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The Oprah-fication Of Medicine

OprahUnfortunately, a frequent topic on SBM has been the anti-vaccine movement, personified these days by celebrity spokesmodel for Generation Rescue Jenny McCarthy and her  boyfriend comedian and actor Jim Carrey. Unfortunately, it is a topic that is unlikely to go away. We’ve all speculated why the anti-scientific emotion-based notion that vaccines somehow must cause autism persists in spite of mountains of evidence to the contrary, but I think the question goes much deeper than that because it’s not just about vaccines. The anti-vaccine movement is but one of the most visible components of a much deeper problem in our public discourse, a problem that values feelings and personal experience over evidence, compelling stories and anecdotes over science.

I’m referring to the Oprah-fication of medicine in America.

Why Oprah? you may ask. I’m happy to tell you. Oprah Winfrey has been the host of the highest rated syndicated talk show in television history, her self-named The Oprah Winfrey Show. The show has been running for nearly 23 years, with over 3,000 episodes. Winfrey is so famous that she is one of those rare celebrities who is known instantly by just her first name. Say “Oprah,” and virtually everyone will know to whom you’re referring, and her show is often colloquially known as simply Oprah. Given this unprecedented level of success, which has made Oprah a billionaire and a ubiquitous presence on TV, her own magazine, her own satellite radio station, and, soon, her own cable channel, Oprah has developed a media empire that few single individuals can match or beat. Indeed Rupert Murdoch is the only person that I can think of who likely has a wider reach than Oprah. Personally, I have no problem with Oprah’s level of success. Clearly, she is a very talented and savvy TV host and businesswoman.

Unfortunately, in marked contrast, Oprah has about as close to no critical thinking skills when it comes to science and medicine as I’ve ever seen, and she uses the vast power and influence her TV show and media empire give her in order to subject the world to her special brand of mystical New Age thinking and belief in various forms of what can only be characterized as dubious medical therapies at best and quackery at worst. Arguably there is no single person in the world with more influence pushing woo than Oprah. Indeed, she puts Prince Charles to shame, and Kevin Trudeau is a mere ant compared to the juggernaught that is Oprah Winfrey’s media empire. No one even comes close. No one, and I mean no one, brings pseudoscience, quackery, and antivaccine madness to more people than Oprah Winfrey does every week. (She doesn’t discuss such topics every day, but it seems that at least once a week she does.) Naturally, Oprah doesn’t see it that way and likely no one could ever convince her of the malign effect she has on the national zeitgeist with respect to science and medicine, but that’s exactly what she does. Consequently, whether fair or unfair, she represents the perfect face to put on the problem that we supporters of science-based medicine face when trying to get the message out to the average reader about unscientific medical practices, and that’s why I am referring to the pervasiveness of pseudoscience infiltrating medicine as the “Oprah-fication” of medicine.

How does Oprah do it? Easy (for her, at least). She makes stars of woo-meisters by featuring them on her show and giving them her stamp of approval, that’s how. Indeed, there was a documentary on the other night that I missed called The Oprah Effect. While not specifically about Oprah’s promotion of pseudoscience, happily it appears not to shy away from it, either. The basic structure of the documentary is to examine what happened to three business after they were mentioned on The Oprah Winfrey Show. Not surprisingly, their sales went through the roof, and apparently the documentary derives much of its interest and drama from how each company reacted to sudden fame and skyrocketing business. However, the Oprah Effect affects far more than companies she may feature on her show or books that she features on Oprah’s Book Club, a regular feature that can make a bestseller out of an obscure book by an even more obscure author. The Oprah Effect also includes her favorites and proteges, and, sadly, most of those people are not particularly science-based in their recommendations about medicine. Indeed, some of them are into dangerous medical practices and quackery, and Oprah gives them the stamp of approval.

The Oprah Winfrey Show and the promotion of pseudoscience

Over the years, Oprah has promoted a wide variety of dubious medical practices, pseudoscience, and mysticism on her show. Indeed, just this week, NEWSWEEK ran a long article (excerpts of which I will quote but which you should read in its entirety) entitled Live Your Best Life Ever! Wish Away Cancer! Get A Lunchtime Face-Lift! Eradicate Autism! Turn Back The Clock! Thin Your Thighs! Cure Menopause! Harness Positive Energy! Erase Wrinkles! Banish Obesity! Live Your Best Life Ever! (Indeed, the article was a big part of my impetus to write about the Oprah-fication of America.) It reveals just how forcefully Oprah and her credulous belief in New Age nonsense are reflected in her show. It starts with the example of Suzanne Somers, whom I’ve mentioned before because of her belief that alternative medicine cured her of her breast cancer:

In January, Oprah Winfrey invited Suzanne Somers on her show to share her unusual secrets to staying young. Each morning, the 62-year-old actress and self-help author rubs a potent estrogen cream into the skin on her arm. She smears progesterone on her other arm two weeks a month. And once a day, she uses a syringe to inject estrogen directly into her vagina. The idea is to use these unregulated “bio-identical” hormones to restore her levels back to what they were when she was in her 30s, thus fooling her body into thinking she’s a younger woman. According to Somers, the hormones, which are synthesized from plants instead of the usual mare’s urine (disgusting but true), are all natural and, unlike conventional hormones, virtually risk-free (not even close to true, but we’ll get to that in a minute).

Next come the pills. She swallows 60 vitamins and other preparations every day. “I take about 40 supplements in the morning,” she told Oprah, “and then, before I go to bed, I try to remember … to start taking the last 20.” She didn’t go into it on the show, but in her books she says that she also starts each day by giving herself injections of human growth hormone, vitamin B12 and vitamin B complex. In addition, she wears “nanotechnology patches” to help her sleep, lose weight and promote “overall detoxification.” If she drinks wine, she goes to her doctor to rejuvenate her liver with an intravenous drip of vitamin C. If she’s exposed to cigarette smoke, she has her blood chemically cleaned with chelation therapy. In the time that’s left over, she eats right and exercises, and relieves stress by standing on her head. Somers makes astounding claims about the ability of hormones to treat almost anything that ails the female body. She believes they block disease and will double her life span. “I know I look like some kind of freak and fanatic,” she said. “But I want to be there until I’m 110, and I’m going to do what I have to do to get there.”

That was apparently good enough for Oprah. “Many people write Suzanne off as a quackadoo,” she said. “But she just might be a pioneer.” Oprah acknowledged that Somers’s claims “have been met with relentless criticism” from doctors. Several times during the show she gave physicians an opportunity to dispute what Somers was saying. But it wasn’t quite a fair fight. The doctors who raised these concerns were seated down in the audience and had to wait to be called on. Somers sat onstage next to Oprah, who defended her from attack. “Suzanne swears by bioidenticals and refuses to keep quiet. She’ll take on anyone, including any doctor who questions her.”

I was actually amazed to read this. I’ve known for a while that Suzanne Somers promotes so-called “bioidentical hormones,” which is the sort of nonsense quack-friendly journals like JPANDS publish. I’ve also realized that it is the height of stupidity for a woman who has survived breast cancer to pump herself full of estrogen in the futile and pathetic quest to reclaim her lost youth. It’s just begging for a recurrence of her breast cancer, and Ms Somers epitomizes the cliche of “I’d rather be lucky than good.” Either that, or her cancer was estrogen receptor-negative, but even in that case it’s definitely pushing her luck to be bathing in “bioidentical” estrogens. Be that as it may, “good” Somers is not with respect to science and medicine, but lucky she is. Although I was aware of Somers’ promotion of bioidentical hormones at doses designed to boost her estrogen levels to what they were in her 20s, but I had been unaware of all the other quackery she promotes, including the multiple supplements, the “nanotechnology patches,” the vitamin C drips, and the chelation therapy. More recently, she has been promoting stem cell quackery. (Yes, indeed, when I want to read about the latest stem cell science, Suzanne Somers is exactly the person to whom I’d look.) In any case, Suzanne Somers promotes medical advice and practices that could be dangerous to women, and Oprah is totally down with them. Moreover, it’s her show, and so her opinion is all that matters:

On Oprah’s show, there is one opinion more equal than others; and by the end of the program there was no doubt where Oprah herself stood on the issue. She told her audience that she found Somers’s bestselling books on bioidentical hormones “fascinating” and said “every woman should read” what she has to say. She didn’t stop there. Oprah said that although she has never had a hot flash, after reading Somers she decided to go on bioidenticals herself. “After one day on bioidentical estrogen, I felt the veil lift,” she wrote in O, The Oprah Magazine. “After three days, the sky was bluer, my brain was no longer fuzzy, my memory was sharper. I was literally singing and had a skip in my step.” On the show, Oprah had her own word of warning for the medical establishment: “We have the right to demand a better quality of life for ourselves,” she said. “And that’s what doctors have got to learn to start respecting.”

That statement epitomizes the attitude that infuses The Oprah Winfrey Show when it comes to medical issues and science. Anecdotes trump science, and scientists should “respect” pseudoscience because of feelings and a desire for “quality of life.” Indeed, thees are exactly the attitudes that permeate the CAM movement and the antivaccine movement. It’s therefore not surprising that Oprah would be drawn to them, especially since she clearly does not have the critical thinking skills necessary to recognize that what Somers offers is a risky false promise. Here’s what also matters to Oprah:

Somers says it’s mainstream doctors who need to get their facts straight. “The problem is that our medical schools do not teach this,” she said in a February interview with NEWSWEEK. She believes doctors, scientists and the media are all in the pocket of the pharmaceutical industry. “Billions are spent on marketing drugs, and these companies also support academic research.” Free from these entanglements, Somers can see things clearly. “I have spent thousands of hours on this. I’ve written 18 books on health. I know my stuff.”

No, Somers does not “know her stuff.” Writing books is no guarantee that she “knows her stuff,” particularly given that she clearly does not understand science and cherry picks references to support her viewpoint, ignoring those that do not. Like Jenny McCarthy (more on her later), Somers also suffers from the arrogance of ignorance, in which she thinks her Google University and self-taught knowledge trump the understanding of scientists who have dedicated their lives to studying such questions deeply. Again, Oprah is drawn to this sort of thinking because it reinforces her message of “empowerment” and her apparent distrust of medical authorities. Truly, she is the perfect representative for the science-free attitudes that have allowed the rise of so much pseudoscience in medicine.

Speaking of bioidentical hormones, another favorite and frequent guest on Oprah is Dr. Christiane Northrup, a woo-friendly gynecologist who has some very strange views about the vagina and has advocated using qi gong to increase “energy flow” (i.e., qi) to the vagina and cure all manner of “female” ills, as well as providing fantastic orgasms. Our very own Dr. Harriet Hall has done a detailed examination of Dr. Northrup’s views. It turns out that Dr. Northrup is also very much “skeptical” of vaccination, in particular the HPV vaccine. She’s even gone so far as to parrot antivaccine propaganda about the VAERS database, as I’ve detailed earlier. Not only that, but she is a germ theory denialist, who has credulously also parroted the myth that Louis Pasteur “recanted” on his deathbed (same link). The NEWSWEEK article describes her thusly:

Northrup holds a special place in Oprah’s constellation of regular guests. A Dartmouth-educated ob-gyn, she stresses alternative therapies and unseen connections between the soul and the body that she believes conventional doctors overlook, but that she can see. She has written about how she has used Tarot cards to help diagnose her own illnesses. (On her Web site, she sells her own “Women’s Wisdom Healing Cards.”) In other words, she gets right to the center of Oprah’s search for hidden mystical meanings. Oprah says she reads Northrup’s menopause book “just like it’s the Bible. It’s the book next to my bed. I read the Bible. I read that book.”

Oprah found Dr. Northrup when she “blew out her thyroid,” and Dr. Northrup promotes a wide variety of pseudoscience with regard to thyroid disease:

But Northrup believes thyroid problems can also be the result of something else. As she explains in her book, “in many women, thyroid dysfunction develops because of an energy blockage in the throat region, the result of a lifetime of ’swallowing’ words one is aching to say.”

This is nothing more than prescientific mystical nonsense about the origins of disease, and Oprah believes it.

And, of course, let’s not forget David L. Katz, MD. You may recall Dr. Katz from Dr. Atwood’s discussion of him on SBM. Dr. Katz is probably best known around the skeptical blogosphere for saying that he thinks:

…we have to look beyond the results of RCTs [randomized clinical trials] in order to address patient needs today, and to do that I’ve arrived at the concept of a more fluid form of evidence than many of us have imbibed from our medical educations.

Dr. Katz has also defended homeopathy, promoted anecdotes above clinical trials and scientific evidence, and gone on to suggest that we need to think more “fluidly” about evidence. For this, he has been roundly criticized and even mocked in the blogosphere–and deservedly so. No wonder he’s a regular, along with Dr. Mehmet Oz, on Oprah. Indeed, one of the NEWSWEEK blogs even refers to him as one of the “resident heath experts” on Oprah and a columnist for Oprah’s magazine.

Until most recently, the low point of Oprah’s malign influence came when she fell under the spell of The Secret. Yes that Secret, New Age nonsense so flaky that even most New Age believers correctly view it as nonsense. Basically, The Secret postulates that there is a “law of attraction” that “always works” in which what you visualize can be yours. In other words, according to The Secret, well, let’s let Oprah describe it, as quoted in an article from Salon.com by Peter Birkenhead entitled Oprah’s Ugly Secret:

…the energy you put into the world — both good and bad — is exactly what comes back to you. This means you create the circumstances of your life with the choices you make every day.

While it is fairly obvious that attitude and motivation do affect one’s chances for success in this world and that a lack of motivation coupled with a bad attitude will usually lead to failure, The Secret takes this relatively easy to accept contention that your attitude and drive have a significant influence on how well you do in life and puts it on more steroids than Major League Baseball players have used over the last couple of decades, to the point of utter ridiculousness. As Birkenhead put it:

“Venality,” because Oprah, in the age of AIDS, is advertising a book that says, “You cannot ‘catch’ anything unless you think you can, and thinking you can is inviting it to you with your thought.” “Venality,” because Oprah, from a studio within walking distance of Chicago’s notorious Cabrini Green Projects, pitches a book that says, “The only reason any person does not have enough money is because they are blocking money from coming to them with their thoughts.”

The truly despicable aspect of The Secret is that a consequence of its teachings is not that people bring good things to themselves with their thoughts but the flip side, too: That people bring evil to themselves with their own thoughts and that it is their fault. Tell that to the six million Jews murdered by the Nazis, or the millions killed by Stalin, or even the 3,000 who died on September 11, 2001. According to The Secret, they all brought that evil upon themselves with their “negative” thoughts. In other words, if you get cancer, AIDS, or other serious and possibly fatal diseases, it’s your fault for not being “positive” enough. If you’re not rich, it’s your fault for not being “positive” enough. If you are a failure in life, it’s your fault for not “believing” hard enough.

This sort of belief in magical thinking came to its toxic conclusion when people started actually listening Oprah’s advice about The Secret:

The message got through. In March 2007, the month after the first two shows on The Secret, Oprah invited a woman named Kim Tinkham on the program. She had been diagnosed with breast cancer, and her doctors were urging surgery and chemotherapy. But Tinkham wrote Oprah to say that she had decided to forgo this treatment and instead use The Secret to cure herself. On the show, Oprah seemed genuinely alarmed that Tinkham had taken her endorsement of The Secret so seriously. “When my staff brought this letter to me, I wanted to talk to her,” Oprah told the audience. “I said, get her in here, OK?” On air, Oprah urged the woman to listen to her doctors. “I don’t think that you should ignore all of the advantages of medical science and try to, through your own mind now because you saw a Secret tape, heal yourself,” she said. A few weeks earlier, Oprah could not say enough in praise of The Secret as the guiding philosophy of her life. Now she said that people had somehow gotten the wrong idea. “I think that part of the mistake in translation of The Secret is that it’s used to now answer every question in the world. It is not the answer to all questions,” she instructed. “I just wanted to say it’s a tool. It is not the answer to everything.” The Law of Attraction was just one law of many that guide the universe. “Although I live my life that way,” Oprah said, “I think it has its flaws.”

Actually, it’s not quite accurate to say that Tinkham tried to use The Secret to heal her breast cancer, although she was clearly profoundly affected by The Secret. I’ve discussed Ms. Tinkham’s case in detail, and it turns out that she is under the care of a quack named Dr. Young who believes that tumors are all an “acid” and that “alkalinization” will cure all disease. On the other hand, it is clear that The Secret did have quite a bit to do with Tinkham’s rejection of conventional therapy, and Oprah’s promotion of The Secret was what sold Tinkham on it. Either Oprah doesn’t know her own power, or she does not want to take responsibility for her promotion of mysticism and quackery. Possibly it’s a little bit of both. Yet, promote quackery is what Oprah does. Moreover, she is now promoting it through her surrogates.

Oprah’s proteges go forth and spread anything but SBM

The first of Oprah’s proteges to get his own show was Dr. Phil, who is not so much a purveyor of pseudoscience as profoundly annoying, sensationalistic, and self-righteous. He’s also been known to flirt with dubious science, as when he promotes polygraph tests as though they were reliable. He’s also done some seriously questionable things from an ethical standpoint, for instance his sensationalistic visit to Britney Spears in the hospital and self-serving statement afterward. Personally, I find Dr. Phil to be not unlike Jerry Springer in that he brings usually lower economic class people suffering from difficulties onto his show and then takes the role of the father figure dishing out stern but simplistic “answers” to their problems.. His self-righteous lectures serve much the same purpose as the abuse heaped on the guests of The Jerry Springer Show, namely to let the crowd heap abuse upon the transgressors and thereby feel superior to them, only with pretensions of being more than that. Still, Dr. Phil is not the worst of Oprah’s proteges.

Neither is the other of Oprah’s most famous pseudoscience-loving proteges is Mehmet Oz, whom we at SBM and elsewhere have castigated for his promotion of CAM as “prevention” and his advocacy for hijacking President Obama’s agenda for health care reform to get the government to pay for CAM. Dr. Oz has been a frequent guest on her show, inappropriate scrubs outside of the O.R. and all. His advice on Oprah tends to be mostly not unsound, but Oz, like Andrew Weil, frequently mixes science-based medicine with woo. He’s also a very famous advocate for CAM who has shown up with Dean Ornish, Mark Hyman, and Andrew Weil at the recent Institute of Medicine woo-fest designed to influence the Obama Administration’s health care policy. He also–surprise! surprise!–is a pitchman for a company that sells information from a dubious test its readers take to pharamceutical companies in order to allow them to send targeted ads to them.

He is also presently poised to get his own TV show in the fall, thanks to Oprah.

The absolute worst of Oprah’s proteges is the celebrity spokesmodel for the anti-vaccine movement, Jenny McCarthy. Beginning in the fall of 2007, Jenny McCarthy, characterized as having “warrior spirit” and as a “warrior mom,” has been a regular guest on Oprah, where she’s been given more or less free rein to spread her gospel of vaccines causing autism and her claims that biomedical quackery can “cure” or “recover” autistic children. Indeed, it may well be that McCarthy is, to paraphrase the title of an excellent book about Operation Market Garden during World War II by Cornelius Ryan (later made into a movie), a woo too far. For it was Oprah’s inking of a deal with Jenny McCarthy to develop a number of media efforts, including one of the most inane blogs I’ve ever seen and a television show, that has drawn the attention of the mainstream media to Oprah’s promotion of quackery. McCarthy’s promotion of antivaccine propaganda and pseudoscience is, quite simply, so egregious and such a threat to public health that even the Oprah-friendly (or Oprah-intimidated) media has become alarmed, given McCarthy’s statements that, if she ever had another child, she would not vaccinate that child. The NEWSWEEK article even notes McCarthy’s crude statement that

I do believe sadly it’s going to take some diseases coming back to realize that we need to change and develop vaccines that are safe. If the vaccine companies are not listening to us, it’s their fucking fault that the diseases are coming back. They’re making a product that’s shit. If you give us a safe vaccine, we’ll use it. It shouldn’t be polio versus autism.

In both articles I’ve cited, reporters tried to get a statement from Oprah. This is what they got. First, from the article on the Oprah Effect:

Asked if Oprah or her show endorses McCarthy’s views, a representative for Oprah’s program said, “We don’t take positions on the opinions of our guests. Rather, we offer a platform for guests to share their first-person stories in an effort to inform the audience and put a human face on topics relevant to them.” When McCarthy’s views have been discussed on the air, statements from the Centers for Disease Control and Prevention and the American Academy of Pediatrics saying that there’s no scientific evidence of a vaccine-autism link have been read.

And from the NEWSWEEK story:

She declined to be interviewed for this article, but in a statement she said, “The guests we feature often share their first-person stories in an effort to inform the audience and put a human face on topics relevant to them. I’ve been saying for years that people are responsible for their actions and their own well-being. I believe my viewers understand the medical information presented on the show is just that—information—not an endorsement or prescription. Rather, my intention is for our viewers to take the information and engage in a dialogue with their medical practitioners about what may be right for them.”

The first-person story that, as Oprah says, puts “a human face on topics” is an important part of the show’s success. Perhaps Oprah’s most attractive quality, and one that sets her apart from other daytime hosts, is that she abhors the celebration of victimhood. She succeeded despite a childhood of abuse, and her own experience left her with very little tolerance for people who indulge in self-pity or blame cruel fate for their troubles. She often features regular people or, even better, celebrities, who have met challenges in their lives.

In other words, Oprah washes her hands of any responsibility for spreading misinformation under the guise of “trusting her audience” to be able to distinguish good advice from bad advice. She also values “self-empowerment” apparently above all else. That would be all well and good, except that Oprah mistakes the story of someone like Jenny McCarthy, who claims to have, through being a “warrior mother,” to have overcome her son’s autism and turned herself into an “autism advocate.” It matters not to Oprah that McCarthy’s claims are based on her belief in autism quackery and anti-vaccine pseudoscience. All that matters is that, by her own narrative, Jenny McCarthy has “triumphed” over the odds for the sake of her son. The compelling personal story of “empowerment” thus trumps science, and the only “balance” Oprah feels compelled to provide is a dry statement from the CDC and AAP.

What is Oprah’s responsibility?

As we have seen, Oprah doesn’t think she is responsible for what people do with the misinformation she promotes. Indeed, note how shocked she was that a breast cancer sufferer (a woman with Stage III disease, if I recall correctly) would take the nonsense she pushes on her show seriously and actually act on it by refusing surgical and medical care that could save her life. Philospher and ethicist (not to mention blogger) Janet Stemwedel asks:

I’m curious to hear what you all think about this. Is it acceptable to give any guest you please a soapbox without taking a position on the opinions they voice from that soapbox? Is reading official statements from the CDC and AAP enough “balance” to Jenny McCarthy’s views on vaccines, or do you think the “Oprah Winfrey Show” needs to do more?

And, if Oprah and her producers are aware of the Oprah effect (which, really, they have to be, right?), should that awareness of their reach lead them to try to meet a higher ethical standard as far as the foreseeable consequences for giving Jenny McCarthy a soapbox?

I have two answers to Janet’s questions: my answers in an ideal world and my answer in the real world. In an ideal world, my answers would be:

  1. No, simply reading an official statement from the CDC and AAP as “balance” to Jenny McCarthy’s idiotic and dangerous views on vaccines, which have led her to a know-nothing activism based on the arrogance of ignorance that is already eroding faith in vaccines. Indeed, there is already a site called the Jenny McCarthy Body Count to chronicle deaths from infectious disease that can be partially attributed to her antivaccine zealotry. She uses emotion and her son to argue falsely that vaccines cause autism and that various quackery “cured” him (and, by inference, can cure other children with autism, too). Reading a dry statement from the CDC is utterly useless in combatting this message. It is nothing more than what I like to call the “token skeptic” who trots out the skeptical viewpoint briefly in a formulaic method.
  2. Yes, the awareness of the Oprah Effect should make the producers of The Oprah Winfrey Show and Oprah herself realize that they have real power and, as the comic geek inside me can’t resist saying, with great power comes great responsibility. Indeed, adding more “balance” is not enough. If they were truly to hold themselves to a higher ethical standard, useful idiots to the antivaccine movement like Jenny McCarthy and the hucksters who barfed The Secret onto the world wouldn’t be allowed within ten miles of Harpo Studios. “Balance,” after all, implies that there is enough scientific validity to a view that it is somewhere on the same planet with science. There is no “balance” between Jenny McCarthy and scientists. Jenny McCarthy is, quite simply, completely wrong about vaccines and autism. There is no “balance” between promoters of The Secret and scientists; The Secret is nothing more than New Age nonsense based on prescientific beliefs that were prettied up for the 21st century. There is no validity to them. “Balance” is a sham used by promoters of pseudoscience and quackery to claim a legitimacy that they don’t deserve.

In the real world, unfortunately, my answer would be this: Oprah doesn’t care about science or accuracy. Rather, she cares about three things: ratings, “empowerment,” and entertainment. If it gets ratings, it interests her. If it fits into her apparent “spiritual” world view (like The Secret does), it’s all good to her. If it fits in with the “alternative” medical beliefs of her audience (as Jenny McCarthy, Mehmet Oz, and Christiane Northrup do), she likes it. If it provides a message of “empowerment” (whether real or not), it is good. Those scientists and nasty skeptics are such downers, too. They harsh the happy buzz of all that “positivity” and overcoming adversity to provide “inspirational” stories. None of this is new, either. After all, remember that Oprah sandbagged James Randi when he was the skeptic on a show about psychics. She was also extremely sarcastic and abusive to a woman named Laura McMahon who had agreed in 2007 to be the token skeptic on another episode of The Oprah Winfrey Show about psychics.

The bottom line is that, whatever good Oprah may have done with her money, when it comes to medicine and science, she is a force for ill. Her intentions may be the best in the world, but that is only why she is the living embodiment of the cliche that the road to hell is paved with good intentions. That’s especially true when that same road is also paved with no mental filter of critical thinking to keep out nonsense, and Oprah clearly has no mental filter when it comes to pseudoscience and quackery. With great power comes great responsibility, indeed. Too bad Oprah doesn’t seem to understand or accept that. The result is the Oprah-fication of the popular discourse about medicine in the media, as epitomized by the “tell both sides” imbalance seen on shows like The Doctors. Indeed, Oprah is one of the most potent forces in American for the undermining of critical thinking and science-based medicine in existence. The Huffington Post may promote a lot of quackery, but when it comes to influence in the media Oprah is the Queen of All Media.

Unfortunately, given the infiltration of quackery into academic medicine, I’m having a hard time determining if Oprah is a symptom or one of the causes of the rise of pseudoscience and quackery over science-based medicine.

*This blog post was originally published at Science-Based Medicine*


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5 Responses to “The Oprah-fication Of Medicine”

  1. Love the article! Thanks for addressing the issue of medical misinformation. I'm very concerned about the increasing numbers of parents opting not to vaccinate their children against potentially deadly childhood diseases, and folks basing their medical decisions on celebrity advice.

    Oprah also did a show a few months ago about multiple sclerosis that contained a number of factual errors which the National MS Society has had to address. Unfortunately, Oprah's audience is both large and trusting.

    While i've had own my grievances with doctors, I believe they are BY FAR the best source of information on medical matters.

    Talk shows and similar venues are valuable for bringing important matters to the attention of the general public but should never be the sole basis for important health decisions.

    Thanks again for posting this.

  2. Love the article! Thanks for addressing the issue of medical misinformation. I'm very concerned about the increasing numbers of parents opting not to vaccinate their children against potentially deadly childhood diseases, and folks basing their medical decisions on celebrity advice.

    Oprah also did a show a few months ago about multiple sclerosis that contained a number of factual errors which the National MS Society has had to address. Unfortunately, Oprah's audience is both large and trusting.

    While i've had own my grievances with doctors, I believe they are BY FAR the best source of information on medical matters.

    Talk shows and similar venues are valuable for bringing important matters to the attention of the general public but should never be the sole basis for important health decisions.

    Thanks again for posting this.

  3. indiancowboy says:

    sigh, as I've said before, if you want a stronger case against the anti-vaccine movement, you're going to have to have a strong idea of vaccine safety in the first place.

    I'm not talking about autism, or any of that. But the bottom line is that there are a lot of reasonable, reasoned, evidence-based, and valid points of contention about vaccine safety. So long as those points remain unaddressed, the ENTIRE movement gains legitimacy.

    We don't have any idea just how safe or unsafe most vaccines are. VAERS/VSD have an abysmal capture rate of 1-10% as reckoned by government officials. And a 5-day safety arm is not long enough to capture subacute/chronic autoimmune sequelae. Which are the most concerning potential side effects, as well as the ones with the best support in the research lit.

    It's not really hard to counter the most well-reasoned claims. Simple long-term followup would suffice. When efficacy arms of trials last for years, there is no reason that side effect arms can't as well. There is zero doubt that my affliction (parsonage-turner syndrome) can be caused by vaccines. 15% of cases are believed to have been caused by vaccines. But no one can quote a figure on just how often this actually happens. Because the data isn't there.

    How can we claim vaccines are safe when we can't actually quote a figure for how often serious side effects actually occur?

  4. Mike says:

    For the most part, I agree with the author of this article. But you have missed your intended audience! This article is well written in many ways to reach reasonable moderately educated and or semi professional people and above. But you probably lost 50% of this in the second paragraph, and 80%+ by the end of the third. Why be cause dispite the rather inciteful and intelligent opposition you resent… it is not respectful. Referring to a person as a quack, or a subject as quackery is inflammatory…. even if it is true. You referred to a number of medical professionals and none professions in such disgust, you actually start to support their line of thinking. Whoa hold the phone, I know you don't support their line of thinking. But by demonizing them you fall into the trap of polarization. You are clearly very brite and have a wealth of resources on hand. Talk about each side with even respect and even coverage. Provide results of a stress test on competing methods of treament. Use a gage that provides little room for error, measurable results, and comrarable factors. ( example: Don't just say FDA approved, state more such as : The FDA approved this treatment after a study of 2500 patients with (X) and (y)% of patients showed positive results) and ( example: Don't JUST say not approved by FDA, state more facts such as : Less than 100 people have been advised to take this method, is not considered a viable treatment by the FDA having failed the intitial testing phase.) The facts can be stated without name calling or ridicul. I myself do believe that the vast majority of alternative medical treatments on the market are in fact not effectize. but their may be a percentage… maybe 2 to 5% that have merit. I am not a doctor and don't claim to have vast medical knowledge, so to make it clear – the 2 to 5% is just a blind quess. And having merit does not mean CURE. It simply means it MAY warrent investigation. We can inform the public or unsafe practices and potential fraud with out polarizing people. some times they become polarized against you…. by you. We can have a respectful discussion on any subject and still reach the core of a problem without polarity and name calling.

    While I believe in modern medicine, it is understandable why some question its value when as funding has shifted to mostly pharma provided. A look at the last 50 years shows less cures and more drugs to treat condisions. paralleled with less cure funding. If Talk about that to. It does not hurt the medical establishment to ask it to do better. It challenges them to meet the expectations of the people it provides for.

  5. Mike says:

    For the most part, I agree with the author of this article. But you have missed your intended audience! This article is well written in many ways to reach reasonable moderately educated and or semi professional people and above. But you probably lost 50% of this in the second paragraph, and 80%+ by the end of the third. Why be cause dispite the rather inciteful and intelligent opposition you resent… it is not respectful. Referring to a person as a quack, or a subject as quackery is inflammatory…. even if it is true. You referred to a number of medical professionals and none professions in such disgust, you actually start to support their line of thinking. Whoa hold the phone, I know you don't support their line of thinking. But by demonizing them you fall into the trap of polarization. You are clearly very brite and have a wealth of resources on hand. Talk about each side with even respect and even coverage. Provide results of a stress test on competing methods of treament. Use a gage that provides little room for error, measurable results, and comrarable factors. ( example: Don't just say FDA approved, state more such as : The FDA approved this treatment after a study of 2500 patients with (X) and (y)% of patients showed positive results) and ( example: Don't JUST say not approved by FDA, state more facts such as : Less than 100 people have been advised to take this method, is not considered a viable treatment by the FDA having failed the intitial testing phase.) The facts can be stated without name calling or ridicul. I myself do believe that the vast majority of alternative medical treatments on the market are in fact not effectize. but their may be a percentage… maybe 2 to 5% that have merit. I am not a doctor and don't claim to have vast medical knowledge, so to make it clear – the 2 to 5% is just a blind quess. And having merit does not mean CURE. It simply means it MAY warrent investigation. We can inform the public or unsafe practices and potential fraud with out polarizing people. some times they become polarized against you…. by you. We can have a respectful discussion on any subject and still reach the core of a problem without polarity and name calling.

    While I believe in modern medicine, it is understandable why some question its value when as funding has shifted to mostly pharma provided. A look at the last 50 years shows less cures and more drugs to treat condisions. paralleled with less cure funding. If Talk about that to. It does not hurt the medical establishment to ask it to do better. It challenges them to meet the expectations of the people it provides for.

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Latest Cartoon

Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

“The urinalysis is not a very exciting medical test,” stated Dr. Fishbinder. “It doesn’t matter that it’s cheap, fast, and most likely to provide an explanation for strange behavior in hospitalized patients. It’s really not as elegant as the testing involved in a chronic anemia or metabolic encephalopathy work up. I keep it in my back pocket in case all other tests are negative, including brain MRIs and PET scans.”

Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

Hospital administrators praise Dr. Fishbinder as one of their top physicians. “He will do whatever it takes to figure out the true cause of patients’ cognitive impairments.” Says CEO, Daniel Griffiths. “And not only is that good medicine, it is great for our Press Ganey scores and our bottom line.”

As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.

***

Click here for a musical take on over-testing.

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