Mehmet Oz’s image took a beating during the GOP primary, and it’s weighing on him as the general election starts.

When Republican Senate nominee Mehmet Oz met with Pennsylvania’s GOP House delegation recently in Washington, he was blunt about one immediate challenge: his scars from primary season.

Oz squeaked out a victory in his first-ever run for office, but the primary left a mark. The celebrity surgeon widely known as “Dr. Oz” absorbed more than $20 million of attack ads that damaged his standing in many voters’ minds, including among the Republican base he’ll have to rally to beat Lt. Gov. John Fetterman, the Democratic nominee, in November.

In his razor-thin win, nearly 70% of the GOP electorate voted for someone else, and early public polling has shown deeply negative views of the GOP nominee, in line with what members of both parties say they saw leading up to the May 17 primary, when even many Republicans viewed Oz in a poor light.

“We are looking at these numbers, and it’s quite disturbing,” said Kathy Barnette, a Republican who ran against Oz for the GOP nomination, and often accused him of being a faux conservative who only repeated the required talking points. “This is on his shoulders, and I want the seat to remain in the Republican corner.”

Incumbent Republican Sen. Pat Toomey isn’t seeking reelection, making this one of the most critical Senate races in the country, and Democrats’ best chance to gain a seat as they try to retain control of the chamber.

Only 28% of likely Pennsylvania voters said they viewed Oz favorably, according to a Suffolk University/USA Today poll in early June, while 50% saw him unfavorably. An AARP survey found even more deeply negative impressions of Oz.

It’s a sharp contrast to Fetterman, who romped to victory with broad support from the Democratic base and faced relatively little resistance from his rivals. His favorability ratings are positive in early polling.

Even Democrats say the situation won’t last: Most Republican voters will almost certainly rally around Oz once they consider the idea of “Senator Fetterman” or turn their focus to President Joe Biden, rising prices, and other issues. And Fetterman’s image will surely take its own hits as the GOP rolls out its attacks and voters give him more scrutiny.

But Democrats argue that the early negative impressions of Oz could foreshadow two lasting weaknesses. At a time when most candidates soften their tones and tack toward the political center, Oz still needs to solidify his support with conservative base voters, many of whom were left skeptical of his credentials. And, Democrats and some Republicans say, the negative views of Oz point to underlying questions about whether voters can trust him.

“He was trying to communicate ‘America First’ values, but I think authenticity matters,” Barnette said in an interview. She urged Oz, who won an endorsement from former President Donald Trump, to spend more time with ordinary voters, and speak to issues such as rising prices that cut across political affiliation.

Barnette, who won 25% of the primary vote and finished third, has so far declined to endorse Oz, even as his other former rivals have lined up behind him.

Several Republicans said they were watching Barnette, noting that she had a loyal following, including among supporters of Trump and State Sen. Doug Mastriano, the GOP nominee for governor.

» READ MORE: Mehmet Oz is running for Senate in Pennsylvania. What are his ties to the state?

Oz’s camp argues that his bruises after being targeted by so much negative advertising are to be expected. Fetterman, they note, has yet to face a similar barrage but won’t get a pass through the general election.

Oz spent a week in early June making more than 20 campaign stops around the state while Fetterman remains off the trail, still recovering from a stroke in May. Oz’s campaign says Democrats are the ones on defense over issues such as crime, inflation, and the economy.

“To hardworking families across the commonwealth, the choice is clear,” said Oz spokesperson Brittany Yanick, calling Fetterman a “radical liberal” who ”supports Joe Biden’s crisis-creation presidency.”

“Dr. Mehmet Oz will protect law-abiding citizens, fight intrusive big government policies, and return economic prosperity to Pennsylvania,” Yanick said.

Republicans say Biden and Fetterman are all the motivation GOP voters need to support Oz.

“Republican voters will start to focus a lot more on who the Democrats are,” said Brock McCleary, a GOP pollster based in York County. “Voters are often more motivated by what they dislike than what they like, and Fetterman is going to engender party unity among Republicans.”

Oz carries his negative ratings after a primary ad blitz that challenged his loyalty to Pennsylvania, accused him of shifting positions on issues such as guns and abortion, and dubbed him a “RINO,” or “Republican in name only,” who couldn’t be trusted to uphold conservative values.

» READ MORE: John Fetterman says he’s not a typical politician. Is that enough in a brutal climate for Democrats?

Oz disputed those characterizations, pointing to Trump’s endorsement as proof of his conservatism, but he also acknowledged the damage from the TV onslaught.

“There are a few counties that are not in a Pennsylvania DMA, and my reputation’s fantastic there,” Oz said with a wry laugh days before the primary, using the shorthand term for media markets. “We’re doing really well in those five small counties, but you know, it’s politics, and people will paint you in a negative [way].”

Democrats say the skepticism of Oz points to deeper troubles.

Add up his loose ties to Pennsylvania — he lived in New Jersey for more than 30 years after attending medical and business school in Philadelphia — and his attempts to distance himself from past statements on guns, abortion, and other topics, they say, and voters have reason to question his character in a race that could come down to just a few percentage points.

» READ MORE: Is Mehmet Oz really a conservative? We looked at the Pa. Senate candidate’s record.

“Mehmet Oz is a fraud and a scam artist who isn’t from Pennsylvania and isn’t trusted by voters here,” said Jack Doyle, a spokesperson for the Pennsylvania Democratic Party.

Much the way Republican rivals did, Democrats have pointed to Oz’s shifts. In a 2019 radio appearance, for example, he expressed concern about strict abortion limits in Alabama. And while he has long said he personally opposed abortion, in 2008 Oz said that “I’m not socially conservative” and that “we should not be creating obstacles during the difficult time that women have when trying to terminate a pregnancy.”

But during the primary he described himself as “pro-life” and favored overturning Roe v. Wade. Asked about exceptions at a GOP debate, he said he would support them to save a mother’s life. In several other interviews, he said he also supports exceptions in cases of rape or incest, and his campaign says that is his full position on the issue.

» READ MORE: Where Pa.’s 2022 candidates for governor and Senate stand on abortion

While many candidates emerge with baggage from tough primaries only to shrug it off for the general election, it’s more likely to stick to someone like Oz, said Anna Greenberg, a Democratic pollster who has worked on Pennsylvania races. He’s already well-known, she said, and the advertising was so extensive that many voters are already aware of the critiques. Unlike in many primaries, the attacks weren’t directed to just a narrow slice of voters.

“Suburban, middle-of-the-road voters have all seen it,” Greenberg said, “and it’s attached to someone with a big personality, with a well-defined big personality.”