Straight Talking Doc Unhinged

The Emergency Room can be life saving, but also can be a place to be feared.  We discuss several cases in which protocols and robotic thinking put patients in precarious positions, exposing them to unnecessary dangers, creating diseases where none exist, and base diagnosis more on tests that should have never been ordered rather than on a history and physical and common sense.We talk about two issues about which we have written articles.  By clicking the hyperlinks you can access the articles, which are at the bottom of the page in each case.  One is syncope, where someone passes out, and in which the testing commonly done in the emergency room and even hospital admission are both unnecessary and potentially dangerous.  The second is the use of a blood test called Troponin, which is supposed to be used to diagnose heart attacks in people who present with symptoms consistent with an MI, but when done on people without such symptoms has a 5% accuracy and 95% over-diagnosis potential, exposing patients to dangerous over-treatment and labeling.

We talk a lot about Big Pharma throughout this podcast but today we discuss its many tentacles.  Soon after making the podcast, Alan watched a hockey game and there was a drug ad on the ice!  The Pharma industry controls virtually all medical research; subsidizes medical schools whose "expert" physicians are dependent on Pharma funds to pay for their grants; finances and provides leadership for many respected institutions such as the FDA, CDC, American Diabetes Association, Alzheimer's Association, American Cancer Society, American Heart Association, and virtually every medical professional society; is one of the biggest doners and lobbyists in Congress; is (with Big Food) the top advertiser in the media, print, TV, and internet; is the biggest advertiser in medical journals and medical conferences; and of course regularly bribes doctors.  We speak a lot about these tentacles in our book Return to Healing, as does Gardiner Harris in his book No More Tears, as do so many health reformers, but the deep penetration of their financial power to manipulate our perception of what healthcare should be has become so normalized as to make it invisible.  Few doctors realize that the protocols they use, the calculators they dazzle patients with, the articles they read, the conferences they attend, the organizations they follow, and the "experts" they listen to are all tentacles of Big Pharma.  And of course, since Medicare is contingent on Congress to determine what it will pay for, and since Congresspeople are heavily supported by generous Pharma gifts, it's no wonder that the most expensive drugs are always passed by the FDA, endorsed by the CDC, and paid for by Medicare.  We will give a brief synopsis of this problem and a few ideas how to fix it.

This week Andy was reported to the Maryland Board of Medicine by a local cardiology group because some studies he included in his practice newsletter offended them.  These were major studies, peer reviewed, but did not coincide with the dogmatic messaging they seek to spread, and thus they accused Andy of spreading dangerous misinformation.  They want the Board to silence him or take away his medical license, merely for sharing medical data with which  they disagree.  These cardiologists, as well as many specialists, practice by using protocols that are written by self-interested specialty societies and by drug companies.  Such protocols are usually buttressed by garbage observational drug company studies and do not include more robust data that gets in the way of their narrative.  Many specialists, including the local cardiology group that wants to censor Andy, robotically follow the protocols and denounce any study or doctor who dares question them.  But isn't science, isn't medical care, all about dialogue, divergent arguments, nuance, concern about the whole person rather than his/her organ of interest or numerical measurements?  Not according to the cardiologists, and we'll see if the Medical Board agrees.  But if we must simply be AI robots who obey flawed protocols and are punished for using our brain and common sense, what is healthcare becoming?  As Osler said: "The greater the ignorance, the greater the dogmatism." And as Einstein reminded us (likely thinking about the cardiologists who are so offended by facts and data that they seek to censor another doctor): "Great spirits always encounter violent from mediocre minds."  Sadly, in our system, the mediocre minds run the show!We also discuss a documentary Andy was in recently, and a link to that documentary is: https://www.theepochtimes.com/epochtv/video-series/healthcare-decoded-6006002?=epochHG

The first half of American Medical History ends at the Flexner Report, which entirely morphed American Healthcare into a monolithic corporate entity under the complete control of the AMA.  Every aspect of healthcare transformed, from education, to payment, to philosophy, to licensing, to dogma.  The Medical Racial Script, long unspoken and oft ignored, became the law of the land.  What are the repercussions of Flexner today?  We will discuss some of the ramifications of the AMA's cooptation, and the corporate ownership of, healthcare before moving on two the second part of the course.

Dementia tells us a great deal about our healthcare system.  Not even noted to be a disease at the time of Medicare's birth in 1965 it is now one of the most onerous and common diseases of the elderly.  Why?  And why is the incidence so much higher in the United States than the rest of the world?  We have tried to medicalize dementia and memory loss and created a multi-billion dollar industry around it including useless drugs, unhelpful tests, and far too many specialist visits.  But we've missed the point.  Dementia can't be prevented or treated by throwing money and drugs at it.  It is a disease of lifestyle, and only by improving inflammation through diet, exercise, and other lifestyle changes can we seek to prevent and mitigate it.  We'll discuss all of this in our podcast.

Two pages of the Flexner Report condemned African American medial providers, hospitals, and patients to decades of struggle.  Relying on the AMA's medical-racial script, and playing into the atmosphere of Progressive eugenics, Flexner's chapter devoted to the African American medical situation flowed from what united white orthodox providers and fed the corporate impetus that would finance the new health care system.  Essentially, Flexner sought to close all but two African American medical schools, condemn graduates from those schools to being sanitation workers who would assure that African Americans don't spread disease to whites, and deflect corporate funding elsewhere.  The results were disastrous.

As the medical community scripts new cholesterol guidelines, the media has compliantly announced that our nation's top scientists, most respected medical agencies, and academic centers want to prevent heart disease by screening for high cholesterol more aggressively and treating cholesterol more aggressively.  The geniuses who created the guidelines want screening and treatment to start even in 10-year-olds!  But there are flaws.  First, no new science is incorporated into the guidelines, and other than drug-company designed observational studies all randomized trials show no value to measuring and fixing cholesterol.  In fact, not only is cholesterol not a prognostic risk factor for heart disease, not only does lowering it not help heart disease, but in people over 60 and in kids/young adults high cholesterol portends better outcomes.  Second, the organizations that printed these guidelines are tainted and self-serving, seeking to push lower cholesterol levels not based on any likelihood of helping people, but solely to sell more drugs, create more office visits, and justify more testing.  The American Heart Association (AHA) is funded and led by drug companies; the American College of Cardiology also has strong ties to drug companies and has as its main objective increasing salaries of cardiologists.  Third, the academic doctors who put their name on these guidelines are a who's who of docs who conduct drug company research, research that pays their institutions.  We know that cholesterol is not worth measuring, especially in kids and elders.  We know that statins come with risks and should be reserved for people with high risk of heart attack and stroke who are over 25 and under 80, but are not helpful in people with high cholesterol.  And we know that pushing LDL cholesterol under 70 is frankly dangerous and medically negligent.  We will explain!

Once the AMA and William Welch orchestrated an alliance of Progressive reformers, corporate interests, and state medical licensing agencies, it was time to sanctify the cogs of a new medical system.  That is what the Flexner Report is all about, a survey of US medical schools largely scripted by the AMA, conducted by a little known educator working for the Carnegie Corporation named Abraham Flexner, and financed by complicit corporations.  The Report entirely transformed the American healthcare system into one that focused on lab rats over clinicians, number measurement over patient-centered care, and a dogmatic top-down system run entirely by the AMA and financed by corporations.  The report closed most medical schools and required the surviving one to use corporate funds to transform into lab-based institutions.  Students would now be taken out of the clinical realm and be placed in the classroom and lab where they would learn about tests and drugs and German medicine, transforming healthcare into more of a technical field than one of critical thinking, humanism, and dynamic science.  Those who complied received higher salaries and status.  Those who did not were excluded from the healthcare landscape.  Poor William Osler protested from England, but his vision for medical care evaporated once the report's findings became the new norm.

Depression is a very vague concept.  How do we determine if someone is depressed?  What does depression even mean, and how is it best prevented and treated?  The realities of depression veer sharply from how the medical industrial complex would like you to think about it.  They have designed screening tools and have incorporated them into the quality indicators required for all doctors to complete.  Then, of course, we have to treat those who test positive, typically with drugs.  And is that not the point of screening, to medicalize what is often normal emotional fluctuations in our lives, and then to sell people medicine?  We will discuss why such screening is flawed, why treatment is dangerous, and how we have all been sold yet another medical myth that profits many and harms many more.

Two of American medicine's pioneers, and co-founders of Johns Hopkins Medical School, represented a fork in the road.  William Osler, whose scientific humanism pushed back against a healthcare system teetering between commercialism and quackery, created a solution at Hopkins: clinical care, doctors as teachers, patients as teachers, an end to protocols and dogma.  He believed in patient centric care: "If you want to know the diagnosis, ask the patient," he said.  He believed that America was becoming a society of drugging rather than healing.  He believed that nuance and uncertainty were inherent to healthcare, and that there could never be one right answer.  His colleague, William Welch, was a pathologist, a eugenicist, a believer in German medicine, an AMA president.  He did not believe in the importance of patient centered care, rather advocating laboratory medicine that trumped the patient.  He believed in drugs and one-right-answer thinking and he rejected the value of clinical care in education.  He wanted a medical education system run only by full time laboratory faculty, not practicing physicians as Osler had set up at Hopkins.  Welch, in the end, won the day.  Once Osler retired, Welch fired all clinical staff, and imprinted the AMA model upon all of healthcare.  He is indeed the father of American healthcare, but of a healthcare system that embraced eugenics and the medical racial script, that marginalized patients, that created diseases out of numerical norms, and that worked with corporations and drug companies.  If you want to know where our system came from, you only have to understand Welch's victory over Osler.  And if you want to know how to fix the system, you only have to understand and revive Olser.

Alan and Andy discuss why they are dinosaurs, why primary care is becoming extinct and why its disappearance will instigate harm to the health care system, to patients, to our national debt, and to reason and sanity in health care.  Talking about changes within the medical environment, they show not only why primary care is being left to die, but also the measures needed to revive it.  It's not hard, but any reasonable measures we as a society institute will run into the wall of profits derived from keeping the system dysfunctional.  

The AMA grew up in a libertarian America, but chose to change its nature during a top-down Progressive America, where experts and scientifically based rules were determined to be crucial to any viable reforms.  Working with corporate foundations, Progressive reformers, and German-inspired Progressive academic doctors, the AMA shifted course and transformed into a top-down organization that sought to control all aspects of American medicine, including education.  It changed its structure to rely on a very narrow board of "experts," it adapted a German ideology of care, it worked with corporations and drug companies to increase its base of money and power, and it started to survey medical schools and determine which ones were capable of surviving in a new Progressive age.  All of this foreshadowed the Flexner Report, which would vault the AMA into total domination over the medical landscape, normalize German medical thinking, and create a formulaic dogmatic medical script that would be templated upon all medical schools and all licensing requirements.

In the 1980's dermatologists were somewhere in the basement of the doctor world in terms of reputation and reimbursement.  It was always felt to be an easy job--not too much thinking, a limited scope of care, no after hours calls--but did not pay well  So the American Dermatology Association hired a publicist and some lobbyists in Congress and created a generalized fear of skin cancer, stating there was an epidemic, that annual skin screens would save lives, and that aggressively removing both cancers and precancers is necessary.  All the sudden it became difficult to even become a dermatologist and their incomes and reputations skyrocketed, with many earning $500,000 to $1,000,000 a year and still working less than virtually every doctor according to statistics.  Yes, despite all this surveying and slicing, skin cancer deaths have not dropped at all.  This has occurred simultaneously with the sunscreen craze, and now we are blocking our skin with substances that have not reduced skin cancer deaths but have likely increased sickness, including cancer, since sun hitting the skin is necessary for our immune system, and we are blocking that with all this toxic cream.  We will dissect the truth of skin cancer and the role of dermatologists, and tell you how you can best protect yourself not from the sun but from snake oil salesmen who have abused your trust.

As the AMA gained power and scripted a plan to commandeer the medical system, it used its medical-racial script to leap on the progressive train, including an embrace of eugenics. Eugenics flowed from the medical racial script, and according to historians, was the secular religion of progressives.  It was deemed to be sanctified science, taught at all major universities, and penetrating the hearts and minds of those who believed that science would solve the world's problems.  Like German progressive medical science, eugenics relied on discrete numerical measurements to reach conclusions about race, intelligence, and even body habitus deemed to be scientifically unassailable.  Thus were most of those who reformed health care in the German-progressive tradition also deeply steeped in eugenics.  While we call eugenics pseudoscience today, that's very deceptive, because in its day it was solid science, and those who discredited eugenics were considered pseudoscientists.  Hence we see that medical science had from the beginning specious origins, and it would only get more muddled and dogmatic as the AMA grew and spread its gospel across the nation.

We are always amazed watching TV.  What used to be ads for car companies, beer, clothes, products are not proliferated by ads for drugs and companies seeking to sell you drugs.  These companies, like Hims and Hers, are willing to provide you with drugs to help everything under the sun, whether your obesity, hair loss, anxiety, ED, or infections.  No need to see a doctor now, just get on line, chat with an AI doc, and buy the recommissioned drugs sold by the company, and you are all set.  Once again, drugs can be had on the cheap, real medical care evaporates in the wake of easy access, and more harm and cost flood the system.  Hear as Alan and Andy discuss this disturbing new trend in healthcare.

Few people realize how important nutrition is, and it's not all about weight loss.  You can lose weight and be less healthy because you are not eating food that will feed your gut bacteria, energize your muscles, and strengthen your brain.  This is occurring in a lot of people on fad diets and taking GLP-1's.  The newer nutrition triangle, which replaces one that was antithetical to health, places fats, fiber, and fruits/vegetables in their correct place as being the very lynchpins of health, with processed foods, sugars, and fake fats being the poisons we should minimize.  We all have our treats, and that's fine, but the key is to focus most of the diet on the good stuff.  The best diet is often the very opposite of what doctors tell you: it's high fat and high carb, and it's important to know how to chose the most quality fats and carbs and avoid the rest.  

Born in Republican America, with its emphasis on democratic decentralization, the AMA was floundering in the late 1800's, with few doctors latching their sails to its agenda.  Most orthodox doctors remained fully independent, many graduated from poorly regulated schools without any firm curriculum, and the medical landscape was dominated by non-orthodox providers.  In this vein, the AMA shifted course in the late 1800's, increasing its funding stream, starting a journal, and gravitating towards a more top-down Progressive model of care.  Part of its shift required certain compromises and a restructuring of its code of ethics, enabling stronger relationships with the growing pharmaceutical industry that led to more ads and increased revenue, and permitting the inclusion of homeopaths into its orbit if they adhered to certain orthodox precepts.  Where the AMA did not bend is in its medical racial script, as it turned its back on the growing orthodox African American medical profession.

The very landscape of organized medicine is being altered by corporate takeovers.  Whether in long term care, hospitals, or large groups, corporations are taking charge and offering "perks" that enhance the wealth of institutions, their leaders, and many specialist doctors, but take one more step in decimating primary care and focusing more on profits than patients.  Andy and Alan will explain why what these corporate vultures sell is appealing but ultimately dangerous and often lethal.  

Excluded from the AMA and from orthodox medicine, African American doctors had to find their own way in the late 1800's.  Virtually no African American doctors existed in the early century, but that changed in the Civil War, especially with the advent of Howard University and then a sprinkling of other medical schools that trained black doctors.  How the African American medical community grew and prospered by essentially engineering an alternate medical landscape is something often overlooked by medical historians, and yet is crucial to understand white orthodoxy, the medical racial script, and the posturing of the AMA.  Ironically, most African American doctors upheld the most foundational tenants of orthodoxy and worked well with white doctors, but were shunned by organized medicine, medical schools, and remained excluded from most medical institutions.  

While we view traditional medical care as the norm, it was not always that way.  Throughout most of the 1800's Americans chose alternative providers more frequently than orthodox doctors; their outcomes were better, their ideas based on common sense, their focus patient oriented, and even their fees lower.  One of the primary goals of the AMA was to snuff out alternative philosophies, especially homeopathy.  We will discuss these alternative ideas and how they impacted the medical landscape.

With orthodox medicine in disarray, with no standards of education, and with alternative medical philosophies ruling the roost, several prominent orthodox doctors came together to forma national organization to represent the needs of orthodoxy, the American Medical Association (AMA).  Founded in 1847 largely by Nathan Davis, the AMA had several goals: To promote licensing requirements, to standardize education, and to provide a collective where all orthodox doctors could gather.  Although formed as a democratic union of orthodox doctors, the organization from the start sought to stamp a unifying dogma upon its members and the nation, one that included the medical racial script.  In fact, the script helped to congeal doctors under a single rubric of medical science, one shared by doctors North and South.  Weak from the start, the AMA hobbled along for many decades before emerging as the predominant Progressive force in American healthcare, one destined to change the system into the one we know today.

After the Revolution, American was severed from the European seat of orthodox medical power.  American orthodox doctors were forced to establish their own schools, their own dogma, and their own leaders.  Much of what glued orthodox doctors together and led to copious research was the medical racial script, much of which was inscribed in the standard medical school curriculum North and South.  However, during the Republican period, Americans eschewed labels, rules, and favoritism.  This translated into an ideal that anyone who thought themselves to be a doctor could be, without any desire to regulate physician education or practice.  For instance, no states maintained licensing requirements despite an orthodox push to do so.  Alternative medical ideas flourished.  We will discuss how orthodox medicine responded and how the American School--researches focused on racial medicine--lofted America into some degree of intellectual independence.

Starting in the colonial period and crystalizing during the Republican Period, American doctors differentiated themselves from their European colleagues and from non-traditional healers by instituting a medical-racial script.  We'll discuss what the script is, how it helped American healthcare and its white male doctors to establish legitimacy, and the toll it took on the African American community.  The script will be woven throughout this course.  Nothing more united white male doctors, helped grow the American medical infrastructure and academic foundation, and imprinted on American medicine its enduring stamp than the script.  As we study the nidus of the AMA in the mid 1800's, the Progressive rise of orthodox medicine in the early 20th century, and the consolidation of modern orthodoxy, the script emerges as an often covert but powerful catalyst to the health care system we know today.

I will be presenting a series of lectures on the history of American Health Care through 1920.  These lectures are interesting in how they lay a framework for the system we have today.  The first lecture explores our colonial origins.  How did the American healthcare system and its doctors change from their European mentors?  What about the American landscape fermented something unique in the colonies regarding the practice and study of medicine?

Antibiotics are one of the most impactful medical discoveries in the past century.  Along with sanitation and sterile technique, antibiotics have led to a dramatic increase in life expectancy.  However, now we have moved down a different road.  We are over-using antibiotics, killing our gut bacteria, causing resistance leading to superbugs that can't be stopped by any of our technology.  The judicious use of antibiotics is lifesaving.  The overuse of antibiotics is just the opposite.  Hear the two docs talk about this important issue!

Drug companies, the media, physician groups, and patient advocacy groups, month others, have convinced the American public that the key to health is more testing, more doctor visits, more drugs, more procedures.  We have invented more diseases and diagnoses the past decade, scared more patients into falling prey to "necessary and lifesaving" interventions for conditions that are more phantom than real, and yet no one is talking about what really matters.  In areas of the world where people live far longer than we do, and have far less chronic illness, they don't see doctors, take drugs, or suffer from fabricated diseases.  They eat well, exercise, and have strong communities, all of which contribute to their better health.  While our system is excellent at fixing urgent problems such as a ruptured appendix or heart attack, it is awful at keeping us healthy, largely because it has spread a false gospel that people are sick when they're not and that they need more of what our system has to offer, all of which contributes to the $5 trillion healthcare cost and simultaneous drop in life expectancy.  Today Alan and Andy discuss what really matters!  And it's not what your doctor will likely tell you!

Today we talk about the impact of drug advertisement on both patient and physician decision making.  These companies know that a huge investment in ads will result in more prescriptions, one of many ways Big Pharma infiltrates so many aspects of the medical industrial complex.

With the opioid crisis looming on the horizon always, the question comes as to how to treat pain.  So many medicines have side effects an are overall dangerous.  Some work about as much as placebo.  We'll talk about medicines, but then discuss better ways to deal with pain, from mindfulness to exercises to other non-medical modalities.  Pain is real, but pain should not be an invitation to be smothers by medicines and the medical system.  We will help you through this!

We have always known about basic cancer screening tests, like mammography and colonoscopy.  But we have expanded the universe of cancer screening, relying on scans, blood tests, and genetic testing.  As we screen more, we find more, we treat more, but are we saving lives?  Much of the screening we do has not been shown to save as many lives as advertised, if any at all once the complications of the screening are taken into consideration.  A new study in JAMA questions some newer screening tests, and past studies in Archives of Internal Medicine have found that overall most screening is not life saving.  The new screens are even more perilous, introducing increased uncertainty to an already uncertain field.  It's interesting to read Malcom Gladwell's take on screening in the New Yorker, helping us to learn about the promise and perils of basic screening.  Alan and Andy will tackle this issue through the lens of their experience and a whole lot of data!

Many books and studies have pointed to the fact that we are a nation swimming in mental health diagnoses and drugs.  The DSM--the bible of mental health diagnoses--has exploded the numbers of mental health sicknesses you may have, and for every sickness there is a drug.  Both the DSM and the American College of Psychiatry are heavily funded by the drug industry, and their recommendations have led to a skyrocketing of drugs for the brain, without any reduction in depression, anxiety, hyperactivity, or any other common ailment; in fact, they are all on the rise.  We are exposing kids and elders to these drugs which are outright dangerous.  We'll talk about this disturbing trend and highlight some books and articles that may be helpful.  

The American Heart Association (AHA) has devised new blood pressure guidelines.  In this iteration, the AHA tell us that any blood pressure over 120 is dangerous and must be treated, with pressures over 180 requiring immediate hospitalization.  There is no age cut off, and no accounting for individual variability. That the AHA is highly dependent on Big Pharma for its financial coffers, and has on its leadership many ex executives of Big Pharma, likely helped trigger there anti-scientific and dangerous recommendations.  In fact, only one flawed study supports their recommendations, while dozens of others refute them.  We will discuss this through the lens of science and common sense, and we'll demonstrate why guidelines are often worrisome, and how these recommendations demonstrate the power of Big Pharma over medical care. 

New studies show that as we are drugging our senior more, they are falling more and dying more from their falls.  We may think that dramatically lowering blood pressure and sugars, fixing cholesterol with statins, using blood thinners to prevent stroke, and medicating sadness are beneficial, but the pile of drugs we're tossing into elderly bodies to "fix" aberrant numbers is leading to more deadly falls.  We must turn our back on specialists who demand we must take so many drugs, and return to common sense and healing as a guide to treatment.

In Return to Healing we lay out a very simple fix to the medical mess we are in.  We spend the first half the book explaining why it is a mess, and then the second half talking about who is profiting from the mess.  Then we give the fix.It's really very easy to repair a system that is simply off the tracks.  We lay it out simply.  This is one you don't want to miss!

Alan and Andy talk about how medical school does not prepare students to be whole-person doctors, focused on numbers and multiple choice answers and slices of the body.  William Osler devised an ideal medical school at Hopkins before the Flexner Revolt took it down.  In the Osler model students work with community primary care doctors from day one and throughout their entire medical school curriculum.  They see patients and then learn the science behind the diseases and aspects of health they present with.  We can easily fix medical school to produce doctors and not technicians, but it requires a knowledge that it is now very broken.

As two primary care doctors with a collective 75 years of experience, we understand the benefits of having a primary care doctor who develops strong relationships built on trust, who customizes care to each patient, who takes a patient-centric and whole-person view of care, and who is critical thinker looking beyond the protocols and drug-company dictated "truths."  Multiple studies have shown that in areas with more primary care providers outcomes are better, people live longer, costs are lower, and patients are happier.  That is because we're not paid for doing things to you--tests, procedures, drugs--but rather are paid to take care of you.  We talk about how a primary care system would work.

There is no question that primary care is dying in this country, much to the detriment of our entire healthcare system and every person who utilizes it.  We talk about an article called The Eulogy for Primary Care that talks about why it's dying and missed opportunities.  Not only are no medical students entering the field, but those in it are burning out and having almost no time to actually care for patients.  We talk about our own experiences and how grateful we are to have been able to carve out a way to still be real doctors for whole people who we have known for long periods of time.  In the end, unless we can revive primary care, there will be no healthcare system, just number fixing and organ repair, all at huge expense with horrific outcomes.

We look at the role of primary care in our health care system and discuss why it is the crucial ingredient to save lives, lower cost, and help people feel better and be healthier.  As we gravitate toward a technician-run specialized system that rewards expensive drugs, tests, and procedures rather than whole-person holistic care, we are devaluing primary care and valuing what makes our system worse.  We talk about the data showing how a viable primary care system is crucial to any reform and why this is not occurring.

We know that at the hospital medical students, residents, and hospitalists dive into a Flexnerian orgy of tests, treatments, and more tests.  Is this helpful?  We'll go back in time and look at Osler's dream at Hopkins before it became the poster child for Flexnerian medicine.  

People are losing weight on the new drugs, but at what cost?  First there is the financial cost: we're paying $35 billion a year for these drugs, and don't be fooled, all of us are paying.  While insurance pays nothing for nutrition or exercise, it gladly pays for this.  And these drugs are untested long term, with some horrific potential side effects if you take them for a long time or if you stop them.  This is how our pharma industry works: big promises, little data, hide the side effects, but no money for actual lifestyle changes.  Maybe these drugs will be great, likely they'll have severe long term problems, but we are all paying a steep cost to put pharma profit over truth and not spending any money for real determinants of health: diet, exercise, stress reduction.  A shot seems appealing and requires no effort, but it can't substitute for what we know will work.

Alan and Andy discuss specialty care and its inherent dangers.  We tell about specific patient examples, why excessive specialization seems appealing but results in over-testing and over-treatment, and how we can instantly change policy to mitigate the damage from specialization.  Ultimately specialists are paid more to convince people they are sick and lead them down a road of testing, procedures, and medicines.A few book and article recommendations:-No More Tears, by NYT journalist Gardiner Harris, which explores the history of Johnson and Johnson and the complicity of media, the FDA, and academic medicine in the drug company's deceptive assault on the American public with dangerous drugs and products.-FDA Approved and Ineffective, by Shannon Brownlee and Jean Lenzer, in The Lever magazine, showing that much of what the FDA approves is both dangerous and ineffective as they bow to the wishes of Big Pharma.  Click Here for Article. 

Alan Roth and Andy Lazris discuss screening for prostate cancer to explain how screening can be less beneficial, and more dangerous, than advertised.  Just finding it early doesn't mean you've done yourself a service.

The Drug Industry was front and center in the creation of our health care industry.  The reforms that created modern healthcare in 1911 and beyond were predicated on developing a research infrastructure in medical schools and in the medical community to generate money for industry.  Nothing really has changed.  Now the drug companies have control over federal agencies like the CDC and FDA; over academic research and academic doctors who are paid to conduct research designed by drug companies; over consumer agencies like the American Diabetes Association, Alzheimer's Association, and the American Heart Association; over Congress members from both parties who they pay; and of course over the media where they advertise endlessly  They have taken over the reigns of our clinical protocols and even invent diseases like prediabetes and osteopenia to sell more drugs.  We dissect this situation and talk about solutions.

In our book, A Return to Healing, we dissect what is wrong with our health care system, and show how you as a patient can better advocate for your own health in a system that often deceives you for profit.  But too, we want to fix the system and we explore a feasible solution at the end of the book, one that is simple to achieve and one that would lead to massive financial savings at the cost of improving your health.  We discuss this idea in our newest podcast.

In the show Apple Cider Vinegar, the writers create a binary: the good and all-knowing doctors vs the charlatan nutrition gurus.  The gap is so wide between the two approaches that the reader is left thinking that in cancer, as in all things medical, doctors always have your best interest in mind and if they thought you should change your diet they'll tell you.  Doctors are not trained in nutrition and are taught to view your body through numerical measurements that, if abnormal, can be "fixed" with drugs or procedures.  We will talk about why diet is so important and why doctors fear talking about it.

Whether it is in attacking Kennedy, or in refusing to acknowledge what is dysfunctional about Medicare, Democrats use us vs them binary thinking to defend the medical system.  By finding easy targets that seem inane, or by inventing those targets by twisting the truth, the defenders of our horrific medical system prop themselves up by posing as the reasonable ones.  David Frum in the Atlantic did just that in his piece "Why the COVID deniers won."  The very title presents a binary: we are the COVID accepters, those are the COVID deniers.  What is a COVID denier?  To Frum, its anyone who disputed the gospel of Anthony Fauci or who questioned the need to take an experimental vaccine.  Frum defines science as listening to the "experts."  In fact, the science he uses in his article is absolutely absurd and unsubstantiated, and the experts he points to are the very people who lied to us, bullied us, censored us, profited from COVID, and turned their back on scientific discourse.  He admits, for instance, that closing schools was a mistake, but at the same time discredits the many scientists who from the start said just that.  He notes that COVID was not dangerous to the young, but labels anyone as anti-scientific and dangerous--even those very young people--who didn't want to take the COVID vaccine or who denies that COVID was a severe universal threat.  He presents no nuance about the vaccine, never brings up that government databases have shown it to be the most dangerous vaccine in history, and that not a single study has demonstrated that it had or has any public health benefit.  His notion of science--do what my self-selected experts say and censor everyone else--and his "facts" about COVID--all of which have been debunked--push him down a road that props up the very people who stood in the way of a scientific and humanistic path through COVID, leading us to the worst outcomes in the world.  That's COVID denialism: questioning bad science, dangerous mandates, poor policies, and censorship?  As we will see in this and the next podcast, by erasing the common-sense middle ground, and by positing every medical issue as an us vs them binary, the system stays afloat, even as it continues to harm those who it tricks into submission.

We all believe that cholesterol is so bad that we better measure it regularly and lower it by drugs.  Just ask your cardiologist: Got to get that LDL cholesterol below 70 or catastrophe will ensue!  But as we explain, this is a myth that germinated back in the 1950's and has been perpetuated and normalized over time.  Virtually all doctors believe in this myth and preach it to you.  The facts are far different.  Measuring and lowering cholesterol does not help prevent heart attacks or allow you to live a day longer; in fact, it is both deceptive and dangerous.  And going on a low-fat died is medically insane and causes significant inflammation in the body that actually promotes diabetes and heart attacks.  This podcast will take you through the history and science and help you to protect yourself from this prevailing myth and become smarter than your doctor.

The statistics bounce around about COVID even as the virus wanes and becomes just another recurrent cold.  But the religious fanaticism of the COVID faithful, the rituals, the restrictions, those have not disappeared.  In my world of geriatrics and long term care, my patients are still being made to suffer and even killed by those doctors and policy makers who insist that the COVID religion must not be challenged.  Here is a story of one such patient, I call her Mrs. X, who made me cry one morning during my rounds because amidst the religious zealotry of COVID and our medical system I stood helpless as her life drifted away.

From masks to one -way aisles to PPE to 20-second hand washing and 6-foot separation, COVID has demonstrated the religiosity of health care more than any singular event in my lifetime.  The Gospel of Infectious Disease, which includes public health, is a frightening one; these doctors and their agents have consistently been on the wrong side of science and have helped orchestrate some of the most heinous medical outrages in our nation's history.  In COVID, they took their religiosity to new heights, condemning our land, its people, and our medical science to baseless rituals and religious mythology all of which they and our nation's doctors conflated with science.  The result has been a desecration of medical science, and the instigation of death and suffering of millions of souls.  This is the first of several discussions of COVID, because COVID opens a window in the most blatant way possible for us to see how our doctors and medical institutions have abused science and inaugurated a medical theocracy that benefits them and harms all those who are its faithful congregants.  

In my book The Great Stupidity, which chronicles the journey of a naive and gullible French boy who seeks to find a cure for the Black Plague and to speak with the Great Frenchie in Paris who promises to provide the scientific means of stopping the plague, from waving ones hands to other absurd but accepted rituals, I seek to show how dangerous it is when we use religion to combat a medical crisis.  When the boyh finally finds the Great Frenchie he sees that this man is misusing science for his own advantage and is in fact a charlatan, although the world refuses to believe such heresy.  In this blog I talk about the religiosity of health care through the lens of the Great Frenchie, showing how we are really no better than those who confronted the Black Death with similar medical deceptions and rituals all to the same devastating end.  I have included the Sciencey Song, although it can also be found on my website under songs at www.andylazris.com.

Prostate cancer helps us understand the religion of health care through a very unique lens.  For any religion to be effective it must instill fear into its adherents, have priests who offer a means of alleviating that fear, and then provide appealing but ultimately deceptive techniques to "cure" someone that seems to be sensible and effective but which in fact are dangerous and misleading.  Prostate cancer inflicts about 30-40% of all men, but kill less than 1% of those who get it.  Most men die with prostate cancer, not of it.  But the Medical Industrial Religion and its Medical Dogmatists (MD's) have used this common and frightening disease to convince millions of trusting men to put their bodies and pocketbooks in the hands of the medical priests to their and society's detriment.  About 1% of men who have prostate cancer die of it, and the very expensive and dangerous treatment (hormones, radiation, surgery, chemo) does not change that calculus.  Let me say that again: 1% of men die of prostate cancer whether they are treated or not.  Since it's a slow growing cancer, it's fairly resistant to treatment.  We can measure a PSA lab test to see if a man may have cancer.  If it's high, we can do a biopsy to confirm it.  Then we can assault that man with treatment that may maim or kill him and almost certainly will cause some palpable harm, but it will not help him live a day longer.  A recent study confirmed this, as have so many others. Checking PSA levels doesn't help anyone live longer or better, and treating prostate cancer doesn't help anyone live longer or better; just the opposite in fact.  But the Medical Industrial Religion has so bamboozled the public as to make them think that PSA testing is useful and treatment is both necessary and effective.  We pay over $100 billion a year to the medical priests and hospitals and other agents of the faith all to lower the PSA number (treatment does do that!) but not to help a soul.  We pay that money to deceive people and harm them all in the name of salvation.  Listen to this podcast to learn how well prostate cancer helps us to understand the power and appeal of the medical religion.