Straight Talking Doc Unhinged

Protocols, Medical Boards, and medical censorship

Sun, 05 Apr 2026 13:00:00 -0400

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 History of Medicine Part 13: Where are we Now?

Sat, 04 Apr 2026 17:00:00 -0400

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: Promises and Reality

Sun, 22 Mar 2026 18:00:00 -0400

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.

The History of Medicine Part 12: Flexner and African Americans

Sun, 22 Mar 2026 18:00:00 -0400

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.

2026 Cholesterol Guidelines: Putting number fixing over people and science

Sun, 15 Mar 2026 19:00:00 -0400

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!

History of Healthcare Part 11: The Flexner Report

Wed, 11 Mar 2026 19:00:00 -0400

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.

The Medicalization of Depression

Wed, 11 Mar 2026 19:00:00 -0400

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.

History of Healthcare Part 10: Welch vs Osler

Sun, 01 Mar 2026 19:00:00 -0500

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.

The Struggles of Primary Care

Sun, 01 Mar 2026 19:00:00 -0500

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 History of Medicine Part 8: The Cogs of AMA Reform 1900-1920

Sun, 08 Feb 2026 12:00:00 -0500

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.

Dermatology and the Illusion of our Skin Cancer Epidemic

Sun, 08 Feb 2026 08:00:00 -0500

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.

History of Healthcare Part 9: Eugenics and Medical Progressivism

Sun, 01 Feb 2026 16:00:00 -0500

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.

The Dangers of TV Medical Providers

Sun, 01 Feb 2026 16:00:00 -0500

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.

Some truths about nutrition, and it's likely not what your doctor tells you

Sun, 25 Jan 2026 13:00:00 -0500

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.

The History of Medicine Part 7: The AMA's change in direction

Mon, 19 Jan 2026 20:00:00 -0500

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.

Corporate Takeovers in Healthcare

Sun, 18 Jan 2026 16:00:00 -0500

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.

The History of Medicine Part 6: The African American Experience

Sun, 18 Jan 2026 16:00:00 -0500

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.

The History of Medicine Part 5: Alternative Medicine in the 1800's

Fri, 16 Jan 2026 22:00:00 -0500

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.

History of American Healthcare Part 4: The Origins of the AMA

Tue, 13 Jan 2026 20:00:00 -0500

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.

History of American Healthcare, Lecture 3: Medicine after the Revolution

Sun, 11 Jan 2026 16:00:00 -0500

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.

The History of Medicine Part 2: The Medical Racial Script

Tue, 06 Jan 2026 19:00:00 -0500

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.

The History of Medicine Part One: The American Colonial Period

Mon, 05 Jan 2026 19:00:00 -0500

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?

The overuse of antibiotics

Tue, 09 Dec 2025 19:00:00 -0500

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!

lifestyle medicine: the crux of what really matters

Sun, 30 Nov 2025 12:00:00 -0500

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!

drug ads

Sun, 16 Nov 2025 17:00:00 -0500

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.

Pain and Pain Medicines

Mon, 03 Nov 2025 19:00:00 -0500

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!

Early Screening for Cancer: The Perils and Promises

Sun, 12 Oct 2025 18:00:00 -0400

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!

Overtreating our mental health

Sun, 12 Oct 2025 08:00:00 -0400

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 Danger of our new Blood Pressure Guidelines

Mon, 29 Sep 2025 17:00:00 -0400

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.

Too many drugs, Too many falls, Too many deaths

Fri, 19 Sep 2025 20:00:00 -0400

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.

A Simple Fix for our Medical Mess

Mon, 18 Aug 2025 18:00:00 -0400

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!

The Medical School We Need

Mon, 11 Aug 2025 19:00:00 -0400

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.

Primary Care Part Three: The Benefits of Primary Care

Sun, 20 Jul 2025 19:00:00 -0400

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.

Primary Care Part Two: A Eulogy for Primary Care

Sun, 13 Jul 2025 09:00:00 -0400

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.

Primary Care Part One: Why it is so Important

Sun, 13 Jul 2025 09:00:00 -0400

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.

Over testing in the Hospital

Sun, 22 Jun 2025 20:00:00 -0400

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.

Weight loss drugs: What's the problem with a taking a shot?

Tue, 17 Jun 2025 20:00:00 -0400

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.

The Dangers of Specialty Care: How misplaced incentives lead to high cost and poor outcomes

Sun, 08 Jun 2025 13:00:00 -0400

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.

PSA Screening

Sun, 27 Apr 2025 18:00:00 -0400

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 Impact of the Pharmaceutical Industry on healthcare

Tue, 25 Mar 2025 19:00:00 -0400

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.

How to Fix our Messed Up Health Care System: Lower cost = Better health outcomes.

Tue, 18 Mar 2025 19:00:00 -0400

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.

Apple Cider Vinegar: Why doctors stray away from nutrition

Sun, 23 Feb 2025 20:00:00 -0500

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.

How "Us vs Them" thinking is used to defend the medical system: David Frum and his Atlantic Article.

Sun, 16 Feb 2025 16:00:00 -0500

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.

the cholesterol myth.

Wed, 12 Feb 2025 20:00:00 -0500

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.

Episode 23: The human cost of COVID's Religious dogma, one patient at a time

Fri, 23 Feb 2024 17:00:00 -0500

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.

Episode 22: the Gospel of Infectious Disease, Book One, COVID rituals

Sun, 14 Jan 2024 10:00:00 -0500

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.

Episode Twenty-One: The Sciency Song and the Voice of the Medical Religion

Sat, 06 Jan 2024 12:00:00 -0500

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.

Episode Twenty: The Gospel of Cancer Book Two, Prostate Cancer

Sat, 30 Dec 2023 12:00:00 -0500

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.

Episode Nineteen: The Gospel of Cardiology Book Three: Eliquis

Mon, 25 Dec 2023 07:00:00 -0500

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!

Episode 18, The Religion of Medicine

Sun, 17 Dec 2023 10:00:00 -0500

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!!

Episode 17: Is your doctor a robot?

Fri, 06 Jan 2023 09:00:00 -0500

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.

Episode 16: The myth of cancer screening and PSA

Tue, 13 Dec 2022 12:00:00 -0500

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.

Episode 15: Debunking the Cholesterol Myth

Sun, 06 Nov 2022 09:00:00 -0500

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-gallery
Blog: https://www.personalphysiciancare.net/post/unlocking-the-cholesterol-myth

Episode Thirteen: The Flexnerian Biostate

Sat, 01 Oct 2022 15:00:00 -0400

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

Episode 13: The legacy of racism spurred by the Flexner Report

Wed, 10 Aug 2022 11:00:00 -0400

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.

Episode 12: The seeds of our medical destruction, Flexner Part Two

Sat, 30 Jul 2022 20:00:00 -0400

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.

Episode 11: The seeds of our Medical Destruction, Flexner Part One

Mon, 25 Jul 2022 19:00:00 -0400

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

Episode Ten: The harm of all those "lifesaving" Snake Oils

Sat, 11 Jun 2022 12:00:00 -0400

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.

Episode Nine: Which outcomes of medical interventions matter

Thu, 02 Jun 2022 16:00:00 -0400

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

Sun, 22 May 2022 19:00:00 -0400

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

Wed, 27 Apr 2022 12:00:00 -0400

“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 Osler

At 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.

Episode Six: The Bricks of Medical Deception

Sun, 17 Apr 2022 15:00:00 -0400

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.

Why patients believe the myths their doctors tell them

Wed, 09 Feb 2022 14:00:00 -0500

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.

Why doctors don't tell you the whole truth

Fri, 21 Jan 2022 17:00:00 -0500

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!

How medical statistics can trick you, the case of afib

Wed, 12 Jan 2022 11:00:00 -0500

How your risk and benefit of medical interventions is explained to you goes a long way into your deciding if you want to take that drug, do that test, or have that procedure. We all trust doctors to tell us the truth. Sadly, they often don't. Afib is an illustrative way to show how medical statistics can skew the truth and make a certain drug or intervention seem more beneficial than it is. We talk about clinical benefit vs numerical benefit, and relative benefit vs real benefit. This will be the start of our discussion to help you understand how doctors pull the wool over your eyes, and the questions you need to ask to make sure they don't.
To see two videos that explain statistical trickery, i have attached links.
This is a video made by Kaiser Health News and featured on NPR which shows the best way to understand medical statistics: https://www.npr.org/sections/health-shots/2016/10/12/497549732/skip-the-math-researchers-paint-a-picture-of-health-benefits-and-risks
And from our website, this is a video we have made: https://youtu.be/J9rA-Eaf57Y
You can also go onto the andylazris.com site and see more books and videos !

Afib and Medical Deception

Fri, 07 Jan 2022 14:00:00 -0500

We will start delving into how doctors and the medical system can fool you by using various statistical tricks, models, and deceptive declarations of fact. No disease is more illustrative of this than atrial fibrillation (afib), which is a heart condition that is a multi-billion dollar business. Whether you have afib or not, learning about it can help you understand the most basic concepts of how to interpret the risks and benefits of what your doctor tells you is "necessary and life saving!" We will break the discussion of this into various episodes, and then use what we learn to talk about other more common conditions. As we will see, what "experts" and your doctor tell you may be far from the reality of what they are peddling.

Introduction: Telling you the truth about healthcare

Fri, 17 Dec 2021 18:00:00 -0500

As a doctor of 30 years, an author of fiction and nonfiction, and someone who studies our healthcare system, I felt it was high time I tell you the truth about the the mess we call healthcare. Because, everything they tell you is necessary and lifesaving, all those drugs and tests they tell you that you better get or God forbid the consequences, it's all a bunch of nonsense. Modern health care has reduced people into measurable numbers that are "fixed," often to the detriment of the patient. In future podcasts we'll look at this one disease at a time. Read more on my website, www.andylazris.com.