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July 20, 2024 • 1hr 40min
#814 - Doctor Mike - Reacting To The Rise Of Anxiety, Microplastics & Antidepressants
Modern Wisdom
In this episode of Modern Wisdom, host Chris Williamson interviews Dr. Mike, a family medicine physician and popular YouTuber. Dr. Mike discusses various topics in healthcare, from evidence-based medicine and mental health treatments to obesity management and medical misinformation on social media. He provides insights into the challenges facing the US healthcare system and the importance of accurate health communication.
#814 - Doctor Mike - Reacting To The Rise Of Anxiety, Microplastics & Antidepressants
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Key Takeaways
- Evidence-based medicine is having a resurgence, but the democratization of health information has also led to confusion and conflicting messages for the average person
- Cognitive behavioral therapy (CBT) combined with medication shows the highest level of evidence for treating anxiety and depression
- There has been an uptick in adult ADHD diagnoses, potentially due to increased awareness, patient requests, and performance enhancement motivations
- SSRIs are still commonly prescribed for depression and anxiety, though their exact mechanism of action is not fully understood
- The US healthcare system prioritizes profits over patients, leading to issues like quotas for doctors and lack of access to care
- Microplastics are likely present in human bodies due to widespread pollution, but their full health impacts are still being studied
- GLP-1 agonist medications for weight loss show promise but are currently expensive and not widely accessible
- Medical misinformation is rampant on social media, especially in short-form content that lacks context
- Dr. Mike emphasizes the importance of providing accurate, nuanced health information without overselling or corrupting the science
Introduction
In this episode of Modern Wisdom, host Chris Williamson interviews Dr. Mike, a family medicine physician and popular YouTuber. Dr. Mike discusses various topics in healthcare, from evidence-based medicine and mental health treatments to obesity management and medical misinformation on social media. He provides insights into the challenges facing the US healthcare system and the importance of accurate health communication.
Topics Discussed
Evidence-Based Medicine and Health Information (04:24)
Dr. Mike discusses the resurgence of evidence-based medicine and the challenges of health information in the age of social media:
- The democratization of health information has led to both benefits and drawbacks
- People are developing healthier skepticism but also encountering conflicting messages
- It's important to understand the nuances and avoid labeling things as all good or all bad
"You can't say anything is all good or all bad. You can't say humans are all good or all bad," says Dr. Mike, emphasizing the importance of nuanced thinking in healthcare.
Mental Health and Cognitive Behavioral Therapy (07:17)
Dr. Mike explains the current evidence for treating anxiety and depression:
- Highest level of evidence is for a combination of mental health therapy (usually CBT) and medications (often SSRIs)
- Treatment should be tailored to the individual patient's needs and severity of symptoms
- CBT helps patients recapture control over their thoughts and emotions
He recommends the book "Feeling Good" by Dr. David Burns as a resource for patients interested in CBT principles.
Adult ADHD and Diagnosis Trends (12:57)
Dr. Mike addresses the perceived increase in adult ADHD diagnoses:
- Factors contributing to the uptick may include increased awareness, patient requests, and performance enhancement motivations
- Severe ADHD can significantly impact a person's ability to function in various aspects of life
- Proper diagnosis involves assessing symptoms across different environments and gathering input from others
SSRIs and Depression Treatment (19:10)
The current state of SSRI prescriptions and understanding:
- SSRIs are still commonly prescribed for depression and anxiety
- The exact mechanism of action is not fully understood, contrary to some popular explanations
- Dr. Mike emphasizes the importance of being transparent about what is known and unknown in medical science
US Healthcare System Challenges (24:52)
Dr. Mike outlines issues within the US healthcare system:
- The hybrid system of government-funded, employer-provided, and individual insurance plans is messy
- Private equity involvement has led to prioritizing profits over patient care
- Quotas for doctors can interfere with providing proper care and being present for patients
- Young people increasingly rely on urgent care, which can disrupt continuity of care
"When you see how often those things happen in an exam room, you understand that putting a quota on healthcare is just flawed from the start," Dr. Mike explains.
Microplastics and Environmental Health Concerns (58:51)
Discussion on the presence of microplastics in human bodies:
- Microplastics are likely present in most people due to widespread pollution
- The full health impacts are still being studied
- It's challenging to completely avoid exposure in modern society
Dr. Mike advises focusing on "big boulders" of health rather than getting overly concerned about every potential risk.
Obesity and GLP-1 Agonist Medications (1:13:53)
The conversation turns to obesity management and new medications:
- GLP-1 agonist medications show promise for weight loss and health improvements
- Currently, these medications are expensive and not widely accessible
- There are concerns about how society will adapt to widely available weight loss options
- Dr. Mike cautions against oversimplifying the effectiveness and availability of these treatments
"Access is a huge issue. And why it's kind of an exponentially problematic issue is that the people who struggle with access to that medication are also the same people that food industry targets the most with junk food," Dr. Mike points out.
Medical Misinformation on Social Media (1:28:30)
Dr. Mike discusses the challenges of medical communication on social media:
- Short-form content often lacks necessary context, leading to misunderstandings
- Some influencers make irresponsible statements or fail to correct misinterpretations
- There's a need for responsible, evidence-based health communication that doesn't oversell or corrupt the science
He emphasizes the importance of providing accurate information without compromising integrity for views or financial gain.
Balancing Clinical Practice and Social Media Presence (1:37:00)
Dr. Mike shares his approach to maintaining a clinical practice while being a public figure:
- He continues to practice medicine, including pro bono work at a community health center
- Clinical practice provides valuable insights and keeps him grounded in real patient experiences
- He uses patient experiences to inform his social media content, making it more relatable and honest
"The things that are discussed on social media versus the problems my patients have in their everyday lives are just completely different," Dr. Mike reflects.
Conclusion
Dr. Mike's conversation with Chris Williamson highlights the complexities of modern healthcare and the challenges of communicating accurate health information in the age of social media. He emphasizes the importance of evidence-based medicine, nuanced thinking, and responsible communication. Dr. Mike's commitment to both clinical practice and public education serves as a model for balancing medical expertise with accessible health information. As healthcare continues to evolve, particularly with advancements in obesity treatment and mental health care, it's crucial to maintain a focus on patient well-being while navigating the complexities of the healthcare system and combating misinformation.