NANA HAVA and the PROBLEM with TELEVISION DOCTORS by Alicair Peltonen CAPSTONE SELECTION 1 April 28, 2017

NANA HAVA AND THE PROBLEM WITH TELEVISION DOCTORS By Alicair Peltonen CAPSTONE SELECTION 1 April 28, 2017 The footage is shocking and a little nauseating. An 80-year old Bosnian grandmother, nicknamed “Nana Hava,” claims she can remove foreign objects from eyes and even cure some vision problems in an unconventional way. She places her bony fingers on the face of a younger man and leans her leopard print babushka- covered head towards his eye. Then, she gently lifts up his eyelid and begins to lick his eyeball. A studio audience groans with disgust and even Dr. Travis Stork and Dr. Andrew Ordon, hosts of the CBS medical panel discussion show ““The Doctors”,” seem grossed out. But now they must put on their doctor’s hats and inform their viewers of the dangers inherent in licking another person’s eyeball. They joke. Ordon pretends to lick Stork’s eyes. Ordon says he’d just use water and that he worries about the spread of diseases like herpes conjunctivitis and then Stork ends the short segment with his two cents. “I wouldn’t try this at home, but whatever floats your boat,” he says. Obviously, licking eyeballs is not sound medical advice for removing anything from your eyes. Stork and Ordon have medical degrees (from University of Virginia and University of Southern California, respectively) and best practices suggest, if water doesn’t work, consult an ophthalmologist, or at the very least, a primary care physician. Legally viewers are not considered patients and therefore Stork, Ordon, Dr. Mehmet Oz, and any other television personalities doling out medical advice are safe from malpractice suits. But as of now, there are no codified guidelines for making medical recommendations on television. And the medical community hasn’t been in a hurry to specify which recommendations are scientifically sound and which are hooey. The American Medical Association (AMA,) however, may chime in soon. ****** Tom Linden, former psychiatrist and current medical journalism professor at the University of North Carolina, doesn’t take medical talk show physicians seriously. “[Oz] is not a medical journalist, he’s a TV entertainer/personality,” said Linden about Oz in a recent phone interview. “Stephen Colbert is closer to a journalist than Dr. Oz.” Linden was a practicing psychiatrist in California in the 1980s when he began popping up on television as a medical reporter for NBC news. He quickly learned that seeing patients and practicing journalism were too time-consuming to be done at the same time. “Both jobs require a lot of time and attention,” he said. “I realized if I did half-time on both I’d probably be a poor journalist and a poor doctor.” Linden chose journalism and left his private practice for correspondent gigs at CNBC, the Financial News Network, and major network affiliates around California before settling in as a medical journalism professor. Despite his career in front of a camera, his disdain for practicing physicians who seek fame is evident. “If you’re a doctor and you’re interested in being on TV, well that’s well and good,” he said. “But you’re not going to be a journalist. You’re going to be a personality.” When it comes to quality medical reporting, correspondents on broadcast and cable network news programs are hounded by a watchdog website called Health News Review. Created and maintained by Gary Schwitzer, a former head of CNN’s medical news unit, the website seeks to give health care consumers and journalists the tools to discern the good from the bad in medical reporting. They do not review recommendations made on either “The Doctors” or “Dr. Oz”. More watchdog websites with specific niches could add to the public’s awareness of scientific criteria and point them to the questions they should ask when a cure-all sounds too good to be true. “We are one of a kind in this country,” Schwitzer said, “and we shouldn’t be.” Official medical guidelines won’t get the job done in pressuring TV doctors, according to Schwitzer. That type of oversight could only come from the National Association of Broadcasters. “There is no one lobbying the NAB to impose guidelines or ethics on the Ozes of the world,” he said. In broadcast television, ratings are the financial driver of everything. “Their job is to get viewers,” said Dr. Darshak Sanghavi, Chief of Pediatric Cardiology at University of Massachusetts Medical School and fellow at the Brookings Institution. In a phone interview, Sanghavi explained that he doesn’t worry about the health impact of daytime medical talk shows because the topics are complicated, but not dire. These shows mostly cover the greatest hit list of what the medical community refers to as the “worried well,” or healthy people who seek medical advice for emotional reassurance. “Weight loss, happiness, depression, sexual health,” Sanghavi said. “There’s not a huge amount of critical medical evidence that is competing in that space, in my opinion.” That doesn’t mean the audience for these shows won’t hear bum info about acute physiological diseases. A segment on “Dr. Oz” last year recommended immature broccoli sprouts, sprouted lentils, and seven tablespoons a day of a mixture of powdered chia seeds, cinnamon, and dried organic orange peel to prevent breast cancer. Although the segment didn’t tell anyone not to seek medical treatment for the disease, it also didn’t discuss a need for exercise or a more balanced diet than sprouts and fiber-powder. Even if the bulk of the information won’t largely affect health, Sanghavi admits that physicians like Stork and Ordon have the trust of their regular viewers. Their words could have more impact than a medical correspondent reporting on numbers from an Ivy League medical school study. “If you watch somebody on TV every day you have a relationship with that person, whether they’re right or not,” he said. “Very few people have an audience like that.” ****** “The Doctors” and “Dr. Oz” don’t have as many viewers as the big daytime draws like Judge Judy or Family Feud (these shows bring in close to 8 million viewers each, per day). However, they consistently grab a 1-1.5 ratings share, which translates to over one million viewers per day. That’s enough to keep them on the air. Sony Pictures Television and Fox Studios recently renewed “Dr. Oz” through the 2018- 2019 season. Thirty years ago, the assumption, according to advertisers, was that people watching television during the day were young affluent mothers who would be going to the grocery store soon. Decades later, however, the socioeconomics of the daytime demographic has changed. While it’s still predominantly female, a 2012 Pew Research study reports that today’s daytime TV audience is less educated and less affluent. Only 19% of daytime viewers have a 4-year college degree, and more than half make less than $30,000/year. So if you watch daytime TV, you’re more likely to be poor, uneducated, and unable to afford a doctor. Add to that a higher likelihood of being uninsured. A 2015 Census Bureau breakdown of the demographics of those without health care insurance found that “people with lower household income had lower health insurance coverage rates,” and “people with higher levels of educational attainment were more likely to have health insurance coverage.” According to a CDC poll in 2014, about half of the adult respondents without health insurance coverage said they had a medical issue that required a doctor, but didn’t see one because of cost. While advertisers see this demographic as a potential gold mine, the medical community has been slow to recognize their vulnerability. During a recent hour of “The Doctors” on the Boston CBS affiliate, the majority of the ads were for credit reporting, student loan debt refinancing, and a plethora of over- the-counter and prescription drugs for chronic issues like pain and cholesterol maintenance. Around the halfway mark, viewers were treated to a two-minute infomercial for SeroVital, an over-the-counter amino acid supplement that declared it would clear bad skin and increase energy and sex drive, all while reducing body fat. There is no peer-reviewed research to support those claims and the company’s own study, consisting of only 16 study subjects, concluded no clear evidence of any of the listed benefits. Without a primary care physician, many of these viewers are reliant on mass media for medical information. For specific illness questions, the Internet is a more likely source. But without health insurance, something like a cancer diagnosis would be catastrophic. Dr. Oz has produced over 20 segments related to fighting, preventing, or ‘starving’ cancer with foods. Taken together, his list of food combinations needed on a regular basis to avoid cancer is staggering, and many of the featured foods, like sesame seeds or “purple foods,” have not been scientifically proven to prevent anything. ****** Dr. Benjamin Mazer, now a resident in pathology and laboratory medicine at Yale- New Haven Hospital, was just a medical student at the University of Rochester when he proposed the Medical Society of the State of New York add a position statement condemning irresponsible mass media medical reporting. Two years later, the statement became a directive proposed to the AMA House of Delegates. In 2015, the House of Delegates adopted the directive, and it is currently being discussed by the AMA Council on Ethical and Judicial Affairs. Mazer doesn’t share the belief of many physician journalists that shows like “The Doctors” and “Dr. Oz” shouldn’t be taken seriously. “Part of my battle has been to make the medical establishment realize not only that misinformation in the media is having a huge influence,” he said in a recent phone interview, “but, also that it’s something worth addressing.” The medical community, Mazer says, is missing a huge opportunity to strengthen the public’s robust, but declining trust in medicine.

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