The Medical Opinion comes from a medical expert. It is derived from the collective wisdom of he Medical Community (Figure 1). The consumer expects The Medical Opinion to be correct i.e. based on solid evidence. If only 33% of a doctor's medical opinions are likely to be correct, and 11% are likely to be wrong i.e. contradicted by the medical literature, then the doctor should be fired.
There is a process for arriving at a medical opinion that involves logical reasoning from established medical data. Medical experts are extensively trained in this process, and they should be able to justify each opinion by explaining the line of reasoning.
The Medical Opinion is not "protected" by Freedom of Speech. In an essay in Time Magazine responding to his critics, Dr. Oz defiantly proclaims "[n]o matter our disagreements, freedom of speech is the most fundamental right we have as Americans. We will not be silenced. We’re not going anywhere." Indeed, under the First Amendment, a doctor is "free" to dispense bad medical advice. However, the First Amendment cannot protect him from being sued for malpractice.
There can be differences of Medical Opinion. Mr. Gifford points out in his opinion piece defending Dr. Oz that "evidence-based medicine" is not always a settled issue: "In scientific inquiry, the “truth” is slipperier and more fluid than distinguished physicians will generally admit." This is true, but the medical community provides guidance on the range of permissible Medical Opinions on unsettled issues. Just because we cannot effectively treat certain types of pancreatic cancer, doesn't mean that any treatment is allowed.
Finally, not all Medical Opinions are 100% correct. As Mr. Gifford accurately observes "Today’s fringe treatments could well become tomorrow’s standard protocol." However, the fringe opinion has to become medically validated before it can overturn current practice. This validation is not some mystical, opaque process. Research is performed, data is collected and interpreted, conclusions are drawn by expert panels, and every aspect is reviewed by members of the community and reproduced to the greatest extent possible. In this way, ordinary opinions (e.g. fringe speculation) can become Medical Opinions.
It is important to note that anybody can participate in this process. You don't have to be a doctor or scientist or have a bunch of degrees; you just need to abide by the scientific norms that are shared by all academic disciplines.
However, mere dialog does not constitute scientific validation. Talking about pushing the boundaries is not the same as actually engaging in the scientific process of pushing the boundaries.
In brief, Medical Opinions are validated and vouched for by the medical community; ordinary opinions are not.
So what is the problem?
The problem is that a medical expert, Dr. Oz, is putting forth on his show a mixture of Medical Opinions and ordinary non-expert advice without distinguishing the two. These are numerous examples in which he offers opinions that are not based on a shred of medical evidence. There is no line of reasoning that Dr. Oz can use to justify these opinions.
Mr. Gifford ends his defense of Dr. Oz stating that
"Here in America, rightly or wrongly, we have clearly chosen a wild and woolly marketplace where free speech comes before regulation and expert ruling. That means that, as patients and consumers, we need to do our own homework and exercise another precious right: the right to a second opinion. And then, maybe, a third."It is not a question of right; it is a question of the expectation of the consumer that the second and third opinions are Medical Opinions, not run-of-the-mill ordinary opinions from some non-expert. There can be no confusion about the two. People entrust their health to what they think is validated Medical Opinion, and when that trust is misplaced, it is a problem.
I believe that Dr. Oz can run his show in a more responsible fashion by making clear when he is stating bona fide Medical Opinion versus offering ordinary non-expert opinion on health-related matters.
Figure 1. It takes a community to make a Medical Opinion.
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