Pulling back the curtain on ‘The Doctors’ and ‘The Dr. Oz Show:’ What our analysis revealed

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Ranit Mishori, MD, is a Professor of Family Medicine at Georgetown University School of Medicine. She is a member of the HealthNewsReview.org team of reviewers.

Earlier this month, Mehmet Oz, MD celebrated his 1,500th “Dr. Oz” show. Oprah Winfrey, Gayle King and Martha Stewart made appearances, proffering congratulations and discussing everything from mercury in fish to the #metoo movement.

The Dr. Oz ShowI felt less jubilant: In the decade that The Dr. Oz Show has been on the air, it hasn’t been unusual for me to encounter patients who ask about topics, treatments and suggestions mentioned on the program and another popular medical show, “The Doctors.” The advice my patients tell me they’ve heard on these shows often does not square with what I know about the medical evidence. 

While I may know that TV shows should be considered entertainment, my patients may not. After all, in our culture, a white coat and a “Dr.” title is a powerful symbol for a trustworthy person of knowledge. 

TV shows likes these are, in part, why the American Medical Association recently formalized a set of guidelines titled “Ethical Physician Conduct in the Media,” which recognize our responsibility to use our knowledge and skills “for the benefit of the community as a whole.” It also highlighted the risks when medical advice is not appropriately conveyed or does not reflect the standard of care.  

A deep dive into the accuracy of TV medical shows

It was that phrase–“standard of care”–that brought me back to a project I worked on in 2013 assessing the accuracy of health claims and recommendations made on “The Dr. Oz Show” and “The Doctors.”

The idea for the project came while I was speaking to colleagues about our experiences with “Dr. Oz phenomenon” — an exasperating situation involving answering a patient’s questions about claims they heard on the show. “Should I eat that berry to lose weight? Will that root extract boost my immunity? Can that supplement really prevent cancer?”

There are times when we know right away the answer is an emphatic no; other times we aren’t so sure. It is always possible we might miss some important new study and need to check the source of the information. With patients who are not simply inquiring, but instead telling us they were doing something based on a Dr. Oz recommendation, it also raises questions for us: Are there any harms that we should warn them about?

For the project, we sought to answer: What are the shows’ sources of information? Are they valid? Reliable? Trustworthy? And do they reflect “the standard of care?”

What we found: The recommendations made on these shows only occasionally follow evidence-based guidelines. Often, we couldn’t find any literature citation (such as a medical study) to confirm the claims made on the show. The costs and harms of the suggested treatments were often overlooked. And, the hosts on the show frequently hawked products made by companies that advertise on the show.

How we collected information

My colleague Dr. Jeffrey Weinfeld, medical librarian Michele Malloy, and I enlisted a group of medical students to tape and view all episodes of “The Doctors” and “The Dr. Oz Show” airing during a full month.

Our students logged all the health recommendations made on the shows, and noted whether harms or costs were discussed, and if a source or reference was given for the health recommendation. Our students also watched and noted the advertisements aired during the show and tracked whether advertisements were related to the show’s content, possibly suggesting a conflict of interest. 

We counted more than 300 health recommendations, and we randomly selected a subset of them for further analysis. Our analysis included categorizing each statement into one of several “levels of evidence” based on a standard evidence-based medicine best practice resource (the Oxford Centre for EBM), and searching the medical literature to find the source of the information.

We further classified each source we found for the on-air recommendation into the following categories: 1) significantly supports claim, 2) supports claim but with limited statistical strength, 3) supports claim with extrapolation (i.e. animal study, in vitro, very small sample size), 4) unclear, 5) no source identified matching claim.  

What we discovered

While it was common for the shows to make medical recommendations, these recommendations typically didn’t include discussions of the risks or costs of treatment:

  • On average, there were 6.91 (Dr. Oz) and 9.55 (The Doctors) health recommendations made per show.
  • Discussion of potential harms or risks were noted in only 8.6% of Dr. Oz’s recommendations, and in 13.1% of The Doctors’ recommendations.
  • The cost of the various recommended interventions was mentioned 23.7% of the time on the Dr. Oz show, and 3.1% of the time for The Doctors.

Nor did the recommendations typically follow evidence-backed guidelines:

  • About 78% of statements made on the Dr. Oz show did not align with evidence-based medical guidelines, society recommendations, or authority statements. For The Doctors, this was about 80%. 

More than half of all recorded shows had content linked directly to advertisements:

  • In the Dr. Oz show: 13 out of 19 (68.4%) shows had ads related to general show content, 11 /19 (57.9%) had specific products mentioned by the host using their commercial name, and 4/11 (36.3%) shows mentioning products by name named more than one product.
  • In The Doctors: 12 out of 18 (66.7%) shows had ads related to general show content, 13 /18 (68.4%) had specific products mentioned by the host using their commercial name and 11/13 (84.6%) shows mentioning products by name named more than one product.

The literature supporting the recommendations was weak, and sometimes non-existent:

  • For both shows, about half of the literature supporting the claims made on the show television was statistically insignificant or required extensive extrapolation.  No literature support could be found for about a third of the claims. Of the supporting evidence we could find, about a third had Oxford EBM classification 3b or lower (the lower end of what’s considered good quality evidence).

What we learned 

We started the project having serious questions about the quality, validity and accuracy of the advice given during daytime health talk shows, and at the end, we weren’t reassured. 

A scene from “The Doctors” TV show.

Our results lent further support to the general feeling among many scientists and clinicians of the shows’ sub-par level of evidence and low quality of information. 

Many of the studies we identified as potentially providing support for the claims made on the shows were problematic–with only a few people enrolled, or they were animal-based, or “test tube” studies. If these sources we found are indeed the sources of information used for the shows, then it appears the show researchers frequently relied on preliminary findings–in lab animals, tissue samples, or very small human trials–and then applied them to everyone. 

This practice is at best misleading to the general viewer, and potentially harmful to viewers and patients with serious or chronic illnesses.

Finding a match or a source in the literature for a recommendation made on the show – even when the searching was conducted by highly skilled individuals with years of experience combing the medical literature – proved to be extremely time-consuming. It would be especially challenging for a lay person to find sources: Our searches were conducted with access to subscription databases and journals not always available outside of academic settings.  

How could these shows improve?

A segment from The Dr. Oz Show

Given their huge popularity, these shows aren’t likely to go away. Instead of presenting dubious claims, they have an opportunity to be leaders in health promotion and education. The AMA guidelines mentioned earlier provide important starting points to bridge that gap.

At a minimum, my colleagues and I believe that these TV shows must:

  • be clear about study limitations (e.g. animal study);
  • be clear about information sources used;
  • be upfront about potential harms;
  • be transparent about conflicts of interest and advertiser influence 

Transparency must take priority, allowing viewers and healthcare providers to find the information sources used to back their claims. This can easily be addressed by providing the citations or links on the shows’ websites, after or during the rolling of the credits, or by putting them at the bottom of the screen. At the moment, it doesn’t appear that anything like this exists–an “important message” from Dr. Oz is all we could find about the claims made on the site. We could find no sources or disclaimers on the The Doctors web site.

We also think the shows could raise their ethical standing by acknowledging when a product or brand being discussed on the show is linked to an advertiser. As the very least, there could be disclosure at the bottom of the screen in the final credits, or on the shows’ websites, that explains the connections. 

Show staff should develop or adopt internal review criteria that are responsible and viewer-centered, perhaps adapting already existing standards of quality health reporting such as those suggested by HealthNewsReview.org.  

At the same time, we continue to encourage our patients, the viewers of these shows, to embrace skepticism and to recognize that TV entertainment is not, and should not be, a source for high-quality medical advice. 

As one Twitter commenter recently noted on a Dr. Oz tweet promoting a segment about detoxing with tea: “One good way to start a detox is to stop listening to Dr. Oz.”

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Comments (15)

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Gayle Zera

February 22, 2018 at 10:51 pm

DR. OZ a few yrs.ago said he cooled his morning egg in coconut oil. Now He’s changed to olive oil
Each oil has its merits & uses
How does he find time to take all those supplements in the morning before.going to work?

Shandele Broyles

February 23, 2018 at 1:18 am

Why is it we can’t question your reporting on these shows when you are doing the same thing. On google they have a health forum. Nothing is said about that. And there is the entire internet full of health information and not all of it is correct and they are almost always combined with advertising. You are acting like Dr Oz a heart surgeon would intentionally put out harmful information. And we don’t know you or anyone who helped you with these comments so why should your advice be any better? And there are many studies put out there that include animal testing. But you made it clear if someone doesn’t agree with you that you will not publish their comments. How is that fair? You can attack another Dr but you won’t allow yourself to have anything said about you? ? Really? ? Also if you don’t allow our comments that we have a right to say then we can always go to Facebook and that is a much bigger place to make our comments. Also not everyone can run to a Dr just whenever so I do think there is alot of useful information on their shows and I haven’t come across one where there are cures for something major. And most people will do research beyond the shows. I think it helps people to eat healthier and how can that be a bad thing? I’m sure you won’t post this comment. But it is my thoughts and opinions and they are just as important as yours.
Also I recently learned something from one and have found it to be true.
Thank you

    Gary Schwitzer

    February 23, 2018 at 7:51 am

    Shandele,

    There are quite a few false statements in your note, but we published it anyway.

    First, by publishing your comment above, your first allegation that you can’t question what we wrote is clearly wrong. Second, there is nothing in our comments policy that “made it clear if someone doesn’t agree with you that you will not publish their comments.” Third, your comment that you don’t know who we are is unwarranted; bios of all members of our team are available on our website – a team that, combined, has hundreds of years of experience in health care journalism, science writing, medicine, and research.

    Dr. Ranit Mishori’s article, which you question, was based on a systematic assessment of the TV programs in question. You may question the importance of that assessment if you wish. But please don’t make false allegations about our work. We may post one round of false statements and then respond to them. We won’t do it a second time.

    Gary Schwitzer
    Publisher

Sandra Maccagnan

February 23, 2018 at 12:52 pm

I just wanted to share that I gained so much knowledge from all the advise and information provided on the Dr Oz show. I have been sick for a long time and haven’t received any good results from my Drs and all the meds they prescribe.  So hearing my symptoms on the show gives me hope that I will get to the bottom of my health situation. His show has encouraged me to continue seeking out additional medical advice to see if any of the options would work for me.  For example, I thought I could possibly have leaky gut as one of my possible problems/symptoms. When I discussed it with my physician he didn’t even know what leaky gut was and dismissed it.  I did learn that it is okay to continue switching Physicians until you find one that will get to the root of the cause and provide some relief. The doctor I’m seeing now is appalled at all the medications I was given to cover up the symptoms I was feeling. I am taking a more natural approach to my health issues under her medical advice and it’s been working for me significantly better than before.  I value the Dr Oz Show and look forward to seeing it on a daily basis, it’s very educational for me. Here are some of the value added features of the show: love the graphics that are shown of the human body; the actual real human organs; the exhibits that demonstrate the point he’s discussing; the good work he does in the field; the encouragement he provides to his viewers; his sincerity and empathy towards people/guests on the show & in the audience; the knowledgeable and resourceful guests he provides, ex: health care providers/authors (discussing the subject matter of their book)/Health Care Professionals: alternative and holistic medicine; all of which are featured on his show and how he provides a forum of discussion for both sides of an issue. The nutrition aspect; healthy eating, healthy recipes, natural & holistic alternatives, demonstrating products that work or not and useful hacks is what I appreciate the most. It’s encouraging to see what other people are going through in their health situation, with their weight and their success stories; it’s something we can rally around and feel hopeful about. I have years of taped shows and I’m constantly taking notes and referring information to friends/family that I know would benefit by it (ex: try acupuncture for your migraines). Well those are my thoughts anyway and I hope that I will be able to continue watching The Dr Oz program in the future. Sincerely & Greatful, Sandy

Nir Tsabar

February 24, 2018 at 10:00 am

Well done! An important research, intriguing results. Very much needed for Israeli TV too…

Odette Hélie

February 26, 2018 at 9:10 am

I never watch Dr Oz “show” and to me his credibility is near zero BUT the argument that he does not “align with evidence-based medical guidelines, society recommendations, or authority statements” almost makes me want to revise my opinion :-) Evidence-based medicine : the data base is more than a little corrupted by unpublished and badly designed studies. Authority statements : are we talking about committees populated by opinion leaders on the industry payroll ??The global status of biomedical research and practice being what it is actually, the argument may not be the most convincing !

Benjamin Gonzalez

February 26, 2018 at 9:23 am

I love it when a patient brings me a concern or advice from a TV show or Google. It presents me an opportunity for me to clarify or at least, address something that may not otherwise be addressed by a physician. Though it can be time consuming and labor intensive (which is the real reason why physicians do not like patients bringing TV or Google info to them). There are other TV culprits that make life as a physician difficult: Pharmaceutical ads. These are the real bane of my existence. The studies for most of these pharmaceuticals are tenuous at best and as this particular article points out concerning Dr Oz-type shows, cost is not discussed in these pharmaceutical ads, let alone health insurance coverage. As a physician, I for one encourage my patients to bring me the info they learn from these shows. Many times I get to “clean out” a patients mess of supplements they take and sometimes, I learn something new and appropriate. “Standard of Care” and Peer Review” is a whole other discussion that should be addressed by this forum. It can be eye opening. A different look at a disease process goes both ways. Physicians, it is OK to challenge your patients and these shows, but it is also OK to look a little deeper at other approaches to a disease process… Ben Gonzalez, MD

Lynn Colwell

February 26, 2018 at 11:00 am

I never watch these shows so I have no input on this particular issue, but my question for you has to do with the fact that so many studies that create “evidence-based” medical guidelines could be questioned. Just one example of this is as I understand it, most studies of drugs are done on (average) 45 year old men. I am neither a man nor 45. So how do I know that a particular drug will not do harm to a 72 year old woman? I have read extensively about the testing of drugs and other studies and just as you have made me even more aware of the bias of headlines and news stories, I am extremely cautious when I am told something is “evidence-based.” One reason that there isn’t evidence around some things is simply because the cost of doing so is impossible for many to go through. I also believe that the placebo effect is not always a bad thing, or dangerous. Finally, I know that some things work for some people and not others. All this adds to the confusion, but also my feelings that “evidence-based” is another buzz word that isn’t impervious to criticism.

Rebecca Andrews

February 26, 2018 at 1:26 pm

As a doctor, Thank you!!!

Ccarl E. Bartecchi, MD, MACP

February 27, 2018 at 10:32 pm

Dr. Mishori does a great job exposing some of the many problems of Dr. OZ, a man who has lost almost all credibility in the field of scientific medicine. I am surprised, however, that this expose comes out of Georgetown Medical School, a school known for its support for unscientific medical practices (alternative medicine, integrative medicine, complementary medicine, etc).I have always considered Georgetown and the Clleveland Clinic as among the worst of the medical centers that adopt, teach, and provide unscientific, unproven therapies at their centers. I am delighted to see that Dr. Mishori might be an exception at Georgetown. It would be heartening to know that there may be others like her at Georgetown.

Bob Maginnis

February 28, 2018 at 11:06 am

I wish Dr. Oz had done more to question Trump when he was on the show, should have demanded the usual blood tests which a good doctor would wnat to comment on, lipid panel etc for the obviously unhealthy Trump.

Dave Ross

March 1, 2018 at 9:34 am

This had to have been the funniest and most interesting episode of the Doctors
https://www.youtube.com/watch?v=qHwjNXh5538

Judith Mabel

March 10, 2018 at 7:02 am

As a graduate of the Institute for Functional Medicine, people often ask me what I think of Dr Oz. My answer is that I love him except when I hate him. Sometimes he is right on the money and saying things that mainstream medicine doesn’t (Medical cannabis to get off opioids, reversing Alzheimer’s w/ Dr. Dale Bredesen).
Other times he is selling product and outmoded ideas. Hard for the average person to know which Dr Oz they are getting.

Ashley Calvillo

March 23, 2018 at 8:27 am

It’s sad that lots of doctors are just marketing tools for the pharmaceutical industry. The reps come in with this hot new medication, feed their office lunch and give them samples to hand out to their patients. It’s all about money, treating the symptoms and not about curing the real problems. The problem that I have with tv doctors is that the statements made, in response to a question by an individual, are intended to help that individual. Sometimes Americans aren’t smart enough to think about if the recommendation are valid for them. They should definitely be required to express the risks, as well!

Doug Currie

March 23, 2018 at 10:04 pm

I find it more than a little odd that you attack the validity of what other doctors view as their opinion for not providing proof behind their statements when you have done the very same thing. These days any doctor that advocates supplements or alternative medicine gets branded as an outcast. The United States arguably has the best medical care in the world. It is also arguably the most financially corrupt. The system no longer is about helping people. It is about making the most money possible in as little time possible. Big Pharma controls way to much in the matter of what doctors are taught. It is the reason that many consider Md’s to be nothing short of pill peddlers. Alternative medicine has gained it’s firm foothold because the reins that used to guide and control standard medicine are no longer controlled by standard medicine. When i was a child being a doctor meant more than just having a profession. They were revered. That is sadly no longer the case.