Respectful Insolence

NOTE: Dr. Novella has written up a detailed description of his experiences on The Dr. Oz Show. Please read it. Also note that the online video for Dr. Novella’s appearance is now available:

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

When I first learned that Dr. Steve Novella, Yale neurologist, blogger, and host of the popular skeptical podcast the Skeptics’ Guide to the Universe was going to be on The Dr. Oz Show, I was concerned. After all, this is the same physician who had in essence given up science-based medicine in favor of media stardom based on the promotion of alternative medicine. Of late Dr. Oz has been getting worse, too, promoting pseudoscience and what can only be described, in my opinion, as quackery. The snake oil that Dr. Oz has promoted over the last several months includes Dr. Joe Mercola, one of the biggest promoters of “alternative” health, whom Dr. Oz first had on his show about a year ago and then defiantly defended in a return appearance in early 2011. Then, in a rapid one-two punch, Dr. Oz had an ayurvedic yogi named Cameron Alborzian, who promoted highly dubious medicine, including “tongue diagnosis,” to be followed a few days later by something I would never, even in my most cynical assessment of Dr. Oz, expected, namely the appearance of faith healer Issam Nemeh on his show. Worse, Dr. Oz showed zero signs of skepticism. Unfortunately, Dr. Oz wasn’t done. In rapid succession next Dr. Oz endorsed a diet that he once eschewed as quackery and then, to top it all off, invited psychic John Edward onto his show, asking Is talking to the dead a new kind of therapy? This latter episode so shocked me that I basically said, “Stick a fork in him, Dr. Oz is done when it comes to SBM.” Dr. Oz’s descent was complete, and that is now the trouble with Dr. Oz and much of the reason why in 2011 the James Randi Educational Foundation awarded him the The Media Pigasus Award for the second year in a row. I fear he very well may three-peat in 2012.

So right from the start I wasn’t very optimistic about how this whole thing would turn out. Fortunately, however, I was pleasantly surprised. Steve managed to hold his own in a completely hostile environment, with Dr. Oz asking him “Have you stopped beating your wife?”-style questions, with only minor stumbles. At one point, he even managed to hand Dr. Oz his posterior. Alas, I doubt it will make any difference to Dr. Oz’s viewers, but we can always hope to change a few minds. I also realize that, however a big deal being on Dr. Oz’s show was to Steve and many members of the skeptical movement (especially supporters of SBM), to Dr. Oz it was just one segment in one show of one season of a couple of hundred episodes. Not to detract from Steve’s achievement at all (it’s truly amazing that he managed to get on the show and do as well as he did, given how the deck was stacked against him), but to us this is big; to Dr. Oz it’s entertainment.

So what happened?

As I watched the beginning of the segment, my experience having watched several episodes of Dr. Oz’s show led me to look for the not-so-subtle signs of the story that Dr. Oz and his producers intended to portray. In such a television show, you always have to look for the story, and the story is revealed by how the issue being discussed is framed. I didn’t have long to wait. One thing I thought as I watched the opening minutes of this episode of Dr. Oz’s show is that that watching Oz really reminded me of was Kevin Trudeau. Remember him? The message he used to spread his snake oil was implicit in the title of his book, Natural Cures “They” Don’t Want You to Know About. The message is the same. It’s you (as in Dr. Oz’s audience or Kevin Trudeau’s readers) against the establishment. The Man is trying to keep you down and keep you from those natural cures that don’t rely on big pharma! So, what are you, sheeple? Or are you among the enlightened, like Dr. Oz and his viewers? Why is your doctor afraid of alternative medicine? (Yes, that was the title of the segment.) It’s an appeal both to the appeal of outsider status and to the vanity of Dr. Oz’s audience. His audience is encouraged to feel not just like a maverick, bucking the system, but to feel superior than everyone else, “empowered” to “fight the power.” Right from the start, Dr. Oz frames the issue of “alternative medicine” as the little guy versus dogmatic physicians, as “taking control” from undefined outside forces. In doing so, he paints himself as the champion of the little person, willing to risk everything to tell his audience The Truth. It’s a load of fetid dingos’ kidneys of course. Dr. Oz is fabulously wealthy and famous in a large part because he’s embraced alternative medicine and found a way to preach it to the masses, all wrapped up in a lovely bit of framing:

Today I’m taking on a controversial issue in medicine that has everything to do with helping you take control of your health. There are a lot of doctors, including me, who are putting their reputations on the line because we’re using alternative therapies in our traditional practices. But many doctors claim that these therapies are nothing more than junk science and may even be dangerous. Your doctor could be one of them. Why are they so afraid of alternative medicine? Should you be too?

Note the “brave maverick doctor” pose. It’s the same pose that quacks who think vaccines cause autism take. Dr. Oz then uses the fallacy of argumentum ad populum; i.e., proclaiming that, since alternative medicine has “reached its tipping point” (in his opinion, at least) and people spend $35 billion a year on it in this country, that there must be something to it. It’s a silly argument. Lots of things are very popular; popularity doesn’t equal “scientifically valid.” I do have to admit one thing that made me totally chuckle here. Dr. Oz referred to chiropractic as “chiropractics.” I mean, seriously, Dr. Oz. If you can’t at least get the terminology right about something as commonplace as chiropractic, I find it very hard to take you seriously. Very hard indeed, even more so after he trots out the “superstars of alternative medicine” that he’s showcased on The Dr. Oz Show, including Andrew Weil, the über-quack Joe Mercola, and Deepak Chopra, to name a few.

Of course, there wouldn’t be any drama if there weren’t any “holdouts,” which is how the argument is framed. It’s very clever. Dr. Oz is the brave, open-minded doctor willing to try things outside the mainstream. Skeptics and proponents of science-based medicine are portrayed as going against the flow, as negative, as “holdouts” against what is portrayed as the inevitable triumph of alternative medicine, when the moon will be in the seventh house and Jupiter will align with Mars. And Dr. Oz is persecuted for it, too. Those nasty skeptics! They’ve portrayed him as having abdicated professional responsibility and gone to the Dark Side. Yes, Dr. Oz actually did show the headlines of two RI posts, Dr. Oz: America’s doctor and the abdication of professional responsibility and Dr. Oz’s journey to the Dark Side is now complete: Faith healing quackery glorified. Never mind that neither post came from Science-Based Medicine, which is where Steve Novella blogs, among other places. They came from me. Quite frankly, the thought of Dr. Oz reading Respectful Insolence amuses me to no end, although I rather suspect that he probably never actually read it and instead my posts were somehow discovered by his producers.

Be that as it may, I’m much less amused by how Dr. Oz panders to his audience. It begins right at the very start of the segment, where Dr. Oz proclaims that you–yes, you!–his viewers (well, maybe not you, as in you who read this blog) “aren’t afraid to test the time-honored traditions of alternative medicine.” That’s because, obviously, if you watch Dr. Oz’s show, you must be a brave maverick, just like him. You’re the brave maverick, and he’s the brave maverick doctor–a perfect combination! If you’re not afraid of alternative medicine, then why should is your doctor? (Yes, Oz actually said that.) All of this was just the introduction, at which point the framing was complete. It’s Oz and his viewers against the world, which leads Oz to the very first question to Steve:

Why are there so many doctors out there–and doctors are our viewers–who don’t like alternative medicine? Why do you not want me to talk about these therapies on the show?

More framing. Notice now that Oz frames alternative medicine as a preference. To Oz and his viewers, doctors who support science-based medicine don’t object to alternative medicine because it is unscientific, because there’s no evidence that most alternative therapies work and a lot of evidence that they don’t, or because it’s a false dichotomy. (Yes, I’m talking about the fact that alternative medicine is by definition medicine that has not been shown to work scientifically or has actually been shown not to work. It can never be repeated too many times in this context that alternative medicine that has been shown to work scientifically ceases to be “alternative” and becomes just “medicine.”) Oh, no, those doctors just don’t like it, as many people don’t like Brussel sprouts, or as some people prefer Coke over Pepsi (or vice-versa). It’s a preference that doctors are trying to impose on their patients, those nasty, reductionist, doctors! Worse, it’s a “Western” preference. Yes, Oz kept repeating the term “Western medicine” or “Western science,” another false dichotomy. Good science is good science; it doesn’t matter whether it was done in the “West” or the “East.”

Notice also how Oz takes on the mantle of the victim. It’s not about him talking nonsense about science and medicine, about him promoting quackery (which he has been doing a lot of in 2011). Oh, no! It’s all about skeptics like Steve trying to shut Dr. Oz up! As if we could! It’s a silly argument, obviously custom made to try to portray Dr. Oz’s critics and close-minded, dogmatic, simpletons. In reality, this is a distortion of our position. Nothing could be further from the truth to claim that supporters of SBM don’t want Dr. Oz to talk about these therapies. What we don’t want him to do is to promote them as efficacious when scientific findings indicate that they are not. What we want is a skeptical, science-based assessment of them. Despite the claim by Dr. Oz and his producers that we are “afraid” of alternative health, in actuality we crave an open dialogue based on science, both preclinical and clinical trials, not marketing hype, pseudoscientific claims, and testimonials.

After some minor stumbling, Steve explained very well how the very concept of alternative medicine is an artificial category that exists primarily to produce a double standard that favors modalities that can’t cut it based on science. Unfortunately, as is frequently the case in such “debates,” Steve was paired with a true believer, Dr. Mimi Guarneri, who did exactly what it is that I complain about all the time. She used the classic “bait and switch” of alternative medicine, claiming nutrition, exercise, and the like as “alternative” and then proclaiming them as not being “alternative.” Steve answered that quite well also, but I doubt it got through the audience. Much of the talk was dominated by herbs and supplements, rather than the more bizarre quackery that Dr. Oz has featured on his show in 2011, such as homeopathy, faith healing, and the psychic scammer John Edward. No doubt this is intentional, because herbs and supplements are at least potentially real drugs (impure drugs with highly variable quantities of the active ingredient, but drugs nonetheless). As such, they are the “bait,” used to lure in the marks, after which the “switch” is made and the true quackery brought out.

One thing that cracked me up is that Oz defined alternative medicine rather artificially by dividing it into three categories. Why three? who knows? Perhaps it’s like the Holy Hand Grenade of Antioch, you know, “…then shalt thou count to three, no more, no less. Three shall be the number thou shalt count, and the number of the counting shall be three. Four shalt thou not count, neither count thou two, excepting that thou then proceed to three. Five is right out.” Whatever the reason for choosing the number three, Oz divides alternative medicine into things you can put in your mouth, things that are done to your body, and then the “mind-body” connection. For each one of these divisions, Dr. Oz then showed a brief video promoting their glories. Particularly irritating and, quite frankly, dishonest, is how Dr. Oz at each point tries to turn around Steve’s statements about how various alternative medical therapies have been studied and found not to work into a straw man in which Steve’s words are represented as saying that there aren’t any studies. At one point, Oz even says, “I totally disagree that these have not been studied and some evidence been found to support them.” Of course, “some evidence” has been found to support that most ridiculous of quackeries, homeopathy; one has to look at the totality of evidence to know that not only is homeopathy ridiculous from a basic science standpoint but that the clinical evidence that exists is most consistent with nothing more than placebo effects.

The utter intellectual bankruptcy of this approach was demonstrated when Dr. Oz brought in Catherine Ulbricht, PharmD, MBA[c], chief editor of Natural Standard and editorial board member of Natural Medicine Journal, who touted Natural Standard. One thing I noticed about the journal for which she is on the editorial board is that it is the official journal of the American Association of Naturopathic Physicians (AANP), which is definitely a strike against it right there. (Actually, it’s two strikes.) Naturopathy is a hodge-podge of mostly unscientific treatment modalities based on vitalism and other prescientific notions of disease that fancies itself to be science-based. In fact, as if to emphasize the connection between Dr. Ulbricht and naturopathic quacks, I found in my e-mail box a mass mailing from the AANP touting her appearance on The Dr. Oz Show. Such are the “benefits” of being on the AANP mailing list. Let’s just put it this way. Dr. Ulbricht has published at least one review of homeopathic remedies, specifically Oscillococcinum, in which she concludes that it probably works and that more studies are needed. Amusingly, in the segment that follows Steve’s segment, Dr. Ulbricht even invokes the alt-med cliche of aspirin having been derived from willow bark and being perfectly safe. Of course, natural product pharmacology is in no way “alternative” (more bait and switch), and aspirin is not without risks, sometimes life-threatening.

If there’s one area that Steve managed to score against Dr. Oz in spite of the deck being stacked against him, it’s acupuncture. Steve pointed out that it doesn’t work above and beyond a placebo. As I like to say, it doesn’t matter where you stick the needles and it doesn’t even matter if you stick the needles. The results are the same, and there is a small risk to sticking needles into people’s bodies. Dr. Oz’s reaction is very telling; he says:

There are billions of people around the world who use as the foundation of their healthcare system. It’s the basis of ancient Chinese medicine. I just think it’s very dismissive of you to say because we couldn’t take this idea that exists with a different mindset and squeeze it into the way we think about it in the West then it can’t be possibly effective.

All of which is utter nonsense. First, it’s very arguable whether there are “billions of people” who use acupuncture as the foundation of their health care system. The Chinese, for instance, are actually moving away from traditional Chinese medicine and acupuncture back towards that evil reductionistic “Western” medicine because it works. But even more telling is that Dr. Oz has fallen back on the hoariest of hoary alt-med excuses for not being able generate evidence in favor of their woo: You can’t use “Western science” to study my woo! He even claims that “Western science” can’t understand acupuncture well enough to “know how to study it the way it has to be studied.” It’s special pleading, and it’s pathetic. In fact, Steve’s response was brilliant in that it managed to point out that popularity doesn’t equal efficacy and to liken acupuncture to bloodletting, a comparison that clearly irked the Great and Powerful Oz. Whether Dr. Oz realized it, this was the one part of the show where it can legitimately be said that Steve handed him his ass, even in spite of everyone being against him. True, Oz would never admit it, but this was the one point in the segment where the mask slipped a bit and Dr. Oz looked quite unhappy.

Finally, there were two very annoying bits in this whole exchange. First, Dr. Oz appropriates the alt-med trope of “individualization” (which in alt-med, really means “making it up as you go along“), even likening his favorite woo to a “bow and arrow” or a “stealth approach” to “hitting what you want to get that works in you” and science-based medicine to a “ballistic missile approach that we have so often become comfortable with.” “Ballistic missile approach”? You mean like Tarceva, Herceptin, Avastin, and other targeted therapies designed to hit very specific molecular targets?

In his finale, Dr. Oz then solidifies the bond with his intended audience:

Alternative medicine, I think, is at the grassroots level, and because of that nobody owns it. Now, that stated, I think we got our homework to do. But I think alternative medicine empowers us, and that’s the big message–but only if you know more about it. And if it does work for you, trust me, do not let anybody take it away from you.

In other words, you brave maverick Dr. Oz viewers, don’t worry your little heads about science. Don’t listen to those buzz killer skeptics. They’re so much less interesting than cupping, acupuncture, homeopathy, reiki, and various other forms of mystical, magical woo. Be “empowered” by listening to whatever message that the latest seller of snake oil is promoting to you. “Learn” more about alternative medicine from Dr. Oz; don’t worry if the information is science-based. Be good Dr. Oz fans. Above all, use your “empowerment” to buy what Dr. Oz says you should buy and, of course, keep watching his show.

Additional commentary:

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

Comments

  1. #1 Aicardi
    April 27, 2011

    Good job i am agree with De OZ he is prove a new since he is doing great job.
    Thank you for post.

  2. #2 Beth
    April 27, 2011

    By staying inside the safe territory of the perspectives of patients without health challenges, he is playing it safe. Oz is taking the short cut of telling people what they want to hear. Accurate health information does not commonly arise from circular thinking.

    I have heard him discuss a patient with a GI motility disorder, stating that her stomach was lazy and that she simply needed to exercise more. Patients from several online patient groups tried to submit comments about the need to identify treatments, yet the comments were not approved.

    Patients taking a proactive, science-based approach were met with silence. Nothing he described as a treatment was explained in terms of actual efficacy. No alternate forms of treatment were suggested.

    Patients with these conditions are diagnosed with biopsies when exercise does not work for them, especially in cases when they have been diagnosed with persistent and long term motility abnormalities.

    Although they are seen rarely by non specialist clinicians, motility disorders can involve significant impairment of gut motility (such as with enteric neuropathy) up to gut failure in the most severe cases. Successful treatment is possible if patients are diagnosed in the early stages and evidence-based interventions are promptly started.

    Comparative research is currently underway, and many other species appear to share significantly similar health problems. Animals with motility abnormalities do not always achieve cures with exercise either. Perfect solution fallacies are not realistic.

  3. #3 ChrisKid
    April 27, 2011

    Having spent a good amount of time lately in ‘discussion’ with anti-vaxxers, and seeing what seems to be their biggest argument – YOU CAN’T TELL ME WHAT TO DO!, I think Dr. Oz’s comment about empowerment is the telling one. It really comes down to “I’m as good as you”. It lets people believe they are smart and in charge.

  4. #4 Nicolas
    April 27, 2011

    Where can we see the show? I missed it and cannot find it on dr Oz website

  5. #6 reasonablehank
    April 27, 2011

    “…proclaiming that, since alternative medicine has “reached its tipping point” (in his opinion, at least) and people spend $35 billion a year on it in this country, that there must be something to it.”

    I also hear that there is something to cocaine. It’s very popular. What is Dr Oz afraid of? Why isn’t he enlightening the masses about the wonders and benefits of cocaine? I think he’s being extremely closed-minded, arrogant and is obviously hiding a COI in his hand-waving at the efficacious marching powder. How can we put our family’s trust in the hands of this man?

  6. #7 Robert S.
    April 27, 2011

    Of course the punchline is that ancient Chinese “acupuncture” was simply bloodletting.

  7. #8 sophia8
    April 27, 2011

    “…proclaiming that, since alternative medicine has “reached its tipping point” (in his opinion, at least) and people spend $35 billion a year on it in this country, that there must be something to it.”
    I can’t find the latest figures, but in 2007 Americans were spending nearly $80 billion a year on tobacco products. So why isn’t Dr Oz telling people to take up smoking?

  8. #9 Anonymous
    April 27, 2011

    Dr Oz is expanding his brand.

    American Dental Association teams with Dr Oz website Sharecare.com
    http://www.ada.org/news/5738.aspx

    “The ADA will join other top health associations as Sharecare resources, including as the American Cancer Society, American Heart Association, the American Association of Retired Persons, American Diabetes Association and several leading hospitals.”

    “Oral health will be among 48 topics covered on the site. Consumers can also ask questions pertaining to cancers, fitness and exercise and mental health among many other areas. Some of the questions currently on the site include: Is it safe to use herbal medicine for mild depression? Are loss of balance and neuropathy related? What can cause my child to get a rash after a fever?”

  9. #10 Aaron
    April 27, 2011

    It’s sad to imagine all of the viewers who have had bad experiences with doctors and therefore will believe anything Oz has to say that bashes them.

  10. #11 Dangerous Bacon
    April 27, 2011

    The title of Orac’s article says it well – Dr. Oz is morphing into Kevin Trudeau.

    He’s building a new career around the woo that They Don’T Want You To Know and becoming a carny sideshow act.

    Too bad that the mindset he’s selling poses a threat to the health of the people he’s supposedly “empowering”.

  11. #12 DavidCT
    April 27, 2011

    It is great that Dr. Novella managed to make some good points. However, the whole thing was staged with Dr.OZ having the final word. I have little doubt that his message is the only one that will be remembered. The audience can now do its homework at the University of Google where the woo is always seen first.

  12. #13 Composer99
    April 27, 2011

    It begins right at the very start of the segment, where Dr. Oz proclaims that you–yes, you!–his viewers (well, maybe not you, as in you who read this blog) “aren’t afraid to test the time-honored traditions of alternative medicine.”

    Curiously, I would say that Dr Oz and supporters of ‘alternative’ medicine are afraid to test these “time-honored” traditions – for fear that they will be found wanting.

    Skeptical and science-based doctors and supporters are, from what I have seen, all for the methodologically rigorous testing of ‘alternative’ medicine – as long as the test does not violate current standards of care – with acceptance or rejection to follow the outcome of the testing.

  13. #14 Chrisj
    April 27, 2011

    I think three categories is about right for Alt-med:

    1) Treatments where there is no proof of efficacy
    2) Treatments which have been shown to have no effect
    3) Treatments which have been shown to be actively harmful in themselves

  14. #15 Lindsay
    April 27, 2011

    Thanks for the write-up, Orac, you channeled my rage perfectly. I had to turn it off after Dr. Novella explained that alternative therapies have been studied and haven’t been shown to work, and Dr. Oz comes back with “I disagree”. What???

  15. #16 Denice Walter
    April 27, 2011

    Although his activities provide evidence to support my trickle-down theory of woo**, Oz, who lives nearby, makes me ill. I can recall tales of people who eschew SB treatment for serious illness (cancer, HIV/AIDS) or as prevention ( vaccines) and parrot memes like those Oz – and the other perps I follow- circulate like viruses. Here is one that hit home this Saturday:

    I visit “Dave” and “Gwen” less frequently than I’d like because they live 150 miles away. I took 2 dudes with me because everyone loves to go to D & G’s: they’re bright, creative, entertaining people with a great house. When I walked in, I immediately saw that something was wrong- she looked nervous, he looked very troubled. Later, we went out, and prior to dinner, over drinks alone, she spilt the beans – she had colon cancer surgery: chemo for 8 months was advised, she declined and has also declined follow-up testing. “Doctors don’t know everything”. The surgery took place about a year ago.

    “Why didn’t you tell me?” I ask. Seems I am “just like Dave”, i.e. extremely good at reading the riot act. Of which she has had enough of already. My questions to her revealed that: it was stage “2 or 3″. She feels that medicine can’t guarantee much and that perhaps these chemical agents are not all they’re advertised to be; it would compromise her quality of life. She would become very sick and lose her hair. She feels that cancer “will eventually ‘get her’ anyway”. She’ll take her chances.

    I know enough from interviewing people not to “push” too hard for “data”- or they might really shut up . She’s intelligent and started her own charity that provides a service for people in 2 states. I respect her. I let the issue go. And suggest that we meet up in Phila. in a few weeks, ostentsibly to hang out in the Old City and other hipster enclaves nearby.

    Woo-meisters and natural health gurus, intoxicated with their own line of opiate , focused on creating their own fame and fortune, fail to appreciate the effects of their tall tales on the choices people make with their lives. Their effects may be subtle, and hard to prove, but just as deady in the long run.

    **which, unlike the trickle-down theory of economics, works.

  16. #17 superdave
    April 27, 2011

    This was the first time I ever watched Dr. Oz. I was expecting him to be much more middle of the road when it comes to alternative medicine and I think you are exactly right. He is closer to Trudeau than I realized.

  17. #18 Richard
    April 27, 2011

    Orac, you are spot on in your analysis. The way he panders to his audience is almost criminal. I’ve always marveled at the clever way alternative medicine is branded as the next step in medical progress and all of us who oppose it are holdouts who are behind the times, when in fact alternative medicine is nothing but witchcraft and its proponents want us to go back to the ways of our primitive ancestors. Steve Novella’s appearance on the Dr. Oz Show may not change many minds, but hopefully it will inspire us to greater courage and effort–to be candles in the dark.

  18. #19 Cuttlefish
    April 27, 2011

    http://digitalcuttlefish.blogspot.com/2011/04/man-behind-curtain.html

    Real medicines that pass a test
    Have evidence that they are best
    In journals on the shelf
    Such data, sadly, alt-med lacks
    And so it must depend on quacks—
    It can’t defend itself!

    When Oprah said, “we need a guy
    To stare the camera down, and lie”
    The doctor took the call—
    How brave of him to take a stance
    Defending things that work by chance
    And often, not at all!

    (…)

  19. #20 Alareth
    April 27, 2011

    Orac, I think some text was left out.

    The paragraph where you introduce Dr. Mimi Guarneri ends with a sentence fragment:

    Much of the talk was dominated by herbs and supplements, rather than the

  20. #21 Composer99
    April 27, 2011

    Bravo, Cuttlefish!

  21. #22 lilady
    April 27, 2011

    @ Cuttlefish: Just a beautiful poem about the man behind the curtain; (awful pun) “poetic justice.”

    I remember Oz, when he had a few spots on TV news programs and using his considerable medical knowledge, offered up some great commentary. Unfortunately, when Oprah got her hooks into him, sprinkling the magical celebrity dust, he went over to the dark side.

    Dr. Steven Novella did a commendable job, in spite of the cardiologist and in spite of the audience’s extreme devotion to the man behind the curtain.

    Who used the word “cheesy?” It is the exact word to describe the spectacle that is the Dr. Oz Show

  22. #23 aek
    April 27, 2011

    Oz practices(d)?) CV surgery, no? Does he rely on magical meridians to know where to locate vessel disease? Does he recommend acupuncture and homeopathy as post-op pain control methods? What % of his surgery patients are offered – and what % accept homeopathy, acupuncture, herbs and other forms of woo? What are his morbidity and mortality outcomes for practicing science-based medicine vs alternative medicine in his patients? What is the stance of his hospital’s risk management relative to his practicing alternative medicine?

    If he’s going to advocate for it, then put it on the table.

    He’s the worst kind of phony, and his hypocrisy knows no bounds.

  23. #24 Yojimbo
    April 27, 2011

    Pay no attention to the man in front of the curtain.

  24. #25 carykoh
    April 27, 2011

    Something that I always find amusing is the alternative medicine claim that most doctors won’t use alternative methods because there’s no profit in it. They then bring out a physician that gave up their conventional practice for an alternative one, surely out of the goodness of their hearts and not the enhanced earning potential. I suspect that alternative medicine is far more profitable for the practitioner than conventional. One example I’ve had in my head is bio-identical hormones. What would an physician make by putting someone on conventional HRT, maybe a $50 office visit. The pills themselves cost like $40 for a years supply at Walmart, of which, the doctor gets no cut. However, prescribe bioidentical and you can get a nice office visit fee, I’ve seen about $350/visit, plus a mark up on the hormones and the testing. Plus frequent visits for the saliva testing and adjustments to the hormones. Probably looking at a yearly cost of like $5,000 for that, or less than a $100 for conventional. But yeah, no profit to be made there.

  25. #26 A. Noyd
    April 27, 2011

    “I just think it’s very dismissive of you to say because we couldn’t take this idea that exists with a different mindset and squeeze it into the way we think about it in the West then it can’t be possibly effective.”

    I think this “other ways of knowing” bullshit could really use an analogue to the Flying Spaghetti Monster–a parody that can be defended on the same vapid pretexts the anti-science morons are using. Something that emphasizes how the woo-lovers have no way of discarding the parody without discarding their preferred woo. Something of such awesome stupidity that even they would find it ridiculous.

    Maybe this exists already and I don’t know about it. If so, it needs more publicity. If not, I suggest something along the lines of the ancient and venerated modality of healing people by slapping them in the face with rotten fishes. When the woo-peddlers bring out the excuse Dr. Oz employs here, agree with them heartily and talk about how deplorably Western the mindset is of people who dismiss the amazing benefits of a six day old flounder to the kisser or a rancid salmon across the brow.

    And it could work for all the other usual defenses, too. When they act insulted at the parody, act insulted back that they’re not taking you seriously. When they dismiss it as not their preference, demand to know if they’ve tried it. (How can they know it’s not for them if they haven’t actually been slapped yet?!) If they say they have, ask if they tried it long enough or if they made sure to do it just right. And so on.

  26. #27 Aaron
    April 27, 2011

    I read Orac and Novella’s reviews this morning and just finished watching the segment. I think Oz is very good at what he does. He comes off as this middle-of-the-road guy who who supports medicine and “alternative” ideas. He’s also very good at slipping in fallacies that to the typical viewer go unnoticed.

    It really bothered me when Novella allowed Oz to accuse him of saying no studies or evidence has been found for alternative modalities.

    It also bothered me that the segment avoided the hard-hitting culprits of alt med: homeopathy, reiki, faith healing, detoxification, etc. Oz painted alt med to be a lot less than it really is.

  27. #28 Sibyl
    April 27, 2011

    “…even likening his favorite woo to a “bow and arrow” or a “stealth approach” to “hitting what you want to get that works in you” and science-based medicine to a “ballistic missile approach that we have so often become comfortable with.””

    I actually think Dr. Oz made a very good analogy here.

    Science-based medicine, at its best, homes on in a symptom or disease and absolutely obliterates it.

    Alternative medicine, at its best, might graze its intended target and pat itself on the back when the symptom or disease falls over dead from sheer coincidence.

    Alt-med: so stealthy you can’t tell it’s doing anything.

  28. #29 W. Kevin Vicklund
    April 28, 2011

    Why is it that whenever CAM gets in a pissing contest with SBM, CAM ends up with Shy Bladder Syndrome?

  29. #30 MartinM
    April 28, 2011

    I think this “other ways of knowing” bullshit could really use an analogue to the Flying Spaghetti Monster–a parody that can be defended on the same vapid pretexts the anti-science morons are using. Something that emphasizes how the woo-lovers have no way of discarding the parody without discarding their preferred woo. Something of such awesome stupidity that even they would find it ridiculous.

    Maybe this exists already and I don’t know about it.

    Not only does it exist, it was written by Steve Novella himself.

  30. #31 MartinM
    April 28, 2011

    Apparently I buggered up the link. Again.

    http://www.quackwatch.com/01QuackeryRelatedTopics/alteng.html

  31. #32 A. Noyd
    April 28, 2011

    @MartinM
    A lovely satire, but not quite what I was after. I want a form of woo invented to be promoted the same way acupuncture and homeopathy and all the rest are but that no woo-lover with a shred of sanity left would welcome.

  32. #33 Michieux
    April 28, 2011

    I would hope that people who watch Dr. Oz have the intellectual wherewithal to determine what constitutes evidence when we speak of science-based medicine, and are able to counter some of the shoddy arguments put forth by people such as Oz. Beyond arming folks with a healthy skepticism, and an ability to critically analyze the claims made by the “alternative” medicine crowd, there is not much we can do.

  33. #34 Prometheus
    April 28, 2011

    Michieux comments:

    “I would hope that people who watch Dr. Oz have the intellectual wherewithal to determine what constitutes evidence…”

    Sorry, Michieux, but the average “Dr. Oz” watcher lacks the intellectual wherewithal to discriminate between horse droppings and high-fiber muffins. This isn’t to say that there aren’t a few intellectually rigorous watchers, but the show is aimed at a much lower demographic.

    Prometheus

  34. #35 Lee
    April 28, 2011

    I want to know how sure Steve Novella is that “Alternative Med” doesn’t work by just reading some literature. Science is supposed to be based on observation and feedback. The drug company funded studies (they’re the most frequently cited based on they have the money!)have been fraught with bias towards their patents as to the point of being harmful. Many drugs are approved based on skimpy or fraudulent data then it takes a lot of effort to remove them after harm is done.
    I say this as my Mom was in a study as a control for Fosamax. She was perfectly healthy and wanted to help. Later she became a “Poster child(Grandma)” for the “side” effects of this drug. She then went on a host of other Meds to stay alive. It wasn’t till I guess 2 yrs ago that the Fda issued an alert to physicians that severe musculo-skeletal pain, osteo necrosis of the jaw and hip then later atrial fibrillation yadayada…resulted from this class of drug. She was told she had “fibromyalgia”!(My A$$)…It’s still being marketed by Sally Field and Fosamax. Who pays you guys to write this stuff anyway? Is it worth it to be so proud of the 35th best health care system in the Industrialized world. People who support Dr. Oz & Mercola are moving on and folowing the best systems in the world that don’t leave so much “collateral damage” around from SBM’s Ballistic missils.

  35. #36 Chris
    April 28, 2011

    Lee:

    I want to know how sure Steve Novella is that “Alternative Med” doesn’t work by just reading some literature. Science is supposed to be based on observation and feedback.

    Perhaps you would know more if you went to his blogs and read some of his articles. If you have a claim that alt-med works, then you need to provide the evidence. Not an anecdote on how a medication harmed someone.

  36. #37 madder
    April 28, 2011

    @A. Noyd:

    I want a form of woo invented to be promoted the same way acupuncture and homeopathy and all the rest are but that no woo-lover with a shred of sanity left would welcome.

    Wow, that’s a tall order. After reading most of Orac’s lamented old “Your Friday Dose of Woo” posts, I shudder to think of what such a thing would even involve. Look into Breatharianism, for example.

  37. #38 Vicki
    April 28, 2011

    Lee,

    I’m sorry your mother is sick. But “Fosamax can be harmful” doesn’t prove anything about alternative medicine: all it proves is that not all medicines are harmless. Nobody is denying that. In most cases, either the harm is rarer than the benefit, or the patient has to decide whether, for her, the benefit is worth the side effects. I know two people who have been given the same migraine preventative. One is still on it, several years later, and very glad of it. The other is about to go off it, because a side effect that many people find harmless or even desirable–weight loss–is dangerous in her case. Neither of these women is going to say “Topamax has serious side effects, therefore meditation will prevent your migraines.” It doesn’t work that way.

    I disliked President Bush, therefore my mother is president of the United States? No. Does not follow. Neither does “This doesn’t work, therefore that must.” Unfortunately. If it did, we would never have to try more than two treatments before we had a cure for something.

  38. #39 Lee
    April 28, 2011

    Chris and Vicki,
    Very clearly you both entirely miss the point. The corruption involved in spinning the word Science with such veracity is harming the patient. I’ve seen so called Alt med used to great success only to be said it was “placebo effect” or they never really had cancer etc. If the Media and Pharma are controlled by the same crowd and guys like Morris Fishbein control the Journals then they decide what is “Scientific” and that the non patent approaches are “Psuedo science”. It’s about money and you two can argue what you want. The nation is moving on away from the Rockefeller owned medical monopoly and the damage it is causing.

  39. #40 TBruce
    April 28, 2011

    If the Media and Pharma are controlled by the same crowd and guys like Morris Fishbein control the Journals then they decide what is “Scientific” and that the non patent approaches are “Psuedo science”.

    ALCAN called, your hat is ready.

    BTW, if Morris Fishbein is controlling the journals, he must be a remarkable fellow, considering he’s been dead for 35 years.

  40. #41 Chris
    April 28, 2011

    Lee:

    The corruption involved in spinning the word Science with such veracity is harming the patient. I’ve seen so called Alt med used to great success only to be said it was “placebo effect” or they never really had cancer etc.

    Actually, you missed the point. You are making lots of statements, but why should we believe you. Either support your statements or we will assume you pulled them out of thin air. Just like claiming a person who died in 1976 is controlling the journals. What is he, some kind of zombie?

  41. #42 Militant Agnostic
    April 28, 2011

    BTW, if Morris Fishbein is controlling the journals, he must be a remarkable fellow, considering he’s been dead for 35 years.

    Never underestimate the capabilities of the Zombie Lizards.

  42. #43 herr doktor bimler
    April 28, 2011

    to discriminate between horse droppings and high-fiber muffins

    Now you tell me.

  43. #44 Lee
    April 28, 2011

    Nice, I said “Like” Morris Fishbein, not him. You “like” strawperson fallacies I see.

    Chris, My point exactly is you don’t need someone else parading as an authority to cite to determine every truth in your belief system. Take Dr. Poul Thorsen. He was instrumental in the fraud perpetrated upon the world for twisting the “Danish Study” data. He was widely quoted and hence further mercury poisoning occurred from vaccines since then. Do you like to cite data like that? God gave you a brain so that you didn’t have to ask everyone else what’s going on. The Danish study was flawed from the onset yet everyone that “wanted” to accept it, did. Now what should I cite to have the opinion that “I don’t even think you care”? (Which is my real point.)

  44. #45 JohnV
    April 28, 2011

    Hey look a crank brings up Thorsen. Must be a Thursday.

  45. #46 Chris
    April 28, 2011

    Lee, I see you just like to make stuff up. Dr. Thorsen had very little to do with both papers, which were just two out a couple of dozen papers.

    Oh, and one of the papers was on the MMR vaccine, which never contained thimerosal. So, you can’t even keep the fantasies straight.

  46. #47 Lee
    April 28, 2011

    You guys have fun and don’t hurt anyone now, OK?

  47. #48 Chris
    April 28, 2011

    Emulating Brave Sir Robin, Lee left the building as he held tightly to his tin foil hat. Because aluminum is one of them toxic metals, that might even be a “heavy” metal!

  48. #49 nejishiki
    April 28, 2011

    #48
    Velostat is now the material of choice for thought-screen hats.

  49. #50 A. Noyd
    April 28, 2011

    Madder (#37)

    Wow, that’s a tall order. After reading most of Orac’s lamented old “Your Friday Dose of Woo” posts, I shudder to think of what such a thing would even involve.

    Hah. Well, I did specify woo-lovers with a shred of sanity left.

    ~*~*~*~*~*~

    Lee (#39)

    It’s about money and you two can argue what you want.

    Translation: “I’ve made up my mind and nothing you closed minded bastards will say can possibly change it.”

  50. #51 W. Kevin Vicklund
    April 29, 2011

    I say this as my Mom was in a study as a control for Fosamax.

    Wait… if she was a control, how did she experience side effects for a drug she never took?

  51. #52 lilady
    April 29, 2011

    @ W. Kevin Vicklund: Right you are about Lee’s mother who was in a study as a “control” for Fosamax.

    I suspect that Lee read something in one of the tabloids or from Mercola or Oz about the dreaded A-Fib side effect in a 2007 small study about Fosamax….it was splashed all over the popular media. The authors themselves stated that a wider better “controlled” study should be done…and here it is:

    Update of Safety Review Follow Up to the October 1, 2007 Communication About the Ongoing Safety Review of Biophosphanates (FDA November 12, 2008, Updated March 4, 2010)

    This newer safety review was a placebo control trial, that followed 19,687 biophosphanate users versus 18,358 placebo treated women.

    There are seven FDA approved biophosphanates prescribed in the United States that were tested here. This latest safety review found that the absolute difference in A-Fib events between each of the 19,687 biophosphanate users and placebo arms varies from 0-3/per 1000 study subjects.

    It would be nice if people who post here provide up to date citations and would be also honest about their mother’s participation as a control in drug studies.

  52. #53 Chris
    April 29, 2011

    W. Kevin Vicklund:

    Wait… if she was a control, how did she experience side effects for a drug she never took?

    I noticed that, but I thought if I brought it up it would confuse him even more. As it stands, he has run away.

  53. #54 The Analysyt
    April 29, 2011

    I disagree with the skeptical movement and however you would like to label the other movements.

    I wasn’t surprised Dr. Oz had the last word. It was his show. That’s to be expected.

    I thought they were all fair to eachother. It would be interesting to me if they sat down and had a 1 hour debate rather than 3 minutes on an entertainment show.

    So, while I disagree with the mindset of both parties, I love seeing healthy discussion (FYI: That doesn’t exist on this blog).

  54. #55 Chris
    April 29, 2011

    Poe of The Analyst?

  55. #56 Karen
    June 7, 2011

    The fact of the matter is we DO need to protect ourselves from The Man. Doctors tend to think they know what’s best even legally. I’m not anyone else’s business and neither are my children. Doctors are nothing more than hired help and they need to remember that.

  56. #57 Vicki
    June 7, 2011

    You are my business when you intrude in my business. The classic formulation is that the right to swing your fist ends where my nose begins. Similarly, it is my business if you set your body to producing harmful or even fatal microorganisms and then put them in the air I breathe or the water I drink. That you aren’t trying to kill people doesn’t mean that you are guaranteed not to, just as a driver with no harmful intentions can kill if they drive drunk or fall asleep behind the wheel.

  57. #59 Jen in TX
    June 24, 2011

    @ZDoggMD:
    My oldest autistic son LOVES that video. Thanks for making him smile. ;>)

  58. #60 ZDoggMD
    June 24, 2011

    @Jen now that makes ME smile, thanks!

  59. #61 doctor oz fans
    July 29, 2011

    Oz practices(d)?) CV surgery, no? Does he rely on magical meridians to know where to locate vessel disease? Does he recommend acupuncture and homeopathy as post-op pain control methods? What % of his surgery patients are offered – and what % accept homeopathy, acupuncture, herbs and other forms of woo? What are his morbidity and mortality outcomes for practicing science-based medicine vs alternative medicine in his patients? What is the stance of his hospital’s risk management relative to his practicing alternative medicine?

    If he’s going to advocate for it, then put it on the table.

    He’s the worst kind of phony, and his hypocrisy knows no bounds.

  60. #62 friendswood chiropractor
    December 23, 2011

    It maybe true that the Chinese are starting to use more western medicine. But it always seems that when other countries copy our way of life, they get obese. Really not sure if that is a good trade off.
    Still have to agree that talking with dead as a therapy is well beyond my belief system

  61. #63 ARB
    January 14, 2012

    I thought I heard Oz say that a particular treatment would “cure” ADD… not alleviate, but _cure_. Did he really??

  62. #64 James Chong
    January 15, 2012

    E² Acupuncture Science Since 2600BC
    Any skeletal muscle pain can be easily cured by Traditional Chinese Medicine (TCM) Acupuncture.

    For 4,610 years (2600BC), Yellow Explorer’s time. Until now acupuncturist continues this ancient TCM practice to eliminating all diseases (trying). All the main hospitals of China use this to treat most patients as busy as KFC fast food.

    Acupuncture treatment will has needling sensation effect for first few days. This called “DE Qi/Chi” (Arrival of Oxy’Blood—needling sensation). it must be achieved so that Yin & Yang(Negative and Positive energy) can be balanced and body’s immune system has strengthens, else diseases can’t be eliminated. The fundamental manipulating techniques are Lifting and thrusting & Twirling or rotating. TCM Acupuncture therapeutic works and easily cures muscular pain if apply correctly.

    Beside sciatica(more trials needed), all others skeletal muscle pains are not recorded in TCM text therefore no “Acupoints(???)” can be provided to any acupuncturist as that they need to advancing the practice and pick the right AcuPoints.

    Be respectful, Acupuncture is not a device or voodoo magic, it does not release any things (certainly not endorphins, inflammation, etc, ..) or anti-inflammatory agents. Please do not mislead. It is a marvelous 4,610+ years old, micro surgical tool, etc, .

    “An acupuncture is bad science”. not much can be expected in 4,610 years ago, science not even exist. Science & Resources only available from the great scientists : Heinrich Hertz (1887) & Albert Einstein (1905).
    Since 2005 E² Acupuncture has added a new chapter of modem acupuncture science. which has scientific proven, formulated, verified and even dispelling the amount of excessive Yins/-Toxin can be calculated. Treatment uses single new save disposal and painless micro-needle insertion to proper “Acupoints(??)” and has no side effects, least risk mainly due to accident same as any treatments. No Lifting and thrusting & Twirling or rotating manipulating needed so that patients can comfortably having a cup of tea/coffee.

    Acupuncturist must fully understood the Five Elements(五行), Five Changes(五变) and Five Shu/Transports(五输/通) Yin & Yang balance principles. if any one treated by 5 X 30 minutes in 2 weeks and has no relief by 4 weeks, please discontinues and search into other illness.

    I have my Plantar fasciitis cured twice by my own EE Acupuncture, last cured was on march/2011 since then pain remains free and no sign of coming back. (E²/EE: Eliminates Excessive Yins/-Toxin/Electrons)

    Aren’t you seeking and unlock this 4,610+ years old great hidden scientific facts of Acupuncture.
    For latest update, please check/click on my site below
    https://sites.google.com/site/jameschongpainfree/
    google.com/site/jameschongpainfree
    or google search with JamesChongPainFree google sites

    Nurse: 3 years of Sciatica (loc: buttock & 5 inches down, 2 spots). Seeking conv’ medical help had failed.
    Only 1 EE Acupuncture treatment on 30th/10/2011 and continue her normal work.
    12 days after and feedback:

    “Been feeling the slight tenderness in the area where the needle were inserted. Felt my legs is tired but not the numbness.” (50% pain relief, 100% no numbness)

    5 weeks Later (email on 4th/11/2011):
    “Seems to be fine, slight tenderness but definitely better than before” (now 90% cure)

    why pain relief if it can be so easily cured.
    and the cost of curing it is so much less then a pair of PF shoes and not to mention others, .

    cheers
    James

    Note:
    I try to post commences to Steven N. of neuroligica blog, but every one has failed. look like the truth of Acupuncture scientific facts is not welcome. any suggestion?

  63. #65 Scottynuke
    January 15, 2012

    Try having someone at least functionally literate in English write your blogspam, for starters…

  64. #66 James Chong
    January 17, 2012

    I’m wonder how many Chinese words do you understand

  65. #67 AdamG
    January 17, 2012

    I’m wonder how many high-quality, peer-reviewed articles do you have that demonstrate acupuncture’s effectiveness

  66. #68 James Chong
    January 17, 2012

    In 2001, published Hendrik Sch..’s scientific scandal can only fool you a year or 2. But not to the scientific facts and so as Acupuncture. It can’t fool you for 4610+ years long.

    Aren’t you seeking and unlock this 4,610+ years old hidden scientific facts of TCM Acupuncture.
    Now you can get the scientific facts from jameschongpainfree
    If you’re remain unconvinced, this has shown that you are know nothing about science but pretend to be one
    You’re welcome to prove E² acupuncture science is a bunk or a science challenge.
    or taking part in http://scienceblogs.com/pharyngula/2011/11/acupuncture_is_bunk.php.
    perhaps silent make you a better science person.
    Or ended like The Mad Man vs E2 Acupuncture science over http://www.topix.com/forum/life/veterans/TFDRMKGFDQM4H0C9J

  67. #69 Chris
    January 17, 2012

    Mr. Chong, I know a few Chinese people who would have a few choice words for you (mostly in Cantonese).

  68. #70 James Chong
    January 18, 2012

    This the problem.

    For some having personal attitude as such Chin or Chong can’t be friends and Yin & Yang can’t be science because they’re not English.

    In 2001, published Hendrik Sch..’s scientific scandal can only fool you a year or 2. But not to the scientific facts and so as acupuncture. It can’t fool you for 4610+ years long.

  69. #71 Narad
    January 18, 2012

    This is like “Eli Stone” gone horribly awry.

  70. #72 Chris
    January 18, 2012

    WTF?

  71. #73 Jack
    February 21, 2012

    You sound close minded and greedy. If you truly care about your patient you wouldn’t be wasting time writing about what care your patients spent THEIR MONEY on. Be a good and unselfish doctor and you will never have to worry about what care we choose – a patient

  72. #74 Bronze Dog
    February 21, 2012

    You sound evasive and manipulative, Jack. If you truly cared for patients, you wouldn’t be wasting your time distracting people from the efficacy and safety of treatments. Actually caring for people involves giving treatment that actually works, and avoiding treatments that are dangerous.

    The patient’s desire for a healthy, productive life is more important than appealing to the marketing deceptions and fads people like you have been filling them with.

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