All of the arguments Dr. Oz made against his critics were wrong

Dr. Oz has come under heavy criticism in recent months for promoting junk science on his widely watched television show. He's been lambasted by experts, by fellow doctors, even by the federal government.

Now Oz is finally responding to those critics. But rather than address their complaints head on, he mostly wants to talk about ... civil liberties. "I know I have irritated some potential allies," he wrote in Time magazine on Thursday. "No matter our disagreements, freedom of speech is the most fundamental right we have as Americans. We will not be silenced."

This is no doubt an excellent PR move. Oz is depicting himself as a victim against critics that, he says, are working hand in hand with industry to silence him. (Some of the doctors who wrote a high-profile letter asking Columbia University to strip Oz do seem to have potential conflicts of interest.)

But Oz has nothing to say about the substantive criticisms against him. We picked through his defense to show why each of his counterarguments are wrong.

1) Dr. Oz might have a right to free speech — but he also took an oath to "do no harm"

Oz's first line of defense is to remind his audience about his fundamental right to free speech. But that doesn't mean he can just say anything he wants about health and science — even if it harms people.

Legally speaking, it's true that Oz has the constitutional right to speak freely on TV. Claudia Haupt, an associate-in-law at Columbia Law School, points out that doctors have to be careful what they say in a clinic, since bad advice could be considered malpractice that's not protected by the First Amendment. On TV, however, Oz is technically speaking as a private individual in public discourse. "That speech is generally protected by First Amendment," Haupt said.

But that's not the whole story. As a doctor, Oz also took the Hippocratic oath to "do no harm." The reason so many people listen to what Oz says is that he isn’t just your run-of-the-mill faith healer. He’s a heart surgeon, one who had a well-respected career as a researcher before starting a TV show. Oz reminds his viewers of that authority in almost every show.

Oz recently tried to protest — preposterously — that his show isn't really a medical show and shouldn't be held to high standards. "We very purposely, on the logo, have 'Oz' as the middle, and the 'Doctor' is actually up in the little bar for a reason," he told NBC. "I want folks to realize that I'm a doctor, and I'm coming into their lives to be supportive of them. But it's not a medical show." But this is absurd. Of course many viewers are going to assume he's speaking from his position as a medical authority. (As John Oliver quipped, the show isn't called: "Check this shit out with a guy named Mehmet.")

So even if Oz has the constitutional right to say whatever he wants, he also has an obligation not to harm people with bad or scientifically invalid advice — particularly when he's going out in public with his white coat. And his critics certainly have the right to hold him accountable for misleading people about medicine — even if he is outside the operating room.

2) It doesn't matter that some of Oz's critics are conflicted

In a phone interview with Vox on Sunday evening, Dr. Oz said many of his detractors had ulterior motives — such as financial ties to the food industry. "Did you know who those people were who were sending the petition [to Columbia University]?" Oz said. "Did you know they work for companies and groups linked to the pro-GMO groups?"

Oz was previewing a defense he has articulated all this week — attacking the integrity of a select few critics. "The lead author [of the Columbia letter], 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," Oz wrote in Time.

Yet even if those letter writers do have conflicts of interest, which they may, it's largely beside the point. They are far from the only critics. Plenty of concerns about Oz's show have been raised by members of medical and scientific communities, as well as by the US Senate and Federal Trade Commission. Experts have complained that Dr. Oz's medical advice too often deviates from science and influences public health for the worse.

The FTC found that at least one of Dr. Oz's guests used the program as a platform to deceive audiences and sell products, capitalizing on the "Oz effect" — the fact that whenever he so much as mentions a product, stores can't restock it quickly enough.

Oz was also called before a Senate subcommittee on consumer protection last summer. He was asked by Sen. Claire McCaskill (D-MO) to explain his use of "flowery" language to champion weight-loss fixes that don't actually work. McCaskill also admonished him for endorsing a rainbow of supplements as potential "belly blasters" and "mega metabolism boosters." "The scientific community is almost monolithic against you in terms of the efficacy of the three products you called 'miracles,'" McCaskill said.

That's the real issue. The backgrounds of a few letter-writers are a diversion.

3) Oz has no defense against the substantive complaints against him

(Peter Kramer/NBC/NBC NewsWire via Getty Images)

One of the highest-profile criticisms of Oz came in a recent paper for the British Medical Journal. The researchers examined health claims showcased on 40 randomly selected episodes of the two most popular internationally syndicated health talk shows, The Dr. Oz Show and The Doctors. They found that about half of the recommendations on these shows either had no evidence behind them or actually contradicted what the best available science tells us.

Oz tried to rebut this study in his Time piece, claiming that he's being held to an unfair standard. After all, he said, only about half the advice that doctors give in their offices is backed by randomized clinical trial data (i.e., the gold standard of research evidence). "This reflects that natural gap between what is proven in clinical trials and the needs of our patients," he said.

But Oz was making a false comparison here. It is true that doctors can't always make recommendations based on the highest-quality evidence. Sometimes randomized clinical trial data isn't available, so they have to make use of other evidence, like cohort studies or case reports.

But the BMJ paper didn't say this is what Oz was doing. It said that half of the recommendations on The Dr. Oz Show were based on no science whatsoever. They were either completely baseless or wrong. This is completely different from what most doctors do.

Indeed, this explains why eight of Oz's own colleagues at Columbia University recently cited this BMJ study to criticize Oz's show. "This [BMJ] report raises concerns that Dr. Oz's presentations of anecdotal therapies as 'miracle cures' occur in the absence of what we see as obligatory discussions of conflicts of interest, possible side-effects and evidence-based medicine (or lack thereof)," they wrote in a USA Today op-ed.

Oz's Columbia colleagues also added this: "Many of us are spending a significant amount of our clinical time debunking Ozisms regarding metabolism game changers. Irrespective of the underlying motives, this unsubstantiated medicine sullies the reputation of Columbia University and undermines the trust that is essential to physician-patient relationships."

To be clear, those Columbia colleagues don't think Oz should lose his faculty position because of his sometimes-dubious TV advice. But they do argue that we need a better way to deal with media doctors and their virtual patients. They're right. Doctors shouldn't be deterred from speaking in public; we need more science-minded people who will work against the erosion of reason and legitimization of pseudoscience that has become pervasive in our society. Unfortunately, Oz clearly isn't always doing that. 

Richard Feynman, one of the greatest scientists of the 20th century, said, "Science is what we have learned about how to keep from fooling ourselves." Right now, Oz is fooling himself — and his audience.

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