9 Comments

I am a primary care provider and I came to this podcast expecting to be irritated the entire time. I can't count the amount of times I've heard people say something like "the healthcare system is failing America." I'm so sick of hearing that. Dr. Atria nails it on the head. What people are dieing from they've been running at for 30 years then they show up in the clinic and expect me to wave a wand a fix for them. I can't exercise for you. I can't lose weight for you. Everyone knows this is what you're supposed to do but no one is willing to do it. There's a pathologic aversion to taking responsibility for one's own health. No amount of medical insurance will change that people don't want to do the work.

As an aside to hear a prominent specialist endorse CICO made me legitimately yell out loud in agreement. How some people think they've defeated the first law of thermodynamics in their own body will never cease to amaze me. I have never once had a patient do an honest accounting of food with a food scale and not realize they weren't eating at a deficit.

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What cooling mattress pad does he recommend?

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I've been a long time health coach and have listened to Dr. Attia for a long time. I was very excited to see this matchup. When I saw only 8 comments (maybe that will change later) I realized that one reason that we are so unhealthy, and Dr. Attia highlights many, is that people say they care, but getting healthy is not a very sexy topic, so people just ignore it. There is no easy fix.

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I have the same question as Thomas R. What mattress topper does the good doctor use? Great episode.

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I listened to a speech from the floor of the House of Representatives (David Schwekert R-AZ) that rather elaborately demonstrated that we cannot save Medicare by taxation. He said that 33% of medical spending is diabetes related and other obesity driven diseases take it to over 50%. Providing Ozempic/Wegovy etc. could make a huge difference.

https://youtu.be/X8_tiLstL-Y

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There is an underlying conflict between the perspectives on preventive care that applies to medicine and beyond. Dr. Attia is basically saying that he can beat the house. That is, he's saying that even for broad-based screening techniques that haven't proven effective at the population level, he can do better at the individual level, by picking the right patient, the right tests, at the right time.

This may be true, but it's increasingly not how medicine is practiced. A lot of what we're doing now is guideline-based care. We follow flowcharts based on standard criteria. I've heard the term "personalized medicine" thrown around by a few intellectuals, but it's not what I see in practice.

For the patient, the question is, can a real doctor give you better care than a cookie cutter approach? For the physician, the question is whether we'll be made obsolete.

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I would love to hear Dr. Attia and Dr. Prassad discuss/debate screenings. This was a great conversation, I’m already on the hunt for a cooling mattress topper!

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