The COVID-19 pandemic has been a fantastic opportunity for charlatans of all shapes and sizes to show off their whole ass on national TV. One variety of quack that has had a particularly tough time are TV doctors, of which Dr. Phil, Dr. Oz, and Dr. Drew are the most famous examples. There are plenty of people saying stupid stuff about COVID-19, but it is particularly shocking to see it come from “experts”. I mean, they’re “doctors” right? Shouldn’t they hold themselves to a higher standard?
These folks have made a spectacle of their ignorance in the last couple of weeks, but if you look into their pasts, you will see that their public disgrace has been a long time coming. TV doctors are questionable for many reasons, but they can be grouped around three main themes. First is giving health advice that is inadequate, insufficient, or beyond the scope of their expertise. Oz, Phil, and Drew are guilty of this in the Coronavirus crisis, but it is also a long-running pattern of behavior. There have been plenty of research papers, statements, and articles written by respected health experts examining the ways TV doctors are not meeting standards of professionalism.
The second pattern you see is the ethics issues. TV doctors have a way of stumbling into lawsuits, or making comments that violate ethical standards. Whether it is shady business dealings, discussing patients in an indiscrete manner, or recklessly pushing medication and treatments, these guys have a hard time playing by the rules.
Finally, there is a broader truth that TV doctors are by definition not involved in much day-to-day clinical practice. TV doctors are “selected” for their skill as media personalities, and spend more time in a production studio than a hospital or clinic. For the TV doctors mentioned here they have decades of experience working in the media, meaning they are almost entirely removed from their field of practice.
It is hard to pick where to start, as all three of these guys have seriously iffy pasts, but it seems best to start with the TV doctor that is not actually a doctor.
Philip McGraw got into hot water over his comments on Laura Ingraham on April 16th. Here is the clip of his appearance.
The longer this lockdown goes on the more vulnerable people get. It’s like there is a tipping point. There is a point at which people start having enough problems in lockdown that it will actually create more destruction and actually more death across time then the actual virus will itself. 250 people a year die from poverty and the poverty line is getting such that more and more people are going to fall below that because the economy is crashing around us. And they’re doing that because people are dying from the coronavirus. I get that. But, look, the fact of the matter is we have people dying… 45,000 people a year die from automobile accidents, 480,000 die from cigarettes, 360,000 a year from swimming pools but we don’t shut the country down for that. But yet we are doing it for this? And the fall out is going to last of years because people’s lives are being destroyed.
There are several inaccuracies here. Dr. Phil says that “360,000 [people] a year [die] from swimming pools” (it is about 1% of that) and implies that the poverty line is moving (it is not — the number of people under the poverty line is changing). This entire rant is also a version of the right-wing “cure can’t be worse than the disease” talking point, which has been addressed by many commentators. Technically, he is right that there is reason to be worried about the mental health impact of an extended lockdown and economic freeze, but that is an unfortunate reality of dealing with a global pandemic.
Phil McGraw is not a medical doctor. He has a doctorate in clinical psychology, but many people misunderstand the difference between a PhD and an MD. Not only that, he has not been a practicing psychologist for almost 15 years. He surrendered his license back in 2006 — yet he continues to provide quasi-psychiatric advice on his show.
This has been a part of long-running history of questionable ethics. In the 80’s he got in trouble for unprofessional relationships with patients. In 2003 he was sued for selling ineffective weight loss shakes, leading to a $10.5 M settlement. In 2005 he and his son were sued for damages to a house that was renovated as part of a spin-off show. In 2006 he was accused of airing an interview that was deceptively edited in relation to the Natalee Holloway disappearance. In 2008 he attempted to stage an intervention for Britney Spears as part of his show, and made comments to Entertainment Tonight that violated the Spears family’s trust. In 2016 he was criticized for acting as a spokesperson for a diabetes drug manufacturer despite not being a medical doctor. In 2017 he and his staff were accused of allowing guests with substance abuse problems to have access to drugs and alcohol.
And so on.
Experts have also been critical of the content of Dr. Phil’s show for years. The National Alliance of the Mentally Ill issued a statement in 2004 saying that Dr. Phil was “insensitive, irresponsible, may put children’s lives at risk”. A 2014 study critiqued the portrayal of eating disorders on Dr. Phil. Another 2014 study said that shows like Dr. Phil “reproduces and affirms rather than diminishes the stigma associated with nonvisible disabilities…”
It is honestly remarkable that Dr. Phil is still allowed to be on the air at all. It is even more surprising that Laura Ingraham is soliciting his opinion on public health and economics — subjects that he has no expertise.
Dr. Mehmet Oz appeared on Sean Hannity on April 14th, and offered a modest proposal:
I tell you, schools are a very appetizing opportunity. I just saw a nice piece in the Lancet arguing that the opening of schools may only cost us 2–3 percent in terms of total mortality.
Many took Oz as saying that that 2–3% of children would die, which would be a massive loss of life. It is more likely that he meant a 2–3% increase in mortality, that is to say that school closures prevent only 2–3% of the deaths that would be seen without school closures. This would be in line with what the Lancet article actually claims (they actually say 2–4%, but whatever). It should be said that the Lancet article did not use data from the COVID-19 pandemic, and the authors themselves note that the need for better numbers. Dr. Oz has also been criticized for pushing hydroxychloroquine as a treatment for Coronavirus, despite the lacklustre clinical results.
Dr. Oz is a medical doctor — unlike Dr. Phil — but he does not have experience relevant to the COVID-19 pandemic. He was trained as a heart surgeon, though it appears that he has been more focused on his TV career over the last 20 years.
During his time on TV, Dr. Oz has become associated with pseudoscientific treatments like homeopathy, Reiki, and aromatherapy. He also has a long history of talking up an endless rotation of weight loss solutions, such as açai berries, raspberry ketone, and many others.
One particularly thorny controversy arose from Dr. Oz’s support of green coffee extract antioxidant (GCA) as a weight loss supplement. One study showed that GCA was effective for helping weight loss, creating a lot of attention in the weight loss industry. Dr. Oz gave a full-throated endorsement of GCA on his show. That GCA study was later retracted on the grounds that the authors manipulated the data. For those not aware, retracting a research paper is very rare, and is typically only done when there is substantial evidence of malpractice. Despite that, Dr. Oz continued to support GCA, and even staged an unscientific study as part of his show to back up these bogus claims! Dr. Oz was even brought to the US Senate to testify about this scandal.
Dr. Oz’s program has long been a bizarre mix of health advice, talk show, and infomercial. This is a particularly problematic mix given Oz’s affinity for alternative medicine, and his disrespect for scientific authorities. One study of his program evaluated 80 health claims made over 40 episodes, and found that only 46% agreed with the literature, and 15% actually contradicted the research. There have been several high-profile articles exposing his problematic past, such as pieces in the New Yorker, Vox, and Popular Science.
Perhaps the wildest element of Dr. Oz’s story is his sincere belief in unconventional treatments. Collogues have said that he was interested in alternative medicine long before he was a TV personality. He has probably played an important role in mainstreaming alternative medicine for the last 20 years, using his reputation as a clinician to push fads and snake oils. It is ironic that Dr. Oz got in trouble for comments that were more-or-less in line with the best available research, when he has spent his career peddling pseudoscience.
Dr. Drew’s comments were ahead of the curve. He was making stupid COVID-19 takes back in early March.
The entire problem we are having is due to panic, not the virus. I was saying this six weeks ago. We have six deaths from the coronavirus. 18,000 deaths from the flu! Why isn’t the message “get your flu vaccine”? It’s milder than we thought. The fatality rate is going to drop as we identify more cases. The entirety of problem now is that people are being pushed into bankruptcy, travel is down, the supply chain is being interrupted. Because of panic. Not because of the virus. The flu virus in this country is vastly more consequential and nobody is talking about it… It is a press induced panic that will have real consequences. It will not be the virus.
For the record, the US averages about 50,000 flu deaths per year, or 140 deaths per day. At the time of writing this, there has already been over 40,000 US COVID deaths this year, and there is an average of about 2,000 deaths per day over the last two weeks despite social distancing. It seems like Dr. Drew was off a smidge.
Dr. Drew Pinsky got his start as a radio call-in show Loveline back when he was in medical school in the 80's. This eventually become a television show of the same name, which he hosted until 2016. He has been involved in a long list of projects focused on sex, drugs, and addiction, including Strictly Sex with Dr. Drew, Strictly Dr. Drew, Celebrity Rehab with Dr. Drew, Sober House, and Sex Rehab with Dr. Drew.
Dr. Drew does actually have training as an addiction specialist, though that doesn’t mean he has always followed best practices. Celebrity Rehab was an absolute disaster, with five participants dying while they were part of the show, and a sixth — the WWE wrestler Joan ‘Chyna’ Laurer — dying shortly after appearing. Researchers investigating shows like Celebrity Rehab have said they “reinforce… the stigma of addiction” by leaning into the spectacle of addicts, which is contrasted with the control and authority of the clinicians.
Beyond the Celebrity Rehab controversies, Dr. Drew was also accused of pushing medication without disclosing that he was a paid spokesperson. In 2012 he was outted for accepting money from a GSK for promoting the “libido boosting” effects of the anti-depressant Wellbutrin, and did not warn viewers about his conflict of interest when talking about the medication. It appears this relationship went as far back as 1999.
Dr. Drew also has a habit of diagnosing at a distance, particularly celebrities. It is considered extremely unethical for medical professionals to offer any medical evaluation of a public figure they have not examined themselves. This practice is so frowned up that the American Psychology Association codified it in the Goldwater rule. This practice is what ultimately played an important role in Dr. Drew’s shows being cancelled, after he commented on Hillary Clinton’s health on Sean Hannity’s radio talk show during the 2016 election.
Since 2016 he has transitioned away from being a TV doctor to become a right wing media personality, running a circuit of podcast interviews, appearances on Fox, and advice talk shows. He often comments on subjects for which he has no expertise, such as homelessness or forest fires. His predictions about coronavirus are in-line with that shtick. It seems Drew is largely out of the business of giving medical advice at this point, and many hope his COVID-19 gaffes will keep it that way.
What is fascinating the last few weeks is not that these TV doctors stepped outside the lines — they do that all the time — but that they become the target of real outrage and backlash. Guys like Dr. Phil, Dr. Oz, and Dr. Drew have been firing from the hip for decades, and they are usually able to manage their loose relationship with ethics and science. The age of COVID is different. It is not enough to be telegenic and charismatic — people are actually going to fact-check you in real time, and hold you to account. While the reckoning for these quacks is long overdue, at least it is finally happening.