The podcast examines Dr. Peter Atia, a controversial figure in the wellness and longevity movement, whose journey from medical training to a high-profile private clinic reflects a broader trend of elitizing healthcare. After working at McKinsey & Company, where consultants advised Purdue Pharma on aggressive opioid marketing, Atia shifted to a career focused on preventive, data-driven medicine for affluent clients. His model involves expensive, often unproven tests and treatments—like continuous glucose monitors and early colonoscopies—targeting the "metabolic syndrome" population, though critics note that such interventions lack clinical evidence and may lead to overdiagnosis and harm. He promotes off-label drugs like rapamycin for anti-aging, despite limited human data and known risks such as immunosuppression and increased infection. While his critiques of mainstream medicine are valid, his approach is criticized for "science washing"—simplifying complex data to create a persuasive narrative. Atia’s work exemplifies a growing divide in healthcare: a two-tiered system where wealth enables access to cutting-edge, aggressive prevention, while most people remain in a system with limited resources and coverage. Despite his intelligent presentation style and credibility in popular media, the lack of formal training in key medical fields, conflicts of interest (e.g., his ties to Dexcom), and promotion of unproven therapies raise serious ethical and medical concerns. Ultimately, the episode highlights how well-intentioned critiques of traditional medicine can be co-opted into exploitative, profit-driven models that prioritize appearance of innovation over patient safety and equity.
(upbeat music) - Cool, sir, media. - Welcome back to Behind the Bastards, a podcast about the very worst people in all of history. And here to talk about, well, we're gonna do a special reverse bastards episode where I don't have to research and write about a terrible person. My guest does is Dr. Kavehota, who has been very kindly teaching us about Dr. Peter Atia. - Yeah, Atia, I don't know. - Actually, it's a good question. - Atia, Atia, sorry. Peter Atia. - Peter, I apologize. - I know that. You said that correctly. I got it wrong, 'cause my brain does not hold pronunciations well. - I might be wrong. Listen, I don't know if I'm saying my own name, right? So I can't be certain about anyone else. So sorry, Peter, if that's the case. Who's to say? - This is an I Heart podcast, guaranteed human. Lisa, tell them about our new show. - We have a new podcast. It's called Don't Lie to Me. I'm Lexi Wanyu, we're two best friends, 22 years apart, but so close at heart. - And I'm Lisa de Julio, the old one, which means we have wildly different references, occasionally different opinions. And at this point in my 50s, I've lived it all. - Now in my 30s, being the founder of new shoes, good taste is my business. - Listen on the I Heart Radio app, Apple podcasts, or wherever you get your podcasts. - I'm Melissa Jeltsin, host of The What Happened to Her podcast. We're kicking off the season with the Sandra Birchmore story, a case the police wrote off as a suicide in a snow storm. Her family never bought it, and the man they suspected wore a badge. - You never know who that devil is because he's wearing disguise. Sometimes it's a police uniform. - And you can get access to all episodes 100% ad-free with an I Heart True Crime Plus subscription, exclusively on Apple Podcasts, available only to I Heart True Crime Plus subscribers. So don't wait, head to Apple Podcasts, search for I Heart True Crime Plus and subscribe today. - I'm Lacey Mosley, author, actor, stand-up comedian, creator, and host of SCAM Goddess Podcasts. - The True Crime Comedy Podcasts all about robbery, fraud, and those who practice it. Each week I bring on an amazing guess. - Ooh, I scammed them. - What? - I could talk to you for an hour. - You're a generational yapper, like me. - That's why I had to make yapping a job. - And now you can catch full episodes of my show on YouTube. - Start listening to SCAM Goddess on the I Heart Radio app, Apple Podcasts, or wherever you get your black ass. ♪ SCAM Goddess ♪ - In 1986, a man named Scott McLean was killed in broad daylight. Police quickly found their suspect. Prosecutors convicted him. But now, almost 40 years later, I'm re-examining this case. I really didn't believe any of it was real. And I was like, well, they're gonna figure out this is not me. They're gonna do their police job. - Has the wrong man been in prison this whole time? Listen to examined, the Backfire Effect, on the I Heart Radio app, Apple Podcasts, or wherever you get your podcasts. - From shocking betrayals to carefully planned murders, the Black Affects new original podcast series, Bloodline Crimes, hosted by me, Morgan Wood, explores the darkest and bizarre cases where family became the most dangerous threat of all. Listen to the Black Affects Bloodline Crimes every Thursday, starting October 8th, from the Black Affects podcast network on the I Heart Radio app, Apple Podcasts, or wherever you get your podcasts. (upbeat music) - Okay, you guys ready to get back into this? - Yeah, yeah, yeah, let's do it. - Okay, when we left off, our hero, Peter, at the head left, the oppressive group think of medical training finally. It was finally. It was only a matter of time. He was pretty upset about not being appreciated for attempting to operate outside the John's Hopkins - Should be an aproposic. - A renegade. - Yeah, isn't played by the rules, but he gets results. - Yeah, you want a rebel doctor. - That's right, I love it. I love it when my doctor's a rebel. That's really outside the box. - Yeah. - Get weird with medicine. - Yeah, that's what she wanted. - A lot of people say a smearing poop into an open wound is bad for you, but they're just sheep. I like to get away from the herd. I like to try new things. - Yeah, get that into real good. - Yeah, yeah, yeah, nothing's bold within sepsis. - I don't get paid enough for the shit. - Can we, that, mm-hmm. - Yeah, well, I mean, if you didn't stop me, I might have gotten stuck in that. - Yeah. - It is disturbing how easily my brain can just like get into that role of the manosphere dude. And that is-- - It's easy. - It's fun to work on. - It's fun to joke about. - It's fun to joke about, yeah. - But back to Petar. - So let's get back to him. So he decides to join, leaving the residency. He decides to join a consulting firm called McKinsey & Company. - Oh, good. Oh, I've found their show enough. - That's fun. - Yeah. - Yeah, I was gonna ask. Have you-- - Real piece McKinsey years. - Yeah, you okay. So there's like bloodless consultant, sorry, you're gonna talk about him, yeah, yeah. - No, no, no, please, please, please. - There's one of those like consulting firms who you bring in to tell like, here's how many people you should fire to maximize shareholder value and the like, right? - That is correct. They are in global management consulting firm that advises major corporations, governments, both here in abroad, and institutions on strategy operations, and some people call them bloodless ghouls. But yeah, right, no, please. - I don't, 'cause I support actually the bloodless ghoul community. You are valid, you are beautiful, and I love you, bloodless ones. - You are seen. They are one of the most influential oldest and maybe controversial consulting firms in the world. Let's talk about them, 'cause you decided to go work for them. I think that says something about a person. So they're firm with the history of being criticized for a lot of things, including involvement with the opioid crisis. Have you heard of the opioid crisis? - I have. - Oh, man. Yeah, I've had a few myself. - Robert. - As a bit, as a bit. - It's a bit, please say it's a bit. - It's a bit. - Doctor, I'm a professional. - I have only two opiates in Mexico, and now I don't do opiates in Mexico anymore, 'cause a fucking fentanyl, man, it ruined so much. You used to be able to just buy opiates off of a pharmacy in Guatemala or something. You know that they were just hydrocodone. You could pick up the grocery store. It was beautiful, anyway, whatever. - Yeah, so McKinsey and company, both of them, were hired by Purdue pharma to work on strategies to increase opioid sales, 'cause they just weren't selling enough. - Yeah, and those six is like peak, getting Americans addicted to painkillers here. - That's exactly what we're talking about here. - Yeah. - Oh, cool. - They provided them service for over 15 years, specifically advising them on marketing and sales strategies to aggressively increase the revenue of oxycontin, the opioid painkiller. Now, you want to aggressively increase people using oxy, yeah, that's what they did. So they advised Purdue, really focusing their sales representative visits on doctors who were already writing high volumes of prescriptions. And according to the New York Times in 2013, McKinsey designed a specific strategy to turbocharge oxycontin sales. And they advised the secular family, the people who own Purdue, to push the higher dose pills. They did a lot of really fun stuff because of this, they faced a lot of legal challenges. And some setbacks for the company, they've had to cut back at least 10% of their global workforce. They had to pay nearly 600 million American dollars to settle investigations. - Oh, fucking. - Hittins, honestly. But yeah. - Probably. Yeah, and by these investigations, brought on by 49 different American states, I'm not sure which state didn't. Actually, I wish I had looked that up, 'cause I'm betting it's Alaska, but I don't know. And the DOJ announced a settlement, resolving civil and criminal probes with McKinsey accepting responsibility for a misdemeanor charge of conspiring, sorry, to aid and abet the misbranding of prescription drugs, isn't? So they also had a senior partner, Martin Elling, who faced felony obstruction of justice for intentionally deleting Purdue. And they had to pay also 125 million into the Purdue Pharmacy bankruptcy estate to fund treatment programs. But what I have here is I printed out, I went to the Department of Justice, the Office of Public Affairs. - Okay. - And I printed out there some interesting stuff that they posted about these court hearings. So they leveled a couple of complaints against the Purdue family. And they leveled a number against McKinsey. - No. - Sackler family. - Yeah. - Sackler family, I'm sorry. And the two of the ones they leveled, two of the charges they leveled were criminal misbranding and false claims to the FDA. So this is fun. So the DOJ, this is quote from the Office of Public Affairs, the Department of Justice, quote, "The DOJ leveled a criminal misbranding charge against McKinsey for falsely marketing it as less addictive, less subject to abuse.
diversion and less likely to cause dependence in withdrawal than other pain medications. This was specifically their recommendations that McKinsey made to Purdue. They were like they worked on messaging to like hey we have to counter these emotional public health warnings including these complaints that mothers had of teenagers that had overdosed and so they had this whole marketing campaign to fight that. Among other strategies intensifying marketing to high value prescribers including prescribers who were writing opioid prescriptions for uses that were unsafe and effective and medically unnecessary. So McKinsey did basically let me translate some of that was like hey yeah these people who are writing the worst prescriptions the most questionable prescriptions let's really drill down on them and get them to write even more hit them up. That should be number one. Don't go to the person that you have to convince go to the person that's just doing it and just work on them the whole time. Make sense. McKinsey consultant spoke with Purdue about the concerns and increasing reluctance of pharmacists and pharmacy chains to fill prescriptions for oxycontin as abuse of the drug rose. McKinsey consultants also went on several write-alongs with Purdue sales representatives in the field as these as these sales representatives called on prescribers and pharmacists. It notes about one of the write-alongs a McKinsey consultant wrote quote pharmacist had a gun and was shaking. Abuse is definitely a huge issue. They set them on write-alongs to convince them to work harder. It's insane. That's nuts. On top of that they also got leveled for claims against the FDA, McKinsey US knowingly misled the FDA by assigning consultants to concurrently work on both FDA projects and competitively sensitive Purdue projects. So basically what they did was they said to the FDA, "Hey, we're gonna give you some of our consultants. They're gonna help you with managing this opioid crisis." And it was the same consultants that will make it worse. Yeah. These guys really know the opioid crisis because they helped cause it, but they're experts. Yeah. It would be like bringing in a bunch of former SS guys as experts on de-naughtsifications like look, they know who the Nazis were. They know what they're talking about. There's also criticism of their work with Enron as well as their work with China and Saudi Arabia and their efforts to enable authoritarian regimes in those places. I'll leave that for James and Mia to discuss. I feel that's probably the more their willhouse, but they've done worse things also in other places as well. Now, a tears work did not seem to be related to anything medical. So I have to say, even though he was there during the opioid crisis, it doesn't seem like it was, he was a part of it. He was focused on corporate risk and he worked as a management consultant during this time. He considers this his recalibration phase where he's exposed to systems level thinking, I don't know who he was working with, but clearly it signals he has an interest in working with affluent optimization-oriented populations. Right. His core audience is high income, like high income, health, maxing professionals, people with the ability to pay top dollar for the health. And I'm sure this is a big part of why he ended up there. So he's there for two years and it kind of correlates when the first major actions are taken against Purdue. So I don't know if that was a part of why he left or not, but he leaves after a couple of years. I think that's common for people doing the consultant gigs. Yeah. Yeah. Right. And for reasons that I'm not clear about, he's drawn back to medicine. He gets very busy. He starts doing presentations, lots of media stuff, doing TED talks. He talks about metabolic dysfunction a lot. He co-found a startup called the Nutrition Science Initiative or NUSI. He gives him a very public facing scientific role and one that he does without needing board certification. Oh, that's handy. That's great, right? His blog helps establish him as a bit of a contrarian. But one that can actually discuss data. So if he knows my thoughts about medical contrarians, it's not great. And this is where the TIA content machine really starts. These long form technical pieces framed as this is what your doctor won't tell you again. Has that real? The one secret your doctors won't tell you energy. And the rise of these doctors, these contrarian doctors, is something that is very much a sore spot for me. Yeah. And not that medicine's perfect is not. I'm not going to say that is. But a lot of these folks, him included, did a lot of what it's called, or I call, I don't know if this is a term of sure it is, science washing, like taking some of the more blatantly crazy quack people, making them seem more legitimate and making the more blatantly anti-vaxxed doctors seem a little bit more legitimate. Really paves the way for the maha movement and where we are currently again in our golden age of diarrhea. Now, eventually in 2014, he starts his own private longevity clinic, early medicine. And this is really the scaffolding on what just whole stick is built on. Yeah. Yeah. Yeah. It allows him to operationalize the Med 3.0 framework that he'll have talking about. I feel like you can see a hint of this and the fact that he got so into nutrition because obviously nutrition is massively important for like health. But also when you're in the business of like nutrition, because of the way supplements and stuff are regulated, it means that you can't, I'm saying he was, but you can be in the business of just selling people nonsense and claiming it's basically medicine as long as you avoid certain phrasing, right? I just said, anytime I hear nutrition, my warning about start going off and like when it's in the in the context of a medical professional. Absolutely true. It's really the wild west because being a nutritionist can mean you have like two to three PhDs in the matter. Yes. Or can mean you're a wellness influencer online and there's really a wide breadth of the conversation between the two. Yeah. Absolutely true. So during this time as he's creating this clinic, things he's doing are things like continuous glucose monitors for non diabetic patients, which you may have ordered gathered from the way I said it is not appropriate. Repeated advanced lipid testing, VO2 max labs, routine MRI scans, DEXA scans, is giving people expensive wear wearables, using off label drugs, doing after hours consults. His clientele's are elite. They want high touch care. They aren't taking new clients by the way I checked. It's years long wait list to get in. And although it's not disclosed exactly how much from the accounts I've seen, he charges anywhere from 100 to 500,000 dollars annually for this care in this clinic. In this work of you can get it, Jesus. I mean if I could find three people to do that. Yeah. Yeah. You give you nutrition advice for half a million dollars a year. Anyone listening, you know, why are the money ahead of time? And I'll give you all the advice you fucking want. Will you be on call though? Will you be on call? Sure. All the time. Sure. You can call me. I may not answer. Eat more fiber. I don't know, man. Fuck it. That's they. Hey, you're hired. You're in. If I start, if I start a concierge clinic, I am going to hire you in a minute. Anyways, yeah. I could see why it's so appealing. I will say this though. As an aside, I can only imagine as a doctor, I would knowing it would be to be a regular doctor of one of these patients. Once they leave this concierge clinic and you have to see them, like the stuff they would expect, it would just be wild and I would not be giving them, but like they'd be like, my last doctor, he did this and this and he ordered this and this and this and he did this for me. And I said, no, I'm sorry. That's just none of that's appropriate or reasonable to do. And it would be so painful. And of course, none of this is accessible to the average patient or I'm sure you can guess covered by insurance. Yeah. People like Atea or Tech Weirdo Brian Johnson, other longevity enthusiasts, they're famous, that guy, that's the guy of the Suns is Bloodboy for your listeners out there. Yeah, yeah, yeah, and it attracts his erections. Don't forget about that. Really love his dragon about his four-hour erections at night when he's sleeping. Yeah, yeah, yeah. Cool, man. I didn't episode on him. It was troubling. Lots of weird tweets about his girlfriend's vagina and his and his son's erection, just real weird, real weird stuff. Really? TMI, my guy. Yeah, yeah. And I'm not a person who says that. Like I don't think I've ever said TMI before, but I think if I were to use it, it would be in this case, TMI. So I
These people, the reason I bring about both him and Natia would have you believe that this is all proof of concept stuff and that yeah, only rich people have it for now, but eventually everyone's gonna have it. But I mean, that's just not true. It's not scalable. These longevity wellness people are essentially creating a two-tiered medical system with a different level for the wealthy. I mean, you could argue we already kind of have one, but that gap will only grow. Right. Of course, like all bad people, he starts a podcast. It's called The Drive in 2018. They cover a range of topics built around his practice and early medicine framework. He's really starting to build this parasocial relationship with a high value audience during this time. He's making appearances on Oprah, at least three times on the Joe Rogan experience. He's hanging out with Bill Ackman, Hugh Jackman and one of his Palatro. Yeah, a lot of Ackman's in there. A lot of Ackman and Jackman's and one of Palatro and other New York elites. His book Outlive comes out in 2023 and shortly afterwards becomes a number one best. Yeah, they loved love titles like that. I can see why that one's sold. Really a good one, right? Yeah, yeah. Over three million copies and spent 131 weeks on the New York Times non-season best seller list. It's crazy. That's bleak. He's, it's not great. He becomes a major figure in the health and wellness scene. Millions of people tuning into what he has to say or write. And I'm a little, I don't want to get too far into the medical minutiae here, but I think it's kind of important to do. And your audience is very smart. And I'm not just saying that because I'm pandering, although I'm clearly pandering. They are very intelligent. I think they can hang with this. So I'm going to dig in a little bit to the medical advice he's endorsing and why it matters. Okay. He's moving past the lifespan stuff. He's now about health span the good years. Again, we remind him about a sharp, I'm into that. I like that. And this medicine 3.0, which is clients are paying top dollar four. And he would describe as preventive personalized and data-driven approaches to health care that focuses on avoiding disease rather than treating it treating disease. And what's, you know, by the way, you know, I get called a shill a lot for being part of big pharma. And it's a lot of the same people who are like, you only want to these diseases to happen so you can be paid by pharma to treat them. And I'm like, what do you think he's doing in these situations? Do you think that these medicines he's giving you are free? I just, anyway, sorry. A key part of his justification for aggressive preventative treatments and aggressive pharmacology is this assertion that he has that 90% of the US population has at least one of five markers of metabolic syndrome. Have you guys heard of metabolic syndrome? Yeah. Is that real? It's real. Okay. It's real. But it is vague. So you want to write to be like, yeah, is it real? I hear a lot of things called signs of metabolic syndrome that just sound, okay, so share a listen to you. It's like, you know, a number of things that make you at risk for other things. Am I in the right place? It just crops up a lot in grief and kind of medical cases. You might have a stroke or all these things that you might get type two diabetes or all these that you're in the right. Is that correct, my friend? You guys, you're so smart. I'm not just saying that. Honestly, I had a lot less specifics than she did, but sure. Yeah, that was good. I mean, but I meant you guys. I meant her. This is really smart. I just don't want you to feel bad. That is correct. Metabolic syndrome is a real thing. Although you're right to be kind of questioning it because it's used by people, both professionally who know what they're talking about and by grifters to sell you an enema made out of like coffee. So you're right to be concerned about it. Now what did what it is? Let's go through it here, okay? Metabolic syndrome is important and then we should touch base on what these five markers of metabolic syndrome are. One, central or abdominal obesity, basically a waist circumference greater than or equal to 102 centimeters in men, 88 centimeters in women, just a big gut. You get adipose tissue in your gut. It changes the way your body acts with insulin. Another marker elevated triglycerides greater than equal to 150, low HDL, which is quote unquote good cholesterol, lower than 40 for men, lower than 50 for women, hypertension or high blood pressure with a systolic of 130 or greater. And a diastolic, that's the bottom number. Sistolic is the top number. You see like what's like 130 over 85? That's top number systolic, bomb number is diastolic probably more information than you need. Sorry. And the last of these markers is elevated fasting glucose if it's over 100. Now Sophie is 100% right. If you have metabolic syndrome, it puts you at risk for diabetes, coronary artery disease, heart problems, and stroke. And his assertion that 90% of people have at least one of these markers is actually not far off. The CDC runs this research program called the National Health and Nutrition Examination Survey and Haynes. And there was an end-hane study from 2009 to 2016 and it showed that about 12 only, I should say only 12% of U.S. adults were considered quote unquote, "metabolically healthy" or basically optimal on all five of those markers I mentioned without medication. That implies that roughly 88% of Americans have at least one abnormal test. I'm assuming that's where he gets this 90% number they talk about. And that part is, I think true. Hey everyone, this is Kaveh from the future after this recording. And I just wanted to jump in here real quick to say that what I said was totally correct. No, nothing's actually wrong. I just hear Robert doing this every now and then and you know, it sounded fun to me. So I wanted to give it a try. But yeah, everything I said was right. So it was back to the podcast. But the thing is, that's not how you define metabolic syndrome. To have metabolic syndrome, you have to have three or more of those markers. Having just one isolated marker is probably very, very common. But it's also clinically far less meaningful. For metabolic syndrome, you have to have at least three of those. And it kind of just drops it to one to start treatment. Does that does that 90? Does that make sense? Let me stop right there. Yeah. Sure. Yeah. These things are important to note. And I want people to be thinking about all these things. But this concept of saying like he's changing the goal post here about definitions that would justify treating people aggressively. And we'll talk about why you don't want to treat everyone aggressively. But I don't believe this justifies it. It's certainly not justifying it in a uniform approach like he applies to his patients. We always say lifestyle modifications should be the first thing you discuss. Rather than reflexively, treating people with medication, I'm the one that gets accused of being a shill for pharma. And I'm the one that's just saying, hey, let's hold off on this medicine that's unproven. You know, I don't, I don't get it. So. You do say that to me often. Yeah, I get it a lot. I'm like, what do you think of this thing? And you're like, no, no. Yeah. In writing medicine is like my bag. I'm an internal medicine doctor at heart. That's what we do. Anyways, you should think of interventions. I feel as a staircase. And not a switch. And the first step should always be lifestyle modifications if you can help it. Now metabolic syndrome is a risk indicator. Non absolute risk. It doesn't account for everything. Age, sex, smoking, LDL, other factors. Aggressive lab testing that he does is a big part of his like practice and recommendations. But in these cases, it's highly questionable about what kind of use that serves. He focuses on these aggressive tests for blood markers that could potentially represent heart disease. His core panel includes something called APOB, LP little ACRP. And then he also recommends imaging the coronary artery calcium or the cac scoring. Okay. As well as a coronary CT. I don't think other people refer to it as cac. But I think it's funnier to refer to coronary artery calcium as cac scoring. I'm not opposed to early focus cardiac intervention of all the stuff he does. I'm the most open to hearing about this. But a lot of what he is recommending. A lot of this testing outruns the evidence that we have to support its use. Some of it hasn't even been shown to be something we could change. So for example, this cac scoring test that he does, they're expensive. They expose you to radiation and downstream test events. And there's no trial so far that shows that doing that actually helps you in any way. Or decreases cardiac events. And whenever you do a test, you should always ask, will the results of this test change our management? That should always be a question you ask. And if there's nothing different, you can do, if there's nothing different, it will give you, then you have to have serious conversations. It doesn't mean you can't do it, but it means you can't be applying that to everybody. He also is a proponent for early screening.
screening tests for things like colonoscopy, which he sees as being proactive, but I see as a gastroenterologist who does them as being a bit reckless. This is my wheelhouse, of course, and we could talk at length about one to start colonoscopy, but for someone without risk factors, it's 45. That's our recommended time for screening colon cancer. And that's lower than 50 where it used to be. He pushes for 40. Now, I mean, there's a lot more younger colon cancer cases, right? So, I don't know, is that wrong, but yeah. - Don't, I could, I could talk to you about that. This is a fascinating topic to me. In fact, I just released an episode about early onset colon rectal cancer and you are correct or are increasing rates. Overall, the absolute risk is still low, but there is increasing rates of why that is, but that's why we drop it to 45. Now, people online constantly get mad when I talk about this, 'cause they'll be like, hey, I want a colonoscopy and you doctors are not giving it to me. And I'll be like, how old are you? And they'll be like 30. And I'll be like, do you have any risk factors? Like family with colon cancer or family with advanced polyps or history of inflammatory bowel disease or do you have any signs or symptoms that are concerning? And the answer is no, they just wanted. And I'm like, that's not what we want you to do. I don't want you getting colonoscopies. I'm a guy who does colonoscopy. I get paid to do colonoscopies, but I don't want you to get it unless you need it. And he's not free from everyone's, not just at a money standpoint, but like doctors don't have unlimited time. Like we, yeah, I get that. - That's a big part of it. And there's more, we'll discuss that a little more. We'll come back to it. But what I think he is tapping into here is a very real dissatisfaction, disillusionment with mainstream medicine. And I feel that people feel like doctors for one reason or another are always gatekeeping health care. And to be clear, I am 100% for preventive care. This idea is not new. We've had primary cares for this exact reason. Why he went into surgery? I don't know. He would have been better off if he had gone to endocrinology, but not a lot of money there. So maybe that's, I don't want to assume that's why he did it. But there are other things you can do to get preventative care. And I'm, as I said, I'm a simple country doctor. Four years of medical school, three years of internal medicine training, a year of chief residency, three years of gastroenterology and a year of liver transplant fellowship under my belt, simple country doc stuff. And I feel so much less confident taking the giant swings he does on all these medical issues. He has no formal training, cardiovascular disease, neurodegenerative disease, endocrinology, or even nutritional science. Yet these are the pillars of his practice. Again, very smart, incredible potential as a doctor. But what he's describing as research into these fields seems more like maybe read a couple studies and having relationships with people that are his friends that do know more about than him. There's something you have to consider when you're doing all these tests, all these advanced genetic testing, CT angiograms, these colonoscopies, there's real harms, real risks associated with them. And we have to weigh the benefits of them. I'm assuming you probably want to take a commercial break before we do that. Yeah, why not? Yeah, speaking of that, ends. Why not? I'm Melissa Jeltsin, and in my new podcast, what happened to her, I'm bringing you new stories and conversations every week. Stories about women whose deaths were too quickly ruled a suicide. She was starting to get worried and get scared for her safety. Stories of survival. The only difference between me and her, frankly, was a little bit of luck, because by all rights, I should be dead. Cases that everyone else called closed. They can't convict her, right? Like, she has so much evidence. These stories all start in the same place, with a woman failed by a system that didn't believe her, that didn't protect her, that didn't see her. No child should ever experience that. And we were babies. She did all of these grave things and came out and spoke about it, and he got a year. I never know who that devil is because he's wearing disguise. Listen to what happened to her on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Lisa, we should tell them about our new show. Oh my god, Lexi. We have a new podcast. I'm Lexi Iwanyu, where two best friends, 22 years apart, but so close at heart. And I'm Lisa Julio, the old one, which means we have wildly different references, occasionally different opinions. I'm not gonna get any worse than fighting. That is wild. I learned that about you today. Now in my 30s, being the founder of new shoes, good taste is my business. And I've always got something to say. If men were just honest about this, there would be so much more peace in the world. We're gonna talk about dating, relationships, beauty, getting older, and a little wiser. We're best friends, but we don't always agree. Because you told us how accommodating you are. Obviously, I would do what I think I could do to fight the fight, but there's only so much fight I can fight. Don't lie to me. Don't lie to me. Don't lie to me. Liar. Listen on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. I don't really care. I'm Lacey Mosley, author, actor, stand-up, comedian, creator, and host of Scam Goddess Podcasts. The True Crime Comedy Podcasts, all about robbery, fraud, and those who practice it. Each week I bring on incredible guests like Conan O'Brien, Iowa Debris, Lamor and Morris, and Nicole Byer. Ooh, I scammed them. What? I could talk to you for an hour. You're a generational yapper, like me. That's why I had to make yapping a job. And the scams run the gamut. I'm talking about scams from the 1800s, all the way up to today. I also warn you and keep you safe against scammers. Call your grandparents. Tell your parents to stop clicking on links, please. And now you can catch full episodes of my show on YouTube. If there's a scam, I'm here to protect you. And I'm also here to laugh with you. So if you like fun, if you like comedy, and you like learning, and protecting yourself from criminals, start listening to Scam Goddess on the iHeartRadio app, Apple Podcast, or wherever you get your podcast. Scam Goddess. My name is Josie Duffy Rice. I'm a journalist who covers the criminal legal system. And over my career, I've heard a count after a count of prosecutorial misconduct, story after story of injustice. But I've never heard a story quite like this. The more I kept reading that stuff, I thought, man, there's more red flags that just kept coming up over and over. We'll hypnotize them to strengthen that memory. So we went into a good France. And I was like, well, they're going to figure out this is not me. They're going to do their police job. Listen to examined, the Backfire Effect, on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. They shared the same name, the same home, the same DNA, the same blood. But behind closed doors, blood isn't always thicker than water. And family loyalty can turn deadly, from shocking betrayals to carefully planned murders. The Black-Evex new original podcast series, Bloodline Crimes, hosted by me, Morgan Wood, explores the darkest and bizarre cases where family became the most dangerous threat of all, because sometimes the person you should fear most is not a stranger, but rather someone sitting at the dinner table with you. Real cases, real families, real killers. This is Bloodline Crimes. Listen to the Black-Evex Bloodline Crimes every Thursday, starting October 8th from the Black-Evex podcast network on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. And we're back. Yes, we are back. Now, there was a JAMA study I want to talk about, because I think this is really funny. And funny may not be the right word. It came out of UC Davis in 2012, so old study. And what it did was this. It showed how happy a patient was with the care they received and how that related to their outcomes. That study showed that the most satisfied patients had not only higher health care spending, but more hospital admissions, and most strikingly, a 26% higher risk of death compared to the least satisfied patients. Cool. The satisfied patients were doing worse. What thoughts do you have about why may that be? We don't know for sure. By the way, the test, the study wasn't powered to be the answer to that. I guess because people like our satisfied, 'cause they like their doctor and they feel listened to, but that doesn't necessarily correlate to actually improving their health care outcomes at all. It's just like how people can be really satisfied with a doctor who's selling them like snake oil that doesn't actually cure their cancer until they fucking die. They don't notice something's wrong. That would be my guess. No, that's right.
So the more satisfied patients are probably getting more than they ask for, more tests, more side effects, more complications, doctors who always say yes, score very well. It's sometimes saying no in medicine is really hard, but sometimes and not always declining to test or medicine or antibiotic or refusing to do a low value scan or imaging study may actually serve patients better. Now, this is a big nuance and difficult conversation because you have to weigh those considerations with listening to your patients and advocating for them. And it is not an excuse to not listen to your patients and take their complaint seriously. I'm fully aware that our country has a very serious problem taking patients seriously, particularly if they are black and or female. This is a real problem that we have in this country, but it's always important to keep in mind that sometimes do no harm is the right step. Not doing the thing is the the better approach to be totally transparent also. There have been follow up studies to that 2012 studies some have supported some have detracted. I feel the weight of time has sort of born this out though and it does seem to be true. There was a 2019 Cochrane meta analysis that showed real dangers to overdiagnosis and treatment. It can lead to unnecessary interventions. One has leads to another test leads to another test and these things have risks. Sometimes they are necessary, sometimes they are not. And these things carry not only real harm, but also psychological burden as well. So I think largely his reason for doing this is not bad or malicious. I think he does want to help before a problem exists. And like I said, a lot of his advice is reasonable stuff. And I actually kind of like some of it eat less processed food, exercise, sleep well. Great. But it's also paired with this really over the top monitoring with intense and very pricey strategies that lack evidence. And some of the relationships he has to these things are not ideal. For example, he as I mentioned promotes continuous glucose monitoring for people without diabetes or signs of insulin resistance. Yeah. Yeah. Not necessarily. Yes. In your medical professional experience, you would also agree with me. And you are correct. But it's become a big hit with a maha crowd, these tests. And there's no evidence that's of any use to nine diabetic patients. And it can lead to unnecessary dietary restrictions, anxiety, even disordered eating. And the information, the data you get from these continuous glucose marineries, it's often difficult to interpret and getting one with an ongoing data plan is hundreds of dollars per month. It's expensive. A lot of people that have diabetes that need these sorts of devices are either unable to get it or the prices are increasing because of things like this. And I know a specific device that you're going to talk about. And I know that it is extremely difficult to at times get that device. And I can't imagine this helps. No, you're exactly right. That's what happens. You the resources are limited. Our problem in this country is not so much that we don't have the things to help patients. It's that we don't have access for them to get to it. Yeah. And also rounding out what Sophie was alluding to there. He was a paid advertiser for a company called Dexcom that sells these devices. That's not ideal. It's not ideal. He's been criticized for not disclosing that very well. I have seen him mention it, but I don't think he did it every time. So I think it's a valid criticism. Sure. By the way, that company has since said his advisor role ended in 2021. But when this topic comes up of concerns, they that aren't we just creating a new tier of medical care for just those with extreme wealth. And that is preventative medicine for people who are already privileged and probably doing better. He'll downplay the cost of these things. He's ordering by correctly pointing out that the end of life care is also very expensive. And that is true. A disproportionate amount of healthcare in this country spending is at the end of a patient's life. The cost of all the machines and the labor and medicine in those critically ill hospitalized patients that adds up quickly. But both things can be true. And nobody's saying we shouldn't practice preventative care. But the thing is this, even if his measures do work, which is a big if it's still just pushing the end of life care and all the money that goes into it further down the road. So you're not saving money this way. You're spending money on both ends. A lot of it. A lot of healthcare dollars are going to go into this on both ends. And you know, and for that reason actually is real quick point move on from end of life care. It's an important reason that doctors recommend having those goals of care discussion. And what you would want done if you were to become critically ill and not be able to weigh in. Unfortunately, when this is reasonably discussed, Republicans refer to it as death panels. And we never get to have this all right. I remember the death panel days. Yeah. And then we had real death panels under Republican. Anyway, whatever we had real death panels. But having end of life care discussions is not only important for saving money. It's also just really important for knowing really what your loved ones want. So I think it's anyways, have that discussion, folks, even if you are healthy. You should at least be having those discussions along the way. Now, all this I think are things that you kind of learn in the actual practice of medicine, something he missed. This do know harm. Yeah. The colonoscopy part I think is a great example of this. So our current guidelines have dropped to 45. He wants it to go down even further to 40. And again, despite how strange I might seem to some people, there are people who want these tests done as early as possible. But that's as Robert said, it's one part of it is we just don't have the people to do it. I mean, I could do colonoscopies every day all day for the end of time. And I will not have scratched the surface of the colonoscopies that need to get done. So we're taking away from people who need it. But on top of that, there's risk to doing these tests. There's actual physical risks that you bad things can happen. It's rare, thankfully, you should get colon cancer screening. But colonoscopy does have some risk and it's not cheap. And again, I'm telling you this as someone who stands to make a lot of money off of you getting colonoscopies. Yeah. So pick my word for this one. You're like, it's something we have to be more mindful about. Yeah. For sure. He talks about some other stuff with his patients that's overall less fun for me. He emphasizes zone two training as optimal for mitochondrial capacity and longevity. This does contradict some substantial evidence behind higher intensity training. Again, kind of what he's doing here is he's cherry picking studies that look at observational data in elite endurance athletes, not sure how that translate. But that cherry picking study stuff is something the RFK junior does as well. And what they all do in this sort of world these days. Yeah. It's the mode is the modus operandi of our current administration. So one thing that they will all do is they will take a little bit of data and then extrapolate it far beyond what that data was meant to do. Something he does us with is one of his quote unquote horsemen. He talks about the four horsemen of the apocalypse. And one of them is cancer. Oh, sorry. That was like an audible grove. Okay. Sorry. I'm back. I felt that way. I felt that again, I actually liked parts of his book. Parts of it were, I thought, very reasonable. But for example, we talked about cancer. He points out that cancer cells require more glucose than normal human cells. And that is true. And you'll hear a lot of wellness people take that little bit of information. Yes. Starve your cancer by avoiding sugar or whatever. I've seen that a lot. They take a little bit truth and they make giant leaps from there regarding the nature of cancer's formation and sugar's role in it. And it's honestly, it's still not clear what that means. Is it the cause of the cancer of the sugar? Or is it just some interesting feature of the cancer to make right jumps from a simple lab tested fact to saying dietary manipulations could help the growth of cancer is shaky at best. And like diet is important. I'm a huge proponent of a healthy diet that is high in fiber. Again, fiber folks. I'm deep in the pocket of big fiber. But there while there is solid evidence that healthy dietary patterns can lower your risk for things. Right now, there isn't the risk of these things. He's recommending like ketogenic diets prolong fast caloric restrictions. There's no evidence that those things work when when we want people to like learn when I want people to learn about what they're eating and how to fix them. I want it to be broad and sustainable patterns mostly plants limited red meat limited process meats. And I don't disagree with limiting sugar either. I agree. For the purpose of maximizing your cardio metabolic risks, that's well proven. I don't find it to be a good argument in the case of cancer. The data just isn't there.
it, or if you're cool, you call it data. Let's talk a little bit more about the medications, because again, I'm the one that gets accused of being a former shill, but if a right wing doctor tells you to buy like a year's supply of Ivermectin, you do it out there. So I don't, I'll never understand that. Not that he's recommended Ivermectin. For the, for the non Netflix watchers, I just rolled my eyes very, very, very, very, very, very dramatically. And he does strain something. I'm going to be careful. He's a big fan of aggressive pharmacologic intervention using medications off label. Now I'll give one example. I can give a lot, but there's one, and I think it's a, I think it's a fun one. And there's a little nerd in me that wants to share this story with you guys. And I think your list is going to enjoy it. It's about a medicine that he prescribes for his patients called a rapa amycin. He might have seen a serolimus, and he prescribes it for longevity enhancing purposes. And yeah, there is a little bit of promising pre clinical data to suggest some longevity benefits. Okay. It's still very much a hypothesis, and there's no phase three trials to prove it. As an interesting aside, this rapa amycin is actually an antifungal, and it's just fun how it was discovered. It was discovered in the dirt of an Easter Island volcanic crater in the 60s in rapa newy. Okay. How did they find it? Great question. What? They just look at it. Oh my God. They're just sucking up different things that they found on the island. Do they just have medical? I don't know. Like, how do they find it? Great, great question. So there was this microbiologist who was collecting soil because they wanted to take samples, and they wanted to figure out why the islanders who live there never got tetanus despite walking around with no shoes. Cool. Actually, that's a really cool thing to do. Yeah. It doesn't have to make sense. But like, you could imagine some Republican talking about this in the day being like, and we're wasting money just testing the dirt in rapa newy. You know, that's how it is. That makes sense. You know where research is going to lead you in that it leads you some really amazing places. Anyways, yeah. Since discovering it, people have studied its use for all kinds of different things. It was actually found to have some immunosuppressive effects. So because of that, it's used for transplant patients to alter their immune system. So if you get a transplanted kidney, you take this medication usually to help prevent your body from rejecting it. Now, as I mentioned, there is some early data that suggests it can affect lifespan of mice. Human trials have been very limited though. Maybe it might help improve the flu vaccine response. It's not quite clear. People thought it could be potentially used for weight loss, but that really didn't pan out. And it's not shown the metabolic stuff that they expected to, but it's a really small example of something that the anti-vaccine community and something that RFK Jr. do, extrapolating a small truth in a small study or an animal study to a large truth in humans. Something that's not powered, meant or designed to do a lot of this. Yeah, it's a big stretch. Yeah. And I mean, it's great clickbait stuff, right? You see an article that says like, this secret medicine discovered in the Easter Island crater will span your life and you're like, that's awesome. And you read it. And sometimes if you're lucky, they'll explain that it's not that. But it's really fun clickbait stuff. It's really, it sits with people and it's exciting. So, yeah. He's also a guy that like is a sound back guy, so you're going to get, you know, two minutes of him talking on some other guy we hate's podcast, talking about how great said thing is. Spreads like wildfire and is actually just not scientifically sound and you're just spreading scientific misinformation and causing harm. That's exactly right. Yeah. Now, because it's off label, there's no regulating the dose. There's no guidelines on dosing or monitoring. Maybe there's some protective effects against aging, but these same exact pathways drive immunosuppression, so you can't take these things lightly. You don't want to be immunosuppressed if you don't need to know as, as the title suggests, your immune system is being suppressed and your immune system isn't going to take immunosuppressants as a longevity treatment because your immune system sometimes helps you stop dying. Like, I get why it helps your longevity if you've got like a transplant. That makes sense. Right. One study, it's used in situations like this. It's long term risk of use for people who don't have a transplant, for example. And there's some real risk with it that we do know about. There's some increased risk to infection, as I mentioned, the development of lymphoma and some metabolic problems that the whole field of longevity is really supposedly aimed to prevent. So it's this kind of fast and loose relationship to science and medicine that's made him a pop culture scientist and star. He sounds really convincing, intelligent when he talks about the stuff, especially if it's in these short bursts. He knows how to talk about data in a way that's even more convincing, I feel, than Andrew Huberman. He's good at it. Yeah. Yeah. And he's influencing people. He's gained the attention of everyone in the atmosphere. His approach to medicine is great for people like RFK Jr. and anti-vaxxers. You can speak intelligently about the data and sound authoritative, and it can help science wash them a little bit. He's got a real credibility behind him. It's like when Brian Cox shows up in super troopers, he gives him this whole sense of gravitas. Great. I often think about super troopers when I'm considering the validity of different medical opinions. Yeah. He doesn't, he doesn't even need to vocally support RFK Jr. He doesn't vocally support him. He's pretty careful about what he says about him. What all he has to do is give them the plausibility by not refuting them and coexisting in the same world with them and going out his way to not trouble them. For example, when he's asked about RFK Jr.'s accusation that Tylenol causes autism. Something that every doctor I know of, even once who don't have the same political links as me, they look at that, they've seen it, and they know anything about it, like that's kind of nonsense. Yeah. That's about it. He describes it sort of as a low probability event and kind of tries to move on from that discussion, okay. Low probability. Is it Pete? From all the available data, it's a no probability event. That's the kind of thing you have to be able to stand up. You have to be able to take a sides, and I know people say doctors shouldn't be political, but this isn't even political. This is not political. This is just due diligence. This is just. Yeah. Say the truth. Say the medical truth, say the scientific truth. This is just the sky as blue bullshit. Yeah. It absolutely is. So when it comes to his bastard, his bastard dosity, is he a medical bastard? Obviously not on the level of Marion Sims, who we discussed, right, or on RFK Jr. even. Or Dr. Oz, either, who I don't like either. He's not as creepy. He's not as creepy as some of the other. He's not as creepy as some of the other longevity guys like Brian Johnson, who doesn't, he's not. He's not. He's not as creepy as some of the other longevity guys like Brian Johnson, who doesn't. Yeah. He's on an episode. Have you done Brian Johnson? No. Who's that? I mean, he comes up every now and again. Yeah. Cause he's not really a bastard. He's not really. He might do it because he's funny. Yeah. He's not. Like the thing about him that I actually do respect a little bit, is that like of all of the super crazy rich maniacs out there, most of them are spending all of their money on like horrible shit or really boring blanchet like I've got a bigger yacht. No, I've got a bigger yacht. He's spending a lot of his money on like dangerous self experimentation and that kind of mania that I actually do respect a little bit like you're, you're genuinely kind of unhinged, but you're, you were committed to being unhinged. You know, I kind of respect that more than like the way Bezos spends his fucking money. Yeah. No, he walks the walk. Yeah. It's a very good point. It's the same way that like, I mean, I'll never totally understand deeply religious people because it's just not, I don't have that part of me. But when someone believes it enough to proselytize as annoying as that is and how little I want to see it, there's a part of me that's like, okay, well, they seem to really believe it or they wouldn't care to proselytize like the proselytizing. They really believe that these people are going to hell, so they want to change their minds about it because they really believe it. So kind of, kind of kind of see that. Anyways. So he's not, he's not that bad and actually compared to ghouls like that. He actually kind of seems reasonable. He did go to medical school. He didn't finish his residency, but he did some of it. If you saw him profiled on 60 minutes last fall or read some of his stuff in Scientific American, he actually comes across as a pretty sound thinker. But this whole schtick is based on critiques of what he calls medicine 2.0. And all of this is based on limited experience actually practicing medicine 2.0. Yeah. A key point he makes in his book, which he illustrates is that the mortality rate for 100,000 people declined relatively little over the course of the 20th century if you subtract out the deaths from the eight-top infectious diseases.
is implying that contemporary medicine has made scant progress against the horsemen of things that cancer in neurodegenerative diseases. - Basically, very frustrating. - Well, first of all, yeah, one, if you take out all these deaths that we're avoiding with treating these infectious diseases, which is like, come on, that's pretty good. Let's be. - Yeah, the problem is that there are individual cancers like up until recently, 'cause there do seem to be some breakthroughs maybe occurring in pancreatic treatment, but there wasn't a massive amount of progress made on pancreatic cancer compared to some other cancers up until fairly recently, but like lung cancer, we've gotten way better at dealing with, right? And like, yeah, there's still some sorts, there's still varying sorts of like heart disease or whatever that we've done it, but we've gotten better at like a lot of other kinds. It's just, I think a lot of it is like, yeah, you lose a loved one to like a disease that we just haven't gotten a good handle on, and it's easier for people in that situation to be like, medical science still hasn't made any progress, and it's, well, I'm sorry, you got hit by that fucking bullet, but that's not the only thing going on, you know? - No, you're exactly right. And it is medicine 2.0, as you would call it, that is providing those advances in things like pancreatic cancer, which, I mean, agreed not as fast as it should be, and we should be pushing this forward, but I don't think that's what medicine 3.0 really is. This whole thing is really not only downplaying the role of antibiotics and vaccines, but these horsemen he's talking about, in particular cancer and Alzheimer's, are diseases of older people. The fact that he gets to write books about how we're not treating them aggressively enough is because our public health system had improved enough to keep us alive long enough to get these diseases, these diseases that are largely of older people, not completely, but largely. And this whole 3.0 thing doesn't even make sense internally. In his book Outlive, he discusses how immunotherapy is amazing, and it is, but that's very much 2.0 medicine. That's conventional medicine and research working. At the end of the day, who has the time and the money to do these things? We have a real problem in this country with access. It's not enough tests, as I said, it's enough access. And he's clearly chosen on purpose, to surround himself with only the wealthiest Americans who have the time and the money for all the exercise he recommends, the ability to pay for all the things that testing the wearable devices, and the desire to live forever. And that's what brings us to the last part of our conversation. - But first. - Okay. Speaking of the lab, oh yeah, so we've got it. - But first. - I'm Melissa Jeltsin, and in my new podcast, what happened to her? I'm bringing you new stories and conversations every week. - She was starting to get worried and get scared for her safety. - Stories of survival. - The only difference between me and her, frankly, was a little bit of luck, because by all rights, I should be dead. - Cases that everyone else called closed. - They can't convict her, right? - These stories all start in the same place, with a woman failed by a system that didn't believe her, that didn't protect her, that didn't see her. - No child should ever experience that. - And we were babies. - She did all of these grave things and came out and spoke about it and he got a year. - I never know who that devil is because he's wearing disguise. - Listen to what happened to her on the iHeartRadio app, Apple Podcast, or wherever you get your podcasts. - Lisa, we should tell them about our new show. - Oh my God, Lexi, we have a new podcast. - I'm Lexi Iwanyu, we're two best friends, 22 years apart, but so close at heart. - I'm not gonna get any of your fighting. - That is wild. - If men were just honest about this, there would be so much more peace in the world. - We're gonna talk about dating, relationships, beauty, getting older, and a little wiser. - We're best friends, but we don't always agree. - Because you told us how accommodating you are. - Obviously I would do what I think I could do to fight the fight, but there's only so much fight I can fight. - Don't lie to me. - Don't lie to me. - Don't lie to me. - Lier. - Listen on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. I don't really care. - I'm Lacey Mosley, author, actor, standup, comedian, creator, and host of SCAM Goddess Podcasts, the True Crime Comedy Podcast, all about robbery, fraud, and those who practice it. - Each week I bring on incredible guests like Conan O'Brien, Iowa Deppery, Lamont Morris, and Nicole Byer. - Ooh, I scammed 'em. - What? - And the scams run the gamut. Call your grandparents, tell your parents to stop clicking on links, please. So if you like fun, if you like comedy, and you like learning, and protecting yourself from criminals, start listening to SCAM Goddess on the iHeart Radio app, Apple Podcasts, or wherever you get your podcasts. SCAM Goddess! - My name is Josie Duffy Rice. And over my career, I've heard account after account of prosecutorial misconduct, story after story of injustice. - The more I kept reading that stuff, I thought, man, there's more red flags that just kept coming up over and over. - We'll hypnotize them to strengthen that memory. So he went into a good France. - I really didn't believe any of it was real. And I was like, well, they're gonna figure out this is not me, they're gonna do their police job. - Listen to examined the backfire effect on the iHeart Radio app, Apple Podcasts, or wherever you get your podcasts. - They shared the same name, the same home, the same DNA, the same blood. But behind closed doors, blood isn't always thicker than water, and family loyalty can turn deadly. From shocking betrayals to carefully planned murders, the Black of X, new original podcast series, Bloodline Crimes hosted by me, Morgan Wood, explores the darkest and bizarre cases where family became the most dangerous threat of all. Because sometimes the person you should fear most is not a stranger. But rather someone's sitting at the dinner table with you. Listen to the Black of X, Bloodline Crimes every Thursday, starting October 8th from the Black of X podcast network on the iHeart Radio app, Apple Podcasts, or wherever you get your podcasts. (keyboard clicking) - And now, Jeffrey Epstein, I know it's here. I know it's here, brought it up in the beginning. Carly Rae, Jeppstein himself. - But that's right, where does all this lead us to? All this medicine 3.0, all the cost, who can do it? Only the wealthiest people. And that is how our hero, Dr. Peter Athea gets connected with one Jeffrey Birmingham Epstein. I'm just kidding, I don't think that's his middle name. - Nope, nope, that was it, yep. - Earlier this year, you might have heard CBS News announce the whole new slate of 19 contributors, as part of the efforts of they are trying to go with Barry Weiss to revamp the network's public image. One of the contributors that they had hired, along with, again, Andrew Huberman, which we could do another two-parter on. Conservative file Ferguson was Dr. Peter Athea. Three days after that, the DOJ released a chunk of Epstein files, which included over 1,700 mentions of the name Peter Athea, and a lot of very embarrassing and very douche-chill-inducing emails between Athea and J.E., as he calls him J.E., and also with Epstein's handlers, a lot of emails with Athea, Epstein's handlers. Because of this, Athea was forced to step down from his role at CBS. 'Cause it turns out, before he became this wellness influencer that he was destined to become, with millions of followers, a very influential book, he relied on Jeffrey Epstein's advice to help get his concierge medical practice going. So let's get into the Epstein files here. - Yeah. - Okay. - Here we go. - Okay. - Yeah. So, from. Atia's own report, he met J.E. in 2014. - I hate every time you say that, right? - I know, but like, it's just like in the, well, it gets worse, wait, hold on. - Yeah. - So he met Joffrey while he was raising funds for scientific research. And interestingly, he makes a point to note that it was facilitated the meeting by a female healthcare leader, and Dr. Eva Anderson Dubin. Interesting person, she was a former model, became a doctor in philanthropist. And that makes sense. Epstein clearly kept ties across academia. They remained in contact over the years, exchanging emails, they exchanged advice. Eventually, Atia lets Epstein know that he's looking for someone to help run his office. I had this office, it's concierge practice, but I needed a patient care coordinator, someone to like walk them through the whole thing, someone that's gonna make the experience really enjoyable for them. And he's asking for his help in finding him or her. Epstein invited Atia to his upper east side mansion and introduced him to a foreign-born model. - Okay. - Yeah, yeah. I might see where this is starting to happen. - Oh, this is 2014, right? - 2000, yes, 2014. - Okay, so he had been convicted and everybody knew. - Oh yeah. - That was 2008, if I remember correctly. - Just always really want to highlight with somebody befriend Jeffery after that, yeah. - Yes, oh yeah, we're gonna get to whether or not he had a sense of what was going on or not here too. I think there's some telltale signs in his emails. So, Atia is introduced to this foreign-born model, they exchanged emails and in other emails, it's clear that Atia has invited her to hang out with some other potential candidates, other people as Swinky Bar in Midtown. I think she will be loyal, Epstein writes to Atia in an email. Turns out this woman was also a victim. Her name is redacted, but she was one of Epstein's victims. And from Atia's spokesperson, they say that this person never ended up working for them after all. They said that for some other reason they went with somebody else, that wasn't even the reason he was at Jeffery Epstein's apartment, but political reports that it was visa issues that were the problem. And you can see this in the emails. The emails are like, hey, she's great, but there's this visa issue, and I don't think we can be able to get past that. And this is the kind of thing you see in a lot of these emails. Atia relying on Epstein for referrals and providing him with health advice and testing. He downplays their relationship. He admits to hanging out about 10 times after that until Jeffery Epstein's arrest. He says the hangouts happened at Jeffery Epstein's home, although from emails, he did have interest in going to the island. And there was even a plan to go to the New Mexico ranch that Epstein owned, but there was, then no evidence that actually proves that he did that. - Zoro Ranch. - Zoro, is that what it's called? - Yeah, the Zoro Ranch. - Yeah. - So he definitely did stay at one of Epstein's apartments in New York for some time period. And he used, he used Epstein to help fill out his clientele as well. That's really where I think Epstein came on big. - Great. - Yeah. - And he was, he can connect him to other rich guys who interested in longevity stuff. - That's exactly right. And it looks like he's giving him medication. He's probably giving him metformin, which is another diabetes medication, which I don't see. - Yeah, it's very popular for live extension folks. - Right, yeah. In return, he provides medical care and advice. And to quote, atia later, he says, "To be clear, I never witnessed illegal behavior "and never saw anyone who appeared under age in his presence. "But to also be clear," - Okay. - "Appeared." - There's got a lot of work. That is a very, very strong piece of, - I hate these fucking meds. - Yeah, burbiage there. There's a lot weighted on that. - Yes. - Exactly right. - It's disgusting. - It's not ideal. No, no, no, no, no, men are terrible. I don't think you're gonna find Robert and I defending men in general. - No. - I'm not being very specific about who I'm, I'm attacking here, yeah. - Okay, also to be clear, it was not a mystery at this point who Epstein was. As you mentioned, he already had a record and a reputation well known. And you can even tell from these emails that atia knows his friend is infamous. I reviewed as many of these emails as I could tolerate. And there's a couple lines I'm gonna read through some of these for you guys that I think stand out. In 2015, an email thread from atia with a redacted photo and the subject line got a fresh shipment. Not clear what atia was referring to there. - Oh, oh, oh, oh, hold on. It's not clear what atia is referring to there. He said later it was the medication metformin, but that kind of way. But Epstein responds with an email that says me too with an attached photo, but the attached photo is redacted. - I got some theories. - Well atia's response, let me tell you first before you tell me your theories. Atia's response was, please tell me you found that picture online dot, dot, dot bastard. - Cool. - Yeah. - Yeah. - Fuckers. - Not a lot of, we're not exactly connecting, like this isn't like a crazy board situation where we have to like draw lines between pictures with like twine, that's pretty obvious what's happening here. Yeah, Epstein's response was afraid not. I need just, he's so coolish, even in his emails. - But always takes me is not Epstein's foolishness 'cause he's Epstein, it's the degree to which you can tell there's so many of these guys that all cool is to them is having access to frighteningly young women. But like that's cool. That's what makes you have like an enviable life is the young girls around you. - Cool. - And to be clear, atia's not the only doctor in these files, providing medical care or doing something for Epstein. And that bums me out so much. There's like one normal Norman Finkelstein to every like 20 other dudes trying to like get in on Epstein and Epstein's world. You know, Norman Finkelstein was invited to go to his, he's a Columbia professor. I don't know if you know who he is, cool dude. Anyways, he was invited by another like academic colleague and he was like, no. And if I ever see you bringing your daughter to hang out with Epstein, I'll throttle you. Like that, there's some cool dudes out there. But for the most part, it's just dudes like this who just want, they want to be close to power. They want to be close to it. They want to suckle at the teeth of these rich and powerful people. And doctors are no exception. And that really bums me out. And not just because we took a stupid oath, but because like, we, it's not our job. And it leads to, leads some more, we'll get to that. I got, I got some, yeah, okay. So anyways, Epstein said, afraid not. So, you know, in defense of, he said, it was a picture of an adult woman. Now, I don't think that makes a lot of sense 'cause if it was a picture of an adult woman, why would he say, please tell me you found that picture online dot, dot, dot, buster. Yeah, I mean, I guess because he's like, theoretically maybe just some hot adult lady that he's like, oh, please tell me that's not someone you're in front of right now, 'cause it's so cool that you get to fuck it, right? Like, that would be the defensive thing. Knowing what we know about Jeffrey, my assumption isn't that she's a VH. I don't think so either. And also it doesn't, I mean, it might also, my buddy was like, hey, this is this hot chick that I'm hooking up with, and she's of age. And it seems like the word, I don't think I know. If he just sends me a picture of her sight unseen, that's also upsetting. That's pretty weird, is it? But also, I mean, here's what I'll say, there were guys, and I kind of suspect Bill Clinton was one of them who Jeffrey would have played them with women, but would have played with adult women. 'Cause he didn't just automatically send to someone underage, that's not what every creepy guy prefers. There's some creepy men who prefer to have sex with like 20 year olds, right? Like that are provided to them by a service or whatever. So that's not impossible. But even if he's playing you with adult women, you know what, Jeffrey, you know he got arrested for trafficking children. You know what he's doing to other guys? Just because your taste is like not a felony, doesn't mean that you're not enabling and supporting a guy who's trafficking children as a pen, right? Even if you never saw it, you know what was happening. - You know when I don't believe the never saw it. - Probably, probably probably probably. - I think Jeffrey brought out a schmorgasbord, you know, for the rich powerful men and some of them were adult and some of them weren't. But the guys, they know what's happening and they often see what's happening, even if their tastes are not in that direction. - Yeah, yeah. So another email from 2016, ATIA tells Epstein that he would, quote, "Love to add five years or more to your life, even if the only reason is to do so is to have more sex." - It's a girl. - Cool stuff, Peter. (laughing) - Nice, good luck, disgusting. - I want you to, I'm gonna read this next one also, but I want you to take a drink of your water while you, while you do it. - Okay. - Okay. In a related exchange, he asked J.E. Have you decided if you're interested in living longer solely for the ladies, of course? Spit them out.
- I was gonna do a spit take, I don't wanna actually like-- - I don't wanna have to then clean up after that. - I've got like vegetable powder in my water. - I don't want you to stand in vegetable powder. - Okay, another email, and this is one's a big one. The biggest problem with becoming friends with you, the life you lead is so outrageous, and yet I can't tell a soul. - Why not, Pete? Why can't you tell a soul, Pete? - Yeah, 'cause of the felonies, 'cause of the felonies. - I, listen, he knew that I was a jerk bag, but I'll say this, I've become friends from doing this podcast with a couple of famous people. I tell everyone about it, because they're not ghouls, Pete. They're not ghouls. If you hang out people that aren't terrible, you can tell people. - Yeah, it's this idea that like what cool is, and like the real, like the only kind of life that's really worth bragging about is one of which you just have constant, very young women or girls around you all the time, and it's all about like, it's a very, wasn't cool enough in a high school and never got over it, attitude, as opposed to like, I don't know, like when I think of the people I know who are like really cool and who I like tell people about, 'cause their lifestyle is so amazing, it's folks who like have hobbies and do stuff, like they participate in like fucking incredible races, or they like build things, they make like weird custom cars or motorcycles, or they engage in like incredible feats of athleticism, you know, they build things, they into 3D printing, like they have skills and they make stuff, and they, I don't know, that all takes money, but it's actually impressive as opposed to just like, oh yeah, you're just hanging out around a bunch of, around a bunch of like really young women who you're probably applying with money, cool. - Yeah, okay, another email that struck me, was completing with Epstein's handlers to basically help arrange a play date with him. I go into J.E. with Drawles when I don't see him. Famously, there is the email from a T.A. to Epstein, discussing the issue of kind of lingus that I brought up in the very beginning of the first podcast. And I apologize, I'm sorry. Pussy is indeed low carb. Still awaiting results on gluten though. Okay, now I'm gonna say something that's very, very controversial here, okay? And I apologize in advance, feel free to cut. But in a vacuum, this conversation, I don't think is completely terrible for a couple of reasons. One, it would at least suggest that they're attempting to provide some pleasure, but that is something that I encourage men to do in general with their partners. Because I think there's a potential health benefit in terms of probiotics for men to get. And more men should be doing it if their partners want it. But I don't know if there are benefits 'cause nobody will ever fund that study. But the point is, if one of the two people in this conversation were at the worst people in history, this could be a genuinely interesting scientific question, the murder of me has curiosity. - If someone's talking about like giving a massage to like a partner, that's perfectly fine. If it's Jeffrey Epstein, it's not, 'cause that partner's probably not the adult, right? - That's the thing, that's the issue, I think. - So is that you just take no idea? - It's very gross, I agree, it's very gross. But I mean, as a scientist, there's a part of me that has questions. But let's move past that. There's one other thing that his emails shed light on and something that was dug up afterwards. I'm not sure if it got enough attention. In his book, he shares that in July of 2017, while he was in New York, his one month old son back in California almost died, has to be resuscitated by his wife, who's a nurse. And for four days, his wife is begging him to come back home. She had to perform the resuscitation herself, the child is in the ICU, she needs him back home, and he didn't, because he felt his work was too important. That's his own admission. Now, he will say that this was a mistake. He frames it as having deep disgust with himself for doing that. He's like, I thought my work was so important, I had to stay to do my work. But here's the thing, in his book, he shares the date being July 11th. And when you go through the files, Epstein files, he has an email exchange on July 13th to Epstein, or basically he's playing to meet him. And he's like, yeah, I'll meet you wherever you want. Like, so during this time, all this kid is in the ICU. - Yeah. - He is still there doing important work, quote, unquote, but really it's the trend hangout with Epstein. And that is rough of all the things. - Yeah. - That's a really, that's a tough one. And I will say this, I think if anything gives him shame, it is that, that's the only good news is that it probably does feel terrible about that. - No. - Yeah. - Along with the CBS fallout, he also parted ways with Protein Bar Company, David, and powdered supplement maker, AG1, or Athletic Greens. And he's currently in a lawsuit with wearable medical tracker aura, the aura ring, after they distance themselves from him. They sound kind of like a sketchy company themselves, but I don't know. - Yeah. - Well, the thing about this, this is really a cautionary tale, I think, for all doctors. It's the cautions of interacting with people with fame and power. Doctors, as I mentioned, are people pleasers at heart. And just like anyone else, we can be drawn to the appeals of the rich and famous. And doctors can find themselves doing things to and for these people that they wouldn't do for other patients. And like that 2012 study, this is not always a service to people. - No. - Patient satisfaction doesn't always correlate with good outcomes. They want to be liked by these individuals, they want to be seen as useful. And that can land the doctor, and more importantly, the patient in serious trouble. Look at Michael Jackson's doctor, Matthew Perry's, Joan Rivers, these are all examples of when doctors probably overstepped the bounds of what they should have done in part at least because they were dealing with a famous and rich person. - Right. - So my closing thoughts, again, there's a lot of what he does that is not bad. I'm well aware, as I said, that he is not the worst person. He's one of the least bad people we've ever done the show. And I still hold out. - I don't know, hung out with Epstein. - The Epstein stuff. - Yeah, pretty bad, pretty bad. - He's my opinion on that a bit. - Yeah. - I still hold out hope for redemption arc as I do for everyone. I don't know why I do that, but I can't help but do that. But what it does is says a lot about the practice of medicine in this country and how it is moving towards becoming something even more economically inaccessible and unequal. It says something about the common pitfalls doctors make once they become public figures and what can happen when influence outweighs the actual science becomes more important than the actual science. I think he's sort of the missing link between the dangerous mahasudo science practitioners and the more mainstream, but kind of also problematic healthcare leaders like recent FDA commission or Marty McCarrie who he claims is his close personal friend. And he's not a bastard because he's malicious. He's because it's consequential. He's part of this push that's making medicine. - I think he's a bastard. I'll just go say it. - That's what you're saying. - Yeah, I will say this. Like I feel comfortable when he talks about certain things, he talks about strength training, fine, do it. But and I do want people listening to these things and learning about metabolic syndrome and learning what it is. I also don't want them being so hyper focused on it. I think we face bigger problems when he faces into areas where he doesn't have expertise. Like for example, we talked about colon cancer and I know and I know what's right there. Then it sounds really silly to me. And I'm like, you just can't be an expert in all things. Which is something that we have to address and grapple with as medical podcasters. And this is something I have to wrestle with all the time. Which is how do we do what we do and not fall into these common mistakes? And I try hard, but I don't know. Maybe I'm not perfect either about this. I don't consider myself a medical influencer like he is. But it's always concerning to me if I'm overstepping my expertise or my bounds. So having the air of authority but without the same responsibility and guardrails of real medical practice is a concern for all physician podcasters myself included and is a concern here with him and something we should all be aware of. But the long short of it is, I think he is a part of this push that is making medicine less scientific and is making medicine less accessible and it really worries me and concerns me. And that is my stick on Dr. Peter Tia. - Well, thank you. Yeah, I think he's on the, yeah, bastard ends of things. You wanna plug things before you're all out here? - I certainly do. I wanna plug my podcast, The House of Pod. It is a slun-ish medical podcast. We look at science. We look at one of the scriptors and make fun of them. And we talk about what JFK Jr. is doing to our terrible country. But even more than that, I want you to listen to my brand new podcast. Then I'm very excited about called Persian of Interest. It's about Persian contributions to art, music, philosophy, science, a lot of the fun stories that we've been written out of or minimized in. And we're gonna cover a lot of great topics with a lot of great casts. It's gonna be a really fun time. Please check it out. Bye. - Bye. - Bye. - Behind the bastards is a production of CoolZone Media. For more from CoolZone Media, visit our website. CoolZoneMedia.com. Or check us out on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Full video episodes of Behind the Bastards are now streaming on Netflix dropping every Tuesday and Thursday. Hit remind me on Netflix so you don't miss an episode. For clips and our older episode catalog, continue to subscribe to our YouTube channel. YouTube.com/atBahindTheBastards. We love about. 40% of you, statistically speaking. - Lisa, tell them about our new show. I'm Lexi Yuanu, we're two best friends, 22 years apart, but so close at heart. - And I'm Lisa Di Giulio, the old one, which means we have wildly different references, occasionally different opinions, and at this point in my 50s, I've lived it all. We're kicking off the season with the Sandra Birchmore story, a case the police wrote off as a suicide in a snowstorm. And you can get access to all episodes 100% ad-free with an I Heart True Crime Plus subscription, exclusively on Apple Podcasts, available only to I Heart True Crime Plus subscribers. So don't wait, head to Apple Podcasts, search for I Heart True Crime Plus, and subscribe today. - The True Crime Comedy Podcast, all about robbery, fraud, and those who practice it. - Each week I bring on an amazing guess. - What? - Start listening to SCAM Goddess on the I Heart Radio app, Apple Podcasts, or wherever you get your podcasts. - From shocking betrayals to carefully planned murders, the Black FX new original podcast series, Bloodline Crimes, hosted by me, Morgan Wood, explores the darkest and bizarre cases where family became the most dangerous threat of all. Listen to the Black FX Bloodline Crimes every Thursday, starting October 8th, from the Black FX podcast network on the I Heart Radio app, Apple Podcasts, or wherever you get your podcast. - This is an I Heart Podcast. Guaranteed Human.
Podcast Summary
Key Points:
Peter Atia, a medical consultant and longevity advocate, left traditional medicine to work at McKinsey & Company, where he was involved in strategies that contributed to the opioid crisis.
Atia later founded a private longevity clinic, promoting aggressive, data-driven, and personalized preventive medicine for wealthy clients at extremely high costs.
His medical practices include unproven or overly aggressive testing like continuous glucose monitoring, coronary artery calcium scoring, and early colonoscopies, many lacking clinical evidence.
He promotes off-label medications such as rapamycin for anti-aging, despite limited human trials, significant risks, and lack of proven benefits.
Atia’s approach is criticized for "science washing," where complex medical data is oversimplified and misinterpreted to appear credible, often appealing to anti-vaccine and anti-establishment audiences.
His practices reflect a two-tiered healthcare system, where only the wealthy access expensive, preventive care, while the majority remain underserved and uninsured.
Critics argue that his model prioritizes profit and perceived risk reduction over patient safety, with real harms like overdiagnosis, unnecessary procedures, and psychological burden.
While some of his ideas are grounded in sound health principles, his broad application lacks medical rigor, transparency, and accountability—especially in disclosure of conflicts of interest.
Summary:
The podcast examines Dr. Peter Atia, a controversial figure in the wellness and longevity movement, whose journey from medical training to a high-profile private clinic reflects a broader trend of elitizing healthcare. After working at McKinsey & Company, where consultants advised Purdue Pharma on aggressive opioid marketing, Atia shifted to a career focused on preventive, data-driven medicine for affluent clients.
His model involves expensive, often unproven tests and treatments—like continuous glucose monitors and early colonoscopies—targeting the "metabolic syndrome" population, though critics note that such interventions lack clinical evidence and may lead to overdiagnosis and harm. He promotes off-label drugs like rapamycin for anti-aging, despite limited human data and known risks such as immunosuppression and increased infection. While his critiques of mainstream medicine are valid, his approach is criticized for "science washing"—simplifying complex data to create a persuasive narrative.
Atia’s work exemplifies a growing divide in healthcare: a two-tiered system where wealth enables access to cutting-edge, aggressive prevention, while most people remain in a system with limited resources and coverage. , his ties to Dexcom), and promotion of unproven therapies raise serious ethical and medical concerns. Ultimately, the episode highlights how well-intentioned critiques of traditional medicine can be co-opted into exploitative, profit-driven models that prioritize appearance of innovation over patient safety and equity.
FAQs
Peter Atia was a rebel doctor who left traditional medical residency to join McKinsey & Company, a global management consulting firm. This shift signaled a move away from conventional medicine toward corporate strategy and systems-level thinking, which later influenced his approach to healthcare.
Yes, McKinsey advised Purdue Pharma on aggressive marketing and sales strategies to increase opioid prescriptions, including targeting high-volume doctors and promoting higher-dose pills. This contributed to widespread addiction and led to legal challenges and settlements.
Med 3.0 is a preventive, personalized, and data-driven approach to healthcare focused on avoiding disease rather than treating it. It emphasizes aggressive testing, lifestyle interventions, and early screenings, often outside standard medical guidelines.
He promotes expensive, often unproven tests like continuous glucose monitoring, coronary artery calcium scoring, and early colonoscopies. These are frequently recommended for people without symptoms or risk factors, raising concerns about overtesting and unnecessary medical intervention.
While 88% of U.S. adults have at least one metabolic syndrome marker, having just one is not equivalent to having the full syndrome. The condition requires three or more markers, and the claim is often used to justify aggressive treatment without sufficient evidence.
These practices expose patients to radiation, financial burden, and psychological stress. Tests like coronary calcium scoring lack proven benefits and can lead to unnecessary procedures, especially when not tied to clear clinical need.
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