Huberman spends too much time sniffing his own farts. My doc has over the last 2 years has been quite literally life changing impact for me, I don't care if she's not an ironwoman athlete at the same time - I'm sure if she spent less time going above and beyond for her patients and the stress of being an NHS GP she'd have more time to work out, but that doesn't stop her from being compassionate which is by far the most important human quality that lifestyle influencers seem to forget about when trying to optimise the heck out of the pointless vitamin routines they're trying to sell.
It's worth pointing the arrow the other direction as well, which is to say that doctor's offering NOTHING is how a lot of patients end up going down the same same path. I've watched my own mother lemming-march herself down the woo-woo path to the point that she's in her 70's and has refused to see a real doctor in over 15 years. As for myself, I've got a condition where the best prognosis a doctor has given me is along the lines of "this medication was shown to reduce the development of new symptoms in 65% of patients by an average of 40%" to which I respond "that sucks, but fine. Do you have anything that can reduce the symptoms I already have?" And the doctor can only say "No". Given that nightmare of a prognosis, the only reason i haven't charged straight into woo-woo land is because I watched my mom do it, and frankly that 65/40 treatment is better than anything she's got to offer
Agreed. Medicine has many shortcomings and it’s understandable why patients get desperate. I would never blame a patient for falling prey to pseudoscience, the blame lies solely with the practitioner.
@@medlife2 - except that the principle of buyer beware applies. Individuals have a duty to themselves to, as far as possible and reasonable, exercise due diligence.
@Ms.Pronounced_Name - The field of medicine is limited by its very nature. Ideally, treatments are based on long term studies as well as a realistic understanding of the biological processes of the illness being treated and the proposed treatment. But this isn't an ideal world and the acquisition of medical knowledge is an arduous and time/resource consuming task. Sometimes, medicine has nothing to offer but symptomatic relief. Sometimes not even that. That's the point at which pseudo science begins to exert its influence and quackery becomes more attractive as it offers false hope. And desperate people seeking hope will often accept false hope. If these treatments were harmless then one can rationalize their use. But all too often quackery is anything but harmless. And that harm can come in different forms. Delay of appropriate treatments for illnesses that can be ameliorated if not cured, or the use of treatments that themselves actively cause harm to the patients. I congratulate you on your reasoned and realistic response to your situation and mourn for your mother who has fallen for the snake oil pitch. I hope she hasn't been harmed by it.
Good ramble Rohin! I recently started strength training and watching some evidence based lifting channels, so of course Huberman was recommended to me by the algorithm. He immediately gave me Roganesque vibes which put me right off, but glad to have confirmed that he's a bit of a knob at best.
Hello. ME/CFS tolerator here. Desperation drives many of us to try all sorts of nonsense, particularly as medical science has nothing to offer. Most of it has no effect but some does - and I'm quietly convinced it's placebo *but I don't care*. After becoming ill in 1993, I was diagnosed in 2015 and given a double-sided, A4, spartan NHS leaflet, and that's been the sum total of my treatment. The one thing I hope for in the covid fallout is that decent research goes into the rubbish illness. It may not help us but it may help those in the future, and, you know, that's very nearly almost as good if you squint a bit and put everything else out of your mind.
May all your placebos be potent ❤ Have you had any luck trying fibromyalgia or sensory overload / burnout recommendations? I hope with the massive increase in interest in funding since long covid they figure out what's wrong and how to help sooner rather than later
Hmm. Strongly agree. However, how do we square this with the fact that most GPs know next to nothing about exercise and nutrition? My friend just had a checkup (healthy, no issues) and was advised BY HER GP, that she needed to consider going keto. I think because the physician also is way too into podcasts.
Its really tricky tbh, I think its always best to consider the doctor as 'advising you'. And to know where their knowledge extends to. They are absolute experts at stuff you don't even understand, but you know your day to day life best and you can think more deeply than they can about what could be causing and effecting things than they can in 7 minutes.
I find the idea that you should listen to "healthy people" when taking care of yourself to be kind of weirdly fascinating, mostly because everything I know about how to navigate health care, how to advocate for myself in healthcare settings, how to effectively communicate with healthcare professionals, and manage all of the issues that I have with my body, all of the information I've ever gotten that has been useful has been from the disability community. I have learned and benefited so so much from all of my disabled friends and their advocacy and their work and their knowledge.
Should I listen to a healthy person who has never dealt with any kind of chronic illness or injury in their life? And are going to blame me and all of my shortcomings for the reason that my wrists don't function properly? Or should I listen to the people who have to navigate medical systems on a weekly or daily basis? Seems like an obvious choice to me.
I really appreciate the compassion with which you approach illnesses like CFS and long covid that don't have a known aetiology. It's so common to see medical professionals, online and IRL, completely dismiss these things. It can be very difficult to engage with healthcare when you have been treated that way.
When I saw a rheumatologist for a reassessment of my fibro and M.E., it broke my heart to see how crestfallen he was knowing how ill I was and that he couldn't do anything about it. I doubt there are many doctors out there who do not want to help people to get better. Especially those who are proactive with their health.
Oh sadly the world is full of them, even in the NHS and even with straightforward physical conditions like diabetes, heart disease, ophthalmic conditions, musculoskeletal injuries and more. I was a carer for two increasingly unwell parents for 30 years starting in my early childhood till they both succumbed to long battles with complex, severe, preventable compounding illnesses. Believe me, the vast majority of doctors we came across in this time had no interest in helping to cure patients/prevent illness, they were just doing a job, often very poorly. But of course the types of illness that can result in death or going blind are the ones the NHS provides the BEST provision for. The worst is Mental Health which essentially does not even exist. In fact what is there is worse than nothing.
I use to believe that until here in Australia they implemented the national pain strategy.Up until age 50,2018, I was a big respecter of the medical profession then I moved here to Australia's capital where this vile program was birthed. This was a real Damascus road experience as I quickly discovered there's no shortage of doctors who simply don't care if you live or die and I mean that literally as I had one pain specialist tell me to go out to the carpark of his premises and kill myself for daring to question his infinite wisdom. I could go on forever regards such cold,callous and cruel treatment but the bottom line is plenty of doctors when back by the coercive power of the state are psychos. I suffered the above stated and more for been proactive.I had presented in 11 jurisdictions across military,public and private for my spinal injuries and was treated exceptionally well due to my proactive actions in understanding my condition.Add a dash of government and this all flips on a dime.
Fantastic to hear-when I started my postgrad research, I started to read many of the studies Huberman mentions in his podcasts. Time after time, I realised that he either; hadn't read the study he was citing, or fundamentally misnterpreted the results; cited some animal study as proof that a treatment or supplement was beneficial for humans; cited decades old research that has no contemporary data that supports said study; or alarmingly, flat out misunderstood the research due to, what I can only assume, is a gaping deficit in his knowledge of anatomy and physiology. The last point is particularly jarring-in numerous conversations about the effects of cold plunges, he cites old papers within the field of neuroscience, of a horrificly small sample size, and repeatedly misinterprets the results demonstrating this complete lack of understanding of basic neurophysiology. Huberman is a quack and arguably a very manipulative one, as he relies on his Stanford PhD to justify being an omniscient medical expert. Can't wait for your video to drop mate.
Sometimes quackery works because of placebo. And when you're desperate, you'll try anything. It's a complex issue, I've been down this path myself with both positive and negative results. Appreciate your take.
This makes me appreciate my doctors more. I see the frustration and sorrow they sometimes have but to offer me platitudes and recommendations not based in evidence would only end up hurting their integrity, my wallet, and my brain. When I see my sleep Dr and it’s the same thing again but he wishes he could do more, that is care. It is care to not send a patient down a muddy path. And it makes me so much more frustrated when pain doctors encourage “alternative medicine” and imply that you should have tried everything else first in order to deserve medical treatment. Infuriating.
you touched on another issue here: in situations like you discribed, even if doctors stick to options established medicine offers, leading a patient on like there was a guaranteed way to get better if we only found it (or if the patient only tried hard enough) is so harmful. when i got diabetes as a kid noone pretended i'd get rid of the disease if i only worked hard enough, and even though now after 32 years i'm exhausted i never felt like there was this miracle cure in reach but somehow fate wouldn't let me have it. but when i got diagnosed with depression and cPTSD it was like «you seem stable, you better finish uni or else» and when that didn't help it was «you better apply for a job yesterday» and when that didn't work out well it was harder meds and when that still didn't work it was yet harder meds (and in the end it turned out the meds were causing a lot of the issues i had to begin with but that's not really the point i want to make). never did someone just sit me down and tell me «look, you've been through some nasty shit, we cannot tell you when or if you are ever going to become a "normally function" person, but that's fine, keep fighting as you pbviously already do but also be compassionate with yourself and take your time; tell people who want to rush things that it is your life and not theirs; and if you need official medical statement we've go your back.» - all of those things _were the case,_ but it took like 15 ish years and a lot of donquijoting to get there. i am now deemed unfit for the job market; i dream of working at my fav tea shop part time but after all the toxic positivity i've been through i'm too scared and anxious to even apply. i lost three beloved family members and a romantic partner in those years and it makes me so sad that i couldn't spend more time with them just because i was lead on to believe that i had to fight _yet_ harder and that everything would be fine if only i accepted my condition / tried harder / did this or that and anyway. i get it, you don't want to come across as if saying "haha, your life is over, have fun being crippled." there needs to be much more diplomacy and you probably need to gauge the personality of the patient, and there's not enough time and money for that.. but when there _is_ enough time and money to throw meds at the patient to see what sticks or to diagnose personality disorders only for those diagnoses to get revoked later.. then it should also be possible to get a doctor or at least a social worker to tell you that you are now allowed to grieve.
Same here, I've had depression for 36 years, and had the trauma of a false personality disorder diagnosis, that it took over a year, for them to accept that, the report said possible personality traits, and it didn't say disorder. The thing that helped my depression the most was magnesium supplements, I take 4.2 g Epsom salts daily. Also a designer dissociative no more than one day every two weeks, as NMDA antagonists can stop depression, and heal the brain damage depression causes. But as the NHS doesn't offer that, I had to figure that out on my own. The point about being allowed to grieve for the life you lost because of your illness, that's hugely important.
Thanks for touching in chronic fatigue syndrome. It's a completely disabling condition that sadly doesn't have any cures or treatments. I wish that there could be more funding put towards understanding the condition. Hopefully day we might get a better understanding of it and a possible treatment
@@mellie4174 yeah, I had a professional CFS research/treatment center reject my application to be seen (signed by my GP after doing all necessary tests to rule out other causes beforehand) because they said that me not getting sick (eg with cold/flu) more often than before was evidence that it wasn't CFS. That isn't even in the official diagnosis criteria! And even if it was compulsory, I applied during the height of the pandemic, when I was staying indoors religiously. It was crushing, to say the least. (They did accept me half a year later, not that it helped.)
The second we accepted chiropractic care as “medicine” and had insurance (in the U.S. pay for it) we gave in to the quacks. Now the chiropractors have gone after animals.
@@JenSell1626 I have chronic frequent low level dislocations due to a connective tissue disease. I don't have an issue with chiropractic as a profession, but I have had specifically poor experience with Palmer school chiros. They don't have good end feel, often use drop tables which I think are dangerous, and use too much force. Their HVLAs often have too much amplitude. At this point, I try to go exclusively to DOs or rely on self-adjustment because I've had 2 palmer school mild/moderate injuries. The school has a great reputation and I don't understand why. Other chiro's I've seen have been able to gently set my joints and help me stablize the joint and improve biomechanics.
Thank you for addressing this. I fell deep into the functional med vortex after a terrible car accident and severe concussion left me with many health issues. I felt abandoned by mainstream medical professionals bc my symptoms didn’t fit neatly into their standards of care. Func med held out their arms. But also made my symptoms worsen. It took going back to school at midlife (20 yrs after accident) to learn about the brain and body to pull me out of a pretty dark place. Having context for how the body (is meant to) keep itself regulated was a game changer for me. Becoming aware of the limitations of research and how long it takes and the rigour required for evidenced-backed protocols to become part of mainstream medical treatment also helped me forgive and understand the need for collaboration with my doctor, and also to ask for evidence from func meds before blithely accepting treatment advice. An unexpected benefit is being able to discern (eventually) when someone egregiously misuses their credentials to take advantage of probability judgments en masse. Not everyone can be so lucky to have the option to go to school to learn these things. I’m doing what I can to help. Grateful to you for doing the same.
Looking forward to your full version. This is an important conversation. As a cancer survivor with an autoimmune condition, I am no longer able to do what I used to. Life has to change. The younger you are the more difficult the adjustment. Thus, people want a fix to go back to who they were before. Unfortunately, it is about having the best life where one is…now. These feelings combined with what you described are a bad combination. You want hope…and sometimes acceptance is what is needed. Thank you
@neilj8224 Without defending the "celery juice conspiracy," do you know much about it? I try not to criticize others who may have looked into something further than I have. You know what else was once considered "bonkers?" Physicians washing their hands. The idea that ulcers weren't caused by "stress & spicy food," and instead by bacteria. The physician suggesting the former died alone in a lunatic asylum; the physician who discovered the latter describes his colleagues walking-out of his presentation (he said, "they were just there for the sandwiches," lol). A decade later? He won the Nobel Prize. Not saying celery juice is the next contender - just saying that it's easy to be cynical in the absence of knowledge.
There's a book "The Adventures of Holistic Harry: True Confessions of an Honest Quack" which has more of an insider view of how a doctor becomes a quack. It's by an MD who used to practice integrative medicine, and it's semi-autobiographical. Holistic Harry started out as a true believer. Patients told him his alternative treatments had done well for them. After awhile, he became disillusioned, realized treatments need to be validated by double-blind studies because of the power of placebo effects, wishful thinking. But, he had too many financial obligations to quit doing the alternative medicine. It's not clear why, because doctors are generally pretty well-off. So then he was in the unhappy position of being a conscious quack, and the book is about his moral struggle. The book is funny and quite readable.
The NHS has a problem with people who are never fully healthy. That's the appeal of functional medicine, apart from the fact that most of us can't afford alternative doctors. I had ME/CFS back in the 1990s, misdiagnosed as depression, of course. I have a neck injury that was missed for 30 years, probably because my Doctor believed I was an overly dramatic woman until I was permanently paralysed. I also have a thyroid condition that has only been partially treated for decades, because the NHS flat out refuses to test for T3. For the sake of my mental health I stuck with a GP practice that had a balance of Doctors who sometimes told me what I wanted to hear, and others who had no explanation for my laundry list of symptoms. But that wasn't the best for my health - was it?
We had a symposium at the clinic I work at. One of the speakers, Dr Melissa Lem, a family doctor was talking on prescribing getting out into nature as a supplement (not an alternative) to treatment. It sounded fairly obvious but the talk was backed up with studies & the idea of having a number (in terms of hours per week) instead of telling a patient to get out & exercise at least gives health workers something to prescribe when patients are looking for something more than we can offer. Without going off into all the quack alternatives.
One of my earliest interactions with you on Xitter was on this topic a few years ago. I was dealing with chronic symptoms following a surgery and became desperate to get back to normal. I saw a few specialists and waited over a year to get a few tests done, but nothing was abnormal. It sounds strange, but I hoped something would come up. At least a diagnosis meant potential hope for a treatment. I eventually found solace in knowing I exhausted most of my options, and learned that medicine doesn't always have an answer, especially in these situations. I was fortunate to have most of those issues subside on their own over a few years, maybe in part to the the reduced anxiety. I can completely understand how people experiencing more debilitating issues would try anything out of desperation. It's hard to not to think ill of those providing unproven treatments, likely taking advantage of that desperation.
I think we need to get comfortable sitting with the reality that sometimes there is no good fix to the problem of aging and disease and be honest about that.
Being on both sides (i.e. patient and health care worker), there are few things worse than reaching the point of "sorry, but we've reached the end of what medical science can do"
There are two kinds of medical quacks imo. The ones who, because they don't know, invent things and jump on bandwagons to grift on people hopeful and desperate to feel better, and those that, because they don't know, dismiss their patients, ignore or blame them for their suffering, rather than realizing that things such as "laziness" and excess weight could be part of the symptoms, the fatigue and sudden weight gain the patient has been complaining about. This type of doctor also tends to get mad if the patient admits to having done their own research and won't acknowledge when the patient's self diagnosis turned out to be correct while they were fighting it and dismissing it, refusing to test for it the whole time, simply because they didn't want to be outdone by a patient. To me both both these type of quacks, just have this disgusting ego that they want to stroke and don't want to admit that they are just not very good and maybe should educate themselves more.
This is the kind of rambling I do in order to untangle my own thoughts about a subject. It's often why when I talk I expect not for my problems to be solved by someone else. I do like to get input by a friend that maybe I haven't considered. But I will fix my problem even if I take up a suggestion I'd rejected before. So whomever I've talked to, don't take it personally. It's how my brain works.
Interesting reflection on doctors. Always surprised by the amount of emotions doctors recieve from patients (suffering, incertainity, fear, expectation of solution) and the little to any formation they receive during training. It's uneasy to confront expectations, but it's an everyday situation. Psychological training and practise on managing and redirecting a patient expectations and emotions should be part of the XXIc curriculum. (Clinical Psychologist having worked in Primary)
In general, when it comes to podcasters, many start out with good intentions because they see this medium as the ideal stage for broadcasting their ideas. But once they hit a certain milestone, like the number of viewers, downloads, or subscribers per month, which inevitably translates to ad revenue, they feel increasing pressure to continue to put out more content in order to keep their lifestyle (typically determined by money and fame), success, and viewership. Eventually, they run out of legitimate discussion topics and wander into quackery or extremes. I think this is an inevitable curse that falls upon anyone who tries to follow the professional-to-podcaster pipeline, but it's especially apparent with medical podcasters (and RUclipsrs) who simply lack integrity. Exceptions apply, of course.
I feel that society still isn’t prepared to handle the effects of long covid. What doctors can offer is often not backed up by very solid studies like for example ,graded exercise therapy. The worst is that some people recover spontaneously and mistakenly attribute the cause. It’s a breeding ground for quakery and disappointment.
I think what you're talking about here applies to many circumstances. Human beings don't like to feel helpless, but we're all going to run into problems in life that we can't do anything about, and accepting that is very hard. Instead we're often tempted to mentally "bargain" and convince ourselves that we have more power over a bad situation than we really do, so we don't have to sit with that discomfort and awareness of our own limitations.
As a patient with a condition that isn't well understood but is sometimes completely disruptive to my ability to live my life, facing a doctor as they give you the results of another fruitless test can be so crushing. You almost want them to find something even if it's bad because at least there is a clear cause of your pain and maybe this round of medication will work. I can understand why it hurts the doctors
See, if there had been less dismissal of patients with these badly understood conditions in the past, we might already have a treatment for Long Covid that you could offer your patients. :( But nope, it was so much easier to tell CFS sufferers that it was all in their heads and they were just lazy.
Going through unknown chronic health struggles where there's a lacking unifying diagnosis, I appreciate the providers who say "I don't know" and are honest about the efficacy of treatments far more than the ones who suggest "medical reiki" or acupuncture or one of the many "functional" treatments I've been offered, however much I'd like that to be the solution. Something I feel is obvious here the US but that also gets quickly forgotten in the mess and confusion of health issues and the bureaucracy is that if a treatment were really that effective, a drug company would find a way to market and sell it. So, thank you for being so open about this issue that shouldn't be controversial, but is, both because of patient and provider desperation, and also because of the unfortunate providers who forget or outright choose to ignore what medicine and care really need to be for a patient. Those bad and almost avoidant practices really only put off finding answers and treatments for longer, and carry so many unnecessary costs.
I couldn’t have expressed this better. The explosion of lifestyle doctors on social media is filling a gap and that gap is people who have chronic illnesses, and want to get better. As an example, years ago I figured out on my own that my severe depression was largely caused by dehydration. Not once -for 20 years-did a doctor ever ask how much coffee are you drinking? How much water are you drinking? If they had and pointed me in the right direction. I wouldn’t have been on antidepressants for so long. Their pharmaceutical industrial complex informed decision to give me drugs instead of treat the root cause is exactly why lifestyle doctors are exploding on social media. They are filling a need. And to the concept that traditional medical doctors use evidence based studies to design protocols: My question is who wrote that study who sponsored that study? Was it Coca-Cola? No wonder they found that fructose is good for you!
@@suziegriffith I think the onus on ensuring you were properly hydrated (which absolutely does have a wealth of cascading effects) should've come from preventative care by your providers, and it's unfortunate that was looked over. The lifestyle doctors are trying to fill a gap in knowledge, sure, but they're doing it horribly, pretending to focus on what preventative care emphasizes and often selling a product or supplement they're getting paid more to promote than pharmaceuticals (a reminder that there are virtually no regulations on supplements in the US, a reason why every benefit under the sun can be marketed without the heavy burden of evidence necessary for actual pharmaceutical products--this is more what I was referring to at the end of my comment). Lifestyle doctors don't treat the root cause. They practice junk science at worst, and faulty pop science at best, basing everything into offhand comments made in proper studies, anecdotal studies, and their own anecdotal experiences. What they've found may have helped them, but they often aren't in proper isolation to determine that exclusively A or B were the real causes, or that when A changed, it came alongside and led to multiple other mindful changes in general healthier daily practices that just led to generally better health. Observation bias is inherently anecdotal evidence to a possible solution, and it's the reason why so many people who try going vegan or vegetarian or subscribing to some diet might cling to it so tightly and often try to prescribe it to others, when really diet is incredibly personal and a major part of the changes came along with the individual paying a lot more attention to more aspects of their health when they make that conscious change in diet. Real medicine is holistic, and lifestyle doctors are damaging the overall field when they go the lifestyle route over actually practicing medicine (which itself is seeing the patient as a whole person and system, where little lies independent of another). Preventative care and ideas should come first in most cases, see what is off and can be changed with lifestyle adjustments (which is not what lifestyle doctors do), then therapies (medicinal and otherwise) to help remedy the issues after that when and where appropriate. I would agree to some extent about the studies and funding, but it becomes far worse when you look at the ones the lifestyle doctors cite. As I mentioned earlier and want to stress again, there is virtually no regulation on supplements in the US, so almost every study on specific foods and specific supplements generally goes under as much scientific rigor as the medieval concept of dragons to so many.
I have a really nice GP. We usually talk for 30 minutes and a good chunk of that is me telling her info i got from your channel or other nonsense 😂. She always listens to me. On the flip side, that might explain why she is almost always late.
My main question is.... Just when did medicine STOP taking the way people exist/live into account??? To focus strictly on lifestyle to the exclusion of all else is just as erroneous as focusing strictly on say, cardiology, or neurology, or endocrinology, or any othe field of specialty or preference and giving those an overwhelming influence on treatment. As a diabetic, you would not BELIEVE what gets blamed on having diabetes. Everything, and I mean EVERYTHING, is suddenly linked to this disease, no matter what else had been pre existing and well diagnosed. I bring this up because as an example, there is an insanely formulaic approach in US medicine to diabetes management. No matter if you live in a mansion, eat perfectly and have a personal trainer...or if you live on the street, or if you simply cant take the most common medications...the advice is the same, and if it doesnt work for you, youre labeled as noncompliant and essentially thrown aside. Theres a role for lifestyle medicine, but why on earth is it being split off like a specialty? The lifestyle and manner of living of EVERY patient should be considered by EVERY doctor, folks. Is it less expensive to see two doctors for 10 minutes each, or one for 20 minutes, hmm? Which provides the better care? If we dont give doctors the time to address their patients needs, or even just actually listen, are we doing justice to the patients? Better time management, better ears, better knowledge of how the patient exists.... Its just good practice, and good medicine.
Since the witch hunts when they labeled all quality doctors pagans and exterminated them, and it really went sour when modern 'western medicine' became the only practice taken seriously. Even Dr Mike has a problem with the latter, it's super enlightening to watch his recent interview with HealthyGamer, who mixes Eastern medical theories in his mental health practice. I have such huge respect for him, but his default bias against non-western medicine (and misconceptions of it), shines a light on a lot. He does give ground in the interview, so I'm not calling him ignorant. It's seriously an enrapturing discussion. Anyway how western medicine treats patients vs how eastern medicine tackles things fuels exactly what this video is addressing. People lose faith in the sterile 'one size fits all, if it's not proven in a lab it's not valid' approach, and over correct to the alternatives. Then a lot of the disingenuous quacks take advantage.
it was the year 2013, when gen Z entered universities for the first time and thought they were smarter than all the people before them. if it's not in a paper, it doesnt exist!
Lifestyle medicine is a board-certified, evidence-based specialty... At least in the U.S. 'Functional' and 'hollistic' medicine is, in fact, mumbo-jumbo that most people learn in poorly regulated online courses. I would not group them in the same sentence.
I do wish that GP appointments were long enough for a patient to say everything, but the best GPs in my experience have a good, listening, inquiring, presence that stretches those short minutes to feel like hours. It is there in them whether new to the job, or long term in the job. Being honest with a patient in a supportive way. Thanks for sharing your ramble of insight into how a good doctor can veer away into sales of false hope. This layperson admires the ones who don't do that all the more.
Thanks, Rohin! This has been pestering me for years: a good, normal doctor considers the patient as whole. Thats not integrative or holistic or vodu medicine. Thats just a well done clinical exam. There's a reason our professors stress so much the importance of taking a good history.
Thanks for resisting. I hate it when my doctor recommends acupuncture. It erodes my respect for her. On your main point, I think you may be too generous toward your quack colleagues. I'd hate to think that after all of those years of study and research that someone can so easily be co-opted by likes. There are always a few teachers who are popular because they do nothing but show movies and give everyone As, and I suppose there will always be a few doctors like that, but I prefer to think better of humanity and imagine that most doctors and teachers do the right thing instead of the popular thing. By the way, the alternative doctors I know of are not opposed to pharmaceutical interventions in general, they are only opposed to the ones that they don't sell out of their offices.
@@dandavis2981 No it doesn't, it very temporarily tricks your brain into believing that it works, big difference there. And for a medication to "work" by definition, it needs to OUT PERFORM placebo, not be equal to placebo.
I used to work in an NHS team for chronic conditions including long covid. The recommendations we made and treatment we provided were lifestyle based, lol (things like pacing, physio, and talking therapies). Hopefully your patient finds themselves in one of those clinics and is able to build a lifestyle that works for her to live with her conditon
Disclaimer: I am skeptical of most medical/lifestyle quackery proliferating online. Doc, your concern is absolutely valid, however I would implore you to recognize allopathic medicine is typically encountered by people as reactive to health conditions which leaves quite a gap in medicine and prescriptions for a healthy life. Last year I had joint and nervous system issues that took me away from work for several months. After consulting many doctors they all left me empty-handed. I was left with the burden of navigating a whole heap of hogwash to find my own path to getting better. Put simply, there is a niche in care the medical establishment is largely failing to fill. That is why people are driven to quackery.
You put it much better than I did. I had an issue and doctors would only offer one diagnosis, even after tests run (that I had to specifically research and request) did not support that diagnosis. I did the treatment for their diagnosis for two years and saw no improvement, and they still would not consider other options. At that point, there is no way to receive treatment from the medical establishment and I have to sort through all the grifting and lies to look for something that might help. I don't know whose fault it is that this is the case and I'm not trying to blame doctors in particular because it's hard to say, but there is most definitely a gap and it has to be filled by something. I'd rather try doing x three times a week or not eating y for a month than live the rest of my life with these limitations and this pain.
@@kinseylise8595 It is the patients fault at that point, for not accepting that the help they are seeking simply does not exist. Quacks are charlatans are always ready to lie and tell the patient what they want to hear, rather than the truth, and that is the major issue here. When it inevitably fails, or has a minor and temporary placebo effect, the patient moves onto the next pile of bullshit instead, and the quack does this to the next person, and the next person, helping no one in reality.
I've found this especially true in the pharmacy. So often people will come in to buy a probiotic or supplement for their condition, and we are expected to provide it. I don't stray from what we're taught to do, but it's not the right setting to shoot down every request without risking an altercation. All I can really give are my recommendations, and how they can stay safe.
How much is quackery and how much is just dart-board medicine? In the right circumstances, when the treatment is a valid medical treatment for at least a plausible diagnosis if not a confirmed diagnosis, I think the dartboard approach can be a reasonable choice. Especially if diagnostic tests are likely to be inconclusive anyway.
@kray3883 Company reps will present sometimes to "train" staff on their products, and I can very confidently call those fields quackery. There's no clinical basis for topical magnesium, bio-Vitamin C, homeopathic melatonin, rescue remedies etc. Surprisingly some formulations like Caruso's Prostate Eze Max appear to be beneficial, but it's still not an established therapy. Even as a pharmacist where we're supposed to be impartial, I do feel that pressure to let many things slide. It's a daily reminder as to why prescribing power remaining with the doctor is so important.
I used to be really into Andrew Huberman when he first started. The content was a lot more rigorous and he stuck strictly to neuroscience topics. Now he's branched out into all this other bullshit, most of it way out of his expertise. Not to mention some of the guests he's gotten are questionable. It's sad to see what was once a solid, science-based podcast go so far downhill. Who'd have guessed money and fame would change a person's integrity lol? Admittedly I must give him some credit for piquing my initial interest in neuro, altho he's definitely not the only one. I fell in love with it, so much that I decided to go back to school and I'm currently majoring in neuroscience. I think it was the pursuit of deeper scientific knowledge that made me realize he was straying away from it. I mean I like hot RUclipsrs too (just one reason I like this channel 😉 ) but Huberman's hotness is not enough for me to look past the nonsense. Thankfully, one of my other favs, Dr. Alok Kinojia(Dr. K, Healthy gamer) a clinical psychologist, is still making solid content, despite his channels growth. Highly recommend him!
@@Sulaiman-xh8wx yeah same here. I've been able to take some of his advice and apply it to my life and it works. He's one of the best communicators I've ever seen and his channel is so unique. Even though his target audience is gamers the stuff he covers is relevant and relatable for literally everyone. His stuff on ADHD and addiction is great and his many years of clinical experience really shows.
Just want to say thank you for giving your perspective on this topic. The first step to fixing problems caused by people doing seemingly evil things, in this case promoting fake therapies over real medicine, is to understand _why_ somebody got to that point in the first place. I have a deep belief that nobody thinks of themself as a baddie, so understanding why people seemingly become baddies anyway is so much more helpful for figuring out how to untangle the brain spaghetti!
From looking at this comment section, i need an antidepressant... Anyways appreciate the video, theres a decent number of podcasters who i previously enjoyed, but now you can literally dig up videos of their recommendations conflicting with other videos of their own recommendations.
Interesting story about people in a bad situation grasping for hope. I also see people in quite regular situations doing a variation of this. People who have unrealistic expectations about sleeping through the night as they get older, falling for ideas that if only they eliminate or add some food to their diet that they'll suddenly start sleeping like how they remember sleeping in their 20s
I was a care giver for my mom who was a cancer survivor for nearly 18 years. We dealt with all sorts of doctors personalities. What I want to share here is that life is messy and in order to deal with it we must be proactive rather than reactivate. Be kind to yourself and make decisions about your life that you can live with.
Thing is, it's very hard to see a formal professional medic these days, whereas social media is everywhere. You can see this all over the Internet, in different fields of science, where nice simple bite size information can be spewed forth and digested by the viewer without the nuance of the real complexity that lies behind it. However, the placebo effect is strong and it's that which these other 'treatments' tap into..something which main stream medicine is beginning to lose due to a plethora of reasons, not least the overall loss of respect and trust in all-'professionals'
I am still having to deal with the consequence of a family member deciding based on RUclips doctors she could control her sky high cholesterol with a high fat low carb diet. 3 strokes and significant cognitive damage she's back on statins plus a whole lot more medication.
You do understand that people can experience strokes on any diet whether they are high carb or high fat or even the standard American diet, don't you ?
@@dogphlap6749 Her previously controlled cholesterol level went up to 12 after stopping statins and going on the fad diet, her daughter ans her GP were asking/begging her to go back on. Then the strokes. I'd say that was a slam dunk.
My sister, who died in 1983 of cancer of the mouth (she did not smoke) at age 31, tried all the available treatments recommended by her doctors. Because she was young and hopeful. Finally her doctor told her that "no treatment" is also an option. My sister/hero said, "medicine is not an exact science" after going through a horrific ordeal trying desperately to save her life... Thank you for caring.
People do not like that answer though, and quacks are fully ready to give them bullshit answers that they want to hear, answers that are blatant lies most of the time, and they will do it with a smile on their face.
You can only make a handful of videos promoting diet and exercise and other lifestyle adjustments that have really solid evidence. You can make a couple dozen more videos promoting things that have weak evidence in their favour but probably do nothing. Eventually your standards for "evidence" get lower and lower, you stop speaking with a lot of nuance, and you enjoy the comments from people who say your advice has helped. You befriend other people in the same industry, doing the same thing. Maybe you eventually make enough money that you really need to remain popular to afford your current lifestyle. What's the harm with telling people to, I dunno, eat fish organs, when you know the placebo effect is real, and you think, "maybe this might actually help some people!" You might even start thinking of yourself as more of an entertainer or "content creator", and no reasonable person would assume what you're saying is advice you're supposed to take 100% literally. Of course, you say to yourself, the audience is smart enough to know that when you say, "Eat absolutely nothing but papaya to cure heart disease!" what you really mean is, "In addition to medicine your doctor prescribes, eating a bit more fruit instead of red meat might have some benefits, and talk to your doctor before making any radical changes." Eventually someone gets really sick or dies following your advice. Chances are you won't know. Even if you do, you can always make the same excuses, or point to some other cause. There's probably a couple sentences in each video you make giving yourself enough plausible deniability for you to keep sleeping at night.
This goes back to the placebo discussion, right. The correct answer would be: once you deal with the basics (health tests are ok, good nutrition, good sleep, moderate exercise), focus on being happy. If sauna (in moderation), or red light therapy, or cold pressed juice in the morning, or a massage once in a while make you happy (and don't break your bank) then do that. That's your best bet to live a good and healthy life. Mental health needs to be talked about more often !!!, not just when there is an obvious problem.
As you said, there is a lack of resources in our system. If people turn to social media to try to fill the gaps, fair enough. I have been able to make some huge changes in my life and health with the help of social media.
You joke, but a family friend drank celery juice despite hating it for a ayear, hoping to lower his cholesterol but with no effect. His cholesterol returned to normal levels after he left his high power corporate job, who could have possibly predicted that lol
My work around as an IM DOC is promoting exercise. Because let's be real 98.6% of my population don't do enough of it and it does have profound mortality and morbidity benefit and is also something docs give up on preaching about. That way no bs, no "drug-only- medicine," great discussion, and more trust.
Well tickety boo. Wheres your balanced outlook and analytic approach, because if you dont have and use that, you're just another person prescribing about their pet peeve.
Oh god I know it was off the cuff but the idea of "sauna therapy" for long covid really drove that home. I've got POTs, and it took +10 years to get a diagnosis, mainly because I'm 23 and "look healthy" (real quote, also untrue). Covid can cause orthostatic intolerance/ POTs, which is often much worse when it's hot (I've feinted in the shower). So just the suggestion of "sauna therapy," which seems harmless, but could cause someone like me to feint & get a head injury really struck home. I can see why people turn to alternate medicine though. I think at the root of it, it's not just quacks taking advantage of people, but an underlying issue in most countries healthcare systems. I was dismissed as a hypochondriac by so many doctors, despite being seriously chronically ill, due to systematic issues within (for me, the Australian) healthcare industry. I'm sure those doctors thought they where doing a good thing in reassuring me that my symptoms where nothing to worry about. But I lost nearly a decade of my life, confused and suffering, because doctor after doctor was unwilling to investigate past the most obvious cause. POTs isn't even that uncommon, but (no offence to good GP's) there's a chronic problem of incurious and ego driven general practitioners, who are absolutely certain that they know more about a patient's body than the person who's living in it. From my experience, most of these doctors have been very nice, but ultimately unwilling to take me seriously, delaying necessary medical treatment for over a decade. Anyway I have a lot more to say about this as it's such a huge topic, but I'll cut it off here.
I strongly agree, except all offense to most practitioners fully intentional, including half my treating providers and more than half I’ve worked for 😂
@@JenSell1626gahahah yeah tbh, I was trying to soften the blow a little but really i trust any practitioner about as far as I could throw them (that is to say, not at all)
This is a somewhat silly, and most definitely uninformed question, but I hope you have some insight: What is the difference between POTS and garden variety fainting when standing up quickly or if you take a bath that is too warm? Is there some defining symptom or oddity except severity and it just persisting? I ask because I grew up with spells of these types of symptoms (+vaso-vagal shocks in my teens), and both family members and doctors just treated it as a nuisance functional thing that you had to guard against. Sit down, head between knees, remember both salt and sugar if you have a period with lots of fainting or near-fainting. Some basic work-ups were done at various points (to exclude dangerous stuff), but mostly I was just told about how our nervous systems works, and that in some people it can be a bit out-of-whack now and then. Maybe because mild(ish) problems like this run in my family, and it was first brought up to a doctor when I was a child, I never experienced it being dismissed. I just found it fascinating, and in periods when it was most frequent, a nuisance (scouting out what to hold on to if you need to when you stand up, things like that - been close to 30 years since I last had a period of frequent episodes and to some extent I still do it).
Very thoughtful reflection. It's extremely difficult to do under time constraints, but arguably the ethical middle way in situations like this is to explore the patient's values and see if there are tolerable activities within their limitations which they find meaningful and beautiful. That just goes to show why multidisciplinary care is essential for complex conditions, rather than putting individual clinicians at the thin end of the wedge where they feel that need to reach for something, anything.
What about the nocebo effect MDs usually dish out? I was told I urgently needed open heart surgery and I thought, really? 10 years later, same cardiologist agrees with me I did the right thing not to go through with the surgery. BTW, it wasn’t for a clogged artery. My angiogram was fine.
I think less business corruption would lead to fewer quacks. The opiod crisis was undeniably real. Also, a lot of doctors never hear about less expensive potential solutions that are buried in the scientific literature. Many things lower TNF alpha besides biologics. Different forms of exercise have different changes in GLUT4 and glucose-insulin response, but doctors say "exercise" and prescribe metformin which actually dampens adaptations to exercise.
i am a burn victim, and i was on many pain medications. by far best for every day use is canabis / marihuana. but in my country, its only allowed for terminal cancer patients - opiods are no problem - but they let you dream far to much, and quite honestly, i dont think they work for this kind of pain i have, which is more like nerve pain.
I really appreciated this “ramble”. As a licensed mental health counselor in the US, I’m frequently combating misinformation and quackery too (Tiktok?). You are a reasonable and approachable voice on the internet and I’m grateful you are here.
Maybe one of the most important things you said is the “I can’t say it won’t work” even though you know there is little to know evidence. You also know that there is some chance you are wrong (ie it actually works). Science is complicated and multi level. The complexity of medical science seems to lend itself to overly confident, simplified statements of. “Fact” and at the same time, a difficulty to definitively say something won’t work.
10:10 I think you’re trying to remember support hose stockings, I am thinking of trying those myself to see if they might help with the dizziness from my orthostatic hypotension,because I’m already adding more salt to my diet like my doctor recommended and taking a reasonable amount of walking at least twice a week to help my general fitness like she said to do and drinking at least two litres of water a day as recommended and doing everything else that my doctor recommended including taking my medications as prescribed but I’m still getting the dizziness when I stand up and as long as all the tests for anything worse keep coming back clear it’s probably nothing to worry about but it still effects what I can do for myself and if I can leave the house alone so I looked around for more suggestions that might help me, my mom was prescribed support stockings for her varicose veins and they do help her to stay standing at work for the whole day so I thought it was worth a shot to try them out myself.
Very interesting indeed. I am a strong believer in the "Lifestyle Medicine" guidance offered by well qualified doctors and researchers such as Greger, Esselstyn, Ornish. They base their work on hard science and modify their advice when new research is published. I'd be very interested to hear your thoughts on their body of work.
I read the plug for this channel in your newsletter and am, as they say, "excited" to subscribe. I've been subscribed to the main channel for ages, but didn't know, or had forgotten about this one. So cross-media marketing does work!
Many people have recently lost faith in medicine ( in the last 3 years). This means many will turn to any and all alternatives. So expect a huge and continued growth in unchecked quakery too. Ps some alternative treatments work very well in paliative care and have been a common mainstream supplement to traditional treatment in hospices.
Very candid - and love the honesty. I agree that the temptation is there to get rich and famous. It's sad to see, and reduces the integrity of ALL medical professionals - there are fewer and fewer medical professionals that do not "flog" their expertise in the name of promotional marketing. It's a very delicate balance - and glad that you have chosen to not go to the dark side.
Dr. Francis: the uni where I live offers doctoral degrees in “osteopathic medicine.” So, often when I’m searching for practitioners, I’m given folks conferred the title of “D.O.” rather than M.D., for example. What do you make of this? It seems the former designation warrants some skepticism?
In the US and other countries they are often licensed to practise medicine. They get broadly the same training as MDs but osteopathy is basically pseudoscience. DOs are also probably more prone to promote quackery than MDs....... I seem to recall reading some research on this a while ago
In the United States, a DO is essentially the same thing as an MD, but they get, I think, an extra semester of education. They tend to treat the whole person instead of focusing in particular issues. My experience is that when I to the DO, they spend as much time as they need to with me. From my general physical, he spends about 30 to 40 minutes with me. Whereas when I’ve gone to an MD I am in and out almost every every single time less than 10-15 minutes.
@@robynf.617 One notable difference between DO and MD training is that DOs spend an additional 300-500 hours to study pseudoscientific hands-on manipulation of the human musculoskeletal system (osteopathic manipulative technique) alongside conventional evidence-based medicine and surgery like their MD peers
I remember a consultant helped me with this as i got into offering a treatment for chronic pain. I got the idea from a BMJ article. I then looked at the evidence and it was just a 50 person retrospective study. I was disappointed to lose the option but i had to drop it because i cant recommend if the evidenc isnt there.
What you experienced in the small with an individual patient is encoded in the way we use social media - people search for things they can do to improve their health or fix problems, so "the algorithm" biases towards content that answers that sort of question. That means that anyone posting on social media will get significantly more engagement from a "this will make you feel better" post, than a "this is why you feel bad". The feedback loop hugely drives us towards posting proactive answers (or, even better, controversial opinions) rather than purely factual videos. Having just unexpectedly been put through a stent procedure (as an otherwise healthy active middle aged male), I know my first response was to ask "well what can I do about this?" above and beyond the (slightly generic) recommendations they gave me when I was discharged. If you as a Doctor advise me to eat healthily, what does that look like? And off we go down the Google rabbit hole of whether each individual food stuff is good for me, which might positively improve my long term health, and so on. Suddenly we're on the edge of "this miracle food will transform you!" and on into outright quackery. If your goal is to grow your subscriber numbers, you will swiftly learn that posts that are in the "Functional Medicine" and healthy lifestyle sphere are far more popular than informative, accurate and useful explorations of current medical knowledge and practice. This isn't just a cold hard calculation, it also means getting lovely messages from people telling you their lives have been transformed. That's a hard psyscological pressure to resist. Anyway, keep up the good work, and thanks for being an (apparently!) honest actor in this space. Always enjoy your videos, scripted or not.
It makes a lot of sense, I listen to a podcast, oh no ross and carrie, that investigate bs claims including supernatural healing, and they tend to thrive where conventional medicine lacks. Whether it’s unaffordable expensive or we haven’t found good treatment yet.
I had to think of my own history with long COVID when I heard the topic of the video. I also approached my doctors with the question of they know of anything I get l could try. I appreciated that they denied. I still tried a couple of things that might help but I was aware that it was to a great deal because I wanted the feeling that I was doing something rather than just being helpless. It makes a difference when doing it with that in mind than doing it upon the advice of a doctor, though.
When the people reading textbooks donot read through the complete chapter for the causes and risk factors for the disease and just focus on one point about Sedentary lifestyle .
Huberman spends too much time sniffing his own farts. My doc has over the last 2 years has been quite literally life changing impact for me, I don't care if she's not an ironwoman athlete at the same time - I'm sure if she spent less time going above and beyond for her patients and the stress of being an NHS GP she'd have more time to work out, but that doesn't stop her from being compassionate which is by far the most important human quality that lifestyle influencers seem to forget about when trying to optimise the heck out of the pointless vitamin routines they're trying to sell.
It's worth pointing the arrow the other direction as well, which is to say that doctor's offering NOTHING is how a lot of patients end up going down the same same path. I've watched my own mother lemming-march herself down the woo-woo path to the point that she's in her 70's and has refused to see a real doctor in over 15 years.
As for myself, I've got a condition where the best prognosis a doctor has given me is along the lines of "this medication was shown to reduce the development of new symptoms in 65% of patients by an average of 40%" to which I respond "that sucks, but fine. Do you have anything that can reduce the symptoms I already have?" And the doctor can only say "No". Given that nightmare of a prognosis, the only reason i haven't charged straight into woo-woo land is because I watched my mom do it, and frankly that 65/40 treatment is better than anything she's got to offer
Agreed. Medicine has many shortcomings and it’s understandable why patients get desperate. I would never blame a patient for falling prey to pseudoscience, the blame lies solely with the practitioner.
@@medlife2 - except that the principle of buyer beware applies. Individuals have a duty to themselves to, as far as possible and reasonable, exercise due diligence.
@Ms.Pronounced_Name - The field of medicine is limited by its very nature. Ideally, treatments are based on long term studies as well as a realistic understanding of the biological processes of the illness being treated and the proposed treatment. But this isn't an ideal world and the acquisition of medical knowledge is an arduous and time/resource consuming task. Sometimes, medicine has nothing to offer but symptomatic relief. Sometimes not even that.
That's the point at which pseudo science begins to exert its influence and quackery becomes more attractive as it offers false hope. And desperate people seeking hope will often accept false hope.
If these treatments were harmless then one can rationalize their use. But all too often quackery is anything but harmless. And that harm can come in different forms. Delay of appropriate treatments for illnesses that can be ameliorated if not cured, or the use of treatments that themselves actively cause harm to the patients.
I congratulate you on your reasoned and realistic response to your situation and mourn for your mother who has fallen for the snake oil pitch. I hope she hasn't been harmed by it.
Good ramble Rohin! I recently started strength training and watching some evidence based lifting channels, so of course Huberman was recommended to me by the algorithm. He immediately gave me Roganesque vibes which put me right off, but glad to have confirmed that he's a bit of a knob at best.
love your channel Linus!
I’ve got plenty more to say about ol Hubes…
Hello. ME/CFS tolerator here. Desperation drives many of us to try all sorts of nonsense, particularly as medical science has nothing to offer. Most of it has no effect but some does - and I'm quietly convinced it's placebo *but I don't care*.
After becoming ill in 1993, I was diagnosed in 2015 and given a double-sided, A4, spartan NHS leaflet, and that's been the sum total of my treatment.
The one thing I hope for in the covid fallout is that decent research goes into the rubbish illness. It may not help us but it may help those in the future, and, you know, that's very nearly almost as good if you squint a bit and put everything else out of your mind.
May all your placebos be potent ❤
Have you had any luck trying fibromyalgia or sensory overload / burnout recommendations?
I hope with the massive increase in interest in funding since long covid they figure out what's wrong and how to help sooner rather than later
Hmm. Strongly agree. However, how do we square this with the fact that most GPs know next to nothing about exercise and nutrition?
My friend just had a checkup (healthy, no issues) and was advised BY HER GP, that she needed to consider going keto. I think because the physician also is way too into podcasts.
Its really tricky tbh, I think its always best to consider the doctor as 'advising you'. And to know where their knowledge extends to. They are absolute experts at stuff you don't even understand, but you know your day to day life best and you can think more deeply than they can about what could be causing and effecting things than they can in 7 minutes.
I find the idea that you should listen to "healthy people" when taking care of yourself to be kind of weirdly fascinating, mostly because everything I know about how to navigate health care, how to advocate for myself in healthcare settings, how to effectively communicate with healthcare professionals, and manage all of the issues that I have with my body, all of the information I've ever gotten that has been useful has been from the disability community. I have learned and benefited so so much from all of my disabled friends and their advocacy and their work and their knowledge.
Should I listen to a healthy person who has never dealt with any kind of chronic illness or injury in their life? And are going to blame me and all of my shortcomings for the reason that my wrists don't function properly? Or should I listen to the people who have to navigate medical systems on a weekly or daily basis? Seems like an obvious choice to me.
I really appreciate the compassion with which you approach illnesses like CFS and long covid that don't have a known aetiology. It's so common to see medical professionals, online and IRL, completely dismiss these things. It can be very difficult to engage with healthcare when you have been treated that way.
When I saw a rheumatologist for a reassessment of my fibro and M.E., it broke my heart to see how crestfallen he was knowing how ill I was and that he couldn't do anything about it. I doubt there are many doctors out there who do not want to help people to get better. Especially those who are proactive with their health.
Oh sadly the world is full of them, even in the NHS and even with straightforward physical conditions like diabetes, heart disease, ophthalmic conditions, musculoskeletal injuries and more.
I was a carer for two increasingly unwell parents for 30 years starting in my early childhood till they both succumbed to long battles with complex, severe, preventable compounding illnesses.
Believe me, the vast majority of doctors we came across in this time had no interest in helping to cure patients/prevent illness, they were just doing a job, often very poorly.
But of course the types of illness that can result in death or going blind are the ones the NHS provides the BEST provision for. The worst is Mental Health which essentially does not even exist. In fact what is there is worse than nothing.
I use to believe that until here in Australia they implemented the national pain strategy.Up until age 50,2018, I was a big respecter of the medical profession then I moved here to Australia's capital where this vile program was birthed. This was a real Damascus road experience as I quickly discovered there's no shortage of doctors who simply don't care if you live or die and I mean that literally as I had one pain specialist tell me to go out to the carpark of his premises and kill myself for daring to question his infinite wisdom. I could go on forever regards such cold,callous and cruel treatment but the bottom line is plenty of doctors when back by the coercive power of the state are psychos.
I suffered the above stated and more for been proactive.I had presented in 11 jurisdictions across military,public and private for my spinal injuries and was treated exceptionally well due to my proactive actions in understanding my condition.Add a dash of government and this all flips on a dime.
Hope you feel better!
Rohin, another great discussion and one with coincidental timing: I'm posting a Huberman video tomorrow.
Fantastic to hear-when I started my postgrad research, I started to read many of the studies Huberman mentions in his podcasts. Time after time, I realised that he either; hadn't read the study he was citing, or fundamentally misnterpreted the results; cited some animal study as proof that a treatment or supplement was beneficial for humans; cited decades old research that has no contemporary data that supports said study; or alarmingly, flat out misunderstood the research due to, what I can only assume, is a gaping deficit in his knowledge of anatomy and physiology.
The last point is particularly jarring-in numerous conversations about the effects of cold plunges, he cites old papers within the field of neuroscience, of a horrificly small sample size, and repeatedly misinterprets the results demonstrating this complete lack of understanding of basic neurophysiology.
Huberman is a quack and arguably a very manipulative one, as he relies on his Stanford PhD to justify being an omniscient medical expert. Can't wait for your video to drop mate.
I'm glad people are coming to realize what a dangerous moron Huberman is.
"This is not my flat"
Serious, thoughtful, heartfelt, compassionate discussion. Hilarious non sequitur ending sentence.
Sometimes quackery works because of placebo. And when you're desperate, you'll try anything. It's a complex issue, I've been down this path myself with both positive and negative results. Appreciate your take.
This makes me appreciate my doctors more. I see the frustration and sorrow they sometimes have but to offer me platitudes and recommendations not based in evidence would only end up hurting their integrity, my wallet, and my brain. When I see my sleep Dr and it’s the same thing again but he wishes he could do more, that is care. It is care to not send a patient down a muddy path.
And it makes me so much more frustrated when pain doctors encourage “alternative medicine” and imply that you should have tried everything else first in order to deserve medical treatment. Infuriating.
I like how before this video, RUclips played me an ad urging people with wobbly glucose levels to NOT drink cold water...
you touched on another issue here: in situations like you discribed, even if doctors stick to options established medicine offers, leading a patient on like there was a guaranteed way to get better if we only found it (or if the patient only tried hard enough) is so harmful.
when i got diabetes as a kid noone pretended i'd get rid of the disease if i only worked hard enough, and even though now after 32 years i'm exhausted i never felt like there was this miracle cure in reach but somehow fate wouldn't let me have it.
but when i got diagnosed with depression and cPTSD it was like «you seem stable, you better finish uni or else» and when that didn't help it was «you better apply for a job yesterday» and when that didn't work out well it was harder meds and when that still didn't work it was yet harder meds (and in the end it turned out the meds were causing a lot of the issues i had to begin with but that's not really the point i want to make). never did someone just sit me down and tell me «look, you've been through some nasty shit, we cannot tell you when or if you are ever going to become a "normally function" person, but that's fine, keep fighting as you pbviously already do but also be compassionate with yourself and take your time; tell people who want to rush things that it is your life and not theirs; and if you need official medical statement we've go your back.» - all of those things _were the case,_ but it took like 15 ish years and a lot of donquijoting to get there. i am now deemed unfit for the job market; i dream of working at my fav tea shop part time but after all the toxic positivity i've been through i'm too scared and anxious to even apply. i lost three beloved family members and a romantic partner in those years and it makes me so sad that i couldn't spend more time with them just because i was lead on to believe that i had to fight _yet_ harder and that everything would be fine if only i accepted my condition / tried harder / did this or that and anyway.
i get it, you don't want to come across as if saying "haha, your life is over, have fun being crippled." there needs to be much more diplomacy and you probably need to gauge the personality of the patient, and there's not enough time and money for that.. but when there _is_ enough time and money to throw meds at the patient to see what sticks or to diagnose personality disorders only for those diagnoses to get revoked later.. then it should also be possible to get a doctor or at least a social worker to tell you that you are now allowed to grieve.
Same here, I've had depression for 36 years, and had the trauma of a false personality disorder diagnosis, that it took over a year, for them to accept that, the report said possible personality traits, and it didn't say disorder.
The thing that helped my depression the most was magnesium supplements, I take 4.2 g Epsom salts daily.
Also a designer dissociative no more than one day every two weeks, as NMDA antagonists can stop depression, and heal the brain damage depression causes. But as the NHS doesn't offer that, I had to figure that out on my own.
The point about being allowed to grieve for the life you lost because of your illness, that's hugely important.
Thanks for touching in chronic fatigue syndrome. It's a completely disabling condition that sadly doesn't have any cures or treatments. I wish that there could be more funding put towards understanding the condition. Hopefully day we might get a better understanding of it and a possible treatment
And is nearly impossible to get diagnosed because you're told you have a psych problem, you're inactive, you're too stressed and you should meditate
@@mellie4174 yeah, I had a professional CFS research/treatment center reject my application to be seen (signed by my GP after doing all necessary tests to rule out other causes beforehand) because they said that me not getting sick (eg with cold/flu) more often than before was evidence that it wasn't CFS. That isn't even in the official diagnosis criteria! And even if it was compulsory, I applied during the height of the pandemic, when I was staying indoors religiously. It was crushing, to say the least. (They did accept me half a year later, not that it helped.)
@lachouette_et_le_phoque there are treatments centres? I don't think it's in Australia as I've never heard of it
@mellie4174 and it's even worse when you have a psych issues. Different doctors will blame other things instead of chronic fatigue
You’re the man, doc. I’m a premed in the US and watching your vids gives me an idea of the type of doc I want to be. You have a strong moral compass.
The second we accepted chiropractic care as “medicine” and had insurance (in the U.S. pay for it) we gave in to the quacks. Now the chiropractors have gone after animals.
We have even got acupuncturists as government-funded healthcare providers down here in NZ! Not something I like seeing my tax money going towards.
When a legitimate professional massage would actually truly help me
Also can anyone tell me personal experience of the Palmer school? It’s come up in other contexts lately.
They sued doctors for pointing out they are charlatans and they won the cases because judges don't understand medicine or the scientific method
@@JenSell1626 I have chronic frequent low level dislocations due to a connective tissue disease. I don't have an issue with chiropractic as a profession, but I have had specifically poor experience with Palmer school chiros. They don't have good end feel, often use drop tables which I think are dangerous, and use too much force. Their HVLAs often have too much amplitude. At this point, I try to go exclusively to DOs or rely on self-adjustment because I've had 2 palmer school mild/moderate injuries. The school has a great reputation and I don't understand why. Other chiro's I've seen have been able to gently set my joints and help me stablize the joint and improve biomechanics.
Thank you for addressing this. I fell deep into the functional med vortex after a terrible car accident and severe concussion left me with many health issues. I felt abandoned by mainstream medical professionals bc my symptoms didn’t fit neatly into their standards of care. Func med held out their arms. But also made my symptoms worsen. It took going back to school at midlife (20 yrs after accident) to learn about the brain and body to pull me out of a pretty dark place. Having context for how the body (is meant to) keep itself regulated was a game changer for me. Becoming aware of the limitations of research and how long it takes and the rigour required for evidenced-backed protocols to become part of mainstream medical treatment also helped me forgive and understand the need for collaboration with my doctor, and also to ask for evidence from func meds before blithely accepting treatment advice. An unexpected benefit is being able to discern (eventually) when someone egregiously misuses their credentials to take advantage of probability judgments en masse. Not everyone can be so lucky to have the option to go to school to learn these things. I’m doing what I can to help. Grateful to you for doing the same.
Looking forward to your full version. This is an important conversation.
As a cancer survivor with an autoimmune condition, I am no longer able to do what I used to. Life has to change. The younger you are the more difficult the adjustment. Thus, people want a fix to go back to who they were before. Unfortunately, it is about having the best life where one is…now. These feelings combined with what you described are a bad combination.
You want hope…and sometimes acceptance is what is needed.
Thank you
I think celery treatment is the next new thing, it's got cells!
I agree with your point about setting the expectation that medication has limitations.
@neilj8224 Without defending the "celery juice conspiracy," do you know much about it? I try not to criticize others who may have looked into something further than I have.
You know what else was once considered "bonkers?" Physicians washing their hands. The idea that ulcers weren't caused by "stress & spicy food," and instead by bacteria. The physician suggesting the former died alone in a lunatic asylum; the physician who discovered the latter describes his colleagues walking-out of his presentation (he said, "they were just there for the sandwiches," lol). A decade later? He won the Nobel Prize.
Not saying celery juice is the next contender - just saying that it's easy to be cynical in the absence of knowledge.
There's a book "The Adventures of Holistic Harry: True Confessions of an Honest Quack" which has more of an insider view of how a doctor becomes a quack. It's by an MD who used to practice integrative medicine, and it's semi-autobiographical.
Holistic Harry started out as a true believer. Patients told him his alternative treatments had done well for them.
After awhile, he became disillusioned, realized treatments need to be validated by double-blind studies because of the power of placebo effects, wishful thinking.
But, he had too many financial obligations to quit doing the alternative medicine. It's not clear why, because doctors are generally pretty well-off.
So then he was in the unhappy position of being a conscious quack, and the book is about his moral struggle.
The book is funny and quite readable.
The NHS has a problem with people who are never fully healthy. That's the appeal of functional medicine, apart from the fact that most of us can't afford alternative doctors. I had ME/CFS back in the 1990s, misdiagnosed as depression, of course. I have a neck injury that was missed for 30 years, probably because my Doctor believed I was an overly dramatic woman until I was permanently paralysed. I also have a thyroid condition that has only been partially treated for decades, because the NHS flat out refuses to test for T3. For the sake of my mental health I stuck with a GP practice that had a balance of Doctors who sometimes told me what I wanted to hear, and others who had no explanation for my laundry list of symptoms. But that wasn't the best for my health - was it?
We had a symposium at the clinic I work at. One of the speakers, Dr Melissa Lem, a family doctor was talking on prescribing getting out into nature as a supplement (not an alternative) to treatment. It sounded fairly obvious but the talk was backed up with studies & the idea of having a number (in terms of hours per week) instead of telling a patient to get out & exercise at least gives health workers something to prescribe when patients are looking for something more than we can offer. Without going off into all the quack alternatives.
One of my earliest interactions with you on Xitter was on this topic a few years ago.
I was dealing with chronic symptoms following a surgery and became desperate to get back to normal. I saw a few specialists and waited over a year to get a few tests done, but nothing was abnormal. It sounds strange, but I hoped something would come up. At least a diagnosis meant potential hope for a treatment.
I eventually found solace in knowing I exhausted most of my options, and learned that medicine doesn't always have an answer, especially in these situations. I was fortunate to have most of those issues subside on their own over a few years, maybe in part to the the reduced anxiety. I can completely understand how people experiencing more debilitating issues would try anything out of desperation. It's hard to not to think ill of those providing unproven treatments, likely taking advantage of that desperation.
There's an old expression: "The road to hell is paved with good intentions."
I don't for a second believe that most of these whackadoos have good intentions. They are just addicted to the smell of their own flatus.
I think we need to get comfortable sitting with the reality that sometimes there is no good fix to the problem of aging and disease and be honest about that.
Being on both sides (i.e. patient and health care worker), there are few things worse than reaching the point of "sorry, but we've reached the end of what medical science can do"
I dread the day that will be said to me, but I 'll have to come to terms with it then. It is a fact of life.
There are two kinds of medical quacks imo. The ones who, because they don't know, invent things and jump on bandwagons to grift on people hopeful and desperate to feel better, and those that, because they don't know, dismiss their patients, ignore or blame them for their suffering, rather than realizing that things such as "laziness" and excess weight could be part of the symptoms, the fatigue and sudden weight gain the patient has been complaining about. This type of doctor also tends to get mad if the patient admits to having done their own research and won't acknowledge when the patient's self diagnosis turned out to be correct while they were fighting it and dismissing it, refusing to test for it the whole time, simply because they didn't want to be outdone by a patient.
To me both both these type of quacks, just have this disgusting ego that they want to stroke and don't want to admit that they are just not very good and maybe should educate themselves more.
This is the kind of rambling I do in order to untangle my own thoughts about a subject. It's often why when I talk I expect not for my problems to be solved by someone else.
I do like to get input by a friend that maybe I haven't considered. But I will fix my problem even if I take up a suggestion I'd rejected before. So whomever I've talked to, don't take it personally. It's how my brain works.
Interesting reflection on doctors. Always surprised by the amount of emotions doctors recieve from patients (suffering, incertainity, fear, expectation of solution) and the little to any formation they receive during training. It's uneasy to confront expectations, but it's an everyday situation. Psychological training and practise on managing and redirecting a patient expectations and emotions should be part of the XXIc curriculum. (Clinical Psychologist having worked in Primary)
In general, when it comes to podcasters, many start out with good intentions because they see this medium as the ideal stage for broadcasting their ideas. But once they hit a certain milestone, like the number of viewers, downloads, or subscribers per month, which inevitably translates to ad revenue, they feel increasing pressure to continue to put out more content in order to keep their lifestyle (typically determined by money and fame), success, and viewership. Eventually, they run out of legitimate discussion topics and wander into quackery or extremes. I think this is an inevitable curse that falls upon anyone who tries to follow the professional-to-podcaster pipeline, but it's especially apparent with medical podcasters (and RUclipsrs) who simply lack integrity. Exceptions apply, of course.
I feel that society still isn’t prepared to handle the effects of long covid. What doctors can offer is often not backed up by very solid studies like for example ,graded exercise therapy. The worst is that some people recover spontaneously and mistakenly attribute the cause. It’s a breeding ground for quakery and disappointment.
I think what you're talking about here applies to many circumstances. Human beings don't like to feel helpless, but we're all going to run into problems in life that we can't do anything about, and accepting that is very hard. Instead we're often tempted to mentally "bargain" and convince ourselves that we have more power over a bad situation than we really do, so we don't have to sit with that discomfort and awareness of our own limitations.
I cannot wait for the medical pod video. Please include the click bait nonsense from Diary of a CEO. Their thumbnails are getting increasingly insane.
Have you ever thought about making a book recommendation video for your favourite non fictions? Maybe related to or adjacent to your field.
Nice idea! Thanks
As a patient with a condition that isn't well understood but is sometimes completely disruptive to my ability to live my life, facing a doctor as they give you the results of another fruitless test can be so crushing. You almost want them to find something even if it's bad because at least there is a clear cause of your pain and maybe this round of medication will work. I can understand why it hurts the doctors
Totally! The worst is a cheerful "No need to worry, your test results are all normal!" >.
Disadvantage of the NHS lack of resources, disadvantage of the private sector is the doctor has a profit motive for treatment
Need a huberman diss track good sir!
You look well rested. This compromises your authority, I refuse to listen to anything you say in this video.
I like how he's 20 years older in some videos than in others
Glad you clarified that it is not your flat. The light fitting was challenging my ability to take you seriously.
Can you elaborate?
@@Dimich1993:
I believe that is a joke.
@@confusedwhale That's too bad, I wanted to learn something about interior design😞
Agreed. It's like his left ear has a really good idea, but, as an ear, it can never be heard.
I was trying to pay attention to him, but I kept staring at the light 😂😳
See, if there had been less dismissal of patients with these badly understood conditions in the past, we might already have a treatment for Long Covid that you could offer your patients. :(
But nope, it was so much easier to tell CFS sufferers that it was all in their heads and they were just lazy.
Going through unknown chronic health struggles where there's a lacking unifying diagnosis, I appreciate the providers who say "I don't know" and are honest about the efficacy of treatments far more than the ones who suggest "medical reiki" or acupuncture or one of the many "functional" treatments I've been offered, however much I'd like that to be the solution. Something I feel is obvious here the US but that also gets quickly forgotten in the mess and confusion of health issues and the bureaucracy is that if a treatment were really that effective, a drug company would find a way to market and sell it.
So, thank you for being so open about this issue that shouldn't be controversial, but is, both because of patient and provider desperation, and also because of the unfortunate providers who forget or outright choose to ignore what medicine and care really need to be for a patient. Those bad and almost avoidant practices really only put off finding answers and treatments for longer, and carry so many unnecessary costs.
I couldn’t have expressed this better.
The explosion of lifestyle doctors on social media is filling a gap and that gap is people who have chronic illnesses, and want to get better.
As an example, years ago I figured out on my own that my severe depression was largely caused by dehydration. Not once -for 20 years-did a doctor ever ask how much coffee are you drinking? How much water are you drinking? If they had and pointed me in the right direction. I wouldn’t have been on antidepressants for so long.
Their pharmaceutical industrial complex informed decision to give me drugs instead of treat the root cause is exactly why lifestyle doctors are exploding on social media. They are filling a need.
And to the concept that traditional medical doctors use evidence based studies to design protocols: My question is who wrote that study who sponsored that study? Was it Coca-Cola? No wonder they found that fructose is good for you!
Sometimes they do even if it isn't. Quite a bit of alt-med pretty much *is* Big Pharma.
@@KaiHenningsen Please give some examples. People throw around "Big Pharma" just to get nods from other people... but are pretty short on the details.
@@suziegriffith I think the onus on ensuring you were properly hydrated (which absolutely does have a wealth of cascading effects) should've come from preventative care by your providers, and it's unfortunate that was looked over. The lifestyle doctors are trying to fill a gap in knowledge, sure, but they're doing it horribly, pretending to focus on what preventative care emphasizes and often selling a product or supplement they're getting paid more to promote than pharmaceuticals (a reminder that there are virtually no regulations on supplements in the US, a reason why every benefit under the sun can be marketed without the heavy burden of evidence necessary for actual pharmaceutical products--this is more what I was referring to at the end of my comment).
Lifestyle doctors don't treat the root cause. They practice junk science at worst, and faulty pop science at best, basing everything into offhand comments made in proper studies, anecdotal studies, and their own anecdotal experiences. What they've found may have helped them, but they often aren't in proper isolation to determine that exclusively A or B were the real causes, or that when A changed, it came alongside and led to multiple other mindful changes in general healthier daily practices that just led to generally better health. Observation bias is inherently anecdotal evidence to a possible solution, and it's the reason why so many people who try going vegan or vegetarian or subscribing to some diet might cling to it so tightly and often try to prescribe it to others, when really diet is incredibly personal and a major part of the changes came along with the individual paying a lot more attention to more aspects of their health when they make that conscious change in diet.
Real medicine is holistic, and lifestyle doctors are damaging the overall field when they go the lifestyle route over actually practicing medicine (which itself is seeing the patient as a whole person and system, where little lies independent of another). Preventative care and ideas should come first in most cases, see what is off and can be changed with lifestyle adjustments (which is not what lifestyle doctors do), then therapies (medicinal and otherwise) to help remedy the issues after that when and where appropriate.
I would agree to some extent about the studies and funding, but it becomes far worse when you look at the ones the lifestyle doctors cite. As I mentioned earlier and want to stress again, there is virtually no regulation on supplements in the US, so almost every study on specific foods and specific supplements generally goes under as much scientific rigor as the medieval concept of dragons to so many.
Great take, you're the voice of reason we need in these podcasts days. Thanks doc!
I have a really nice GP. We usually talk for 30 minutes and a good chunk of that is me telling her info i got from your channel or other nonsense 😂. She always listens to me. On the flip side, that might explain why she is almost always late.
Yeah my GP also always takes the time with their patients, which often means sitting half an hour longer in the waiting room lol
My main question is....
Just when did medicine STOP taking the way people exist/live into account???
To focus strictly on lifestyle to the exclusion of all else is just as erroneous as focusing strictly on say, cardiology, or neurology, or endocrinology, or any othe field of specialty or preference and giving those an overwhelming influence on treatment.
As a diabetic, you would not BELIEVE what gets blamed on having diabetes. Everything, and I mean EVERYTHING, is suddenly linked to this disease, no matter what else had been pre existing and well diagnosed.
I bring this up because as an example, there is an insanely formulaic approach in US medicine to diabetes management. No matter if you live in a mansion, eat perfectly and have a personal trainer...or if you live on the street, or if you simply cant take the most common medications...the advice is the same, and if it doesnt work for you, youre labeled as noncompliant and essentially thrown aside.
Theres a role for lifestyle medicine, but why on earth is it being split off like a specialty?
The lifestyle and manner of living of EVERY patient should be considered by EVERY doctor, folks.
Is it less expensive to see two doctors for 10 minutes each, or one for 20 minutes, hmm? Which provides the better care?
If we dont give doctors the time to address their patients needs, or even just actually listen, are we doing justice to the patients?
Better time management, better ears, better knowledge of how the patient exists....
Its just good practice, and good medicine.
Since the witch hunts when they labeled all quality doctors pagans and exterminated them, and it really went sour when modern 'western medicine' became the only practice taken seriously.
Even Dr Mike has a problem with the latter, it's super enlightening to watch his recent interview with HealthyGamer, who mixes Eastern medical theories in his mental health practice. I have such huge respect for him, but his default bias against non-western medicine (and misconceptions of it), shines a light on a lot. He does give ground in the interview, so I'm not calling him ignorant. It's seriously an enrapturing discussion.
Anyway how western medicine treats patients vs how eastern medicine tackles things fuels exactly what this video is addressing. People lose faith in the sterile 'one size fits all, if it's not proven in a lab it's not valid' approach, and over correct to the alternatives. Then a lot of the disingenuous quacks take advantage.
it was the year 2013, when gen Z entered universities for the first time and thought they were smarter than all the people before them. if it's not in a paper, it doesnt exist!
Lifestyle medicine is a board-certified, evidence-based specialty... At least in the U.S. 'Functional' and 'hollistic' medicine is, in fact, mumbo-jumbo that most people learn in poorly regulated online courses. I would not group them in the same sentence.
I do believe in placebo as long as patients are told it's a placebo and they aren't paying for it.
Exactly. I'm not sure why he's conflating all these things but maybe it's different in the UK
Seven minutes? I thought the half hour I spend with my primary care doctor twice a year seemed like not enough.
It depends on your visit type.
@@MNP208 I'm trying to imagine any visit type where seven minutes would suffice. At that point, just handle it via email.
If alternative medicine worked, it would just be called "medicine".
I do wish that GP appointments were long enough for a patient to say everything, but the best GPs in my experience have a good, listening, inquiring, presence that stretches those short minutes to feel like hours. It is there in them whether new to the job, or long term in the job. Being honest with a patient in a supportive way.
Thanks for sharing your ramble of insight into how a good doctor can veer away into sales of false hope. This layperson admires the ones who don't do that all the more.
The road to hell is littered with good intentions.
I’m just so relieved that’s not your flat
Thanks, Rohin! This has been pestering me for years: a good, normal doctor considers the patient as whole. Thats not integrative or holistic or vodu medicine. Thats just a well done clinical exam.
There's a reason our professors stress so much the importance of taking a good history.
That ending was gold 😂
Thanks for resisting. I hate it when my doctor recommends acupuncture. It erodes my respect for her. On your main point, I think you may be too generous toward your quack colleagues. I'd hate to think that after all of those years of study and research that someone can so easily be co-opted by likes. There are always a few teachers who are popular because they do nothing but show movies and give everyone As, and I suppose there will always be a few doctors like that, but I prefer to think better of humanity and imagine that most doctors and teachers do the right thing instead of the popular thing. By the way, the alternative doctors I know of are not opposed to pharmaceutical interventions in general, they are only opposed to the ones that they don't sell out of their offices.
Placebo works. Safer than many medicines.
@@dandavis2981 No it doesn't, it very temporarily tricks your brain into believing that it works, big difference there. And for a medication to "work" by definition, it needs to OUT PERFORM placebo, not be equal to placebo.
I used to work in an NHS team for chronic conditions including long covid. The recommendations we made and treatment we provided were lifestyle based, lol (things like pacing, physio, and talking therapies). Hopefully your patient finds themselves in one of those clinics and is able to build a lifestyle that works for her to live with her conditon
Disclaimer: I am skeptical of most medical/lifestyle quackery proliferating online.
Doc, your concern is absolutely valid, however I would implore you to recognize allopathic medicine is typically encountered by people as reactive to health conditions which leaves quite a gap in medicine and prescriptions for a healthy life.
Last year I had joint and nervous system issues that took me away from work for several months. After consulting many doctors they all left me empty-handed. I was left with the burden of navigating a whole heap of hogwash to find my own path to getting better.
Put simply, there is a niche in care the medical establishment is largely failing to fill. That is why people are driven to quackery.
Extremely measured and well-said
You put it much better than I did. I had an issue and doctors would only offer one diagnosis, even after tests run (that I had to specifically research and request) did not support that diagnosis. I did the treatment for their diagnosis for two years and saw no improvement, and they still would not consider other options. At that point, there is no way to receive treatment from the medical establishment and I have to sort through all the grifting and lies to look for something that might help.
I don't know whose fault it is that this is the case and I'm not trying to blame doctors in particular because it's hard to say, but there is most definitely a gap and it has to be filled by something. I'd rather try doing x three times a week or not eating y for a month than live the rest of my life with these limitations and this pain.
@@kinseylise8595 It is the patients fault at that point, for not accepting that the help they are seeking simply does not exist. Quacks are charlatans are always ready to lie and tell the patient what they want to hear, rather than the truth, and that is the major issue here. When it inevitably fails, or has a minor and temporary placebo effect, the patient moves onto the next pile of bullshit instead, and the quack does this to the next person, and the next person, helping no one in reality.
I've found this especially true in the pharmacy. So often people will come in to buy a probiotic or supplement for their condition, and we are expected to provide it. I don't stray from what we're taught to do, but it's not the right setting to shoot down every request without risking an altercation. All I can really give are my recommendations, and how they can stay safe.
How much is quackery and how much is just dart-board medicine? In the right circumstances, when the treatment is a valid medical treatment for at least a plausible diagnosis if not a confirmed diagnosis, I think the dartboard approach can be a reasonable choice. Especially if diagnostic tests are likely to be inconclusive anyway.
@kray3883 Company reps will present sometimes to "train" staff on their products, and I can very confidently call those fields quackery. There's no clinical basis for topical magnesium, bio-Vitamin C, homeopathic melatonin, rescue remedies etc. Surprisingly some formulations like Caruso's Prostate Eze Max appear to be beneficial, but it's still not an established therapy. Even as a pharmacist where we're supposed to be impartial, I do feel that pressure to let many things slide. It's a daily reminder as to why prescribing power remaining with the doctor is so important.
More rambling is fine by me
I used to be really into Andrew Huberman when he first started. The content was a lot more rigorous and he stuck strictly to neuroscience topics. Now he's branched out into all this other bullshit, most of it way out of his expertise. Not to mention some of the guests he's gotten are questionable. It's sad to see what was once a solid, science-based podcast go so far downhill. Who'd have guessed money and fame would change a person's integrity lol? Admittedly I must give him some credit for piquing my initial interest in neuro, altho he's definitely not the only one. I fell in love with it, so much that I decided to go back to school and I'm currently majoring in neuroscience. I think it was the pursuit of deeper scientific knowledge that made me realize he was straying away from it. I mean I like hot RUclipsrs too (just one reason I like this channel 😉 ) but Huberman's hotness is not enough for me to look past the nonsense. Thankfully, one of my other favs, Dr. Alok Kinojia(Dr. K, Healthy gamer) a clinical psychologist, is still making solid content, despite his channels growth. Highly recommend him!
Yeah Dr K has helped me a lot hes great.
@@Sulaiman-xh8wx yeah same here. I've been able to take some of his advice and apply it to my life and it works. He's one of the best communicators I've ever seen and his channel is so unique. Even though his target audience is gamers the stuff he covers is relevant and relatable for literally everyone. His stuff on ADHD and addiction is great and his many years of clinical experience really shows.
I'm more concerned with doctors who become gaslighters.
Anything to lower the hospital's energy bill
its hard because doctors are still people, and most people have unexamined baggage that keeps them from having positive clinical relationships
Just want to say thank you for giving your perspective on this topic. The first step to fixing problems caused by people doing seemingly evil things, in this case promoting fake therapies over real medicine, is to understand _why_ somebody got to that point in the first place. I have a deep belief that nobody thinks of themself as a baddie, so understanding why people seemingly become baddies anyway is so much more helpful for figuring out how to untangle the brain spaghetti!
From looking at this comment section, i need an antidepressant...
Anyways appreciate the video, theres a decent number of podcasters who i previously enjoyed, but now you can literally dig up videos of their recommendations conflicting with other videos of their own recommendations.
We have a problem with quack doctors here in Brazil 😢 lots of them advising for chloroquine for COVID and stuff like that
Interesting story about people in a bad situation grasping for hope. I also see people in quite regular situations doing a variation of this. People who have unrealistic expectations about sleeping through the night as they get older, falling for ideas that if only they eliminate or add some food to their diet that they'll suddenly start sleeping like how they remember sleeping in their 20s
"Because we all like to follow hot influencers..."
Us, who are subscribed to medlife crises: Yes.
Ooof, that was below the belt!
I was a care giver for my mom who was a cancer survivor for nearly 18 years. We dealt with all sorts of doctors personalities. What I want to share here is that life is messy and in order to deal with it we must be proactive rather than reactivate. Be kind to yourself and make decisions about your life that you can live with.
Thing is, it's very hard to see a formal professional medic these days, whereas social media is everywhere.
You can see this all over the Internet, in different fields of science, where nice simple bite size information can be spewed forth and digested by the viewer without the nuance of the real complexity that lies behind it.
However, the placebo effect is strong and it's that which these other 'treatments' tap into..something which main stream medicine is beginning to lose due to a plethora of reasons, not least the overall loss of respect and trust in all-'professionals'
I am still having to deal with the consequence of a family member deciding based on RUclips doctors she could control her sky high cholesterol with a high fat low carb diet. 3 strokes and significant cognitive damage she's back on statins plus a whole lot more medication.
You do understand that people can experience strokes on any diet whether they are high carb or high fat or even the standard American diet, don't you ?
@@dogphlap6749 🙄 he meant diet only. She only went back to statins after 3 strokes plus cognitive deficits.
@@dogphlap6749 Her previously controlled cholesterol level went up to 12 after stopping statins and going on the fad diet, her daughter ans her GP were asking/begging her to go back on. Then the strokes. I'd say that was a slam dunk.
Nobody:
Rohin: This is not my flat
That had me laughing too loud
Huberman is a bell end
My sister, who died in 1983 of cancer of the mouth (she did not smoke) at age 31, tried all the available treatments recommended by her doctors. Because she was young and hopeful. Finally her doctor told her that "no treatment" is also an option. My sister/hero said, "medicine is not an exact science" after going through a horrific ordeal trying desperately to save her life...
Thank you for caring.
People do not like that answer though, and quacks are fully ready to give them bullshit answers that they want to hear, answers that are blatant lies most of the time, and they will do it with a smile on their face.
Wonderful video, thanks for the amazing thoughts and transparency
You can only make a handful of videos promoting diet and exercise and other lifestyle adjustments that have really solid evidence. You can make a couple dozen more videos promoting things that have weak evidence in their favour but probably do nothing. Eventually your standards for "evidence" get lower and lower, you stop speaking with a lot of nuance, and you enjoy the comments from people who say your advice has helped. You befriend other people in the same industry, doing the same thing. Maybe you eventually make enough money that you really need to remain popular to afford your current lifestyle. What's the harm with telling people to, I dunno, eat fish organs, when you know the placebo effect is real, and you think, "maybe this might actually help some people!" You might even start thinking of yourself as more of an entertainer or "content creator", and no reasonable person would assume what you're saying is advice you're supposed to take 100% literally. Of course, you say to yourself, the audience is smart enough to know that when you say, "Eat absolutely nothing but papaya to cure heart disease!" what you really mean is, "In addition to medicine your doctor prescribes, eating a bit more fruit instead of red meat might have some benefits, and talk to your doctor before making any radical changes."
Eventually someone gets really sick or dies following your advice. Chances are you won't know. Even if you do, you can always make the same excuses, or point to some other cause. There's probably a couple sentences in each video you make giving yourself enough plausible deniability for you to keep sleeping at night.
Maybe that's the Huberman complex lol
This goes back to the placebo discussion, right. The correct answer would be: once you deal with the basics (health tests are ok, good nutrition, good sleep, moderate exercise), focus on being happy. If sauna (in moderation), or red light therapy, or cold pressed juice in the morning, or a massage once in a while make you happy (and don't break your bank) then do that. That's your best bet to live a good and healthy life. Mental health needs to be talked about more often !!!, not just when there is an obvious problem.
As you said, there is a lack of resources in our system. If people turn to social media to try to fill the gaps, fair enough. I have been able to make some huge changes in my life and health with the help of social media.
Celery therapy it is
Organic celery - don't forget.
A pretty nice triple phonetic pun: sellery, cellery. and celery, not to mention salary.
It detoxifies the body.
You joke, but a family friend drank celery juice despite hating it for a ayear, hoping to lower his cholesterol but with no effect. His cholesterol returned to normal levels after he left his high power corporate job, who could have possibly predicted that lol
@@kinseylise8595 yeah but without the year of celery juice it wouldn't have worked 😉
My work around as an IM DOC is promoting exercise. Because let's be real 98.6% of my population don't do enough of it and it does have profound mortality and morbidity benefit and is also something docs give up on preaching about. That way no bs, no "drug-only- medicine," great discussion, and more trust.
But everybody's saying it can be harmful if you've got Long Covid.
Well tickety boo. Wheres your balanced outlook and analytic approach, because if you dont have and use that, you're just another person prescribing about their pet peeve.
Oh god I know it was off the cuff but the idea of "sauna therapy" for long covid really drove that home. I've got POTs, and it took +10 years to get a diagnosis, mainly because I'm 23 and "look healthy" (real quote, also untrue). Covid can cause orthostatic intolerance/ POTs, which is often much worse when it's hot (I've feinted in the shower). So just the suggestion of "sauna therapy," which seems harmless, but could cause someone like me to feint & get a head injury really struck home.
I can see why people turn to alternate medicine though. I think at the root of it, it's not just quacks taking advantage of people, but an underlying issue in most countries healthcare systems. I was dismissed as a hypochondriac by so many doctors, despite being seriously chronically ill, due to systematic issues within (for me, the Australian) healthcare industry. I'm sure those doctors thought they where doing a good thing in reassuring me that my symptoms where nothing to worry about. But I lost nearly a decade of my life, confused and suffering, because doctor after doctor was unwilling to investigate past the most obvious cause. POTs isn't even that uncommon, but (no offence to good GP's) there's a chronic problem of incurious and ego driven general practitioners, who are absolutely certain that they know more about a patient's body than the person who's living in it. From my experience, most of these doctors have been very nice, but ultimately unwilling to take me seriously, delaying necessary medical treatment for over a decade. Anyway I have a lot more to say about this as it's such a huge topic, but I'll cut it off here.
I strongly agree, except all offense to most practitioners fully intentional, including half my treating providers and more than half I’ve worked for 😂
@@JenSell1626gahahah yeah tbh, I was trying to soften the blow a little but really i trust any practitioner about as far as I could throw them (that is to say, not at all)
This is a somewhat silly, and most definitely uninformed question, but I hope you have some insight:
What is the difference between POTS and garden variety fainting when standing up quickly or if you take a bath that is too warm? Is there some defining symptom or oddity except severity and it just persisting?
I ask because I grew up with spells of these types of symptoms (+vaso-vagal shocks in my teens), and both family members and doctors just treated it as a nuisance functional thing that you had to guard against. Sit down, head between knees, remember both salt and sugar if you have a period with lots of fainting or near-fainting. Some basic work-ups were done at various points (to exclude dangerous stuff), but mostly I was just told about how our nervous systems works, and that in some people it can be a bit out-of-whack now and then.
Maybe because mild(ish) problems like this run in my family, and it was first brought up to a doctor when I was a child, I never experienced it being dismissed. I just found it fascinating, and in periods when it was most frequent, a nuisance (scouting out what to hold on to if you need to when you stand up, things like that - been close to 30 years since I last had a period of frequent episodes and to some extent I still do it).
Very thoughtful reflection. It's extremely difficult to do under time constraints, but arguably the ethical middle way in situations like this is to explore the patient's values and see if there are tolerable activities within their limitations which they find meaningful and beautiful. That just goes to show why multidisciplinary care is essential for complex conditions, rather than putting individual clinicians at the thin end of the wedge where they feel that need to reach for something, anything.
What about the nocebo effect MDs usually dish out? I was told I urgently needed open heart surgery and I thought, really? 10 years later, same cardiologist agrees with me I did the right thing not to go through with the surgery. BTW, it wasn’t for a clogged artery. My angiogram was fine.
basically, doctors are people and people are idiots. so there you go.
I think less business corruption would lead to fewer quacks. The opiod crisis was undeniably real. Also, a lot of doctors never hear about less expensive potential solutions that are buried in the scientific literature. Many things lower TNF alpha besides biologics. Different forms of exercise have different changes in GLUT4 and glucose-insulin response, but doctors say "exercise" and prescribe metformin which actually dampens adaptations to exercise.
And the asthma inhalers from 20 years ago and off-patent are unavailable because of CFC's supposedly. The real motive is new patents using HFA's.
i am a burn victim, and i was on many pain medications. by far best for every day use is canabis / marihuana. but in my country, its only allowed for terminal cancer patients - opiods are no problem - but they let you dream far to much, and quite honestly, i dont think they work for this kind of pain i have, which is more like nerve pain.
Thank you for your honesty and transparency! 🙌🙌
I really appreciated this “ramble”. As a licensed mental health counselor in the US, I’m frequently combating misinformation and quackery too (Tiktok?). You are a reasonable and approachable voice on the internet and I’m grateful you are here.
Thank you for taking time out of your burglary to make this video. You really ought to be wearing gloves, though.
Maybe one of the most important things you said is the “I can’t say it won’t work” even though you know there is little to know evidence. You also know that there is some chance you are wrong (ie it actually works). Science is complicated and multi level.
The complexity of medical science seems to lend itself to overly confident, simplified statements of. “Fact” and at the same time, a difficulty to definitively say something won’t work.
Arrogance and ignorance go hand in hand.
Your looks are the main reason I follow you on RUclips?
Please see an optician
10:10
I think you’re trying to remember support hose stockings, I am thinking of trying those myself to see if they might help with the dizziness from my orthostatic hypotension,because I’m already adding more salt to my diet like my doctor recommended and taking a reasonable amount of walking at least twice a week to help my general fitness like she said to do and drinking at least two litres of water a day as recommended and doing everything else that my doctor recommended including taking my medications as prescribed but I’m still getting the dizziness when I stand up and as long as all the tests for anything worse keep coming back clear it’s probably nothing to worry about but it still effects what I can do for myself and if I can leave the house alone so I looked around for more suggestions that might help me, my mom was prescribed support stockings for her varicose veins and they do help her to stay standing at work for the whole day so I thought it was worth a shot to try them out myself.
Very interesting indeed. I am a strong believer in the "Lifestyle Medicine" guidance offered by well qualified doctors and researchers such as Greger, Esselstyn, Ornish. They base their work on hard science and modify their advice when new research is published. I'd be very interested to hear your thoughts on their body of work.
What critiques of their work have you read so far?
I read the plug for this channel in your newsletter and am, as they say, "excited" to subscribe. I've been subscribed to the main channel for ages, but didn't know, or had forgotten about this one. So cross-media marketing does work!
Many people have recently lost faith in medicine ( in the last 3 years). This means many will turn to any and all alternatives. So expect a huge and continued growth in unchecked quakery too.
Ps some alternative treatments work very well in paliative care and have been a common mainstream supplement to traditional treatment in hospices.
Thank you for this nuanced discussion.
Very candid - and love the honesty. I agree that the temptation is there to get rich and famous. It's sad to see, and reduces the integrity of ALL medical professionals - there are fewer and fewer medical professionals that do not "flog" their expertise in the name of promotional marketing. It's a very delicate balance - and glad that you have chosen to not go to the dark side.
Dr. Francis: the uni where I live offers doctoral degrees in “osteopathic medicine.” So, often when I’m searching for practitioners, I’m given folks conferred the title of “D.O.” rather than M.D., for example.
What do you make of this? It seems the former designation warrants some skepticism?
They are the same in America. Basically same training.
In the US and other countries they are often licensed to practise medicine. They get broadly the same training as MDs but osteopathy is basically pseudoscience. DOs are also probably more prone to promote quackery than MDs....... I seem to recall reading some research on this a while ago
In the United States, a DO is essentially the same thing as an MD, but they get, I think, an extra semester of education. They tend to treat the whole person instead of focusing in particular issues. My experience is that when I to the DO, they spend as much time as they need to with me. From my general physical, he spends about 30 to 40 minutes with me. Whereas when I’ve gone to an MD I am in and out almost every every single time less than 10-15 minutes.
@@robynf.617 One notable difference between DO and MD training is that DOs spend an additional 300-500 hours to study pseudoscientific hands-on manipulation of the human musculoskeletal system (osteopathic manipulative technique) alongside conventional evidence-based medicine and surgery like their MD peers
Is your friend's flat next to the tower of Sauron?
I remember a consultant helped me with this as i got into offering a treatment for chronic pain. I got the idea from a BMJ article. I then looked at the evidence and it was just a 50 person retrospective study. I was disappointed to lose the option but i had to drop it because i cant recommend if the evidenc isnt there.
What you experienced in the small with an individual patient is encoded in the way we use social media - people search for things they can do to improve their health or fix problems, so "the algorithm" biases towards content that answers that sort of question. That means that anyone posting on social media will get significantly more engagement from a "this will make you feel better" post, than a "this is why you feel bad". The feedback loop hugely drives us towards posting proactive answers (or, even better, controversial opinions) rather than purely factual videos.
Having just unexpectedly been put through a stent procedure (as an otherwise healthy active middle aged male), I know my first response was to ask "well what can I do about this?" above and beyond the (slightly generic) recommendations they gave me when I was discharged. If you as a Doctor advise me to eat healthily, what does that look like? And off we go down the Google rabbit hole of whether each individual food stuff is good for me, which might positively improve my long term health, and so on. Suddenly we're on the edge of "this miracle food will transform you!" and on into outright quackery.
If your goal is to grow your subscriber numbers, you will swiftly learn that posts that are in the "Functional Medicine" and healthy lifestyle sphere are far more popular than informative, accurate and useful explorations of current medical knowledge and practice. This isn't just a cold hard calculation, it also means getting lovely messages from people telling you their lives have been transformed. That's a hard psyscological pressure to resist.
Anyway, keep up the good work, and thanks for being an (apparently!) honest actor in this space. Always enjoy your videos, scripted or not.
It makes a lot of sense, I listen to a podcast, oh no ross and carrie, that investigate bs claims including supernatural healing, and they tend to thrive where conventional medicine lacks. Whether it’s unaffordable expensive or we haven’t found good treatment yet.
I had to think of my own history with long COVID when I heard the topic of the video. I also approached my doctors with the question of they know of anything I get l could try. I appreciated that they denied. I still tried a couple of things that might help but I was aware that it was to a great deal because I wanted the feeling that I was doing something rather than just being helpless. It makes a difference when doing it with that in mind than doing it upon the advice of a doctor, though.
When the people reading textbooks donot read through the complete chapter for the causes and risk factors for the disease and just focus on one point about Sedentary lifestyle .