Fact-checking the Trump – Oz health sitdown

Kevin Lomangino is the managing editor of HealthNewsReview.org. He tweets as @Klomangino.

We’re no strangers to the wacky claims of ratings-driven TV docs and the often evidence-free statements of their guests.

But the Trump – Oz health sitdown promised to bring a new level of surreality to our corner of the media landscape.

The cognitive dissonance leading up to this encounter was palpable.

Here we had the prospect of Dr. Mehmet Oz — the Columbia professor of surgery who’s known for touting green coffee beans for weight loss, homeopathy, and other dubious health remedies — playing the role of campaign journalist revealing and evaluating Donald Trump’s fitness to lead the free world. All in front a live studio audience and for millions of Dr. Oz Show viewers.

We wondered: Would the Dr. Oz who showed up to the taping act in a journalistic capacity to soberly vet Trump’s health records as a public service to voters? Or would Oz the TV host capitalize on the moment to burnish his brand and broadcast more misguided health hype?

In days before the interview, Oz encouragingly promised at one point to ask “pointed questions” about Trump’s health. But then he immediately turned around and pledged that he wasn’t “going to ask [Trump] questions he doesn’t want to have answered.”

So much for the hard-hitting journalism.

Candidate Trump, of course, has not been shy about making his opponent’s health an issue, with his campaign and its surrogates floating outrageous theories about Hillary Clinton’s supposed debilitating brain injuries.

Trump also has been the object of much health speculation, with many in the media offering armchair diagnoses of Trump’s alleged mental health disorders. One of our contributors, psychiatrist Susan Molchan, called for that rumor-mongering and chatter to stop.

Trump’s own doctor, remarkably, claimed: “If elected, Mr. Trump, I can state unequivocally, will be the healthiest individual ever elected to the presidency.”

So what did the show reveal about Trump’s health and were those messages accurate? 

In the end, the show focused largely on the results from a recent physical that included a list of lab readings, all of which were in the normal range. Trump said he takes a statin to manage his cholesterol and claimed that his speaking engagements in hot venues are “a form of exercise.” Dr. Oz complimented his “good” testosterone readings.

Oz asked the candidate about his health history, which revealed no red flags, and he did briefly press Trump about his anger issues, asking: ” Why do so many people question your temperament?” Trump dismissed it as the impact of “Madison Avenue” — i.e. negative advertising.

In what promised to be another substantive exchange, Oz asked whether undocumented immigrants would have a right to emergency medical care under Trump’s administration. Trump sidestepped the issue — “Under my plan the undocumented person wouldn’t be in the country” — and Oz let the non-answer stand.

From the standpoint of improving communication about health care interventions (our primary mission at HealthNewsReview.org), a few issues immediately stood out for me:

• Oz commented that Trump’s PSA, at 0.15, was “low,” to which Trump replied: “My PSA has been very good. So many of my friends have had problems where they’re going to get radiation.” This exchange makes it sound like the test is routine and that having a high PSA is indicative of prostate cancer. That’s unfortunate. As we pointed out just yesterday, all major professional groups recommend against routine PSA testing because its potential harms — in the form of false positive results and unnecessary treatment of slow-growing tumors that may never cause a problem during the patient’s lifetime — outweigh the benefits. The test is also not recommended for those over age 69 and Mr. Trump is 70.
• Trump’s coronary artery calcification score, reported to be “98,” was suggested to be an indication of the candidate’s excellent heart health. But again, there’s plenty of debate as to the value of this test, which isn’t endorsed by guidelines from U.S Preventive Services Task Force because there’s not enough evidence to accurately assess the risk-benefit balance of administering the test. The test involves potentially carcinogenic radiation exposure, and it’s not clear that the information from the test leads to an improvement in patient outcomes — issues we touched on in this story review.

Timothy Caulfield, a University of Alberta professor who studies the intersection of celebrity culture and health (among other things), offered an immediate comment based only on the clips he saw on CNN. (The show hasn’t yet aired where he is and hasn’t been posted online.)

No surprise, the interaction had almost nothing of substance. There was little meaningful discussion of health issues, just the usual laundry list of test results. For example, Dr. Oz did not challenge him on any of his pseudoscientific beliefs. (But given Oz’s pseudoscience beliefs, not sure this was technically possible.) There was an implied endorsement of questionable screening strategies (specifically, the exchange about the value of PSA testing). Bottom line: This was nothing more than two celebrities using each other’s pop culture brands to create noise.  Unfortunately, from their perspective, it worked.”

Susan Molchan, MD, who also hadn’t had a chance to view the entire interview (only the CNN clips) said:

In general it’s too bad there’s so much focus on an individual’s health, and very little on our health care system, which misprioritizes so much. Tests for one thing, like the PSA—although we know it’s value as a screening test is questionable and “numbers” are way overemphasized in our system. It’s great he wears a hat against the sun (though I wonder why he always looks like he has a tan?). And like most Americans, he’d rather take a pill to control his cholesterol than exercise. Again, I suppose like many Americans, he rationalized that a minimal form of activity–his hand motions while speaking–counts as exercise.

Contributor Yoni Freedhoff, MD, also suggested that the attention on Trump’s health is misguided — but for different reasons:

The man is a terrifying caricature with real potential of becoming President of the United States. Who cares what his PSA is or isn’t?

— Yoni Freedhoff, MD (@YoniFreedhoff) September 14, 2016

Readers are invited and encouraged to weigh in with their observations in the comments.

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Update 9/19/16: Contributor Dan Mayer, MD, wrote to us with the following observations after watching the show. He references a brief exchange where Donald Trump said that birth control pills should by available over the counter, and not by prescription, so as to improve access.

There was no mention about Trump’s mental health.  Does someone who has never been in politics deserve to be the president of the US without some psychiatric evaluation?  I think the this is a legitimate question when asking someone about their ability to handle a different kind of stress such as would be in being president.  Does Trump want to make birth control pills over the counter so that no insurance has to pay for it?  This doesn’t even consider the medical issues for women who should not be on the pill and about other contraceptives that may be more else effective and safer than the pill.  Then Trump’s very vague description of how he will change the health care system, but he seemed to be implying that perhaps some sick people will have to do without any care.  Dr. Oz was very conciliatory to Trump and never called him on how this would be paid for.