American Healthcare continues to go backward

[RxCowboy]

My sister-in-law was in the hospital for almost a week due to complications from diabetes and an infection. Then she was transferred to a rehab facility on Monday. Today she tested positive for Covid.

Has she been vaccinated?

 

[CptnQuirk]

Has she been vaccinated?

Yes, at least most of the Covid vaccinations. I don’t know if she has had the most recent one.

 

[steross]

Through mid-2025 almost 14 billion doses of covid vaccine have been given, covering almost 6 billion people. The US accounts for about 700 million doses to date. Contrast that with about 500 million doses of all other vaccines (including influenza) being given in the US from 2020. This was the most massive public health vaccination campaign of all time, beating even the 1967 smallpox vaccination campaign. There are four things at work here, and if the physician in the video had half a brain he would realize it, but he is thinking with his political (lizard) brain and not his scientific brain:

Politicization - covid vaccination became a political issue, smallpox did not. And as we've seen, how you view events depends entirely on your political affiliation.
Recency bias - the physician in the video doesn't remember the smallpox campaign because it wasn't yesterday like the covid campaign.
Post hoc ergo propter hoc - "I got the stab and two weeks later ran over my left foot with a lawn mower because of it."
Solipsism - the world is bigger than the people he knows.

Adverse effects of the smallpox vaccine
View attachment 12842

Yes, we are in an incredible time when physicians in government positions are able to make official statements that are pure medical misinformation.

And sadly, because of this misinformation campaign, the pro-vaccine side starts using its political brain and makes misinformed statements the other way. It is pretty obvious that the elderly and sick benefit greatly from vaccination, and boosters. It gets more murky for other age and health groups. To counter the misinformation that these vaccines are pure poison, I feel they went "Hey, they are wonderful for just about everyone!" I think a more balanced approach would have been more honest and validated people's concerns.

It is conceptually similar to statins. The internet is full of garbage about statins being poison that kill mitochondria and gives you diabetes. But, when providers just look at an LDL and if it is more than 100 say "You must take a statin forever" and if it is less than 100 say "You are fine" they are missing the boat and losing patients to their "research." People want to hear exactly their own risk, how cholesterol plays into the overall picture, and what benefit they would get versus the "harm" of taking a pill every day. And, there is some harm to it, at least mentally.

 

[RxCowboy]

Yes, we are in an incredible time when physicians in government positions are able to make official statements that are pure medical misinformation.

And sadly, because of this misinformation campaign, the pro-vaccine side starts using its political brain and makes misinformed statements the other way. It is pretty obvious that the elderly and sick benefit greatly from vaccination, and boosters. It gets more murky for other age and health groups. To counter the misinformation that these vaccines are pure poison, I feel they went "Hey, they are wonderful for just about everyone!" I think a more balanced approach would have been more honest and validated people's concerns.

It is conceptually similar to statins. The internet is full of garbage about statins being poison that kill mitochondria and gives you diabetes. But, when providers just look at an LDL and if it is more than 100 say "You must take a statin forever" and if it is less than 100 say "You are fine" they are missing the boat and losing patients to their "research." People want to hear exactly their own risk, how cholesterol plays into the overall picture, and what benefit they would get versus the "harm" of taking a pill every day. And, there is some harm to it, at least mentally.

One of my performance measures is “percentage of diabetic patients on statins.” But I am ALWAYS going to under-perform in that measure because I’m in the survivalist part of Michigan and “I don’t trust big pharma.” They trust big tobacco somehow…

 

[steross]

One of my performance measures is “percentage of diabetic patients on statins.” But I am ALWAYS going to under-perform in that measure because I’m in the survivalist part of Michigan and “I don’t trust big pharma.” They trust big tobacco somehow…

And that is exceedingly unfair to you.

What should be your performance measure is that you had an honest risk-benefit discussion with your patients.

I'd love to see a long term study of those two performance measures side by side because I would not be surprised if over time more patients did not end up on appropriate therapy if they did not get the impression the provider was forced or paid to do it but was sincerely recommending it.

 

[RxCowboy]

And that is exceedingly unfair to you.

What should be your performance measure is that you had an honest risk-benefit discussion with your patients.

I'd love to see a long term study of those two performance measures side by side because I would not be surprised if over time more patients did not end up on appropriate therapy if they did not get the impression the provider was forced or paid to do it but was sincerely recommending it.

I have that discussion about risks and benefits, but it often starts with "It doesn't matter what you say, I don't want to be on a statin." Or they have muscle cramps if you even mention lipid lowering meds. Had a patient a couple of weeks ago claim to get muscle cramps on colestipol, which isn't absorbed from the GI tract. I very nearly said "bullsh*t" to him.

 

[steross]

I have that discussion about risks and benefits, but it often starts with "It doesn't matter what you say, I don't want to be on a statin." Or they have muscle cramps if you even mention lipid lowering meds. Had a patient a couple of weeks ago claim to get muscle cramps on colestipol, which isn't absorbed from the GI tract. I very nearly said "bullsh*t" to him.

Yep. And there are definitely those who are so far gone that you will not win. But, I can tell you I have many that were refusers that over time became low-does accepters by discussing things instead of forcing them.