Real Doctor Reacts to “Adam Ruins the Hospital”

– [Adam] I said that’s the
problem with statistics is that they can play into, if
they’re not framed just right they can play into the more fearful parts. – [Mike] That’s exactly
what you’re doing Adam! (intense violin music) I’ve watched Adam Ruins
Everything in the past. Sometimes I agree, but sometimes
I very, very much disagree. So let’s take a look at
his episode on hospitals. Pee-whoop! – [Patient] I just need to be healthy. Just give me everything. – Actually when it comes to medicine, getting everything could
make you less healthy. – That is a 100% accurate,
getting more care isn’t necessarily better than getting less care. Not only can it be a waste of money, but it can also lead to over-diagnosis, which means giving you a
diagnosis that had you not known about it, you’d live
a healthy normal life. Or it can lead to further
downstream testing which then can carry
their own side effects. If I give you an unnecessary test to check for prostate cancer and
then it says you may have prostate cancer, gives
you a false positive, then you end up getting a
prostate cancer biopsy which is an invasive procedure
with a needle down there. And then as a result of
that you get an infection, and then we find out you didn’t
really have prostate cancer. You’d be pretty mad at me right? – I know a hospital is expensive but it is worth it if I
get the best treatment. – No it isn’t, American
healthcare is not the best in the world, but despite
that we spend more per person annually on healthcare than any other developed nation. And a big part of the reason
for that is that American hospitals overcharge patients massively. – I’ve seen this show before
and I really like how he takes apart the concepts and
makes it easy to understand, relatable and also it’s very data driven. However, when you take such
a complicated topic like healthcare and you try and water it down to a single statement, you’re often gonna be misleading people. America’s healthcare system
is not the best in the world, and it’s because hospitals
are overcharging you, that’s a drastic, drastic
oversimplification. Do hospitals overcharge, yes. The reasons they overcharge
are very important to discuss because if you just allow the
regular person to hear that, they think hospitals are just trying to get rich off people getting sick. It’s more complex than that. – The problem starts with
something called the Chargemaster. The Chargemaster is a secret
document full of insane prices that hospitals use to
charge us whatever they want. – Seven dollars for a single alcohol swab? That’s ridiculous! – And true. – Well, I only pay my premium. If they wanna rip off my
insurance company with their fake prices what do I care? – Insurance companies have
been paying more and more out of pocket ’cause the hospitals have been inflating their prices. The way insurance companies
have dealt with this is they try to keep your
premiums from rising too much. So you don’t notice
that you’re paying more, but what they do is they make
your deductible much higher, which means that before
your insurance even kicks in you have to pay higher amounts of money. – Don’t have insurance? You actually get charged
these fake prices. – [Game show Host] Let’s see heart X-rays. That’ll be 33,000 dollars. – This part is interestingly true. If you don’t have insurance
and you have to pay out of pocket you’re gonna be
paying insane prices. A lot of hospitals, ’cause
I don’t wanna make hospitals to sound like totally evil corporations, they have charity care programs. Like my hospital, where they
actually subsidize your care. And if you fall below the poverty line, you can get care extremely low
cost or even free of charge. This is why I say that it’s such a dense and complicated topic. Just narrowing down and
saying hospitals are evil, mmm…not exactly the case. They’re not just upping the
prices for their own good. – [Doctor] Every hospital
has its own Chargemaster. A treatment that costs $7000 at one hospital could cost 100 grand down road. – And you can’t comparison
shop when you’re dying. – So this is 100 percent true. When I talk about the cost of healthcare or even the cost of drug
prices like insulin, I have to make the statement
that you can’t treat healthcare like you do
any other commodity. If a toy is too expensive and people refuse to pay that cost, the cost of that toy is gonna go down or the toy is gonna go off the market. However, if insulin is too expensive and you need insulin to live, whatever cost is set for
you you’re gonna pay it. Even if it means going
bankrupt in the process because you need that insulin to live. And the thing that really bothers me, there’s no transparency here. You don’t know what the pharmaceutical companies are charging,
you don’t know what PBMs which are Pharmacy Benefit Managers are making off medications. Without the transparency, you can’t make an educated consumer decision. For example if you look
at an industry where the prices are transparent
like let’s say plastic surgery. If you go to one office
they’ll tell you what it costs to get a procedure done then
you can go to another office and they tell you what the procedure is. The reason they do that is
that is ’cause you pay cash. So they’re forced to tell you. But when you go through insurance, they’re not necessarily
forced to tell you. Therefore it becomes very cloudy and you can’t make a good decision. This is why prices in the
plastic surgery industry are much better regulated and
are much more transparent. Because they’re forced to be,
because it’s consumer driven. In healthcare because
you don’t have a choice, and because it’s going
through the insurance company, and there’s no transparency,
the whole system falls apart. – How can I stop it, what do I do? – Honestly, nothing, we need
to go to the hospital so they have no incentive to
change how they do business. And politicians have spent
decades arguing over how to pay the bill instead of
asking why the bill is so high. – Hospitals need to exist and they also need to turn a
profit in order to exist. If hospitals just start
handing out free care or not following up on the bills, or taking lower premiums
from insurance companies. They’re gonna go out of
business and we’re gonna have no place to get healthcare. So villainizing the hospital
system is not ideal. Working the entire
system and evaluating the system as a whole and saying
the system is failing us, that’s more of the big picture that we need to be looking at. Saying that politicians
have been arguing at how to pay the bill instead of
actually fixing the problem, is a 100 percent accurate. It’s so much easier as a
politician to get people behind you to say we should just pay all your bills, than actually figuring out
why the bills are so high, and getting into the nitty
gritty details of them all. – That’s it, I’ll get a mammogram. It won’t cure my cold but
it will tell me I don’t have cancer so at least I will
have beaten one disease today. I don’t understand, I thought every woman needed screenings like constantly. – Yeah, that’s what doctors and advocacy groups have told us for decades. In the 80’s, the American
Cancer Society even ran an ad that said if you
haven’t had a mammogram, you need more than your breasts examined. – He wants to make it a very visceral primitive reaction to
what happened in the 80’s. But in the 80’s the research
that we had at the time, the best research that
we had at the time showed that by getting mammograms we
can extend life and save lives and prevent people from
developing worse breast cancer. Now, because we did that
research and we over screened people unfortunately part of the course when you’re doing preliminary research. We’ve realized that we
should push the start date of when you should be
getting your mammograms to a little bit later in life, unless you fall into
a very specific set of circumstances like if
you have a specific gene mutation or family history,
that sort of thing. – Based on randomized clinical trials, if you took 10,000 women in their forties. Here’s how many might die
of breast cancer if they didn’t get any mammograms for a decade. And here’s how many of
those same women might die if they did get those
mammogram screenings. – Take off your blindfold,
they both look the same. – Exactly. – Very oversimplified of how
he’s presenting the data. This research that he’s talking about is about people that died that decade. Not taking into
consideration how that breast cancer effected them in
their quality of life, in the decades moving forward. But that is the reason
in general why we moved our recommendations to getting
screenings later in life, and getting them less frequently. Now it doesn’t mean you
shouldn’t get mammograms, you absolutely should get mammograms. It’s just about when you
get them and that’s why I recommend everyone
at home to go and talk to their doctor about
what’s right for them. – Mammograms find cancer. I have many pamphlets that say that. – [Female Doctor] Well they
definitely find cancer, but not all cancer is the same. – [Adam] There’s the kind of
cancer you were thinking of, the kind you hope to catch early. – Yeah, that one hasn’t
reached the finish line yet. A mammogram could stop it in time. – It might. The problem is mammograms
can’t tell the difference between these types of cancer. – That’s true but that’s why
when you get a mammogram, we don’t just do a mammogram
and then say oh well you either have cancer or you don’t. We follow that up with a
biopsy which then tells us which type of cancer it is and that’s how we guide our treatment. So again, an oversimplification that can confuse the average person. – [Female Doctor] There’s a
chance the X-ray will show something suspicious when the woman doesn’t even have cancer. That’s called a false positive. This happens to about one out of ten women and it can be very stressful. – [Adam] And the more
often you get mammograms, the more likely you are
to get a false positive. – I try and watch this from
an average person perspective. And when I do that, what
I feel is mammograms are useless and can actually hurt me. That’s not the message
we wanna send to people. The message we wanna send to people is go talk to your doctor and
if you need a mammogram your doctor recommends
them, it’s a good thing. Now challenge them and ask
them why or should you wait, and ask good questions. But putting the information
out to the general public like this that doesn’t have a
lot of scientific knowledge? You can really confuse people and actually encourage them to not get screened. Most people will do
anything to skip out on one of these cancer screenings. And to have a show like
this tell them that it’s not the greatest test in the world? A woman who’s 55 will
watch this and who already has a predisposition to
not wanna get a screening will watch this and say
I’m just not gonna get it, and that’s not what we want to happen. – If you do feel a lump
or an abnormality please go see your doctor and if they recommend a mammogram, get one at that time. – Exactly that’s good advice, but the problem is all
that advice comes after you just scared the
bejeezes out of people who might actually need mammograms. So I’m not a fan of the way
that this mammogram special was presented, even
though factually accurate. – There is some good news,
our treatment of breast cancer is so much better
than it used to be. The mortality has dropped significantly. – The reason why our
treatment is so much better is because we found so many of these cancers early because of mammograms. They spent all this time
knocking mammograms, at least give credit to
mammograms for causing breast cancer mortality rates to drop. – [Female Doctor] One
in eight in a lifetime, and it’s of a diagnosis not of death. – I see, I see, that’s the
problem with statistic is that they can play into, if
they’re not framed just right they can play into the more fearful parts. – That’s exactly what you’re doing Adam. I mean yes, we don’t say
one in eight women will die from breast cancer we
say they’ll develop it. So if you’re being clear with
the statistic that you’re giving, a patient or a person
can make their own decision on how they feel about that statistic. Adam has great intentions
and he wants to present information, he wants it to
be controversial and edgy and disruptive, and that’s good. But unless you’ve had
clinical experience where you understand how patients normally come in. You won’t be able to tailor that information to do something meaningful. Like if I was to make this show, I would make it with the
presumption and the knowledge that patients come in
generally afraid of mammograms. And I would be able to tailor
the show with that in mind. And maybe it won’t be as
funny or edgy or disruptive, but at least it’ll be meaningful. ‘Cause that’s the idea of
making quality health content. It’s to not only entertain
but to somehow give a piece of education that’s
gonna make a lasting impact. And that’s why have to
always measure the intentions and then see if the outcomes
match the intentions. ‘Cause I bet if I show this to
a 100 women who are let’s say at the age let’s say 50
years old to get a mammogram. And I let them watch this really quickly, and ask them what they feel
about mammograms after. I guarantee you the majority
of them will be more turned off on mammograms even
though they shouldn’t be, because of this show, and
that’s a negative outcome. Did you see where Dr. Mike
ruins Detox Teas, click here. And stay happy and healthy. (chill electronic music)

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