A physicians' attack on Dr. Oz explodes into a new controversy

Will the M.D.s' attack on Dr. Oz backfire?

Sometimes a cogent attack on a worthy target ends up making the target stronger. That may be happening with last week's letter signed by 10 physicians urging Columbia University to sever its ties with Dr. Mehmet Oz, who has made a fortune promoting quack nostrums to his huge television audience.

Oz's TV producers say he'll be devoting a large portion of a forthcoming "Dr. Oz" show, probably Thursday's, to a counterattack. Of the doctors behind the letter, the producers say, "We plan to show America who these authors are, because discussion of health topics should be free of intimidation."

As is often the case with Oz's spiel, there will be a nugget of truth in what he says. Much of that also will be irrelevant to the substance of their campaign, which is that Oz, a licensed physician who assiduously spotlights his relationship with Columbia to burnish his own credibility, pushes unproven and even potentially dangerous therapies, treatments and health choices to his listeners.

Still, it is true that big public debates often make allies of people or groups that otherwise should be at each others' throats. It's not only politics that makes strange bedfellows; economics and science sometimes do too. That doesn't cancel out their main thrust of the attack on Oz, but it does open the door to discussions of whether conflicts of interest are driving the campaign against him.

Make no mistake: Oz's activities discredit Columbia's medical school, where he's vice chair of the department of surgery. Last year, the British Medical Journal reported that of 80 recommendations made in a sample of 40 episodes of "The Dr. Oz Show," scientific "evidence supported 46%, contradicted 15%, and was not found for 39%."   

But it's also true that the letter questioning his faculty appointment may reflect back on some of its signatories, and not in a good way. Two prime targets of Oz's counterthrust are likely to be the letter's author, Henry I. Miller, a fellow of Stanford's Hoover Institution; and signatory Gilbert Ross, executive director of the American Council on Science and Health. You can expect their institutions to come in for some heat too. 

Even some of Oz's most important critics have expressed misgivings about the tenor of the letter and the potential for blowback: "A publicity stunt against Dr. Oz threatens to backfire spectacularly," David H. Gorski, a prominent surgical oncologist who frequently confronts pseudoscience--including Oz--headlined his post Monday at his blog Respectful Insolence, where he posts under the pseudonym "Orac." Gorski also is managing editor of the blog Science-Based Medicine

Gorski further questions the goal of the letter. The chances that Columbia would fire a tenured professor are essentially nil, he observes, especially since Oz has brought some of his feelgood therapeutic approaches into his operating rooms at Columbia, without resistance from the university. Gorski's conclusion is that the letter was issued merely "to create embarrassing publicity for Dr. Oz and Columbia University," which will have limited impact.

The positives are vastly outweighed by the downside of giving Oz more publicity and a tailor-made defense, Gorski asserts.  

Oz already has painted Miller and Ross and their organizations as cat's-paws of genetically-modified organism, or GMO, interests, which he persistently attacks. Others, including some of Oz's detractors, also are uneasy with the support of the Hoover Institution and ACSH of some decidedly unscientific positions, especially climate change denial. 

Miller was a prominent critic of California's anti-GMO 2012 ballot measure Proposition 37, which went down to defeat, weighed down by its supporters' pseudoscientific claims.  

Indeed, Miller told me last week he was inspired to write the letter in the course of researching his recent piece for Slate.com defending GMOs, which exposed him to Dr. Oz's anti-GMO spiel. As for whether Miller's pro-GMO position represents a conflict of interest undermining his campaign against Oz, he called that "total rubbish" in an interview Monday. 

Oz's "promotion of fraud and quackery is well known," he told me. As for the Hoover Institution's position on climate change and other issues, he said, "unlike some other think tanks like the Heritage Foundation, Hoover does not have an institutional position on things." He said that while Hoover is often called a right-wing think tank, it's more accurate to say it "leans toward free-market positions."

Miller said he hasn't written about global warming. But while it's true that's not his main topic, he did write an op-ed in 2010 for the Orange County Register in which he warned that stringent emissions starts could cause economic chaos: "Assuming for the sake of argument that the Earth is, indeed, warming and even that it's due to human activities, any significant lowering of emissions will be too costly, too little and too late," he wrote. That resembles the position taken by many of his free-market colleagues at Hoover.

As for Ross' American Council for Science and Health, it's hard to identify a single consistent worldview from its position on many important issues in science. The ACSH has taken strong stands in favor of vaccination (the prominent pro-immunization authority Paul Offit is on its scientific advisory board) and against the scandalous nonregulation of nutritional supplements in America.

ACSH also has been a reliable bird dog of the egregious Joseph Mercola, a hawker of "organic" nostrums and questionable treatments and therapies that somehow tend to put money in his pocket. (Mercola also has been a star of Dr. Oz's show.)

But the organization also has taken money, and courted donations, from big corporate interests, including the tobacco and petroleum industries, and from organizations connected to the Koch family.

It's fair to conclude that has something to with its positions on e-cigarettes, which it says are useful in combating tobacco smoking, on in which traditional tobacco companies have taken a strong financial interest. It's in favor of fracking. On climate change, the ACSH says it doesn't currently take a position on the issue.

But in a 1997 paper, it seemed to accept the scientific consensus that climate change is real and caused by human activity, but warned that "stringently limiting" greenhouse gas emissions "would not be prudent" because of the economic impact.

Even today ACSH states its mission is to protect "consumer freedom from a variety of unscientifically based activist organizations — such as the Natural Resources Defense Council, the Center for Science in the Public Interest and the Environmental Working Group — that...promote fears about our food, pharmaceuticals and chemicals, and other environmental and lifestyle factors."

That suggests that, at least implicitly, it's on the opposite side of the climate change issue from those organizations, which believe man-made climate change is a big problem. And two well-known climate change denialists, Patrick Michaels of the Cato institute and Dennis Avery of the Hudson Institute, are also on its scientific board. ACSH says "there's no litmus test" for board membership, and that it represents a wide range of views.

Ross himself may be vulnerable to an ad hominem attack: in the 1990s he did time in federal prison and his New York physicians license was revoked for his participation in a Medicare fraud scheme. His license was eventually reinstated, but an ACSH spokesman says he doesn't see patients anymore.  

All these factors could be cause to be wary of ACSH. Gorski says he has turned down an offer to join its scientific advisory board. "It’s frequently on the right side of science, but seemingly only when that position aligns with industry positions," he says.  

None of this, of course, changes the fact that Dr. Oz commonly promotes charlatanism and scientific nonsense, a point stressed by both Miller and Ross in emails to me Monday. But their letter and their backgrounds have provided Oz with the smoke for a smokescreen. That's bad. 

Columbia's role as an enabler of Dr. Oz shouldn't be overlooked; he's not merely a teacher and staff surgeon, but an administrator, a position that gives him a voice in policy. No one with Oz's record to pseudoscience should have that authority, and at the very least, Columbia should remove him from the administration. 

But it's even more important to keep the scientific research debunking so many of Oz's claims and positions foremost in the public's mind. Last week we recommended such takedowns as those of Todd Neale at MedPage Today, Miller at Slate.com last week, and Julia Belluz's heroic voyage into the fantasy land of Oz at Vox.com. The British Medical Journal study of Oz's recommendations should be required reading for anyone pondering whether to believe a word he says.

The answer, plainly, is no. 

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