Whenever anyone asked, Columbia University has long had a simple rebuttal for critics of Mehmet C. Oz, its telegenic purveyor of medical miracles: “academic freedom.”
But as questions mount about the doctor’s media-fueled influence, it’s becoming apparent to some experts — even those from and within Columbia — that the case of Dr. Oz might be demonstrating the need for a more modern framework for assessing academic and medical integrity.
Their central complaint is that Dr. Oz, a tenured professor of surgery at Columbia, has been using his popular Dr. Oz Show and website to give millions of people medical advice that is often wrong and perhaps dangerous. That charge grabbed a chunk of national attention over recent weeks, after a group of 10 doctors from outside Columbia called on the university to fire him. The university flatly refused. Experts and media commentators have been speaking out, both in opposition to Dr. Oz and in his defense.
But amid the firestorm, less attention has been paid to a broader question: When a university doctor pushes the envelope outside his institution, who, if anyone, is responsible for playing the watchdog?
There is no shortage of candidates. The Federal Trade Commission, which is responsible for false-advertising claims, reached a $9-million settlement in recent months with two companies the FTC accused of using The Dr. Oz Show to falsely promote a green-coffee-bean supplement as a weight-loss tool. But the FTC took no action against Dr. Oz, who said he too had been duped by the companies.
The U.S. Food and Drug Administration is responsible for investigating claims of harmful food products, but it is often overwhelmed by the demand and, according to some reports, suffers from conflicts of interest.
The American Medical Association declares that “all physicians have an ethical responsibility to ensure that medical information shared with the public is reliable and scientifically valid,” but it leaves disciplinary action to state and federal authorities.
The New York State Department of Health licenses physicians, but it largely bases any disciplinary actions on doctors’ own activities, not on claims they may make about others.
Keeping Up the Pressure
One other potential watchdog is more controversial: Columbia University itself. Some prominent Columbia alumni don’t consider their university’s defense of Dr. Oz a closed matter. “There’s no doubt that his performance on TV, and his ideas and his promotions, have tarnished the name of Columbia,” said one Columbia University medical-school graduate, Marvin M. Lipman, a clinical professor of medicine emeritus at New York Medical College, in Valhalla. “But the fact is, what can Columbia do about it?”
Officially, Columbia doesn’t appear to want to do anything about it. The 10 doctors who demanded Dr. Oz’s dismissal from the university were organized by Henry I. Miller, a fellow at the Hoover Institution at Stanford University.
The dean of Columbia’s medical school, Lee Goldman, gave them a one-sentence response through a spokesman: “As I am sure you understand and appreciate, Columbia is committed to the principle of academic freedom and to upholding faculty members’ freedom of expression for statements they make in public discussion.” Dr. Goldman declined a request to comment to The Chronicle.
But internally, university leaders are described as concerned at the situation and carefully monitoring Dr. Oz’s actions. Another alumnus, Donald M. Marcus, an emeritus professor of medicine and immunology at the Baylor College of Medicine, kept up the pressure by following Dr. Miller’s effort with his own letter of complaint to Dr. Goldman. He’s been trying to get other alumni to join him.
One political obstacle, Dr. Lipman acknowledged, may be Dr. Miller and his letter. Just before sending the protest letter to Columbia’s dean, Dr. Miller co-wrote an article for Slate in which he castigated Dr. Oz for an episode of his program last month. In that program, Dr. Oz raised safety concerns about a type of apple that has been genetically modified to avoid turning brown when it is cut open. Dr. Miller and his co-author called the apple a product of “simple biology” and dismissed Dr. Oz’s concerns as “New Age nonsense.”
But during a special edition of his program last week to rebut the letter, Dr. Oz pointed out that Dr. Miller and some of the nine cosigners of the letter had extensive ties to manufacturers of genetically modified food, and oppose legislative proposals to require labeling such food. Dr. Miller denied any conflicts of interest in writing the letter, saying its authors “were not asked or encouraged to write the letter by anybody. We did it wholly out of conviction.”
Either way, the episode points to the difficulty of adjudicating disputes over medical work and academic freedom. Dr. Lipman, who has served as chief medical adviser to Consumer Reports since 1967, said Dr. Oz was justified in questioning Dr. Miller’s fitness to serve as his chief inquisitor. “It’s sort of like the pot calling the kettle black,” Dr. Lipman said.
By letting Dr. Miller make the first move, however, concerned Columbia alumni and faculty members may have lost a chance to keep the focus on Dr. Oz, where it belongs, Dr. Lipman added. “They missed the boat on that,” he said.
‘A Mixed Bag’
Dr. Oz may be today’s most prominent beneficiary of the gap in official fact-checking, but he’s not the only university medical expert using public airwaves and websites to offer medical advice that lacks scientific grounding.
His medical advisory board lists experts from at least a dozen other institutions, many of whom also make regular appearances on the show. Like Dr. Oz, many of them have side businesses that offer consumer advice, emphasizing proper nutrition while also steering people toward products such as weight-loss drinks, cancer-reversing skin creams, and hormone injections.
One of them, Caroline M. Apovian, a professor of medicine and pediatrics at Boston University, endorses amino-acid supplements as a means of tackling conditions that include obesity, high cholesterol, diabetes, insomnia, erectile dysfunction, arthritis, hair loss, and wrinkles. Karen H. Antman, dean of medicine at Boston University, said she had no comment on Dr. Apovian’s public medical advice.
Another, Arthur W. Perry, a clinical associate professor of plastic surgery at the Rutgers Robert Wood Johnson Medical School, uses his website to sell a skin cream that he describes as having the ability to decrease skin cancers because it contains vitamin A.
Asked about such public pronouncements, the school’s interim dean, Vicente H. Gracias, agreed to an interview, calling it a topic worth discussing. But a few days later, his spokeswoman, Patricia M. Hansen, wrote back to cancel the interview.
Ms. Hansen instead offered a written statement: “New ideas brought about through the concept of academic freedom are welcome to be added to the discovery pipeline and tested for scientific rigor and safety.”
Deans at the 10 other institutions with experts listed on Dr. Oz’s science board either declined to comment or did not respond to repeated requests for comment.
There’s scientific evidence backing large amounts of the advice given by Dr. Oz and his advisory team — that people need to get more exercise, make wiser choices about their diets, choose organic food alternatives, and seek nonpharmaceutical alternatives for pain relief.
But there’s very little evidence that dietary supplements of the kind trumpeted by Dr. Oz’s team work as weight-loss aids or confer other medical benefits, according to experts including the director of the National Center for Complementary and Integrative Health. The center, a division of the National Institutes of Health, has financed about a dozen major human-patient studies of dietary supplements, and “by and large those studies have been negative,” said the center’s director, Josephine P. Briggs.
Dr. Briggs said she did not want to comment directly on the Dr. Oz situation but expressed uneasiness over the types of advice he has given. “I am as horrified as any other physician when I hear about quack cures or remedies for weight loss that have no basis,” she said.
Dr. Oz, for his part, has not endorsed weight-loss supplements for more than a year, and has apologized for doing so in the past. He declined an interview request, but wrote an article last week for Time in which he acknowledged the poor quality of many supplements and the research that had supported them. “I wish I could take back enthusiastic words I used to support these products years ago,” he wrote in the article. “And I understand the criticism I’ve received as a result.”
But last week, two days before the rebuttal episode of his program, Dr. Oz’s guests included the actress Suzanne Somers. Dr. Oz listened and smiled as the 68-year-old actress described her use of hormone-replacement therapy, which helps reduce postmenopausal symptoms but has also been scientifically associated with higher risks of breast cancer. Ms. Somers enthusiastically described the benefits but made no mention of the potential danger. Neither did Dr. Oz or anyone else.
The program’s spokesman, Tim Sullivan, said celebrities such as Ms. Somers are invited as guests “because their stories offer teachable moments for our audience.” Yet, he said, their comments are “not meant as advice,” and “we believe our audience knows that.”
Scientifically, the show’s endorsements are “certainly a mixed bag,” said Michael F. Jacobson, executive director of the Center for Science in the Public Interest. That appears to be the result of a genuine desire to help people, Mr. Jacobson said, mixed with a determination to engage in showmanship.
“The best thing would be for him to have a responsible show, where a viewer didn’t have to guess, is this the quack or is this the real doctor giving advice?” Mr. Jacobson said. “But he doesn’t seem capable of doing that.”
Meanwhile, Columbia not only is committed to upholding Dr. Oz’s right to free speech; it also sees advantages in his prominence. The program last week in which Dr. Oz derided the Miller letter finished with a heart-warming segment of him conducting heart surgery on an 87-year-old patient. It was filmed, with permission, on the Columbia campus at New York-Presbyterian Hospital, the university’s major teaching-hospital affiliate.
Paul Basken covers university research and its intersection with government policy. He can be found on Twitter @pbasken, or reached by email at paul.basken@chronicle.com.
