“Doctors Should Stop Acting Like Scientists”

this is a really tough decision and when they make it personal that's when we because we've left all 90 of our content is controversialize death threats but but then when that stuff comes in and they if they bring my kids in or anything like that like shutting that right yeah it's frequently said that doctors aren't scientists and we need to stop speaking as if we were scientists well my next two guests are both scientists please welcome Dr steyer and Dr love to the show hosts of the unbiased science podcast to debate that very point when I say debate it's more like discuss because we not only discussed that my RSV controversy all the topics that exist in the health and wellness space surrounding natural supplements natural cures and is inflammation to blame for all of our problems this is going to be a really contentious exciting educational and even collaborative conversation so please enjoy let's get started with the checkup I've two scientists in front of me I am not a scientist but I feel like doctors like to think of themselves as scientists it feels like you have a commercial stance on this at least within our community of doctors correct who wants to take first stab at proving why I'm not a scientist well I think the thing is is that some clinicians are scientists but not all clinicians are scientists and the public just automatically assumes that all clinicians are scientists but I mean you could speak to this better than than we can my husband's an nerdoc and he always says he had no formal training in epidemiology and data science and how to critically appraise evidence you don't get training in that so yes you have clinical expertise but do you all know do you I mean I don't know do you know how to really read and critically appraise I would like to take a step back okay so let's no no this is a good place to be but for the audience what is your definition of what a scientist is versus a clinician okay that's a very good question so so I I can jump in I think I think there is a difference so I think clinicians can often be called like applied scientists right so you're taking scientific information things that have been designed developed evaluated by trained scientists basic scientists you could call them and are using it to apply to treatment of a single individual whereas scientists by and large are looking at population level information they're designing studies in order to evaluate or investigate a given phenomenon or an observation and then they're evaluating the data that they collect to make generalizations or interpretations of the body at large and that could be an entire human population it could be a population of cells in a Petri dish it could be a population of animals um but it's it's very different because you're making these broad um conclusions based on a comprehensive body of evidence as opposed to tailoring the knowledge that's been created by scientists in order to apply it to a single individual if that makes sense makes a lot of sense now why is it on a practical level an issue when a doctor starts treating themselves as a scientist when they don't have the background knowledge to do so well I think the biggest thing comes down to the training in study design and interpretation of the data so a lot of times clinicians are going to be provided clinical recommendations right from a variety of credentialed organizations that provide clinical guidance right like you're you're not expected to pull out treatment plans you know out of a hat as it were right there are a lot of standard procedures not to say that there aren't exceptions right certain cases and that's why you know you collaborate and have differential diagnoses and try and you know investigate the problem but there's not a lot of formal um training with regard to okay is the study designed in a way that will appropriately evaluate the question at hand are we actually collecting the data that need to be collected are there variables that may skew these data that we're not accounting for and and you know that's totally fine because people can't be trained in everything right there are reasons that there are specific fields of expertise and that's why scientists and clinicians really need to work together to do that because just like just like clinicians We're not gonna go treat people we're not going to go make treatment recommendations we're going to say okay well the data support this as a treatment for X Y and Z or the data do not support you know the evidence for the treatment of X Y or Z the way that I'll put this on a practical perspective is if I have a patient in front of me and I'm a clinician I'm a doctor I am going to diagnose the patient based on my evaluation of what's going on which includes a history a physical potentially some tests and then my treatment plan will come from the evidence that was collected by scientists that was evaluated by scientists and therefore these clinical guidelines that were sort of laid out for me I go off of those yes right and I feel like good quality clinicians which is myself would go not out saying that I'm a good quality physician but meaning the clinician is myself will base their decisions more so off good evidence-based data right as opposed to just solely their experience exactly right and we just want to say like we are pro clinician like I think a lot of times we're pitted against clinicians and that's why I'm so happy that we're tackling this because it's like people assume that there's a hierarchy and that clinicians are at the top and we're just somewhere in the middle right but that's not the case you guys are amazing you're experts in treatment and you know diagnosis and treatment and all that but you're not necessarily trained in the scientific process and so like Andrea was saying you people can put anything they want like you could publish anything but we've been trained to understand the quality of the evidence and that's like the eye that's how we approach every all the information that we consume is okay what are the threats to the validity and the reliability of this is this generalizable or is this just an anecdote is this an outlier what's the body of evidence what's a scientific consensus and that's where I think the difference lies but I do want to also make the point and I know you know Ethan and I even spoke about this so Ethan's her husband yep ER doctor yeah boxer Ethan Chapin um so you know he has come up against us as a younger clinician where some of the older more entrenched clinicians are very um you know intractable in this expertise-based or experience based um practice as opposed to an evidence-based practice and younger clinicians more you know newer generations of clinicians are really looking more to the science which is great to see because that's how it should be working together right um but we saw a lot of this during coven and and during a lot of other medical issues but you know a lot of people you can publish an opinion piece in in you know prestigious journals and the general public doesn't know how to discern you know this is an opinion with no data to support it and it happens to be in a journal name I recognize versus a very well designed study with an appropriate number of sample subjects you know appropriate number of controls you know whatever the case happens to be and and they're really unable to discern like well why is this one credible and this one isn't when they're in the same Journal absolutely I don't think it's one or the other because when I get General guidelines population based guidelines and what I should do for a given patient I have to remember that that is not given to that patient yes because if that was the case AI would just diagnose and treat everybody right but the reality is medicine is the science and art that's what I think differentiates a clinician they have to incorporate that art yes where in the lab if you're doing art stuff maybe that's a problem actually so uh I think the human is part of the art form so while I may know I'll just finish the point I'll um I may know that this is what's recommended for patient an a right but I know patient a has a bias or they've experienced something with this negatively and I know they won't buy into this yet and I have to take an extra visit for this I can adapt the research that you've provided me into an individual exactly and I think that really comes to the Crux of all like science and health in general is that it's multifactorial yes and too often people get hung up on this like singular antidote and not not realizing that there's a lot of other factors in play and what works for a single individual does not necessarily mean that that is you know the de facto data-driven evidence and I've seen a lot of clinicians get frustrated with scientists and these guidelines because it's like I'm the clinician I'm sitting in front of the patient I know their history you know like the Nuance of their of their clinical background or whatever like why should I follow a guideline I'm the clinician and so so working in data science like you mentioned Ai and machine learning and there's all these amazing things that I think are going to come out in the next few years where we could figure out okay this patient has a probability of you know of success or of being discharged if we follow XYZ protocol but we always have to work in conjunction with the with the clinician I don't think personally and I know Andrew I don't speak for you but I think you agree that should never supersede your clinical judgment but we're a team and I think like that thinking needs to change like we're often pitted against clinicians but we are a team no yeah the new aspect is absolutely right the multifactorial thing is right because multifactorial is probably the answer for all these things right Nuance uh as Jonathan Heights said actually on my channel is a superpower that we we need to uh and is lacking in most people I will say to play a little Devil's Advocate older clinicians will oftentimes rely too heavily on anecdote and their experience and therefore less so on evidence-based medicine I have seen that pattern at the same time I have seen a new pattern in my younger residence that I'm training that are very focused on the evidence-based information and guidance so much so that they forget that there's a human sitting in front of them yeah that's so that's where the like boots on the ground thing yeah and why I think collaboration between scientists clinicians needs to happen more often when we're making clinical guidelines when we're making legal decisions on what is covered in insurance plans and pharmaceuticals plans and all that so yeah I feel like being the clinician the thing that I'm seeing on my side is both ends of the spectrum and the Pendulum constantly swinging one way or another right and constantly trying to bring it into homeostasis back into the middle somehow absolutely no I totally agree I mean you know you could certainly see you know someone who's so fixated on what do the data say and and they forget you know a very potentially critically important key detail of patient history right and that could lead them to a misdiagnosis and so yeah I mean in medicine you need both of those things yes absolutely I think that's cool and to answer the question that we started with I think there's a wide spectrum of how doctors learn research and Science in the first two years of medical training right some get a heavy lecture on it some get a very glossed over sort of summary of it but then in residency training is where I see either a strong emphasis from the program where they're learning and they have Journal club and they have times where they're dissecting weaknesses of Articles and research that has been put out and there's such a wide variability right so I think it's difficult to pan down and say all doctors are not good at research or or they are and when we do say doctors aren't scientists the problem that comes up is then the Skeptics of medicine come in and use that as an an entryway and say your doctor doesn't know what they're talking about I know the science and most people don't have the time and the energy and the dense informational background to know the difference as you said between two different opinion articles or research articles and they're left confused yeah and I think I mean you know to play Devil's Advocate on the other side you know you obviously get the people who say I know the science when they in fact do not know the science um and that can be true even for scientists right there are scientists that you know we've seen it a lot in the twitterverse where they are going outside of their field of expertise and they're misinterpreting the conclusion of a study because it's not in their scope of knowledge and that's true for scientists clinicians general public I mean everywhere in between so I think you know that's why there has to be collaboration and that's why there has to be discussion and you know constant evaluation of rigor of data that's emerging agreed and this brings us nicely to our point of how we met do you remember how uh yes we came to I remember died into DM s yeah I think it was me I think it was me that's literally to the DMS so he had you were on you were a guest or you had a guest on your show and you were talking about the RSV Surge and you were discussing how there was an increased proportion of hospitalizations or severe illness because there was this timing shift timing shift exactly what we can call the the exposure um you know Gap exposure Gap not immunity Gap everyone um we've covered that already but um the fact that the first the first time a child gets RSV is off most often the most severe time and you got a lot of flack from people about that actually immunologist no not from clinics oh from scientists from scientists wow so it was actually heavy from the science Community very interesting and they were using the same talking points that you're saying right now which is interesting and why I really want to discuss this okay because they were saying he clearly doesn't understand he's a clinician not a scientist and I remember I slid into his DMS and I said before the drama before the drama and I was like I appreciate your take on this um and I sent him our video about you know debunking the yeah about why there are yeah why is there why is there such a surge of respiratory viruses this season and a lot the multifactorial aspect of it right right so we have you know the the covid burnout people are going back to pre-pandemic behaviors you have routine circulation of a lot of respiratory viruses um and and and I think you know it was just like it was like a it was like a commiseration sort of thing initially what was frustrating about it was that I said in opening my statement that this is one of the leading theories right essentially saying that this is multifactorial right so but there's no new ones no no no yeah and I and then I asked you even after the the critique started do you think I said something wrong that I need to issue correction because I want to as a clinician put out accurate scientifically so you're absolutely correct typically a lot of these child I don't want to say childhoods because of course adults can get RSV as well but these illnesses that are typically more severe in childhood influenza RSV otitis media I mean a lot of these things right your first interaction action with that pathogen is most often and I don't want to say always because of course it's multifactorial things change throughout the course of someone's life but very often in fact most often RSV is fine kids do fine yes so that's what reassurance for parents because as a clinician I'm also worried about the parents right being worried for the most part yeah it's generally mild um but your first interaction your first encounter with that virus typically leads to the most severe illness presentation and so if there are kids not that their immune systems are compromised from not being exposed to it but it's just the first time they've seen it um it will often be more severe than the next time they see it now that's because we don't develop full immunity long-term immunity to RSV and that's why you can get infected repeatedly however you have a little bit there's a lot of different components of the immune system right you have the innate immune system which doesn't have any memory and it's always there to patrol but then you have different arms of memory immunity and some of those taper off more quickly and some do not and so you can still get sick but it's typically less severe in future encounters but but nothing of what you said was incorrect there's a lot of factors at play this year yeah the immunologists were pointing out that they're saying the the size of the Airways changing as the child gets older is the reason for the second illness being less bad and that's true we don't disagree one of the reasons so General development of the immune system occurs as people age right so you know and that and that also goes the other direction right you have a peak and then you have a valley where you have immune senescence so then older people their immune system is less responsive and they now have similar risk factors as you would as a younger person can I just say I think it was awesome how you went about like you reached out and you really wanted input and you were open to you know is any are there any inaccuracies and I feel like what's so interesting about what we're doing it's so public and when these scientists or clinicians whatever it's like clinician on scientists violence like they do it so publicly and then think about what the public is seeing exactly that's my concern right right it like totally discredits everything that we're doing it's like a journal club or a peer review process but like in front of an audience eating popcorn like scientific discourse is normal it's encouraged it's the beauty of science right but now that it's all playing out in the public eye they are they're like oh look this is wrong they can't they can't get it together they're they're such disagreement and it I just feel like it erodes public trust in science and medicine and also like when you're a professional in the field clinician scientist whatever when you're on social media what is your purpose you have to think about what is your purpose are you just trying to have a pissing match with another person in the field to make yourself feel better or feel smarter are you trying to do something for the general good of society right if it's the latter then what is your point of calling someone out publicly if you have a critique about what they're saying message them privately you don't need to go and Dogpile them to make yourself feel better that's completely unproductive and as just said erodes public trust in both science and medicine right and I think the goal is evidence-based medicine and getting people to buy it you should avoid that at all exactly exactly we have to get our act together honestly like I feel like kovid really lit a fire and there are so many of us out there who are now inside common in the public eye but like I don't know there's not a whole lot of Kumbaya behind the scenes at least it hasn't been for us I don't know if it well I know so I RIS so we've got ball have seen and we're not Super Active on Twitter I'll just kind of preface that we do most of our work on Instagram and we do have the weekly podcast um but you know every now and then and Jess is kind of forcing us into the reals world and Tick Tock sorry I mean that's where the world is going yeah I was just I facilitate I want to hide my face I'm a scientist I'm gonna go hide in the lab with my coat and my sweatpants you just also happen to be beautiful and I think it would be nice to be got your face on social media but okay go on but anyways so so we have gotten a lot of messages from people who follow the podcast page because again our page is really geared towards providing content for the general public it's not really designed for complex scientific discourse like let's talk about toll like receptor signaling and how it activates interferon regulatory factors that's not regret saying I was a scientist at the beginning but that's but you know so that's like the Twitter scientist I raise you a tnf outfits um so anyways you know we got a lot of a lot of messages from people who were so concerned with a lot of these um articles coming out about post covid and long covid and how it was leading to immunodeficiency what and there and and people are liking it likening it to HIV and acquire an immunodeficiency syndrome and I was like I just wanted to alleviate people's concerns that there's nobody of evidence to support primary immunodeficiency after covid and in fact even these temporary changes in immune cell populations are totally normal I gotta set this up because this is what you're saying is really important okay okay and if we don't set it up this might go over people's heads because I feel it going over my head and yet I already know what you're saying there is a concern yes this is the problem we're gonna set the table the problem is people are worried that after covid their immune systems are going to be weakened correct they're the theory is potentially kids are having worsening RSV spikes because they've been sick with covet right right so what has the evidence shown us on a practical level from experiencing covet to what happens to our immune systems after so there's a lot of different things that happen and that's the that's the challenge right so there are there are some data that suggests that some of the persistent symptoms of what we're calling long covid which is the post-acute sequeli of the infection can be due to overactive or hyperactive immune responses meaning you have persistent populations of T cells inflammatory populations of T cells that are leading to inflammation that is then leading to some of these symptoms that people are reporting there's also some data that suggests okay so some data says there's inflammation happening after you're sick with covet and you might have some symptoms as a result and then there's some data there's some data that also suggests that some people memory immune system is less responsive which is one of some of the theory behind why people are getting sick more frequently with other respiratory viruses that are always circulating and then there's some data that suggests that there are no long-term changes or persistent changes for other people and that is kind of what you would expect after a viral infection there are going to be some populations that have one response some populations that have the Other Extreme and then some in the middle right it's a bell curve and so unfortunately a lot of media outlets and professionals on Twitter have kind of leaned into one of those directions and really harping on this like long covet is destroying your immune system and leading to immunodeficiency and it's suppressing your immune response one par with HIV HIV like a lot of fear a lot of fear-mongering and there are very vocal people on Twitter who are doing this and so we wanted to Simply alleviate the concerns that there are no data to suggest that it's that bad right that it's that bad that there may be temporary changes to your immune system but that's that makes sense right your immune system's fighting a virus so it's going to take some damage and it's going to take a little bit of time to recover as you would expect but people are not getting um infections opportunistic infections that you would expect if your memory immune system was basically destroyed got it so it's not as bad as people are making it seem on that lane correct what's the other lane that some people are going into well so what happened there was that I got called out for basically ignoring all of the data that are suggesting that there is temporary perturbations when that was not what I was saying at all and I actually noted that there were temporary perturbations so the fear-mongering camp of covid is destroying everybody's immune systems and you're going to be sick forever basically dogpiled me and they thought we were downplaying long covid that was the whole thing like why are you downplaying this like this is feeding into this idea that covet is over we shouldn't be concerned with it when we've never done that and and this is the the problem with social media you have a very limited amount of time right like we had a 60 second 90 second reel and Andrea was responding to that fear to the fear-mongering headlines like oh my goodness obviously you know 50 of people are getting long covered it's like HIV or immune systems will never be the same and they came after her and really you're not even I mean it was it was vicious people really going after her specifically there are people who have page is dedicated to trying to take us down and they were related to credential I mean I'm sure you've experienced the same and again I mean it's sort of interesting like the medium as message like the the medium of social media is interfering with our ability like if you if you want a thesis on like what Andrea obviously like you could talk for answers 150 pages right but that's not productive right you know what you're experiencing right now and I'm only smiling because you're experiencing what clinicians experience you're trying to take a lot of complex data yes and you're trying to simplify it into a visit yeah but the challenge but the people the people that actually were doing the attacking were clinicians yeah there was a very angry dermatologist yes well I'll tell you why I actually agree with you on on your stance um why I'm against fear-mongering specifically and not to downplay long covid or the temporary changes that we see in the immune system's Effectiveness post covet because the human mind is so powerful and it really shouldn't be mind and body it should be Mind Body that if I plant the seed in either one patient or in many patients by talking on social media that their immune system is weakened their immune system gets weakened that's actually true yes I agree with you and okay so this so this is that wild no but but it's but it's 100 true because we know again multifactorial um word of the day stress hormones cortisol there's a whole Pat a whole lot of Pathways that get activated but your endocrine system feeds into your immune system your immune system is involved in every bodily system it you know that that exists so everything there's interplay and and this is actually a a struggle I'm having with the long covet because there is no clinical diagnostic criteria there is a giant encyclopedia long list of symptoms that are associated with long covid many of which can be associated with the fact that we've all been living in a pandemic that is in traumatic absolutely and people have PTSD and people have depression because they've been locked in their home is that actually a consequence of a viral infection you can't say that because there's no way to parse that out and so all of these things are getting lumped into the umbrella of long covid and that is I think in some ways inflating the numbers of people that are reporting saying that they have long covid because if you look at the actual biology of this virus yes it can do some damage for sure we have never downplayed that we actually have a lot of posts on long covid and and covid in general and highly encourage people to get vaccinated and take mitigation measures but there is no robust body of data that suggests that physiologically plausible that you know all of these things are going to be associated with all of these people who had covid and it's like correlation doesn't equal causation we always say just because it happens after you had coveted it doesn't mean it's because of covet or it's long covered and anytime we try to articulate that people come for us because they feel like we're downplaying I feel like in medicine what ends up happening is you have arguments over nomenclature like what word did you choose to describe this given when in reality we're talking about the same thing yes we are on the same team yeah you might think this is five percent I might think it's seven but the difference doesn't matter and I think what is created is like a very tribalistic situation where there are ulterior motives to argue about the five to seven percent difference and then the person that suffers in all of this is not the person like you getting attacked or the person doing the attacking but the viewer the the average person who's trying to figure out what the heck is going on so we so out of the interest of that we actually ended up taking down that particular post because oh I feel bad that you guys I mean honestly the only reason we did it and they were just saying they were really doxing her they were coming but now you've empowered them to say if they dox you hard enough you can do it well no but but the reason we took it down is because we want to do a more comprehensive summary well you could have done that as well and left that one up no you know I haven't had the talk this was a really tough decision and when they make it personal that's when we because we've left all 90 of our content is controversial sexualize death threats but then when that stuff comes in and they if they bring my kids in or anything like that like shutting that right down you know but but normally like we have no problem arguing you know publicly or not but but it was it was more because the whole thread just completely lost track of like the purpose of it it was not for some clinicians to get into a pissing match it was sure we were trying to alleviate a very specific concern that you know people are afraid now right because the public health emergency it's ending nobody's wearing masks only 15 of people have gotten the bivalent booster so there are people that have a lot of health anxiety and they're afraid to leave their house and so we're literally trying to alleviate and be like it's okay yeah it I don't want to say it's inevitable but right now with you know xbb 1.5 like it's gonna spread pretty quickly but but we don't want people to have this overwhelming paralytic fear that if they get covered they're never going to be the same not to say that there's not bad outcomes but vaccination booster all those things can improve you know improve your your outcome or reduce the risk of severe outcomes can I say one other thing I feel like what what we try how we try to set ourselves apart from some other scientists icon pages is that we are obviously yes we're scientists first but we're also practical and it's like real life like you know like people really came for us when we when we said like we're not necessarily masking all the time like this is when there was a real lull it's like real real life like I have young kids like we we are we're slowly returning to normalcy going to restaurants and a lot of scientists and people in the cycom community were like how irresponsible are you it's like we're being what's interesting is there's a level of hypocrisy there um from people that are pretending like there's perfect levels of protection that exists right and that you'll even see Dr fauci Who's uh who's on my channel a couple of times we're talking about look appropriate levels of risk for you might not be worse so we try and talk about a lot is that you know if I lived with a family member that was really high risk yeah I would be Jewish exactly but but there's some people where it's an all or none and and initially early in the pandemic when we didn't know anything about this virus like of course I was very cautious yeah I stopped hosting group runs outside because we didn't yet know how quickly this could spread even Outdoors my husband lived in it like again he's an ER doc he lived we got an Airbnb for him he showered outside like he was literally like writing his will like we thought it was like end of days no one knew what was going on but that's what the problem is they start kidnapping the information from what you said you know when the pandemic first started yes to what's going on now you lied yeah you lied right it's no no science has evolved that's what science is like our knowledge about science evolved all those things changed data has emerged yes yeah outside safety interesting is that there are some cycom pages who are still like very militant about a lot of things like the mask wearing and almost shaming like how dare you go to the supermarket let's talk about the Shaving because I think this is smart because the again let's go back to the goal if this person's goal from a psychological perspective is to increase masking and throughout the years of practicing medicine we know shaming does not work we saw it with HIV pandemic we see it with vaccine hesitancy you shame you break lines of communication you don't help anyone right so what are your theories as to why people are shaming if there are evidence-based people who know shaming doesn't work I mean you know is it emotional I was gonna say it's emotional you know they they've kind of they've kind of dug their heels in about this given topic and I think it I think it's a gap in effective communication skills they don't know another way to communicate that someone should be wearing a mask aside from this kind of Shame rhetoric I also feel like we're not academics I worked briefly in clinical Academia but we're not academics and I feel like the approach to the non-academic approach is very different like there's a lot of pride a lot of like Ivory Tower type approach and I feel like they take a stance and they just double down you know like I I but I think so I would say yes I think it's very emotional a lot of Pride they want to be an expert you know and for whatever reason the black and white very bold statements those are more impactful those are the things that get shared and res at for whatever reason and it's so frustrating for us because we always say science is all about the gray and there's nuance and like now I do mask if I'm going to a like a you know I don't know a supermarket or whatever and it's because there was an optic in cases like things change like I don't see the the reason that we need to double down on a particular stance it's like why can't we evolve why can't we acknowledge that there's Nuance in Gray so I don't know if I'm answering your questions I have a different Theory oh I want to hear yeah sorry but but I would I mean I think it's also I think it's definitely there's there's definitely a little bit of that Ivory Tower yes because because again I did work in academic research and and now I'm not now I'm in biotech that's my full-time job but but now I'm also involved in you know this Lyme disease foundation and you know again the goal of that is to provide you know evidence to the masses as well and dispel misinformation and I think you know academics who live in that academic bubble they don't they don't realize that the rest of the world there's a gap right there's a gap in scientific literacy there's a gap in understanding the granularity of things yes yes yeah exactly yeah I'll tell you what I think is causing it algorithms oh yeah I could agree with that too I'm I mean it not like this is an evil AI thing coming to get us I think clinicians scientists whoever these people are that are very heels dug in one way or the highway have realized that if you take the stronger stance the algorithm then will have a higher chance of recommending your content therefore you this is the point where I think they make the mistake they for they think they're being more effective yep because they're saying look this when I'm very heels dug in I get more views that means I'm being a better clinician doctor whatever but the reality is the type of you where you're getting there yes is someone who just wants to argue rather than the person's mind you actually need to change you're becoming the clickman yeah exactly yeah yeah and we always say like just beware of any extreme statement like but you're right like the statement's like this is going to kill you or this is going to cure you like those are what people want to hear it's like oh my goodness here's the answer and it's boring when we say well you know like there's new like they're sort of not not exactly like sometimes that you know whatever you know you don't want to get in that and I feel like sometimes we get sucked into like will like some of our posts and I guess I'm being a little self-critical here like they I guess people now are followers who who like our Nuance they're like oh no this is a little bit reductionist like you came down too hard on this and there's Nuance there's middle ground and yeah right yeah but I would argue that those posts that we do it's because we're trying to reach other audiences yes and it's a topic that we've already done a two-hour podcast on that we've already done you know 10 uh 10 slide Carousel posts on and sometimes you need to draw in but it's never a single format or a single time for sure but to your point like we're not doing this like just for fun like this what we're doing on scicom takes a ton of time and energy and effort and the reason we're doing it is to reach a large audience no that's that's why that's why that's what we're doing it it the way that I like to think about it because I'm everything is reductionist to me because I'm not very smart so I have to make everything very simple okay so when you are in first grade I don't know when this is actually happening to learning you tell kids you can subtract five from two because they're not ready for negatives yet right and then you have a calculus Professor going to this teacher and say you're an idiot of course you can and it's like well yeah but they're like fine but you're not there yet yeah we're not there yet so when you're making a piece of content and you're saying the end of the world is not here because covet is happening right and the the researcher that's the calculus scientist in this example goes and starts yelling at you you're like dude I know but yes I'm trying to get this you have to think about your audience and match the level of understanding yeah exactly and that is I think the challenge with the academics because they're teaching and communicating with other academic bubble yes they don't necessarily frame things in a way that's going to resonate with the public that's not at that level well and also I don't know if this is getting off topic but like the different platforms of social media it's like they're totally different so we're big on Instagram which is you have an infographic you have 10 slides and then a caption on Facebook it's all you know what it seems to do is more text Heavy if you're on Tick Tock it's a video what was my point of this Twitter um Twitter that some of them are different in terms of Effectiveness or anger well and so what Andrea was getting it like on Twitter a lot of academics like really they get into the details and it's like academics talking to academics on Instagram we're using infographics to to we're not trying to talk to other academics for the general public and then when we like cross post that's when we get into trouble exactly sorry we don't we don't spend a lot of time on Twitter but like I'll go on Twitter and it's like you know very reputable immunologists who are literally dissecting a paper and going through all the different cellular Pathways and the inflammatory cytokines and the different populations of T cells and it's like that's cool but again what's your goal should that be in a a med sigh room on Twitter like does that should that be in the main feed like is that adding to confusion to the general public like I think it is because I think what our role should be as scientists and clinicians is communicating to the audience that needs to hear it you know we go to conferences around you know know throughout the year where we can get into the nitty-gritty the granularity the presentations every single cellular process that's happening we don't necessarily need Twitter as a forum for that as well you know right and we're focused on the takeaways like what's going to have the most relevance for like you know for the public um you know this is not a we're not speaking to peers necessarily right and we always say like I'm not an I call an architect if I want to build something like where I'm not saying I'm better than anyone because I have a doctorate right but we have very specialized expertise we went to school we trained for a freaking decade you know what I mean like we can't communicate all of the detail in all of our posts so our goal is to distill it yeah no there's there's never been a theory or concept presented at a medical Symposium that's not met with some level of debate yeah right but if that level of debate happened in the public every time it would make people very confused and that's what's playing and nobody would trust science or medicine as a result and and we're seeing that erosion in in a very concerning rate right now I think which is why I am trying to prep the audience and educate the audience that this level of discourse is to be expected that's my new thing yeah on the thing on the channel is to get people to say okay here's what I'm saying and expect a level of pushback that not everyone will agree with what I'm saying and here are the reasons for why to hopefully the same way that if you're making a marketing campaign you're telling the brand hey I will do this 90 of people will love my post but then 10 of people absolutely hate it you're prepping them for the potential negative feedback yep same thing for the audience when it comes to medical knowledge and I've seen this play out on Twitter with um some infectious disease docs that I'm friendly with uh up north in Canada and they're getting absolutely destroyed for things that they've said in the news unfairly when they are presenting a very balanced nuanced approach and it's not one way or the highway exactly what we've been talking about let's move off actually the pandemic because I think it's um people are probably they're tired there are three subjects that you guys wanted to discuss today that you're feeling is very prevalent in science communication maybe in the health Wellness woo space yeah what uh what's one of those topics so I think I think the first and actually you know this really kind of goes back to a lot of what we've been discussing but it's the concept that you know people will co-opt a legitimate scientific term something that's happening on a cellular level or an organism level and they co-opt it to explain away a whole slew of ailments and you know one of the the terms of the day is inflammation right so inflammation is a normal process of the body it needs to happen for many reasons for life it's balanced by the anti-inflammatory responses but you find even scientists even clinicians definitely the general Republic definitely like the wellness influencers use it as a way to explain or create in some ways new medical issues right so oh you have GI issues it's inflammation oh you have brain oh it's inflammation oh you have this oh it's inflammation like it's not again nuanced multifactorial if you didn't have inflammation in your body certain cellular processes would not exist every time you literally consume something you generate inflammation because you're you're breaking down a large molecule into smaller molecules that's a catabolic are you launching a PR campaign for inflammation right now foreign while it's true inflammation occurs in a lot of those issues yeah it also occurs and other things that are very good yeah and also like the most inflammatory thing that you could do as a her as a person is exercise so you know an infection and need influence so you know it's very frustrating as an immunologist because you know that you know a lot of the other buzzwords that come along with it like autophagy and free radical like these are all like words that have meaning in science but they're sexy words yeah but don't have meaning when they're being applied in like the health and wellness space and it's leading to a lot of um like cropping up of faux medical diagnosis a lot of pseudoscience um and of course it's praying now or something down give me some pseudoscience diagnoses well so like the leaky gut syndrome that's one that is what is what do people say about leaky gut let's define it so people are claiming that leaky gut syndrome is an issue where your intestinal cells become permeable so that food bits and toxins are leaking out from your GI tract into your bloodstream and are leading to inflammation and that's why you have all these symptoms fatigue lethargy brain fog headache bloating diarrhea whatever like every symptom Under the Sun so intestinal permeability is a scientific term because your cells are not cemented to each other they have little Junctions little proteins that are like little gaps and that actually allows the transport of nutrients molecules that you need but it's not allowing food bits and bacteria and toxins to leak into your bloodstream and so again scientific term got co-opted for the wellness and now they're diagnosing this or self-diagnosing it and then selling supplements to cure your leaky gut because it's all due to this inflammation got it so they've kidnapped the word inflammation created a condition called leaky gut that people have real symptoms for and instead of getting the treatment and diagnosis of what their symptoms are coming from correct they're getting this photo diagnosis leading them to missing the proper treatment which is the big problem yeah and that and that's the big problem that I have is that right you know they're getting preyed upon by these people that are making a profit well that's the thing they're all vilifying Pharma and Industry because it's a for-profit what do you think the wellness industry is p i mean everything I'm sorry are people so naive everything is for-profit like we don't work for free I I don't understand this concept you know it's the most frustrating thing in the world and love to talk more about that but yeah so then it gets co-opted by the wellness industry and my big thing I guess related is this natural and the appeal to Nature fallacy and that everything that's not natural and clean is automatically better for us and that anything that's synthetic or made in a lab is just it's it's bad for us it's toxic and it's full of chemicals and we always say everything is a chemical and of course you know that's not true and the example we once gave is that was it willow bark Yeah well yeah what is that thing salicylate which is now you know now we've synthesized it into aspirin so people were chewing on willow bark eating willow bark for pain relief and yeah that was great but they were you know pooping their brains out vomiting they're all these GI side effects and now we're able to um concentrate it in a lab get rid of all the stuff that was making people violently ill and also spoiler alert by synthesizing thing and things in a lab we're preserving nature because we don't need to destroy nature you know we're able to so I just don't unders I feel like we're as a society moving towards this idea that everything that's a drug or synthesizer made in a lab manufactured is automatically bad for us and this Wellness industry multi-billion dollar you know booming based on this premise so that's my and the reality of the wellness quote-unquote Wellness space yeah is the supplements they make are not regulated yes they're synthesized and purified in the same ways that yeah they're made in the lab no no not even in the same ways in worse ways because there's no over no quality control exactly exactly the appeal to nature of house I mean it's everywhere right like I only want all natural ingredients it's like well you know arsenic is all natural too and botulism toxin is all natural too and you know I mean and and you know again those have higher toxicity than a lot of synthetic things so I have someone in my family I'm not going to say anything more than that I was just diagnosed with Graves disease and um you know her whole thing is that she does not want to take any medication for it because it's synthetic and she only wants to go on the what is it the AIP autoimmune protocols which we've covered on our boxes gluten-free dairy free and she's only doing Homeopathy I mean you as a clinician like I'm sure you deal I'm sorry I'm asking you a question but you know but like how do you deal I'm sure you get a lot of people who come in they're like oh no I don't want to treat that with medicine it's toxic it's bad for me I want to treat it naturally I mean do you get that a lot all the time in in ways on both sides of that equation okay so I'll have people come in and say I don't want the pill for this I want natural approach and then on the other end of the spectrum I have me saying you don't need antibiotics for this oh yeah yes or I'm depressed and I'm like okay well we need to do some therapies and talk therapy right so it happens on both ends right which is why the pendulum again I'm trying to bring it back to the middle and it's multifactorial because you know it's like I want to tell her you know we're not saying that you take a pill for everything I mean a medication helps people you know all the time but yes there are other things other factors other lifestyle changes that we that we could make it's not like we're saying you take a pill you take medicine it'll fix it and then to your point you're right on the other side of it you know people like I know my best friend's a pediatrician and she said like parents come in they want to leave with a prescription you want to feel like you're doing something tangible to make your child better yourself feel better so they'll you know they're prescribing medications and antibiotics even when they know this is viral and antibiotic is not going to do anything yeah another one of my friends actually it was a he was a med student when I was doing my PhD and we taught clinical microbiology the second year Med students and he's an emergency room physician in Arkansas now and he was like I'm guilty of prescribing antibiotics when I know I don't need to because they come into the Ed and they want something yes yeah yeah well the way that I try and position myself in times where a patient might come in and want something natural or have a distrust of the medical system I try and put myself in their shoes as much as possible and figure out what is the cause of this yes and as a person who's experienced a decent amount of life in my young age of 33 I have still seen what they have seen which is doctors don't spend enough time they want to make a quick diagnosis they want to throw a pill at it because we don't have the time to discuss lifestyle modifications to debate lifestyle modifications to see if the patient is actually doing this because we don't have enough appointment slots available for follow-ups so as a result I get why people believe in the naturopathic cure so everything better than the modern system we talk about this all the time I mean the healthcare industry has a lot of flaws and that's exactly and people are suffering there are chronic issues there are major problems with our health health care system and I hate when people come in and are fighting with my husband and blaming him it's like he first of all he's getting chastised from the higher refs in the administration move fast see as many people as possible he wants to spend more time talking to his patients so we get why some people are drawn to like naturopathy and Chiropractic and you know stuff like that and we just want to educate people like okay we understand why you're drawn to it there are problems but the evidence is just not there to support it and if you're foregoing actual Medi you know necessary medical treatment and and you care that's the problem right you want to put onions on your feet that's fine you know if you're sick that's fine but if you're not getting your kid an antibiotic if they need it for a bacterial infection that is a problem yeah this is where my sort of clinician had gets put put on and my scientist hat comes off because guidance general for the population might be okay get this patient uh you know thyroid replacement medication but patient wants to do this unique diet the the treatment says only do the pill not the diet but now for this patient I will try and find some level of Middle Ground sure where okay maybe we don't have to take the the dose that I was going to start you on let's start on a lower dose recheck and make some this is against what the evidence shows yes but I'm doing this well you want to get trust you want to get trusted make my way through the time because because presumably you know or at least have an inkling that the other modifications are not going to be as effective and So eventually you're gonna have to get them up to that dose but you have to take baby seats because they're not there you're being practical and realistic you want some adherence you know better some medication let's start them you know then just having them completely say okay this guy this doctor is not listening to me at all you know he's not hearing me and we want to be heard right exactly so we totally get that Andrea you sometimes though and I love to talk about this like the slippery slope like we sort of try to figure out like do you want to talk is it okay okay how like you know sometimes people will come for us it's like well don't you can't say blankedly that like you know Chiropractic is bad and acupuncture is bad and all this and that and like it's true like there is no evidence right so we don't want we're not condoning it because there really is no evidence to support its use but then if we say like don't do it it's not helpful like people yeah so we try to we try to you know approach it from like a risk committee like there are some legitimate risks with X Y or Z right you know the data don't support it right we we've done a lot on the placebo effect which you know we kind of discussed earlier on earlier that you know if people believe that they're getting something that's going to help them feel better and sometimes it can also contribute to that and a lot of people you know they're like well I took the supplement and I felt better and it's like well you could have been at the end of your infectious illness to begin with and so it's just a matter of time um but we're trying to get people to think more critically about those sorts of things and you know the wellness industry plays on this like desire to get a quick fix right they're like well you're going to take this right and the other the way the reason why their quote unquote winning is because the wellness industry you're requiring people to think critically at a time where they're exhausted they're tired they have a lot of stuff going on and maybe they don't have the health background to know right right and then the wellness industry is simplifying and asking them to not think critically and saying here we've already solve this for you just take it and then we expect people to be like wait why don't you agree with us but you know what's interesting and I would love your thought on this is that you know so you said you know you have people you they come to you they don't want to take a pill but then the wellness industry packages up uphill of herbs or whatever and are like take this pill and they're much more inclined to take that you know what that's what I would explore that's what happens in my visits so just my last guest on the podcast was uh Angela Johnson Reyes and she was telling me about how she prefers this naturopathic approach and it would have been very easy for me in that moment to point out and say why her thing isn't proven to do what it's doing for her but what do I win by doing that outside of making myself feel good that I'm morally Superior or not morally knowledgeable Superior whatever it gives nothing to the conversation so instead the conversation changed to what happened that she went this route and she started telling me all those stories of doctors neglecting her not answering her questions jumping to medications giving her an antibiotic when they were like I don't really know if you need an antibiotic and now all of a sudden I can then create some education not even in the moment of where we disagree but in general why my mindset is negative on an industry higher on this industry and we can create a level of Common Ground instead of constantly putting stones in our path yeah and I think you know it's a it's a broader issue like we know there are in the healthcare industry often scientists get conflated with the healthcare industry which were typically not you know directly involved with and clinicians often get lumped into the category of I had this one bad clinician that ignored my complaints they didn't believe when I said my pain was at an eight they didn't do this and then and then that leads to a general Mistress of all Health Care Providers which is a whole other you know issue that needs I don't think that's unreasonable yeah I think if you've been in one crap situation and then you're put in that same exact situation the fact that you're experiencing the same set of feelings that you did on the previous one is Almost Human yeah and for us as doctors to not believe it or be confused by it is weird right but people always have risk aversion and aversion to negative experiences like think about like you go to a particular type of food restaurant you had a really bad meal like you know the next time you're thinking about a restaurant like you might not even look at exactly that type of Cuisine not not even just that restaurant right that's how the mind works yeah and we've seen that even like an animal mouse studies or rat studies being someone that has studied medical history to some degree mostly for the YouTube channel not because I'm smart again um I've seen how science gets really overconfident at times yes and I have to be open to the idea that things change and not just data like improving but also breakthroughs in how treatments that we once believed to be really good are not really good or something that we believe to be bogus actually got some proof behind it yep so when I hear like the topic of let's say acupuncture come up and I have a patient who's trying to skip surgery because they we see negative outcomes in their specific instance with musculoskeletal surgery and they said I've tried Physical Therapy I've tried epidural injections I've tried this do you think I could try acupuncture I think it works and they try it I in this situation as a doctor have to think about okay what is the risk of them trying acupuncture and not overplay it the risk yeah because it's very easy as the doctorate to be like this is risky for no reason right it's not risky for no reason even if you believe acupuncture doesn't work as a doctor there's a 30 chance it'll work because right right now you have to think if they can get a 30 benefit from this that they believe in acupuncture what is the true risk that they're experiencing and the risk is quite low so that's why I say I think it's worth a try well and would you agree with that well so you know we actually did an episode on acupuncture um and and I you know our general conclusion when you look at the evidence is yes the risk is pretty low there are some documented really severe Adverse Events like pneumothorax because the you know needles are placed inappropriately but if you look at kind of like the realm of pseudoscience I guess we can kind of lump that into that bucket um we're gonna get attacked for that no yeah I wouldn't put acupuncture yeah maybe not pseudoscience is made up yeah that's true okay also alternative yeah alternative integrative yeah um in the bucket of all those options the risk of acupuncture is low and again there could be a per you know a potential benefit for Placebo I think there was a little bit of evidence that for certain particular conditions especially when coupled with other modalities like Physical Therapy actually did have a benefit and I think if you are an individual and your option is invasive surgery with long recovery and maybe trying this for eight weeks you know and the risk is low and you make that personal risk assessment that's why I don't destroy integrated therapies right simply on what you just said and there are doctors in this space who will say never yeah it's quackery they'll they'll downplay and I understand where they're coming from but at the same time I got to think of that practical implication that you just referenced it's so interesting because I feel like we're now kind of labeled as like the [ __ ] of cyclone and like be like oh [ __ ] I'm sorry Andrew I'm telling you people closest and that we've just like shoot down anything yes and I need people to understand like it's because we're coming from the perspective of scientists and there's not a whole lot of evidence for it and you as a clinician I understand stand why you're maybe more open-minded to it and trying to establish a connection with a patient you don't want them to shut down completely and right you need them to buy into your recommendations on text is different from an Evidence point of view there's not a whole lot a whole lot of evidence for its use right and I worry as a population but then what correct individually yes we actually were working on a post about clinicians versus scientists and how it's individual versus population right well exactly people like we're describing our goal is to describe the average and yes there are outliers you know I don't know it's it's such a different like different world and it's also a different end goal right yes it's a different end goal yes so the approach will be there I don't want us to be seen as like just being anti-all these things it's just we're we're trying to educate people on the available evidence and then but by the same coin it's like are we also eroding then the impact of the potential placebo effect by telling people no you know I don't think it's that true no because I think I think you know and I I think your job is to be unbiased and so most people you know I think most people are like yeah we get this you know we always try and balance it with potential risk so like if the potential risk is is low then you know that's fine but like a lot of times it's like well you don't need to waste your money on this supplement because there's no evidence to support its use and a lot of it is like people are spending thousands of dollars on these things that are being sold to them on social media and our issue like we're not judging the people who are taking these things and trying these therapies or whatever alternative they're you know because again I understand like I saw my dad struggle with emphysema and and cancer and like we were thinking like are there like for a time we were thinking like okay the treatments aren't working like should we explore these things I understand that mindset of desperation and of chronic pain and fear I get that um where was I going with this um I'm sorry I do this all the time and she has to finish my thoughts so we're not judging the people but I think oftentimes people come at us like you're being so rude and you're judging us and you're gonna no it's the industry and the charlatans and the sneak oil salesman that's what frustrates us like they know there's no evidence the way that I like pose it to someone who is a firm believer in supplements and believes that they work for all of these issues is if you walk into a supplement store there's a supplement to cure aging there's a supplement to cure um ugliness there's a supplement to cure uh sex drive yeah and yet we're all suffering with those things yes and every person in that store still has yes yes so like that's my thing I'm like if it worked then everyone in the cell phone store would be yeah gorgeous invincible and living forever gray hair yeah so like I I hope that I can just induce skepticism on that yeah alone it's a great I mean it's a great tactic and and you know I mean we try and we try and approach it you know okay well this is the evidence you know if if this was you know like there's a reason that they have to use these buzzwords right there's a reason that they have to sell it in this way because there isn't the data to support it and we're not in front of a patient like you are like it's different for us when we're presenting information like we don't have that same relationship with people so I really do understand like what you're saying and I respect it I think what we're all coming back to the point is that this is a collaborative effort I'm not going to try and run scientific rigorous trials because I'm not good at setting up those trials and uh on your end making the deduction on which individual level to make these recommendations probably doesn't make sense either right so that's why we team up to do it in that way and that's and that's how it should be and it's and it's unfortunate you know and I think social media certainly has accelerated but the pitting the pitting of each other against each other is I think a good title for this podcast is like Dr verse scientist oh oh gosh okay that way it sounds a little salacious but it does but it's not actually it's quite Unified um I was gonna just share a quick story of uh how Okay uh for placebo effect to work you have to believe in it and all these things that we know well I did I never believed in acupuncture and I had uh a torn labrum in my left shoulder me too really right my right though okay so I had surgery so here's what I did I had this issue for three four years uh probably from being a goalkeeper landing on an outreached arm or maybe bench pressing incorrectly and I had it for a long time it never really went away there was maybe a day it wouldn't be so bad we were constantly lock and catch and then my dad took me to his friend who's a pain management doctor who also did some acupuncture he did one session and I didn't believe in it I was like what is this ridiculousness I didn't have pain for 10 years really and I don't know how to wrap my head around that as a physician who I can't understand the pathway of how this worked and then I had a same instance I had a medial epicondylitis uh 10 uh not 10 cell a golfer's elbow from boxing and I went I'm like you know what this has been going on really long let me try acupuncture because it worked for my shoulder 10 years ago I went first session 85 relief of symptoms despite Physical Therapy failing meloxicam failing all these things that I tried and that this is where it gets tricky I went for the second acupuncture session for the elbow when I probably shouldn't have it was already so much better but the person said come back for a second session to make it 100 he hit my nerve and I got no and I had ulnar nerve neuropathy that was terrible for like six weeks that I had to seek second opinions for my nerve was lighting up so it goes to show yeah and the risks are there right so I'll tell you my story about my so I used to be a competitive judo player okay um yeah is that fighter whatever yeah beat the crap out of people um and so I tore my labrum I was going to throw somebody and you know my arm was here and their body went that way anyway um so it was like an acute SLAP tear and I didn't want to get surgery because you know I knew it was going to be an impediment and I did physical therapy and it helped a little bit and then I postponed it for 10 years probably and and then it got to the point where my biceps tendon like basically started suffering completely frayed and so they had to slap it all together again um but I ended up finally giving it and getting the surgery in grad school and so I remember I was in my slang and I was pipetting I'm a lefty so it actually but I drove six shift and I had to trade cars with my dad because I couldn't shift when I was in a sling for a month but I did didn't try acupuncture I just tried physical therapy and it wasn't enough imagine it worked did it work imagine it worked no imagine it worked you were gonna save the surgery you could have pipetted I could have had it with both hands um but yeah but it's interesting and I also had the same thing happen and I'm gonna also an osteopathic physician so I'm a do um so we have some extra Hands-On stuff but none of it is magical it's all based on like physical therapy-esque reflexes of the human body and we see people get better from things that they really shouldn't be getting better from all the time I had Oscar Schlatter growing up where I had this like uh inflammation below my knee and that's very common in Young Folks and adolescents to experience this and it hurt for like four years every time I played basketball it was a chronic issue whether it was Oshkosh Slaughter or Jumpers knee same thing basically and I did I saw KT taping was getting hot very popular looking very magical it looks cool like different colors it got me excited about I was young I was like 21 at the time I put on KT Tape I did it the way that they said for the knee and I wore it for seven days showered with it all of it it never hurt again for the rest of my life ex I need an explanation I didn't believe it I actually I started taping my shoulder after what happened having his face medicine scientists well it was during the same fanaticism when there wasn't evidence but um it was a it's sticky tape right it's sticky stretchy tape that you know and they were like well it might if you tape it tight enough pressure of them it might help hold it in place of surgery and it's so popular with the elite Runners now um but yeah there's really there's not a lot of evidence behind it there's not a lot of explanation as to why it would help behind it it cured me how I yeah see it didn't cure me it didn't cure me he wants an answer how did it happen I don't have an answer either that's so like that's where yeah that's your place humility of medicine has to be like okay like look it cured me and I would be the first person that if a patient brought that in a bit come on it was just black it was basic it wasn't even fancy science needs that humility too and like we've done posts like scientist and perfect you know yeah so because it's sexy to say trust the size I know I know we used to use that hashtag it's all beautiful sexy for like a wellness influencer to say like all food is toxic well we were just well everything is toxic depending on the diet oh my goodness well there's a post that we're going to be debunking soon and it's like you know seven for all your organic counterparts because they're non-GMO right well so they show all these things and the takeaway is eat organic because this thing has GMO this has red dye so what none of those things detrimental why are we vilifying these things you know so but anyway again I don't even know why I said that I keep losing my training don't vilify this no no there was a humility humility science isn't perfect I don't know anything inside it's a sexy or Sciences oh because it's sexy to see those things and just you know it's easy to create uproar one right and this person has a million followers on you know Instagram is getting reshared reshared and then we have a very boring post about how GMOs are not inherently bad and how dyes are not you know and that doesn't get shared a million times it just doesn't because her post is sexier so we have to figure out how to make science sexy well I have maybe this is not the solution for you but this was my solution for society that I could come up with um I've been able to get a pretty big social media following with never straying from evidence-based recommendations on the channel which is almost unheard of because most people who are medical influencers who have millions of followers are usually sharing some kind of Beats right they're Hawking a product yes exactly they're doing that that's like Dr Oz thing that constantly comes up so don't even get me started I live in Pennsylvania and I've also to be fair when I was a resident he invited me on his show and I went on to talk about a program I piloted a pilot in my hospital with doctors working out their patients so at least like he gave the evidence-based doctors a chance sometimes so I'll just say that once upon a time he was not and he was a great cardiothoracic surgeon he trained in my hospital and there's countless Physicians said he did amazing surgery so something happened right something happened changed evidence changed [Laughter] um and I decided to create a course uh for professionals whether you're medicine a lawyer a bookkeeper and you want to put out evidence-based good info and you don't know how to do it through media or social media kind of created a Playbook of how you can do it and be successful that's that's my thing because otherwise what I see young doctors doing is either selling out to the bunk and selling the nonsense miracle cure stuff or they go into this I'm going to do call out culture and join tick toxic and yell at these people sorry no I hate I mean don't do that there's a middle ground yeah you don't want it successful we don't want to do financially well off yeah you can do all we get offers all the time and this is what I wish people understood like oh you could make so-and-so amount of money if you push this product and we're like no we're not you know we're not going to do that but if the product was good and evidence and there's nothing wrong with that well the public thinks there's something wrong I know there's we know there's nothing wrong and we vote like but we have to make the living things that we've been you know that we've partnered with companies I have to make a pause again I think scientific minds are corrupting you right now uh-oh do you really think all of your audience is upset when you make money no exactly so why are you I'm Jess gets upset I'm a people pleaser I don't know what's wrong I know what it is to stay off comments because I know how pure our intentions are and like it hurts her it hurts I know it really does it offends me because we could be making the quick cash and like I'm gonna be real with you Pfizer and moderna they have foundations we talk all the time about vaccines we have not taken a penny from Pfizer and moderna but like it's like if they have foundations and we could apply for a grant where we are getting funding to do the cycom that we're now doing for free why should we say no to that and I don't like I that's my struggle you know and the thing is is the the critics are going to be the ones that are going to Dogpile and comment and you know it's going to be a very small proportion and I try a little louder yes because we're humans and we have a negativity bias turn off notifications don't read the comments we don't eat we don't sleep we don't shower we both have no time jobs I sometimes no yeah but my point is like I just my doctor mine turned on knowing what goes into what we do I it just it hits a nerve and I don't know how I have to stop myself from doing that and also stop reading the comments is what she has but also we should be compensated for our time and expertise and so I think this is the reassurance I'll give you because I am same position as you are okay I get very upset when I read the comments Sam frequently tells me never read the comments Mike stop reading the comments smart man there was a period of time where I needed to literally go to therapy and part of the advice of the therapy was to at night not read comments in my UPS my critique of that advice was initially that that's avoidance behavior we shouldn't practice avoidance behavior and she taught me that avoidance behavior done recklessly could be problematic sure right but if it's targeted at something that you see as a problem for you it might be a good behavior and a good coping mechanism I've actually taken the practice of not trying to get off social media like after 8 PM like my job I often work long hours and so I will be online a fish actually you know in the evenings but I've started especially recently just staying off and sometimes Jess will like screenshot a comment or a message and often I just don't even acknowledge them anymore because it does it it adds to my anxiety and I have to disconnect otherwise like I don't sleep I already take Trazodone to sleep right and I have to shut that part of my brain off you don't know how many times we've considered like just shutting down the page like it's like this is just please don't you know what it is it's tough because us simple clinicians is smart scientists name is not helping us though like and I love our name I've had a really clever name when we first well I wanted to do like a play on like you know show me the data or like there was like some other remember like once I came up with show me I don't remember there was a bunch of ones that we were but but you know we had to also factor in the the fact that it was her data analytics firm that was kind of you know bankrolling the podcast in the first place and you know there were other people involved in some of the decision making and so we couldn't be as witty or you know yes and also trying to find it like we are in two very different scientific Fields we're trying to like find a common yeah like you had she had some things what the [ __ ] you're talking about yeah I don't even I don't know like whatever anyway you see her she talks she's a very very technical that's why we're a good team I'm more big picture um so what do you think can I this is a really I'm curious for your input we're unbiased science um and all the time we hear more like bioscience I mean you don't even know what if moderna and Pfizer their foundations funded us not to you know talk oh get the Pfizer by Valen we would never do something like we just wouldn't do that but to help fund our education efforts should we take it or would that be like suicide I don't want to put your eyes for you it might hurt but in general no okay meaning for you knowing your personality as you've shown it to me personally okay it might be hard for you to function in that space now okay but what about individuals individual advice might not be great okay that's my clinician okay because I feel like we would be very transparent like I would be fine with it anytime anytime we do a spot like a sponsor you're very clear you're yeah it's always like she sometimes is over I know I think I see like we just did could I just I know I talked too long but like we just did a podcast on infant feeding we brought on two pediatricians we all happen to be scientific advisors except for Andrea for for Bobby for but we're Bobby Labs which is the scientific arm of this formula company they didn't even pay us to do the podcast there was no payment they get there was no script it was just I felt it was important to disclose that we do have this advisory relationship with Bobby because I had you know people look us up and they're like oh look formula shell you know there's a relationship so I maybe yeah there are five people yes okay so maybe I'm over disclosing okay this is a good do this when yeah you don't have to you don't have to follow it up with like okay we didn't take a penny we didn't do like let's say it short of like giving a like a copy of the agreement to the public like I've thought about that like literally no one's giving us a script we are in control of everything we're saying we weren't we didn't even if you were Shady the audience would know yeah okay and when I say the audience that's the majority of the audience right and you have to remember like how many followers there are versus how many are the people that are actually dogs no it's very hard it's very hard because I struggle with the same thing that's why I can speak to it this much but um I I even just did a campaign right now with like the covid-19 vaccine project where they reached out to us to do sponsored posts for the vaccine I'm like I don't want to take money for the vaccine not because I'm high and mighty just because I don't even want to create that relationship for people so I said I'll do it you could use my image I'll post about it but use the money to buy space and newspapers or Billboards or whatever it is to put the message out there so like you don't have to fall on the knife every time well you have to be forthcoming and once you are and you're an open book yeah yeah people will see it it's like when you step into a room with someone and you're spend an hour with them how soon do you know they're full of [ __ ] immediately immediately yeah that's what your audience is doing so you don't have to worry and if you make a mistake right and there are people that follow just to be a troll and those are going to be the ones you know so you don't have to engage with them because that's just giving them energy tonight we're doing a partnership with it might be the group yeah the coven vaccine Equity project oh yes that's the problem so so so the aafp board chair Sterling Ransom he's gonna come on they get funding from artists but again like no one told us what to say we're just educating the public and we're just having a discussion with of course people focused on that and we had some people no it was persons it was actually one person yeah this is an easy trick and something I started doing say minority minority yeah okay minority focus on and also same with like when you're like oh the comments are coming in hot like it's three people okay you know okay yeah okay people the only time where I actually get upset with the minority is the situation when it's your peers and that's when I get really but it's not your periodic or whatever no because those were not peers either some pharmacist and empty okay well there was you know who but okay we're talking about her but yes so as you can tell it's a very complicated space to existence so yes I'm glad we share um all these trials and tribulations even though we're on opposite ends of this collaborative Spectrum yes clinicians but it's collaborative so you know exactly it could be a circle yes more of this you know if you have a line Circle yes yeah this is a triple venn diagram yes if I was having an aerial view would be there you go more overlapping yeah yeah well thank you for coming on thank you so much keep up the good work don't stop you're not allowed to you know if you if there's a point where you want to stop you DM me and say we want to see no and I'll fight you okay I can't I just accept she has a torn labrum I know her weakness now I had surgery no I'll break it it's still crackly a little bit where can people go to learn more about you you can follow us on Instagram Facebook Twitter and Linkedin at unbiased scipod um our website is www.unbuyescipod.com and we have a sub stack where you can subscribe it gives you access to our monthly live q and A's and our private Facebook group and that is the unbiased scipod.substack.com we have show notes for everything everything we say is evident space we give the links to the primary sources that we use we also have I said show notes but we have a database a searchable database that you'll see on our website where you could actually search by keyword if you have a question about a particular topic I love it yes for those who wanted to see my response to the RSV controversy click here you get to see all the negative comments people wrote about me and as always stay happy and healthy

Channel: Doctor Mike

Views: 51,524

Keywords: doctor mike, dr mike, dr. mike, drmike, mikhail varshavski, doctor mike varshavski, dr mike varshavski, dr varshavski, dr. varshavski, mike varshavski

Id: zM843MnSWZA

Length: 81min 57sec (4917 seconds)

Published: Mon Feb 20 2023