Steven Novella appears on Dr. Oz

I recently wrote a blog criticizing Mehmat Oz after he advocated the use of psychics as a form of grief counseling. Shortly thereafter I watched him hawk a hybrid of homeopathy and acupuncture as a kind of panacea. Surprisingly, he invited Dr. Steven Novella – neuroscientist, skeptic, author of the terrific blog Neurologica, and vocal critic of "alternative" medicine and of Dr. Oz himself – on the show. The interview was more than a bit lopsided – Dr. Novella was the only skeptic among several advocates, and Dr. Oz spent the last few minutes delivering a pro-alternative-medicine monologue. Nonetheless, it's great that Dr. Oz at least gave a notable skeptic an audience, and Dr. Novella was able to make some sharp arguments.

Watching the interview, I was a bit struck by some of Dr. Oz's statements. For example, he suggests that we shouldn't be so dismissive of therapies which have been used for "thousands of years". Ask yourself: what was the average life expectancy 100 years ago? 500? 1000? 3000? Not long ago, there was a fascinating article in Scientific American about the discovery of a small tribal culture on the southern tip of South Africa which indicates that the earliest use of tools was over 100,000 years earlier than previously believed. These indigenous peoples foraged for fresh food and ate shellfish from the nearby oceans. They never touched a single morsel of processed food, never encountered industrial pollution, and got lots of fresh air and exercise. And yet, any one of them would have been lucky to live to 30.

But there's a more specious argument Dr. Oz is peddling here – that it's okay if there's something mysterious about these "therapies", as long as you think they work for you. What bothers me about so-called "alternative" medicines or therapies – indeed their calling card – is their lack of specificity. Science-based medicine is rooted in specificity – identifying the physiological mechanisms for a compound or therapy, and then defining precisely what the compound or therapy actually treats. Alternative medicine, on the other hand, thrives on histological and diagnostic ambiguity. Acupuncture, for example, is based upon a mystical energy force called Qi, which circulates through the body via meridians; it's been claimed to treat everything from inflammation in the joints to cancer to hair loss. Chiropractic similarly lacks a sound histological basis (just Wiki the term "vertebral subluxation") and is hawked as a treatment for everything from back pain to migraines to heart disease. If you press advocates for pseudosciences on how, specifically, their modality of choice affects the body, you'll get either evasive or dishonest answers.

I could ramble on – "herbal remedies" like echinacea and ginko balboa, and even common practices such as megadosing vitamins, are peddled with the same ambiguity as the above "therapies", generally peddled as panaceas and/or "ancient remedies". But it's here where I want to emphasize Dr. Novella's most important point: the term "alternative medicine" simple creates a false dichotomy in which certain compounds or therapies are not subject to the same empirical standards as "traditional", or science-based medicine. Or, as the comedian Tim Minchin said, "Alternative medicine is, by definition, medicine that hasn't been proved to work. Do you know what they call alternative medicine that has been proved to work? Medicine!"

Here are the links to the interview with Dr. Novella:

Controversial Medicine: Alternative Health, Pt 1.

Controversial Medicine: Alternative Health, Pt 2.
Controversial Medicine: Alternative Health, Pt 3.