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Jun 18, 2014 08:54 AM

Dr. Oz's Comeuppance

You mean, there's no magic, over-the-counter, weight loss pill? But, I sold my treadmill . . . .

Seriously, I can't be the only 'hound who found it nice to see hyperbolic hucksterism called out. Could we hope to see a future reduction in the passion of pop health pitches? Science before celebrity?


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  1. I saw Dr. Oz getting publicly flogged before the Senate on the news last night. It made me smile.

    Apparently his miracle green coffee bean magic pill was nothing more than snake oil and he knew it. The funny thing is that most of us knew it all along too.

    1 Reply
    1. re: jpc8015

      A pill is just a pill, and a shill is just a shill.

    2. Hi, MGZ:

      I'm NOT defending Oz or weight-loss hucksterism, but there is a scientific basis for the 3 claims attacked by Sen. McCaskill.

      Citizens need to be aware that there are many, many politicians who eagerly do Big Pharma's bidding. And one item near the top of Pharma's wish list is the strict regulation of nutritional supplements. Why? If they can prevent herbalists and health food stores from selling you naturally-derived (read not patentable) products, e.g., hibiscus tea for high blood pressure, they can sell far more of their patented drugs.

      Personally, I prefer some hucksterism of the kind exemplified by Oz to a Big Pharma monopoly on nutriceuticals.


      34 Replies
      1. re: kaleokahu

        Dr. Oz is a charlatan. There is no magic bullet for a healthy life.

        I, on the other hand, have developed a failsafe weight loss plan that is guaranteed to work or your money back. I will give it to you for free right now.

        Burn more calories than you consume.

        1. re: jpc8015

          Um, not exactly. Your body metabolizes sugar differently than other calories. A calorie is not a calorie (i.e. not all calories are treated the same by our liver).

          Conventional wisdom is sometimes incorrect, and the conventional wisdom that says all calories are equal is a myth that serves the aims of the processed food industry.

          1. re: Josh

            Dude, if I consume 2,000 calories each and every day for a year and I burn 2,500 calories each and every day for a year. I will lose weight. You can too or your money back.

            1. re: jpc8015

              That's true enough, but simplistic. It doesn't begin to get at the cause of the obesity epidemic and what to do about it.

              1. re: jpc8015

                Dude, the research into obesity, metabolic syndrome, and the way our livers metabolize sugars, specifically fructose, is clear. When the liver encounters fructose in sufficient quantity it tells the pancreas to produce insulin which triggers fat storage instead of burning of those calories.

                The "all calories are the same" myth is a pernicious one.

                I suggest looking into the work of Dr. Robert Lustig, who is a pediatric endocrinologist at UCSF. It's eye opening.

                1. re: Josh

                  The work of Lustig is very controversial in the scientific community (just google or better use pubmed). If your only argument against "a calorie is a calorie" is the work of Lustig than you should expand your reading to other scientific journals and studies. Even today the science is not clear about the "conversion" between different "types" of calories (fat vs carbo etc). Marion Nestle's book "Why calories count" is actually a good starting point with some references.

                  1. re: honkman

                    I'm looking on pubmed but having trouble finding what you're referring to. Do you have an example?

                    1. re: Josh

                      I am refering for example to papers about the complexity of (clinical) studies to measure the impact of calories from different sources and if all calories are equal. I will try to look up some later but you should really read the Nestle book, e.g. chapter 19 has the title "Are all calories created equal" (Short answer based on today's research yes)

                    2. re: honkman

                      I'm not saying everything is settled, but Dr. Lustig's take on the problem of controlling weight gain is the first out of countless weight-loss schemes over the past several decades that makes any sense to me as a scientifically trained person. Most weight-loss diets are just flim-flam, and Dr. Lustig at least has tried to establish a scientific basis and put his theory before his peers for review.

                      The experts can sort it all out but I'm not waiting. I'm well into my sixties and don't have time. I gained a lot of weight in my fifties and was technically obese. I don't want to go back there. I'm following Dr. Lustig by eliminating, as far as is practical, all added sugar (in whatever form) and I'm getting good results.

                      1. re: GH1618

                        Me too. His observations about obesity in infants seem pretty hard to refute.

                        1. re: GH1618

                          Nobody argues that cutting sugary drinks (and foods) out of the regular diet will help to lower weight but there is little scientific evidence that this is in any way the best or most effective way or if simply calorie counting and higher output than input is the best (and simplest) way

                          1. re: honkman

                            "Nobody argues that cutting sugary drinks (and foods) out of the regular diet will help to lower weight but there is little scientific evidence that this is in any way the best or most effective way"
                            I don't much feel like spending an hour digging up links to studies, but I do suggest you watch Dr Lustig's first big presentation on sugar and metabolism as a jumping off point, because he makes a fairly compelling case (despite employing a little rhetoric and maybe some hyperbole):

                            "...or if simply calorie counting and higher output than input is the best (and simplest) way"
                            There's no reason you can't do both. There's no known medical benefits of ingesting added sugars (for the sake of this post, we'll exempt the sugars found in whole fruits and vegetables) outside of a few specific situations (hypoglycemia, recovery from extreme workouts, etc).

                            The upside of cutting out, say, sugary drinks, candy, and dessert as opposed to cutting out, say, fat (as was popular in the last big diet trend) is that there is ample historical reason to believe that cutting out added sugars at least won't do you any harm.

                            1. re: cowboyardee

                              And of course you have to do both. You can't eliminate added sugars then pig out on other calories and expect to lose weight. Dr. Lustig's point is that eliminating the sugar makes it easier to reduce the total caloric intake.

                            2. re: honkman

                              I disagree that there is "little" scientific evidence. There may not be enough for scientific consebsus, but there's enough for me.

                            3. re: GH1618

                              It's been common scientific knowledge for over 100 years that not all calories are metabolically equal.

                              I forget which American polar explorers volunteered to replicate, in controlled conditions, the diet of all fat similar to seal blubber and pemmican. In hospital and bed-ridden, these guys ate nothing but butter--and thousands of calories of it every day--for an extended period of time, and they all lost weight.

                              Bodybuilders have known for decades how to manipulate their insulin responses by structuring the composition of their meals. Protein+Fat and Carbs+Protein meals (avoiding Fat+Carbs) is only the crudest method. Compounds such as HMB allow for simultaneously adding lean mass and burning body fat.
                              These things and more would be impossible if "a calorie is just a calorie".


                            4. re: honkman

                              It's not limited to Lustig; different macronutrients stimulate different hormonal changes post meal. Other hormones are different from person to person and even within the same person under different conditions. Marion Nestle is all wrong on calories. They count, but some are much more fattening than others.

                          2. re: jpc8015

                            Where it could theoretically make a difference is if the diet you have changes your metabolism and fat / muscle composition. Such that doing the same daily activities results in a different calorie burn. Then the idea that a calorie is just a calorie may not be true.

                            1. re: FattyDumplin

                              If it doesn't work for you then you get your money back.

                      2. re: kaleokahu

                        That's cool. I'm anti-bully pulpit abuse in all forms.

                        1. re: MGZ

                          FWIW, Oz irritates me a lot. Congress and the lobbyists who pay them irritate me a lot more.

                          1. re: kaleokahu

                            Don't get me started. I spent seven years at ground zero regarding healthcare reform and how significantly the big insurers influence the legislation passed/not passed. I was in the inner circle with big insurers. It's sickening and I'm glad I'm finally out.

                            Anyway, I think Oz tries but has been sucked up by the celebrity thing. As he said, he's trying to appeal to a broad range of folks.

                            1. re: breadchick

                              Sounds like we have similar experiences with Big Pharma. As a former PR professional in the healthcare/biotech/pharma industry
                              I have to laugh when people talk about the ACA as a socialist plot.

                              Oz long gave up his creds as a scientist or a physician. He is an entertainer and apparently up for sale to the highest bidder. Either that or he really doesn't understand science at all.

                              1. re: chicgail

                                Lol. I threw a potential marketing career out the window because I refused to accept interviews with the drug companies. I called them out on their sales practices in front of a room full of MBA's and they were still willing to give me an interview. I just couldn't do it. And that was a few years before I was diagnosed with a chronic illness that has left me permanently at their mercy. (Can you say $400/mo. for one prescription WITH insurance? I knew you could.)

                                1. re: rockycat

                                  There is a lot of variation from one insurance plan to another with respect to drug coverage. I think most will agree that there are great inequities in the way health care is distributed in the US. We are far behind many countries in this area. But the policies needed to fix it are socialistic, and Americans are wary of socialism, even in its mildest forms and even when applied to an area of such obvious need. It's an aspect of our culture that goes far beyond the pharmaceutical companies.

                                  1. re: GH1618

                                    Let's just leave it at the fact that I have no desire to get into anyone's definition of socialism or the relative merits of any healthcare plan on this board.

                                  1. re: chicgail

                                    He's still a reportedly highly skilled heart surgeon. The rest is crap.

                                    1. re: mcf

                                      If he is such a highly skilled heart surgeon, how come he has apparently chosen entertainment over medicine? When was the last time he actually practiced medicine, let alone operated on anyone? And why in the world ($$$) is he endorsing highly questionable nutritional supplements about which he knows very little.

                                      As a person with a long career in health care public relations, I have known plenty of physicians who were happy to sell out to the highest bidder and I have had clients who wanted me to buy the likes of Oz or Nancy Snyderman to endorse their services. It's why I don't do that any more.

                                      1. re: chicgail

                                        He's an actively practicing heart surgeon. I'm not defending him, he clearly craves the attention. But he's a very highly regarded heart surgeon.

                                        BTW, when I said the rest is crap, I meant his TV and nutrition stuff.

                                        1. re: chicgail

                                          Besides the money and fame perks perhaps he is securing a second career path for when he retires from cardiothoracic surgery. He was still doing surgery as recently as 5 years ago when he operated on a friend’s MIL. She was told she needed a heart transplant but refused to have the surgery unless Oz was her surgeon because he was the only one she trusted (she’s a little crazy like that). Calling in old favors, her son managed to get her an appointment with Oz who ultimately did her transplant.

                                          1. re: EM23

                                            It doesn't really matter what I think, but it appears that he should stick to thoracic surgery.

                                        2. re: mcf

                                          MplsM ary helpfully listed a link to an article in the New Yorker from last year that profiled Dr. Oz. I now know much more about "America's Doctor" than I did before, which was nothing.

                                          The most telling paragraph re: Dr. Oz's career as a heart surgeon follows, as the writer of the article interviews Dr. Eric Rose*:

                                          <I asked if he would place his confidence in a heart surgeon, no matter how gifted, who operated just once a week, as Oz does. “Well,” he replied, “in general you want a surgeon who lives and breathes his job, somebody who is above all devoted to that.” Again he mentioned Oz’s experience, but when I asked if he would send a patient to Oz for an operation, he looked uncomfortable. “No,” he said. “I wouldn’t. In many respects, Mehmet is now an entertainer. And he’s great at it. People learn a lot, and it can be meaningful in their lives. But that is a different job. In medicine, your baseline need has to be for a level of evidence that can lead to your conclusions. I don’t know how else you do it. Sometimes Mehmet will entertain wacky ideas—particularly if they are wacky and have entertainment value.”>

                                          *< In 1984, Rose made history when he performed the first successful pediatric heart transplant. He hired Oz in 1986 and then, several years later, when he served as chairman of the surgical department at New York-Presbyterian, assigned him to his transplant team.>

                                          If someone is going to hold my life, literally, in his hands, I want that person to be dedicated to medicine and surgery, to have done the operation hundreds, even thousands of times. I want him current, well-practiced, and sure. A part-time surgeon isn't what I need...or want.

                                          1. re: mcsheridan

                                            I have no way of evaluating Oz's credentials nor his skill. I'd say he has enough procedures under his belt at this time in his career for that not to be an issue. But focus, yeah, that could be a problem or it could be no problem.

                                            A lot of those extremely full time surgeons mess up, or have no interest in their patients as people, nor empathy.

                                            There are always tradeoffs. I have not heard of issues among Oz's patients. I don't really care, either. He's too cute by half for me, period.

                                      2. re: breadchick

                                        If you look at the clips for those episodes of his show, he was a shameless carnival barker for those products. Not "flowery" language as he tried to paint it, but pure flim flam come ons.

                                2. Dr. Oz is a smart guy, and it takes a certain amount of courage for him to discuss some of the less-than-mainstream medicine he often talks about on his show, but the incessant focus on weight loss and the hyperbolic pitching you mention just ruin everything.

                                  He's clearly been coached to present himself as a sunny rah-rah personality when he's not, and to make things suuuuuuper simmmmmple for the TV audience, but he dumbs things down so much they get distorted.

                                  On the other hand, I think it's typically hypocritical that Congress is taking up arms against some guy talking about natural remedies that have been used for centuries, when they let big pharmaceutical companies hawk dangerous, faultily-tested drugs designed for far more serious medical conditions all day long.

                                  5 Replies
                                  1. re: ninrn

                                    See, I think he is that shallow and his recommendations are not well researched and do not withstand scrutiny. He is dumbed down on nutrition and supplement topics.

                                    I think he should stick to surgery, but not enough publicity for him.

                                    1. re: ninrn

                                      It's not that he's pitching "natural remedies" it's that he's making claims that he admitted to Congress he doesn't believe. I don't care what it is you're pitching, if you don't believe the claims you're making, you're just a con artist.

                                      1. re: Ruth Lafler

                                        He tried to say he had to be "flowery" (more like sensational and enthused) to drum up audience response.

                                        Because his having a show is more important than personal integrity. I mean, if that's what you feel you have to do to have a show, maybe you should turn your focus to something else?

                                        1. re: mcf

                                          Yeah, I saw that. He should tell his viewers that: don't believe what I'm saying, I'm just using "flowery language" to keep your attention. :-)

                                        2. re: Ruth Lafler

                                          I just watched 16 minutes of John Oliver (Last Week Tonight) skewering and verbally pantsing Dr. Oz, Congress (both parties), lobbyists, the FDA, and a few other entities. Absolutely brilliant! Plus it has a tap dancing Steve Buscemi and a puppy. ;-)


                                      2. i ddint' see this anywhere, but has he been paid or compensated in any way for these endorsements? i've personally never liked oz, nor oprah or any of her sycophants, for that matter.

                                        3 Replies
                                        1. re: FattyDumplin

                                          I don't believe Oz has endorsed, nor has he been compensated, particularly in association with this green coffee elixir.

                                          1. re: monavano

                                            watching his show is all the endorsement he will even need.

                                          2. re: FattyDumplin

                                            Anyone who continues to listen to or believe Dr. Oz's hyperbolic deserves being conned and no Congressional hearing will help. And I'm with you on Oprah and her self-promotion of how great she is.

                                          3. Any pushback against quackery is good, but this seems like a rare and rather modest effort. Anti-science attitudes are widespread in the US and I don't see the things changing much anytime soon. The fight against ignorance is never-ending.

                                            56 Replies
                                            1. re: GH1618

                                              Is there a fight against the ignorance of American doctors regarding diet and vitamin and herbal therapies?

                                              1. re: sandylc

                                                I think it's called cash. Folks willing to pay cash can find doctors with all manner of enlightenment.

                                                I think folks who want to use their leveraged medical benefits get just that.

                                                I could be wrong.

                                                1. re: Shrinkrap

                                                  Not so. Been doing it for years. Still a very tough slog.

                                                  1. re: mcf

                                                    Me too. 30 years in last month.Husband too, and many of my freinds and coworkers. And in a variety of settings.

                                                    In my private practice, I have to think about who is my customer. When the check comes from an insurance company, in addition to providing my best of the standard of care, I also have to keep in mind what that insurer wants to see documented for a billing code. I could and do do more, when time allows. When the patient is the only customer, aside from the standard of care, I only have her to answer to. If she wants time to talk about the pros and cons of other things, and doesn't need me to factor in "networks", formularies, priot auths, and uncovered benefits, I'm all in.

                                                    Don't even get me started with the staff model HMO, or County Health services.

                                                    Not true for you? Maybe we should"talk" on Medscape.

                                                    1. re: Shrinkrap

                                                      I don't disagree with your points in terms of the benefits of practice for both practitioner and patient outside the insurance strait jacket.

                                                      I disagree that there are doctors of all manner of enlightenment to be had for the most part. And I'm not joking.

                                                      Enlightenment is in Very Short Supply, IME. Even at tens of thousands unreimbursed, out of pocket.

                                                      1. re: mcf

                                                        And perhaps in short demand! I think it will increase, and does incresse where the market will bear.

                                                        But we may not all agree on what enlightenment is.

                                                        1. re: Shrinkrap

                                                          To me, enlightenment is when the medical establishment does an about face and begins to view their work as that of assisting people in becoming healthy, rather than as having a symptom-squashing, single-symptom, quick-fix without regard to consequences, let's just cut it or drug it and move 'em on out attitude.

                                                          Enlightenment comes when power is removed from pharmaceutical and insurance and processed food companies.

                                                          Enlightenment comes when it is generally understood that we truly are what we eat.

                                                          EDIT: Oh, and more stuff, too, ha. That's just off the top of my head.

                                                          1. re: sandylc

                                                            I agree Sandy, sort of. Might we have to tend to the sick, with pre existing conditions first?

                                                            Enlightenment is not just about what the best of us want, but also about what the least of us "need".

                                                            Yes; bla, bla, bla about who is at fault.

                                                            Or maybe it's about the world cup! See ya!

                                                          2. re: Shrinkrap

                                                            I'd start with knowledge enough to do no harm and accountability for one's practices. And doing due due diligence, not practicing from a consensus guideline cookbook.

                                                            Really basic stuff. And many of the worst have been dept chiefs in prestigious academic practices, IME..

                                                            1. re: mcf

                                                              Uh oh.....1-0

                                                              But I was responding to a post that said " Is there a fight against the ignorance of American doctors regarding diet and vitamin and herbal therapies?"

                                                              Not sure thats a "do no harm/accountability" issue.

                                                              Back to the game!

                                                              1. re: Shrinkrap

                                                                It does, say, when they tell diabetics to eat a diet of mostly starchy carbs, for example. Not supported by clinical outcomes nor unbiased research. Causes amputations, kidney failure, and vision loss, for starters. Serious harm.

                                                                1. re: mcf

                                                                  " when they tell diabetics to eat a diet of mostly starchy carbs,"

                                                                  I have read that here before, but never anywhere in real life. And never on a medical forum. I wonder if it could be a regional thing.

                                                                  1. re: Shrinkrap

                                                                    More likely, it is just not representative, perhaps only based on the experience of a few people. Medical doctors, like all professionals, keep up with the developments in their field. To belittle the profession as a class because of one's own experience is just a cheap shot.

                                                                    When one's primary care physician cannot treat an illness effectively (according to the standard of care), then either a specialist or a new PCP may be necessary. When treatment of one's illness demands a special diet, there are other resources, for example the American Diabetic Association.

                                                                    1. re: GH1618

                                                                      The American Diabetic Association’s recommendations for “best choices” for a diabetic include whole grain breads, oatmeal, potatoes, brown rice, etc.


                                                                      1. re: EM23

                                                                        I didn't get a chance to read the whole thing (patients waiting!), but on that page it says

                                                                        "One thing is for sure.....IF...... you are going to eat grain foods, pick the ones that are the most nutritious. Choose whole grains. Whole grains are rich in vitamins, minerals, phytochemicals and fiber. .

                                                                        You left out the IF, and the part leading up to it. Like this page where they specifically mention NON starchy vegetables.


                                                                        And here is their link to "Standards of Care', that mentions glucose monitoring.


                                                                        I didn't see the part where the "diabetes educators tell diabetics not to test at one hour post meal" and "wait til two hours, when the glucose has cleared", but I did not read it all.

                                                                        Okay, this time I'm done for real!

                                                                        1. re: Shrinkrap

                                                                          That’s why I included the link to the article, and while I get your point about “if”, most folks scan through articles on the web and that article has a list of foods that includes spuds and bread labelled as “best choices” for a diabetic diet.
                                                                          My mom was a diabetic and when she was released from a stay at the hospital she was visited by a nutritionist who advised a diet with whole grains and specifically suggested oatmeal and whole wheat bread as breakfast choices.

                                                                          1. re: Shrinkrap

                                                                            Obviously, one of us has had a great deal of information from many years of managing and researching diabetes and the implementation of clinical guidelines and the other is googling for argument's sake.

                                                                            My information comes from 16 years of scouring the literature, following the organizations scandalous ties to industry and recommendations to include sugar in diabetic diets because it does no more harm than grains. Big time sugar industry sponsorships and lobbying and all.

                                                                            One of us has been communicating with literally hundreds of diabetics in person and onine for many years and has reversed diabetic damage to kidneys and nerve function for over a decade by doing the direct opposite of what the consensus guidelines recommend.

                                                                          2. re: EM23

                                                                            Then that would be an appropriate place to take the discussion, or to start a new thread in the "Special Diets" forum here. The "comeuppance" of Dr. Oz had to do with his weight-loss advice, not his advice to diabetics, as I understand it.

                                                                            1. re: GH1618

                                                                              When I listened to a bit of the hearing I believe he said something regarding new information about food recommendations for diabetics informing his advice going forward, but I have yet to find this after searching for a transcript of the hearing. I will continue to search...

                                                                        2. re: Shrinkrap

                                                                          Every diabetic I know has been given that advice. It's in the dietary guidelines of the ADA (45 gms of carbs per meal), the AACE and Joslin diabetes center and the dietetics assn.

                                                                          I guess all the hundreds of diabetics I've communicated about this with over almost two decades, my mother, other relatives and I are a pretty good sample You know what they bring to diabetics in the hospital for breakfast? Waffles, juice, cereal, muffins... It's not regional, it's international.

                                                                          Not only that, diabetes educators tell diabetics not to test at one hour post meal, which is when glucose peaks, they tell them to wait til two hours, when the glucose has cleared, so they never know how badly the meals their told to eat are harming them.

                                                                          1. re: mcf


                                                                            No way have I communicated with hundreds of diabetics. Dozens of POTENTIAL diabetics though, as I prescribe meds that "cause" it.

                                                                            I am going to check with the FP's, peds and endocrinologists over on medscape though. I've never heard anything like that!

                                                                            May I quote you?

                                                                            1. re: Shrinkrap

                                                                              I suggest you ask diabetics, or read forum archives on diabetes groups. Read this thread, it's exactly what's happening in hospitals and health care facilities and offices due to lobbying by grain, sugar and drug companies:

                                                                              Include this in your assessment:


                                                                              The last link is the site with a lot of free info, of an engineer and long term type 1 diabetic who didn't do well following medical advice for management until he researched on his own, and took the kind of approach one might expect from an engineer. His wife was a doctor. He later went to med school to learn more and to be more empowered, and became a FP, who was named to the scientific advisory committee of the AACE years back.

                                                                              1. re: mcf

                                                                                Thanks - there is a lot of good reading there.

                                                                                My mother and sister - both diabetic. I test myself using their meters periodically and it's always fine - ???

                                                                                1. re: sandylc

                                                                                  The most important information is before your first bite of a meal, and 45-70 minutes later. Then 2 hours after first bite. Then the second hour post meal.

                                                                                  If you're hyperinsulinemic, you could be acquiring damage from high insulin levels that are keeping your glucose normal.

                                                        2. re: sandylc

                                                          I don't see why anyone would fight against doctors over such things. Medical doctors are ignorant of herbal "therapies" because such things are not medicine. They are aware of vitamin deficiencies and can test for them. They understand the importance of a good diet, but they are not dieticians. It is not their job, for the most part, to give much time to dietary advice. There are exceptions, of course. For example Dr. Lustig treats pediatric obesity, which is largely a dietary problem. My General Practitioner, however, doesn't tell me what to eat or not eat and I don't want him to.

                                                          1. re: GH1618

                                                            "Medical doctors are ignorant of herbal "therapies" because such things are not medicine"

                                                            Wow. How old is modern "medicine"? Compared to herbal medicine?

                                                            You CANNOT separate diet and health from illness without paying dearly. You have illustrated here one part of what is wrong with "modern medicine" - the total disregard of what it takes to produce HEALTH.

                                                            Ugh. Arrogant ignorance is one of my least favorite things.

                                                            1. re: sandylc

                                                              Oh, come on; not TOTAL. Many health I surance companies help with wellness initiatives, and some cover alternative therapies. So eti es better tha tney cover mental health a d drug an alcohol treatment.

                                                              It's funny, but I often watch cooking shows, or read forums like this one, and end up thinking about health and medicine. Then something wakens me from my rhapsody and I remember "good" food is not a covered benefit.

                                                              1. re: Shrinkrap

                                                                That was supposed to say.....

                                                                "Sometimes better than they cover mental health and drug and alcohol treatment."

                                                            2. re: GH1618

                                                              Physicians communicating to the public what the effects of eating certain foods are isn't being told what or what not to eat. Your comment reminds me of what the beverage association says when arguing against soda bans.

                                                              1. re: Josh

                                                                That's a laugh. I think the beverage industry is peddling poison in sugar-sweetened sodas.

                                                                1. re: GH1618

                                                                  Of course, but the point is that we live in a country where PR is used to muddy issues.

                                                                  1. re: Josh

                                                                    We live in a country where drug industry CME (credits for continuing medical education) is the norm. Miuch more pernicious than garden variety PR.

                                                                    1. re: mcf

                                                                      Drug companies no longer create CME. They give unrestricted grants to certified medical organizations who produce CME. Drug companies still have promotional educational programs but no longer drive CME.

                                                                      1. re: cwdonald

                                                                        Please. Seriously. They pay for them and they get what they pay for.

                                                                        1. re: mcf

                                                                          Having worked in the industry I can tell you that there is a huge difference in the nature of the product that was produced 10 years ago and now. Writing a check to a medical school, versus ghost writing a whole program produces a very different product. The overall net effect is that pharma is spending a lot less in the CME field now. The Sunshine laws have had an effect.

                                                                          1. re: cwdonald

                                                                            They are very creative in getting around it. It was less than ten years ago that Harvard med students protested against the quality of their education... all about using new drugs and tech, not patient care. And only last year a Harvard researcher stated: "drug companies own medicine."





                                                                            1. re: mcf

                                                                              A lot of smoke about nothing. The overblown case of the photography in Cambridge. The startling fact that the smartest people who wirte practice guidelines also consult with the Pharmaceutical Industry (would you prefer that it is physicians for Insurance companies who have the incentive to minimize all treatment?).

                                                                              Biotech and Pharma may drive some innovation, but today the greater influences on physician pharmaceutical choices are from insurance companies, and formularies, rather than directly from Pharmaceutical companies.

                                                                              1. re: cwdonald

                                                                                I think the photos are the least of it, but if not used for potential reprisals or intimidation, I can't understand why Pfizer, rather than journalists, were taking them.

                                                                                The smoke clogging the health care systme is blowing is chugging out of the drug industry.

                                                                                A lot of doctors have no experience with the drugs they're being paid to "teach" other doctors about. Drug reps just hand them a script and pay them to show up.

                                                                                1. re: cwdonald

                                                                                  True. Insurance companies are the dominant player. They can limit what treatments a patient can receive, and also act as a restraint, to some extent, on drug prices. It's a clash of the titans between insurance companies, pharmaceutical companies, and hospital groups.

                                                                                  1. re: GH1618

                                                                                    And where is the patient in all of this?

                                                                                    Disregarded; a necessary annoyance.

                                                                                    1. re: sandylc

                                                                                      The patient is the receptacle into which all those drugs are dumped.

                                                                                      1. re: mcf

                                                                                        I don't know what that is supposed to mean. I have never had a physician prescribe anything which he or she did not believe was medically necessary. And, ultimately, an adult patient has the right to refuse any medication.

                                                                                        1. re: mcf

                                                                                          Hi, mcf: "The patient is the receptacle into which all those drugs are dumped."

                                                                                          Right. But you forgot: "...and forced payors to Big Pharma via Big Insurance" and "bankruptcy court fodder".


                                                                                        2. re: sandylc

                                                                                          That's an exaggeration. My experience (which is considerable in recent years) is that those who provide medical services directly to patients sincerely try to provide the best care they are able to, given the constraints under which they operate. The problems in delivery of medical services are systemic — there is no one part of the system which should be made the scapegoat.

                                                                                          1. re: GH1618

                                                                                            Here we agree (well, except for the exaggeration part).

                                                                                            I do believe that most medical providers do the best that they can under terrible constraints. The system is VERY broken and allows them little opportunity to truly help people.

                                                                                            I had a conversation recently with a neurologist about how now is a miserable time to be a doctor.

                                                                                            1. re: sandylc

                                                                                              I hear it's also a miserable time to be a lawyer, a farmer, a high school student, and a recent grad. Or on Spain's World cup Team!

                                                                                              I remember my grandmother having both arms and both legs amputated dues to DM, although my sister says that's not exactly true. When I was a child kids with DM didn't grow up, have babies, and raise them, but my bff did. I'm seeing kids who weighed less than two pounds when they were born 15 years ago; they wouldn't have made it 20 years ago. When I was in medical school we suited up like we were going to Mars, and in medical school there were wards FULL of abandoned babies with AIDS. I remember giving Factor VIII to kids in 1983, and seeing the same kids for HIV a few years later. One was a medical student. Last year I read about a child CURED of AIDS!

                                                                                              I think things are changing, but some of it is for the better. A lot of stuff is being done by someone other than doctors right now. I think that is the only way this can work.


                                                                                              "The multidisciplinary foot team consisted of a diabetologist, a vascular surgeon, a specialist in infectious diseases, a chiropodist and an orthopaedic surgeon, who all were educated in the consensus guidelines for foot care. At the multidisciplinary foot clinic, patients were treated for hyperglycemia, hypertension and hyperlipidemia, and were given the opportunity to attend programs to quit smoking. Vascular surgeons performed percutaneous transluminal angioplasty or bypass surgery and, when necessary, a specialist in infectious diseases decided the antibiotic treatment, whereas orthopaedic surgeons decided on surgical revision and/or off-loading treatment. Diabetologists were responsible for metabolic control and, when necessary, the treatment of heart failure and kidney failure."

                                                                                              1. re: Shrinkrap

                                                                                                Sure, not everything is bad an there are great things happening, but how much of this is trickling down to the army of GPs who see too many patients daily and might as well be living on Mars when it comes to new methods or nutritional education and actually being able to spend enough time with each patient?

                                                                                                1. re: sandylc

                                                                                                  I don't know what you mean by "new methods of nutritional education," but a lot of new "methods" pertaining to food are not medicine and therefore not something a medical doctor need spend much time on.

                                                                                                  There is no shortage of people willing to promote the latest food fads. Leave the medical doctors out of it — they have more important business to attend to.

                                                                                                  1. re: GH1618

                                                                                                    New methods OR nutritional education. If you're going to argue it, at least get it right.

                                                                                                  2. re: sandylc

                                                                                                    "Might as well be living on Mars"? Seriously?

                                                                                                    I am not sure what you mean by "GP", but most primary care docs are Pediatricians, OBGyn's, and FP's, and if my husband is any example, it's "enough". He has hoop after hoop top jump through to prove he is up to date, and it includes a broad range of subjects.

                                                                                                    I would agree that there must be limits when a resource is in short supply, and that includes time with primary care doctors. In my experience the patients who want/need more than an average amount of time ( 15 minutes or so) are assigned to physician "extenders". NP's and PA's probably average 20-30 minutes, or so our mutual patients tell me.

                                                                                                    And then there is this;

                                                                                                    "Sutter Weight Management Institute"

                                                                                                    Keep in mind this is a " covered medical benefit", as opposed to a personal choice about what and where to eat.

                                                                                                    Did you have something in mind?

                                                                                                    1. re: Shrinkrap

                                                                                                      "GP" means General Practitioner. The term of choice these days seems to be Primary Care Physician (PCP).

                                                                                                      1. re: GH1618

                                                                                                        Hmmmm.....GP used to be an insult to FP's. From back in the days when you didn't have to be board certified to practice. To get and stay board certified in FP means a whole lot has had to "trickle down".

                                                                                                        BTW, PCP can mean primary care PROVIDER, which may not be a physician at all.

                                                                                                        Anyway, this is no longer about Dr. Oz, so I'm going to give it a rest.

                                                                                              2. re: GH1618

                                                                                                Well, yeah, the whole system sucks. And only patients who do their due diligence and other practitioners know how bad it is.

                                                                                    2. re: mcf

                                                                                      Nevermind. This is for a different venue.

                                                                      2. re: GH1618

                                                                        Too bad you can't recommend more than once