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How should journalists cover quacks like Dr. Oz or the Food Babe?

When a new book by blogger Vani Hari, who calls herself the "Food Babe," arrived on my desk a few months ago, I looked at the cover, thumbed through a few pages, and tossed it away.

"Break free from the hidden toxins in your food," The Food Babe Way boasted. "Lose weight, look years younger, and get healthy in just 21 days."

Everything about this reeked of pseudoscience: the suggestion that people can reinvent their bodies with quick fixes. The notion that we're being attacked by chemicals and in need of a thorough detox. I didn't want to dedicate any reporting energy to addressing Hari's nonsense.

A couple months later, I wondered if I'd made a mistake. Profiles of the Food Babe were turning up in the New York Times and the Atlantic. Her audience now numbered in the millions, and her mostly insane tirades against the toxins in our environment seemed to be catching on. Some were even calling her the next Dr. Oz.

The Food Babe was now impossible to ignore, so I wrote a quick item highlighting some of the reasons scientists think she’s completely off-base. It's a tactic I've used a lot in reporting on people like Hari. Highlight the gap between what a misinformed celebrity says and what the science says. Point out how they're hoodwinking the public, when necessary. Advocate for science and rational thinking.

But even then, I wasn't sure if that was the right way to deal with Hari. Perhaps I should have dedicated many more reporting hours to debunking her ideas. Or perhaps I should have continued to ignore her altogether. Maybe drawing any attention to Hari would help popularize her message — making me complicit in spreading misinformation.

Science writer Keith Kloor was puzzled by a similar question recently: "How do you communicate to a popular and deeply flawed messenger of health concerns, such as a Dr. Oz or a Vani Hari, who has a large, built-in audience and who seems immune to facts?" It's not a dilemma that the media always addresses well.

The media needs to get better at dealing with pseudoscience

food babe

The Food Babe, Vani Hari. (Chip Somodevilla/Getty)

The debate over how to handle peddlers of pseudoscience comes up again and again in the newsroom. With every Food Babe, Dr. Oz, Robert F. Kennedy Jr., and Jenny McCarthy, we mull some combination of the following: Do they deserve to be addressed? Should we seriously engage their ideas? And if we cover them, what’s the best way to do so: mockery? Earnest debunking?

I decided to ask other researchers and science communicators who have grappled with this problem. Everyone I spoke to seemed to agree that it probably isn't worth it to engage fringe theories that don't really break through to the mainstream. "If they are unknowns, the best thing to do is to ignore them, because they thrive on attention, however negative it may be," said Stephan Lewandowsky, a psychologist at the University of Bristol.

But it's a harder call for phonies who have gained a sizable platform and whose positions pose a risk to public health — like, say, Jenny McCarthy. In these situations, experts had more varied advice. Once these hoodwinkers get endorsed by public figures, major media outlets, or government institutions, critical coverage is important, the experts advised. Be clear on where the balance of scientific evidence lies. Be careful of turning quacks into martyrs. Don't gin up scientific controversies where they don't exist. Hold their enablers accountable, too.

1) Don't just go after cranks — hold their enablers accountable

oprah Kevin Winter/Getty

Oprah Winfrey: Is she the most powerful crank-enabler on the planet? (Kevin Winter/Getty)

I made my first call to Ben Goldacre, a British author, physician, and longtime slayer of bad science. When asked how he decides to cover a quack or crackpot idea, he said, "To me, it depends on whether the way they misused science is interesting enough that it makes a good pop-science column." This was all part of his science advocacy mission. "Mocking people who misuse science is a really useful gimmick for communicating how science works," he said.

But Goldacre doesn't just go after cranks; he also criticizes those in the media who give them credibility. "Going after people who facilitate the cranks is more likely to produce long-term benefits and also more closely reflects where the true source for the problem lies," he explained. "I can tell you who hates having their name in the paper, and that is journalists, editors, broadcasters, and policymakers. They are used to being able to hide in the shadows, anonymously, and if you can call them out by name I think that changes their behavior quite well."

Goldacre had a point. I've written about Dr. Oz's misrepresentations of medical evidence over the years, with little measurable impact. But I also once criticized an anti-vaccine story in Canada's largest newspaper. My reporting — one voice in a chorus of criticism — pointed out that the paper's editor-in-chief was in denial about its bad coverage, and that he was ridiculing well-meaning critics. (In a memorable turn of phrase, he called me a "bathwater gargler.") The result? A rare retraction of the story.

Brendan Nyhan, a political scientist at Dartmouth, agreed with Goldacre's advice, relating it to Dr. Oz. "Oprah Winfrey should be ashamed of how she helped give Dr. Oz a platform. People who put Dr. Oz on TV should be embarrassed," Nyhan said. "I advocate naming and shaming, not just naming and shaming the public figures who mislead people but the institutions that give them platforms."

2) Be clear on where the balance of scientific evidence lies

John Oliver nails the problem with the climate-change "debate." (YouTube)

The experts I spoke to all said it's extremely important to reflect the state of the science in coverage, and to avoid giving equal weight to both sides of an argument that aren't actually equal according to science. When reporters do that, we risk misrepresenting the research and creating controversy where there isn't any.

Many journalists covering discussions of climate change have struggled with this for years. In the early days, they often allowed those who deny the existence of manmade warming to weigh in on a variety of stories. Broadcast programs typically featured one person who "believes in" climate change alongside one denier, giving the false impression that the evidence is split 50-50. Of course, research for years has overwhelmingly suggested that humans are behind global warming. But even today, reporters aren't sure how to cover politicians who deny the existence of climate change.

Here's Ivan Oransky, a physician and longtime health journalist and editor: "The doubt industry knows that journalists actually do want to get things right and reflect nuance, and they have figured out how to craft their messages and arguments in such a way that they seem like honest academic questions."

3) Beware of turning cranks into martyrs

andrew wakefield

Andrew Wakefield, whose fraudulent research suggested a link between vaccines and autism. (Peter Macdiarmid/Getty)

Oransky raised a problem that can sometimes occur when journalists cover charlatans critically — we risk turning those spreading misinformation into martyrs.

A great example can be seen in media coverage of chronic fatigue syndrome, a condition that scientists once doubted was real but now has the endorsement of the Institute of Medicine (albeit with a different name). Back in 2009, researchers proposed that a virus might be at the root of the condition, and sufferers of chronic fatigue latched on to the theory. "But that research didn't hold up," Oransky explained. For the most part, reporters tended to reflect what scientists learned in the ensuing years — the virus likely wasn't causing chronic fatigue syndrome.

Unfortunately, that coverage ended up backfiring. "Every time [the media] would say the research wasn't holding up, the patient community would turn around and say, 'You’re denying we have an illness,'" Oransky said. One of the leading researchers behind the viral theory, Judy Mikovits, has essentially been turned into a martyr, seen by patients as someone who is really trying to get to the bottom of their issue — despite the fact that the weight of science is now stacked against her.

A similar dynamic occurred with Andrew Wakefield, the fraudulent physician who popularized the autism-vaccine link. He fabricated his research — research that was retracted, research that is blamed for stoking vaccine fears and bringing back preventable diseases. But all along, he has insisted he's the victim of a witch hunt and PR campaign, and some vaccine deniers see him as a sacrificial lamb. "The more press coverage, the more scrutiny, the more you end up with these martyrs and with people saying, Everyone is against us,'" Oransky said.

The other difficulty is that these martyrs often wade into areas that relate to our very deepest fears and desires. Wakefield exploited parents' worries about vaccines and autism. Dr. Oz trades on the near-universal pursuit of better health and weight loss and mistrust of Big Pharma. Food Babe Vani Hari has built her brand around the worry that unseen and ubiquitous toxins are slowly killing us all.

When these figures are ridiculed and struck down by critics, their audiences can interpret the criticism of their work as diminishing or making fun of their own, often understandable concerns, thus helping to fuel the crank-to-martyr transformation.

4) Don't overstate the influence of cranks

jenny mccarthy

Jenny McCarthy: she just makes stuff up about the dangers of vaccines. (David Becker/Getty)

Just last week, Robert F. Kennedy Jr., a well-known vaccine denier, attended a Sacramento viewing of an anti-vaccine documentary, and told his audience that mass inoculation is akin to "a holocaust."

I asked Dan Kahan, a professor of law and psychology at Yale, how he would suggest covering this event. He said it was important to consider the broader context here: "The fortunate truth of the matter is that there's tremendous confidence by the American public in vaccines," he said. "We have had 90 percent coverage for well over a decade. There are enclaves of people who are concerned. But most parents vaccinate and don't give it a second thought."

So any reporting on vaccine deniers like RFK Jr. should reflect that this is a minority view, Kahan explained. Otherwise reporters risk creating an appearance of significant conflict when there isn't really any — signaling to the unconcerned that they should potentially worry, which could have a negative impact on vaccine rates.

"You don't want to [write] that there's a public health crisis because more and more parents are becoming anxious," he said. "That trope is false. There are some people anxious about vaccines. But they are an outlier." So a story about RFK Jr. might explain how he represents a tiny sliver of Americans. It would also explain that the majority of people abide by the social contract of safeguarding public health through mass inoculation.

But, Kahan added, reporters need to be mindful of a potential pitfall in doing even that: "Even when you're telling people not to worry about something, they worry a bit more about it. It doesn't help to start screaming, 'There's no fire in the theater, everybody!'"

5) Critical coverage is important — but avoid creating controversy for its own sake

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Dr. Oz. (Tom Williams/Getty)

I've been covering Dr. Oz's promotion of pseudoscience for several years. Recently, my dad made an astute observation about that work. He suggested I was somehow dependent on Oz's shenanigans, benefiting from his erroneous medical infotainment to build an audience. I couldn't deny the charge, and his words made me think of the central conflict in Janet Malcolm's ethics tome, The Journalist and the Murderer, summed up on its first page: "Every journalist who is not too stupid or too full of himself to notice what is going on knows that what he does is morally indefensible." 

But given that Oz is, depressingly, the most influential public figure in health in America, I would argue that the coverage is warranted and necessary.

Brendan Nyhan raised this conundrum, calling it a "synergy between people who are pushing these theories and people who are covering them in a kind of freakshow style."

This doesn't mean that journalists should shy away from covering charlatans, he added. Instead, reporters should only start to write on theories when they are being "endorsed by public figures and discussed in government institutions and other settings that matter." At that point, he said, "It’s appropriate to cover that claim, to say how dubious it is, because of the watchdog function of the press."

I was a bit surprised by Nyhan's response, since his own research has shown that it's extremely difficult to change people's opinions about subjects that are important to them through debunking. In a study on perceptions of flu shots, Nyhan found that correcting myths actually had the opposite of the desired effect among vaccine skeptics. In his political research, he has demonstrated that giving people corrective information can backfire and deepen their misperceptions. The findings can be disheartening for any slayer of bad science.

Yet despite those findings, Nyhan pointed out that critical media coverage of incorrect claims is still valuable: "I’m not convinced media coverage will necessarily convince people who are predisposed to believe the Food Babe or Dr. Oz that they are wrong," he said. "But the principle of holding people accountable for saying misleading things is an important one."

That is, even when journalism doesn't change minds, it can still serve a greater good by getting cranks on the record, showing the gap between what they say and what science says, and holding them accountable.