were affiliated either with the Hoover Institution or the American Council on Science and Health (ACSH)—or both—wrote a letter to Lee Goldman, MD, the Dean of the Faculties of Health Sciences and Medicine at Columbia University complaining that Dr. Mehmet Oz shouldn’t be faculty at Columbia University because of his “disdain for science and for evidence-based medicine, as well as baseless and relentless opposition to the genetic engineering of food crops” and “an egregious lack of integrity by promoting quack treatments and cures in the interest of personal financial gain.” The letter produced a fair amount of media attention a week ago. I originally mildly approved of it, but over the course of a few days after the letter was released, my opinion on it soured. The reasons were several and included a profound distaste for threatening letters sent to a person’s employers, admittedly based in part on my own experiences having been at the receiving end of such intimidation tactics, as well as a concern that the letter had been written with no clear purpose behind it other than as a publicity stunt to embarrass Dr. Oz and Columbia. When I learned that Dr. Oz was planning to answer the letter on his show this week, there were predictions that this particularly bone-headed publicity stunt would backfire spectacularly. And it did.

America’s quack counterattacks by calling his critics industry hacks

So I finally watched Dr. Oz’s counterattack show, having DVRed it because his show airs on weekdays during working hours, and have to conclude that it’s profoundly depressing how badly Miller’s stunt backfired. I suppose it’s little consolation that I had accurately predicted Dr. Oz’s line of attack. Sadly, Dr. Oz has officially become Mike Adams, one of the most conspiracy-mongering and despicable of conspiracy theorists, whose massively unhinged attacks on behalf of Dr. Oz that I noted (in a pair of posts entitled “Vicious attack on Dr. Oz actually waged by biotech mafia; plot to destroy Oz launched after episode on glyphosate toxicity went viral” and “Mainstream media FAIL: Sleazebag doctors attacking Doctor Oz have histories of criminal fraud and ties to Monsanto’s “Discredit Bureau”“) basically said the same things that Oz ended up saying, minus intimations of domestic violence. (At least Oz restrained himself that much.) Truly, if I thought that maybe Dr. Oz might have had a shred of honor left before, I harbor no such illusion now. Oz is about as despicable as it gets.

Actually, the morning his “counterattack” show was to air, Oz published an article in TIME entitled “Exclusive: Dr. Oz Says ‘We’re Not Going Anywhere’“, that was a summary, an outline, if you will, of his planned line of attack, so much so that when I read it I thought maybe I wouldn’t have to watch Oz’s actual show when I got home. But, damned that sense of duty—the things I do for my readers—I did watch, and I was amazed at just how low Oz was willing to go.

First, let’s look at the TIME article. Not having science to back him up, Oz goes for the same gambits that quacks and antivaccinationists go for: Appeals to freedom, claims to be “fighting for you,” and ad hominem attacks on his enemies, up to—or should I say down to—the very same ad hominem attacks used by Mike Adams in his series of screeds attacking the letter writers. In fact, the TIME article very much resembles Oz’s opening monologue on his “counterattack” show, but the show was a bit more dramatic, as you might expect. Indeed, if you doubt anything I write from here on out, you can watch the segments for yourself if you like:

  1. Dr. Oz Breaks His Silence
  2. Dr. Oz Reveals the Truth About His Critics
  3. Dr. Joel Fuhrman Defends Dr. Oz Against the Controversial Headlines.

There was another long segment recapping some of what Dr. Oz has said about GMOs, but that doesn’t appear to be online, perhaps because it consisted mainly of snippets from past Oz shows.

In his opening monologue Oz immediately blames “ten mysterious doctors” with industry ties to for trying to shut him up because he criticized genetically modified organisms (GMOs). Then, with a heavy sigh implying a heavy heart delivered with the cheesy portentous manner of an aging gunman in a B-grade western forced to strap on his six gun one last time to go into battle—no, Dr. Oz is not a very good actor—he intones:

I’ve long believed that doctors should never fight their battles–or each other–in public. But now I believe I must.

Hoo boy. You could smell the cheese. You could also see the lie, as Oz made the claim that “many papers mistakenly claimed my own hospital’s doctors were out to get me.” Really? If there were any such stories claiming that it was Columbia University doctors going after Oz, I sure didn’t see them. I wonder if Oz will put up some links to those stories. Somehow I doubt it.

Oz also invoked this gambit:

This can lead to confusion and irritation when analyzed by conventional physicians. For example, another daytime TV show and mine were recently noted in a BMJ article for only having proof for half of what we shared with the audience. A similar figure is often used to approximate the amount of randomized clinical trial data underlying conversations in physician’s offices across America. This reflects that natural gap between what is proven in clinical trials and the needs of our patients.

Here, Oz is referring to a study Steve Novella and others blogged about. Oddly enough, I hadn’t been aware that the authors of that study had later said that their data didn’t support the contention that Dr. Oz or The Doctors were “quacks or charlatans or worse.” Of course, no one actually said that this study did imply such a thing; rather, we merely pointed out how it simply showed how little of what Oz recommends is evidence-based. In fact, if you look at the study more closely, it was even worse than that. For example, the reviewers looking at the claims were willing to consider case studies as the minimum form of evidence to support a recommendation. That’s a really low bar. By that standard, you could say that there is “some” evidence to support the idea that the MMR vaccine is associated with autism, given that Andrew Wakefield’s infamous 1998 study—now retracted—was a case series. Actually, since it was retracted, you couldn’t use Wakefield’s study, but there are plenty of other case reports and bad studies used by antivaccine-sympathetic doctors and researchers out there that one could cite. In any case, that’s how bad Dr. Oz did, given how low a bar a case study is. When the authors raised the bar and used the slightly higher threshold of “Believable or somewhat believable evidence” then only 33% of recommendations on The Dr. Oz Show met that standard. Contrary to what Oz claims, medicine, even as imperfect as it is, is far more evidence-based than that.

Of course, the only thing that disappointed me about the study was that the authors didn’t look at what percentage of advice from Dr. Oz is based on pure fantasy (such as his episodes on homeopathy, using psychic mediums like John Edward and “Long Island MediumTheresa Caputo as therapists, faith healing, and the like). That’s the core of the complaint I and many skeptics have against Dr. Oz., not that he does the occasional anti-GMO segment, although those are bad too.

In any case, the TIME article basically described much of the segment’s ad hominem attacks. Oz introduces them, but they were, as Dan Diamond pointed out, “outsourced” to The Dr. Oz Show correspondent Elisabeth Leamy, who enthusiastically performs the requisite hatchet job. Unfortunately, given who Dr. Miller and his fellow cosignatories are, it wasn’t difficult for her. I could have done the same thing as well as she did without even bothering to get my posterior off the couch. I found everything Leamy “reported” with just five or ten minutes of Googling and reading sources. Some “reporter”!

In any case, here it is, in the TIME article:

With a few clicks and some simple searches, a remarkable web of intrigue emerged—one that the mainstream media has completely missed. The lead author, Henry I. Miller, appears to have a history as a pro-biotech scientist, and was mentioned in early tobacco-industry litigation as a potential ally to industry. He also furthered the battle in California to block GMO labeling—a cause that I have been vocal about supporting. Another of the letter signees, Gilbert Ross, was found guilty after trial of 13 counts of fraud related to Medicaid. He is now executive director of American Council on Science and Health, a group that has reportedly received donations from big tobacco and food and agribusiness companies, among others. Another four of the 10 authors are also linked to this organization.

The segments on Miller and Ross included unflattering photos with graphics worthy of the lowest form of political attack ads, complete with a graphic showing Miller being “put under the microscope” and concluding with jail doors closing in front of Ross. Then Oz interviews Lisa Graves of SourceWatch and executive director of the Center for Media and Democracy, and Gary Ruskin from US Right To Know. SourceWatch is a wiki run by the Center for Media and Democracy that bills itself as a “collaborative, specialized encyclopedia of the people, organizations, and issues shaping the public agenda.” Graves explicitly called Miller and the ACSH “shills for corporations,” in the most blatant use of the “shill” argument I can recall having seen in a long time. In the process, ACSH was referred by Ruskin as “rent-a-scientists,” who described this characterization as being “really well-established.” It might well be true that all of Oz’s arguments against his critics are misleading or downright wrong, but, contrary to what has been argued, it actually does matter who Oz’s critics are and that they have massive conflicts of interest. It is not “beside the point.” Maybe on some airy abstract plane it shouldn’t matter, but this is the real world, and to the average person it does matter, as much as we as skeptics might like to wish otherwise. Again, Ross and the ACSH are, in my opinion, often industry shills, but that doesn’t mean what Miller wrote about Oz in his letter was wrong It does, however, make it child’s play for someone like Dr. Oz to discredit them, particularly given Miller’s foolish decision to frame the letter so heavily based on Oz’s recent non-science-based criticism of GMOs.

Meanwhile, Graves cited the words of the judge presiding over Ross’ Medicaid fraud trial, who referred to him as “a highly untrustworthy individual,” emphasizing that “those were his exact words,” before concluding, “I think this is definitely a smear campaign against Dr. Oz and I think it’s a campaign that’s driven by individuals who are connected to big industries.” I note that the term “big industry” was bandied about a lot during Oz’s segment. To be honest, besides its tendency to align with industry interests, I have always been bothered by the ACSH keeping Gilbert Ross in a leadership position, even back when his release from prison was not very far behind him. Yes, it’s true that a person’s past shouldn’t necessarily have any bearing on his scientific arguments, but, again, Oz knows that that’s not how the average person thinks. That’s why his attack was so devastating, particularly the bit where a photo of Dr. Oz is projected next to photos of several of the ten signatories of the letter, and the question is asked, “Who should you believe?” Indeed, Even Ross now regrets having signed the letter because by signing it he foolishly gave Oz and his allies a weapon to attack the letter and the ACSH, and in particular to distract from the criticisms of Oz’s promotion of quackery and pseudoscience on his show.

FREEDOM!

There was one misfire that made me laugh out loud when I saw it. For whatever reason, the producers of The Dr. Oz Show decided it would be a good idea for Oz to interview Dr. Joel Fuhrman. I’ve mentioned him a few times before. For example, Fuhrman appeared in a pro-raw food diet movie, Simply Raw, in which he took a vitalistic view of food in which cooking somehow destroys living antioxidants, phytochemicals, and a variety of other compounds, without which the body can’t be healthy and “must break down.” He describes processed food as “foods whose life has been taken out of them” and makes the claim that, without these micronutrients, cells accumulate “toxins” that need to be “detoxified,” while touting broccoli and various vegetables as having “incredible medicinal power.” Elsewhere, he’s been known to trot out the same old alt-med tropes against chemotherapy, particularly its “barbaric” nature. He’s also been known to make some rather overheated claims for the benefits of diet, in essence claiming that virtually any disease is preventable. No wonder Oz likes him. No wonder he likes Oz, given that he’s on the medical advisory board of The Dr. Oz Show and has made quite a few appearances to promote his wares.

Fuhrman serves as Oz’s surrogate and really lays it on thick. He describes the signatories of the letter as “not representative” of physicians and their letter as an “attack against all physicians” (nonsense!), pushing a “dangerous agenda,” and being “anti-American” and, of course, “anti-freedom.”

Of course. Because criticizing quackery is “anti-American” and “anti-freedom.”

Naturally, Oz can’t resist insinuating a conspiracy theory to explain why Miller and his cosignatories decided to send their letter now, referring to it as bullying, which is particularly amusing given the mismatch in media presence between Miller and Oz. In any case, Oz concludes that the reason Miller and colleagues must have decided to choose now to strike is because of a federal bill being considered, the “Safe and Accurate Food Labeling Act,” which would prohibit any mandatory labeling of GMOs by states. Of course, the bill failed to pass last year, so it’s unclear to me why its reintroduction this year would provoke an attack by pro-GMO interests against Dr. Oz, but Oz and crew sure do blatantly insinuate dire conspiracies on the part of big industry to use more glyphosate, which GMOs allow it to do. It’s as though Oz has finally given in to the dark side so much that he’s channeling Alex Jones, Gary Null, and Mike Adams.

He concludes:

No matter our disagreements, one of the goals of this show is to have an honest discussion with diverse opinions. Freedom of speech, my friends, is the most fundamental right we have as Americans. These ten doctors are trying to silence them, and I’m not going to let that happen.

Yes, freedom of speech is one of the most fundamental rights we have as Americans, but freedom of speech does not mean freedom from criticism, nor does it obligate a production company to give Oz a platform or a TV station to broadcast his opinions.

Oz wanted to shill for Sony

Ironically, it turns out that Oz’s flagrant use of the “shill” argument as his almost sole tactic for sliming his opponents and arguing against their position is disingenuous at best, given a recent Wikileaks dump that included correspondence between Sony executives, staff working on The Dr. Oz Show, and even Dr. Oz himself. The e-mails leaked and archived on Wikileaks demonstrate that Dr. Oz has been looking for some tasty, tasty shilling opportunities himself, particularly with Sony, which distributes his show. I first learned of this new Wikileaks dump from story by Julia Belluz, “New WikiLeaks documents reveal the inner workings of the Dr. Oz Show“:

Dr. Mehmet Oz often appears on his popular show to promote new health products and devices. Most viewers are likely under the impression that he’s doing this because he’s closely considered their merits and decided the products are widely beneficial.

But newly leaked emails suggest that business considerations — not health or science — can be a driving factor in which products Oz decides to promote.

Last week, WikiLeaks released a series of emails sent between Dr. Oz, his staff, and executives at Sony (one of his show’s producers). They shed some light on how Dr. Oz’s daily talk show works behind the scenes.

Of course Oz is driven by business considerations. It’s syndicated, commercialized TV; by definition commercial considerations are, if not paramount, very, very important. The question is whether commercial considerations overruled science. Of course, The Dr. Oz Show being The Dr. Oz Show, I suspect we already know what the answer to that question is. The only real question is how much did commercial considerations rule? What hadn’t occurred to me is that there might be damning e-mails in the big Wikileaks release of Sony e-mails relevant to Dr. Oz, mainly because, although I knew Sony was one of the producers of Oz’s show, I just didn’t connect the dots.

In any case, Belluz gives one example showing that Oz is a driving force in pushing for deals:

In a January 2014 email, for instance, Dr. Oz reaches out to Michael Lynton, the CEO of Sony Entertainment, about his interest in wearable fitness and health tracking devices.

“I have been carefully following the wearable device market and am pretty close to consummating a longer term relationship, but just saw the piece below quoting Kaz Hirai [the president and CEO of Sony] and realized that Sony is moving into the space as well,” Oz writes in an email. “We should leverage the Sony-driven success of our TV show into other arenas where Sony thrives, like health hardware.”

Here is the complete text of the e-mail. Oz follows up, asking, “If you agree, how do you suggest we proceed? Could you jump start the process with an appropriate introduction to someone involved with the ‘Core’ initiative?” So what we have here, is Dr. Oz, first reaching out through his people, then jumping in the conversation himself, about in essence making a deal to have his show shill for Sony wearable devices, all in the name of “synergy.” I also can’t help but note from Oz’s mentioning that he’s “close to consummating a longer term relationship” that Oz was almost certainly approaching Sony to see if he could get a better deal.

So, judging from the Wikileaks dump (which also revealed that Sony executives are very concerned about Oz’s growing reputation as a quack), what we appear to have here is a wannabe shill criticizing shills for being shills.

Oz is a symptom of something deeper

Unfortunately, few people who aren’t skeptics who’ve been following Oz’s antics for a while are aware of the inconsistencies in Oz’s story or of just how much pseudoscience he’s been peddling over the last few years. So he’ll almost certainly get away with his slime attack against Dr. Miller and his cosignatories linked to ACSH and/or the Hoover Institution. Indeed, I feel sorry for the docs who weren’t affiliated with either group and probably were unaware of exactly what they were hitching their wagon to when they agreed to sign the letter.

Unfortunately, Oz’s counterattack is magnificent propaganda that utterly crushes Miller and his letter, just as I predicted that it would a week ago. Oz cynically completely reframes the criticisms directed at him from his support of pure quackery by featuring homeopathy, Mike Adams, faith healing, and all manner of other pseudoscience on his show as potentially valid health care options to his being attacked by industry interests seeking to protect their GMO profits. Oz succeeds in making a big deal out of the fact that he doesn’t recommend these options as replacements for conventional care. Instead, he advocates “integrating” quackery with conventional medicine. Given that doing exactly that is actually part of Oz’s day job at Columbia as director of its integrative medicine program, I was not in the least surprised that Columbia did nothing in response to the letter other than issue some stereotypical bromides about “academic freedom.” That’s because, other than the faith healers and psychics on his show, Oz is doing nothing that Columbia doesn’t routinely do itself.

In fact, that’s exactly what I said when I predicted disaster for Miller and his band, and that’s what I say now. Michael Specter gets it too. The problem is that what Oz promotes on his TV show is not that different from what he probably promotes as the director of Columbia’s integrative medicine program, which is not that different from what is happening in the rest of quackademia, as increasingly quackery is “integrated” with academic medicine to become quackademic medicine. Oz is a symptom of the problem—a big symptom—but not the problem itself. There are many other examples, from medical schools as diverse as the Cleveland Clinic and its promotion of reiki, traditional Chinese medicine, and “functional medicine,” George Washington University, the University of Michigan (my alma mater), the University of Arizona, Memorial Sloan-Kettering Cancer Center, and the University of Maryland.

If you don’t believe me, just check out this op-ed published in USA TODAY yesterday by several Columbia faculty, entitled “What do we do about Dr. Oz?” In the letter, Dr. Michael Rosenbaum, professor of Pediatrics and Medicine at Columbia University Medical Center, and his co-authors, practically bend over backwards not to be too critical of Oz, praising him for “bringing alternative therapies which are generally under-researched and under-regulated into the public forum”—which nearly made me spit out my iced tea on my computer when I read that phrase—even as the authors lament how Oz’s brand of “unsubstantiated medicine sullies the reputation of Columbia University and undermines the trust that is essential to physician-patient relationships.” The best they can come up with to counter Oz, apparently, is a proposal for increased governmental scrutiny of claims made on television and other media or, barring that, “Dr. Oz might begin each program with a simple disclaimer: ‘The opinions expressed on this program may not be evidence-based or part of accepted medical practice and have no endorsement from Columbia University.'”

What else can we expect when medical academia becomes medical quackademia? For example, I note that the Columbia University Medical Center’s Integrative Therapies Program for Children with Cancer offers herbal and nutritional counseling and guidance, aromatherapy (quackery), acupuncture and acupressure (quackery), massage therapy and reflexology (super duper quackery), reiki (rivaling homeopathy for the title of The One Quackery To Rule Them All), meditation, exercise, yoga & movement therapy, and a chef program. Yes, Dr. Oz has become a TV snake oil salesman, but selling snake oil is what quackademia increasingly does. Other than the psychics, he’s not doing anything worse than what happens at his own university. That’s the problem that needs to be attacked. Dr. Oz is just the most famous symptom.

In the end, Dr. Miller’s strategy was misguided and missed the main target. All he managed to accomplish was to provide Dr. Oz an excuse to attack and crush his critics. Going forward, I fully expect that Oz will dismiss legitimate criticism of his promotion of quackery as being somehow affiliated with the ACSH and “big industry” protecting GMOs. Since we know he knows about SBM, it wouldn’t surprise me if at some point Oz’s minions aim the “shill” argument at us.

Posted by David Gorski

Dr. Gorski's full information can be found here, along with information for patients. David H. Gorski, MD, PhD, FACS is a surgical oncologist at the Barbara Ann Karmanos Cancer Institute specializing in breast cancer surgery, where he also serves as the American College of Surgeons Committee on Cancer Liaison Physician as well as an Associate Professor of Surgery and member of the faculty of the Graduate Program in Cancer Biology at Wayne State University. If you are a potential patient and found this page through a Google search, please check out Dr. Gorski's biographical information, disclaimers regarding his writings, and notice to patients here.

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