A taste of Belle Gibson or Dr Oz’s star power isn’t worth a doctor’s integrity

Dr Oz
Dr Mehmet Oz testifies on Capitol Hill in Washington. Ten top physicians want Columbia University to remove the celebrity doctor from his medical faculty position. They cite what they call the heart surgeon’s “egregious lack of integrity” as host of a television program where he promotes weight loss products. Photograph: Lauren Victoria Burke/AP

When she heard that I present a health segment on Australian television a nurse was thrilled.

“That’s so cool! Are you on Dr Oz?”

“No, it’s the ABC,” I replied.

“Oh.” Her expression contained a hundred laments.

Sheepishly she explained, “Dr Oz is the only medical show I watch. Like everyone else, I guess.”

I nodded politely because she wasn’t alone. The most oft-repeated and unsolicited advice I have received about being a doctor in the media is to get myself on Dr Oz. Someone even offered to find me a publicist, earnestly telling me that it was the best way to realise my potential.

And why not? Every day, Dr Mehmet Oz’s show attracts nearly three million American viewers alone. It is syndicated in more than 100 countries and the host, a cardiothoracic surgeon, has been hailed as one of the world’s chief health “influencers”.

“These things you do, love,” a grateful cancer patient enthused as she handed me my annual box of chocolates. “Imagine spreading your message on Dr Oz! And my, I’d be so proud to say that my doctor is on TV!” Then she had a brainwave. “I know! Why don’t your doctor friends help you get through to Dr Oz?”

I didn’t have the heart to tell her that those doctor friends would never recommend Dr Oz as a source of credible advice, especially following the publication of a revealing study in the British Medical Journal.

The researchers, including doctors, pharmacists and a biostatistician, found that on a typical Dr Oz show, more than half of the recommendations were not supported by evidence. The most common of them related to diet and non-dietary weight loss techniques such as immune-boosting diets. The magnitude of benefit was mentioned in less than 20% of cases but tellingly, the potential for harm, cost of care, and the recommendation to consult a doctor, featured even less. Therefore, people who choose to follow the advice dispensed on the show would do so based on plain trust of the host and guest rather than an understanding of the risks and benefits.

The show offers advice on metabolic makeovers, toxic stress and determining the colour of your personality. Cancer attracts its fair share of catchy headlines starting with the individual’s latent fighting power and moving on to self-diagnosis, radical remission and touting “resistant” carbs as “miracle cure-alls.” Along the way there is a 60-second fix for back pain, a pill to reinvigorate your sex life and umpteen ways to bust your bloat and grow smart cuticles.

Given the prevalence of health illiteracy, I can see the appeal of quick fixes and simple explanations and hence, why an episode of Dr Oz is more likely to attract attention than a doctor’s often dispassionate advice.

My cancer patients must listen to a lengthy disclosure about the possibility that a given drug could do more harm than good and I spend a fair amount of time disavowing the promise of the latest blockbuster treatment hawked on a tabloid show. But influenced by medical shows, the truck driver with chronic back pain can’t believe the doctors’ incompetence in denying him a permanent fix. The morbidly obese woman dismisses advice on gradual weight loss, insisting on an affordable version of the amazing diet her friend is on. Another counters her doctor’s rational prescribing by quoting essential probiotics and vitamins that every woman “needs” in her medicine cabinet.

The authors of the BMJ study rather politely conclude that consumers should be sceptical about any recommendations provided on television medical talk shows. They pose the thoughtful question whether we should expect such shows to provide more than entertainment.

But people seem to have already answered this question – they believe what they see and hear on television medical shows and they don’t see the need to question the credibility of doctors who appear on them. Despite the flattening of hierarchies, doctors enjoy enormous respect and trust in wider society. It would never cross the mind of many of my cancer patients, for example, that someone highly credentialed might mix critical medical advice with a touch of “shock and awe” even when this very behaviour earns the reprimand of the US Senate.

Under fire from his colleagues, Dr Oz contends that the establishment doesn’t want to hear that “their answers are not the only answers, and their medicine is not the only medicine.” Here, I agree that the medical profession must shed its traditional arrogance and learn to admit the plentiful flaws in its methods. Engaging our patients, communicating with them meaningfully and helping them become their own best advocate is medicine’s highest calling and no one denies we need to get better at this. But patients must appreciate that the solution doesn’t lie in distilling difficult questions into sound bites, however catchy.

The BMJ study has some good lessons for doctors in the media, starting with the reminder that practising clinicians must consider their dual role with care. The ethical compass that guides us in individual patient interactions must hold steady in the media, even when there is temptation to attract an audience. This can be a difficult terrain to navigate for doctors like me, whose vocation is bedside medicine but who welcome the opportunity to convey broader health messages.

Last year I was given the opportunity to interview Belle Gibson, the now discredited author of The Whole Pantry. I was told that her extraordinary story of recovery from cancer through whole foods was “inspirational”. At a time when natural healing was all the rage, it was suggested I could be a bridge between the cold clinician and the holistic provider. I had never heard of Gibson and read her book before the interview with an open mind, but the further I read the more my initial unease deepened. I found her entire premise quite preposterous and didn’t see how I could feign even a passing interest in its contents. A doctor’s mere association with a product seems to send a signal of its trustworthiness. I declined the offer to interview a star but part of me couldn’t help wondering whether I was mistaken. My relief was incalculable when her cancer claims turned out to be bogus.

I must admit I am still feeling my way in the media but as someone who regards my taxpayer-funded medical degree as sacred, I ask myself two related questions whenever I appear: 1) Will I still be able to look my colleagues in the eye? 2) Can I still uphold my integrity with my patients?

If the answer to both is yes, it seems safe to proceed.