Science

Sarah McBride seeks reelection to Delaware State Senate seat – Los Angeles Blade

NEWPORT BEACH, Ca – By now, most folks are probably familiar with the widely ridiculed video released by Mehmet Oz’s Senatorial campaign, which followed his journey through a supermarket’s produce section on a mission to find ingredients for a crudité platter (otherwise known as a vegetable tray).

Oz’s Democratic opponent in the Senate race, Pennsylvania Lieutenant Governor John Fetterman, was quick to join the online mockery over the viral video, which began with the celebrity doctor’s announcement that he was at “Wegners” (not a real place, though possibly a portmanteau of Wegmans and Redner’s, two actual grocery chains with stores in Pennsylvania.) 

In response, the Oz camp told Business Insider that had he “ever eaten a vegetable in his life,” perhaps Fetterman would not have suffered a stroke in May. That provoked a strong rebuke from Real Doctors Against Oz, a group of more than 100 Pennsylvania physicians who have vocally raised their objections to the candidate’s habit of promoting dangerous pseudoscience and dubious medical advice. 

But Oz’s peers in the scientific and medical community have been sounding the alarm about these concerns well before his campaign’s suggestion that a plate of crudité keeps the stroke away, as Newport Beach-based cardiologist Dr. Danielle Belardo told The Los Angeles Blade on Friday. 

Newport Beach-based cardiologist Dr. Danielle Belardo

Co-chair of the American Society for Preventive Cardiology Nutrition Committee, Dr. Belardo is an influential advocate for science-based medicine and accurate communication about health and nutrition, including through her podcast “Wellness: Fact vs. Fiction.” 

She told The Blade Oz is a symptom of broader and more systemic problems in the American healthcare system. And if elected, he would gain even more power and influence at a time in which the internet and social media have, by orders of magnitude, accelerated the spread of false information about science and medicine. 

“America’s Doctor” has already caused tremendous harm

Oz’s credentials are impeccable. It was not for no reason that Oz was once hailed by The New York Times as “one of the most accomplished cardiothoracic surgeons of his generation.” Triple board certified, he was vice-chair of Columbia University’s surgery department, the author of hundreds of peer-reviewed papers, and the recipient of several patents. Dr. Belardo pointed to his involvement in the creation of the MitraClip – a device used to treat leaky heart valves that effectively replaced the conventional treatment, a far riskier open-heart surgery. (A study by the New England Journal of Medicine found it could save millions of lives.) 

Oz’s subsequent “foray into pseudoscience,” Dr. Belardo said, “was quite a departure from his previous career.” 

After becoming a public figure through his appearances on “The Oprah Winfrey Show,” Oz won a national audience and a wildly popular daytime TV program. There, he embraced and promoted ideas about science and medicine that, in many cases, even a layperson would be capable of correctly identifying as pseudoscientific quackery. (The reasons why he chose this path are a mystery not worth exploring here. A lengthy 2013 New Yorker profile offers some answers, none that are particularly satisfying.) 

According to research in the British Medical Journal, which analyzed the overall quality of health claims made on “The Dr. Oz Show,” fewer than half of a sample of recommendations made on the program were supported by any credible evidence. 

Below is semi-complete accounting of the ways in which Oz abused his platform as “America’s Doctor” over 13 seasons from 2009 to 2022.

  • Oz claimed popular brands of apple juice contained dangerous levels of arsenic, which was not true and caused unnecessary alarm. The FDA called the segment “irresponsible and misleading” 
  • Oz promoted homoeopathy as an alternative to prescription drugs for the treatment of aches and pains, despite the overwhelming scientific and medical consensus that there is no evidence the practice works. Homeopathy is among the most widely debunked forms of alternative medicine, and safety concerns with homeopathic products have been flagged by the National Institutes of Health, the Federal Trade Commission, and the FDA
  • Oz discussed conversion therapy, treating arguments from proponents and opponents of the practice as equally legitimate, despite the position held by mainstream medical and psychiatric organizations that it’s ineffective and dangerous
  • Oz promoted iridology, all forms of which have been rejected by medical doctors as pseudoscience and quackery 
  • Oz told his viewers about a study that purported to show that genetically modified foods have damaging health impacts and can cause cancer. Almost as soon as it was published, researchers had discredited the study
  • Oz repeatedly promoted the use of colloidal silver supplements for a variety of maladies including colds, viruses, bacteria, and wounds, despite the absence of any evidence for its use in the treatment or prevention of any medical condition and the risk that it may cause a condition called argyria, which turns the skin blue-grey and is irreversible
  • Oz warned that women increase their risk of developing breast cancer by carrying cellphones in their bras, which is not supported by any scientific evidence and again caused unnecessary alarm
  • Oz told his audience that supplements containing green coffee extract is “magic” and a “miracle” for weight loss, despite the absence of reliable evidence of any health benefits. The segment was among the reasons Oz was called to testify before a Senate hearing on consumer protection, where he was roundly criticized by members of both parties including former Missouri Sen. Claire McCaskill, who told him: “The scientific community is almost monolithic against you in terms of the efficacy of the three products that you call ‘miracles,’” adding, “I don’t know why you need to say this stuff, because you know it’s not true”
  • Oz promoted the unproven use of hydroxychloroquine for treating covid, parroting – on his own show and in more than 25 appearances on Fox News – the claims about the drug made by then-President Donald Trump. (Oz stopped advocating for hydroxychloroquine only after a Veterans Affairs study showed covid patients were more likely to die when treated with it) 

Oz is not alone

Few American physicians can boast of professional accomplishments in science and medicine that rival Oz’s. None have attained his level of celebrity. But with respect to providers who peddle pseudoscience despite having the education and professional training to know better, or despite having ties to respected institutions like academic research hospitals, Oz is not unique.

Dr. Belardo pointed to Mark Hyman of the renowned Cleveland Clinic, a trained MD who “promotes tons of misinformation about pseudoscience…selling things like detoxes and cleanses.” The American Council on Science and Health (ACSH) branded him the “Dr. Oz of nutrition” for peddling pseudoscientific “lies” about dietary health, once going as far as to compare the harms of processed foods to the Holocaust. Hyman practices “functional medicine,” which ACSH described as “a form of alternative medicine that encompasses a number of unproven and disproven methods and treatments.”

“Unlike politics, when it comes to science there is no ‘two sides,’” Dr. Belardo said. “Scientific evidence is a process of critically evaluating data in a systematic and rigorous way and interpreting that data,” she said. Unlike politics, it’s based on facts, not feelings.

Likewise, “There’s no such thing as ‘alternative medicine’ and ‘regular medicine’ – there’s just medicine,” Dr. Belardo said, adding: “If something that might be considered ‘alternative’ has enough robust scientific evidence, it would be included in medical care” – for instance, in the guidelines published and maintained by major medical organizations.

“Alternative medicine” covers a variety of practices, often with fuzzy definitions and unclear distinctions. Among many others, common terms include “complementary and alternative medicine,” “wellness,” “integrated” or “integrative medicine,” “holistic medicine,” and “natural” or “naturopathic medicine.” 

They are all pseudoscience – lacking biological plausibility, testability, reproducibility or repeatability, or evidence of their safety and efficacy (as gathered via clinical trials) – the very standards that, by contrast, are demanded of the diagnostic tools, pharmacological treatments, surgical procedures, and other forms of care offered in traditional medicine.

Sometimes, alternative medicine is provided as a supplement to traditional, evidence-based care, in which case it can be benign or even helpful – insofar as it may have a placebo effect or provide comfort to patients. In other cases, for a variety of reasons, people forego care from legitimate medical providers in favor of those practicing pseudoscience. 

Complicating matters is the fact that it can often be very hard to tell the difference, Dr. Belardo said: “Predatory pseudoscientific providers prioritize and take advantage of the people who don’t understand the scientific process.” They typically use scientific language that only those with formal medical training would be able to recognize as bogus – and even doctors can be misled. 

“Even though I’m a physician, I still can get duped and confused about scientific claims that are outside my specialty,” Dr. Belardo said. She added that some of the claims about “clean” beauty products – billed as less harmful to the skin and body because they are free from synthetic chemicals – looked facially plausible to her but did not hold up to scrutiny by “rigorously scientific dermatologists.”  

Practitioners with formal training in legitimate medicine like Hyman and Oz further “muddy the waters,” Dr. Belardo said, lending the veneer of legitimacy to pseudoscientific practices while sowing doubt and mistrust towards lifesaving evidence-based medicine.

Pseudoscience kills

The financial incentives for practicing pseudoscience are considerable. The providers and businesses associated with non-evidence based medical practice (like supplement companies) are making lots of money, Dr. Belardo said. The industry is also backed by a powerful lobby and faces far less regulation than traditional medicine. 

Many patients seeing pseudoscientific providers will pay out-of-pocket for products, supplements, treatments, and procedures that are often not covered by insurance and have not been proven safe, nor shown any therapeutic effect for the treatment of any disease or health condition. 

Other patients will suffer physical harms. Dr. Belardo said she has seen arrythmias, liver toxicity and failure, and bad interactions with prescribed heart medicines from patients because they were treated by an alternative provider who gave them underregulated herbal medications and supplements. 

That is hardly the full extent of the problem, however. “When we think about harms we’re not just talking about unregulated supplements – which can cause harms – but rather, something I see frequently, harms from misdiagnoses,” Dr. Belardo said. In such cases, the patient sees “an alternative provider and it delays the diagnosis of an underlying medical condition that requires guideline-directed medical therapy and treatment.”  

Dr. Belardo recounted a case where a gastroenterologist in her practice saw a patient who had been prescribed supplements for an iron deficiency, under the care of an alternative provider who did not perform a workup to determine the underlying cause of her condition. When Dr. Belardo’s colleague did a colonoscopy/upper endoscopy on the patient, per the diagnostic protocol, she discovered stage 4 colon cancer. “Had that been caught two years earlier, it would be a different scenario,” Dr. Belardo said. 

There are even more extreme examples of negligent and harmful practices by alternative providers. For example, a few years ago, a California patient died after a naturopathic doctor intravenously administered curcumin as a supposed treatment for eczema. The provider was previously among 34 defendants served with a lawsuit for their use or advertising of so-called “ozone therapies,” through which the toxic gas is injected into joints or into a patient’s rectum or vagina with a catheter. 

In 2020, a practice in Dallas was ordered to stop claiming that ozone therapy can cure covid, an example of a larger trend identified by Canada’s Institute for Research on Public Policy (IRPP), which wrote in 2020 that “Alternative medicine practitioners are leveraging the fear around coronavirus to sell products and procedures that are scientifically unproven.”

Oz and others practicing pseudoscience accelerate the spread of false information about science and medicine

The IRPP also linked alternative medicine to the proliferation of online misinformation about covid, with different “specialties” associated with different forms of “harmful noise”: Naturopaths have recommended useless supplements as preventative solutions as well as treatments, while homeopaths have endorsed a concoction later shown to cause liver damage. Aromatherapists and acupuncturists have stepped in to offer their services, which are comparatively benign but no more useful for the prevention or treatment of covid (or any other virus, for that matter).

When it comes to harmful, false messages about vaccines, practitioners of alternative medicine are among the worst offenders. A 2018 NIH study found that childhood vaccinations were less likely to be up to date among families that consulted a practitioner of alternative (“complementary”) medicine and more likely to be up to date among families that saw a general practitioner. 

These problems get worse as Americans become less literate in health science, more susceptible to conspiratorial thinking, and more distrustful of modern medicine and legitimate health institutions. As Carl Sagan wrote, “Pseudoscience is embraced, it might be argued, in exact proportion as real science is misunderstood.”

“Unfortunately, I see it frequently and all too often,” Dr. Belardo said. “And this is actually something that physicians are seeing across the U.S., and it’s no longer just a southern California trend. With the advent of social media, pseudoscience and disinformation is accessible through the internet,” where it spreads widely and quickly, presenting problems that the medical community has been slow to understand and address. 

“Medicine is an older system. Our medical societies are just catching up with social media. The pandemic was first time many physicians who are older and who are higher up in our field began to grapple with the amount of misinformation that is spread on social media,” Dr. Belardo said. Thankfully, “major organizations are starting to take a stand,” she said, noting the American Medical Association’s pledge to intervene when misinformation about covid is spread online and on social media platforms. 

Oz’s election to Congress, certainly, would not help matters. “Just looking at his history of endorsing pseudoscientific views and non-evidence-based medicine, he is not someone capable of helping to elevate social media to a place where people can find trusted scientific information,” Dr. Belardo said. 

Oz may have soiled his reputation among his peers, but he did not earn the moniker of “America’s Doctor” or build a devoted fanbase that propelled his TV show to win nine Daytime Emmy Awards over its 13 seasons for no reason. With Americans’ confidence in Congress reaching a new low of 7% this year, is the public likelier to trust Oz’s opinion less than another Senator’s when they differ on issues like the safety of vaccines or public policy solutions to mitigate a new strain of covid? 

Lest anyone think this would come into play only in the context of immunizations and infectious disease, consider that Oz, who is armed with far greater expertise in science and medicine than now exists in the entire Congressional GOP caucus, was “just asking questions” in that segment on his show about whether conversion therapy should be considered a legitimate “treatment” for homosexuality and gender dysphoria. (Dr. Belardo called Oz’s unscientific and anti-LGBTQ+ framing of the topic “nauseating.”) 

In the Senate, Oz would have a powerful regulatory role over alternative medicine 

What is the difference between a wellness influencer and physician practicing pseudoscientific alternative medicine? Well, it might depend on where they live. To the extent that any regulation may exist, rules governing the practice of non-mainstream medicine differ tremendously state-by-state. 

Complicating matters, distinctions among the various forms of alternative medicine are unclear and confusing – as are the occupational titles and educational and training requirements of those who practice in the space. 

The classification and regulation of naturopaths provides a representative example of how alternative medicine is treated differently across different jurisdictions in America. According to overwhelming evidence presented in peer reviewed journals, naturopathic providers recommend against evidence-based medical testing, pharmacological treatments, vaccinations, and surgery in favor of unscientific diagnoses and treatments without evidentiary support. Quacks, in other words, who practice charlatanism and promote therapies that are often ineffective, harmful, and unethical. 

Seventeen U.S. states allow naturopathic doctors to use the designations ND (“Naturopathic Doctor”) or NMD (“Naturopathic Medical Doctor”). Among these states, 12 allow for some health insurance coverage. In these states, the widely discredited alternative medical practice is given the appearance of legitimacy. 

Even more alarming, 12 states and U.S. jurisdictions allow naturopaths to prescribe prescription medications, while nine allow them to perform minor surgeries. South Carolina and Tennessee specifically prohibit the practice of naturopathy. 

It is not difficult to imagine that if elected to the Senate, Oz would use his legislative powers to loosen regulations of alternative medical providers and associated industries or otherwise treat these actors favorably. 

In the absence of clear regulatory solutions to the multifaceted problems presented by alternative medicine and the spread of misinformation and disinformation, Dr. Belardo stressed the role of self-regulation by doctors – and the importance of advocating for evidence-based medicine wherever possible.

She pointed to California State Sen. Richard Pan (D-6), a practicing pediatrician as “a wonderful example.” Dr. Pan wrote a bill, signed into law in 2019, that prohibits fake medical exemptions for vaccinations of minors. For this, he was targeted with smear campaigns and violence from anti-vaccine advocates. 

In an interview with the AMA, Dr. Pan said he urges physicians to tell “their patients that the COVID vaccine is safe and effective. It’s been thoroughly evaluated, administered to hundreds of millions of people.” And “If their patients have questions, they should encourage them to ask those questions and get accurate answers from either themselves or trusted sources, like the American Academy of Pediatrics or the Centers for Disease Control and Prevention.”

Dr. Belardo said other prominent figures in the medical community who have used their platforms to advocate for evidence-based science and medicine include Drs. Jennifer Gunter and Yoni Freedhoff. 

For laypeople, meanwhile, there are ways to filter out pseudoscience. Dr. Belardo said she advises her patients to find another provider if given a diagnosis or offered a treatment that contradicts with the scientific consensus of major medical organizations. These groups typically have resources and guidelines – unassailably reliable – that are written specifically for patients, she said.