Lately I have been getting a LOT of emails from doctors. Given how often I write negatively about healthcare and medicine, I want to know why you read me - and what I can do better.
I am a physician - I read your articles because our profession is so corrupted by Pharma, and hospital and insurance companies that absolutely no one is keeping an eye on reality.
I read your articles because I feel I can trust you to provide authentic information regarding what you are writing about. I started following you during Covid where it was impossible to find reliable information. I maintain that this issue exists through to today. As a physician, I relied on you to help educate me about all things related to what was going on during the pandemic. We encountered such morbidity and mortality from the vaccines and this was not supported by any mainstream anything. So, you have been a valuable resource to me and so many. Thank you, Alex!
I read you because I think you are not only analytical and insightful, but honest.
There has been a time or two when I disagreed with a comment on physicians, but your handling of the COVID panic has been extremely valuable to any honest person.
The sad fact is that there is no profession more dishonest than the medical one. Physicians as a group showed themselves to be cowardly liars during COVID, and breathlessly overreacted in embracing every stupid one-size-fits-all demand from the government. As it happened, doctors became the camp guards for the government-Big Pharma fascistic canal, herding the public on to the COVID vaccine boxcars, “just following orders.”
For anyone offended by my analogy … tough. By touting pointless mass masking and embracing lockdowns, we caused far more harm than the virus alone could have. By advocating mass vax mandates irrespective of risk, we actively harmed people who trusted us. This was unforgivable.
I am a retired physician who found you during Covid. You are unafraid to tackle the dangerous groupthink that taken over the medical profession. The top-down lockstep I see among physicians today is disheartening. I think it has many sources. One big contributor has been the death of individual private practice as mega corporations have taken over. Whether hospital networks or private equity, the focus has become profit rather than patients. Even the doctors still actually thinking for themselves are often afraid to speak out for fear of losing their job or their license. When I trained in the 70’s we were exhorted to avoid one-size-fits-all solutions. Rather we were to LISTEN to our patients and find a best solution for each individual. And always suspect that a drug or treatment might actually be the CAUSE of a problem rather than the solution. Keep shining a light on the profit-driven aspects of the system.
I trained at Bellevue School of Nursing in NYC - also in the early 1970s. I was trained in a way similar to you. What has happened to both medicine & nursing is tragic - & dangerous.
IMO part of what happened to nursing is this: like teaching, intelligent women no longer go into nursing because there are so many other job/career opportunities.
I went to nursing school with some brilliant & compassionate women. The "new breed" of nurse is neither - automatons content to stare at computer screens more than their patients.
When I went to our 45th anniversary reunion in 2019 I was so proud to belong to this group of remarkable women. It makes me unspeakably sad to see what has happened to this once very honorable profession.
Yes, Bellevue was notorious for its psychiatric hospital on 29th Street.
What most people don't realize is that it actually offers very high-quality care in all its departments. And if I were in a trauma incident (hit by a car, stabbed, gunshot wound, etc.) I wouldn't want to go anywhere else.
It is our flagship public hospital. What people also don't realize is that it's basically the same medical staff at private NYU Langone up the street (they rotate thru both hospitals).
Bellevue accepts all types of patients so I believe.
I had a boss who spent many years at Bellevue. She taught me a lot about sociopaths and psychopaths. I worked for her for one year before I went to school.
I couldn't agree more about the "death of individual private practice." Doctors joining corporate group practices & keeping bankers' hours (not to mention implementing medicine-by-algorithm which this type of practice demands) greased the slippery slope to the bottom of clinical practice where we are now.
When I was in training the type of person who was in medical school or in a residency program was usually highly intelligent, intellectually very curious & capable of independent thought. I'm not entirely sure when that changed, but I'm guessing the mid-1990s.
Another factor leading to the demise of both medicine & nursing is the execrable electronic health record (EHR). Ostensibly it was developed to decrease medical errors & improve patient care. If anything it has increased medical errors (drop-&-click medication prescribing is a disaster) and has practically destroyed patient care (clinicians of all stripes spend more time keyboarding & staring at computer screens than actually looking at, listening to or touching their patients). I think the EHR was actually brought on board to increase billing.
I had this confirmed by an ER administrator at a NY-Presbyterian facility who told me billing (read: revenues) there increased by 40% after the EHR was introduced.
As one who worked helping the government to get physicians to increase use of EHRs (I've since repented) I can tell you the other purpose is to improve data reporting to government programs, in my case Medicare/Medicaid. We were told it was to improve patient outcomes and thereby decrease costs, a great goal, but it was more than that in the end. Can't let all that data go to waste. I quit when I saw that my goal (to help improve healthcare) was not being met through my work.
I never knew much about finance and investing and I saw that so many politicians had large sums of money invested in EHRs. It made me realize that making big money was most important to those who already had lots of money to invest.
Charts expanded exponentially with EHRs. My son is an attorney who works at a medical malpractice defense firm. When he first started in this practice area he was aghast at the the number of pages even just a visit to the ER could generate. I helped him at bit at the beginning with suggestions as to how to "separate the wheat from the chaff" (so to speak). Luckily, he is a quick learner - & thankfully, after 8 years, he is leaving this practice area next month.
I didn't realize the game until I was thick in it. I thought I had a job that actually helped physician offices improve care, and to a small extent we did. But then came the $44,000 "incentive" given per provider to implement an EHR and suddenly my eyes were opened.
You are absolutely correct about the evils of EHR. The “bring forward” feature means the history is never actually rechecked and errors introduced are propagated in perpetuity. But they make it easy to “upcode” a visit, making it seem more detailed and comprehensive than it was. And when I would refer a patient to a specialist I would get a 10-20 page report with often no indication of what the actual diagnosis and proposed treatment was going to be. A one page thoughtful summary of findings and opinions would be so much better.
I knew EHRs would wreck medicine. Who can convey what a patients tells us when we have no time to put in a decent note ? I was lucky as I was able to speed write my notes till the end.
I still have one doctor who does handwritten notes in a paper chart.
Probably the only reason he can still do it is that he left the faculty practice at NYU Langone & set up shop around the corner. He doesn't take insurance but he's worth it.
As a non-medical person, I offer this analogy: doctors seem to act like “dealership mechanics” who input mileage and “diagnose” from a computer without looking at your car. Go in for a 100 buck oil change be handed 2000-3000 dollar list of maintenance & repairs. My rare “private practice” mechanic has saved me so much time & money.
I retired Emergency Medicine in July 2021 after 33 yrs in the ER. Your articles were the only place I could read actual truth. The lies and political extremism among the media and my colleagues was demoralizing and sickening. Our census dropped to 47% even while all the news media claimed the hospitals “were overwhelmed!”. I’d look around and think what the hell are they talking about?! The ICU is ALWAYS full. Anyway, your articles were a light in the darkness. I don’t even recognize my profession any more.
I kept wondering why the NEJM kept pushing the vaccines. I saw how the Infectious Disease societies were destroying the docs who didn't agree with the Covid narrative. I wondered why we were not hearing about remedies learned from SARS 1 and from MERS.
I've just retired after practicing medicine for 45 years. I didn't come from money, and couldn't imagine borrowing $250K, so I indentured myself to the Air Force. Even though military and I saw eye to eye on very little, it was a valuable experience. Since then, in private practice, I've watched the training quality demonstrated by new physicians declining at an incredibly pace. Since I'm now a consumer rather than provider of medical care, I'm appalled at how many recently trained physicians don't even know how to take a good history of current illness or do a competent physical exam. I perform strict overwatch of all of my relative's medical care, and frequently have to fix painful shortfalls in their diagnosis and treatment. I believe that the problem starts with the degradation of education from the earliest years, with particular damage during college. Medical school and residency have been watered down and adulterated, with labor laws and unions shortening "work" hours for residents to the point they just don't have time to learn what they need to practice safe and competent medial care. We are at the point now where we have the products of this poor education teaching new physicians in a downward spiral. The education system needs to be rebooted from K through postgraduate school.
Your comments nicely sum up why medicine is chasing AI based diagnoses so hard…. As you say, it’s a skill that is not being learned by current students.
To Gary Wade: I read a book by an attending at Penn in Philadelphia, PA. In their Ivy League mecca he was saying what you described about the quality of med students and many residents. He was forced to retire.
I was an enlisted Marine late 60s. We were not treated well by the USMC but those Air Force pilots were wonderful to us whenever we were in their big transport planes.
And then with Covid I saw how much resistance so many Air Force pilots put up about those Covid shots An eye opener !
Alex, someone needs to say this because clearly, they’re not listening to the rest of us.
Take a look at practices that don’t accept insurance; their appointments are booked out. Check in with alternative health clinics (my own field of study and work), many have months-long waitlists. Why? Because the current system isn't working. The numbers speak for themselves.
All doctors should be arriving at the same conclusion: we need change. When profit is prioritized over people, especially in medicine and food, the consequences are undeniable, and they're showing up everywhere.
Unfortunately many of the people who need good help with their health the most (and for their kids!) are tied in to the insurance system and do not have the disposable income to spend hundreds of dollars each appointment on a health and wellness professional who doesn’t take insurance. Not that I begrudge the practitioners. Their education is expensive and they deserve to be able to pay their bills and thrive.
My teenager’s friends are almost all on some form of medication - amphetamines or SSRI’s or a combination. Most are on Medicaid level insurance programs. Most have a mental health diagnosis in addition to allergies or some autoimmune disorder. And they are all “normal”.
I think the pattern Alex is honing in on is that like everything else in American society there are powerful financial interests (whose sole purpose is to optimize for shareholder profit) in between all human interactions. It used to be that a doctor interacted directly with the patient and used his knowledge and training to the best of his ability on his patient’s behalf. It was human to human interaction. Sure there were a few charlatans and sociopaths in the midst but generally the doctor’s interest was in curing his patient or at least alleviating suffering. Then insurance companies jumped on the middle. Then doctors had to start considering the need to cover their own ass as they sought to help their patients. Patients in turn could only get the treatments approved by the insurance companies.
Now there are more insidious interests in betwixt doctor and patient. Private equity owned hospitals and clinics have replaced private practices. A layer of administrators decides what services to promote and which to discourage. Physicians - at least at the PCP level - are essentially order takers in a process that is aimed largely at data harvesting because behind the layers these clinics are dependent on money from social impact investing, federal grants and venture capital.
When we get back to the days where a doctor can be paid directly by the patient (in tomatoes, eggs or a goat?) and works for the patient and not some unseen funding source way behind the scenes, then we might get real healthcare again. But unfortunately the system seems to be driven by those lined up to reap exponential profits at human beings’ expense with the “answer” being AI and ubiquitous data collection via wearables.
I hope the independent practitioners can continue to thrive. And I wish there was a way to make those services more widely available. But short of putting enough money directly into the hands of the people seeking medical treatment and letting them have free will on how to use it, the future of medicine is only going to get more anti-human. Sigh. 😕
My son’s girlfriend dropped out of her osteopathic medical school at the end of her 3rd year (it’s a 4-year program). Many people are shocked but I’m so proud of her! She saw so many bitter female docs in her clinical rotations, she was seeing a future that was the exact opposite of what she had envisioned.
She’s now getting a masters in nursing, and I’m hoping to influence her toward homeopathy or naturopathy…we need more providers that are anything but allopathic.
I’m a retired pharmacist, covid woke me up BIG TIME. I am appalled and ashamed that I never questioned the vaccine schedule. If anyone, I should have learned about them, right?!? Nope, nothing. The fact that there are no true placebo-controlled studies is the end of any pro-vax argument, imo. We are injecting healthy babies, the bar needs to be higher in terms of safety, not lower.
I suspect many want to help people and do not understand how the system has been transformed behind the scenes. I suspect others are looking for a good career option and also don’t realize how the practice of medicine has changed since the hey day of doctors being much esteemed and wealthy. Many are foreigners who came to the US for education that translates into a green card. Others are foreign educated who came here with a job in the medical field and are just busy doing the jobs they have been hired to do and don’t have any other concept of what health care could be. Mostly I think the people in the field are good people doing the best they can and they are so busy that they don’t have time or energy to lift up their heads and seek to see the broader picture.
Always thought remarkable that paying cash didn’t get a discount like insurance gets. Buy a special insurance plan - no benefits- cash now gets the discount. WTF!
The Midwestern Doctor Substack "Forgotten Side of Medicine" has recently written extensively about DMSO.. There are lengthy, detailed articles about many medical issues that real physicians appreciate. https://www.midwesterndoctor.com
Some people (https://www.midwesterndoctor.com/ - Midwestern Doctor is anonymous, claims to be an MD, sounds smart) claim dimethlyl sulfoxide (DMSO which comes from wood, acts as a solvent, but CANNOT be patented since it comes from nature/wood) can help many, MANY, health problems, but powerful drug companies conspired to keep the public and healthcare providers ignorant in order to keep patients reliant on their patented meds. Others (FDA) say DMSO only helps a few things (bladder symptoms, solvent to get antifungals to penetrate toenails to kill toenail fungus) and it has FDA approval for those treatments.
I've never read a book on it. Some other commenters mentioned books on DMSO that they thought were good. Search these comments.
https://www.midwesterndoctor.com/ - Midwestern Doctor is anonymous, claims to be an MD, sounds smart. This Substack talks about DMSO among other things. It's very pro- DMSO so you're only getting the pro- side.
AMD has done plenty of research that doesn't need repeating. The safety of it is well known. Get yourself some and use it, start slow like he suggests. Saved me from a knee replacement
Thank you. I have some and just got a book about how to use it. I just think Alex would lend credence and with his broad voice, could push general acceptance.
Lots of literature on this. As a bench scientist, I can tell you it's used in solution to freeze mammalian cells so ice crystals don't destroy them. I believe it's also used in transplant medicine. Years ago I read a little paperback that claimed that it's medicinal properties where not explored since it's not patentable and cheap. Widely used on horses. I suspect Alex is the wrong person to cover this as the work lacks scientific rigor. No company could recoup the cost of a clinical trial. Lots of books on the subject. https://www.amazon.com/Dmso-True-Story-Remarkable-Pain-Killing/dp/0688007163
"I suspect Alex is the wrong person to cover this as the work lacks scientific rigor."
You may be correct, but I have gotten the impression from reading Midwestern Doctor that there was something in the literature on DMSO even it was just case studies from decades ago. But on the other hand, I don't recall ever seeing links to any of such studies.
I would find it helpful to know what there really is.
A google scholar search of "medical studies on DMSO" says there are 1,070,000 results and I was able to scan the titles/authors of the first 100. I would appreciate a look by UT.
What Alex could write on is more about the suppression of knowledge and use of DMSO. Equally, about Hydroxychloroquine and Ivermectin. There's a long history of development, use, safety and success of these drugs, and ultimate suppression of them by the drug industry.
Honestly, I think that is more of a legit medical question, to be answered by medical folk. A Midwestern Doctor has already done extensive Substack articles on DMSO, there's really no reason for Alex to waste his time duplicating the research and writing.
I was disappointed at the number of doctors who cited their medical degrees as evidence for the nonsense they were promoting during Covid. I'm not a doctor, but I have enough academic degrees to know that it doesn't work that way.
The deeply flawed “studies” on the “dangers” of IVM were some of my earliest WTH moments. Researchers added IVM to 2-3 other QT prolonging drugs (would never be done in actual practice), and even then were only able to eke out one adverse outcome. Painful awakening.
Fred: It was hard to take the lies spread about ivermectin and HCQ. There was little mention or none about how HCQ was used at least in vitro for SARS 1 and MERS.
Spudjr60 : At least the Lancet put out an apology. I believe it was Science or Nature that went with the Covid narrative. NEJM went with the Covid narrative.
Is it 10 years now that Scientific American cannot be trusted ?
I am a retired pediatrician, retired just prior to COVID. I couldn’t believe how our profession screwed up that response, throwing out all we ever knew historically about viral infections and immunity. I also couldn’t believe how much the data about who was truly at risk for severe/fatal disease was ignored or distorted to push the fear porn of the pandemic. I feel similarly about the whole trans movement and the response of “professional” organizations, particularly the American Academy of Pediatrics, to this other epidemic. This is truly disgusting, and had I not already retired I would have renounced my Fellowship in the Academy in protest. You are also correct about the overmedication of our children and young adults for depression, ADHD, gender dysphoria, and so on. Rather than suggesting a healthier diet and lifestyle, highlighting physical activity and outdoor activities, we allow our children to eat unending highly processed foods, spend most of their waking hours sitting in front of screens, and having communities that are too dangerous for them to play outside. Also they have either no personal responsibility and are forbidden to be outdoors alone, or they have absolutely no parental involvement and supervision. The world truly seems to have gone mad. I think these would be very excellent tangent areas for you to investigate, as it appears the medical profession has minimal interest in doing so.
I read your articles because you have, from the beginning of the COVID days, been the sanest, most data driven source of truth out there. Good bless you.
to Liz: I am still astonished and disturbed that the AAP and the ACOG and most organizations would push Covid "vaccines" on children (infants ) and pregnant women.
The ABFM and Internal Medicine societies go along with the narrative.
I am a nurse and now teaching nursing at a private university. I read your work because you relentlessly pursue the truth and share it. I am completely outnumbered at my place of work and your Substack keeps me sane most of the time. It gives me hope.
I wonder why people remain uninformed. Many are waking up but not at your place. Many don't want truth. I am old now and it astonishes me that people don't care about truth and they still play the politics game.
I am a retired Physical Therapist who has learned over 40 years to look, listen and try to think critically. It was unbelievable how during Covid we were not allowed to ask questions and we watched as 100 years of pandemic research was thrown out the window. You, Alex were excoriated for asking questions and for your reporting. I SO admire you for not backing down! You are appreciated more than you know! 💕
I am a physician. I appreciate your honest reporting. It helped during COVID when I was trying hard to help people understand why they should not take the shot or mask up. Since then, I find you to give a balanced overview of the situations you write about. There are so many things in the news these days that beg for honest, objective coverage. Climate and weather manipulation are of interest to me as I have concern about use of metals in cloud seeding and impacts on long term health. Thanks for all your work.
I trained at an Ivy-League medical school and residency. I trusted everything I was taught. I had an interest in complementary/alternative medicine, but mostly I trusted standards of care. Until one of my own children had a severe neurodevelopment regression at the age of 2.4 (after developing beautifully--physician friends would comment on his excellent language and motor skills). The medical establishment failed him and our family. He is now 17 and has profound, minimally verbal "autism" although I now think that most regression is driven by neuroimmune disorders..... I began reading and researching everything I could get my hands on. I realized our drug and biologics safety systems are horrid. I began to understand how corrupt Pharma-funded research is. I began to appreciate the serious and pervasive conflicts of interest at EVERY LEVEL of our medical-research establishment. From Pharma funding at med schools, residencies, continuing education.....to what research gets funded....the the capture of regulatory agencies....the corruption of scientific journals. Honestly, it makes me sad to be a physician. I have a lot of grief around how much of my sweat, tears and HEART I gave this system, which is unequivocally mostly corrupted--even though there are many good people. I like what Aseem Malhotra says about Pharma corporations as "psychopathic entities". I believe that's true and it has infected all of medicine. I like your substack b/c you report on data and studies that the journals are not publishing and mainstream medicine is not discussing. As a physician, you can't read everything......reading your column gives me an overview of new studies/issues that I then go back and read on my own. Thank you. I don't agree with everything you post but mostly I am so happy there is an independent journalists covering the Covid debacle, inducing the unequivocally harmful injections.
To Paulette: White collar psychopaths and sociopaths are everywhere. Many years back I read Hare's book and later Stout's book. When I was in the 60s military I didn't realize that there were sociopaths here and there. Years later I became pretty tuned in.
I figure the mainstream media has many of these types.
I am old now. As a kid I had chicken pox, German measles, American measles, mumps, etcetera. I am disgusted that so many of our youth have autism/Asperger's.
If I tell some other people nearing 80 years of age that RFK has good ideas they start in with me.
Does your son have skills in anything like music ? How much is he disabled if that is the right word ?
Thanks Dennis. I appreciate your comments. I see every day in my practice that overall health, including neurological health has declined. Anxiety, OCD, tics, learning disabilities..... I think many of those who remember a time when childhood health was better are either older (like yourself) or don't have an "expert" opinion to share. Thanks for asking about my son. He is very disabled and needs help with all aspects of daily life. He is very intelligent in certain domains. Although he can't speak he can type to communicate--although it is taxing for him as he has to concentrate VERY hard to get his body to do what he wants (even his eyes). But at least we have that. The Boston Globe just published an article about a young man, , non-speaking, who uses typing to communicate who just got accepted to MIT. So while many non-speakers have skills/talents we need to access--many still need support with basic living skills (showering, toilet ting, dressing....). It's a lot. Keep speaking out. I find that if we can say things with out listener in mind and say them in ways that the listener might be able to hear--it can help. Even if it means we don't get our whole truth out in the first pass. Wishing you good health and fortitude going forward.
i would have clicked on either a "none of the above" or "i would sooner entrust anything short of a car accident to essential oils than modern medicine" if those options were available
I am a physician - I read your articles because our profession is so corrupted by Pharma, and hospital and insurance companies that absolutely no one is keeping an eye on reality.
I read your articles because I feel I can trust you to provide authentic information regarding what you are writing about. I started following you during Covid where it was impossible to find reliable information. I maintain that this issue exists through to today. As a physician, I relied on you to help educate me about all things related to what was going on during the pandemic. We encountered such morbidity and mortality from the vaccines and this was not supported by any mainstream anything. So, you have been a valuable resource to me and so many. Thank you, Alex!
I read you because I think you are not only analytical and insightful, but honest.
There has been a time or two when I disagreed with a comment on physicians, but your handling of the COVID panic has been extremely valuable to any honest person.
The sad fact is that there is no profession more dishonest than the medical one. Physicians as a group showed themselves to be cowardly liars during COVID, and breathlessly overreacted in embracing every stupid one-size-fits-all demand from the government. As it happened, doctors became the camp guards for the government-Big Pharma fascistic canal, herding the public on to the COVID vaccine boxcars, “just following orders.”
For anyone offended by my analogy … tough. By touting pointless mass masking and embracing lockdowns, we caused far more harm than the virus alone could have. By advocating mass vax mandates irrespective of risk, we actively harmed people who trusted us. This was unforgivable.
I am a retired physician who found you during Covid. You are unafraid to tackle the dangerous groupthink that taken over the medical profession. The top-down lockstep I see among physicians today is disheartening. I think it has many sources. One big contributor has been the death of individual private practice as mega corporations have taken over. Whether hospital networks or private equity, the focus has become profit rather than patients. Even the doctors still actually thinking for themselves are often afraid to speak out for fear of losing their job or their license. When I trained in the 70’s we were exhorted to avoid one-size-fits-all solutions. Rather we were to LISTEN to our patients and find a best solution for each individual. And always suspect that a drug or treatment might actually be the CAUSE of a problem rather than the solution. Keep shining a light on the profit-driven aspects of the system.
I trained at Bellevue School of Nursing in NYC - also in the early 1970s. I was trained in a way similar to you. What has happened to both medicine & nursing is tragic - & dangerous.
IMO part of what happened to nursing is this: like teaching, intelligent women no longer go into nursing because there are so many other job/career opportunities.
I went to nursing school with some brilliant & compassionate women. The "new breed" of nurse is neither - automatons content to stare at computer screens more than their patients.
When I went to our 45th anniversary reunion in 2019 I was so proud to belong to this group of remarkable women. It makes me unspeakably sad to see what has happened to this once very honorable profession.
I walked the streets on New York as a teenager in the 60s. Everyone heard of Bellevue.
I was a patient in St. Albans Naval Hospital in 1970 . The nurses were terrific. I was in heaven.
Yes, Bellevue was notorious for its psychiatric hospital on 29th Street.
What most people don't realize is that it actually offers very high-quality care in all its departments. And if I were in a trauma incident (hit by a car, stabbed, gunshot wound, etc.) I wouldn't want to go anywhere else.
It is our flagship public hospital. What people also don't realize is that it's basically the same medical staff at private NYU Langone up the street (they rotate thru both hospitals).
Bellevue accepts all types of patients so I believe.
I had a boss who spent many years at Bellevue. She taught me a lot about sociopaths and psychopaths. I worked for her for one year before I went to school.
I couldn't agree more about the "death of individual private practice." Doctors joining corporate group practices & keeping bankers' hours (not to mention implementing medicine-by-algorithm which this type of practice demands) greased the slippery slope to the bottom of clinical practice where we are now.
When I was in training the type of person who was in medical school or in a residency program was usually highly intelligent, intellectually very curious & capable of independent thought. I'm not entirely sure when that changed, but I'm guessing the mid-1990s.
Another factor leading to the demise of both medicine & nursing is the execrable electronic health record (EHR). Ostensibly it was developed to decrease medical errors & improve patient care. If anything it has increased medical errors (drop-&-click medication prescribing is a disaster) and has practically destroyed patient care (clinicians of all stripes spend more time keyboarding & staring at computer screens than actually looking at, listening to or touching their patients). I think the EHR was actually brought on board to increase billing.
I had this confirmed by an ER administrator at a NY-Presbyterian facility who told me billing (read: revenues) there increased by 40% after the EHR was introduced.
As one who worked helping the government to get physicians to increase use of EHRs (I've since repented) I can tell you the other purpose is to improve data reporting to government programs, in my case Medicare/Medicaid. We were told it was to improve patient outcomes and thereby decrease costs, a great goal, but it was more than that in the end. Can't let all that data go to waste. I quit when I saw that my goal (to help improve healthcare) was not being met through my work.
I never knew much about finance and investing and I saw that so many politicians had large sums of money invested in EHRs. It made me realize that making big money was most important to those who already had lots of money to invest.
Charts did not get smaller with EHRs.
You sound like a nice person !
Charts expanded exponentially with EHRs. My son is an attorney who works at a medical malpractice defense firm. When he first started in this practice area he was aghast at the the number of pages even just a visit to the ER could generate. I helped him at bit at the beginning with suggestions as to how to "separate the wheat from the chaff" (so to speak). Luckily, he is a quick learner - & thankfully, after 8 years, he is leaving this practice area next month.
I didn't realize the game until I was thick in it. I thought I had a job that actually helped physician offices improve care, and to a small extent we did. But then came the $44,000 "incentive" given per provider to implement an EHR and suddenly my eyes were opened.
You are absolutely correct about the evils of EHR. The “bring forward” feature means the history is never actually rechecked and errors introduced are propagated in perpetuity. But they make it easy to “upcode” a visit, making it seem more detailed and comprehensive than it was. And when I would refer a patient to a specialist I would get a 10-20 page report with often no indication of what the actual diagnosis and proposed treatment was going to be. A one page thoughtful summary of findings and opinions would be so much better.
You are so right. And there doesn't seem to be a way to delete or correct errors.
To Barry- you have me laughing.
I knew EHRs would wreck medicine. Who can convey what a patients tells us when we have no time to put in a decent note ? I was lucky as I was able to speed write my notes till the end.
I still have one doctor who does handwritten notes in a paper chart.
Probably the only reason he can still do it is that he left the faculty practice at NYU Langone & set up shop around the corner. He doesn't take insurance but he's worth it.
As a non-medical person, I offer this analogy: doctors seem to act like “dealership mechanics” who input mileage and “diagnose” from a computer without looking at your car. Go in for a 100 buck oil change be handed 2000-3000 dollar list of maintenance & repairs. My rare “private practice” mechanic has saved me so much time & money.
Bingo!
… “when I trained in the 70s” …seems to be a recurring demographic indicator on this thread
🤣 When giants walked the earth…
...and dinosaurs!
I retired Emergency Medicine in July 2021 after 33 yrs in the ER. Your articles were the only place I could read actual truth. The lies and political extremism among the media and my colleagues was demoralizing and sickening. Our census dropped to 47% even while all the news media claimed the hospitals “were overwhelmed!”. I’d look around and think what the hell are they talking about?! The ICU is ALWAYS full. Anyway, your articles were a light in the darkness. I don’t even recognize my profession any more.
Oh my gosh, yes!! All the hysteria was maddening!
So true!! Hospitals in my area were ghost towns according to patients who worked there.
I kept wondering why the NEJM kept pushing the vaccines. I saw how the Infectious Disease societies were destroying the docs who didn't agree with the Covid narrative. I wondered why we were not hearing about remedies learned from SARS 1 and from MERS.
Painful awakening, isn’t it? Thanks for sharing!
I've just retired after practicing medicine for 45 years. I didn't come from money, and couldn't imagine borrowing $250K, so I indentured myself to the Air Force. Even though military and I saw eye to eye on very little, it was a valuable experience. Since then, in private practice, I've watched the training quality demonstrated by new physicians declining at an incredibly pace. Since I'm now a consumer rather than provider of medical care, I'm appalled at how many recently trained physicians don't even know how to take a good history of current illness or do a competent physical exam. I perform strict overwatch of all of my relative's medical care, and frequently have to fix painful shortfalls in their diagnosis and treatment. I believe that the problem starts with the degradation of education from the earliest years, with particular damage during college. Medical school and residency have been watered down and adulterated, with labor laws and unions shortening "work" hours for residents to the point they just don't have time to learn what they need to practice safe and competent medial care. We are at the point now where we have the products of this poor education teaching new physicians in a downward spiral. The education system needs to be rebooted from K through postgraduate school.
Your comments nicely sum up why medicine is chasing AI based diagnoses so hard…. As you say, it’s a skill that is not being learned by current students.
🎯!
To Gary Wade: I read a book by an attending at Penn in Philadelphia, PA. In their Ivy League mecca he was saying what you described about the quality of med students and many residents. He was forced to retire.
I was an enlisted Marine late 60s. We were not treated well by the USMC but those Air Force pilots were wonderful to us whenever we were in their big transport planes.
And then with Covid I saw how much resistance so many Air Force pilots put up about those Covid shots An eye opener !
Alex, someone needs to say this because clearly, they’re not listening to the rest of us.
Take a look at practices that don’t accept insurance; their appointments are booked out. Check in with alternative health clinics (my own field of study and work), many have months-long waitlists. Why? Because the current system isn't working. The numbers speak for themselves.
All doctors should be arriving at the same conclusion: we need change. When profit is prioritized over people, especially in medicine and food, the consequences are undeniable, and they're showing up everywhere.
Unfortunately many of the people who need good help with their health the most (and for their kids!) are tied in to the insurance system and do not have the disposable income to spend hundreds of dollars each appointment on a health and wellness professional who doesn’t take insurance. Not that I begrudge the practitioners. Their education is expensive and they deserve to be able to pay their bills and thrive.
My teenager’s friends are almost all on some form of medication - amphetamines or SSRI’s or a combination. Most are on Medicaid level insurance programs. Most have a mental health diagnosis in addition to allergies or some autoimmune disorder. And they are all “normal”.
I think the pattern Alex is honing in on is that like everything else in American society there are powerful financial interests (whose sole purpose is to optimize for shareholder profit) in between all human interactions. It used to be that a doctor interacted directly with the patient and used his knowledge and training to the best of his ability on his patient’s behalf. It was human to human interaction. Sure there were a few charlatans and sociopaths in the midst but generally the doctor’s interest was in curing his patient or at least alleviating suffering. Then insurance companies jumped on the middle. Then doctors had to start considering the need to cover their own ass as they sought to help their patients. Patients in turn could only get the treatments approved by the insurance companies.
Now there are more insidious interests in betwixt doctor and patient. Private equity owned hospitals and clinics have replaced private practices. A layer of administrators decides what services to promote and which to discourage. Physicians - at least at the PCP level - are essentially order takers in a process that is aimed largely at data harvesting because behind the layers these clinics are dependent on money from social impact investing, federal grants and venture capital.
When we get back to the days where a doctor can be paid directly by the patient (in tomatoes, eggs or a goat?) and works for the patient and not some unseen funding source way behind the scenes, then we might get real healthcare again. But unfortunately the system seems to be driven by those lined up to reap exponential profits at human beings’ expense with the “answer” being AI and ubiquitous data collection via wearables.
I hope the independent practitioners can continue to thrive. And I wish there was a way to make those services more widely available. But short of putting enough money directly into the hands of the people seeking medical treatment and letting them have free will on how to use it, the future of medicine is only going to get more anti-human. Sigh. 😕
To India- It makes me wonder what the mindsets are of those accepted into medical schools.
My son’s girlfriend dropped out of her osteopathic medical school at the end of her 3rd year (it’s a 4-year program). Many people are shocked but I’m so proud of her! She saw so many bitter female docs in her clinical rotations, she was seeing a future that was the exact opposite of what she had envisioned.
She’s now getting a masters in nursing, and I’m hoping to influence her toward homeopathy or naturopathy…we need more providers that are anything but allopathic.
I’m a retired pharmacist, covid woke me up BIG TIME. I am appalled and ashamed that I never questioned the vaccine schedule. If anyone, I should have learned about them, right?!? Nope, nothing. The fact that there are no true placebo-controlled studies is the end of any pro-vax argument, imo. We are injecting healthy babies, the bar needs to be higher in terms of safety, not lower.
I suspect many want to help people and do not understand how the system has been transformed behind the scenes. I suspect others are looking for a good career option and also don’t realize how the practice of medicine has changed since the hey day of doctors being much esteemed and wealthy. Many are foreigners who came to the US for education that translates into a green card. Others are foreign educated who came here with a job in the medical field and are just busy doing the jobs they have been hired to do and don’t have any other concept of what health care could be. Mostly I think the people in the field are good people doing the best they can and they are so busy that they don’t have time or energy to lift up their heads and seek to see the broader picture.
Always thought remarkable that paying cash didn’t get a discount like insurance gets. Buy a special insurance plan - no benefits- cash now gets the discount. WTF!
Alex, I would like your researched opinion about DMSO. A Midwestern Doctor has written extensively about it. We need your voice.
I second reporting on DMSO.
Same. Is DMSO a real solution for health related problems?
Good question, as I have heard mixed reviews. My husband tried the tinnitus protocol with no luck unfortunately.
I would also like UT reporting on DMSO.
The Midwestern Doctor Substack "Forgotten Side of Medicine" has recently written extensively about DMSO.. There are lengthy, detailed articles about many medical issues that real physicians appreciate. https://www.midwesterndoctor.com
For the less informed (like me) what does DSMO stand for?
An internet search could help you answer that yourself. But I'll help you.
https://en.wikipedia.org/wiki/Dimethyl_sulfoxide
Some people (https://www.midwesterndoctor.com/ - Midwestern Doctor is anonymous, claims to be an MD, sounds smart) claim dimethlyl sulfoxide (DMSO which comes from wood, acts as a solvent, but CANNOT be patented since it comes from nature/wood) can help many, MANY, health problems, but powerful drug companies conspired to keep the public and healthcare providers ignorant in order to keep patients reliant on their patented meds. Others (FDA) say DMSO only helps a few things (bladder symptoms, solvent to get antifungals to penetrate toenails to kill toenail fungus) and it has FDA approval for those treatments.
I don't know enough about it. Can you recommend good books about DMSO.
I've never read a book on it. Some other commenters mentioned books on DMSO that they thought were good. Search these comments.
https://www.midwesterndoctor.com/ - Midwestern Doctor is anonymous, claims to be an MD, sounds smart. This Substack talks about DMSO among other things. It's very pro- DMSO so you're only getting the pro- side.
AMD has done plenty of research that doesn't need repeating. The safety of it is well known. Get yourself some and use it, start slow like he suggests. Saved me from a knee replacement
Thank you. I have some and just got a book about how to use it. I just think Alex would lend credence and with his broad voice, could push general acceptance.
Lots of literature on this. As a bench scientist, I can tell you it's used in solution to freeze mammalian cells so ice crystals don't destroy them. I believe it's also used in transplant medicine. Years ago I read a little paperback that claimed that it's medicinal properties where not explored since it's not patentable and cheap. Widely used on horses. I suspect Alex is the wrong person to cover this as the work lacks scientific rigor. No company could recoup the cost of a clinical trial. Lots of books on the subject. https://www.amazon.com/Dmso-True-Story-Remarkable-Pain-Killing/dp/0688007163
"I suspect Alex is the wrong person to cover this as the work lacks scientific rigor."
You may be correct, but I have gotten the impression from reading Midwestern Doctor that there was something in the literature on DMSO even it was just case studies from decades ago. But on the other hand, I don't recall ever seeing links to any of such studies.
I would find it helpful to know what there really is.
Hmmm.
https://scholar.google.com/scholar?hl=en&as_sdt=0%2C34&q=Medical+studies+on+DMSO&btnG=
A google scholar search of "medical studies on DMSO" says there are 1,070,000 results and I was able to scan the titles/authors of the first 100. I would appreciate a look by UT.
What Alex could write on is more about the suppression of knowledge and use of DMSO. Equally, about Hydroxychloroquine and Ivermectin. There's a long history of development, use, safety and success of these drugs, and ultimate suppression of them by the drug industry.
I commented above but will also here. Go for and comment on Dmso. I'll first read and then maybe comment on Dmso.
Also read Healing With DMSO by Amandha Vollmer to get familiar. Available on AMZN.
Honestly, I think that is more of a legit medical question, to be answered by medical folk. A Midwestern Doctor has already done extensive Substack articles on DMSO, there's really no reason for Alex to waste his time duplicating the research and writing.
Anecdotally, I have used it a few times over the years for articular pain and recovery. I felt it was very effective.
I was disappointed at the number of doctors who cited their medical degrees as evidence for the nonsense they were promoting during Covid. I'm not a doctor, but I have enough academic degrees to know that it doesn't work that way.
Brilliant response!
I am not a medical professional, but I was a real scientist.
So, I know how to read scientific papers and most medical journals don't publish studies that pass the smell test.
This became increasingly obvious starting with the COVID lockdowns
Yes, the 'peer review' process is a complete scam.
The deeply flawed “studies” on the “dangers” of IVM were some of my earliest WTH moments. Researchers added IVM to 2-3 other QT prolonging drugs (would never be done in actual practice), and even then were only able to eke out one adverse outcome. Painful awakening.
Fred: It was hard to take the lies spread about ivermectin and HCQ. There was little mention or none about how HCQ was used at least in vitro for SARS 1 and MERS.
Spudjr60 : At least the Lancet put out an apology. I believe it was Science or Nature that went with the Covid narrative. NEJM went with the Covid narrative.
Is it 10 years now that Scientific American cannot be trusted ?
I am a retired pediatrician, retired just prior to COVID. I couldn’t believe how our profession screwed up that response, throwing out all we ever knew historically about viral infections and immunity. I also couldn’t believe how much the data about who was truly at risk for severe/fatal disease was ignored or distorted to push the fear porn of the pandemic. I feel similarly about the whole trans movement and the response of “professional” organizations, particularly the American Academy of Pediatrics, to this other epidemic. This is truly disgusting, and had I not already retired I would have renounced my Fellowship in the Academy in protest. You are also correct about the overmedication of our children and young adults for depression, ADHD, gender dysphoria, and so on. Rather than suggesting a healthier diet and lifestyle, highlighting physical activity and outdoor activities, we allow our children to eat unending highly processed foods, spend most of their waking hours sitting in front of screens, and having communities that are too dangerous for them to play outside. Also they have either no personal responsibility and are forbidden to be outdoors alone, or they have absolutely no parental involvement and supervision. The world truly seems to have gone mad. I think these would be very excellent tangent areas for you to investigate, as it appears the medical profession has minimal interest in doing so.
I read your articles because you have, from the beginning of the COVID days, been the sanest, most data driven source of truth out there. Good bless you.
Thank you! I agree 100%.
Brilliant!
to Liz: I am still astonished and disturbed that the AAP and the ACOG and most organizations would push Covid "vaccines" on children (infants ) and pregnant women.
The ABFM and Internal Medicine societies go along with the narrative.
I am a nurse and now teaching nursing at a private university. I read your work because you relentlessly pursue the truth and share it. I am completely outnumbered at my place of work and your Substack keeps me sane most of the time. It gives me hope.
I wonder why people remain uninformed. Many are waking up but not at your place. Many don't want truth. I am old now and it astonishes me that people don't care about truth and they still play the politics game.
I am a retired Physical Therapist who has learned over 40 years to look, listen and try to think critically. It was unbelievable how during Covid we were not allowed to ask questions and we watched as 100 years of pandemic research was thrown out the window. You, Alex were excoriated for asking questions and for your reporting. I SO admire you for not backing down! You are appreciated more than you know! 💕
Brilliant!
I am a physician. I appreciate your honest reporting. It helped during COVID when I was trying hard to help people understand why they should not take the shot or mask up. Since then, I find you to give a balanced overview of the situations you write about. There are so many things in the news these days that beg for honest, objective coverage. Climate and weather manipulation are of interest to me as I have concern about use of metals in cloud seeding and impacts on long term health. Thanks for all your work.
I joined Geoengineering Watch.
I learned some twenty years ago about HAARP and other ways to manipulate climate.
Pilots are paid big money to seed the clouds.
I believe the floods and destruction in the south to include Appalachia were due to weather manipulation.
I trained at an Ivy-League medical school and residency. I trusted everything I was taught. I had an interest in complementary/alternative medicine, but mostly I trusted standards of care. Until one of my own children had a severe neurodevelopment regression at the age of 2.4 (after developing beautifully--physician friends would comment on his excellent language and motor skills). The medical establishment failed him and our family. He is now 17 and has profound, minimally verbal "autism" although I now think that most regression is driven by neuroimmune disorders..... I began reading and researching everything I could get my hands on. I realized our drug and biologics safety systems are horrid. I began to understand how corrupt Pharma-funded research is. I began to appreciate the serious and pervasive conflicts of interest at EVERY LEVEL of our medical-research establishment. From Pharma funding at med schools, residencies, continuing education.....to what research gets funded....the the capture of regulatory agencies....the corruption of scientific journals. Honestly, it makes me sad to be a physician. I have a lot of grief around how much of my sweat, tears and HEART I gave this system, which is unequivocally mostly corrupted--even though there are many good people. I like what Aseem Malhotra says about Pharma corporations as "psychopathic entities". I believe that's true and it has infected all of medicine. I like your substack b/c you report on data and studies that the journals are not publishing and mainstream medicine is not discussing. As a physician, you can't read everything......reading your column gives me an overview of new studies/issues that I then go back and read on my own. Thank you. I don't agree with everything you post but mostly I am so happy there is an independent journalists covering the Covid debacle, inducing the unequivocally harmful injections.
So sorry! Thank you for sharing your heartbreaking story!
To Paulette: White collar psychopaths and sociopaths are everywhere. Many years back I read Hare's book and later Stout's book. When I was in the 60s military I didn't realize that there were sociopaths here and there. Years later I became pretty tuned in.
I figure the mainstream media has many of these types.
I am old now. As a kid I had chicken pox, German measles, American measles, mumps, etcetera. I am disgusted that so many of our youth have autism/Asperger's.
If I tell some other people nearing 80 years of age that RFK has good ideas they start in with me.
Does your son have skills in anything like music ? How much is he disabled if that is the right word ?
Thanks Dennis. I appreciate your comments. I see every day in my practice that overall health, including neurological health has declined. Anxiety, OCD, tics, learning disabilities..... I think many of those who remember a time when childhood health was better are either older (like yourself) or don't have an "expert" opinion to share. Thanks for asking about my son. He is very disabled and needs help with all aspects of daily life. He is very intelligent in certain domains. Although he can't speak he can type to communicate--although it is taxing for him as he has to concentrate VERY hard to get his body to do what he wants (even his eyes). But at least we have that. The Boston Globe just published an article about a young man, , non-speaking, who uses typing to communicate who just got accepted to MIT. So while many non-speakers have skills/talents we need to access--many still need support with basic living skills (showering, toilet ting, dressing....). It's a lot. Keep speaking out. I find that if we can say things with out listener in mind and say them in ways that the listener might be able to hear--it can help. Even if it means we don't get our whole truth out in the first pass. Wishing you good health and fortitude going forward.
i would have clicked on either a "none of the above" or "i would sooner entrust anything short of a car accident to essential oils than modern medicine" if those options were available
First time I skimmed this I read "a car accident of essential oils." And, whew, can you imagine the smell?
cinnamon + peppermint + lavender + lemon
should help improve the mood and increase the relaxation of the first responders, lol
“[trust] essential oils” 🤣