We know that at the hospital medical students, residents, and hospitalists dive into a Flexnerian orgy of tests, treatments, and more tests. Is this helpful? We'll go back in time and look at Osler's dream at Hopkins before it became the poster child for Flexnerian medicine.

People are losing weight on the new drugs, but at what cost? First there is the financial cost: we're paying $35 billion a year for these drugs, and don't be fooled, all of us are paying. While insurance pays nothing for nutrition or exercise, it gladly pays for this. And these drugs are untested long term, with some horrific potential side effects if you take them for a long time or if you stop them. This is how our pharma industry works: big promises, little data, hide the side effects, but no money for actual lifestyle changes. Maybe these drugs will be great, likely they'll have severe long term problems, but we are all paying a steep cost to put pharma profit over truth and not spending any money for real determinants of health: diet, exercise, stress reduction. A shot seems appealing and requires no effort, but it can't substitute for what we know will work.

Alan and Andy discuss specialty care and its inherent dangers. We tell about specific patient examples, why excessive specialization seems appealing but results in over-testing and over-treatment, and how we can instantly change policy to mitigate the damage from specialization. Ultimately specialists are paid more to convince people they are sick and lead them down a road of testing, procedures, and medicines.
A few book and article recommendations:
-No More Tears, by NYT journalist Gardiner Harris, which explores the history of Johnson and Johnson and the complicity of media, the FDA, and academic medicine in the drug company's deceptive assault on the American public with dangerous drugs and products.
-FDA Approved and Ineffective, by Shannon Brownlee and Jean Lenzer, in The Lever magazine, showing that much of what the FDA approves is both dangerous and ineffective as they bow to the wishes of Big Pharma. Click Here for Article.