Televised Medical Talk Shows – Is There Truth in Edutainment?

It’s time to tell your patients that mom was right. You shouldn’t believe everything you see on television. Televised medical talk shows have become a daily viewing ritual for millions around the world. The Dr Oz Show is so popular that it earned him the title “America’s Doctor”, attracting massive numbers of followers as did the show The Doctors. It is no surprise that the public is drawn to the attention-grabbing headlines and sound bites used by the media to embellish health claims.  But to what extent are the recommendations and claims made by medical shows supported by evidence?

Several studies have raised concerns about the completeness and quality of reporting by popular “lay” media with regard to health information. One United Kingdom study analyzed the newspaper coverage of complementary and alternative therapies for cancer.  The study found that half of the therapies discussed in these newspaper articles were not supported by trial data.¹ A similar study in Canada examined newspaper coverage of new prescription drugs and found that while all of the articles mentioned at least one benefit of the drug, 68% made no mention of possible side effects or harms.² Similar findings about the drug information reported in newspaper and television stories was reported in a U.S. study more than a decade ago.³ Foods like endive and red onion were touted to prevent cancer in a segment from The Dr Oz Show titled “Anti-Cancer Diet.” However, these claims are not supported by sufficient evidence.⁴

Whether influenced by the internet, newspaper, or one of the celebrity physicians working for mass media outlets, some patients come to their medical (and pharmacy) appointments armed with strong opinions. It is no surprise that health professionals have voiced frustration with the recommendations aired to mass audiences.⁵ Although these public proclamations and health messages from celebrity physicians sometimes engender skepticism and criticism by health professionals, there is lack of research systematically analyzing the credibility of televised health claims.  A recently published study in BMJ revealed that many of the recommendations made on these medical talk shows lack evidence and, in some cases, are outright refuted by the evidence.⁶

In this study, researchers assessed a broad range of recommendations made on two internationally syndicated televised medical talk shows.⁶ Forty episodes each of The Dr Oz Show and The Doctors that aired in early 2013 were randomly selected. Healthcare providers from a group of family medical practitioners and pharmacists independently searched for evidence.  A maximum of one hour was allotted to search for evidence per recommendation. Resources allowed included the databases Pubmed/Medline, Embase, Cochrane Database of Systematic Reviews, Natural Standard Database, and Google. The search was considered complete when a systematic review of randomized controlled trials or large randomized controlled trials addressed the question or recommendation. Four of the investigators reviewed and discussed the evidence for consistency and the believability of each recommendation. The investigators then cast their votes. Consistency within the study and between studies, was evaluated, and believability was based on the quality, quantity, and type of evidence. The authors indicated that their original approach of two independent reviewers categorizing evidence led to too many inconsistencies.  Their adapted approach of four reviewers examining and discussing the evidence was also imperfect but led to greater consistency.

Only 54% of the 160 recommendations (80 from each show) were supported by published evidence (in some cases merely a case report). Many (40%) of the recommendations were nonspecific with regard to the proposed benefits.  Roughly one third to half of the recommendations were supported by believable or somewhat believable evidence.  No evidence was found for 39% of the recommendations made on the Dr Oz Show and 24% of the recommendations on The Doctors.  More importantly, there was believable or somewhat believable evidence found to refute 11% and 13% of the recommendations made on The Dr Oz Show and The Doctors, respectively.

The most common topic addressed was general medical advice, which encompassed diet, weight loss, exercise, and cosmetics. The most common recommendation made was dietary advice on The Dr Oz Show and to consult a healthcare provider on The Doctors. Furthermore, recommendations were often justified using an intermediate or surrogate outcome that was then extrapolated to a patient-oriented outcome.  For example, “flossing every day decreases inflammation of the gums, and this inflammation causes aging.” Surrogate markers, which may correlate with a clinical endpoint, do not necessarily have a guaranteed relationship.

This study, which is the first to systematically assess health claims aired on television talk shows from an evidence based perspective, showcases the need for future studies to examine the behavior changes consumers adopt based on these recommendations.

The subjective manner in which health recommendations were identified from each show as well as the authors’ interpretation of the evidence to support (or refute) these recommendations is an unavoidable limitation of this study. Other limitations include the short time period for sampling episodes — the quality and type of recommendations may be different over multiple years. Furthermore, evidence could not be found to support some common and well-accepted medical recommendations, such as “sneezing into your elbow prevents the spread of germs.” Lastly, the authors had significant latitude and often used general terms when searching the literature because many recommendations were not associated with a specific benefit.

This study reveals that recommendations made on edutainment shows are often unsubstantiated by evidence and fail to state the benefits of adopting the health behavior. Although medical talk shows may be entertaining, following the advice from charismatic hosts is not (always) a formula for improved health. Health professionals would be well advised to inform patients that general recommendations provided to the public are not the best ways to make health decisions. When faced with patients who come to their visits armed with recommendations they heard on social media, read in the newspaper, or saw on TV, we should clearly explain there are few recommendations that can be made to the population as a whole.  Patients eager for a healthier life should seek advice that’s tailored to their specific circumstances. Until medical talk shows substantiate their recommendations with high quality evidence, consumers and clinicians should either watch with skepticism or change the channel.

Tell us what you think.  Do medical talk shows and other health advice programs directed at the lay public do more harm than good?