Totally agree. Thanks for getting to the core of what makes Norwitz and similar contrarian influencers so annoying and harmful to patients. The concept of citizen scientist may be attractive but the KETO-CAD debacle is a great example of how badly research can be done by passionate advocates of a theory who have no proper research training.
Thanks again for a great article. I welcome these discussions with most patients. On the rare occasion when I encounter patients who claim to know more than I do based on their YouTube research or accuse doctors of being stupid or corrupted, I have a simple response: “Then why are you here? If I believed what you believe about doctors, I wouldn’t go to one.” My experience is that it is rare to get these personalities to listen to your argument or evidence. Most have already decided what they’re going to believe.
I have also been accused of being corrupted or stupid. I think it’s very hard to avoid an emotional response but also important. I just try to remind patients that we both have the same goal - I don’t want you to have a heart attack and you don’t want to have one
Medicine genuinely does have a tendency to psychologize complex chronic illnesses, especially those that predominantly affect or present differently in women, so I won't pretend that skepticism of physicians isn't entirely warranted. In fact, medical gaslighting is likely why influencers find a receptive audience for their message because readers see their experiences mirrored back to them.
At the same time, selling certainty that one will never get Alzheimer's with an omega-3 supplement based on preliminary data is reckless and irresponsible. Valid critiques shouldn't convert into misrepresentation of data or disingenuous promotion of unvalidated cures, and that seems to be the gap many internet personalities fall into.
I agree medicine isn’t perfect and that doctors - myself included - make mistakes all the time. But I really was disappointed w the type of discussion I saw from norwitz et al. Just a really smart guy who seems to me to be wasting his talents
"The second point is that not every patient who reads this information is a lean, metabolically healthy person in their early 30s with clean arteries and no alarming family history."
That's almost no one. Aside from we all age if we are lucky right off it's a very small percentage that would be considered lean, maybe 10% of the population. It's not a bad thing to study these people but may not have as much value for the population doctors see. I wonder how many people watch one of Nick's video's and think it might be relevent to them and really wouldn't be.
I tried googling the percentage of people that have a family history of heart disease and came up empty but I expect it could be quite high. I still feel better knowing my Lp(a) vs guessing details of my dad's health but it shouldn't be ignored.
So….. I subscribe to your ’content’ (despicable word) because I trust you and that trust is due to a pre-Substack newsletter I subscribed to called The Skeptical Cardiologist who linked to one of your articles. I’m in a silo of my own making because I trust advice that cites serious medical journals. I don’t fault people who find a different silo. I just hope I’m right.
Doc, this is a brilliant analysis and commentary. I worked in Pharma for 20 years and retired last year after Parkinson’s dx. In my early 60’s and fit, so developed a well designed exercise and nutrition regimen. Came across Dr Nick a year ago and appreciated some of his nuance, but always ran it through my learned evidence based framework. I challenged him on many of these issues in comments, and quit following after he would tee up one of his nuance’s that eventually led to him promoting a supp that he was connected to as a consultant!! Thanks for calling out what I would deem social media malpractice.
I bailed on this “physician turned influencer” when I finally felt the Wizard of Oz prolly wasn’t as profound as the constant firewalls suggested. Why didn’t he go to residency? Why didn’t he ever speak of patient care? Why didn’t he ever address a question I posed to him that was ONLY about patient care? Nah, this man is very, very intelligent, that goes without saying, but he is not someone who actually has practiced medicine or cared for living, breathing patients, and that, in my mind makes all the difference in the world.
I enjoy Nick’s content, especially the way he explains the science involved. I think his audience is more educated/motivated to have individualized care than what the article suggests. If you read beyond the titles, you can see he really does value nuance, curiosity, and questioning the status quo (those aren’t bad things). Conventional medicine set themselves up to be doubted by exhibiting sheep-like behavior during the COVID pandemic. I worked in a university hospital in infection prevention at that time, and can’t express how disappointing hospital leadership and medical staff were during that period.
No curiosity whatsoever! Such a waste of time and resources.
My litmus test with doctors is “Did you take the COVID-19 shot? Do you think it’s wise to continue taking boosters?” That tells me whether or not they trust the science. And that tells me whether I should trust them. To see if they are naturally curious, ask them if they believe the covid-19 virus was a lab leak or a natural mutation? That will tell you if they trust Dr. Fauci. If they don’t trust Dr. Fauci they probably don’t trust the science. If they have no opinion, I assume they have no interest in keeping up with the science.
Well done. Happening with vaccines too. And people avoid having conversations with their providers about it. Mostly bc they are ill equipped to refute what their Dr might tell them. Bc the influencers are not trying to actually educate anyone. That was never the end point. My daughter won’t vaccinate her child. Mostly bc her husband has been scared out of his wits by the influencers. And he stays in his echo chamber. I ask them…have you spoken to your pediatrician about this? Isn’t he the best or at least ONE of the resources you should consider consulting along side your internet memes? Do you really believe he is 1) trying to intentionally harm your child or 2) too stupid to understand what’s really going on with childhood vaccination? If either of those is true, why do you still take her to see him? Its nuts.
Totally agree. Thanks for getting to the core of what makes Norwitz and similar contrarian influencers so annoying and harmful to patients. The concept of citizen scientist may be attractive but the KETO-CAD debacle is a great example of how badly research can be done by passionate advocates of a theory who have no proper research training.
It’s a lot of misdirected energy and ultimately just a really disappointing situation
Thanks again for a great article. I welcome these discussions with most patients. On the rare occasion when I encounter patients who claim to know more than I do based on their YouTube research or accuse doctors of being stupid or corrupted, I have a simple response: “Then why are you here? If I believed what you believe about doctors, I wouldn’t go to one.” My experience is that it is rare to get these personalities to listen to your argument or evidence. Most have already decided what they’re going to believe.
I have also been accused of being corrupted or stupid. I think it’s very hard to avoid an emotional response but also important. I just try to remind patients that we both have the same goal - I don’t want you to have a heart attack and you don’t want to have one
" Then why are you here ?" That is a great line!I will have to remember that.
Medicine genuinely does have a tendency to psychologize complex chronic illnesses, especially those that predominantly affect or present differently in women, so I won't pretend that skepticism of physicians isn't entirely warranted. In fact, medical gaslighting is likely why influencers find a receptive audience for their message because readers see their experiences mirrored back to them.
At the same time, selling certainty that one will never get Alzheimer's with an omega-3 supplement based on preliminary data is reckless and irresponsible. Valid critiques shouldn't convert into misrepresentation of data or disingenuous promotion of unvalidated cures, and that seems to be the gap many internet personalities fall into.
I agree medicine isn’t perfect and that doctors - myself included - make mistakes all the time. But I really was disappointed w the type of discussion I saw from norwitz et al. Just a really smart guy who seems to me to be wasting his talents
"The second point is that not every patient who reads this information is a lean, metabolically healthy person in their early 30s with clean arteries and no alarming family history."
That's almost no one. Aside from we all age if we are lucky right off it's a very small percentage that would be considered lean, maybe 10% of the population. It's not a bad thing to study these people but may not have as much value for the population doctors see. I wonder how many people watch one of Nick's video's and think it might be relevent to them and really wouldn't be.
I tried googling the percentage of people that have a family history of heart disease and came up empty but I expect it could be quite high. I still feel better knowing my Lp(a) vs guessing details of my dad's health but it shouldn't be ignored.
The reason this conversation matters is because real people get caught in the middle
So….. I subscribe to your ’content’ (despicable word) because I trust you and that trust is due to a pre-Substack newsletter I subscribed to called The Skeptical Cardiologist who linked to one of your articles. I’m in a silo of my own making because I trust advice that cites serious medical journals. I don’t fault people who find a different silo. I just hope I’m right.
It’s hard when there is a lot of information out there
It’s so HARD!!!!!!
Same here!
Doc, this is a brilliant analysis and commentary. I worked in Pharma for 20 years and retired last year after Parkinson’s dx. In my early 60’s and fit, so developed a well designed exercise and nutrition regimen. Came across Dr Nick a year ago and appreciated some of his nuance, but always ran it through my learned evidence based framework. I challenged him on many of these issues in comments, and quit following after he would tee up one of his nuance’s that eventually led to him promoting a supp that he was connected to as a consultant!! Thanks for calling out what I would deem social media malpractice.
Great work Dr Katz. Thank you. Or as DJ Khaled would say "Anotha ONE!".
Thanks!
"What they don't want you to know" is a gold standard click bait....
Great article. Way too many of these influencer docs out there. I'd probably add Mercola, Hyman, Attia
I bailed on this “physician turned influencer” when I finally felt the Wizard of Oz prolly wasn’t as profound as the constant firewalls suggested. Why didn’t he go to residency? Why didn’t he ever speak of patient care? Why didn’t he ever address a question I posed to him that was ONLY about patient care? Nah, this man is very, very intelligent, that goes without saying, but he is not someone who actually has practiced medicine or cared for living, breathing patients, and that, in my mind makes all the difference in the world.
I enjoy Nick’s content, especially the way he explains the science involved. I think his audience is more educated/motivated to have individualized care than what the article suggests. If you read beyond the titles, you can see he really does value nuance, curiosity, and questioning the status quo (those aren’t bad things). Conventional medicine set themselves up to be doubted by exhibiting sheep-like behavior during the COVID pandemic. I worked in a university hospital in infection prevention at that time, and can’t express how disappointing hospital leadership and medical staff were during that period.
No curiosity whatsoever! Such a waste of time and resources.
I think we can agree to disagree about his content
Such an outstanding post. Needs to be shared widely.
Thank you for this exposé. I've given your article a prominent link in an update of my post:
https://drmick.substack.com/p/gaslighting-public-health-1
My litmus test with doctors is “Did you take the COVID-19 shot? Do you think it’s wise to continue taking boosters?” That tells me whether or not they trust the science. And that tells me whether I should trust them. To see if they are naturally curious, ask them if they believe the covid-19 virus was a lab leak or a natural mutation? That will tell you if they trust Dr. Fauci. If they don’t trust Dr. Fauci they probably don’t trust the science. If they have no opinion, I assume they have no interest in keeping up with the science.
That was a great read!
Well done. Happening with vaccines too. And people avoid having conversations with their providers about it. Mostly bc they are ill equipped to refute what their Dr might tell them. Bc the influencers are not trying to actually educate anyone. That was never the end point. My daughter won’t vaccinate her child. Mostly bc her husband has been scared out of his wits by the influencers. And he stays in his echo chamber. I ask them…have you spoken to your pediatrician about this? Isn’t he the best or at least ONE of the resources you should consider consulting along side your internet memes? Do you really believe he is 1) trying to intentionally harm your child or 2) too stupid to understand what’s really going on with childhood vaccination? If either of those is true, why do you still take her to see him? Its nuts.