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.

Health Care has taken the shape of a religious theocracy in this country, with Trillions spent for the allure of salvation and eternal life, and a medical industrial complex mimicking the Catholic Church of the Middle Ages driving people down dangerous roads of myth and dogma to feed the beast.  Medical priests, aka doctors, drive the faith and convince vulnerable and frightened patients to dive into the teeth of the medical religion lest they suffer eternal damnation.  No group of priests has so mastered the medical religion than cardiologists, who themselves have convinced their obsequious flock to sacrifice hundreds of billions of dollars and their bodies and souls to the gospel of cardiology.  Today we look at book three of that gospel, whereby the cardiologist priests have dogmatically declared the unassailable necessity of a very dangerous and often lethal drug called Eliquis (or Xarelto, same thing).  As we explore the Gospel of Cardiology, we will see that all the life-saving snake oils that these powerful priests toss at their faithful flock have led to more heart attacks, more strokes, and more deaths than had cardiologists merely left them alone.  As with many religions, the deception of the gospel maims and kills the very people it promises to save, and Eliquis is very illustrative of how these crafty priests have bamboozled so many people to hand over their money and bodies in obeyance to mythical cures clearly in opposition to their own self-interest.  A recent study shows us what we thinking doctors have known for quite some time: that the chance of dying or getting a stroke from Eliquis in the elderly far exceeds the chance of stroke prevention; 2% of people on these drugs die or get serious strokes a year and 15% end up in the hospital per year (all from bleeding), while only 0.6% of them prevent a stroke.  This calculus would mean that any Medical Dogmatist (MD) who prescribes this pill for afib in the elderly clearly is violating his/her Hippocratic Oath, while any patient knowingly taking it is more interested in the false allure of salvation than the dagger of scientific fact.  The proliferation of Eliquis, and its facile acceptance into medical society as a necessary and lifesaving drug despite robust data to the contrary, shows us the power of the Medical Industrial Religion, its self-serving and huckster Medical Dogmatists (MD's), the allure of the Gospel of Cardiology, and the propaganda network employed by the medical religion to harm people, drive up costs, and claim to be saving souls.  This is the medical religion in a nutshell, bloody and ugly but oh so revealing!

The only way I can grasp the huge gap between medical fact and the dogmatic myths spewed out by doctors and slurped up by frightened patients who seek salvation and long life is to view health care through the lens of it being a religion.  Everything about our health care system and its doctor-priests is tainted by dogma.  We spend $4 trillion dollars largely ticking people into selling their bodies and souls, and a lot of cash, for the promise of cure and life.  People rarely question doctors or the medical system.  They are inundated by dogmatic proclamations on TV, by their friends and family, by doctors and agencies like the CDC and various societies (American Cancer Society, Alzheimer's Association, ect) that tell them to dive into the health care system and to ask no questions.  It's all about faith, not science, and all of it is orchestrated and financed by our medical industries from big Pharma to the hospital lobby to physician organizations. That fact that our bloated Medical-Industrial complex is fueled by self-serving doctors and drug companies and hospitals and other agents of dogmatic deception, the fact that it has led to shorter lives and more chronic illness, that fact that science proves that it does not work, none of that deters people from believing their smart and caring doctor-priests and from tasking the Eucharist and adhering to the requisite rituals that they are assured will give them salvation and ultimately eternal life.  Thus will we unravel the religiosity of health care, the danger of believing doctors and others whose own goals verge far from yours, and the huge gap between science and the medical dogma being sold to us under the guise of being necessary.  See my most recent blog about this, and I have more books on the way!!

We have talked about how Flexner's imprint on US health care leaves doctors as unthinking pimps for the drug companies.  Doctors rarely independently evaluate interventions and tests, nor is their gaze patient-specific.  Rather, they are apt to listen to "experts," many of whom are either directly or indirectly (in terms of their academic funding and research opportunities) beholden to drug companies.  Doctors also listen to "authoritative" groups like the CDC or American Diabetes Association, all of which too receive the bulk of their funding and leadership from the pharmaceutical industry.  Rather than read studies, digest the pros and cons of purported "life saving" drugs an tests and treatments, and treat each patient as a complex nuanced individual, doctors rely on protocols typically scripted by drug-company tinged companies or doctors.  They essentially become robots, reciting the company line and not actually using their own brains.  This is most apparent when a doctor uses a calculator to tell you whether you are at risk from a certain ailment or should take this drug or that.  Calculators like this seem precise, but they are programmed with bogus data of which the doctor is unaware, and typically they are drug-company created.  Doctors don't know about this; they simply use the calculators as though they are factual and spit out the conclusions as thought they are unassailable.   These are robot doctors, and we will discuss more about them, as they can be very deceptive and dangerous.

We have been told that picking up cancers early and fixing them will save lives.  But does it?  It depends on the cancer.  For breast and colon cancer, for instance, lifetime screening saves 1/1000 people from cancer deaths compared to those never screened.  Other cancers, such as ovarian and pancreatic, are so aggressive that screening is not of value, since once these cancers are visible they have already spread.  Prostate Cancer is the opposite.  It effects 35% of all men, but kills only 1% of them.  It grows so slowly that early treatment doesn't impact the rate of death; if you're unlucky enough to have the rare and severe form, treatment won't help.  Doing PSA blood tests will pick up prostate cancers, lead to biopsies and tests, lead to aggressive and harmful treatments, but save no lives.  Then, why do we do it?  It costs our health care system tens of billions of dollars every year, feeds doctors and other members of the Medical Industrial Complex with lots of money, and gives men the illusion that their lives are saved, but causes far more harm than good.  Listen to why PSA tells us a lot about our nation's doctors and health care system and why we need to fear both.

Since the publication of Ansel Keys landmark and fraudulent Seven Countries Study over 50 years ago, our nation has been on an anti-cholesterol kick.  We ascribe almost God-like meaning to the cholesterol measurement--especially Big Bad LDL--and are hell bent in doing whatever is necessary to bring it below some magically drug-industry defined threshold either with medicines or by sticking to a low fat diet.  What we have known for decades, and what a recent article reinforced (https://www.sciencedaily.com/releases/2022/03/220314120702.htm#:~:text=2-,Link%20between%20high%20cholesterol%20and,'inconsistent'%2C%20new%20study%20finds&text=Summary%3A,as%20strong%20as%20previously%20) is that cholesterol is a meaningless measurement.  By focusing on it, we have over-medicated Americans to the tune of likely a trillion dollars of wasted treatment, we have glorified a low fat diet that is both dangerous and ineffective, and we have effectively slaughtered millions of people and disabled hundreds of millions more by passing out bad advice about cholesterol.  And what is most tragic is that our Flexnerian trained doctors have not relented, still measuring cholesterol, still deluging patients with often toxic and typically ineffective pills,  and still thinking that the low-fat dogma is good medical care.  It's not, and in this podcast we'll explain why.  Our Flexnerian obsession with finding a number that defines us, and then "fixing" that number, has led us down many very dangerous and expensive roads, but cholesterol is the road that should be most disturbing only because of how heavily traveled it is.I have discussed this too in a video on my practice website and in a blog i wrote for my practice website, but it's also in all my books and several articles that can be found on my general website www.andylazris.com.  video, look for cholesterol: https://www.personalphysiciancare.net/video-galleryBlog: https://www.personalphysiciancare.net/post/unlocking-the-cholesterol-myth

From the seeds of Flexner's Report grew the biostate in which we currently live.  COVID certainly was the biostate on steroids, although the biostate has been part of our lives for decades thanks to Flexner.What are the ingredients of a biostate?  First and foremost, I don't want it to sound like some conspiratorial James Bond Villainy type of creation.  In fact, the biostate is multifactorial, not controlled by some nefarious government, but rather driven by a health care system constructed under Flexner that encompasses industry, physicians, hospitals, government agencies, private agencies, and all citizen of the nation henceforth called "patients."  In the biostate, patients are willing to trade their freedom, their skepticism, and their very bodies to those who promise cure for diseases they are told they have.In the biostate, fear is the fuel of everything.  There must be constant fear infused in the air for patients to be willing to trade their souls for a promise of medical salvation.  Fear of catching COVID prompted a large sector of the population to willingly mandate experimental vaccines even on kids who had minimal risk of illness while decrying all pretense of "pro-choice" or "our bodies ourselves," shut down society for almost two years including both stopping and then severely impinging upon education and low wage jobs, allot to Governors and Mayors unprecedented power over people's lives and even people's ability to speak, promote censorship, and engage in medically meaningless but culturally oppressive measures such as universal masking and travel restrictions.  While COVID required an intense and unending flow of fear to enable the biostate to exert such power and influence over the population, Flexnerian medicine has been using the flames of fear to achieve its goals more insidiously during most of our lives.In the biostate, all knowledge and data is produced by those agents most likely to benefit from a universal compliance to medical dogma, with physicians, drug companies, and academic medical centers taking the lead in creating medical myths.In the biostate, patients are told they must submit their bodies to tests, drugs, and treatments for diagnoses they have been given by numerical testing lest they die or suffer, without any concern for the negative ramifications of such aggressive care.The biostate does not distinguish between the old and young, rich and poor; it scares everyone equally and shoves pills and tests and procedures down everyone's throats with a false promise of saving lives.The biostate has transformed our society into a medicalized dystopia, with everyone leaping from doctor to doctor, taking drug after drug, test after test, procedure after procedure, to "fix" all the abnormalities and address their frightening diagnoses, all done under false pretenses, with drug companies providing the false data, the media using drug company data to scare people into submission, and doctors acting as the pimps of drug companies.As our biostate spends more and more money tricking people into giving our their bodies and money to robotic swindlers with an MD after their name, as they wear masks and swallow handfuls of pills with a religious-live submission to those who preach medicalized myths, we are living shorter than virtually every advanced nation in the world.  We spend the most, and we do the worst, and even so, all the patients promised cure, those who stent their arteries and suck down pills, those who trust their specialists and believe that their lives are being saved, they are the willing accomplices to the Flexnerian nightmare in which we live.To understand our dysfunctional, self-serving, and nefarious health care system, you have to understand Flexner and the biostate it created.  We will explore the concept here, and then move on in subsequent podcasts analyzin

We have already heard how the Flexner Report in 1911 reduced doctors to robotic drones, beholden to corporate America, under the strict rule of AMA policies and dictates, who were taught that patients are nothing more than a series of numbers to be measured and fixed.  The blueprint of Flexner--drawn up by corporate tycoons, eugenic doctors, and the AMA brass--sought to homogenize American medicine, make it subservient to corporate America, and reduce it to a one-right-answer "science" in which human nuance, individual choice, and the breath of scientific knowledge is bulldozed by dogmatic absolutism, much as we are seeing with COVID but which has been present since 1911 when the report was published.   The critical thinking and humanistic patient-centered gaze advocated by William Osler collapsed in the face of what we have today: doctors following protocols, treating numbers, and acting as unwitting pimps of the pharmaceutical industry, all while touting that they are scientific and patient-oriented.  Sadly, Flexner did to our doctors what the German educational system--upon which the Flexner Report was based--did to its doctors, the majority of whom became enthusiastic Nazi's.  Really, there is little difference between us and them.One lost legacy of Flexner is how the report essentially--and intentionally--decimated the black physician professional class and relegated all black Americans to potential spreaders of disease to whites whose contagion had to be contained.  The Report--which is still the foundation of our health care system today and how medical students are trained--devoted several pages to describing its anti-black position, claiming it to be necessary, and which the AMA had been already practicing for decades.  The Report's recommendations closed all but two black medical schools, depriving them of funding and seeking to transform them into institutions to train black health-workers whose sole job was to keep black Americans from spreading disease to whites.As the decades progressed, the exclusion and marginalization of blacks within our health care system only worsened, and black physicians had to fund their own schools and create their own medical organization--the NMA--merely to survive.  Black Americans have suffered the consequences of this horrific policy.  Only recently did the AMA apologize for its racist past, but the gears of that racism inscribed into the Flexner Report still drive our entire medical-industrial complex today.Part 3 of our Flexner podcast mini-series is a bit long and taken from the final project I completed as a student at University of Maryland last year, where I am working toward a Masters of History.  While this is a bit of a detour from the theme of the podcast, it's crucial to know just how deeply racism is embedded in our health care system even today, and understand the roots of its perfidy, the very roots that drive the cogs of the doctors who you trust so much but who remain shackled by the handcuffs of Flexner.

In part 2 of our look at the Flexner Report, we explore the nuts and bolts of the report and show how an insignificant educator, a fledgling medical organization, and a Eugenicist at Hopkins conspired with industry to reshape the entire medical industrial complex.   The Report determined which medical schools would live and die.  To survive the onslaught schools had to shift their curriculum to one that was formulaic, number-focused, taught by full time research faculty, and dependent on the largess of the Rockefeller and Carnegie Foundations.  Osler was bulldozed as medical schools were now set up to train drones focused not on patients and using real doctors and patients to teach students but rather on one-right-answer absolutism, where number fixing and dogmatic protocols became the norm.  We show how this report grew and thrived, and begin to explain how its imprint--and even the details of its blueprint--define American health care today.

In 1911 the medical world redirected itself with the publication of the Flexner Report, a legacy we still live with today.  Everything we discuss in this podcast--from putting numbers over people, to doctors being pimps of drug companies, to industry infiltrating every aspect of health care, to people being bamboozled by false promises and expensive treatments--was born out of the womb of Flexner.  In the first of a four part podcast, we will explore how the patient-centric, critical thinking, scientific, and humanistic creed of William Osler fell prey to the Flexner alliance.  With the report, eugenic medical thinking--in which all people could be reduced to fixable measurements--, industry, academia, and the AMA all joined forces to gain everlasting hegemony over doctors and the entire health care system.  From now all, all doctors must be trained and licensed under the centralized top-down claws of the AMA, academic centers had to follow strict AMA protocols, and industry financed and controlled the whole thing.  While we think that our health care system is scientific and caring, in fact it is just the opposite, and by understanding Flexner we'll learn why.  My colleague and I, Alan Roth, have written a book about the role of the Flexner Report in poisoning our health care system, a book likely due out in a year.  This is a sneak peak!  You can see a bit about it on our website, https://www.andylazris.com/a-fork-in-the-road-at-hopkins

When doctors uses deception and tricks to convince you to think that all the tests, drugs, and procedures they sell to you are "necessary and lifesaving," it's also crucial that they sell you on a fiction even more crucial to their role as unwitting pimps for the drug and device companies.  They have to convince you that their snake-oil remedies are safe!  Of course, they have tricks up their sleeve to do that,  but studies show that most doctors don't need tricks, since 90% of doctors don't even know the dangers of the drugs they're prescribing or the tests and procedures they are being paid handsomely to push on you.  Doctors get the majority of their knowledge from the media, from specialty society guidelines, and from drug-company sponsored studies.  And to them, drugs and procedure are all good.  If blood thinners help 0.6% of people with afib avoid meaningful strokes and kill 0.6% of people, to a doctor that means:  "You better take this medicine or you'll get a stroke, and there are really very few side effects."  We will dissect some of this deceptive thinking and provide you with tools that you had better bring to your doctor lest you become a victim of the number fixing game.  Remember, in the world of modern medicine, your numbers and diagnoses are more important that you are.  And in many cases, for patients not aware of the risks, that formula can well be debilitating and even fatal.

When we have a medical society hell-bent on measuring and fixing your numbers, you'll get a lot of tests, procedures, and drugs all designed to find abnormal numbers and fix them.  But really, we need to base our tests and treatments on clinically meaningful outcomes:  does the intervention actually help you.  That help may be subjective  and not subject to be measured ("I have less pain from that medicine," or "My depression is much better since I started therapy."), or it may be measurable such as having fewer fractures, fewer heart attacks, fewer strokes, less confusion, or less chance of dying.  However, even there our doctors and their drug-company pimps have tossed a trick in .  For instance, drugs for atrial fibrillation may reduce strokes by 5%, but since we don't notice the vast majority of strokes that hit us, we care about strokes we actually notice, and on that score these drugs only cut the risk by 0.6%, of clinically relevant strokes, something your cardiologist won't tell you and likely doesn't even understand.  Similarly, certain drugs can reduce the chance of your getting a compression fracture of your back, and that's what the doctor will say.  But fractures aren't clinically meaningful unless you notice them, unless they hurt, and on that score, very very few clinically relevant back fractures are prevented with these drugs, even if the doctor will tell you otherwise based on the fact that your x-ray looks better.  When we start looking at tests and procedures and medicines--from opening blocked arteries to fixing your bone density to treating your dementia to lowering your sugar--the only outcomes we care about are clinically relevant outcomes, outcomes that improve your health or quality of life in some way, and this is something your doctor will almost never talk with you (or likely you won't buy their snake-oils), but something you need to know about before you dive into all these worthless tests and interventions deemed as "necessary and lifesaving" by your myth-peddling doctor.

As we delve into the dysfunction of our health care system, the most salient problem is that of numbers.  We as doctors and as a profit-driven health care mega-complex have reduced patients into a series of measurements that, if abnormal, label them with defined diseases and subject them to number-fixing treatments.  Whether medicines to lower sugars and cholesterol, stents to fix blocked arteries, medicines to "fix" low bone density, or going on blood thinners to cure afib, we are tabulated into numerical disease states and carved up and treated.  Patients love this stuff; it fits well into their cognitive biases that everything is measurable and fixable.  I mean, who would want to walk aroud with a 90% heart blockage or a bad bone density if they can be fixed, and why not get the sugar and blood pressure as low as possible?  Sadly, though, none of this helps the person being "fixed." Doctors don't care if patients get sick in the process, if they feel horrid, if they become more medicalized and anxious; the drive to slice people into numbers and fix those numbers is ingrained into the very ethos of American health care.  And what's worse, we keep changing the "normal" numbers so more and more people are abnormal, more people think they are sick, thus creating "numerical epidemics" like diabetes and hypertension that leads to more drugs and tests and procedures and more $$$ for doctors and industry at the expense of longevity and quality of life.  To understand everything wrong with health care, you must first understand just how dangerous it is to treat people as numbers.

“Far too large a section of the treatment of disease is today controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science.”-William OslerAt the turn of the last century, William Osler's vision of a patient-centered health care system based on science, critical thinking, and compassion was taking root at Hopkins.  But then came the Flexner Report in 1910, and everything Osler fought to achieve collapsed under the weight of the corporate number-fixing blueprint that is still in tact today.  While Osler said:  "The person who takes medicine must recover twice, once from the disease and once from the medicine," todays doctors say, "Take the medicine or you will die, and don't worry about side effects, if you get any, they're in your head."  While Osler said: "One of the first duties of the physician is to educate the masses not to take medicine," today's doctors are all about flooding you with medicines lest some arbitrary numerical abnormality not fall in the proper range, and scaring you to death if you dare defy their all-knowing wisdom.  Today's doctors are really nothing more than pimps for the drug companies.  They do their bidding, they sell their drugs and devices, and they advertise their products.  They do this by not caring about the patient and by convincing themselves (and getting paid very well to do so) that science and compassion implores them to force patients to do a lot of tests, get labeled as having a lot of diseases, and then taking a lot of medicines and having lots of procedures to fix these things.  No one is living longer because of these drug dealers masquerading as doctors, but patients--like all those addicted to drugs--believe that it's all cool, that they can't get by without those drugs and tests and procedures, that they'd be dead otherwise.  It's easy to see why patients are so deluded and manipulated, it's easy to see why drug and device companies want patients to be addicted to their stuff, but it's more difficult to understand why doctors are the very people selling patients this pernicious myth that is no more scientific or humanistic than the charlatans of old.  We'll explore this before we move on to discuss in more detail how doctors pimp their wares.  As to why they do it, beyond being well paid, well, that will require us to figure out a better way to choose and train doctors, because right now medical schools--which are essentially financed by the drug industry--want nothing more than doctors who keep dealing drugs and act as well respected pimps.

When we fall prey to doctors who promise us the world and delivery us a dish of deception and snake oil covered in a sauce of science and benign intent, we are easily fooled.  Doctors are good at frightening us and then telling us, in the most detailed and complex way, that we have a disease and they have the cure.  We either listen to them or we die.  We all received a big dish of this medical deception during the 2 years of COVID, and we believed everything we were told was necessary and lifesaving, the results of which were catastrophic:  the highest COVID and non-COVID death rate in the world, and a reduction of life expectancy by almost 5 years.  That's how doctors save us?  We will look at the tools doctors use in their dish of deception, tools that an unwary public swallows and thinks is helpful to them.  These include treating numbers and not people, using surrogate markers to stand in for real disease, and treating "diseases" that are not clinically relevant and that are of no consequence to the patient.  We'll discuss all of these ideas and then move on to some real life examples.

To understand why our medical system spends so much money to generate such bad results, we have to understand how it convinces patients to engage in acts that do not help them but which they believe are necessary and lifesaving.  Doctors often used deceptive statistics and false promises of cure to sell patients drugs, tests, and procedures that are either not beneficial or are actually dangerous.  Sometimes, like with afib, the sales job doesn't benefit the doctor, but the doctor has herself been brainwashed to believe in the intervention and becomes a proselytizer of a drug or procedure, something our drug companies love!  Other times, in the case of looking for and opening blocked heart arteries, doctors benefit greatly by selling patients snake oil wrapped in a caring package of scientific trickery.  We will look at cognitive biases--why patients believe things that are inaccurate but appealing--using the case of stents and blocked heart arteries.  The fact that hundreds of billions of dollars are spent looking for and opening blocked heart arteries, without anyone benefiting from this self-serving dish of snake oil, speaks to how much cognitive bias oils the gears of our medical industrial complex.  Unless you as a patient can understand this idea, you will be easy prey to those who seek to sell you dangerous and deceptive cures.

We've been discussing afib and the use of blood thinners to prevent strokes.  We showed how medical statistics can be manipulated to show exaggerated benefit while minimizing risk, how surrogate markers (all strokes vs clinically significant strokes) are used to exaggerate the benefit of the blood thinners, and how that flawed data can put inputted into a calculator to show a precise risk of stroke if you don't take the blood thinner.  But, doctors don't get paid more if you take blood thinners, so why are they so dogmatic that you follow that course?  Why are they so adamant that people must take these medicines, and why do they rely on surrogate markers, flawed statistics, and inaccurate calculators rather than discussing actual risk and benefits with their patient and being very up-front about the nuance and uncertainty in all medical decision making?  The answer doesn't come down to money, but rather to how doctors are trained and how they think.  We'll talk about all of that in this episode!