Dr. John Abramson was a family physician for 20 years who left his practice in 2002 to devote himself to researching the commercial takeover of medical knowledge. He has since served as an expert in medical litigation, served as a consultant to the FBI & US Dept of Justice & authored two books – Overdosed America & Sickening.
In this episode, he shares how the power of public conversation could be the key to sustainable change in the American medical system. He also explores why your doctor is a captured agent, answers the question, are Americans too lazy for healthy lifestyle changes?, the drug that that killed more Americans than the Vietnam War & the specific wording you’ll need at your next doctor’s appointment to help your doctor help you.
If you liked this episode, you’ll also like episode 176: HEALTH & WELLNESS MIXTAPE: HEART DIESEASE, STRESS REDUCTION & EMF SAFETY
Request to join my private Facebook group to give your opinion & participate in giveaways https://www.facebook.com/groups/mfrcuriousinsiders/
Guest: https://a.co/d/9cgu9Ci
Host: https://www.meredithforreal.com/ | https://www.instagram.com/meredithforreal/ | meredith@meredithforreal.com | https://www.youtube.com/meredithforreal | https://www.facebook.com/meredithforrealthecuriousintrovert
Sponsors: https://www.jordanharbinger.com/starterpacks/ | https://uwf.edu/university-advancement/departments/historic-trust/ | https://www.ensec.net/
Dr. John Abramson was a family physician for 20 years who left his practice in 2002 to devote himself to researching the commercial takeover of medical knowledge. He has since served as an expert in medical litigation, served as a consultant to the FBI & US Dept of Justice & authored two books – Overdosed America & Sickening.
In this episode, he shares how the power of public conversation could be the key to sustainable change in the American medical system. He also explores why your doctor is a captured agent, answers the question, are Americans too lazy for healthy lifestyle changes?, the drug that that killed more Americans than the Vietnam War & the specific wording you’ll need at your next doctor’s appointment to help your doctor help you.
If you liked this episode, you’ll also like episode 176: HEALTH & WELLNESS MIXTAPE: HEART DIESEASE, STRESS REDUCTION & EMF SAFETY
Request to join my private Facebook group to give your opinion & participate in giveaways https://www.facebook.com/groups/mfrcuriousinsiders/
Guest: https://a.co/d/9cgu9Ci
Host: https://www.meredithforreal.com/ | https://www.instagram.com/meredithforreal/ | meredith@meredithforreal.com | https://www.youtube.com/meredithforreal | https://www.facebook.com/meredithforrealthecuriousintrovert
Sponsors: https://www.jordanharbinger.com/starterpacks/ | https://uwf.edu/university-advancement/departments/historic-trust/ | https://www.ensec.net/
This is Meredith for real, the curious introvert and I'm Meredith here, we explore the taboo less obvious and paradoxical aspects of society. Questions that need nuanced answers, not just Google results, topics like Sex addiction racism. And like today wellness, each episode is different. So bring your add and your earbuds and have a look around. I got to say, this is not one of those episodes where we all just get fired up about the American healthcare system and head to the streets to riot. Although let's be real, most people would just head to Twitter. No, I really. I really do try. Too. To do things with actionable resolution for change. And that's where my guest really shined. if you're like me and you feel disempowered in this area of your American existence, and you're looking for ways to not just not die, but to live well, I think this episode will give you some precise, Strategies to work with your doctor, even down to what to say and how to say it. I have summarized the wording and the advice that my guest gives in the Saturday email. So if you don't get those and you want to, you can go to my website to get included. It's Meredith for real.com. If you end up liking this episode, you'll also like the one I did that is a compilation of wellness clips from the show. I call it a mixtape it's episode 1 75. All right, friends, keep it curious. Prius.
meredith_2_05-06-2024_130146:I think we all know that the American medical system is not working for us. The number one cause of bankruptcy here is medical debt. We're tempted to think, yeah, we're overpaying, but it's a quality product that solves our health problems. But. What are the chances that we're overpaying for declining health outcomes? John Hopkins, the NIH, and the BMJ all report medical error as the third leading cause of death in the United States. And a 10 year analysis in the Journal of the American Medical Association found a third of all FDA approved drugs had negative safety events after reaching the market. That's a D grade on a test. It may seem all doom and gloom, but My next guest believes that the power of public conversation could actually turn things around. He was a family physician for 20 years who left his practice in 2002 to devote himself to researching the commercial takeover of medical knowledge. He has since served as an expert in medical litigation. Consultant to the FBI and U. S. Department of Justice and authored two books, Overdosed America and Sickening. Today, he's going to share why our health depends on asking the right questions and how our response to corporate medicine corruption could be more than a collective shrug. Shifting perceptions and following the money trail, researching the research, Dr. John Abramson. I'm so happy you're here.
john_1_05-06-2024_140147:Well, Meredith, it's a pleasure to be here with you.
meredith_2_05-06-2024_130146:I think it's, safe to say that the goal of our conversation today is not to get ourselves and anyone listening simply worked up because as, you know, I alluded to, you feel like we can actually make a change if enough of us start having these conversations, with each other and our medical providers. But, my first question is, what would that change look like? Like, what would it look like if you were writing, I don't know, a movie script or something, and we all started having these conversations, what would be the process for that change to occur through simply having a more vocal public?
john_1_05-06-2024_140147:Right. So the first step would be to look at what's going on with American health care, how we're functioning, how the health of Americans compares to the health of, people in other wealthy countries. And what you see when you do that is that Americans have very much worse health than the citizens in the other wealthy countries. In 2000, the healthy life expectancy, the number of years we live in good health. Ranked 38th in the in the United States, 38th in 2000 and in 2019 before the COVID pandemic started, we had fallen all the way to 68th.
meredith_2_05-06-2024_130146:Oh my gosh.
john_1_05-06-2024_140147:in the world. So now Americans dying in excess of the level predicted by the average age adjusted death rates in the other wealthy countries and excess of more than 1 million Americans are dying each year. if our health were as good as the citizens of the other wealthy countries, one million fewer Americans would be dying each year. That's, that's like a 9 11 every single day because our health and healthcare is so inferior to that of the other countries. and it's not just, that a million Americans are dying in excess, it's But for that, Americans pay twice as much for their health care, which amounts to two trillion dollars in excess each year. That's more than the federal budget, deficit, each year is spent in excess on health care. So a million Americans are dying in excess each year. and we're wasting 2 trillion a year. 2 trillion. To put that in perspective, that's about as much money as is spent in the whole world on military arms. We're wasting on health care. so we've got a disaster going on. And, How to understand that disaster and how we got here is one thing. And another thing is why we haven't had this public conversation and why this, what I'm saying is going to be news to most of your listeners. It shouldn't be news. It should be on the front page of the newspapers and the headline of the news reports every day. it's just unimaginable that 3000 Americans are dying in excess every, so the first thing we need to do is talk amongst ourselves about these truths about our health care. It's hard to have this discussion in public. The mainstream media won't cover this. I've written two books. One was written, one was published in 2004 and one was published just a year and a half ago in 2022. And the first book, I got, good coverage in the media. I had op ed pieces in the New York Times, in the LA Times, Atlanta Journal of Constitution, reviews, and did maybe 80 national TV shows in 2004. When Sickening was published, I got zero mainstream coverage. Zero. A complete blackout. So that I've done a lot of podcasts. I've done the biggest podcast, Rogan and Lex Friedman and so forth.
meredith_2_05-06-2024_130146:Oh, and Meredith, for real, the curious introvert,
john_1_05-06-2024_140147:I was, I was getting to that. I I was getting to
meredith_2_05-06-2024_130146:I'm sure that. was top of your, publishing team's list. Like, oh, that Meredith girl. We totally have to reach out to
john_1_05-06-2024_140147:yeah. Well, they, they missed your first time around, but now we got it.
meredith_2_05-06-2024_130146:We
john_1_05-06-2024_140147:and, and, we'll straighten this problem out because now that you've covered it, the mainstream media will have to cover it.
meredith_2_05-06-2024_130146:I mean, here we go. Buckle up, everyone. Well, I think if I could interrupt a little bit, I think what. stops me personally. I can't speak for everyone from getting too into the weeds about this topic is it's upsetting. It makes me feel disempowered. It, it honestly will upset me to the point of tears. that sounds dramatic, but I feel so powerless in this department of My American existence that it is not something I want to talk about because I feel like there is no potential for change. So before we go more into the why and the how and all of that, if we were to have more conversations, if I could emotionally regulate myself so that I can talk about this more, I mean, what does change look like? What is the hope? that is before us that would cause us to push through the discomfort, the awkward conversations and the arguments that surely we would be having with our physicians. So
john_1_05-06-2024_140147:two separate issues. One is really good news because a large part of why Americans health and health care is so inferior to the citizens of the other wealthy nations is that we're not focusing. On the important things, prioritizing the important ways that we can protect and improve our own health, and that's part of what's getting drowned out by the biotech innovation and all the claims of the whiz bang technology. But the good news is that 80 to 90 percent of our health is determined by how we live our lives, how we exercise, how we eat, and If we smoke, if we, practice safe sex, if we don't over drink, regular exercise is a key part of this, and that's 80 to 90 percent of our health. 10 to 20 percent of our health is about health care, and we'll talk about that, and that'll get you depressed. But the good news is that when you understand that the biomedical world is not going to rescue you from bad health if you don't rescue yourself, and you can rescue yourself effectively, so you can take charge. As long as you don't get, as long as the ads and the, biotechnology industry doesn't get inside your head so that you're feeling, Oh, I can do whatever I want. I can smoke and the cat scans will find the lung cancers and I can, live an unhealthy lifestyle and, and I can get rescued by cancer drugs. That stuff, occasionally it works, and if you're sick, you use it, but the key message here is self empowerment. Take control. Now, some people can't take control. Some people don't have the time or energy. Some people live in food deserts. Some people live in communities that aren't safe to exercise in. And that's a real problem. That we have to handle at a government level. But for those of us who are fortunate enough to have pretty much control over our lives, let's take care of our own health and our family's health and not pretend that we can be rescued after our bad habits cause illness.
meredith_2_05-06-2024_130146:what you're saying by changing our own perception as individuals, then we will realize that the medical interventions and the, advancements that are being recommended and propagandized. That's not a word, but let's pretend it is. change our perception to be resilient towards the commercials and towards the, like automatic. I hate to use the word compliance because I know you're supposed to be compliant at your doctor's office, but like if we can resist that automatic Oh, whatever you say doc attitude Then you're saying by individually taking back that power seat that we will be Healthier because we'll understand we have more options
john_1_05-06-2024_140147:We have the options to live the kind of life that will make us healthier. So let me layer in another issue here. 96 percent of the research that is funded in the United States is about new drugs and devices. Okay. 4 percent is about improving our healthcare systems and making the population healthier. So 96 percent of the research that's done about new drugs and devices, that's what becomes doctor's knowledge, air quotes knowledge. That's the research that's done, the studies that are done, the studies that are published, that are picked up by the mainstream media. It's 96 percent about drugs and devices. The reason, and from an epidemiological point of view, it should be about 90 percent of our research ought to be about how to help people live healthier lives, create communities in a country. That is conducive to living a healthier life, but it's the reverse, and the reason why it's the reverse is because commercial market financial markets pretty much determine what the research agenda is, and they make money when they patent new drugs and devices, so we've got a tremendous distortion in the Allocation of the research to produce, so called knowledge that's about expensive new products over and above producing knowledge about how to make Americans healthier. So when you understand that, and that's the information that doctors rely on, that's what's in the medical journals. when you understand that as a first step, you're going to understand that your doctors are doing their best to keep up and practice so called evidence based medicine. But the evidence is hugely over weighted. Towards biotechnological innovations instead of a holistic approach to protecting and improving our health.
meredith_2_05-06-2024_130146:some might say that Americans are lazy and they're not going to follow lifestyle recommendations from their physicians if they were given. So a pill is better than nothing. Is there a little bit of truth to that?
john_1_05-06-2024_140147:Exactly. A little bit of truth. so two parts of that. Number one is that Americans are lazy and won't, engage in a process of taking control of their own health habits. That's just plain not true. That was proven in a study that was funded by the National Institutes of Health, published in the New England Journal in 2002, about people who are at high risk of developing type 2 diabetes. It's called the Diabetes Prevention Program. And this was a well done study, that randomized people at high risk of diabetes into three groups. A control group that just did their thing. A medication group that was treated with metformin, a drug for type 2 diabetes. And the third group was an intensive lifestyle modification group. Now, these patients were randomized into these three groups, so it's not like the people who were athletic previously volunteered to be in the exercise group. That didn't happen, and the studies that do that, that look at whether people who do in fact exercise are healthier than people who don't, those aren't good studies. They always show that the people are healthier, but Those are the people who are going to be healthier anyway, regardless of their approach to exercise. But this study showed that when you randomize people to engage in this intensive lifestyle counseling, that it worked. It reduced the risk of developing diabetes by 58 percent compared to the people in the control group. And the drug worked half as well. It reduced the risk of diabetes by 31%. So on the surface, this study is about helping people at high risk of type 2 diabetes to prevent themselves from getting type 2 diabetes by adopting a healthy lifestyle. But deeper than that, this study proves unequivocally, randomized controlled trial funded by the NIH that shows that the people who were randomized to the intensive lifestyle group did it. They did it. They lost weight. They increased their exercise. They decreased the risk of diabetes. So part one of your statement is that it's not true. it's a misleading meme that people won't make positive change. And I was a family doc for 20 years and I was deeply committed to helping people improve their, their health. Healthy lifestyle, to protect their health. and when I had somebody who was at risk of developing a disease, diabetes, osteoporosis, cancer, whatever, because of lifestyle, I would spend time with them, explain the benefits and, answer their questions and then have them come back in a month for a recheck. And about 95 percent of the people Hadn't made major changes at the end of the month. But the reason for bringing them back at the end of the month wasn't to give them star for the refrigerator if they made change. The reason was to say, okay, now you've tried to make changes and you've failed. Why did you fail? Now we start to work to figure out why you're not able to do this. Do you have to pick your kids up at daycare and take care of them because your husband or wife is not around? What is the problem here? And then we would work together to solve those problems. And I would get many of those people to adopt healthy lifestyle changes. Now, on the other side, question you posed is, Look, people don't want to make changes, they want to go on with their lives, so why not just take a pill? Well, let's look at the statins, for example, the cholesterol lowering drugs. There's never been a study about statins that compared taking a statin to adopting a healthy lifestyle. That's that study has never been done, and it's never been done because the drug companies don't want to do it because their sales of statins are just fine. And originally they were on patent. Now they're generic, but nobody ever wanted to fund that study. But the real issue here is that taking a statin, can reduce your risk of heart disease. High risk people reduce the risk of heart disease by about 20%. And that may be a good thing. we can turn the microscope up on those numbers if you want to. But a 20 percent reduction is what you get out of the statin if you're at high risk. The problem here is that there's an 80 percent reduction in the risk of heart disease by adopting a healthy lifestyle. So when people say, Doc, I just don't have the time. Just give me a pill. That would be fine. I don't have a moral objection to treating people with pills if a pill would do just as well, but the pills don't do just as well. It's an illusion. That's what all the drug ads are doing is they're creating the impression that these drugs work like a miracle and can sort of wash away your sins. They can't. They're not that effective.
meredith_2_05-06-2024_130146:So you said, Lifestyle changes can reduce the risk of heart disease by 80%, but if there's never been a study done to measure lifestyle changes on heart disease, how do we know that 80 percent number?
john_1_05-06-2024_140147:from population studies. So you can see in the populations of people who do exercise and do follow a healthy diet and don't smoke and don't drink too much and practice safe sex that they have an 80 percent lower chance of developing heart disease or stroke than people who don't do those things. Whereas statins at best can reduce your risk by 20%.
meredith_2_05-06-2024_130146:Okay. I think the tricky part for people who want to be healthy are open to lifestyle changes is they don't know where to start. And when they go to their doctor, because their doctor is working within this collection of, technological biomedical innovation, Those are the tools in their tool belt. they shrug. The doctor's like, I don't know. You know, you'd have to speak to somebody else about that. So how can a person begin to find credible resources in order to make Healthy and sustainable lifestyle changes that would help their overall, you know, well being.
john_1_05-06-2024_140147:That's a great question. And this is where the public can help their doctors be better doctors. there are electronic medical records, and the doctors are going to get graded on what people's cholesterol levels are, and all these, kind of facts, about, healthcare, but not the overall picture. But if you go to your doctor and you say, Doc, what's my cholesterol level? Should I be taking a statin? The doctor is going to respond to that. But if you go to your doctor and say, not what's my cholesterol level and should I take a statin, but how can I best prevent myself from developing heart disease? What can I do as a patient to best protect myself? if the doctor, and many doctors will, they'll get right into, we'll measure your cholesterol levels and so forth, and say, no, no, no, no. That's not what I'm talking about. I'm talking about what can I do to, modify my lifestyle so I minimize my risk of developing heart disease. And the doc will tune in on that. If the doc doesn't tune in on that, Then, they may send you for a consult with a trainer or something, but the doc should be able to tune in on that once the patient has. redirected the doctor away from a knee jerk biotech solution. the doctor will be amenable to that. Doctors are good people. They're trying to get through the day and practice evidence based medicine and do what they're supposed to do. If you say, doc, wait a minute, wait a minute. I'm talking to you. Look at me. Tell me what to do with my lifestyle to maximize my chance of staying healthy. I think Nine out of ten doctors are going to respond to that. And they're going to welcome that. That gives them permission to do what they really want to do, which is make people healthy, instead of worrying about numbers and tests and all the things that get checked off on a computer.
meredith_2_05-06-2024_130146:Are they equipped to give that information? I'm a little skeptical that if I were to ask a doctor that, that they would have information that I could lean on. Because, as I understand it, very Very few physicians have any nutritional studies in their medical training. it's like fewer than four hours. I forget what the status, but it was pretty bad. and, and honestly, if I'm being brutally honest, most of them are overweight and I have a strict policy. Dr. Abramson, I don't take advice from people I wouldn't trade places with.
john_1_05-06-2024_140147:Well, that's a good policy. But you've got to be careful, because you may need the doctor at some point.
meredith_2_05-06-2024_130146:Well, I'm not trying to offend them, but, you know, between you, me, and a fence post and whoever else is listening, that's kind of why I get hung up on, like, oh, I'll ask my doctor, and as you said, they are a bit of a captured agent
john_1_05-06-2024_140147:Yes, that's that's exactly right. And the ads that say, ask your doctor. The ads know that the doctors are trusting information that's not trustworthy, and the doctors don't have any option but to do that. That's another part of this conversation. but if you look your doctor in the eye and say, I want to know how to optimize my health by, modifying my lifestyle, they will either have an article ready for you from, the American Academy of Family Practice or other sources. the World Health Organization has good stuff. They'll have it there or they got to get it for you.
meredith_2_05-06-2024_130146:I love the word optimize. I feel like, language can be so powerful. We're limited in English, but, optimize is a great word because it would, in my imagination, at least signal to the physician that, Hey, I am not looking for ways to just not die. I'm looking for ways to live well.
john_1_05-06-2024_140147:Yes, precisely. And most doctors are going to respond to that. They may not volunteer it in the first instance. They may be looking at their computer and checking off the quality monitoring facts about cholesterol and your bone density and whatever. But you can reorient them. They're good people. They're trying to do the right thing. Now, another side of this. is the commercial distortion of the information that the doctors do have that you're referring to. And a shocking fact that very few doctors know, and even a lesser percentage of the public knows, is you always hear that a clinical trial is done and published in a good journal, New England Journal, JAMA, Lancet, whatever, and it's been peer reviewed. So that means that the Article that's being published is accurate and doctors not only can trust it, but must trust it to be a good doctor. And then those peer reviewed articles get put together and they get turned into clinical guidelines and the doctors have to follow their clinical guidelines. The fact that very few people know, who aren't listening to your show, is that the peer reviewers they read the manuscripts that are submitted, Summarize the clinical trials that are mostly commercially funded and the write ups have commercial involvement in them. And those manuscripts are submitted to the journals and then peer reviewers go over those manuscripts and decide whether the article should be changed and whether it should be published. What people don't know and doctors don't know is that the peer reviewers don't get the actual data from the trials. They don't get to see the data. So they can't assess whether the report that's published in the journal, which is peer reviewed and there's supposed to be you know, next to a word from God, they don't know that those manuscripts have not been independently reviewed. And this is an enormous problem that, Is not getting solved. We try and talk about it and there's little motions, head fakes to increase the transparency of the data, that the peer reviewers get to see.
meredith_2_05-06-2024_130146:So are you saying that the research is being ghostwritten by commercial interests?
john_1_05-06-2024_140147:I'm saying that much of the research is being ghostwritten. And almost all or all the research About drug company sponsored study is overseen by the drug company. it's so bad. There was an article that looked at the terms of research contracts, between academic medical centers and drug companies. So, most of the studies are done by private for profit research companies, but about a quarter of them are still done in academic medical centers. If you look at the terms of those contracts, half of the contracts between drug companies and academic medical centers give the drug companies the right to write the article and give the authors of the article The right to make suggestions about revising the manuscript, but not the authority to revise the manuscript. So literally, half of the studies of the highest quality studies, the ones that are done in academic medical centers and not for profit research centers, half of those studies actually say that the drug company can write the article and the authors can't change it. it's unbelievable. I mean, that's just straight ghostwriting.
meredith_2_05-06-2024_130146:to be incredibly deadly when you were an expert witness in the Vioxx case. I feel like that is such a dramatic but necessary example to bring up at this point because, It might be hard for people to really digest, like, what you're saying and the extent to which it matters, and so correct me if I'm wrong, but on the Vioxx case, Vioxx was an anti inflammatory, I think, that, ended up killing upwards of 60, 000 Americans, which collectively was more Americans. That, then those who died in the Vietnam War, but nobody was arrested and they didn't lose any money? Is that right?
john_1_05-06-2024_140147:they maybe broke even. I mean, it was a horrific problem. But just to get to the nuts and bolts of that, because it's the perfect case study to talk about the peer reviewers and the medical journal editors not getting the data. So Merck did a big study of Vioxx. Because they wanted to show that it was safer than other anti inflammatory drugs, because it didn't cause as many serious stomach problems. Now Merck knew that there was some risk that it would increase heart attacks and strokes. That the biology of the drug was such that it might tip the clotting balance. They knew that. And they designed the study to try and get around that. Well, the study was finished on March 9th, 2000. And it's called unblinding. When the study's finished, then the data are opened and the research executives look at it. So, the study was finished March 9th, and the data were opened, and the president of Merck Research Labs sent out an email, and the only reason we know this is because of the litigation that went on, sent out an email that said, it's a shame, but the increase in cardiovascular risk is there, with Vioxx and other drugs in the class, but it said, even so, the drug will do well, And we will do well, meaning we will make money. So they wrote it up and they sent their article to the New England Journal and it was published November 2000, nine months later. And in that article, there was no mention of overall cardiovascular events. There was no mention of the data that the FDA had that showed that the people who took Vioxx had more than twice as many heart attacks and strokes than the people who took the standard anti inflammatory drug. The editors and peer reviewers at the New England Journal didn't know that was true because Merck didn't include that data in its article that it submitted. And, after, the president of Merck Research Labs wrote that email that says the cardiovascular events are really there but the class of drugs will do well and will do well, After that, more than 50, 000 Americans died from cardiovascular disease. This was brought to my attention. I knew about Vioxx. I included it in my first book. And I was on the Today Show. week after my first book came out, Vioxx got pulled from the market. And I had talked about it in my book. So I was the guy who wrote the last book, and I was on the Today Show, and just maybe 80 national TV shows over the next year or two. I was on the Today Show twice. The second time I was on, I received an email from a mother who said, Will you please look at my daughter's autopsy report? She took Vioxx and died of a stroke, and nobody will tell us what happened. Will you please get involved in this? And that brought it home, this poor young lady, the, these facts have changed, so that the identity is masked. but this young lady fell, hit her head, in gymnastics practice. And had a CT scan and a workup and she broke her wrist, but she was otherwise fine, but she developed headaches and ordinary anti inflammatory drugs didn't treat the headaches. So the doctor gave, her mother eight samples, eight pills of Vioxx and she was dead two weeks later of a massive stroke. And this was going on all over the country. And the article that had been published in the New England Journal, which the New England Journal editors didn't know it was, untruthful, and the peer reviewers didn't know it was untruthful, but when it came out, when the FDA's review of, the VIGOR trial came out a few months later, the New England Journal didn't change its article, and the FDA knew that the cardiovascular events had been left out of the article, and they didn't correct the article either. That's their policy, is not to correct articles.
meredith_2_05-06-2024_130146:That seems so backwards. Is there a chance that part of the reason that this is such a difficult conversation to have on open platforms like mainstream media? Is that? We as Americans tend to be particularly susceptible to, snake oil salesmen when it comes to our health because we have No passed down knowledge. you know, our great great grandma, me, we don't know what country she was from. And so that, kind of, ancestral knowledge has been lost. And therefore we're like, Oh, if we dance naked in the moonlight backwards with an essential oil on our earlobe, we will cure cancer. Is that, is there a chance that the reason that this is becoming a difficult conversation or impossible really to have in the mainstream is because there's someone that thinks, well, this will actually end up saving lives because it'll keep people from being naked and stupid in the woods with essential oils.
john_1_05-06-2024_140147:You're absolutely correct. We have lost our deep heritage. But we also, on the plus side, we have this amazing biotechnology, knowledge that's been generated. Unfortunately, as a people, in an evolutionary sense, it's been lost. we learned to trust that historical knowledge, that ancestral knowledge. But now that ancestral knowledge is replaced by biotech innovation. And the problem here is that some biotech innovation is really good, like the drugs that can suppress AIDS infections. Some of it's really good. One out of four drugs is really better than drugs that were available before. But what's happened is that trust that people had for the ancestral wisdom has been transferred to the biotech industry. And the biotech industry knows that their job is to maximize the profits for their investors, not the American people's health. And the doctors who, I would say 95 percent or more are trying to do the right thing, have no choice but to follow the air quotes knowledge that is produced by the commercial, commercially funded research. they have to practice evidence based medicine. They have to follow the guidelines. And they don't understand The extent to which the privatization of this research and the non transparency of the data, they don't understand how important that is. I spent 10 years in litigation. In litigation, we would get about 20 million documents per case. 20 million documents and this isn't litigation like one person got hurt. These are national cases where there are committees of lawyers that are appointed by the court to develop the case and experts. I was part of a team of experts and the work that we did was applicable to all the people who were allegedly injured by the drug. I know what happens. And that's what's sickening is about the book that was published in February 2022. it's what is in those computers. that doctors don't understand because you can't get into those computers without a subpoena or litigation with discovery. And most of that information that I know remains secret. but enough of it, I can tell so that if people read Sickening, they'll understand. And doctors, especially, please give this book to your doctor, buy it for your doctor, give you give a copy or steal a copy and give it to your doctor, whatever, get it in your doctor's hands. Because the doctors just have no idea that the commercial interests are playing a kind of hardball that is just so lethal. They don't understand that that can be happening, that it can be that bad.
meredith_2_05-06-2024_130146:Hmm. Is it true that the FDA will stonewall better treatment options if they're not as profitable as what they're evaluating?
john_1_05-06-2024_140147:I don't think that's true. I think the market will stonewall them. I'm starting to see two drug ads in a row. I mean For the same illness. I mean, it's it's craziness. But you think, why are the drug companies spending six or 8 billion a year on these ads, which nobody would believe? And the answer is because it creates a kind of a baseline of imposed credibility about their products. And people and doctors just don't understand that not having to provide all the data to peer reviewers and guideline writers. Is creates this health crisis in the United States again. A million Americans are dying in excess of the deaths in the other wealthy countries. A million and we're spending 2 trillion extra for that. And it has to do with this commercial capture of what we call medical knowledge. And the doctors in their defense, they don't understand it. And it's not like I wish my doc would spend more time reading the journals. Because it's not in the journals. You need to be in litigation or have a subpoena in order to get this information.
meredith_2_05-06-2024_130146:Hmm. That, that feels so overwhelming, but I do like your point about talking to your doctor using. the right words, asking the right questions. And I think I heard you say in one of your lectures that you negotiate with your doctor to my generation, I think at least for me personally, that is a concept that I grew up with, that my mother taught me and I was in charge of talking to my doctor and asking questions and learning to You know, say, well, what else is my option at, I think age 16, like she would still go with me, but she wouldn't talk, but I, maybe that's not everybody's experience. Right. And so I heard you say that you negotiate with your doctor. What should that look like for someone who might hear that and go, what I can negotiate with my doctor?
john_1_05-06-2024_140147:Absolutely. So again, this is in sickening and you'll have the tools that you need if you read that, but let's talk about statins because the most widely prescribed class of drugs and many visits include doctors trying to get patients to take statins. So what that would look like is, let's say you go to your doctor and you don't have a history of heart attack or stroke. And the doctor says, well, your cholesterol is a little bit high. Let's put you on a statin and see what it does for you, meaning how it affects your cholesterol. The question you want to ask in this negotiation is what's the chance that that statin will help me? And if you look at the data, you can calculate the number needed to treat for a healthy woman of your age, is probably infinite because there may not be good evidence that it helps, young, healthy women, but let's say it's a man and the guy says, doc, I want to prevent heart disease, so let's talk about lifestyle first, but I want you to tell me what's the chance that my taking a statin will help me. There's a, say a 40 year old man without heart disease. and the doctor should know or can quickly find out that you have to treat between 100 and 140 such men for five years with a statin. to prevent one non fatal heart attack or stroke. Those are the numbers. And that's the best it can be. The research isn't transparent, so we've got to accept the conclusion of the people who can see the data. So then you establish that you've got to treat between 100 and 140 such men to prevent one non fatal heart attack or stroke. So then, the doctor should ask the patient, Given the odds that either 99 or 139 people out of 100 or 140 won't derive a benefit from the statin, and one will, do you want to take a statin? You the patient. This is not the doctor's decision. It's not the doctor playing the odds. Should you take a medicine or take a chance? And by the way, four times more improve your lifestyle. It's the patient's decision. So negotiating with your doctor about statins is getting your doctor to tell you what the data show the benefit will be and then working with your doctor to say, well, let me think this through. There's a. very small chance that it will help me, but There's a much larger chance that I'll get side effects, somewhere around 20%. and then you can decide with the doctor whether you want to take a statin or not.
meredith_2_05-06-2024_130146:Is there a way that we can reduce our risk of being labeled as noncompliant and being removed from our doctor's practice? Because I feel like In our best day and in the best situation, these conversations are happening and the doctor is excited about a patient that wants to live optimally and not just, you know, eat whatever and take a pill, but I suspect that there are many physicians out there who are already quite stressed and in this, whatever it is, 15 minute window that they've been allowed to speak with this patient on this overloaded caseload that the doctor might be, irritated and label this patient as noncompliant. And there you go. You're, you're out of the practice and it's a six months wait to get in with the next doctor of that particular specialty.
john_1_05-06-2024_140147:So, we've got to be skillful. Because when you bring this up, many doctors, probably most doctors, will get defensive. I'm the doctor, I know what's right, and I'm telling you what the recommendations are. So you have to understand that your doctor is going to be defensive. And the burden is on the patient here. It ought not to be, but it is. To be skillful in engaging in this conversation. But to reframe it in a way that's acceptable to the doctor. Doc, what I really want to do is minimize my chance of developing a heart attack or stroke. that's my goal. And, in order to do that, I need to think about lifestyle and I need to think about what is the real chance that a statin will benefit me. What's the number needed to treat for the statin. And most docs, if you do that skillfully, will engage with you. Now they are in a 10 or 15 minute window. And as a primary care doc, I found that that wasn't such an impediment because I can bring people back. I can bring them back in a month and say, look, let's do lifestyle changes and see how you do. And we'll continue the conversation. And maybe when you go home, you want to read a little bit about number needed to treat so you can understand the conversation. So it's not just a 15 minute time slot in good primary care. The conversation continues and it picks up right where it left off. The trick here, Meredith, you're 100 percent right that you, the patient, has to be very skillful in not, evoking a defensive, angry response from your doc. So you don't want to say, I heard this guy Abramson and he said you don't know what you're talking about and you don't have access to the data, which is not totally an inaccurate Summary. But don't want to lead with that. What you want to lead with is my goal is to minimize my risk of heart disease. I want you to help me do that. And if you're recommending a statin, can we talk about the number needed to treat? And if we don't have a chance to finish this conversation, I'll go home and I'll clean up my lifestyle a little bit. And let's talk about it in a month. And that fits into the doctor's model. The doctors working fee for service are getting paid in some way per patient that he or she sees. And so we've got to fit in to that model. We can't say, wait a minute, doc, I demand an hour right now for you to give me a statistics lesson. that's not going to work. but you can help the doctor work within the doctor's framework to carry on this conversation. And if you do that, you're going to be doing a fabulous service for you and your family. But you're also going to be doing a fabulous service for the rest of the doctor's patients. Because the doctor is going to start to catch on that these conversations don't have to be paternalistic dicta about you should do this or you shouldn't do this, but they can be constructive, cooperative conversations. And that's what's going to lead to better health care. Yeah,
meredith_2_05-06-2024_130146:Like I don't, I don't think I was triggered once.
john_1_05-06-2024_140147:I've been on good behavior. I've been on good behavior. Yeah, yeah.
meredith_2_05-06-2024_130146:but I think the difference maker is that you've given us tools. to go to our doctors with. And you've given us, information that 80 to 90 percent of the health that we desire for ourselves can be achieved through lifestyle. And it is more cognitive labor to dig out that information. but it could be, Be safer than the air quotes medical innovation That is always being spatted at us through our commercials And so for that I I truly thank you as a wrap tell people where they can find Both of your books and anything else that you have going on that you want to share.
john_1_05-06-2024_140147:you can find the books wherever books are sold. certainly Amazon, I'm not suggesting people just use Amazon, but it's, if you want to see what the book's about, you can go to the Amazon website and see what it's about, but it's so important, Meredith. I mean, even cancer, the cancer drugs cost a fortune and they're toxic. The American Cancer Society, Says that half of cancer deaths could be prevented by adoption of a healthy lifestyle these issues are so important and we're so brainwashed by the control that the biotech industry has over what we think we know, including what doctors think they know that we've got to put some work into this to educate ourselves.
meredith_2_05-06-2024_130146:It's well worth it and your book names are sickening and
john_1_05-06-2024_140147:Overdosed America, but get Sickening. Sickening is, overdosed. Yeah, it's the second one. But Overdosed America is about 20 years in family practice and learning that the commercial companies were taking over the journals. Sickening is about what's in those computers. It's what I learned in 10 years of litigation. What's in those corporate computers, and why it matters that peer reviewers and editors and guideline writers don't have access to the real data. And if you really want to understand this problem, that's the knowledge basis of the problem.
meredith_2_05-06-2024_130146:Thank you again. This was really, really good.
john_1_05-06-2024_140147:Great. Well, thank you. I really appreciate the opportunity to share these ideas.
Thanks for listening. If you liked this episode, you'll also like the one I did. That's a compilation episode of wellness clips from the show. I call it a mixtape it's episode, 1 75. Stay tuned next week for a remastered favorite with the mother of the fire movement. Uh, fire is financial independence retire early. We ask the question, what's the point of financial freedom until then cubic curious.