In Depth

Medicine Gets Personal

‘America’s Doctor’ Tailors Information to ‘Oprah’ Viewers

Dr. Mehmet Oz is not a wizard, but to many television viewers, his no-nonsense, clear answers to important medical questions make him more valuable than a wizard. That’s how he has earned the label “America’s Doctor,” a title that has actually been trademarked.

Dr. Oz is well known as a regular contributor to “The Oprah Winfrey Show,” as well as a mainstay on Discovery Health (which is being transformed into OWN, or Oprah Winfrey Network). In addition to those media projects, bestselling books and a column in Esquire magazine, Dr. Oz is a busy physician attached to New York Presbyterian Hospital.

He spoke with TelevisionWeek correspondent Allison J. Waldman about his role as “Oprah’s” main source of medical advice and counsel and shared his views on the state of health care journalism on television.

Television Week: How did you become Oprah’s main medical expert?
Dr. Mehmet Oz: I had a show called “Second Opinion,” which was on the Discovery Health Channel, and the show’s premise was to create 13 hours of programming that covered the first couple of years of medical school. We wanted to teach America what we learned in the very beginning of med school. I needed a big guest to launch the show, so I reached for the stars. Thanks to Gayle King, who is not only one of Oprah’s best friends, but one of mine, too, Ms. Winfrey came on as my first guest. When the show aired there was a big feature in People magazine, and as a result of that, the Oprah producers saw that and decided that since she came on my show, I should come on her show and do the same kind of lessons. So I did it. It was a popular show and we did it again, then we did it again. I became more comfortable and she taught me more and more about how to give these messages to America. Thanks to her, I’ve tried to get better at it and she’s been very kind to have me on the show.

TVWeek: How have you changed your medical messages so that Oprah’s audience can understand them?
Dr. Oz: There were a few lessons I learned from her. Instinctively, when I felt that someone wasn’t getting my message, I would give more information, because in medicine that’s what we do. If I don’t understand why a patient’s sick, I get more information about the patient. That doesn’t work in television. In television, if people aren’t getting the message, it’s because you’re not appealing to the emotional side of the problem. So if I go over their risks of getting the flu and how you need to get the flu shot, then you don’t get it, I’m not going to give you more reasons to get a flu shot. I’ve got to get into an emotional discussion about what you are fearful of getting a flu shot. What is it about the flu that makes you feel you’re going to get it no matter what—that kind of stuff that challenges the underlying assumption that prevents you from acting. We don’t get that in medicine. That’s issue No. 1. Relying on emotional hooks to people to get them to change behavior is not facts. Don’t browbeat them with information.

TVWeek: What’s issue No. 2?
Dr. Oz: No. 2 is that it’s got to be fun. People in medicine are so accustomed to giving sour and dour information, you know, “If you don’t do this, you will die.” Well, you cannot scare people who are afraid to do better. They’re already afraid. You can’t insult people with low self-esteem in order to get them motivated. It’s the opposite. So by making it fun, but taking away the fear and making it a more joyful experience to know about your body, you start to break down the walls, the barriers between people learning what they need to learn.

TVWeek: What else did you learn from Oprah?
Dr. Oz: The third thing is that in order for it to be transformational, it has to be very real. It cannot be abstract. I can’t speak generically about what happens during a heart attack. I have to show you a heart that’s died from an infarction. I have to bring you a kidney that’s suffocated from no blood flow. That works for people. They see that and no longer am I crayoning in the dark corners; I’m actually bringing it alive to you by showing you what it really looks like. That works.

TVWeek: Do you find that people need to relate to the information you’re providing on a personal level?
Dr. Oz: Absolutely. When you ask people why they change things in their life, you find that something that was very dear to them—either themselves, if they have enough self-esteem, or someone that they love, their wife or kids—had a problem and they finally, finally have an insight that allows them to act on it. If you think about our lives, we have many, many examples of people near to us doing things that are not in their best interests. You don’t know how to quite get to them. We spend a lot of time on the show not just giving you the information, but sharing with you ways to communicate that information. Our goal, very clearly, is to create an army. When people watch the show, we want them to say, “You know, I got what he said and now I’m going to tell these five people about it, because those five people have that problem.” So instead of just getting the viewer to change, we want to get them to be activists.

TVWeek: What do you feel is your responsibility as a health care journalist?
Dr. Oz: The biggest responsibility is to make sure the advice I’m giving is authentic. That doesn’t mean it’s correct. Let me be clear on that. I want to give correct information, but the more positive you are that the information is correct, oftentimes the less useful it is, either because it’s already obvious to everybody or it’s so limited in scope. So if I’m going to tell you not to drink soft drinks, can I prove without any question in anyone’s mind that soft drinks are a big problem that we see in America? No. I have dozens of studies to show you it’s a problem, but you can show me five studies that say it’s not. But at the end of the day, we can battle and the polemic goes on. I have to make the ultimate judgment about whether it’s good enough for my viewer and what that means, I tell people, is that I tell you and share with you things I tell my family. I treat you the way I treat people I love more than anyone in the world because I love you. I’m going to share with you stuff that I think is right. I may be proven wrong one day, but I’m responsible. I’m responsible for what I write but I’m not responsible to it.
I’ve been speaking a lot about water, that we need to drink more water. Recent data came out that we already drink enough water because most food has 50% or greater water content. The original data on water came from U.S. Army studies in the 1940s, and it never thought about the water in food. The data was not incorrect, it’s just the way it was extrapolated to humans wasn’t right. So I went on the show and said, “You don’t have to drink water.” Historically, medical information has always been delivered in a very concrete way, very obtusely, because they were only interested in telling exactly what we knew for sure so you couldn’t argue with it. What America wants is advice. When you go to a doctor’s office, you want advice. You don’t get facts, you get advice.

TVWeek: Talk about health care policy, such as ideas that have been proposed to help people afford health insurance.
Dr. Oz: Sometimes they’re completely on target, sometimes they’re not. Fifty percent of the people without insurance in America make the economic decision not to buy it. They can afford it. They’re making incomes that are reasonable, but for a variety of reasons, they roll the dice and don’t get the insurance they probably should have. Fifty percent of people don’t have a choice. There are some people who are really in trouble, but many actually have the opportunity to get it. What I would ask them is what they are giving up financially worthwhile. You know, people who are smoking say they can’t afford these nicotine patches to stop smoking, but cigarettes cost more than nicotine patches. They priced them that way on purpose. You can’t make that argument, but people still make it. You have to call people on the carpet. However, there are many times when … if something is not essential, you [should] not get it. For example, CT angiograms, which are rapid CT scans to look at your heart arteries. When Oprah had hers on the show and I did that show, I spoke very clearly about the fact that there are some people who would really benefit from this. However, it absolutely should not be thought of as a basic screening test. It should not be obtained by people willy-nilly. Not just because of the cost, but also because of the risk of radiation. But the cost is the big reason I hold back. Cost is a major consideration. We’re never going to solve all those problems, but I want people to make the rational decision with enough information to know the cost benefits.

TVWeek: Do you believe that America needs a better health care policy?
Dr. Oz: Oh yes, of course. We have a terrible health care policy. I went to business school at Wharton to study this. I actually got a degree in health care finance. I think there are things we can do that are fairly simple that would have a huge impact. Some of them are not easy to do from the perspective of the average consumer, but we’re going to have to do them. No. 1, everybody has to be in the system. We can no longer allow people to walk around without insurance. That means you have to make it affordable for them, but also mandatory, in the same way that if you drive a car, you need insurance. If you file a tax return in America, I think you should have insurance. No. 2, we have to change the tax laws so it’s fair for everybody. Right now people who don’t work for large companies don’t have access to the same price of insurance that I have, for example, at the university. We can do that with vouchers, we can do it with a chit from the government, to have a certain amount of money each year for your health care plus catastrophic insurance, which you can use as you wish.
There are good ideas, but they’re going to cost money. At the end of the day they’re not going to be more expensive than what we’re spending now. And eventually we’ll get more for our money. The big question is not are we spending too much, it’s are we getting our money’s worth? The answer to the latter is no.

TVWeek: How do you balance being a doctor with being a celebrity?
Dr. Oz: I really do not feel like a celebrity. When people ask me to sign their books and everything, it’s very flattering. But this has always been a calling for me. It still is a calling. I feel blessed every time someone hears something and changes their life. I can see that look in their eyes. It’s like when a teacher sees a pupil light up when he learns something, a new epiphany hits him. The word doctor means teacher. I’m not up there to be a celebrity. I always get a little bit embarrassed when somebody comes up and says, “Oh, you were so great on the show yesterday.” But I must say the benefit of that is that when people criticize me, it doesn’t bother me as much. I’m not doing what I do for the critics. I’m doing it because it’s the right thing to do, and hopefully enough people like it and will benefit from it.

TVWeek: Do you think the quality of health care journalism on television has improved?
Dr. Oz: I think the American public is much more sophisticated about what they listen to; the ability of medical journalists to talk about progressively more sophisticated messages has increased dramatically. I think a lot of this revolves around the reality that Americans recognize that not all the answers are going to be delivered in a doctor’s office and they can educate themselves. Advertisers have built this belief as well. I have strong feelings about advertising medical products on television, which is that we should not do it, but one side benefit is that people now know what restless leg syndrome is. But now we have really smart people doing TV health care journalism. Top-notch people like Dr. Tim Johnson, super guy, very high quality. Nancy Snyderman, you’ve got some really, really sharp people. Jon LaPook is my best friend. We have spent a lot of time together and he’s superb. Before he got the main job as medical expert on CBS for Katie Couric, Jon was the best gastroenterologist in the country. I sent everybody to him.

TVWeek: It seems that the TV networks have made a concerted effort to improve the quality of the health care reporting on the nightly news.
Dr. Oz: Absolutely, and I think they have also done a lot of stuff on the Web. A lot of time goes into these reports; they’re short, but they’re deep in scope. The fact that the networks are investing that kind of effort into making information available to Americans reflects back to the fact that we have a population that’s a little bit older and much more willing to think about health issues than even 20 years ago.

TVWeek: What are the major medical concerns that you hear about from people in your travels?
Dr. Oz: Metabolic syndrome—that is, high blood pressure, high cholesterol and high blood sugar. Prostate cancer, breast cancer, gender-specific cancers and then colon and lung cancer, those are the big ones that come up most often. Especially because you can screen for some of these now. My specialty is heart disease, so I hear about that. It comes up because it’s so expensive, so it’s health economics as well as health care. There are also a lot of questions about vitality and longevity, so it’s not just illness. It’s how do I live longer and balance that with my desires?

TVWeek: Do you believe new media can be used to extend health care messages in the future?
Dr. Oz: It’s not in the future, it’s here. If I’m watching the “CBS Evening News” and Jon LaPook is doing a report on Alzheimer’s—oh, I forgot to mention that one, it comes up all the time. So if I’m watching the news and that comes up and I’m not interested in it, I turn the channel. If I’m a viewer, I’m going to go to ABC or NBC. But if I’m researching Alzheimer’s and CBSNews.com comes up, that’s the first one I’ll watch. That means the work he put into that story, that document, is that much more accessible. It’s news you can use, when you need it.

TVWeek: Has your work on “Oprah” been a way for you to fulfill the calling you talked about, to teach people about health care?
Dr. Oz: For me, definitely. First of all, it’s a blessing working at Harpo. It really is a very humble organization. These are people who are not all caught up in themselves. It’s not about them; it’s not about her. She’ll be the first to tell you it’s not about Oprah. It’s about the viewer. She is at once ordinary and extraordinary, which is what is so appealing to viewers. They see her as like them, but she’s so different, so unique, such a special individual, incorruptible and authentic, that they are also able to elevate her. If it was just one or the other, you wouldn’t watch, so it’s that tension that’s crafted. And she understands all your issues and you get to understand how she sees them, and that comes about because the focus is always on “What is the viewer experiencing?” This is not show business for them—this is life.

TVWeek: I get the impression with the Dr. Oz segments that the first word that comes to mind for all of you is curiosity. Am I right?
Dr. Oz: It’s funny you picked that word; it’s very perceptive of you. When I was going through grade school, you know how teachers say something about you every year? I got two things all the time: I had ants in my pants, and I was curious. That is exactly what I see in the questions we get for “Ask Dr. Oz.” I then pick the ones I am most curious about. Sometimes they’re very mundane questions, like what causes bad breath. When I’m curious, I do my homework and find out. The most interesting answers are the ones we put on the show. Curiosity drives the Dr. Oz shows. I’m a doctor, so I’m a teacher, but I’m also a medicine man, which means I’m a healer. We try to do segments where I try to deal with the emotional blockages that many of us have in life. The science of what’s going on, I can explain to you. But I have to figure out the why also. Why aren’t you motivated to take better care of yourself?

TVWeek: Where do you see yourself five years from now?
Dr. Oz: Still married, which is important to me. Family structure is important to me and I get a lot of my energy from them. I want to still be working with Oprah; it’s a wonderful experience and they’re great people. I trust them to not just take care of me, but to make sure that what we do is always high quality.

TVWeek: Do you have any pet peeves about the way TV is approaching health care?
Dr. Oz: Yes, I think we too often assume that we have to have headline news. Sometimes a topic doesn’t have a headline to it, but given 30 seconds I could get you interested in it. We don’t tackle those frequently. It only happens when some crisis occurs to bring them to light. Heath Ledger’s death is a good example. When he passed away, the first thing I thought of—and it might turn out to be the case—was taking a lot of medications. If you’re on six medications, you have a 94% chance of having a drug interaction. Now that’s not a headline issue, but it was because he died. That’s the kind of insight that catches your attention if you give me a few seconds to explain it to you. I think we don’t give the public enough credit to pay attention.