#317 ‒ Reforming medicine: uncovering blind spots, challenging the norm, and embracing innovation | Marty Makary, M.D., M.P.H.

The Peter Attia Drive

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Marty Makary, a Johns Hopkins surgeon and New York Times bestselling author, returns to The Drive to discuss his latest book, Blind Spots: When Medicine Gets It Wrong, and What It Means for Our Health. In this episode, Marty explores how a new generation of doctors is challenging long-held medical practices by asking critical new questions. He discusses the major problems of groupthink and cognitive dissonance in the medical community and delves into several of the "blind spots" raised in the book, including treatments for appendicitis, the peanut allergy epidemic, misunderstandings about HRT and breast cancer, antibiotic use, and the evolution of childbirth. He explains the urgent need for reform in medical education and the major barriers standing in the way of innovative medical research. Throughout the conversation, Marty offers insightful reflections on where medicine has succeeded and where there’s still room to challenge historic practices and embrace new approaches.

We discuss:

• The issue of groupthink and cognitive dissonance in science and medicine [2:30];
• How a non-operative treatment for appendicitis sheds light on cognitive dissonance [7:00];
• How cognitive dissonance and effort justification shape beliefs and actions [13:15];
• How misguided peanut allergy recommendations created an epidemic [17:45];
• The enduring impact of misinformation and fear-based messaging around hormone replacement therapy allegedly causing breast cancer [25:15];
• The dangers of extreme skepticism and blind faith in science, and the importance of understanding uncertainty and probability [28:00];
• The overuse of antibiotics and the rise of antibiotic resistant infections and poor gut health [33:45];
• The potential correlations between early antibiotic use and chronic diseases [40:45];
• The historical and evolving trends in childbirth and C-section rates [50:15];
• Rethinking ovarian cancer: recent data challenging decades of medical practice and leading to new preventive measures [1:05:30];
• Navigating uncertainty as a physician [1:19:30];
• The urgent need for reform in medical education [1:21:45];
• The major barriers to innovative medical research [1:27:30];
• The dogmatic culture of academic medicine: why humility and challenging established norms are key for progress [1:38:15];
• The major successes and ongoing challenges of modern medicine [1:51:00]; and
• More.

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