PODCAST

Straight Talking Doc Unhinged

Andy

A podcast by a doctor telling you all the dark and dirty secrets of my profession and how to understand what docs say and use it to become wiser and healthier! I separate myth from truth so you can be a better advocate for yourself.Remember the three keys to health: eat well, exercise, and stay away from doctors!

Start Here
Episode Nine: Which outcomes of medical interventions matter
Jun 2 2022
Episode Nine: Which outcomes of medical interventions matter
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.
Episode Eight: It's all about Numbers
May 22 2022
Episode Eight: It's all about Numbers
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.
Pimps and Drug Dealers
Apr 27 2022
Pimps and Drug Dealers
“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.