Response to Adam Conover’s Tweet | Hospitals & Mammograms | Wednesday Checkup


– Wow. Adam Conover from
Adam Ruins Everything responded to our reaction video. And you critiqued it as well, so we’re talking about it on this weeks Wednesday Checkup. Beewoop. (upbeat music) Just to catch everybody up, a couple weeks ago, I did a reaction video to the show Adam Ruins Everything. The topic of the episode was hospitals. So I was very comfortable giving genuine opinion on the matter. Since then, it got a lot of attention. Over 11 thousand comments,
two million views, the host of the show actually responded via twitter. So I wanted to take some of his critiques, some of your critiques, address them, and explain to you how
I film a reaction video. Cause I think its important
for you to understand not only how my mind works, but how this editorial process happens. If you look at a TV show, they have multiple rounds of revision. They can film extra
things, plug things in, have experts come in, give extra advice. I don’t do that. In this channel, it’s myself, my awesome videographer Dan Owens. We sit down in front of the television and we watch the episode
for the first time. I’ve never watched these episodes before because I feel like if I go in with some kind of
preconceived talking points it loses the genuine
nature of the conversation. And I feel like there’s something special when both you and I are watching this episode for the first time. When it comes to the editing process, I never fill in information. If I don’t know something, I
look it up on camera with you or I don’t include it in the final edit. I don’t know all the terms. I don’t know all the conditions. But if there is something
that I do know about I chime in and try and present it in the easiest, most fun, entertaining way so that you can understand it as well. That doesn’t always hit home, so if I discuss a subject that I feel didn’t come off well,
or wasn’t explanatory in a way that’s understandable I’ll edit that part out. I will never edit it to
make myself look smarter or to make someone look stupid. It’s simply to make the
information digestible, interesting, and so that
the pace of the piece kind of moves quickly. Now that you know the process I go through in filming one of these, lets talk about the comments and critiques
you left underneath the video. First you mentioned that you suspect that I have a level of bias, because I am employed
by a hospital system. Well, actually you’re
right. On two counts. First, all humans have some level of bias. In fact, those who are more educated have a higher level of bias, because they are able
to convince themselves by rearranging data and information to suit their own beliefs. Second, I do work for a hospital system. I am an outpatient, office based doctor so I’m not really in the hospital but it sort of holds true still. However, I have to push back a bit here. What I’m most passionate about, what I pride this channel on, is that we identify bias,
and we try and prevent it from corrupting this information. I try to present information as honestly and accurately as possible, without putting my own opinions in, unless I’m explicitly saying
that this is my opinion and not everyone else’s. Or not matching of the facts. I’m no stranger to controversy, and I’ve covered some really controversial topics on this channel like polarization, diversity, telemedicine statements made by politicians
and health care professionals and I’m not afraid to face my biases and their biases head on, so that we can have a healthy debate, have an honest conversation. And if you ever catch me being biased, or I ever catch myself being biased I’m going to be the first
to admit that on camera. The next point you’ve brought up quite commonly in the comment section is that you worry that Adam actually explained certain points
but I don’t show that, therefore I make it look like I know something that he doesn’t. I don’t edit in this type of bad faith. If there was something that I critiqued about the show, and then he went on to correct it, I would either a jump in and say, oh, he pointed that out,
so we’re on the same page or I would completely erase my critique and not include it in the final cut. To make someone look bad, just
to make myself look better that is something I absolutely abhor, and will avoid doing at all costs. And the final point that
I saw a lot of critique on and rightfully so, is that
I didn’t quite qualify why I believed hospitals
to be so expensive if it wasn’t just to make a buck. The reason why I left that bit out, is because when I explained
it on that first take I don’t do extra takes it wasn’t clean when I
looked back at the edit, didn’t explain it well, and I felt it would slow down the overall pace of the video, so I just completely deleted it and felt that if you wanted
further clarification I could do it in the comments or do as I’m doing now. But let’s chat about why
hospitals are so expensive. I don’t disagree with Adam, that part of the reason why hospitals have such crazy prices,
is to make a profit. That definitely exists, and I think that certain hospitals, based on
how much money they spend on marketing, branding, hiring new talent, innovation, all of these factors, charge more money and they
want to make more money and it’s a for profit business. Whether you agree with a hospital being a for profit business is a whole different conversation. But that is not the only reason why hospitals charge so much. And in fact, it’s not
the main reason either. The major reasons of why
hospitals charge so much, first and foremost, is
administrative costs. When you look at a graph
of how much physicians have been costing the health care system over the last 30 years, it
hasn’t really changed much. The real uptick in spending has come from the administrative burden
placed on the system and doctors as well. In fact there’s this whole spike in doctors being unsatisfied
with what they do. It’s not because medicine’s changed. It’s because the administration
of medicine has changed. The reason for this
uptick in administrators comes from the fact that our system is so complex and not intuitive at all. When a patient is admitted into a hospital from the emergency room, there has to be three people to figure out how to best bill that patients insurance so that they approve the fee, and get the hospital can get paid. Then if I didn’t fill
out the patients chart in a way that’s applicable
to that insurance policy I have to then go and change the chart. The system is so fraught with inconsistencies, with redundancies, that the cost goes up significantly, to receive the same thing that if you were in another country, it would cost a portion of the price. There was a great interview done in 2010 from a Harvard economist, who said that as an example in Duke University hospital, that there was a 900 bed hospital. Means that they could fit 900 patients. And they had 1,300 billing employees. You don’t even need 900 doctors to take care of 900 patients. But you need 13 hundred
billing specialists to take care of 900 patients. Something’s wrong there. The second reason why
hospitals are so expensive is because doctors are afraid to get sued. And they begin practicing
what’s known as C-Y-A medicine. Cover your butt medicine. This is where doctors
order confirmation tests or extra imaging, or prescribe
unnecessary treatments just based on the fear
that they may get sued. A great example of this is antibiotics which Adam does a great job
of covering in his video. Where doctors are
worried that if a patient has a virus, but gets worse, and they didn’t prescribe antibiotics, it could be blamed on
them, and they may be sued. So they prescribe unnecessary antibiotics. I don’t like when doctors practice this type of protective
or defensive medicine. It’s not honest, it’s not ideal, and you’re not helping the
human sitting in front of you. The third reason why
hospitals are so expensive is because in the United States, we have more specialty care, than anywhere else in the world. Specialists cost more money. This is why I’m a strong believer in primary care medicine, family medicine what I do, because we not only lower the cost of healthcare, we prevent problems from happening, and we educate our patients to live the best quality of life possible, to avoid these situations in the future. I have no shortage of examples of patients coming in,
asking to see a specialist for some very common conditions. High blood pressure, high cholesterol, skin biopsies, and I remind them as a family medicine doctor, I’m fully capable of taking care of a lot of these common conditions. That’s not an exhaustive list of why hospitals are expensive, but I think those reasons are a lot more important to take action
on, and talk about, than just the profiteering
by some individual hospitals. And that was my issue with Adams segment. Again, he wasn’t saying anything wrong or innacurate, it’s just the focus of the piece was, I
felt, a little misguided. Let’s move on to Adam Conovers tweet. And I have to say at the outset, I’m so happy that he did this publicly that we’re able to have our sort of different point of views
put out into the web. Have a healthy conversation about it. So that everyone learns
what our points of view are where we’re coming from,
because that’s what it’s about. It’s not about labeling someone, or calling someone a name, that’s not ideal for
this type of discussion. I think the best way to do this is I’m just gonna read a
couple sentences of his tweets and then just respond to them one by one. In this video, real doctor mike affirms that every factual point that we make in our episode is correct so we’re off to a great start. His only criticism
seems to be of our tone. I disagree with that a little bit. While I did say a few things about the tone of some of the pieces, some of my critique comes from the focus. And we’re gonna be getting into that as we cover each point, but know that my critique
is not coming from a producers standpoint, a
TV executives standpoint, entertainment standpoint,
it’s strictly coming from a doctors concern
of what an average person may take away from one of these pieces. He seems to have two complaints. One, that we’re being too mean to hospitals that systematically overcharge their patients, two, that our mammogram segment might frighten women away from getting mammograms all together. It’s not so much that I care that he’s being mean to hospitals, it’s the fact that I feel the focus, is too heavily places on profiteering when I feel there’s other
systematic issues at play that weren’t adequately
discussed within the episode. And the second point, dead on. I agree, that’s what I was worried about that the mammogram segment actually does frighten women away
from getting mammograms. It’s unclear why Mike believes that hospitals should be above criticism. He agrees that their pricing is capricious and inflated, and that it has devastating
costs for the uninsured. He even criticizes these practices in the pharmaceutical
industry, so why not hospitals? First, I don’t believe
hospitals are above criticism. I think no one is above criticism. And I don’t think criticism
is even a bad thing. You can give constructive criticism. In fact in my residency program, which is part of my hospital, we consistently give
criticism, to improve it. So that where we work is a better place. Next line, I do believe that these crazy elevated costs are out of control and they have devastating
effects on the uninsured. (ding) totally see eye to eye on that one. Mike claims that hospitals
aren’t in it for the money, but there are thousands of for
profit hospitals in the US, and even non-profits wildly overcharge. Yes there are many causes
of high healthcare costs but this is one of them,
and it deserves scrutiny. I don’t think that I ever claimed that hospitals aren’t in it for the money. I agree that for profit hospitals exist and I think in the video
I actually mentioned that hospitals need to turn a profit. I agree that it deserves scrutiny. But I think the laser
focus that was placed on hospital profiteering,
was a little misguided because there’s so many other things that are contributing more so to the rise of healthcare costs, that weren’t discussed. My job is to use comedy to point out bad business practices that hurt people. I’m not in the business of protecting the feelings of hospital bosses. I respectfully reject this criticism. I agree, I don’t think he should worry about offending hospitals. And I don’t think this
is an issue of outrage that I think that hospitals are
being unfairly treated here, and hospital bosses feelings
should be under consideration. No, this is a business,
and it’s a big industry that effects millions of individuals. So we should be criticizing it openly. I just think that if we’re
gonna criticize any topic or debate any topic,
we need to think about all the factors at play, and if we’re gonna be
discussing any of them at such a high stake and with such focus it should be the ones that are the major drivers of this problem. And I just don’t think
hospital profiteering is one of those main drivers. It’s definitely one of them, and it deserves scrutiny, but the other issues
deserve more scrutiny. That’s all I’m saying. Mike worries that we send the message that no one should ever get a mammogram. This is odd, since our episode clearly and explicitly lays out
that the United States preventive services task force guidance. You like how I know what that stands for. That you should discuss routine mammograms with your doctor starting in your forties. Again, factually this is all good stuff. And I don’t think that
there’s a problem there. My issue lies with how the average person will interpret the way the
information is presented. The order, the tone, all of these things. When we had the segment critiquing antibiotic overuse and overprescription, that’s really good. Because patients actually come in requesting unnecessary antibiotics, and doctors give it. What happens much much less often is patients coming in, asking
for unnecessary mammograms and then doctors giving them. I don’t think that this is even a situation I’ve ever encountered or heard of a doctor encountering. Being a primary care doctor, I have a pulse, that’s funny
that I used this metaphor, but I have a pulse on what my patients think about medicine,
what their fears are, what they think works, doesn’t work. and their feelings on
mammograms are negative. They don’t want them,
they’re afraid of them. They’ve heard that they hurt, they’ll do anything to get
out of getting them done. And when patients at baseline are already scared of them,
by presenting them information the way that it was presented, I think that it could turn
them off even further. Mike also seems to take issue with our over criticism of how mammograms were over promoted in the eighties. However as he admits,
those myths contributed to a dangerous over
diagnosis and over treatment. Since they’re still with us today, it’s important we correct them. I don’t think necessarily
mammograms were over promoted, because at the time, our best research showed that getting
mammograms was beneficial. Now we know that starting later in life is more beneficial and less harmful. So, I wouldn’t necessarily call these myths that were propagated, it was the best research
that we had at the time, but as we know now, that isn’t the truth. That’s the thing with medicine. A lot of the things I’m doing today, that are accurate based on
the evidence that I have will be proven wrong in the coming years. This is just bound to happen, as more research comes out. We need to not be afraid of that. And while I agree we do need to point out that advances in research, and changes in guidance have happened, that’s really something for
doctors to take note of. Because if we overload patients with when they should be getting this and how these rules
change year in year out it’ll cause so much confusion
for the average person that they won’t be able to
make and accurate decision. The average person wants
to avoid mammograms and has an unfavorable
view of them already. And now were just throwing
more fuel on the fire. Finally, Mike says that as a doctor, he may have presented the
information differently. I agree that when covering medical issues, deferring to doctors is essential. That’s why our script was reviewed by a physician, cancer researcher, and our expert for this
episode, Doctor Joan Elmore. We did multiple rounds of
revision on this script based on Doctor Elmore’s extensive notes and feedback which drew from her clinical experience
treating cancer patients. It was vert important to us and her that the segment accurately represented the advice she’d give in her office. Again, I agree that this
episode is factually accurate and I loved the sit down interview that was done at the end of the episode. However that initial skit, which is the most engaging
part of the episode and the first part of the episode, that’s where people pay attention to most, really painted mammograms
in an unfavorable view. I understand that factually speaking, it was painting them
in an unfavorable view when patients don’t need them, like getting them too early, but I don’t know if that was clear. And I worry how that might affect somebody who’s already having a fear
of getting a mammogram. Which is most patients. So if I was to redo this episode, or do it on my own, all
I would do to change it is take some of the information that was given in that sit down interview, and incorporate it in that beginning skit. Or, maybe make the
beginning skit even clearer that we’re talking about people
who don’t need mammograms. Cause there’s a huge
percentage of the population who do need them, but are afraid, and we don’t want to scare them away. Of course, we knew taking a comedic look at such an important medical
topic risked misunderstanding, that’s why this segment had
one of the most thorough fact checking and review
process we’ve ever done. We took it extremely seriously, and sacrificed comedy
for clarity many times. That said, we were of course limited by the six minute segment runtime, that’s why we brought Doctor Elmore in for an extended interview on our podcast, where she went deep on
the nuances of the issue. I think comedy’s a great tool to educate people about health, and I think that simplification is actually a good thing, because we want the average person to
understand the basic concept get a level of general interest, and then do a deep dive into the research. What I don’t think is ideal
is oversimplification. When we take a complex, nuanced matter like why the American health
care system costs so much, and we just limit it to talking
about one of the factors, and its not one of the
most important factors. I think that can be deceiving. I think that when we’re
talking about mammograms and we don’t focus on right away the benefits that mammograms carry, that’s a little bi deceiving. Because it’s such a nuanced matter that oversimplification
can be dangerous at times. We need to constantly
reevaluate our good intentions and see if they match
up with good outcomes. Again, I wanna give a huge huge thank you for Adam Conover, for
tweeting me this reply so that we can continue this conversation and really understand that
we’re not disagreeing on much. The facts that are in
this episode are accurate. And the fact that we’re talking about this and getting people engaged on a topic like the American health care system and mammograms is amazing. This is what I’m all about, and I encourage all my patients to educate themselves further. This type of debate is healthy, and I want to continue encouraging that by telling you to go
into the comment section write up your response, who do you agree with, do you
have your own point of view? I enjoy learning from you guys as much as you hopefully
enjoy learning from me. So drop your comments your thoughts your own point of views
down below in the comments, and as always, stay happy, and healthy. (jazzy music)

100 thoughts on “Response to Adam Conover’s Tweet | Hospitals & Mammograms | Wednesday Checkup

  1. Dr. Mike, I wish you were my family doctor. I CONSTANTLY get referred to specialists for conditions that I feel like my PCP should be able to handle. Now, I have to wait 3 months for resolution to an issue that I should have been able to get taken care of in an afternoon at my family doctor. It is super frustrating.

  2. There’s something I don’t like about the way Dr. Mike talks about “the average person”. As if an average viewer of Adam’s show wouldn’t know any better to see the segment beyond the initial skit. The point of the show is to think critically about all the things we take for granted in every day life, so it saddens me to see that Dr. Mike doesn’t seem to have much faith in the “average people” who watch the show to do just that: think critically. I probably shouldn’t be offended and maybe I’m just blowing this out of proportion, but it still kinda hurts

  3. I think that Adam Conover's response, while slightly defensive, wasn't unreasonable either, considering we live in the age of Twitter where not all criticism is…even-handed, let's say. Ultimately I think this was just a matter of the Adam Ruins Everything show being a good introduction to the topic, but not the best platform to go in-depth with it. I mean, six minutes to discuss a nation's health care system is enough time for a brief introduction at best, and that's not accounting for writing/editing for the sake of comedy.

    I think the best way to look at videos and topics (both Adam's show and Dr. Mike's response) is that they introduce an important topic and points of view, but not comprehensively. Always take whatever you see and hear with a grain of salt, and if the topic resonates with you follow up with your own research. That's why, in this case for instance, it's called a medical 'community' – doctors are educated and more well-informed than the average person, but they're still human, and it's wise to compare notes with others and get their own views and educational materials in order to reach the best possible conclusion. The fact that this conversation happened is awesome, but it should only be the start for us, the audience.

  4. The saddest thing about Adam Ruins Everything is that it is a rip-off of "Penn&Teller's Bullshit" without the humor and sexiness, and without fixing all of "Bullshit"s flaws.

    It oversimplifies. It tries to twist data to fit a biased point. It attacks the worst examples of a side, the lowest hanging fruit, and contrasts it with the best examples of the opposite side. It debunks one myth and replaces it with another.

    Even Penn said he wanted to make a "Bullshit of Bullshit" episode and apologized for a lot of the worst of his show.

    Adam should know all the problems of this kind of show format, but seems to have no interest in improving it.

  5. Adam unfortunately is in the business of TV, the facts will often be misrepresented because ratings rule in that field of work. That is not to say that Adam does this on purpose or even maliciously, it’s just the nature of the field he is in. The nature of Dr. Mike’s field is caring for people and the consequences of patient’s healthcare, his view reigns supreme on this subject in my opinion. Great video

  6. Bravo on being so composed because he is being completely disingenuous regarding what your actual criticisms are.

    Hurting the feelings of hospital bosses?

    Thinks they send a message of 'never get mammograms'?

    If you can't argue in good faith, you probably don't have much of an argument.

  7. Late to comment on this video, but many of those points about high cost stem from the completely incorrect practice of privatizing basic human rights. Education and medicine should never have private control. It's crazy, and it's an environment dictated by profit. What you've said about insurance paper work and multiple staff members being required to correctly bill an insurance company shows it's infected more than just the hospital itself. It's a completely flawed system from the ground up.

    It's so sad to see. Especially when so many deaths happen because of it.

  8. "Yes, there are many causes of high health care costs, but this is one of them, and it deserves scrutiny."

    That sounds an awful lot like Adam trying to sound like he's addressing Mike's point without actually saying anything substantive. Adam is implying that the only alternative to giving profiteering absolute focus is ignoring it completely, and thereby implying that that is what Mike is arguing for.

    This kind of thing is why I don't trust Adam.

  9. Honestly, for me it felt like Adam criticized things Dr. Mike didn't even say or didn't fully understand what Dr. Mike was trying to say.
    Dr. Mike even said, that he understood, that for comedy sake, things had to be portrayed a certain way, but he as a doctor didn't like it. That doesn't mean it's wrong information or not enough checked by doctors, it is just not the way of presentation he would have chosen. But he's still aware, that it is a result of the comedic footing of the video.

    I've got the feeling, that there were many emotions involved, when the tweets were written. I don't know how the internet reacted to either video (Adam's or Dr. Mike's), so perhaps that flared up the emotions. (We all know that the internet can be quite savage)
    But all in all for me the tweets didn't really "honor" what Dr. Mike said in his video, since a lot of it was (from my perspective) misunderstood.

    Ps: I'm sorry, if there are passages, that aren't easy to understand, but English isn't my native language. So I tried to convey my thoughts as best as possible 🙂

  10. Seems like Adam Conover was speaking as an artist whose creation was being critiqued, while Doctor MIke was speaking as a health care professional regarding an existing medical health situation that exists in this (U.S.) country that is more exacerbated by insurance companies, pharmaceutical companies and legal concerns than hospitals (although the billing departments of a few hospitals can be more aggressive than the IRS). But then all of this is just…my opinion. I enjoyed this reply from Doctor Mike regarding Adam Conover's Tweet. Another opinion, NOT directed at anyone in particular, sometimes it seems like Twitter is where intellect, patience and discourse goes to die…again just my opinion.

  11. 2 things Adam and Bernie Sanders have in common , oversimplification. Everything is either racism, sexism or corporate greed.

  12. Ive watched adam ruins everything shows where I know about the topic being presented and have multiple times heard misleading and non factual statments. I stopped watching a couple years ago due to this and the fact that he puts out a "facts" show and cant take some criticism from another expert is sad. Really showed his true colours. Bravo to the Dr. for being able to address his criticisms like an adult and not like a bratty youtube star.

  13. This guy is a board certified doctor, the fucking dude with the hair gel and glasses is specialized in what again? It's time we start listening to professionals who actually do the work versus personalities that couldn't pass a general ed to save their life.

  14. prescribing antibiotics unnecessarily is fucking insane! People die from resistant bacteria! Bacteria that if antibiotics were rare would easily be treatable!

  15. Not gonna lie I LOVE Adam's episodes, I also love Mr. Mike here. But I think Adam is being reasonable, but I also like to listen to Mike's explanations as well.

  16. There is no reasoning with SJWs. They are totalitarian fanatics who have no problem murdering anyone who disagrees with them.

  17. Even non-profit hospitals are just expensive as for profit hospitals. So Dr. Mike is right here, it’s not solely based on profiteering, but is based on an accumulation of things that all deserve scrutiny.

    Adam doesn’t seem to be taking Dr. Mike’s criticism’s as seriously as Dr. Mike is taking Adam’s. Either Adam watched Dr. Mike’s video and wrote his responses after or he watched it with his own biases getting in the way. Adam is claiming Dr. Mike said and claimed many things that Dr. Mike clearly did not say. I just watched the video again to confirm these things. Very frustrating and unprofessional of Adam.

    “Mike claims that hospitals aren’t in it for the money….” um no he didn’t claim that. Dr. Mike said “hospitals need to exist, so hospitals needs to make a profit in order to exist.”

    By rejecting Dr. Mike’s criticism as a whole, it seems Adam didn’t watch Dr. Mike’s video, he was given bullets points by his team on what Dr. Mike critiqued. Dr. Mike explained so clearly how Adam’s timeline of discussing mammograms could cause women to avoid them. It was the timeline, not the content. If you watch Dr. Mike’s video you can clearly hear him explain these things.

    I watch both Adam and Dr. Mike and enjoy both of their content so I hope my own biases don’t get in the way. I saw Adam’s segment first, then Dr. Mike’s. I agree with so many of Adam’s points made in his segment and agree it harmed the segment by being limited to only 6 or 8 minutes. This is a topic that can be discussed for hours so it’s difficult to reduce it to such a short amount of time.

  18. Since you're on about hospitals, I want to share a little about my experience with the VA hospital in San Francisco. I had two knee replacement surgeries. I had not been walking for a couple of years because of arthritic pain. I came out of that experience wishing I had two more knees to get done! Talk about getting my ego stoked! All this super expensive equipment, all these dedicated, well trained specialists, all focused of li'll ol' me and at every turn actually thanking me "Thank you for your service." I found everyone wonderfully humored and even laughing at my bad jokes. As for the cost? Excuse the descent into politics but I really think Americans need to understand: VA hospital–absolutely free. Yea Socialism! —John McDonough

  19. They also need to cover the cost of having medicare patients ie cost shifting, information asymmetry, adverse selection and technology advancements that relate very much to the pay for service model. The US adopts new treatments and purchases equipment at about 4 times the rate per capita. Every time you "plan" your medical treatment so it coincides to reach your maximum out of pocket you drive up premiums. At the end of the day the formula is cost + profit = price …..if you save on your price it will be made up in higher deductibles or higher rates.

  20. Please do not use "thump" music – it can affect heart rate. Why do you believe barely audible background sound is necessary ? For those of us with good hearing, it is annoying, like a buzzing insect.

  21. I believe that both Mike and Adam have the best intentions. They just come at it from different angles. My suggestion would be a collaboration video on a topic they are both passionate about.

  22. You moved the goal post though he was specifically talking about the business practice any other factors is moving the goal post you didn't focus on the specific topic

  23. 'I', 'don't' and 'know' are three words Adam needs to use more often. In that order.

    Doc Mike: I believe noone is above criticism.
    Haven't you heard Doc? Adam Connover is above criticism. 😂

  24. I am not a fan of Adam anymore, this is because his points and facts aren't 100% factual. They are very biased and not fully in depth and aimed to his bias.

  25. When I watched that video, I was terrified of mammograms.
    I believe Dr Mike is correct with the tone and telling of the episode could be better.

  26. I don't have an opinion of mammograms either way. I found 3 of my 4 benign lumps when I was 16. A womens' hands are the best tools to find abnormalities as a first line of discovery. Now that I have a history of lumps, mammograms will be part of the rest of my life for the ones I can't feel. Know yourself and your body. You know what is right and what is off.

  27. This is part of why I love Doctor Mike, he takes criticism well, and then explains his processes and clarifys on the points he made and information he has shared.. and in the process teaches us about ourselves and each other and how to not make a drama out of things… if only more people were like him…

  28. Dr. Mike, there is a DO in Grand Rapids, MI who is very similar to you in demeanor and geniality. Oh, yea, and he is a D.O. as well! You and Brian Wilder, D.O. should do a workout video together where you discuss basic fitness, injury, recovery, and lifestyle fitness choices!

  29. The medical billing system is so jacked up. When my wife was pregnant we went in for a (perceived) emergency , since baby wasn't moving and hadn't in several hours. Wife is crying and scared. And all she wanted was them to confirm a heartbeat. Instead, first thing they ask for after getting her in the room is her insurance card. 20 minutes later they finally came in.

  30. some of the shows i've watched you watch i have seen before but not most of them… … …THIS one yep, & house yep!

  31. Adam Conover goes into every TV show he films with a level of bias. Afterall his show is called "Adam Ruins Everything". He doesn't go into a show with the subject he's so called investigating to find what their doing right. I used to watch his show but I gave it up. It's just to one sided.

  32. It's a whole other level of maturity when a public criticism on Twitter is considered an exciting opportunity for an informative debate.

  33. Wow! This really shows who Doctor Mike and Adam really are. Adam gives a needlessly passive-aggressive tweet that would irritate even the calmest of people and that aggression washes right off Doctor Mike's back. Bravo! I have a lot to learn about emotional intelligence from you.

  34. I have pretty much no respect for Adam Ruins Everything because he is biased, oversimplified, and he spreads misinformation. The herpes episode brought all the nasty people out to dating sites screaming "you need to love my scores because everyone secretly has herpes like me!"

    ARE is a damn joke. This guy is 100% amazing as an individual and a medical professional.

  35. I am an oncology certified nurse and work in radiology. I was very upset by this episode and stopped watching Adams show as a result. I highly doubt the doctor they interviewed put her seal of approval on the FINAL cut of this episode, either that, or she was a bit clouded by the excitement of being on TV. Thank you for your CONSTRUCTIVE criticism, and especially for your explanation of how evidence based practice works! Love your videos. Keep them coming.

  36. Mike, Adam debates to win and I don't think he's interested in discussing things for the sake of learning.
    He probably watched your entire video with the mindset of "winning". I'm just saying, he might not be as friendly as you think he is. You might see it as a healthy conversation, but he might not share the same mentality. I'm not even saying he is necessarily that way, but just that he might be.
    Maybe you already know that, but you seem like an optimistic guy so I didn't want you to get surprised. I don't know.

  37. Adam's response was passive aggressive, but to be fair your reaction video not only missed some of points he made but also reiterated the same thing but differently.

  38. I don't think you should even give this Adam guy a second thought for his 'criticisms'. His show is there for sensationalism. Whether or not there are any facts in his shows, he's doing it in a television, entertainment-leaning sensationalist delivery. And not to be mean, but stupid people, who believe anything on tv (like an ex friend of mine's mother), would start to freak out and take jokes and sensationalism as real facts. When you present people with themes like "you think you know something, well guess what, here's what's really going on", that draws people in to believe in things they typically wouldn't. Because it contradicts 'the system'.

  39. I know I'm late to the party but here I go anyway.
    I live in Canada which means as long as you have OHIP (Ontario Health Insurance Plan) which makes basically every basic medical and emergency needs are payed for by the government VIA Tax.
    This is good because it means most of us here in Canada will most likely never pay the ridiculous prices doctors have in America.

    At the same time, if your going in for a check up this means that it's first come first serve. Which is not really a bad thing for basic medical needs like a simple check up. Sure it means your going to be stuck in the waiting room for potentially hours if not the entire day, depending on how many people are there. But at the same time you can wait because it's just a health check up, your not dying.

    The issue with OHIP is that medical professionals here aren't payed NEARLY as much as their American counterparts. Which leads a lot of these medical professionals to pack their bags and go to America. Here in Canada an average family doctor such as yourself makes around $230K per year with their American counter parts making around an average of $339K per year.

  40. Dr. Mike, just become a lawyer already, I mean you could win with no problem. I literally used this tactic in school, like how he presented and reviewed his information and how he makes it clear. I won the debate easily with this tactic. I wouldn’t suggest using a tactic like Dr. Mike in school and take a big risk to your grade, but if your sure is gonna work VERY well, than go ahead and use it also.

    I was a portion of Dr. Mike that day at school, thank god the teachers didn’t find out that I was copyrighting Dr. Mike type of speech.

  41. Adam is retarded and simply misrepresents facts to suit his agenda.

    He hates white people for being capitalist yet capitalises on it.

  42. I definitely feel like this was a well articulated response to the tweets while attempting to remain as unbiased as possible. That alone is a massively difficult thing to do. It also does well that you managed to stay solid on the points and concerns you had without it being in a stubborn, for the sake of debate way. They were logical and well explained, and helped for the sake of clarity throughout the video. I believe Adam was definitely in the right place with responding and keeping this alive, however I believe that he took the good criticism first and mayne a bit too well, and front loaded his tweets with it to illicit a more open reaction to the following statements. While continuing to push the positive criticism throughout, I was disappointed at how little he had to think of the negative, even going so far as to mention having a specialist look at the script and more or less using it as a justifying factor for the way things were presented. This didn't sit well with me, as it seems to willingness to further clarify was left more to you.

    I also wholeheartedly agree that oversimplification can be a dangerous thing, and I think Adam missed that point. While profiteering is an issue, I don't believe that essentially demonizing most hospital costs is a good thing without getting into the heart of it. This is especially important when messages are going out to the public, who may be uneducated on the topic specifically. A response that plays into pre existing bias will be taken on a lot easier by the consumer, however there's also a bit of an issue having bias on an issue that one doesn't fully understand or care to understand. At that point, unnecessary divisions are taking away from the main topic and shifting focus on blame.

    Personal note now: I really want to be a doctor, though as I watch your videos I worry sometimes about if I'm cut for it. In high school I had a major problem accepting negative criticism, much less giving criticism in a meaningful and unbiased way. While I've worked to improve and have a long way to go, I can't help but wonder if I'll ever get to a point where I can give and take it in a productive way while being able to put my pride aside. Hubris sucks, man. While online it's a bit easier to take a step back now and regroup, in a face to face situation I know that reevaluating those immediate reactions can be difficult for me. Any advice?

  43. Adam Conover is trying to pull a Cathy Newman.
    "Mike says [misquote]" "Mike claims [misquote]"
    It's really disgusting. Or maybe he's just stupid and actually didn't understand what you said.

  44. Not talking sides or anything but I think a lot of people misunderstood the situation here so I will clarify it to the best of my understanding, Adam wasn't taking any shots at dr.mike or anything like that he was asked by fans of dr.mike and his own show to criticize dr.mikes reaction video. He did this in a respectful way by not insulting or discrediting dr.mike, now the way adam structured his criticism was not perfect and he did misunderstand some things dr.mike said in his reaction video but regardless he did try his best to criticize or correct things he felt dr.mike was implying or saying but he did still agree with many of dr.mikes points and explained why they had to make the mammogram section so simplified. Finally to be fair in dr.Mike's reaction video mike wasn't clear on some of the things he was saying either (which is fine) and that is probably the thing that Adam got wrong when criticizing dr.mikes video. This Is what I understand at least and if you want to correct me or tell me how to make this comment clearer on the message I was trying to convey please say so.

  45. Your ability in handling critique as well as your eloquence in replying to this criticism is highly commendable and inspirational. Honestly mate your empathy, humour and love for your patients is admirable and as student nurse hopefully going into medicine one day you are a huge inspiration to me.

  46. Do I believe a comedian with a very obvious objective in his video or a genuine doctor? Hard choice… Adam has a bad habit of handling people countering his work, just watch Joe Rogans podcast with him. I thought Adam was an ok guy but the jre showed he is only hyper intelligent when there is a script.

  47. Wow, what a lame pile of excuses.

    REALLLY dishonest in making them, too.

    Plus, your entire critique is essentially you shitting on the ability of the "average person" to understand anything more "complex" than a bubble-gum comic.

    Intellectually patronizing while not being exactly a thousand candlepower luminary yourself.

    And what a gigantic hot-air balloon of an ego. Repulsive.

  48. The problem with going into a podcast to present more information on a subject, especially information that would be beneficial, is that not everyone who saw a video will listen or watch a podcast that follows it up. Imagine if he covered smear tests in this way, in the UK at least, we have a drop in the number of women getting them done already and here they're covered on the NHS.

  49. I think that ARE could have addressed these point and made it funny. Personally, I think it was the use of the graphic. When each graphic was crossed off as unnecessary, I got more frightened each time. Specifically because when we find cancer early we can treat and get better outcomes. It just looked like if you have 10 mammograms, you wouldn't need any of them. Or something like that. I loved this segment, Doctor Mike! Thanks. I watch you to learn how to have calm and crucial conversations.

  50. Oh lord, bless your heart Mike. You are so eloquent and calm with your points.
    Adam, the problem is very much oversimplification. As a man who says he is for information and the power of knowing, he should know that oversimplification is a gateway to ignorance.

  51. Without Profit how can hospitals invest into more things… I mean it's likely that people believe that they are entitled to dr's time for free…

  52. I'm a fan of Adam's show but also Dr. Mike, I'm so surprised how Adam gives criticism daily on all kinds of topics but when someone questions a small point of his he gets all hurt & his comments back were shady. Great job on your reply Dr. Mike you for sure showed how great of a person you are & Adam showed how his ego was hurt by someone trying to do the best thing for the people at home watching the episodes.

  53. A little late to the party but I thought I'd add my 2 cents.
    1. While he still maintained a professional air, Adam obviously took Dr. Mike's critique personally and was pretty defensive and arrogant as a lot of people have already pointed out. And for someone who's job it is to criticize things I find it funny that he couldn't take a little constructive criticism.
    2. Saying that he discussed mammograms in more depth in a podcast is inadequate in my opinion because from what I understand the majority of Americans don't listen to podcasts as it is and while I don't know for sure I can bet he never mentioned the podcast in the episode.
    3. As an average woman who has reservations about mammograms I can confirm that if I had only watched Adam's show and not Dr. Mike's reaction I would have been completely turned off to the procedure because Adam made them sound unnecessary and expensive and scary.

  54. I think that where some of the issue lies in understanding how to take the information (such as how Adam presented the mammogram segment) is that we need to find a way to educate people to take everything with a grain of salt, this is why they say it's sometimes good to get a second opinion. We need to stop taking the first bit of information we get and immediately accepting it as true, or dismissing it because we disagree, and instead learn to take that information to spark further research into it. If we can find a way to do that, then we can avoid situations such as someone scared of a mammogram who needs it getting further scared away.

    This is of course no easy feet, so your concerns about it are still valid, but thats my thoughts on it as you requested Doctor Mike. And i liked your video analysis of Adam's as it reminds me to always look deeper into a subject he covers just in case something has more to it than what he presents, especially since sometimes the network forces him to change / remove something due to how the networks sponsors might disapprove.

  55. The mammogram video absolutely scare women from getting mammograms. Because it scared ME from getting a mammogram lol. Scared to waste my money.

  56. I was surprised how clearly angry and insulted Adam clearly was. It was clear, even though he obviously used his public relations consultant to make his rant more "kosher". I've seen what moderate success can do to people's ability to handle criticism, though. Aggression is the most common psychological cover-up for feelings of vulnerabilities, such as guilt or shame.

  57. I’m not gonna lie I’m on a dr. Mike binge but I believe it’s because it is nice to see someone that is my age actually acting like a adult. This is how you have a conversation. Hats off to this the younger adults coming behind this take note.

  58. To me, having seen the episode it feels more like adam is placing blame for a large portion of healthcare costs on insurance. He states plainly that in the past hospitals ran very much as you'd expect a business to run. They charged patients for the materials used, the overhead, and a slight premium to make a profit. Then insurance companies came in. They asked for bulk discounts the way that purchasers of services often request when they are doing large transactions (you don't think that walmart pays the same for the water they use that you do do you?). The result was that hospitals couldn't provide those discounts and insurances removed them from covered areas, or networks. Without the in network referrals hospitals lose money, after all do you go to the place that is going to charge you a full price (even if its less than your insurance would have been charged) or do you go to the place that is in your coverage network where your insurance will pay for the bulk of it? The result is that hospitals had to play ball. So they created the book Adam talks about that inflates the cost of medicine and procedures so they can claim to be giving the insurance companies a bulk rate. In reality what this does is mean that insurance companies (the vast majority of interactions the hospital has) pay what is the hospitals rock bottom price: the cost of the medicine, labor, administrative fee/service charge, and overhead (rental of space, electricity etc), while those who don't have insurance get billed the inflated cost. If this were not about profiteering the disparity between the insurance cost and the uninsured cost would be smaller, they wouldn't charge people the inflated cost in spite of being uninsured, and you would have a leg to stand on. Remember: if hospitals lost all insured traffic through their doors, they would close, if all uninsured traffic stopped then they probably wouldn't notice, or hell even do better. In fact medical bills support this idea in several ways: firstly they are needlessly confusing (for instance instead of billing you for the cost of a pill they lump the cost of the labor and a few other things together, or even worse they don't itemize at all), second the bill for both insured and uninsured look exactly the same right down to the prices (if they weren't in it for the money the prices would be different at the very least if not itemized differently). Hospitals have to make insurance companies happy, that requires at least making it seem like they are playing quid pro quo. Insurance companies provide them with patients and hospitals provide special treatment to insurances. The only way for them to do this (as providing differential care based on insured vs not insured would be discrimination) is to provide price breaks as incentive to allow insured patients to go to their hospital. Its not so much profiteering but rather survival in a rigged system.

  59. Our local dr. Small town USA, WAS A very good dr. When I was much younger 50 years ago he had one RN his wife in his Employment by the time he retired in the late 1980's he had one RN and 2 LPNS plus a receptionist/insurance filer..cost continued to increase, after his retirement he continued to practice by volunteering at the local Nursing Home finally quiting that after his wife told him that malpractice insurance was too costly. He was in his mid 80's when he finally quit practicing med he's been dead about 10 years now.

  60. OK Mike if not greed please explain a $35.00 asprin How about Doctors investing in iimaging centers and buying an MRI machine followed by every single patient of theirs needing to get an MRI every visit.

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