Dr. Oz is running for the Senate
Easily the longest newsletter that I've written
After the news broke that Mehmet Oz is running for the United States Senate in Pennsylvania, I can’t tell you how many people texted, called, and emailed me to ask what I thought about my former boss running for office.
I spent a year between my third and fourth year of medical school working for The Dr. Oz Show, so I’ve had Mehmet Oz as a boss and seen up close how he works and how he synthesizes information.
The New York Times article anonymously quoted a couple of my colleagues who worked in the medical unit on the show at length:
“Two researchers who worked on “The Dr. Oz Show” for a year during a break from medical school in the 2010s said in interviews that the show’s producers had originated most of its topics, often getting their ideas from the internet. But the researchers, whose job was to vet medical claims on the show, said that they had little power to push back, and that they regularly questioned the show’s ethics to one another and discussed quitting in protest.
“Our jobs seemed to be endless fighting with producers and being overruled,” said one of the former researchers, both of whom are now physicians and insisted on anonymity because they said they feared that publicly criticizing him could jeopardize their careers.
Let me be clear: I was not one of the researchers quoted on background here.
And I think that their stated rationale for insisting on anonymity is nonsense.
Criticizing Dr. Oz as an insider would have been great for my profile in the world of academic medicine
Throughout every phase of my academic career, I had to answer tough questions about my decision to pause my medical career in order to spend time working for a TV show. Most physicians in academic medicine didn’t applaud my choice, and I spent most of my interview seasons on the defensive - not just regarding the details of my CV or the quality of my work, but about what that work said about me as a person.
I heard from quite a few people during my residency, fellowship, and job interviews that my choice made them question my ethics and Hippocratic oath. A couple of examples:
“I’d love for you to explain to me how working for Dr. Oz wasn’t a total waste of your time.”
“Are you embarrassed about your role pitching weight loss drugs that don’t work and lowering the quality of scientific communication?”
“How do you justify your role in selling bad supplements to vulnerable people just trying to get healthy?”
I’m pretty sure that a doctor who previously worked for Mehmet Oz blowing the whistle on what they saw behind the scenes would increase their profile and burnish their academic bonafides.
That’s not what you’re going to get here.
This isn’t a takedown piece.
I’m not blowing any whistles.
But I think it’s worth discussing my time at the show, what I learned, the content we made, and what my experience working with Dr. Oz was like.
A quick caveat: I’m not a confidant of Mehmet Oz, and I don’t know his family. I have no idea what his motivations are for running for the Senate, but it’s obvious from the media coverage that lots of people are interested in understanding it.
Working for Mehmet Oz and his show was one of the formative experiences of my professional life
My time working at the Dr. Oz Show changed me in really profound ways.
I’d be hard pressed to come up with anything that I’ve done that’s been more influential on the way that I view the world.
The experience was deeply impactful on the way I practice medicine, the way I think about science, and the way that I communicate.
Thinking about medical content from the perspective of a TV viewer (and hearing what our focus groups said about the topics on the show) taught me a lot about what’s important to people about their health. It’s often very different than what I focus on as a physician.
Thinking about content development from the perspective of our supervising and executive producers made me realize quickly that you’re only as good your results say that you are.
It doesn’t matter how high the quality is or how proud you are of your work. If a segment doesn’t get good ratings, it’s not a good segment (and you probably shouldn’t cover that topic again for a while). You’re judged on your results, not on a curve based on how you got there.
Thinking about turning a study into a segment from the perspective of a TV producer taught me how important it is to be able to synthesize a long, complex story into a succinct but nuanced message. You need to get your point across before you get tuned out.
Seeing how the producers I worked with understood the science made me use really different language when talking about medicine.
The producers there are at the top of their field - they’ve won multiple Emmy awards and they’re some of the smartest people I’ve worked with in any setting. But even speaking to them in what I thought was a non-jargonized way often left a real gap between what I thought I had communicated and what they heard.
Since the producers needed to understand the content in order to develop each segment, I learned quickly that the information asymmetry in medicine is simply gigantic - even really smart and accomplished people don’t think like a physician and don’t use the same language that we do.
There is not a single day that I work in my current job that has not been influenced by my time at the show.
Dr. Oz himself taught me some really important things
I’m not talking about the benefits of sea buckthorn oil - I actually learned some real life lessons from Mehmet Oz.
People don’t change based on what they think. People change based on what they feel.
Easily one of the most impactful things that I’ve ever learned.
When I interviewed with Oz for my job, one of the things he brought up was something that Oprah taught him about being a positive influence on people. You can’t be an agent of change if you don’t understand this concept viscerally.
This point - people don’t change based on facts, they change based on emotion - is the whole ballgame.
Humans are emotional creatures. We often come to a conclusion based on our values and identity, and then we reason backwards to justify it.
You don’t inspire people to change their lives by providing an explanation of the cardiovascular impact of hyperinsulinemia any more than you do by showing calorie counts on a fast food menu.
A great argument isn’t persuasive if it doesn’t elicit an emotional response that connects.
Once you’ve made the connection, the facts and figures can start to be influential. But until that time, you’re probably wasting your breath.
It doesn’t matter what your message is if no one pays attention to it.
The corollary to the first point is that you can only get a message out to those who hear it.
Why do you think we rarely did segments on exercise?
It wasn’t because no one believed in it or we wanted to keep our audience on the couch so they’d watch more TV.
It’s because those segments didn’t rate.
If your content makes people turn the TV off, close the book, go to a different web site, or mute your tweets, what was the point of even making it?
The ability to acquire and sustain attention from an audience is the only thing that will ever give you the ability to persuade.
Talking to an expert for a few minutes is worth more than hours of your own research
This isn’t a piece of insight specific to Dr. Oz, but his emphasis on it really did have an impact on me.
Anytime I included expert interviews in my pre-show briefing notes, I observed that Oz would comment on them. They always seemed to make more of an impression than my own summary of the content.
As I started to do it more, I realized how valuable the context only an expert could provide was to my understanding of what I was reading.
I’ve written before about the importance of deep understanding and expertise, and the first place I really understood this was as a researcher working for Dr. Oz.
The Oz brand - only “YOU” are in charge of your health - is the lens through which to understand the show
The reason that I was hired to work at the show was because of the answer I gave to the first question that Susan Wagner, the supervising producer of the medical unit at the time, asked me at my interview: “Why do you want to work here?”
My answer: “I believe in the mission of the show - that one of the most valuable things I can do in medicine is empower people with information to take control of their own health.”
It’s certainly something I [still] believe, and if you look at Oz’s answers to the tough questions that he’s faced, you’ll see that’s the place where a lot of the nonsense on the show comes from:
“My job, I feel, on the show is to be a cheerleader for the audience, and when they don’t think they have hope, or when they don’t think they can make it happen, I look everywhere for any evidence that might be supportive to them.”
Everything in the show is based on the idea of a solution that you can implement.
We made 180 episodes over the year that I worked there. That’s a whole lot of solutions to come up with. One of the more bizarre questions that we would get in the medical unit from some of the producers was, “has anyone discovered any new organs recently?”
The job of the medical team at the show is to find evidence that might support the suggestion of a benefit of each of our solutions.
We would often look for a mechanistic study showing that so-and-so supplement worked in vitro (or in lab animals) along with evidence that it appeared safe in human studies. We would then extrapolate those findings with the suggestion that it might work in humans as the justification to put something on the show.
Nothing was totally made up. It was all based on a kernel of truth, a study showing this mechanism, an epidemiologic association demonstrating that connection - and that’s why Olivia Nuzzi’s New York Magazine article had this quote from a producer:
“And the way I’d defend it was to say that it was a difficult place to work because the content was complicated; you had to find a way to take a complex medical issue and make it easy to understand and entertaining. I know there were controversies, but I had never seen anything in daytime TV vetted so closely in my life.”
We were always super careful about the precise nature of the language - “may” instead of “will,” for example - so that nothing we said was totally false. But we would often have the facts right even if the story was wrong.
And I was certainly a part of that, signing off on scripts that were factually accurate based on strict wording, but totally wrong when looking at the big picture.
Oz behind the scenes: he reads, he thinks critically, and he treats people well
We wrote long, detailed briefing notes for Dr. Oz before each show. He always read them and would bring up points we raised in his notes (but got cut from the producer’s scripts) to add to the show regularly.
He also asked a lot of questions - we would be “on call” to answer questions on weeks we were doing morning briefings, and you needed to be prepared each night for the possibility of an 11pm email asking a probing question about tomorrow’s script.
When we did a segment on colon cancer lives saved through screening, Oz didn’t think that some of my stats made sense, and he actually emailed Thomas Frieden, the CDC director at the time the night before the segment to question some of the official CDC stats that I had sent him (my numbers were right, in case you were wondering).
Oz would often have really thoughtful questions about the topics that we covered, both about the directly medical and the not-directly medical. I never got a sense that he just took information fed to him by a producer and mindlessly regurgitated it without thinking critically about it.
And I do think that it’s worth saying that he treated everyone at the show kindly and with respect.
When you’re in charge of the TV show, you can be an asshole to anyone who works there and no one can do anything about it. That’s certainly not the way Mehmet Oz ever acted.
How you feel about Mehmet Oz comes down to your assessment about the benefits and drawbacks of his work
I will always stand by the fact that the show does a lot of good - there are a lot of people who lost life-changing amounts of weight or were inspired to get a screening colonoscopy or Pap smear because of the show.
We had some really great scientific content - like talking about the connection between insulin resistance and Alzheimer’s disease or the way bloating can be a symptom of ovarian cancer.
We also put out a lot of bullshit.
And that doesn’t even get into any of the controversy surrounding his COVID comments. I’m not going to spend much time on them (he’s been wrong about hydroxychloroquine but right about vaccination).
I don’t share about the positive with the goal of obscuring the negative.
I share it because it’s part of the whole story.
I talk all the time in this newsletter about the concept of risk versus benefit. So when you think about the contribution of the Dr. Oz Show, it’s worth remembering that for every raspberry ketones or green coffee bean extract that made news there’s probably a high blood pressure screening that no one talked about.
When you run for office, it’s only fair to be judged on the entirety of your contribution
When deciding on the impact of Mehmet Oz on society, you get to weigh the positives and the negatives however you want.
It’s reasonable to take the perspective that the negative impact of the scientific misrepresentation trumps the positive impact that the show has had on many people’s lives.
And to be clear: I fully understand - and have participated in - many of the criticisms of the overhyped “solutions” pitched on the show.
I’m not excusing the misleading or inaccurate things that Oz has said. And it’s fair to criticize me as well. After all, I played a role in lowering the overall quality of the scientific discourse.
But it wasn’t all negative, and I certainly stand by that.
Creating content is hard. And getting people to tune in is even harder.
It’s a pretty remarkable achievement to keep a daily, hour-long medical show on the air for more than 10 years.
Not many people have the ability to do that.
It’s a testament to Oz’s connection with his audience, his work and the work of the producers, and the hunger that many people have for a trusted voice on confusing but important topics.
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